Maybe Trump should try harder not to sound like a mob boss

MSNBC

The Rachel Maddow Show / The MaddowBlog

Maybe Trump should try harder not to sound like a mob boss

By Steve Benen      December 17, 2018 

Apropos of nothing, Donald Trump lashed out yesterday afternoon at his former personal attorney / “fixer”, unusual for an American president:

“Remember, Michael Cohen only became a “Rat” after the FBI did something which was absolutely unthinkable & unheard of until the Witch Hunt was illegally started. They BROKE INTO AN ATTORNEY’S OFFICE! Why didn’t they break into the DNC to get the Server, or Crooked’s office?”

To the extent that reality still has any meaning, the FBI did not “break into” Michael Cohen’s office. Rather, federal law enforcement executed a court-approved search warrant.

That’s neither “unthinkable” not “unheard of.” It happens every day. Even Trump, for all of his limitations, should be at least vaguely aware of this.

What’s more, the president’s tweet was, as best as I can tell, the first time Trump has referred to anyone publicly as a “rat” – a label he used to condemn Cohen for cooperating with law enforcement.

So what we have here is a sitting president – who’s responsible for faithfully executing the nation’s laws, who appoints federal judges, and and who chose senior members of the Department of Justice, including the attorney general and FBI director – publicly condemning someone for cooperating with federal law enforcement, while simultaneously criticizing the FBI for executing a lawful search warrant.

In other words, the line between Donald J. Trump’s rhetoric and the dialog from villains in mob movies is getting uncomfortably blurred.

There is a degree of irony to all of this. To hear the president tell it at campaign rallies, he’s a great champion of law enforcement. In practice, however, Trump’s posture toward law enforcement tends to break down into three categories:

  1. Trump opposes common law-enforcement procedures: When the president isn’t condemning the execution of lawful search warrants, he’s arguing that “flipping” witnesses should be illegal.

2. Trump opposes law-enforcement institutions: As recently as September, the president said he sees his conflict with the FBI as one of his “crowning achievements.” Trump added at the time that he sees some leaders who’ve served in federal law enforcement as “a cancer in our country.” He’s similarly referred to the DOJ as the “Department of ‘Justice’ ” – as if he believes the DOJ’s commitment to justice is in doubt – and called it “an embarrassment to our country!”

3. Trump expects the justice system to be a tool of his political agenda: This president hasn’t just undermined the judicial system by abusing his pardon powers, he’s also urged law enforcement to enforce his political vendettas – more than once – and help Republicans win elections.

In August, The Atlantic’s Jeffrey Goldberg said of this president, “He’s doing nothing less than elevating gangster ideology to the status of high principle.”

That was nearly four months ago. Trump is, if anything, sounding even more like the head of a crime family now.

Explore:

The MaddowBlog and Donald Trump

Dollar Stores Are Taking Over the Grocery Business

Cival Eats

Dollar Stores Are Taking Over the Grocery Business, and It’s Bad News for Public Health and Local Economies

A new report shows growth of dollar stores in low-income and rural communities furthers inequity and pushes out local businesses.

Outside a Dollar General in Fort Hancock, Texas. (Photo credit: Thomas Hawk)

 

Today, there are more dollar stores in the United States than all Walmarts and Starbucks combined. These low-priced “small-box” retailers, like Dollar General, offer little to no fresh food—yet they feed more Americans than either Trader Joe’s or Whole Foods, and are gaining on the country’s largest food retailers.

Detailing the explosion of dollar stores in rural and low-income areas, the Institute for Local Self-Reliance (ILSR) recently released a report that shows how these retailers exacerbate economic and public health disparities. The report makes the case that dollar stores undercut small rural grocers and hurt struggling urban neighborhoods by staving off full-service markets.

ILSR also argues that the proliferation of dollar stores is the latest outgrowth of an increasingly concentrated grocery sector, where the top four chains—Walmart, Kroger, Ahold-Delhaize, and Albertsons—sell 44 percent of all groceries, and Walmart alone commands a quarter of the market. These dominant chain stores have decimated independent retailers and divested from rural and low-income areas, as well as communities of color.

A Dollar General in Morgantown, West Virginia. (Photo credit: <a href="https://www.flickr.com/photos/andrewbain/2937354096">Taber Andrew Bain</a>)

A Dollar General in Morgantown, West Virginia. (Photo credit: Taber Andrew Bain)

“Earlier trends in big box store [growth] are making this opening for dollar stores to enter,” says Marie Donahue, one of the report’s authors. “We’re seeing a widening gap of inequality that’s a result of wealth being extracted from communities and into corporate headquarters… Dollar stores are really concentrating in communities hit hardest by the consequences of economic concentration.”

“Before this report, I had no idea that dollar stores were proliferating in this way,” says Dr. Kristine Madsen, Faculty Director of the Berkeley Food Institute. But, she adds, “it doesn’t surprise me that these incredibly cheap stores may be the only choice for people [who] may be choosing between medicine and rent and food.”

Dollar General did not respond to a request to comment for this article.

Profiting Off Customers in “Food Deserts”

Two companies, Dollar Tree (which acquired Family Dollar in 2015) and Dollar General, have expanded their footprint from just under 20,000 stores in 2010 to nearly 30,000 stores in 2018, with plans to open yet another 20,000 stores in the near future. Dollar General alone opens roughly three stores a day.

Most of these new stores are in urban and rural neighborhoods where residents don’t often have access to fresh fruits and vegetables. In 2015, in fact, Dollar Tree and Dollar General represented two-thirds of all new stores in “food deserts,” defined by the U.S. Department of Agriculture (USDA) as low-income areas where a third or more of residents live far from a full-service grocery store. Dollar General predominantly targets rural areas, though it s beginning to compete with Family Dollar, which is ubiquitous in urban food deserts.

Profiting off these left-behind places is baked into dollar stores’ business plan. In 2016, low-income shoppers represented 21 percent of Dollar General’s customers but 43 percent of their sales. Dollar General executives publicly described households making under $35,000 and reliant on government assistance as their “Best Friends Forever.” When discussing growing rural-urban inequality, Dollar General’s CEO said “the economy is continuing to create more of our core customer,” i.e., more struggling rural families.

Undercutting Independent Grocery Stores

Some, including dollar-store executives themselves, argue that a low-cost retailer seeking to go where no one else will benefits underserved communities. But ILSR argues that dollar stores are not a true solution to hunger or food insecurity. Furthermore, the group says, they do nothing to promote food sovereignty, or people’s right to control the production and distribution of their own food.

Inside a Dollar General store in Eldred, Pennsylvania. (Photo credit: Random Retail)

Inside a Dollar General store in Eldred, Pennsylvania. (Photo credit: Random Retail)

“To the extent that dollar stores are filling, in some ways, a need in communities, I think that is true in the short term,” says Donahue. “But really our research is demonstrating … those foods aren’t as good quality as full-service grocers or independent local stores, which may be able to connect to local farmers and the larger food system.”

Dollar stores sell predominantly shelf-stable and packaged foods. Four-hundred-and-fifty Dollar General locations are experimenting with an expanded refrigerator section to respond to a demand for more fresh fruits and vegetables. But, to date, the fresh and frozen offerings that do exist in these stores consist of processed meats, dairy products, and frozen meals. In other words, customers don’t have the same wide selection as they do in a traditional full-service grocery store.

“Grocery stores have more variety and a higher quantity of healthy foods than do dollar stores,” says Dr. David Procter, director of the Rural Grocery Initiative, a program of Kansas State University’s Center for Engagement and Community Development.

Despite their reputation, dollar stores don’t provide the best deals either. They often sell products in smaller quantities to keep a low price tag and draw in cash-strapped buyers. But when comparing per-ounce prices to a traditional grocery store, dollar store customers tend to pay more. Reporting by The Guardian found that the prorated cost of dollar store milk cartons comes to $8 per gallon, for example.

Dollar store customers do, however, find genuine value in things like greeting cards, pasta, coat hangers, and other everyday home goods. But this very cost-cutting is what makes dollar stores uniquely brutal competitors for smaller independent grocers.

“There’s very little money made on all kinds of segments of the [independent] grocery store, but where [grocers] do make their most money … is in paper goods and dry goods,” explains Procter. “That is really the heart of Dollar General … and it’s cutting into the largest profit area of the grocery store, that’s the real challenge.”

  • Support Civil Eats Today!

    Support from readers like you is what keeps Civil Eats going.
    Please consider making a year-end donation or signing up for an annual subscription if you haven’t already.
    Thank you from the Civil Eats team!

By sucking away this source of revenue, dollar stores tend to drive out the few independent grocers that remain, especially in rural areas. ILSR’s report found that “it’s typical for sales [at local grocery stores] to drop by about 30 percent after a Dollar General opens.”

Additionally, a survey by the Rural Grocery Initiative found that competition from large chain stores is the single largest challenge facing independent rural grocers. In the ’90s, Walmart was their main challenger; now Dollar General is moving in where even Walmart wouldn’t go, pushing out more local businesses.

The Benefit of—and Fight for—Small, Local Stores

Residents lose more than fresh foods when their local grocery store disappears. They lose jobs, local investment, and a voice in their food choices.

According to federal data, small independent grocers employ nearly twice as many people per store when compared to dollar stores. “When you have a hometown grocer owned by people who are committed to that community, not only are all the decisions made locally, but all of the profits stay in that town,” says Procter. “Some of the money that’s being generated in Dollar General stores is going to their headquarters in Tennessee, and the decisions about whether or not that [store] stays open or what they offer is being made by out-of-state corporate decision makers.”

A Dollar Tree store in Cheshire, Conn. (Photo credit: Mike Mozart)

A Dollar Tree store in Cheshire, Conn. (Photo credit: Mike Mozart)

In addition to undercutting existing stores, the proliferation of dollar stores can shut out new entrants. This is a particular concern in low-income urban areas and communities of color. ILSR’s report features the case of Tulsa, Oklahoma, where there’s a 14-year life expectancy gap between residents in the predominantly Black north Tulsa neighborhood and residents in the predominantly white south Tulsa neighborhood. ILSR found that dollar stores have “concentrated in [Tulsa] census tracts with more African American residents,” and community members are not happy about it.

“I don’t think it’s an accident they proliferate in low socio-economic and African American communities,” Tulsa City Councilor Vanessa Hall-Harper told ILSR. “That proliferation makes it more difficult for the full-service, healthy stores to set up shop and operate successfully.”

However, Tulsa’s story also provides a glimpse of hope into what some communities can do to halt the invasion of dollar stores. Hall-Harper worked to pass zoning ordinances that would limit dollar store development and encourage full-service grocers to set up shop. She rallied residents to protest the opening of a new Dollar General and join city council meetings to show support for a temporary dollar store moratorium. City council passed the moratorium and the zoning changes seven months later. North Tulsa will soon have a new grocery store, operated by Honor Capital, a veteran-owned company that has a food-access mission. Rural communities in Kansas have similarly organized and leveraged city council to halt a proposed Dollar General.

“It’s great to see a community really fight for this ordinance and show up to public meetings and hearings and challenge those traditional systems that would have just approved development for more dollar stores in the area,” says Donahue.

This 15-year-old activist just called out world leaders for their global inaction on climate change.

U.S. Senator Bernie Sanders
December 14, 2018

“You say you love your children above all else, yet you are stealing their futures right before their very eyes,” – This 15-year-old activist just called out world leaders for their global inaction on climate change.

15-year-old Climate Activist Calls Out World Leaders for Inaction

"You say you love your children above all else, yet you are stealing their futures right before their very eyes," – This 15-year-old activist just called out world leaders for their global inaction on climate change.

Posted by U.S. Senator Bernie Sanders on Friday, December 14, 2018

Jim Carrey’s latest artwork – If there’s a hell…..

Now an innocent seven-year-old girl has died of medical neglect because of Trump’s sadism at the border. If there’s a Hell…

December 14, 2018

Claire McCaskill Says There Are ‘Too Many Embarrassing Uncles’ in Senate

NowThis Politics shared a post.
December 15, 2018

The Senate ‘puts the ‘fun’ in ‘dysfunction”

Claire McCaskill Says There Are ‘Too Many Embarrassing Uncles’ in Senate in Farewell Remarks

Claire McCaskill Says There Are 'Too Many Embarrassing Uncles' in Senate in Farewell Remarks

Some seriously tough love from Sen. Claire McCaskill as she prepares to leave office: '[The Senate] just doesn't work as well as it used to.'

Posted by NowThis Election on Friday, December 14, 2018

Dogs Patiently Wait for Sick Owner at the Hospital

Best Life

Adorable Dogs Patiently Wait for Sick Owner at the Hospital, Go Viral

Diana Bruk              December 14, 2018
dogs wait for human outside hospital

If you’ve read about the puppy who saved his owner from a rattlesnake, or the dog who waits at a train station for 12 hours a day for his human to come home from work, you know that the love of these magical creatures knows no bounds.

However, if you have any doubts, allows us to direct your attention to a touching photo recently shared on Facebook by Cris Mamprim, a healthcare worker at Hospital Regional Alto Vale in Brazil.

At around 3 a.m. last Sunday, the hospital admitted a homeless man named César, who needed to be treated for some medical issues. When the hospital staff looked at the door, they saw a group of faithful dogs, anxiously standing at the periphery to make sure their human was all right.

Even though César is homeless, he still cares for the dogs, and that care is infinitely reciprocated, because there’s no such thing as unrequited love in the world of a dog. Mamprim wrote on Facebook:

“A simple person, without luxury, who depends on help to overcome the hunger, the cold, the pain, the evils of the world, has by his side the best companions, and the exchange is reciprocal. Exchange of love, affection, warmth, understanding. A person who confessed to us that he sometimes goes hungry in order to feed them. I don’t know what his life is like, because he’s on the street, and I don’t even want to know and judge him, but I admire the respect and love he has for [his dogs]. Seeing them like this, waiting on the door, just shows how loved and cared for they are.”

The staff invited the dogs inside, and fed both César and his canine crew. An hour later, he was discharged from the hospital, and while there’s no telling what the rest of his life will be like, you can be sure the dogs will be by his side. And for another amazing story about canines, read about this patient dog who went viral for politely obeying a cafe’s “no dogs allowed” rules.

Understanding Dementia

Self

Understanding Dementia

Understanding Dementia
Dementia—Comprehensive overview covers symptoms, causes, and treatments of this mental deterioration.

Overview

Dementia isn’t a specific disease. Instead, dementia describes a group of symptoms affecting memory, thinking, and social abilities severely enough to interfere with daily functioning.

Though dementia generally involves memory loss, memory loss has different causes. So memory loss alone doesn’t mean you have dementia.

Alzheimer’s disease is the most common cause of a progressive dementia in older adults, but there are a number of causes of dementia. Depending on the cause, some dementia symptoms can be reversed.

Symptoms

Dementia symptoms vary depending on the cause, but common signs and symptoms include:

Cognitive changes

  • Memory loss, which is usually noticed by a spouse or someone else
  • Difficulty communicating or finding words
  • Difficulty reasoning or problem-solving
  • Difficulty handling complex tasks
  • Difficulty with planning and organizing
  • Difficulty with coordination and motor functions
  • Confusion and disorientation

Psychological changes

  • Personality changes
  • Depression
  • Anxiety
  • Inappropriate behavior
  • Paranoia
  • Agitation
  • Hallucinations

When to see a doctor

See a doctor if you or a loved one has memory problems or other dementia symptoms. Some treatable medical conditions can cause dementia symptoms, so it’s important to determine the underlying cause.

Causes

Dementia involves damage of nerve cells in the brain, which can occur in several areas of the brain. Dementia affects people differently, depending on the area of the brain affected.

Dementias are often grouped by what they have in common, such as the part of the brain that’s affected or whether they worsen over time (progressive dementias). Some dementias, such as those caused by a reaction to medications or vitamin deficiencies, might improve with treatment.

Progressive dementias

Types of dementias that progress and aren’t reversible include:

  • Alzheimer’s disease. In people age 65 and older, Alzheimer’s disease is the most common cause of dementia.

    Although the cause of Alzheimer’s disease isn’t known, plaques and tangles are often found in the brains of people with Alzheimer’s. Plaques are clumps of a protein called beta-amyloid, and tangles are fibrous tangles made up of tau protein.

    Certain genetic factors might make it more likely that people will develop Alzheimer’s.

  • Vascular dementia. This second most common type of dementia occurs as a result of damage to the vessels that supply blood to your brain. Blood vessel problems can be caused by stroke or other blood vessel conditions.
  • Lewy body dementia. Lewy bodies are abnormal clumps of protein that have been found in the brains of people with Lewy body dementia, Alzheimer’s disease, and Parkinson’s disease. This is one of the more common types of progressive dementia.
  • Frontotemporal dementia. This is a group of diseases characterized by the breakdown (degeneration) of nerve cells in the frontal and temporal lobes of the brain, the areas generally associated with personality, behavior, and language.

    As with other dementias, the cause isn’t known.

  • Mixed dementia. Autopsy studies of the brains of people 80 and older who had dementia indicate that many had a combination of Alzheimer’s disease, vascular dementia and Lewy body dementia. Studies are ongoing to determine how having mixed dementia affects symptoms and treatments.

Other disorders linked to dementia

  • Huntington’s disease. Caused by a genetic mutation, this disease causes certain nerve cells in your brain and spinal cord to waste away. Signs and symptoms, including a severe decline in thinking (cognitive) skills usually appear around age 30 or 40.
  • Traumatic brain injury. This condition is caused by repetitive head trauma, such as experienced by boxers, football players, or soldiers.

    Depending on the part of the brain that’s injured, this condition can cause dementia signs and symptoms, such as depression, explosiveness, memory loss, uncoordinated movement, and impaired speech, as well as slow movement, tremors and rigidity (parkinsonism). Symptoms might not appear until years after the trauma.

  • Creutzfeldt-Jakob disease. This rare brain disorder usually occurs in people without known risk factors. This condition might be due to an abnormal form of a protein. Creutzfeldt-Jakob disease can be inherited or caused by exposure to diseased brain or nervous system tissue.

    Signs and symptoms of this fatal condition usually appear around age 60.

  • Parkinson’s disease. Many people with Parkinson’s disease eventually develop dementia symptoms (Parkinson’s disease dementia).

Dementia-like conditions that can be reversed

Some causes of dementia or dementia-like symptoms can be reversed with treatment. They include:

  • Infections and immune disorders. Dementia-like symptoms can result from fever or other side effects of your body’s attempt to fight off an infection. Conditions such as multiple sclerosis that result from the body’s immune system attacking nerve cells also can cause dementia.
  • Metabolic problems and endocrine abnormalities. People with thyroid problems, low blood sugar (hypoglycemia), too little or too much sodium or calcium, or an impaired ability to absorb vitamin B-12 can develop dementia-like symptoms or other personality changes.
  • Nutritional deficiencies. Not drinking enough liquids (dehydration); not getting enough thiamine (vitamin B-1), which is common in people with chronic alcoholism; and not getting enough vitamins B-6 and B-12 in your diet can cause dementia-like symptoms.
  • Reactions to medications. A reaction to a medication or an interaction of several medications can cause dementia-like symptoms.
  • Subdural hematomas. Bleeding between the surface of the brain and the covering over the brain, which is common in the elderly after a fall, can cause symptoms similar to dementia.
  • Poisoning. Exposure to heavy metals, such as lead, and other poisons, such as pesticides, as well as alcohol abuse or recreational drug use can lead to symptoms of dementia. Symptoms might resolve with treatment.
  • Brain tumors. Rarely, dementia can result from damage caused by a brain tumor.
  • Anoxia. This condition, also called hypoxia, occurs when organ tissues aren’t getting enough oxygen. Anoxia can occur due to severe asthma, heart attack, carbon monoxide poisoning, or other causes.
  • Normal-pressure hydrocephalus. This condition, which is caused by enlarged ventricles in the brain, can cause walking problems, urinary difficulty, and memory loss.

Risk factors

Many factors can eventually lead to dementia. Some factors, such as age, can’t be changed. Others can be addressed to reduce your risk.

Risk factors that can’t be changed

  • Age. The risk rises as you age, especially after age 65. However, dementia isn’t a normal part of aging, and dementia can occur in younger people.
  • Family history. Having a family history of dementia puts you at greater risk of developing the condition. However, many people with a family history never develop symptoms, and many people without a family history do. Tests to determine whether you have certain genetic mutations are available.
  • Down syndrome. By middle age, many people with Down syndrome develop early-onset Alzheimer’s disease.
  • Mild cognitive impairment. This involves difficulties with memory but without loss of daily function. It puts people at higher risk of dementia.

Risk factors you can change

You might be able to control the following risk factors of dementia.

  • Heavy alcohol use. If you drink large amounts of alcohol, you might have a higher risk of dementia. Some studies, however, have shown that moderate amounts of alcohol might have a protective effect.
  • Cardiovascular risk factors. These include high blood pressure (hypertension), high cholesterol, buildup of fats in your artery walls (atherosclerosis), and obesity.
  • Depression. Although not yet well-understood, late-life depression might indicate the development of dementia.
  • Diabetes. If you have diabetes, you might have an increased risk of dementia, especially if it’s poorly controlled.
  • Smoking. Smoking might increase your risk of developing dementia and blood vessel (vascular) diseases.
  • Sleep apnea. People who snore and have episodes where they frequently stop breathing while asleep may have reversible memory loss.

Complications

Dementia can affect many body systems and, therefore, the ability to function. Dementia can lead to:

  • Inadequate nutrition. Many people with dementia eventually reduce or stop their intake of nutrients. Ultimately, they may be unable to chew and swallow.
  • Pneumonia. Difficulty swallowing increases the risk of choking or aspirating food into the lungs, which can block breathing and cause pneumonia.
  • Inability to perform self-care tasks. As dementia progresses, it can interfere with bathing, dressing, brushing hair or teeth, using the toilet independently, and taking medications accurately.
  • Personal safety challenges. Some day-to-day situations can present safety issues for people with dementia, including driving, cooking and walking alone.
  • Death. Late-stage dementia results in coma and death, often from infection.

Diagnosis

Diagnosing dementia and determining what type it is can be challenging. A diagnosis of dementia requires that at least two core mental functions be impaired enough to interfere with daily living. They are memory, language skills, ability to focus and pay attention, ability to reason and problem-solve, and visual perception.

Your doctor will review your medical history and symptoms and conduct a physical examination. He or she will likely ask someone close to you about your symptoms, as well.

No single test can diagnose dementia, so doctors are likely to run a number of tests that can help pinpoint the problem.

Cognitive and neuropsychological tests

Doctors will evaluate your thinking (cognitive) function. A number of tests measure thinking skills such as memory, orientation, reasoning and judgment, language skills, and attention.

Neurological evaluation

Doctors evaluate your memory, language, visual perception, attention, problem-solving, movement, senses, balance, reflexes, and other areas.

Brain scans

  • CT or MRI. These scans can check for evidence of stroke or bleeding or tumor or hydrocephalus.
  • PET scans. These can show patterns of brain activity and if the amyloid protein, a hallmark of Alzheimer’s disease, has been deposited in the brain.

Laboratory tests

Simple blood tests can detect physical problems that can affect brain function, such as vitamin B-12 deficiency or an underactive thyroid gland. Sometimes the spinal fluid is examined for infection, inflammation, or markers of some degenerative diseases.

Psychiatric evaluation

A mental health professional can determine whether depression or another mental health condition is contributing to your symptoms.

Treatment

Most types of dementia can’t be cured, but there are ways to manage your symptoms.

Medications

The following are used to temporarily improve dementia symptoms.

  • Cholinesterase inhibitors. These medications—including donepezil (Aricept), rivastigmine (Exelon), and galantamine (Razadyne)—work by boosting levels of a chemical messenger involved in memory and judgment.

    Although primarily used to treat Alzheimer’s disease, these medications might also be prescribed for other dementias, including vascular dementia, Parkinson’s disease dementia, and Lewy body dementia.

    Side effects can include nausea, vomiting, and diarrhea.

  • Memantine. Memantine (Namenda) works by regulating the activity of glutamate, another chemical messenger involved in brain functions, such as learning and memory. In some cases, memantine is prescribed with a cholinesterase inhibitor.

    A common side effect of memantine is dizziness.

  • Other medications. Your doctor might prescribe medications to treat other symptoms or conditions, such as depression, sleep disturbances or agitation.

Therapies

Several dementia symptoms and behavior problems might be treated initially using nondrug approaches, such as:

  • Occupational therapy. An occupational therapist can show you how to make your home safer and teach coping behaviors. The purpose is to prevent accidents, such as falls; manage behavior; and prepare you for the dementia progression.
  • Modifying the environment. Reducing clutter and noise can make it easier for someone with dementia to focus and function. You might need to hide objects that can threaten safety, such as knives and car keys. Monitoring systems can alert you if the person with dementia wanders.
  • Modifying tasks. Break tasks into easier steps and focus on success, not failure. Structure and routine also help reduce confusion in people with dementia.

Alternative medicine

Several dietary supplements, herbal remedies, and therapies have been studied for people with dementia. Some may be beneficial.

Use caution when considering taking dietary supplements, vitamins, or herbal remedies, especially if you’re taking other medications. These remedies aren’t regulated, and claims about their benefits aren’t always based on scientific research.

Some alternative medicines for Alzheimer’s disease and other forms of dementia that have been studied include:

  • Vitamin E. Evidence for taking vitamin E to slow Alzheimer disease is soft. Doctors warn against taking large doses of vitamin E because it may have a higher risk of mortality, especially in people with heart disease.
  • Omega-3 fatty acids. There is some evidence that eating fish three times a week might lower your risk of dementia.

    However, in clinical studies, omega-3 fatty acids haven’t significantly slowed cognitive decline in mild to moderate Alzheimer’s disease. More research is needed.

  • Ginkgo. Although ginkgo is considered safe, study results have been inconsistent in determining whether ginkgo helps people with dementia.

Other therapies

The following techniques may help reduce agitation and promote relaxation in people with dementia.

  • Music therapy, which involves listening to soothing music
  • Pet therapy, which involves use of animals, such as visits from dogs, to promote improved moods and behaviors in people with dementia
  • Aromatherapy, which uses fragrant plant oils
  • Massage therapy
  • Art therapy, which involves creating art, focusing on the process rather than the outcome

Preparing for an appointment

Most likely, you’ll first see your primary care provider if you have concerns about dementia. Or you might be referred to a doctor trained in nervous system conditions (neurologist).

Here’s some information to help you get ready for your appointment.

What you can do

When you make the appointment, ask if there’s anything that needs to be done in advance, such as fasting before certain tests. Make a list of:

  • Symptoms, including any that may seem unrelated to the reason for which you scheduled the appointment
  • Key personal information, including any major stresses or recent life changes and family medical history
  • All medications, vitamins, or supplements being taken, including the doses
  • Questions to ask the doctor

Even in the early stages of dementia, it’s good to take a family member, friend or caregiver along to help you remember the information you’re given.

For dementia, basic questions to ask the doctor include:

  • What is likely causing my symptoms?
  • Are there other possible causes for my symptoms?
  • What tests are necessary?
  • Is the condition likely temporary or chronic?
  • What’s the best course of action?
  • What alternatives are there to the primary approach being suggested?
  • How can dementia and other health issues be managed together?
  • Are there brochures or other printed material I can have? What websites do you recommend?

Don’t hesitate to ask other questions.

What to expect from your doctor

The doctor is likely to ask questions, such as:

  • When did your symptoms begin?
  • Have symptoms been continuous or occasional?
  • How severe are symptoms?
  • What, if anything, seems to improve symptoms?
  • What, if anything, appears to worsen symptoms?
  • How have the symptoms interfered with your life?

Lifestyle and home remedies

Dementia symptoms and behavior problems will progress over time. Caregivers might try the following suggestions:

  • Enhance communication. When talking with your loved one, maintain eye contact. Speak slowly in simple sentences, and don’t rush the response. Present one idea or instruction at a time. Use gestures and cues, such as pointing to objects.
  • Encourage exercise. Exercise benefits everyone, including people with dementia. The main benefits of exercise include improved strength and cardiovascular health. There is growing evidence that exercise also protects the brain from dementia, especially when combined with a healthy diet and treatment for risk factors for cardiovascular disease.

    Some research also shows physical activity might slow the progression of impaired thinking in people with Alzheimer’s disease. And it can lessen symptoms of depression.

  • Encourage activity. Plan activities the person with dementia enjoys and can do. Dancing, painting, gardening, cooking, singing, and others can be fun, can help you connect with your loved one, and can help your loved one focus on what he or she can still do.
  • Establish a nighttime ritual. Behavior is often worse at night. Try to establish going-to-bed rituals that are calming and away from the noise of television, meal cleanup, and active family members. Leave nightlights on in the bedroom, hall, and bathroom to prevent disorientation.

    Limiting caffeine, discouraging napping and offering opportunities for exercise during the day might ease nighttime restlessness.

  • Encourage keeping a calendar. A calendar might help your loved one remember upcoming events, daily activities and medication schedules. Consider sharing a calendar with your loved one.
  • Plan for the future. Develop a plan with your loved one while he or she is able to participate that identifies goals for future care. Support groups, legal advisers, family members and others might be able to help.

    You’ll need to consider financial and legal issues, safety and daily living concerns, and long-term care options.

Coping and support

Receiving a diagnosis of dementia can be devastating. Many details need to be considered to ensure that you and those around you are as prepared as possible for dealing with a condition that’s unpredictable and progressive.

Care and support for the person with the disease

Here are some suggestions you can try to help yourself cope with the disease:

  • Learn as much as you can about memory loss, dementia, and Alzheimer’s disease.
  • Write about your feelings in a journal.
  • Join a local support group.
  • Get individual or family counseling.
  • Talk to a member of your spiritual community or another person who can help you with your spiritual needs.
  • Stay active and involved, volunteer, exercise, and participate in activities for people with memory loss.
  • Spend time with friends and family.
  • Participate in an online community of people who are having similar experiences.
  • Find new ways to express yourself, such as through painting, singing, or writing.
  • Delegate help with decision-making to someone you trust.

Helping someone with dementia

You can help a person cope with the disease by listening, reassuring the person that he or she still can enjoy life, being supportive and positive, and doing your best to help the person retain dignity and self-respect.

Caregiver support

Providing care for someone with dementia is physically and emotionally demanding. Feelings of anger and guilt, frustration and discouragement, worry, grief, and social isolation are common. If you’re a caregiver for someone with dementia:

  • Learn as much about the disease as you can and participate in caregiver education programs
  • Find out about supportive services in your community, such as respite care or adult care, which can give you a break from caregiving at scheduled times during the week
  • Ask friends or other family members for help
  • Take care of your physical, emotional and spiritual health
  • Ask questions of doctors, social workers and others involved in the care of your loved one
  • Join a support group

Prevention

There’s no sure way to prevent dementia, but there are steps you can take that might help. More research is needed, but it might be beneficial to do the following:

  • Keep your mind active. Mentally stimulating activities, such as reading, solving puzzles and playing word games, and memory training might delay the onset of dementia and decrease its effects.
  • Be physically and socially active. Physical activity and social interaction might delay the onset of dementia and reduce its symptoms. Move more and aim for 150 minutes of exercise a week.
  • Quit smoking. Some studies have shown smoking in middle age and beyond may increase your risk of dementia and blood vessel (vascular) conditions. Quitting smoking might reduce your risk and will improve your health.
  • Get enough vitamin D. Research suggests that people with low levels of vitamin D in their blood are more likely to develop Alzheimer’s disease and other forms of dementia. You can get vitamin D through certain foods, supplements and sun exposure.

    More study is needed before an increase in vitamin D intake is recommended for preventing dementia, but it’s a good idea to make sure you get adequate vitamin D.

  • Lower your blood pressure. High blood pressure might lead to a higher risk of some types of dementia. More research is needed to determine whether treating high blood pressure may reduce the risk of dementia.
  • Maintain a healthy diet. Eating a healthy diet is important for many reasons, but a diet such as the Mediterranean diet—rich in fruits, vegetables, whole grains, and omega-3 fatty acids, commonly found in certain fish and nuts—might promote health and lower your risk of developing dementia.

Ryan Zinke Is Leaving Interior Department

New York Times

By Julie Turkewitz and Coral Davenport     December 15, 2018
Mr. Zinke had been the subject of at least a half-dozen federal investigations, one of which was recently referred to the Justice Department.CreditCreditCliff Owen/Associated Press.

Interior Secretary Ryan Zinke, a key figure in President Trump’s sweeping plan to reshape the nation’s environmental framework, resigned under pressure on Saturday as he faces numerous ethics investigations into his business dealings, travel and policy decisions.

“Secretary of the Interior @RyanZinke will be leaving the Administration at the end of the year after having served for a period of almost two years,” Mr. Trump wrote on Twitter. “Ryan has accomplished much during his tenure and I want to thank him for his service to our Nation.” The president said he would name a replacement this coming week.

Mr. Zinke is the latest Trump official to exit an administration plagued by questions of ethical conflict. And his departure comes as Mr. Trump has begun a shake-up in his administration. In early November, the president fired Attorney General Jeff Sessions, and last weekend he announced that his chief of staff, John F. Kelly, was leaving.

In one of the final acts of Mr. Kelly’s tenure, his team told Mr. Zinke that he should leave by year’s end or risk being fired in a potentially humiliating way, two people familiar with the discussion said.

Mr. Trump has been looking at replacing a number of other cabinet officials. He has been telling associates for weeks that the commerce secretary, Wilbur Ross, will be leaving now that the midterm elections are over, and he has also frequently complained about Betsy DeVos, the education secretary. The homeland security secretary, Kirstjen Nielsen, is also seen as likely to depart soon.

But Mr. Trump is aware that the confirmation processes for any new nominees are likely to be more contentious in the second half of his term, as he faces re-election.

Mr. Zinke, a former Montana congressman and member of the Navy SEAL’s best known for riding an Irish sport horse through Washington on his first day in office, oversaw mineral extraction and conservation on roughly 500 million acres of public land. He had become the subject of several federal investigations, one of which his department’s top watchdog has referred to the Justice Department, a potential step toward a criminal investigation.

The inquiries include an examination of a real estate deal involving Mr. Zinke’s family and a development group backed by the Halliburton chairman, David J. Lesar. Mr. Zinke stood to benefit from the deal, while Mr. Lesar’s oil services company stood to benefit from Mr. Zinke’s decisions on fossil fuel production.

Mr. Zinke has repeatedly denied wrongdoing. “I love working for the President and am incredibly proud of all the good work we’ve accomplished together,” he said on Twitter. “However, after 30 years of public service, I cannot justify spending thousands of dollars defending myself and my family against false allegations.”

Mr. Trump had tolerated the seemingly endless drips of scandal surrounding Mr. Zinke in part because he liked him personally and in part because his focus on the cabinet was concentrated on his desire to oust Mr. Sessions.

At the same time, though, Mr. Trump disliked the bad press that was amassing for Mr. Zinke, given how it reflected on him personally. And as the incoming House Democratic majority made clear that Mr. Zinke would be a prime target, Mr. Trump’s aides convinced him that the time had come to shove out Mr. Zinke.

A few months ago, the White House Counsel’s Office indicated to some West Wing aides that officials would be less likely to be subpoenaed by the new House majority if they left before the new Congress was sworn in in January. That has helped speed up the departures of several.

“This is no kind of victory, but I’m hopeful that it is a genuine turning of the page,” said Representative Raúl M. Grijalva, who as the incoming chairman of the House Natural Resources Committee has repeatedly tangled with Mr. Zinke. He added, “The next interior secretary should respect the American people’s desire for strong environmental standards and an end to corporate favoritism.”

Mr. Zinke’s exit follows that of the other major architect of the Trump administration’s environmental policies, Scott Pruitt, the administrator of the Environmental Protection Agency. Mr. Pruitt, also known for his aggressive rollback of environmental regulations, resigned in July amid questions about alleged spending abuses, first-class travel and cozy relationships with lobbyists. Among other actions, Mr. Pruitt came under fire for reaching out to the chief executive of Chick-fil-A with the intent of helping his wife open a franchise.

Beyond examining the real estate deal, the Interior Department’s inspector general had faulted Mr. Zinke for allowing his wife, Lola, to travel in government vehicles, contrary to department policy, and chided him for using $12,000 in taxpayer money to take a charter plane after a talk to a hockey team owned by one of his biggest donors.

The inspector general has also been examining the secretary’s decision to block two Native American tribes from opening a casino in Connecticut after his office received heavy lobbying from MGM Resorts International. The entertainment giant had been planning its own casino not far from the proposed tribal one.

Delaney Marsco, ethics counsel at the Campaign Legal Center, a nonpartisan watchdog group, said Mr. Zinke’s actions had sometimes been overshadowed by Mr. Pruitt’s more obvious fumbles. That let the secretary operate in an “ethical Wild West,” she said.

“There are these laws and these ethical norms that are being blown to bits by these cabinet secretaries,” Ms. Marsco said. “And that’s the pattern, the problem, that keeps us up at night.”

You’re Hired! You’re Fired! Yes, the Turnover at the Top of the Trump Administration Is … “Unprecedented.”

Since President Trump’s inauguration, White House staffers and cabinet officials have left in firings and resignations, one after the other.

The federal investigations follow several other examinations of Mr. Zinke’s behavior. He has been criticized for claiming on dozens of occasions that he is a geologist, though he has never held a job as one. When he was a candidate for Congress, campaign finance experts questioned whether it was legal for him to benefit from a super PAC that he had created. And as a Navy SEAL, he admitted to improperly billing the government $211 for a trip home to Montana, something that two admirals told The New York Times prevented him from rising to senior levels in the Navy.

Mr. Zinke’s resignation, rather than an end to his pro-fossil fuel policies, quite likely signals a passing of the playbook. Mr. Zinke’s deputy, David Bernhardt, a former oil lobbyist, is expected to step in as acting head of the department.

Mr. Zinke, 57, grew up in Whitefish, Mont., a timber and tourism town at the edge of Glacier National Park. When he took charge of the Interior Department, he promised that his youth in the West would help him balance conservation and extraction on the land in his care. Much of that land is in the West, and it includes the national parks and monuments that have become the nation’s environmental icons.

With his flashy leadership style and aggressive approach to deregulation, Mr. Zinke had largely escaped the public thrashing that Mr. Trump has directed at other cabinet members. But in recent weeks the president had signaled that the secretary’s tenure might be coming to end, possibly as a result of the ethics inquiries.

“I do want to study whatever is being said,” Mr. Trump said at a news conference on Nov. 7, referring to the investigations into Mr. Zinke. “I think he’s doing an excellent job, but we will take a look at that, and we’ll probably have an idea on that in about a week.”

Mr. Zinke was considered a surprise choice for the position. He had reportedly gained favor with Donald Trump Jr., because, like the president’s son, he is an avid game hunter.

He ran the office with a swaggering flair that won him the admiration of the president and conservative Westerners, many of whom applauded his effort to move major department operations to places like Denver or Boise, Idaho. But his style also drew derision from the environmental community and the quiet mockery of many career staff members in his own agency.

In Washington, he flew a special interior secretary flag above the Interior building when he was present, and he often skipped a coat and tie for fishing shirts and boots. Beyond the capital, he hiked and rode across landscapes in a cowboy hat, even as he pushed plans to drastically reduce monument boundaries.

In June, Politico reported that Mr. Lesar, the Halliburton chairman, was lending financial backing to a major development in Mr. Zinke’s hometown, Whitefish, that would significantly raise the value of property owned by Mr. Zinke. The development would include a hotel, shops and a brewery, and Mr. Zinke’s wife had pledged in writing to allow the developer to build a parking lot that would help make the project possible. The land for the potential lot is owned by a foundation created by Mr. Zinke.

Because Halliburton is the nation’s largest oil services company, and because Mr. Zinke regulates the oil industry on public land, the deal raised questions as to whether it constituted a conflict of interest. Mr. Zinke’s schedule also showed that he had hosted Mr. Lesar and a developer involved with the hotel-brewery project in his secretarial office in 2017.

In response, three Democrats sent a letter to the Interior Department’s top watchdog, Mary L. Kendall, requesting an investigation into whether Mr. Zinke had used his position as secretary for personal financial gain. In July, Ms. Kendall complied, opening an investigation. In October, her department forwarded at least one inquiry to the Justice Department.

Heather Swift, a spokeswoman for Mr. Zinke, has said that the secretary did nothing wrong and that he resigned from his charitable foundation’s board of directors before the deal was made.

Before Mr. Zinke joined the Trump administration, he often called himself a conservative conservationist. But as secretary, he quickly became one of the chief proponents of Mr. Trump’s energy-first agenda, promoting policies that seek to open the East Coast to offshore drilling, weaken the standards of the Endangered Species Act and shrink two national monuments, constituting the largest rollback of federal land protection in the nation’s history.

Last year under Mr. Zinke, the United States offered up 12.8 million acres of federally controlled oil and gas parcels for lease, triple the average offered during President Barack Obama’s second term, according to an analysis by The New York Times.

These policies won Mr. Zinke favor with Mr. Trump, who had made promotion of the fossil fuel industry a key part of his campaign platform, as well as from the oil and gas companies that had increasingly made up Mr. Zinke’s donor base as a Montana politician.

His policies have angered environmentalists, who have filed lawsuits trying to block these plans. Many have argued that Mr. Zinke has turned his back on the nation’s environmental heritage just as dire news about climate change has made land, water and air protection increasingly urgent.

The likely replacement by Mr. Bernhardt of his former boss in an acting capacity echoes events that followed the resignation of Mr. Pruitt at the E.P.A. Mr. Pruitt, once a favorite of Mr. Trump’s for many of the same reasons as Mr. Zinke, was replaced in an acting capacity by his deputy, Andrew Wheeler, a former coal lobbyist with a low profile and a deep knowledge of the agency he ran and the regulations he sought to undo.

While Mr. Zinke spent his tenure as the face of many of the Trump administration’s efforts, many on the inside saw Mr. Bernhardt as the effective manager who was able to push policies through. Mr. Bernhardt, with years of experience in the George W. Bush administration, and as a former lawyer and lobbyist for some of the nation’s largest oil companies, brings a deep insider’s knowledge to his job that Mr. Zinke lacked. His former legal clients included the Independent Petroleum Association of America and Halliburton.

Since his Senate confirmation last summer, Mr. Bernhardt has generated criticism from environmental and government watchdog groups that his new role will create a conflict of interest, as he oversees proposals that could directly benefit his former clients.

Maggie Haberman and Sheryl Gay Stolberg contributed reporting.

7-year-old immigrant girl dies after Border Patrol arrest

Associated Press

7-year-old immigrant girl dies after Border Patrol arrest
Associated Press        December 14, 2018

Wisconsin Republicans couldn’t accept that Scott Walker lost an election

Vice News posted an episode of Vice News Tonight
December 14, 2018

Wisconsin Republicans couldn’t accept that Scott Walker lost an election.

So they did this. And he just signed it into law.

Wisconsin Republicans Are Trying to Strip Power From Newly Elected Democrats

Wisconsin Republicans couldn't accept that Scott Walker lost an election.So they did this. And he just signed it into law.

Posted by VICE News on Friday, December 14, 2018