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One of the points I?ve tried to emphasize through my contributions to Science-Based Medicine is that every treatment decision requires an evaluation of risks and benefits. No treatment is without some sort of risk. And a decision to decline treatment has its own risks. One of the challenges that I confront regularly as a pharmacist is helping patients understand a medication?s expected long-term benefits against the risks and side effects of treatment. This dialogue is most challenging with symptomless conditions like high blood pressure, where patients face the prospect of immediate side effects against the potential for long-term benefit. One?s willingness to accept side effects is influenced, in part, by and understanding of, and belief in, the overall goals of therapy. Side effects from blood-pressure medications can be unpleasant. But weighed against the reduced risk of catastrophic events like strokes, drug therapy may be more acceptable. Willingness to accept these tradeoffs varies dramatically by disease, and are strongly influenced by patient-specific factors. In general, the more serious the illness, the greater the willingness to accept the risks of treatment.
As I?ve described before, consumers may have completely different risk perspectives when it comes to drug therapies and (so-called) complementary and alternative medicine (CAM). For some, there is a clear delineation between the two: drugs are artificial, harsh, and dangerous. Supplements, herbs and anything deemed ?alternative?, however, are natural, safe, and effective. When we talk about drugs, we use scientific terms ? discussing the probability of effectiveness or harm, and describing both. With CAM, no tentativeness or balance may be used. Specific treatment claims may not be backed up by any supporting evidence at all. On several occasions patients with serious medical conditions have told me that they are refusing all drug treatments, describing them as ineffective or too toxic. Many are attracted to the the simple promises of CAM, instead. Now I?m not arguing that drug treatment is always necessary for ever illness. For some conditions where lifestyle changes can obviate the need for drug treatments, declining treatment this may be a reasonable approach ? it?s a kick in the pants to improve one?s lifestyle. Saying ?no? may also be reasonable where the benefits from treatment are expected to be modest, yet the adverse effects from treatments are substantial. These scenarios are not uncommon in the palliative care setting. But in some circumstances, there?s a clear medical requirement for drug treatment ? yet treatment is declined. This approach is particularly frustrating in situations where patients face very serious illnesses that are potentially curable.? This week is the World Cancer Congress in Montreal and on Monday there were calls for patients to beware of fake cancer cures, ranging from laetrile, to coffee enemas, to juicing, and mistletoe. What are the consequences of using alternative treatments, instead of science-based care, for cancer? There are several studies and a recent publication that can help answer that question.
Who uses CAM instead of medicine?
Surveys suggest the vast majority of consumers with medical conditions use CAM in addition to, rather than as a substitute for medicine ? that is, it is truly ?complementary?. But there is a smaller population that uses CAM as a true ?alternative? to medicine. A study by Nahin et al in 2010 looked at data from the 2002 National Healath Interview Survey (NHIS), which is described as a representative sample of Americans.? It examined the group that did not use ?conventional care? in the past 12 months ? no health professionals, no emergency room visits, no surgery, and no nursing care of any kind. It asked about alternative medicine, which included acupuncture, ayurveda, biofeedback, chelation, chiropractic, energy healing/Reiki, hypnosis, massage, naturopathy, homeopathy, specialized diets, high-dose vitamins, yoga, tai chi, qui gong, and meditation. The survey found that 19.3% of adults did not access any ?conventional? health care in the past 12 months. Of this group, over one third (38.4%) had some health need (of which 23.8% considered a serious condition). In the population that did not use conventional care, one-quarter (24.8%)? used some form of alternative medicine. And 12% (approximately 4.6 million Americans) were estimated to be using alternative medicine, and not conventional medicine, to treat one or more health issues. Barriers to accessing health care were explored and users of alternative medicine had poorer health and had more barriers to care, with about 20% noting the decision to use alternative care was based on cost considerations of conventional care. There were several limitations worth noting: Most importantly, the types of conditions treated with ?only CAM? were not collected. And as some users cited the costs of conventional care as a barrier, different insurance schemes might be expected to change utilization patterns.? Finally, there is no assessment of outcomes. But this survey suggests that there is a small population that will preferentially treat a medical condition with CAM and not medicine.
So how would a decision to accept no treatment, or to only use alternative medicine, compare to ?conventional? cancer care (chemotherapy, radiation, and surgery)? And what about delaying conventional cancer care to allow a trial of alternative medicine ? does it have a measurable effect? Answering this question isn?t straightforward.? In cancer research, new drugs are typically added to, or follow, established therapies, so all patients receive standard treatment options as part of their care. So we can?t ethically randomize patients to nothing, when established treatments exist. But we can answer this question in a different way: Patients that voluntarily opt out of cancer treatment can be followed, and compared to patients that do take cancer treatment. While it isn?t a prospective randomization, which would be the gold standard, it?s the best we can get. But even this approach is difficult. Most patients who decide to opt-out of cancer treatment, also opt-out of any follow-up evaluation. So tracking down patients, and their outcomes, is essential.
The effects of treatment refusals and delay, and the effectiveness of CAM as a substitute, has been evaluated in several groups of patients with breast cancer. Breast cancer is well studied, frequently diagnosed, and if detected early, potentially curable. Conventional treatment for early (localized) breast cancer is surgical resection of the tumor, followed by radiation and chemotherapy to reduce the risk of disease recurrence, by killing any residual cancer cells that remain.? The overall effectiveness of conventional treatment is strongly influenced by the extent of the disease at diagnosis. When treated early in the disease course, the long-term outlook for for women with breast cancer can be excellent. However, once the cancer has spread to the lymph nodes, or metastasized to other part of the body, the outcomes are much worse. The treatment focus shifts from curative to palliative. (An old study of untreated breast cancer suggest the 5 year survival rates are 18% at 5 years and 3.6% at 10 years.) Given the potential for treatment cures, very few women elect to reject conventional treatment, or substitute CAM. But some do, which can inform us of the effectiveness of conventional care, as well as that of CAM. I found 5 studies which look at this question:
1. Patients? Refusal of Surgery Strongly Impairs Breast Cancer Survival
This was a Swiss study by?Verkooijen et al, published in 2005 in the Annals of Surgery that looked at 5339 patients under the age of 80 with non-metastatic breast cancer. It didn?t examine CAM, just the decision to refuse breast cancer surgery. It compared patients who refused breast cancer with those that those that accepted surgery. Only 1.3% of women (70) refused surgery. Of that group, 37 had no treatment, 25 had hormone-therapy only, and 8 had other types of treatments. So only a small percentage refused all treatment. In this study, the five-year survival of women that refused surgery was 72% versus 87% of women who had surgery. Adjusting for prognostic factors, the authors estimated that women that refused surgery had a 2.1-fold increased risk of death from breast cancer compared to conventional treatment. The survival curves make this clear:
The bottom line in this paper was that a decision to forgo surgery for breast cancer is associated with dramatically worse outcomes and survival.
This was a medical chart review by Chang et al, published in the American Journal of Surgery in 2006. It examined breast cancer patients who refused conventional chemotherapy, or delay its initiation, in order to use CAM. The authors calculated each patient?s prognosis at the time of diagnosis. In total, 33 women were included. (Notably, patients who refused treatment and did not return for follow-up were excluded from the analysis, possibly biasing the results.) The results were grim:
Consistent with the study above, the vast majority of breast cancer patients who refuse surgical intervention developed progressive disease. Even delaying surgery increased risks and overall mortality. Outcomes were better for patients that accepted surgery, but refused adjuvant treatments, like chemotherapy. However, even this strategy significantly raised 10-year mortality estimates.
3.? Alternative therapy used as primary treatment for breast cancer negatively impacts outcomes
This study from Han et al was published in the Annals of Surgical Oncology in 2011, and may include some of the patients in the Chang analysis. This was a retrospective chart review of breast cancer patients who refused or delayed conventional treatments. 61 patients were identified. On average patients had Stage 2 disease at diagnosis, which is highly treatable and potentially curable. In patients that omitted or delayed surgery (26 women) 96.2% had disease progression with 50% dying of the disease. At the time of diagnosis, the median tumor size was 2.0cm. Upon follow-up, the median-size was 7.8cm. (The authors include this photo of a tumor in a woman who elected to use diet and herbal treatments, rather than receive surgery.)
In patients that accepted surgery but rejected adjuvant therapy (chemotherapy/radiation), the initial 10-year relapse-free survival was estimated at 59.2%, which would have been 74.3% had the patients accepted these treatments. Actual outcomes were much worse than predicted. The actual? observed relapse-free survival was only 13.8%. Some subsequently elected to take palliative chemotherapy and radiation to control their disease. From this study we can conclude that refusing or delaying conventional cancer care is associated with much worse outcomes.
4. Prognosis following the use of complementary and alternative medicine in women diagnosed with breast cancer
This analysis, by Saquib et al, was a secondary analysis of the Women?s Healthy Eating and Living (WHEL) study. It looked at 2562 breast cancer survivors and surveyed for rejection of systemic treatment (i.e., chemotherapy) and use of CAM following surgical resection. All women had to be aged 18-70 and had operable Stage I-IIIa breast cancer. In this group, 177 women were identified who declined systemic treatment. 80% of this group used CAM. Compared to women that took chemotherapy, women that declined systemic treatment had a 90% greater risk of an additional breast cancer event, and the risk of death increased by 70%. CAM use had no effect on this finding. In addition, the lack of effect was consistent between ?high supplement users? (>3 per day) and low supplement users. The authors concluded that women that decline systemic treatment are at greater risk for subsequent recurrence and death due to breast cancer. The use of CAM had no measurable effect on the recurrence of breast cancer or on the risk of subsequent death.
5. Outcome analysis of breast cancer patients who declined evidence-based treatment
Here is the recent paper I referred to above, which studied women with breast cancer in Northern Alberta who refused standard treatments.? It was also a chart review with a matched pair analysis (age, disease stage, calendar year) that compared survival with those that? received conventional cancer care. Between 1980 and 2006 they identified 185 women (1.2%) that refused cancer care following diagnosis by biopsy. (Notably, cancer care is an insured service in Alberta, so there should have been no financial barriers in accessing treatment.) Women older than 75 were excluded from the analysis because this population is generally not included in clinical trials and active treatment regimens. In addition, women that accepted surgery, but rejected chemotherapy/radiation were excluded from the analysis. To qualify, women had to have rejected all conventional care. The final population studied was 87 women, most of whom presented with early (Stage I or II) disease. Most were married, over the age of 50, and urban residents. In this group, the primary treatment was CAM in 58%, and was unknown in the remainder. Some women in this group eventually accepted cancer care, and the average delay was 20-30 weeks due to CAM use.
The results were grim. The 5 year overall survival was 43% for women that declined cancer care, and 86% for women that received conventional cancer care. For cancer-specific survival (i.e., those that died of breast cancer) survival was 46% vs. 85% in those that took cancer care. The survival curves are ugly:
(a) All causes of deaths and (b) deaths due to breast cancer only
The authors compared the ?CAM? group to those where treatment plan (if any) was not known:
(a) All causes of deaths and (b) deaths due to breast cancer only
Note that the difference is only statistically significant in (a) where all-causes of death were included and not (b), cancer-specific causes. So does that mean CAM helps? Probably not. The two groups are not well defined, and the ?unknown? group could include CAM users ? it is not a comparison of CAM versus no treatment.? And as the types of CAM used was not documented, this is a heterogeneous group. The key point this comparison illustrates is that CAM users did dramatically worse than women that took conventional cancer care. Even delaying surgery to allow for CAM first significantly decreased the effectiveness of subsequent conventional care.? The authors conclude, correctly, that there is no evidence to support using CAM as primary cancer treatment.
Effectiveness Evaluations
The data show that avoiding or delaying conventional cancer care is associated with negative outcomes, and CAM used does not seem to modify this risk. But have any specific CAM interventions shown any benefit? Probably the most comprehensive single review is a systematic review by Gerber et al, published in Breast Cancer Research and Treatment in 2006, which looked at CAM effectiveness for early breast cancer. It concludes:
There is no compelling evidence that any of the numerous complementary treatments available is sufficiently effective in breast cancer patients to justify its use. It should be the responsibility of those who claim efficacy for CAM to support these claims with acceptable evidence, rather than the responsibility of those who criticize CAM to prove its non-efficacy.
Based on the current evidence, there is nothing to suggest that any specific CAM treatment has any meaningful clinical effects.
Conclusion
Despite widespread claims, there is no evidence to support the use of any CAM treatment as a replacement for conventional cancer care. As the studies in breast cancer show, delaying treatment or substituting CAM for conventional cancer care dramatically worsens outcomes.The results of these studies will hopefully provide patients and health providers with a better understanding of the risks and consequences of CAM for cancer. CAM is no alternative to science-based cancer care.
References
1. Verkooijen HM, Fioretta GM, Rapiti E, Bonnefoi H, Vlastos G, Kurtz J, Schaefer P, Sappino AP, Schubert H, & Bouchardy C (2005). Patients? refusal of surgery strongly impairs breast cancer survival. Annals of surgery, 242 (2), 276-80 PMID: 16041219
2. Chang EY, Glissmeyer M, Tonnes S, Hudson T, & Johnson N (2006). Outcomes of breast cancer in patients who use alternative therapies as primary treatment. American journal of surgery, 192 (4), 471-3 PMID: 16978951
3. Han E, Johnson N, DelaMelena T, Glissmeyer M, & Steinbock K (2011). Alternative therapy used as primary treatment for breast cancer negatively impacts outcomes. Annals of surgical oncology, 18 (4), 912-6 PMID: 21225354
4. Saquib J, Parker BA, Natarajan L, Madlensky L, Saquib N, Patterson RE, Newman VA, & Pierce JP (2012). Prognosis following the use of complementary and alternative medicine in women diagnosed with breast cancer. Complementary therapies in medicine, 20 (5), 283-90 PMID: 22863642
5. Joseph K, Vrouwe S, Kamruzzaman A, Balbaid A, Fenton D, Berendt R, Yu E, & Tai P (2012). Outcome analysis of breast cancer patients who declined evidence-based treatment. World journal of surgical oncology, 10 (1) PMID: 22734852
Source: http://www.sciencebasedmedicine.org/index.php/rejecting-cancer-treatment-what-are-the-consequences/
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U.S. Attorney General Eric Holder told the NAACP annual convention on July 10 in Houston that he opposes a new photo ID requirement in Texas elections because it would be harmful to minority voters.
By NBC News staff and news services
Updated at 2:42 p.m. ET: A federal court in Washington on Thursday blocked a Texas law that would require voters to present photo IDs to election officials before being allowed to cast ballots in November, saying it would place an unfair burden on minorities and the poor.
A three-judge U.S. District Court panel ruled that that SB 14, described as the most stringent voter ID law in the country, imposes "strict, unforgiving burdens on the poor" and noted that racial minorities in Texas are more likely to live in poverty.
?Texas, seeking to implement its voter ID law, bears the burden of proof and must therefore show that SB 14 lacks retrogressive effect. But as we have found, everything Texas has submitted as affirmative evidence is unpersuasive, invalid, or both,? the opinion said.
The Justice Department blocked the new Texas ID law in March, and now a federal court in Washington has done the same, saying it would hit minority voters especially hard. NBC's Pete Williams reports.
?Moreover, uncontested record evidence conclusively shows that the implicit costs of obtaining SB 14-qualifying ID will fall most heavily on the poor and that a disproportionately high percentage of African Americans and Hispanics in Texas live in poverty. We therefore conclude that SB 14 is likely to lead to ?retrogression in the position of racial minorities with respect to their effective exercise of the electoral franchise.??
Read the court opinion (.PDF)
The ruling was the second legal blow to Texas this week. On Tuesday, another federal court panel threw out a Texas redistricting plan, finding evidence of discrimination in voting maps drawn by the state's Republican-controlled Legislature.
The decision on the voter ID law involves an increasingly contentious political issue: a push, largely by Republican-controlled legislatures and governor's offices to impose strict identification requirements on voters.
Republicans are aggressively seeking the requirements in the name of stamping out voter fraud. Democrats, with support from a number of studies, say that fraud at the polls is largely non-existent and that Republicans are simply trying to disenfranchise minorities, poor people and college students -- all groups that tend to back Democrats.
Who can vote?: Special series on voter ID issues
The ruling comes in the same week that South Carolina's strict photo ID law is on trial in front of another three-judge panel in the same federal courthouse. A court ruling in the South Carolina case is expected in time for the November election.
Texas Gov. Rick Perry signed SB 14 into law on May 27, 2011. The law has yet to take effect because the state needs ?preclearance? for any change in voting procedures from either the U.S. attorney general or a three-judge U.S. District Court panel.
Watch the most-viewed videos on NBCNews.com
The judges said such voter ID laws might well be approved if they ensure that all prospective voters can easily obtain free photo IDs, and that any underlying documents required to obtain that ID are truly free of charge.
But the judges noted the Texas Legislature tabled or defeated amendments that would have, among other things, waived all fees for indigent persons who needed the underlying ?documents and reimbursed poor people for ID-related travel costs.
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In the Texas case, the Justice Department called several lawmakers, all of them Democrats, who said they detected a clear racial motive in the push for the voter ID law. Lawyers for Texas argued that the state was simply tightening its laws. Texas called experts who demonstrated that voter ID laws had a minimal effect on turnout. Republican lawmakers testified that the legislation was the result of a popular demand for more election protections.
During an appearance at the NAACP convention in in Houston in July, Attorney General Eric Holder said Texas' photo ID requirement amounts to a poll tax, a term that harkens back to the days after Civil War Reconstruction when blacks across the South were stripped of their right to vote. The attorney general told the NAACP that many Texas voters seeking to cast ballots would struggle to pay for the documents they might need to obtain the required photo ID.
In a statement Thursday, Holder said he was pleased by the court's action.??The court?s decision today and the decision earlier this week on the Texas redistricting plans not only reaffirm -- but help protect -- the vital role the Voting Rights Act plays in our society to ensure that every American has the right to vote and to have that vote counted," he said.
White House spokesman Jay Carney said the Texas law does not comply with the landmark Voting Rights Act of 1965, which?outlawed discriminatory voting practices blamed for the widespread disenfranchisement of blacks. "As you know this administration believes it should be easier for elligible citizens to vote, to register and vote. ?We should not be imposing unnecessary obstacles or barriers to voter participation," Carney said.
Texas Attorney General Greg Abbott said the state will appeal the panel's rejection to the U.S. Supreme Court.
?The Supreme Court of the United States has already upheld voter ID laws as a constitutional method of ensuring integrity at the ballot box,? he said in a statement. ?Today's decision is wrong on the law and improperly prevents Texas from implementing the same type of ballot integrity safeguards that are employed by Georgia and Indiana - and were upheld by the Supreme Court. The State will appeal this decision to the U.S. Supreme Court, where we are confident we will prevail."
The Associated Press contributed to this report compiled by NBC News' James Eng.
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Source: http://usnews.nbcnews.com/_news/2012/08/30/13571150-federal-court-rejects-texas-voter-id-law?lite
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The typical college preparatory school has a good reputation among parents of students, but not every student needs to go to one. If you are wondering if your child would benefit from this type of environment, you should get an idea of the advantages offered to students. Then you can make an informed decision.
Schools like this are usually great and even necessary when you want your child to go to an impressive university. If you and your high schooler have your eye on the Ivy League schools, or other colleges that require very good stats to get in, you may need the boost that a college preparatory school will offer. Schools of this caliber usually provide challenging classes and experienced teachers who can push students to do their best, with the full knowledge that every grade counts when you want to get into a great university. If you know your child is motivated to get a degree from a highly rated school, you should enroll him or her in this kind of institution.
You also need to make sure your child can handle the pressure and expectations that come with a college preparatory school. Most students at these schools are particularly driven and strive to get good grades in tough classes. If your child tends to get good grades and is even bored in regular classes, you should consider switching schools so he or she is properly challenged. Most kids who were previously bored appreciate being enrolled in tougher courses that can challenge them and prepare them for a university in the future.
Finally, you have to make sure you are prepared to pay for the tuition associated with a college preparatory school. Like typical private schools, they cost money that most people would only expect from colleges. Of course, you get a lot of advantages for your money, but that does not make it any more affordable. Some children can get need-based scholarships, or you may have to take out loans. Either way, you need to be able to budget for four years at schools like this if you want to avoid disrupting your child?s education by suddenly not being able to afford it anymore.
If you are considering college preparatory school for your student, you should schedule an interview at a few local schools of this type. This way, you can find out which one, if any, is the right fit for your family. Interviews and campus tours can also let you see whether your high schooler really wants to go there or not.
Find the right College preparatory school Florida can an arduous process. Contact http://www.steds.org and find out the right fit for your child.
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The PNG LNG Project is partnering with the Papua New Guinean Government and key non-government organisations to provide new medical equipment and hygiene programs.
These community health initiatives, featured in the latest PNG LNG Environmental and Social Report, reinforce the Project?s commitment to building sustainable health capacity and infrastructure within the Project impact areas.
To date the Project has contributed 2.6 million Kina to support tuberculosis control through various programs and activities which will increase the knowledge and skills of health personnel and strengthen infrastructure. This includes assisting the Papua New Guinea Institute of Medical Research to secure three state-of-the art GeneXpert? diagnostic machines for the fast and accurate diagnosis of tuberculosis. The machines will be provided to medical facilities in Kikori, Madang and Port Moresby.
PNG LNG Project Executive Decie Autin said faster and more accurate technology will allow for early intervention in tuberculosis cases to enable higher quality treatment.
?We recognise that the incidence of tuberculosis is high in Papua New Guinean communities. As a result, we are committed to improving diagnostic practices and treatment to minimise this debilitating disease,? Ms Autin said.
?Traditionally, people have had to wait six to eight weeks for a result. The GeneXpert? machines can provide a same day response with 98 percent accuracy, so the correct course of treatment can be prescribed immediately,? she said.
The Project has also partnered with Population Services International (PSI). Their successful Water, Sanitation and Hygiene (WASH) Program includes a Community Led Total Sanitation initiative, the distribution of WASH kits and awareness education about personal hygiene behaviors that affect their communities. To date, 1000 kits have been distributed in Papa and Porebada in Central Province as well as several villages in the Hides-Komo area. A WASH Kit contains safe water and diarrheal treatment items to prevent and manage illness.
?Protecting the health and safety of Project workers and local communities, as well as the environment in which Project-related activities occur is a core value for the Project,? said Ms Autin.
As well as supporting local health institutions, the Project has also sent 10 trainees to Dallas, Texas to take part in biomedical equipment repair training for six months with MediSend International.
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Source: http://www.lngworldnews.com/png-lng-improves-health-and-wellbeing-of-locals/
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The original owner of the mansion, built in 1893, was George B. Douglas and family. In 1906, Douglas negotiated a house trade with Brucemore mansion owner, widow Caroline Sinclair. The structure has been the home of John R. Turner and Son funeral homes since 1924. Iowa artist Grant Wood was paid to help decorate the mortuary at that time. (Photo October 24, 1983 - Turner Mortuary)
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CEDAR RAPIDS ? Commercial real estate broker Scott Byers is hard-pressed to think of a similar building that?s gone on the market in recent years in the Cedar Rapids area.
A former house-turned funeral home known as Turner Mortuary or the George B. Douglas mansion, 800 Second Ave. SE, has been listed for sale by the Linge family, owners of Cedar Memorial.
?It?s an interesting property to represent,? Byers said. ?It?s not your cookie-cutter real estate.?
The 10,085 square-foot house, built in 1893, is listed for $645,000.
Byers noted that the building is on the National Register of Historic Places and contains design touches by artist Grant Wood, including iron gates and stained glass windows.
Grant Wood stands in his studio at 5 Turner Alley in Cedar Rapids. In the mid-1920s, he lived in the carriage house of the former George Douglas mansion, which was being converted to John B. Turner and Son Mortuary at the time.
From 1924 to 1935, Wood lived next to the home above a carriage house at 5 Turner Alley, where he painted ?American Gothic? and other works.
The Cedar Rapids Museum of Art owns that studio ? a gift from the Linge family ? which is also on the National Register, but is not included in the sale.
Executive Director Terry Pitts said owning another building is not in the museum?s mission.
Museum executive committee members met with Byers, but ?we made the decision that we were not potential purchasers,? he said.
Pitts would like to see an area college or arts non-profit buy the building to provide synergy with the Grant Wood Studio.
Otherwise, he could also see it used as an office building or for other commercial purposes.
?No one sees any scenario in which the Douglas Mansion would be torn down and we would, of course, fight that tooth and nail,? Pitts wrote in a letter to the museum?s Board of Trustees this week.
Pitts said this summer?s demolition of First Christian Church, just a block away, served as ?a lesson about what could go wrong.?
A parking lot will be installed where the church was razed and a four-story parking ramp is under construction next to the Grant Wood Studio for the new Physicians? Clinic of Iowa medical pavilion.
Cedar Memorial president John Linge said the family would oppose any demolition plan.
The second floor staircaase at the Douglas Mansion/Turner Funeral Home. (Amanda Proper, GLD Commercial Real Estate Advisors)
The mansion is one of few remaining near downtown Cedar Rapids and sits in the city?s new medical district.
Its history extends to the historic Brucemore estate, 2160 Linden Dr. SE.
Brucemore Executive Director David Janssen noted that Caroline Sinclair, who owned the estate, traded homes in 1906 with the George Douglas family so she could live in the city and the Douglasses moved to what was then the countryside.
?It was a big deal,? Janssen said of the swap, considered the largest real estate transaction in the city?s history at the time.
John B. Turner acquired the property from the Sinclairs in 1923 and converted it into Turner Mortuary.
Linge said Cedar Memorial, which purchased Turner Funeral Homes in 1978, has not used the building for funerals for several years.
In 1982, the building was renovated to reflect the Victorian era and for years, students intending to study mortuary science lived on the building?s third floor, he said.
After the Floods of 2008, Theatre Cedar Rapids and the Cedar Rapids Symphony/Orchestra Iowa were headquartered at the site.
Families prefer more modern settings for funerals, along with convenient parking that is offered at other Cedar Memorial locations, Linge? noted.
A staff member held a wedding inside the building in recent years, which prompted the family to think it could serve as a destination event center or other business.
Linge said the building was recently tuck-pointed and has a new heating and cooling system.
?She?s got real good bones,? he said.
The second floor sitting room of the Douglas Mansion/Turner Funeral (Amanda Proper, GLD Commercial Real Estate Advisors)
Timeline:
1891 George B. Douglas purchases three adjacent Second Avenue lots on which to build a new home. George B. Douglas? father was one of the founders of Quaker Oats, while he founded the Douglas Starch Works. A few years later, construction begins on the Douglas? new residence and carriage house. The architect?s identity is not known.
1906 George B. Douglas completes a deal with Caroline Sinclair, owner of Brucemore, to exchange the Douglas mansion for the Brucemore mansion. The Sinclair family eventually moves into 800 Second Avenue. At some point during their tenure here, the Sinclairs have the entire carriage house moved about 40 feet to the east.
1920s After the popularization of the automobile, the 600 and 700 blocks of Second Avenue became known as Auto Alley because of all the car dealerships and service stations located there.
1923 John B. Turner, who established his mortuary business in 1888, and his son David Turner acquire the property from the Sinclairs and being the process of converting it into Turner Mortuary. It opens to the public in 1924 and The Gazette reports Grant Wood ?was responsible for the decorating and furnishing of the interior, and the landscaping of the grounds. He not only personally supervised the work, but also did much of it himself.? Wood also designed the iron gates at the front entrance. The brick barn in the rear of the property was converted into a ?modern garage, with space for six cars.?
1924 At the suggestion of the Turners, Wood begins to build a studio and residence above the garage. The ability to live rent-free means Wood can eventually give up teaching his job at McKinley High School. The Community Players produce their first play before a tiny audience in Grant Wood?s studio, starting the theater group that leads today?s Theatre Cedar Rapids.
1932 A fire burns part of the studio, injuring Grant, Nan, and their mother. Grant had to replace the original wooden floor with the one that remains today.
1935 John B. Turner dies at the age of 74. Wood moves out of 5 Turner Alley into a home he purchases in Iowa City. Over the next 65 years, the Studio is rented out as an apartment and even boutique on occasion.
1954 David Turner dies.
1972 John Bu. Turner II (son of David Turner) and his wife Happy donate 84 works by Grant Wood to the Cedar Rapids Museum of Art. They make additional gifts through 1983.
1978 Cedar Memorial Funeral Homes, founded by David Linge, purchases Turner Funeral Homes.
1982 The Douglas Mansion and Grant Wood Studio are placed on the National Register of Historic Places.
1983 John B. Turner II dies.
2000 The last tenant moves out of 5 Turner Alley.
2002 The Grant Wood Studio building and related property are donated to the Cedar Rapids Museum of Art.
2004 Grant Wood Studio & Visitor Center opens to the public.
Source: The Cedar Rapids Museum of Art
The first floor sitting room of the Douglas Mansion/Turner Funeral Home. (Amanda Proper, GLD Commercial Real Estate Advisors)
Source: http://thegazette.com/2012/08/29/douglasturner-mansion/
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Nutrients and Nutrient Supplements
Our body needs to get vitamins and supplements to assist in the chemical reactions that maintain cellular health and wellness. These materials are should improve digestion, assistance nervous system function and aid a host of physical processes
Vitamins and supplements can be advantageous means to supplement your diet plan and acquire all the nourishment your body requires. It is necessary to know exactly what vitamins are most advantageous for your health and how you get the right ones.
Vitamins are needed for regular growth, metabolic process and good health. Their task is to metabolize various nutrients to supply power and begin counteractions in the bodily figure. They are found in fruits, vegetables and some other food, however may be lacking as a result of a number of causes. The USDA encourages a bare minimum requirement of vitamin supplements to protect against deficiencies.
Vitamins and minerals are generally accepted important nutrients? because acting in concert, they carry out hundreds of roles in the body. They assist bolster bones, heal wounds, and maintain your body?s defence mechanism. They also transform foods into bodily energy, and repair cellular damage.
Nowadays there are tons of high quality vitamins on the market, and there are numerous methods to obtain them.
The majority of experts concur that generic vitamin supplements are basically as efficient as brand names, provided they consist of just the very same amounts of each active ingredient. Meticulously read the whole label of the vitamins you are looking at.
Some vitamins and minerals may have more or less of a specific ingredient. Some multivitamins are inspected for quality by non-profit organizations
Although certain vitamins execute specific operations. Vitamin An is good for the eyes while vitamin K helps in blood clotting and vitamins in most cases strengthen the immune system, support body organs and cells do their tasks, and assist in the growth and advancement of your health and wellness.
vitamin supplements and medicines will expire just like food, so it is necessary to check out expiry dates imprinted on the bottles prior to when you purchase supplements. The expiration date generally consists of a month and year and is printed on the bottle?s label. Only get vitamin supplements in quantities which you will definitely consume before the noted expiration date.
Consult your neighborhood pharmacist with any type of inquiries you have prior to when you get vitamin supplements. The pharmacist could address concerns regarding interactions, vitamin dosages and the potential health advantages of a vitamin.
To ensure that your body system stays at its best, you must ensure that you take the correct amount of vitamin supplements with your eating plan. You are able to locate vitamin supplements in the community or on the net, with hundreds to pick from. You need to even feature selenium and colostrum in your day-to-day diet plan as well, as these 2 vitamins will help you with your health and wellness. If you take the appropriate vitamins with your regimen ? you?ll locate that your well-being and energy will definitely consistently continue to be at their leading levels of performance.
For more information on vitamins visit Vitamin Tips and explore more topics including discount vitamins
Source: http://articlepdq.com/health-fitness/supplements-and-nutrition-supplements/
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28 August, 2012 at 1:02 pm in Services
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ScienceDaily (Aug. 28, 2012) ? Increasingly humanitarian organizations will find themselves responding to health emergencies provoked by the adverse effects of mining and other extractive industries, setting up a potential clash to do with the core principles and values at the heart of humanitarian medicine, writes Philippe Calain from the humanitarian medical organization, M?decins Sans Fronti?res (MSF), in this week's PLoS Medicine.
"A pragmatic approach of engagement with the corporate sector for the delivery of aid, or an implicit support to mainstream development agendas could compromise the legitimacy of humanitarian medicine," argues Calain. He continues, "A principled understanding of humanitarian medicine entails selfless moral commitments that are incompatible with the for-profit objectives of corporate industries."
Drawing on MSF's experience responding to the "worst lead poisoning epidemic in modern history" resulting from artisanal gold mining in Nigeria's Zamfara state, Calain explores the pitfalls, difficult alliances, and challenges medical humanitarian organizations must navigate in confronting the dire health consequences resulting from extractive industries, whether informal, illegal, or sanctioned.
He argues that, in developing countries, extractive industries (including ore mineral mining and oil extraction) have far reaching consequences on health through environmental pollution, communicable diseases, violence, destitution, and compromised food security. While humanitarian organisations might be called to intervene in areas occupied by the extractive sector, Calain argues that oil and mineral exploitation reveals a fundamental clash of values between humanitarianism, the for-profit sector, and privatised global philanthropy.
Operating in this relatively new terrain for medical humanitarian organizations -- outside the traditional humanitarian response to armed conflict, epidemics, and natural disasters -- requires a deeper examination of which types of compromises and alliances are acceptable. Responding to these kinds of emergencies, warns Calain, cannot be reduced to the development of medical and technical expertise alone.
"While advocacy and expansion of their operational expertise are obvious paths for non-governmental organizations, a more complex and ideologically loaded question to solve is about what type of relationships humanitarian organisations should entertain with the corporate sector," writes Calain. "Specific medical humanitarian organisations can respond to these challenges in different ways, based on their position between pragmatic or principled approaches, and their willingness to develop new technical capacities."
According to Calain, many mainstream medical humanitarian organisations would rather opt for no engagement with the natural resource extraction sector due to questions of values and conflicts of interest.
He concludes: "the Zamfara outbreak has called attention to a novel agenda for medical humanitarian organisations, including technical preparedness for environmental disasters, dialogue with international environmental organisations, and a better understanding of the exact role of resources extraction in perpetuating humanitarian crises."
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Source: http://feeds.sciencedaily.com/~r/sciencedaily/~3/y3899SN-JAc/120828171740.htm
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BRAWLEY (CBSLA.com) ? Homeowners in the Imperial Valley and across the Southland may be rethinking their insurance coverage after a swarm of light to moderate earthquakes has left the region rattled.
KNX 1070?s Pat Haslem reports only 12 percent of California homeowners have earthquake insurance, which means a majority of California homeowners could be on some shaky ground if a major temblor hit.
As of Monday morning, over 300 quakes have been recorded in what is known as the Brawley Seismic Zone, knocking out power to 2,500 homes and shifting 20 mobile homes off their foundations.
Brawley, a small farming community located near the Salton Sea, last experienced a similar earthquake swarm in 2009.
Pete Maraga of the Insurance Information Network of California said the quakes are a sobering reminder for homeowners in the region.
?With the standard homeowner policy, that does not include any kind of damage from an earthquake,? said Maraga. ?It?s a separate policy, it?s separate coverage that you have to get, different than your homeowner policy.?
A standard earthquake policy will not only cover the structure of a home, but also all contents kept inside the structure as well as any additional living expenses incurred by the quake.
And while many homeowners expect the federal government to provide benefits in the event of a disaster, but Maraga said that notion was all but dispelled after Hurricane Katrina devastated the Gulf Coast in 2005.
?The most that you can get in a FEMA grant is about $30,000, and then you can get a low-interest loan through SBA (U.S. Small Business Adminstration),? he said. ?Even though that is low-interest, you have to understand that you?re gonna have to pay that back and pay off your mortgage as well?with the earthquake policy, you don?t have to pay anything back.?
Scientists from California Geological Survey, US Geological Survey, Cal Tech and the Southern California Earthquake Center warned Monday of the potential of an earthquake as large as or larger than Sunday?s M5.5 earthquake that could ?cause damage to older structures?.
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A paper published last year by Traci Mach of the Federal Reserve Board of Governors and John Wolken, formerly of that organization, shows how important access to credit is for small business survival.
Using data from the Federal Reserve?s Survey of Small Business Finances, Mach and Wolken found that businesses that had less access to credit in 2003 were more likely to go out of business between 2004 and 2008. In addition, they found that measures of the businesses? access to credit were more predictive of company survival than were attributes of the business, owner, and market.
When this paper first came out, I thought the findings were self-evident. If lenders are any good at their jobs, then they should provide more credit to better companies run by more talented founders. Therefore, businesses that had better access to credit in 2003 should have been more likely to survive over the next five years than other companies. Presumably, they were the better companies.
But upon further reflection, I think this paper illustrates an important problem that central bankers, like Ben Bernanke, face. If the fraction of talented small business owners with good business ideas is roughly the same whether its 2008 or 2012, then this paper shows the importance of the getting public policy toward credit tightness correct.
When bank lending standards are looser, then the average business has more access to credit than when bank lending standards are tighter. That means that the average small company is more likely to survive in years when small business credit is easier to get.
That point highlights a key issue for the Fed chairman: Should the central bank encourage lenders to have easy or tough credit standards? If standards are low, then more businesses have access to credit and will survive over time. But if the businesses themselves are no better than when standards are high, then low standards means that the banks are propping up weak businesses with loose credit.
Because we don?t know how tight lending standards should be, the Fed risks making one of two mistakes in creating incentives for banks to lend money to small businesses. If it makes the banks maintain high lending standards that are too high, then it will cause many small businesses to fail, including some that should remain in operation. But if the Fed lets the banks maintain lending standards that are too low, then it is leading banks to keep alive small businesses that aren?t viable.
I?m glad I am not trying to get the job of Federal Reserve Bank Chairman.
Tug Photo via Shutterstock
Source: http://smallbiztrends.com/2012/08/access-credit-business-survival.html
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This July 20, 1969 file photo provided by NASA shows Neil Armstrong. The family of Neil Armstrong, the first man to walk on the moon, says he has died at age 82. A statement from the family says he died following complications resulting from cardiovascular procedures. It doesn't say where he died. Armstrong commanded the Apollo 11 spacecraft that landed on the moon July 20, 1969. He radioed back to Earth the historic news of "one giant leap for mankind." Armstrong and fellow astronaut Edwin "Buzz" Aldrin spent nearly three hours walking on the moon, collecting samples, conducting experiments and taking photographs. In all, 12 Americans walked on the moon from 1969 to 1972. (AP Photo/NASA)
This July 20, 1969 file photo provided by NASA shows Neil Armstrong. The family of Neil Armstrong, the first man to walk on the moon, says he has died at age 82. A statement from the family says he died following complications resulting from cardiovascular procedures. It doesn't say where he died. Armstrong commanded the Apollo 11 spacecraft that landed on the moon July 20, 1969. He radioed back to Earth the historic news of "one giant leap for mankind." Armstrong and fellow astronaut Edwin "Buzz" Aldrin spent nearly three hours walking on the moon, collecting samples, conducting experiments and taking photographs. In all, 12 Americans walked on the moon from 1969 to 1972. (AP Photo/NASA)
FILE - In this July 20, 1969 file photo provided by NASA shows Apollo 11 astronauts Neil Armstrong and Edwin E. "Buzz" Aldrin, the first men to land on the moon, plant the U.S. flag on the lunar surface. The family of Neil Armstrong, the first man to walk on the moon, says he has died at age 82. A statement from the family says he died following complications resulting from cardiovascular procedures. It doesn't say where he died. Armstrong commanded the Apollo 11 spacecraft that landed on the moon July 20, 1969. He radioed back to Earth the historic news of "one giant leap for mankind." Armstrong and fellow astronaut Edwin "Buzz" Aldrin spent nearly three hours walking on the moon, collecting samples, conducting experiments and taking photographs. In all, 12 Americans walked on the moon from 1969 to 1972. (AP Photo/NASA)
FILE - In undated photo provided by NASA shows Neil Armstrong. The family of Neil Armstrong, the first man to walk on the moon, says he has died at age 82. A statement from the family says he died following complications resulting from cardiovascular procedures. It doesn't say where he died. Armstrong commanded the Apollo 11 spacecraft that landed on the moon July 20, 1969. He radioed back to Earth the historic news of "one giant leap for mankind." Armstrong and fellow astronaut Edwin "Buzz" Aldrin spent nearly three hours walking on the moon, collecting samples, conducting experiments and taking photographs. In all, 12 Americans walked on the moon from 1969 to 1972. (AP Photo/NASA)
FILE - In this 1969 photo provided by NASA the crew of the Apollo 11 mission is seen. From left are Neil Armstrong, Mission Commander, Michael Collins, Lt. Col. USAF, and Edwin Eugene Aldrin, also known as Buzz Aldrin, USAF Lunar Module pilot. The family of Neil Armstrong, the first man to walk on the moon, says he has died at age 82. A statement from the family says he died following complications resulting from cardiovascular procedures. It doesn't say where he died. Armstrong commanded the Apollo 11 spacecraft that landed on the moon July 20, 1969. He radioed back to Earth the historic news of "one giant leap for mankind." Armstrong and fellow astronaut Edwin "Buzz" Aldrin spent nearly three hours walking on the moon, collecting samples, conducting experiments and taking photographs. In all, 12 Americans walked on the moon from 1969 to 1972. (AP Photo/NASA)
FILE - In this Sept. 17, 1962 file photo, Neil Armstrong, one of the nine astronauts, is shown as he was introduced to the press, along with the other astronauts in Houston. The family of Neil Armstrong, the first man to walk on the moon, says he has died at age 82. A statement from the family says he died following complications resulting from cardiovascular procedures. It doesn't say where he died. Armstrong commanded the Apollo 11 spacecraft that landed on the moon July 20, 1969. He radioed back to Earth the historic news of "one giant leap for mankind." Armstrong and fellow astronaut Edwin "Buzz" Aldrin spent nearly three hours walking on the moon, collecting samples, conducting experiments and taking photographs. In all, 12 Americans walked on the moon from 1969 to 1972. (AP Photo/FILE)
CINCINNATI (AP) ? Neil Armstrong made "one giant leap for mankind" with a small step onto the moon.
He commanded the historic landing of the Apollo 11 spacecraft on the moon July 20, 1969, capping the most daring of the 20th century's scientific expeditions and becoming the first man to walk on the moon.
His first words after the feat are etched in history books and the memories of the spellbound millions who heard them in a live broadcast.
"That's one small step for man, one giant leap for mankind," Armstrong said. He insisted later that he had said "a'' before man, but said he, too, couldn't hear it in the version that went to the world.
Armstrong, who had bypass surgery earlier this month, died Saturday at age 82 from what his family said were complications of heart procedures. His family didn't say where he died; he had lived in suburban Cincinnati.
He was "a reluctant American hero who always believed he was just doing his job," his family said in a statement.
The moonwalk marked America's victory in the Cold War space race that began Oct. 4, 1957, with the launch of the Soviet Union's Sputnik 1, a 184-pound satellite that sent shock waves around the world. The accomplishment fulfilled a commitment President John F. Kennedy made for the nation to put a man on the moon before the end of 1960s.
Armstrong and Buzz Aldrin spent nearly three hours walking on the lunar surface, collecting samples, conducting experiments and taking photographs.
"The sights were simply magnificent, beyond any visual experience that I had ever been exposed to," Armstrong once said.
In those first few moments on the moon, Armstrong stopped in what he called "a tender moment" and left a patch to commemorate NASA astronauts and Soviet cosmonauts who had died in action.
Although he had been a Navy fighter pilot, a test pilot for NASA's forerunner and an astronaut, the modest Armstrong never allowed himself to be caught up in the celebrity and glamour of the space program.
"I am, and ever will be, a white socks, pocket protector, nerdy engineer," he said in 2000 in one of his rare public appearances. "And I take a substantial amount of pride in the accomplishments of my profession."
Rice University historian Douglas Brinkley, who interviewed Armstrong for NASA's oral history project, said Armstrong fit every requirement the space agency needed for the first man to walk on moon, especially because of his engineering skills and the way he handled celebrity by shunning it.
?????????"I think his genius was in his reclusiveness," said Brinkley. "He was the ultimate hero in an era of corruptible men."
Fellow Ohioan and astronaut John Glenn, one of Armstrong's closest friends, recalled Saturday how Armstrong was on low fuel when he finally brought the lunar module Eagle down on the Sea of Tranquility.
"That showed a dedication to what he was doing that was admirable," Glenn said.
A man who kept away from cameras, Armstrong went public in 2010 with his concerns about President Barack Obama's space policy that shifted attention away from a return to the moon and emphasized private companies developing spaceships. He testified before Congress, and in an email to The Associated Press, Armstrong said he had "substantial reservations."
Along with more than two dozen Apollo-era veterans, he signed a letter calling the plan a "misguided proposal that forces NASA out of human space operations for the foreseeable future."
Armstrong was among the greatest of American heroes, Obama said in a statement.
"When he and his fellow crew members lifted off aboard Apollo 11 in 1969, they carried with them the aspirations of an entire nation. They set out to show the world that the American spirit can see beyond what seems unimaginable ? that with enough drive and ingenuity, anything is possible," Obama said.
Obama's Republican opponent Mitt Romney echoed those sentiments, calling Armstrong an American hero whose passion for space, science and discovery will inspire him for the rest of his life.
"With courage unmeasured and unbounded love for his country, he walked where man had never walked before. The moon will miss its first son of earth," Romney said.
NASA Administrator Charles Bolden recalled Armstrong's grace and humility.
"As long as there are history books, Neil Armstrong will be included in them, remembered for taking humankind's first small step on a world beyond our own," Bolden said in a statement.
Armstrong's modesty and self-effacing manner never faded.
When he appeared in Dayton in 2003 to help celebrate the 100th anniversary of powered flight, he bounded onto a stage before a packed baseball stadium. But he spoke for only a few seconds, did not mention the moon, and quickly ducked out of the spotlight.
He later joined Glenn, by then a senator, to lay wreaths on the graves of Wilbur and Orville Wright. Glenn introduced Armstrong and noted that day was the 34th anniversary of his moonwalk.
"Thank you, John. Thirty-four years?" Armstrong quipped, as if he hadn't given it a thought.
At another joint appearance, Glenn commented: "To this day, he's the one person on earth I'm truly, truly envious of."
Armstrong's moonwalk capped a series of accomplishments that included piloting the X-15 rocket plane and making the first space docking during the Gemini 8 mission, which included a successful emergency splashdown.
In the years afterward, Armstrong retreated to the quiet of the classroom and his southwestern Ohio farm. In an Australian interview earlier this year, Armstrong acknowledged that "now and then I miss the excitement about being in the cockpit of an airplane and doing new things."
Glenn, who went through jungle training in Panama with Armstrong as part of the astronaut program, described him as "exceptionally brilliant" with technical matters but "rather retiring, doesn't like to be thrust into the limelight much."
The 1969 landing met an audacious deadline that President Kennedy had set in May 1961, shortly after Alan Shepard became the first American in space with a 15-minute suborbital flight. (Soviet cosmonaut Yuri A. Gagarin had orbited the Earth and beaten the U.S. into space the previous month.)
"I believe this nation should commit itself to achieving the goal, before the decade is out, of landing a man on the moon and returning him safely to Earth," Kennedy had said. "No single space project in this period will be more impressive to mankind, or more important to the long-range exploration of space; and none will be so difficult or expensive to accomplish."
The end-of-decade goal was met with more than five months to spare. "Houston: Tranquility Base here," Armstrong radioed after the spacecraft settled onto the moon. "The Eagle has landed."
"Roger, Tranquility," Apollo astronaut Charles Duke radioed back from Mission Control. "We copy you on the ground. You've got a bunch of guys about to turn blue. We're breathing again. Thanks a lot."
The third astronaut on the mission, Michael Collins, circled the moon in the mother ship Columbia 60 miles overhead while Armstrong and Aldrin went to the moon's surface.
"He was the best, and I will miss him terribly," Collins said through NASA.
In all, 12 American astronauts walked on the moon before the last moon mission in 1972.
For Americans, reaching the moon provided uplift and respite from the Vietnam War, from strife in the Middle East, from the startling news just a few days earlier that a young woman had drowned in a car driven off a wooden bridge on Chappaquiddick Island by Sen. Edward Kennedy. The landing occurred as organizers were gearing up for Woodstock, the legendary three-day rock festival on a farm in the Catskills of New York.
Armstrong was born Aug. 5, 1930, on a farm near Wapakoneta in western Ohio. He took his first airplane ride at age 6 and developed a fascination with aviation that prompted him to build model airplanes and conduct experiments in a homemade wind tunnel.
As a boy, he worked at a pharmacy and took flying lessons. He was licensed to fly at 16, before he got his driver's license.
Armstrong enrolled in Purdue University to study aeronautical engineering but was called to duty with the U.S. Navy in 1949 and flew 78 combat missions in Korea.
After the war, Armstrong finished his degree from Purdue and later earned a master's degree in aerospace engineering from the University of Southern California. He became a test pilot with what evolved into the National Aeronautics and Space Administration, flying more than 200 kinds of aircraft from gliders to jets.
Armstrong was accepted into NASA's second astronaut class in 1962 ? the first, including Glenn, was chosen in 1959. He commanded the Gemini 8 mission in 1966, bringing back the capsule back in an emergency landing in the Pacific Ocean when a wildly firing thruster kicked it out of orbit.
Aldrin said he and Armstrong were not prone to free exchanges of sentiment.
"But there was that moment on the moon, a brief moment, in which we sort of looked at each other and slapped each other on the shoulder ... and said, 'We made it. Good show,' or something like that," Aldrin said.
An estimated 600 million people ? a fifth of the world's population ? watched and listened to the landing, the largest audience for any single event in history.
Parents huddled with their children in front of the family television, mesmerized by what they were witnessing. Farmers abandoned their nightly milking duties, and motorists pulled off the highway and checked into motels just to see the moonwalk.
Television-less campers in California ran to their cars to catch the word on the radio. Boy Scouts at a camp in Michigan watched on a generator-powered television supplied by a parent.
Afterward, people walked out of their homes and gazed at the moon, in awe of what they had just seen. Others peeked through telescopes in hopes of spotting the astronauts.
In Wapakoneta, media and souvenir frenzy was swirling around the home of Armstrong's parents.
"You couldn't see the house for the news media," recalled John Zwez, former manager of the Neil Armstrong Air and Space Museum. "People were pulling grass out of their front yard."
Armstrong, Aldrin and Collins were given ticker tape parades in New York, Chicago and Los Angeles and later made a 22-nation world tour. A homecoming in Wapakoneta drew 50,000 people to the city of 9,000.
In 1970, Armstrong was appointed deputy associate administrator for aeronautics at NASA but left the following year to teach aerospace engineering at the University of Cincinnati.
He remained there until 1979 and during that time bought a 310-acre farm near Lebanon, where he raised cattle and corn. He stayed out of public view, accepting few requests for interviews or speeches.
In 2000, when he agreed to announce the top 20 engineering achievements of the 20th Century as voted by the National Academy of Engineering, Armstrong mentioned one disappointment relating to his moonwalk.
"I can honestly say ? and it's a big surprise to me ? that I have never had a dream about being on the moon," he said.
From 1982 to 1992, Armstrong was chairman of Charlottesville, Va.-based Computing Technologies for Aviation Inc., a company that supplies computer information management systems for business aircraft.
He then became chairman of AIL Systems Inc., an electronic systems company in Deer Park, N.Y.
Armstrong married Carol Knight in 1999, and the couple lived in Indian Hill, a Cincinnati suburb. He had two adult sons from a previous marriage.
Armstrong's is the second death in a month of one of NASA's most visible, history-making astronauts. Sally Ride, the first American woman in space, died of pancreatic cancer on July 23 at age 61.
Just prior to the 50th anniversary of Glenn's orbital flight this past February, Armstrong offered high praise to the elder astronaut. Noted Armstrong in an email: "I am hoping I will be 'in his shoes' and have as much success in longevity as he has demonstrated." Glenn is 91.
At the Griffith Observatory in Los Angeles on Saturday, visitors held a minute of silence for Armstrong.
For anyone else who wanted to remember him, his family's statement made a simple request:
"Honor his example of service, accomplishment and modesty, and the next time you walk outside on a clear night and see the moon smiling down at you, think of Neil Armstrong and give him a wink."
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Borenstein reported from Washington. Associated Press writer Steve Peoples in New Hampshire and AP Science Writers Alicia Chang in Los Angeles and Marcia Dunn in Cape Canaveral, Fla., contributed to this report.
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