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Sexual dysfunction is an important issue that affects many cancer survivors who are increasingly being cared for by internists.
To examine the attitudes and reported practices of internists regarding survivorship care as it pertains to sexual dysfunction.
Surveys were sent to 406 physicians affiliated with the Department of Internal Medicine at the University of Colorado Denver School of Medicine. Of the 319 eligibles, 227 were returned (71% RR).
Of the 227 responders, 46% were "somewhat/very" likely to initiate a conversation about sexual dysfunction; 62% "never/rarely" addressed sexual dysfunction. Each additional weekly hour spent in patient care was associated with a 2% increase in the likelihood of sexual dysfunction being addressed or discussions about sexual dysfunction being initiated. Reported inadequate preparation/formal training around survivorship issues was associated with sexual dysfunction being addressed less often (odds ratio [OR] = 0.45). Perception of patient anxiety or fears about health was associated with sexual dysfunction being addressed more often (OR = 2.38). Perceived preparedness to evaluate long-term effects was associated with a greater likelihood of physicians initiating discussions about sexual functioning (OR = 2.49).
Cancer survivors receive their long-term care from internists. Our results suggest that sexual dysfunction is often not addressed during their follow-up care. Additional training is needed to prepare physicians to negotiate this difficult issue.
Within this Article
- References
- References
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- Ries LAG, Melbert D, Krapcho M, et al (eds). SEER cancer statistics review, 1975–2005, National Cancer Institute. Bethesda, MD: http://seer.cancer.gov/csr/1975_2005/, based on November 2007 SEER data submission, posted to the SEER web site, 2008. Accessed May 8, 2009.
- Hewitt M, Greenfield S, Stovall E, eds. From Cancer Patient to Cancer Survivor: Lost in Transition. Washington, D.C.: The National Academies Press; 2006.
- Kornblith AB, Ligibel J. Psychosocial and sexual functioning of survivors of breast cancer. Semin Oncol. 2003;30(6):799–813. CrossRef
- Siegel T, Moul JW, Spevak M, Alvord WG, Costabile RA. The development of erectile dysfunction in men treated for prostate cancer. J Urol. 2001;165(2):430–5. CrossRef
- Kornblith AB, Anderson J, Cella DF, et al. Hodgkin disease survivors at increased risk for problems in psychosocial adaptation. Cancer. 1992;70(8):2214–24. CrossRef
- Monga U, Tan G, Ostermann HJ, Monga TN. Sexuality in head and neck cancer patients. Arch Phys Med Rehabil. 1997;78(3):298–304. CrossRef
- Schover LR, Jensen SB. Sexuality and Chronic Illness: A Comprehensive Approach. New York, NY, US: Guilford Press;1988.
- Andersen BL, Woods XA, Copeland LJ. Sexual self-schema and sexual morbidity among gynecologic cancer survivors. J Consult Clin Psychol. 1997;65(2):221–9. CrossRef
- Bruner DW, Boyd CP. Assessing women's sexuality after cancer therapy: Checking assumptions with the focus group technique. Cancer Nurs. 1999;22(6):438–47. CrossRef
- Marwick C. Survey says patients expect little physician help on sex. JAMA. 1999;281(23):2173–4. CrossRef
- Tsimtsiou Z, Hatzimouratidis K, Nakopoulou E, Kyrana E, Salpigidis G, Hatzichristou D. Predictors of physicians' involvement in addressing sexual health issues. J Sex Med. 2006;3(4):583–8. CrossRef
- Sadovsky R. Asking the questions and offering solutions: The ongoing dialogue between the primary care physician and the patient with erectile dysfunction. Rev Urol. 2003;5 Suppl7:S35–48.
- Gott M, Galena E, Hinchliff S, Elford H. "Opening a can of worms": GP and practice nurse barriers to talking about sexual health in primary care. Fam Pract. 2004;21(5):528–36. CrossRef
- Holzapfel S. Sexual medicine in family practice Part 1: How to help. Can Fam Physician. 1993;39:608–14.
- Hartmann U, Burkart M. Erectile dysfunctions in patient-physician communication: Optimized strategies for addressing sexual issues and the benefit of using a patient questionnaire. J Sex Med. 2007;4(1):38–46. CrossRef
- Humphery S, Nazareth I. GPs' views on their management of sexual dysfunction. Fam Pract. 2001;18(5):516–8. CrossRef
- Recklitis CJ, Campbell EG, Kutner JS, Bober SL. Money talks: Non-monetary incentive fails to increase response rates to a physician survey. J Clin Epidemiol. 2009;62(2):224–6. CrossRef
- Bober SL, Recklitis CJ, Campbell EG, et al. Caring for cancer survivors: A survey of primary care physicians. Cancer. In Press.
- Penson RT, Gallagher J, Gioiella ME, et al. Sexuality and cancer: Conversation comfort zone. Oncologist. 2000;5(4):336–44. CrossRef
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- Title
- General Internist Communication about Sexual Function with Cancer Survivors
- Journal
Journal of General Internal Medicine
Volume 24, Issue 2 Supplement, pp 407-411
- Cover Date
- 2009-11-01
- 10.1007/s11606-009-1026-5
- Print ISSN
- 0884-8734
- Online ISSN
- 1525-1497
- Publisher
- Springer-Verlag
- Additional Links
- Topics
- Keywords
- general internist
- survivorship
- sexuality communication
- Industry Sectors
- Authors
- Author Affiliations
- 1. Institute for Health Policy, Massachusetts General Hospital, Harvard Medical School, 50 Staniford Street, 9th floor, Boston, MA, 02114, USA
- 2. Perini Family Survivors' Center, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
- 3. University of Colorado Denver School of Medicine, 50 Staniford Street, 9th floor, Denver, CO, USA


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Man arrested over Mary Boyle disappearance
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Pistorius sentenced to five years in prison
South African judge Thokozile Masipa has sentenced Olympic and Paralympic athlete Oscar Pistorius to five years in prison for the culpable homicide of his girlfriend Reeva Steenkamp.
Review of cases linked to Maíria Cahill announced
Three cases linked to the alleged rape of Belfast woman Maíria Cahill are to be reviewed.
Noonan: No plan to change Irish Water management
Minister for Finance Michael Noonan has said he does not know of any plans to change senior management at Irish Water.

subset: commoncrawl


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by Ben Rich
For Syrian president Bashar al-Assad, the recent murder of Free Syrian Army (FSA) commander Abu Basir by Islamist State of Iraq (ISI) militants must have felt like his birthday had come early.
The assassination of Basir highlights the deep divisions within the opposition rebel movement, and will give Western international backers further pause for thought over the potential flooding of the Syrian conflict with arms.
A house not well in order
Chaos within the ranks of the opposition forces has become the norm in the Syrian civil war. The Syrian National Council (SNC), the major international umbrella group for the opposition, has performed abysmally in its ongoing quest to form a coherent political alternative to the Ba'athist al-Assad government. Ideological divisions and petty rivalries pervade the SNC and the body remains disconnected from realities on the ground.
In the conflict itself the scene is just as dismal. An interview with FSA colonel Mohammed Aqidi, who fought in the recent battle of al-Qusair, paints a picture of scattered militant groups, lacking unified command and poor logistical support. Facing these fighters is a competent and determined Syrian Arab Air Forces (SAAF)-Hezbollah coalition that appears to be retaking ground against the rebel insurgency.
The Islamist-secularist division adds a further variable to this uncertainty. Up until recently, this competition had been more inferred than material in nature. Many analysts had commented on the rising influence of Islamist groups, like Jabhat al-Nusra (JAN), whose efficacy, capabilities and resources seemed to far outstrip their secular rivals. Despite this, outright violence between Islamists and the FSA remained a relative unknown.
Abu Basir's death has likely weakened this tacit truce, with reprisal attacks already being reported. FSA secularists are now calling on the international community to supply them further weapons to combat "al Qaeda elements". But regardless of the EU's recent moves to open arms channels, the confidence of international actors who could oblige this request will have been shaken.
My jihad ain't your jihad
Things are not peachy in the Islamist camp, however. Jabhat al-Nusra appears to be currently resisting efforts from the ISI (formerly al-Qaeda Iraq) to force it into a grand merger. Pressure from Iraq has been so great that al-Nusra's leader, Abu Mohammed al-Julani, appealed publicly to his al-Qaeda counterpart Ayman al-Zawahiri to intervene in the dispute.
The al-Qaeda chief responded with a letter, advising both parties to continue operating autonomously in pursuing their own separate objectives against the Syrian regime.
However, orders from al-Qaeda's central command appear to have fallen on deaf ears. ISI's commander Abu Bakr al-Baghdadi has remain steadfastly committed to the merger and has nowopenly scorned Zawahiri's orders. This flagrant defying of orders suggests a weakening of al-Qaeda core's influence over its regional subsidiaries, and a further sectorisation of the movement. At the same time, JAN has seen mass defections to the ISI in some provinces, a phenomenon that will likely lead to a degradation of operational capabilities.
With such bold moves characterising its recent behaviour, the Islamic State of Iraq may currently be in the process of trying to establish itself as the central hegemon within opposition forces. Naturally, this would require the removal of key players in both the secular and Islamist camps. Al-Julani is no-doubt watching his back.
Open hand versus closed fist
For the Assad regime, this turmoil is nothing if not beneficial. Internationally, flagrant infighting, assassinations and backstabbing within the opposition will weaken the confidence Western backers. Domestically, the emergence of a second front between secularists and Islamists will diminish resistance to the cohesive and centralised Ba'athist/Hezbollah forces supporting the Assad regime.
With Russia now suggesting it may revisit its prohibition against selling offensive weapons to the Syrian Arab Armed Forces, the current status of revolutionary forces appears grim. The regime's strategy of biding its time, staying organised and intervening opportunistically may just be paying off.
Ben Rich is working on a PhD at the Global Terrorism Research Centre, Monash University. His research currently focuses on structural drivers for radicalization in the Arabian Peninsula.
This article first appeared on The Conversation.
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VA Health Care:
Opportunities to Increase Efficiency and Reduce Resource Needs
T-HEHS-96-99: Published: Mar 8, 1996. Publicly Released: Mar 8, 1996.
Additional Materials:
- Full Report:
(202) 512-4800
GAO discussed ways in which the Department of Veterans Affairs (VA) could operate more efficiently and reduce resources needed to meet its mandatory care obligations. GAO noted that: (1) VA has overstated its resource needs to meet its mandatory care obligations because its projections do not reflect the expected decline in the veteran population or the amount of discretionary care it provides, overstate workloads, and include uncovered services, service expansions, and services to nonveterans; (2) VA could save billions of dollars by completing its planned efficiency improvements, which include using lower-cost methods, consolidation of underused or duplicate processes, reducing VA hospitals' nonacute admissions and days of care, closing or converting underused hospitals, and enhancing VA revenues from veteran and nonveteran care; (3) traditionally, VA has not given managers incentives to improve operating efficiency; (4) veterans may be denied care because VA facilities bear little risk when they provide inappropriate care and do not guarantee the availability of covered services; and (5) VA is implementing efficiency incentives, such as performance accountability, authority to realign services, and capitation funding, and its reorganization of its health care facilities into service networks could reduce overall costs.
Oct 6, 2014
Medicaid:Information on Inmate Eligibility and Federal Costs for Allowable ServicesGAO-14-752R: Published: Sep 5, 2014. Publicly Released: Oct 6, 2014.
Private Health Insurance:The Range of Base Premiums in the Individual Market by County in January 2013GAO-14-772R: Published: Sep 5, 2014. Publicly Released: Oct 6, 2014.
Oct 2, 2014
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Dog of the Week - Diamond
Diamond is a sweet pea looking for her forever home. She had a home, but was sadly turned in by her owners. Not a whole lot is known about Diamond. We do know she is about 7 years old. She is a white female Labrador mix and she has had a few litters of puppies.
Dog of The Week- Bam BamDog of The Week- WilburMargaret Cho visits KOOLDog of The Week- MickeyDanny Elfman performs Tim Burton's - The...Dog of the Week - TrixieDOTW 9-9-14 Brazil.mp4Dog of the Week - Brazil 09-09-2014DOTW 9-9-14 BrazilDog of the Week - Lulu & BelleDog of the Week - Gomer 08-19-14Dog of the Week - DuchessSee Rick Springfield this Saturday!7-8-14 Alexis DOTWCarlos Mencia visits Smasher and MariaEarth to Echo with Smasher & MariaDog of the Week - TalonJon Reep visits Smasher and MariaGabriel Iglesias visits with Smasher and...Smasher & Maria night at Chase Field


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Posted by nickshalfpintI found this recipe and thought I would give it a try. I'm so glad I did. This is soooooo good. We eat this sometimes by itself =)
Strawberry Cream Filling!!!!
- 4 cups strawberries 1 cup sugar 2 tbsp unflavored gelatin 4 tbsp COLD water 6 tbsp BOILING water 1 cup heavy whipping cream
- 1. Add sugar to the strawberries. Pu aside.
- 2. Soften gelatin in the cold water, then add the boiling water, mix until disolved.
- 3. Stir gelatin into the strawberries. Let cool.
- 4. Whip Cream until forms soft peaks.
- 5. Fold whipping cream into the strawberries.
- 6. Refigerate until set.


text:
So I have a head I'm sculpting in Hexagon and it looks all well and good in Hex but as soon as I send it to Daz it turns into a weird ball and laying on the floor at a weird angle.
What am I doing wrong?
Have you collapsed the dynamic geometry in hex before sending to DS ?
(wow, that almost sounds as if i actually know what i'm doing in hex )
my freebies at ShareCG
me at DeviantArt
1-(800) 267-5170 | 1-(801) 495-1777
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Use this in your forum signatures, email messages, or anything else you can come up with!


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Vinyoflex has reported a sales turnover of Rs 5.74 crore and a net profit of Rs 0.07 crore for the quarter ended Sep '12
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From Wikipedia, the free encyclopedia
FEKO is a computational electromagnetics software product developed by EM Software & Systems - S.A. (Pty) Ltd. The name is derived from the German acronym "FEldberechnung für Körper mit beliebiger Oberfläche", which can be translated as "Field Calculations for Bodies with Arbitrary Surface". The software is based on the Method of Moments (MoM) integral formulation of Maxwell's equations.[1] [2] [3] [4] and pioneered the commercial implementation of various hybrid methods such as:
- Finite Element Method (FEM) / MoM where a FEM region is bounded with an integral equation based boundary condition to ensure full coupling between the FEM and MoM solution areas of the problem.
- MoM / Physical Optics (PO) where computationally expensive MoM current elements are used to excite computationally inexpensive PO elements, inducing currents on the PO elements. Special features in the FEKO implementation of the MoM/PO hybrid include the analysis of dielectric or magnetically coated metallic surfaces.[5]
- MoM / Geometrical Optics (GO) where rays are launched from radiating MoM elements.[6]
- MoM / Uniform Theory of Diffraction (UTD) where computationally expensive MoM current elements are used to excite canonical UTD shapes (plates, cylinders) with ray-based principles of which the computational cost is independent of wavelength.
- ^ Jakobus, Ulrich (1995). Erweiterte Momentenmethode zur Behandlung kompliziert aufgebauter und elektrisch großer elektromagnetischer Streuprobleme. Düsseldorf: VDI Verlag.
- ^ Jakobus, U.; Van Tonder, J.J. (2005), "Fast Multipole Solution of Metallic and Dielectric Scattering Problems in FEKO", 21st Annual Review of Progress in Applied Computational Electromagnetics, Applied Computational Electromagnetics Society (ACES)
- ^ Jakobus, U.; Van Tonder, J.J. (2005), "Fast Multipole Acceleration of a MoM Code for the Solution of Composed Metallic/Dielectric Scattering Problems", Advances in Radio Science 3, Copernicus GmbH, pp. 189–194
- ^ Jakobus, U.; Van Tonder, J.J. (2006), "Challenges Regarding the Commercial Implementation of the Parallel MLFMM in FEKO", IEEE Antennas and Propagation Society International Symposium 2006, IEEE, pp. 95–98
- ^ Jakobus, U.; Theron, I.P. (2003), "Analysis of Coated Metallic Surfaces with Physical Optics for the Solution of High-Frequency EMC Problems", 15th International Zurich Symposium on Electromagnetic Compatibility, pp. 257–261
- ^ Jakobus, U.; Bingle, M.; Schoeman, M.; van Tonder, J.J.; Illenseer, F. (December 2008), "Tailoring FEKO for Microwave Problems", IEEE Microwave Magazine, pp. 76–85


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Jeremy Pruitt's Gold Mine
At the end of last season former Alabama defensive backs coach Jeremy Pruitt became Florida State's…
Seminoles Changing Recruiting Philosophy
By Wayne McGahee
Date: Sep 9, 2013
Florida State recruiting has taken an upturn since coach Jimbo Fisher took over in 2010, and nearly every position has been thoroughly improved. One position that Florida State fans haven't been impressed with is offensive tackle.
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At the end of last season former Alabama defensive backs coach Jeremy Pruitt became Florida State's…


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- Veneţia spectacole - Veneţia expoziţii - Veneţia festivale - Veneţia Concerte -
Evenimente la Veneţia şi în împrejurimi: detalii
From 07 June 2014 to 23 November 2014
Mikhail Roginsky. Beyond the Red Door
The very first Italian exhibit of the works of Mikhail Roginsky, the main inspiration for Russian pop art. A journey through technique and color, restoring a different vision of pop art - one that is sure to elicit interest and curiousity. An event that is part of the Architecture Biennale 2014.
Mikhail Roginsky. Beyond the Red Door
7 June - 23 November 2014
Università di Ca' Foscari, Venice
Nozio © 2014


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We're big fans of any efforts to help build the riding community, especially in Marin County where getting access to trails is a constant struggle. This up and coming weekend, Access 4 Bikes is hosting an Outdoor Adventure Film Festival to raise funds and awareness of their challenges ahead. [more after the jump…]
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Weather diversity and the scarcity of fishing pressure have produced excellent fishing at this Patagonia fly fishing lodge. It is common to catch fish in the 2-4 pound range daily and there is reasonable chance you will catch a 5-10 pound trout during a week of fishing. The lodge itself is very comfortable with outstanding views from each room. Enjoy international style meals livened with local dishes and superb Argentina wines. Relax around the massive stone fireplace after a full day's fishing, or tie up some special patterns at their fly-tying desk. Non-anglers have a wide variety of activities to choose from and families are welcome. Read our Patagonia fly fishing lodge reviews to learn more about the Rio Manso Lodge.
Although there is access to good fly fishing during the entire length of the season, most anglers prefer to plan their trips after the first half of December through March. This is generally the part of the season that provides the widest variety of fishing, allowing anglers to catch fish on nymphs, dries and streamers. In November and early December large fish can be caught fishing sinking lines with streamers but very little dry fly fishing is available. The weather is also cooler and less predictable. The dry fly fishing starts to pick up in mid-December and usually remains very good until late January. February is a transitional time and the warm weather can slow the fishing. Although good fishing can still be found in February knowledgeable anglers usually prefer to visit earlier in the season or wait until the fishing begins to improve again in early-mid March. April is when the larger brook trout become more readily available in the lakes but the cooler water does put a damper on the dry fly fishing as winter approaches.
Summer air temperatures average around 70-75 degrees Fahrenheit. February is the warmest and driest month with temperatures that may reach the mid to upper 80's during the day. Early and late season have a higher chance of rain and often see daytime temperatures in the mid-50's. The climate is very similar to Montana's Rocky Mountains.
Bariloche, Argentina, is the closest airport and flights from Buenos Aires arrive several times a day. You can also reach the lodge through Esquel. Once you've collected your bags you will be met by a representative of Rio Manso Lodge who will transfer you to lodge. The drive from Bariloche is about 90 minutes, and is included in your package. The optional transfer from Esquel is approximately 3 hours, and is available at an additional cost.
7 night, 6 day package
Every trip is different and customized to your interests. The following itinerary is a just an example of a fly fishing trip and is provided to give you a feeling for the variety of fishing available in the area. In most cases you leave the USA on an evening flight; arriving in Buenos Aires early the next morning. You can often connect to a flight to Bariloche the same day, avoiding an overnight in Buenos Aires or arrive a day or two early and spend some time in the city. "B.A." is one of the most cosmopolitan cities in South America, has excellent hotels and restaurants, and a lively cultural scene.
The international and domestic airports are in separate locations and the transfer between them can take over an hour depending on traffic. If you plan to connect the same day we recommend giving yourself at least 4½ hours between flights, so you can make your connections. Orvis Travel will assist with airline information, private transfers between airports, and hotel arrangements in Buenos Aires if requested.
Your trip begins at San Carlos de Bariloche airport, where a representative from Rio Manso will pick you up for the scenic 1 & ½ hour drive to the Lodge. Flights from Buenos Aires arrive at Bariloche several times a day and your transfer will be coordinated with your flight schedule. Part of the road to the lodge is closed to inbound traffic until 2:00 PM each day so we recommend trying to schedule your arrival in Bariloche after 12 noon so you can go straight to the lodge upon arrival. After settling in, you'll have the chance to fish a stretch of river right in front of the lodge until about 9:00 PM. This section of river runs for about 2 miles from Lake Hess to the Cascada de los Alerces (waterfall). You will likely float the river using a raft, fishing along the way and stopping to fish the more productive runs, riffles and pools.
After breakfast at around 7:30 AM you will leave the lodge and fish Beat #3 of the Manso River. The drive to the river takes only 10 minutes. Your guide will use a raft for transportation only as today all fishing will be done while wading. The river in this stretch winds through a lush forest and has a healthy population of browns and rainbows. At midday your guide will find a nice sandy beach to enjoy the lunch that the lodge's chef has packed for you. You will continue to fish the runs, pools, riffles and pocket water in the afternoon as you make your way to Lake Hess and "The Channels" right in front of the lodge where you will finish the day. Dinner will be served around 9:00 PM.
After breakfast at around 8:00 AM you will leave the lodge for Lago (Lake) Fonck, about 3 miles away. With a large population of rainbows, browns and brookies ranging from 18-22 inches, the lake is a perfect place to explore with a variety of techniques including dry fly fishing, nymphing or using streamers. At lunch time your guide will set up on a beach on the western side of the lake, only a couple miles from the Chilean border. You will fish until dark once again before returning to the lodge where the chef will have a nice fire burning in the fireplace and some hors d'oeuvres and wine to enjoy while he puts the finishing touches on dinner.
Today breakfast will be served a little later so you can catch up on your rest. You and your guide will leave the lodge around 9:00 AM headed for Beat #5. This remote beat includes some spectacular scenery and is only a 15 minute drive from the lodge. The fishing here is technical and consists of nymphing, streamer and dry fly fishing in deep pools and fast moving riffles. This particular stretch of river is very remote and at the end of the float the guides will pack up the equipment on horses for the hour long walk or horseback ride to the lodge, where dinner will be waiting.
You and your guide will leave the lodge by 8:00 AM this morning for the 15 minute drive upstream. This stretch is only about 3 miles long and has waterfalls at the top and bottom of the beat creating a natural barrier to fish migration. This is a good stretch to wade fish for fish that see little pressure. You will eat lunch on the river again today and be picked up by a driver at dusk.
This beat is the furthest beat from the lodge, but still only about a 20 minute drive upstream. Here the Manso River flows gently as it leaves Mascardi Lake and passes through small Moscos Lake. Today you will float in a MacKenzie style drift boat while trying to catch the large browns that are cruising looking for baitfish and large nymphys near the bottom of the river. Streamer fishing is usually the most productive technique in this section of river. As the day progresses the water will speed up and you will fish runs, riffles and pocket water. The incredible green color of the Rio Manso contrasts with the forest that is recovering from a natural forest fire that burned the area years ago. You will have lunch on the river again and at dusk you will finish the day at Tobogan Rapid. Dinner will be served around 9:00 PM.
You will start fishing around 9:30 AM this morning. The Quieto River drains Lake Fonck and flows into Hess Lake right in front of the lodge. The river can only be floated early in the season because of is small size. It meanders through some very thick forest so access is very limited and the fishing can provide some of the best fishing in the area. This fishing is best done with a 3-4 weight rod since the short casts demanded can be challenging with a heavier rod. You will eat lunch in the field again today, ending the float at "The Channels" in time to catch what is often referred to by the guides as "the last hour hatch".
If there is time, you may be able to get in a little fishing before leaving the lodge. Since there are several flights each day from Bariloche to Buenos Aires your transfer will be coordinated with your flight schedule or extension to another lodge in the area. The road leaving the lodge is closed to outbound traffic after 2:00 PM each day so if you book a flight late in the day you may have to be transferred to the airport several hours before your flight departs. Make sure to give yourself at least 4½ hours for your connections in Buenos Aires.
Rio Manso Lodge is the only fly fishing operation located within the Nahuel Huapi National Park. Although it is possible you will see other anglers, the remote location of the lodge and challenging access assures guests of Rio Manso a quality wilderness fishing experience with all of the comforts of a nice lodge very close by. The fishing is catch & release. Brown Trout, Rainbows, and Brook Trout were introduced to these waters in 1904 and have bred in the wild without further interference from man ever since. These ancestors established the self-sustaining wild populations found here today. You can expect an average of 15 strikes or more per day with shots at fish between 2 and 4 pounds. Occasionally a much larger fish will make an appearance. Whether or not you land one of these monsters is up to you.
There's a 25 mile stretch of the Manso River within easy fishing distance of the lodge. Big and brawling in some areas, it is almost spring creek-like in character in others. The river is a good mix of sight fishing and prospecting by water-type. If you like stillwater fishing, you can also fish the nearby lakes using belly boats or from a skiff. Whatever your preference for water type, you will most likely find it here. The Patagonia fly fishing lodge has a strict catch & release policy.
Rio Manso Lodge caters mostly to fly fishers. However, non-fishing companions are most welcome and can enjoy a variety of other activities, such as floating in the surrounding rivers, birding, trekking or horseback excursions through the still virgin areas around the lodge. It is even possible for the lodge staff to set up day trips to Bariloche. Guided tours and activities are included in all non-angler packages and can be set up on short notice. We recommend discussing the options with your hosts upon arrival. If you are an avid birder let us know ahead of time and we may be able to set up an excursion with a local ornithologist.
Located just 90-minutes south of Bariloche airport, Rio Manso Lodge sits on the shore of Lake Hess alongside the Rio Manso in the Andes Lake District of Northern Patagonia. Surrounded by an ecologically preserved wet forest, Rio Manso Lodge accommodates up to 8 flyfishers in comfortable cozy rooms with private bathrooms, Jacuzzi tubs, full size beds and international level comfort. All rooms have a spectacular view of Mount Tronador, Lake Hess and the Manso River. A welcoming fire will greet you after a full day of fishing, and the warm living room also contains a fully stocked fly-tying desk so you can tie up that "killer fly" for tomorrow's fishing. A wading room is conveniently located just inside the entrance and the comfortable dining room and bar will help you relax and enjoy every moment of your stay. Telephone and Internet access is available, as well as a small fly that serves as a good back up for those items you mysteriously forgot to bring. Rental gear is also available.
The lodge's hosts will welcome you upon your arrival at Río Manso Lodge. Both hosts share their passion for this place along with a wide knowledge of all the activities you can enjoy during your visit. The lodge staff is welcoming and will do everything they can to make sure you have an enjoyable visit. Whether visiting Rio Manso to fish or just to relax and enjoy the area, the lodge management and staff will make sure you don't have to worry about anything during your stay.
The cuisine at the lodge is of the international variety, accented with typical local dishes and homemade delicacies, and enhanced by ingredients from their own vegetable garden. Rio Manso Lodge takes great pride in their assortment of Argentine wines and invites you to partake in their fine selection. Lunches are typically taken in the field although it is possible, and sometimes nice, to return to the lodge for lunch. Lunches typically consist of nice sandwiches, fruit and a nice snack or a more extravagant lunch prepared by your guide on the river. Meals and local beverages are included in your package.
Season: beginning of November through the end of April.
|November 2014 - April 2015
|4 nights/3 days
|5 nights/4 days
|6 nights/5 days
|7 nights/6 days
(Orvis Travel special)
|Non-angler rates (per night)
Single angler supplement: $250 per night for a private guide.
*Single angler rates do not apply if you are willing to share the guide with another angler.
Orvis-exclusive departures:
Join Rio Manso Lodge Owner Roberto Pandolfi for an Orvis Travel exclusive "Owner's Week" April 4-11, 2015. Each angler will receive a free Helios 2 trout rod and a $200 Orvis Gift Card.
Contact Orvis Travel today at 800-547-4322 to reserve your spots on this special trip.
Accommodations in double room, guided fishing (2 anglers per guide), transfers to and from Bariloche airport, fishing on arrival and departure days if time allows, all meals, refreshments, local wines and spirits, Internet access, laundry, fishing permits, horseback riding, and boats. Non-angler packages include guide tours and activities, other than fishing.
International and domestic flights, fishing equipment, gratuities, phone calls, optional transfers from Esquel (approximately $250 each way), and items of a personal nature.
Overall: 5.0 / 5 based on 3 reviews
3 of 3 reviewers would recommend this product to a friend.
Outstanding! -
By: DavidB from NC
The ENTIRE experience was enjoyable. Roberto(owner) and Sharon ( manager) have a FIRST CLASS lodge and staff. They will work tirelessly to make your trip a hassle-free and unforgettable outdoor experience. Once my wife (who did NOT travel with me) saw the photos of the Lodge and the Patagonian beauty, she was ready to go. In summary, the fishing is OUTSTANDING! The Lodge is OUTSTANDING! Patagonia is OUTSTANDING ! Jason and the Orvis Travel folks are OUTSTANDING ! What are you waiting for ?
Can't Wait to Go Back -
By: ChrisT from Detroit, Michigan
My wife and I visited Rio Manso over Christmas, 2008. This was our third trip to Patagonia, each time at a different location. While every trip was a "once in a lifetime" trip, our visit to Rio Manso set a new benchmark. The accommodations, the staff, and the cuisine were all exceptional. Owner Roberto, and manager Sharon made you feel like friends as well as guests. You expect good food at a lodge of this caliber, but chef Walter exceeded our expectations. But the point of a trip like this is the fishing - and here too we were we couldn't have asked for anything better. My wife and I have both fished for several years, and have caught some nice fish during that time - but when we both caught the largest brook, brown, and rainbow trout of our lives in a single day (browns were up to 26"), on dry flies no less, we knew we were in the right place!
World Class Experience -
By: 4count from Cin., OH
I have travelled fairly extensively throughout the world- mostly in the pursuit of fly fishing- and this trip was definitely among the best. To begin with, Patagonia is a fly anglers paradise. The region is replete with gin-clear rivers and alpine lakes. The lodge itself is particularly well situated, as I fished a different body of water every day for 5 days, and never spent more than 25 minutes en route to the destination. This diversity of local trout habitat, is part of what makes this trip such a rich fly fishing experience. So is the fishing at the Rio Manso amazing? Definitely. Was it an absolute thrill to catch "trophy" trout with everything from #4 zonker on 300 grain DC line to #16 mayfly on 5x tippet? Absolutely. However, what made this trip truly exceptional was the people at Rio Manso. Alejandro Martello and Sharon Greene are the current managers, and they are among the best you will encounter. They are gracious, extremely hospitable, and eager to get to know you. From the moment we (my wife and I were in Arg. for business) arrived at Rio Manso, they made us feel as though we were spending a much anticipated week with long time friends. A further testament to Alejandro and Sharon was my wife's experience at the lodge. Prior experience had taught her to bring plenty of reading material, as lodge life can get a little boring for non-anglers. Ironically, she quickly became so enthralled with the guided trekking and horseback riding trips, I don't think she got through so much as a chapter during the trip. Every detail that makes a destination truly exceptional, for both anglers and non-anglers, is provided for by Alejandro and Sharon; the cuisine is no exception. We found not only the quality, but diversity of cuisine to be of gourmet caliber. In particular, the chef's special dish is a "7-hour lamb" that practically warrants a return trip on its own. I could continue singing the praises of the Rio Manso indefinitely, however, the essence of a good review is to provide a concise summation of an experience. Accordingly, I would offer the following: there are many places to go for large numbers of "trophy" fish, but in my experience, there are few which offer the totality and depth of the experience which you will find at the Rio Manso.


text:
Depends on our likes and chemistry.
Counting the stars together on a clothing optional beach
I'm open for anything fun, where we could get to know one another.
If I say it then it's not special
Just cuddle up on the couch and get to know each other
My idea of a perfect date would be going to see a scary movie and then dinner :)
Just sitting on the couch together watching movies with a bottle of whiskey sounds good to me.
Haven't dated in years so I'm open to suggestions
Take me somewhere we can have some real fun you decide.
Going to a movie? Hangin with friends? I love bowling and I'm open to pretty much anything (: but I have to say because I'm old fashioned I'm very much a believer in my date picking me up and dropping me off.
Anything from exploring, hiking, picnics, coffee date, dinner, or anything! It doesnt matter where the place, as long as we get to know one another :)
we could meet for lunch,,,talk,,,,maybe do some shopping,,,then its to a nice hotel where we can relax,,,,
Need to be entertained looking to entertain can someone help me lol
Beach, random drive, chat see where the day/ night takes us
Go for a drink maybe some dinner then of to the movies then just go with the flow
LargeFriends does not conduct background checks on the members of this website.


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Mini-robot finds surprise in Mexicos ancient Temple of Quetzalcoatl
2013 04 23
By Alan Boyle |
A diminutive robot helped researchers make a substantial discovery during preliminary tests conducted in a tunnel running under the Temple of Quetzalcoatl at the archaeological site of Teotihuacan, the team said Monday.
The team expected to find only one chamber in the last section of the tunnel but instead, they found three, team leader Sergio Gomez said in a
report published by the Mexican newspaper El Universal
. The chambers are thought to have been used by Teotihuacans rulers roughly 2,000 years ago for royal ceremonies or burials, but theyre so choked with mud and rubble that they havent been explored in modern times.
A worker from the National Institute of Anthropology and History walks next to a robot used to explore ruins at the entrance of a tunnel in the archaeological area of the Quetzalcoatl Temple, near the Pyramid of the Sun at the Teotihuacan archaeological site.
Thats where the 3-foot-long (1-meter-long) robot known as Tlaloc II-TC comes in: The robot is designed to drive through the tight spaces leading to the back of the tunnel beneath the Temple of Quetzalcoatl, also known as the Temple of the Feathered Serpent. Its equipped with a video camera as well as mechanical arms to clear obstacles.
The current project follows up on an earlier round of robotic exploration by Tlaloc II-TCs predecessor, Tlaloc I, in 2010. (Tlaloc was the Aztec god of rain.)
In 2010, Gomez said there was a "high possibility that in this place, in the central chamber, we can find the remains of those who ruled Teotihuacan." The city was once an influential center of Mesoamerican culture, but little is known about its rulers. Archaeologists have not yet found any depictions of a ruler, or any tomb of a monarch.
Visitors look on at the archaeological area of the Temple of Quetzalcoatl, near the Pyramid of the Sun at the Teotihuacan archaeological site, about 60 kilometesr (37 miles) north of Mexico City.
Read the full article at:
Tlaloc Is first transmitted image.
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Houzz is the new way to design your home.
10,237 Red Lion, PA General Contractors
Heck Construction Company Inc (717) 336-1020
Mission Statement - Our mission is to develop long lasting relationships with customers by exceeding their expectations in every aspect of their project experience. Read More
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text:
Private company
A private company is one which is not publicly traded on any stock exchange.
Expanded Definition
A private company is owned entirely by a relatively small group of individuals or other entities providing capital. By definition, private companies don't raise money by selling shares to the public; funding sources could include the company's founders, investors close to the founders, banks, and funds that specifically invest in private companies.
A privately held company has more flexibility in how it operates because it answers to fewer masters than a public one. The group with money on the line is restricted and select. A private company does not have to offer up detailed information on how it's faring for public and government scrutiny, as do public companies under the regulations of the Securities and Exchange Commission.
Companies can go from private to public, by selling shares to the public, often as a way to raise a large amount of money. In reverse, public companies can be taken private if, for example, a majority owner wants to consolidate control.
A private company does not have shares of stock listed on an exchange for public sale, so it is not capable of being publicly traded in the secondary market.
SC Johnson -- A Family Company, with brands such as Johnson's Wax, Pledge, Fantastik, Scrubbing Bubbles, Ziploc and Windex, is an example of a well-known private company. It was founded in 1886 and remains family owned. Another is Cargill, famous as a grain trader.
Compare: public corporation
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If these rumors are true, I think it's even safer to say Beyonce and Jay Z's marriage is solid. Dash Radio reported in an exclusive (you can hear it after the break) that the 'On The Run' duo are planning to work together on a joint album. And TMZ reports the two are eyeing an $85 million Beverly Hills mansion. These are NOT the actions of a couple on the verge of a split! RELATED: Beyonce and Jay Z release short film called 'Bang Bang Part 1.'
Beyonce & Jay Z
Beyonce & Jay Z
Release Short Film 'Bang Bang Part 1′ (Video)
The 'On The Run' tour may be over, but Beyonce and Jay Z are continuing the Bonnie and Clyde stuff with a series of short films. Beyonce and Jay Z released 'Bang Bang Part 1.' What's interesting about this "short film" (and it truly is short at a little under two minutes, with an additional minute of credits) is that it's not a video for one of their songs. There's no dialogue. It's a vignette set to music (not theirs). RELATED: Beyonce and Jay Z are 'Crazy in Love' at the end of their 'On The Run' tour.
Beyonce & Jay Z
'Crazy In Love' At End Of 'On The Run' Tour
Last night Beyonce and Jay Z wrapped up their 'On The Run' tour in Paris. Contrary to all the rumors from the summer that they wouldn't even make it to their final performance or that they would be announcing their split by the end of the tour, the couple appeared very much in love. Both paid homage to each other. RELATED: Is Beyonce expecting baby #2?
Is She Expecting Baby #2?
So now they've gone from rumors about marital problems to rumors about pregnancy? Jay Z and Beyonce performed in Paris, and Jay Z changed the lyrics to one of his songs to suggest that Beyonce might be pregnant with their second child!
Thanks Her Fans With A Cartwheel
Last week, Beyonce celebrated her 33rd birthday. Jay Z posted a video "birthday card" to his wife. She's still enjoying a vacation in Portofino, Italy. Yet she still took time to thank her fans, who also flooded her with plenty of birthday wishes. RELATED: Beyonce and Jay Z enjoy a romantic vacay.
[Read more...]
Beyonce & Jay Z
Romantic Vacay In Portofino, Italy
There are no signs of marital problems here! Beyonce and Jay Z are enjoying a romantic vacay in Portofino, Italy. They look pretty cozy, don't they? RELATED: Watch Jay Z's birthday tribute to Beyonce.
Beyonce & Jay Z
Watch Jay Z's Birthday Tribute Video To Beyonce
Yesterday was Beyonce's 33rd birthday. Jay Z posted a video tribute to his wife. It was 33 seconds long: one second for each year of her life. Check it out after the break. RELATED: Beyonce's dad calls marital trouble rumors a "Jedi mind trick."
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Dr. Arlene E. Hudson, MD
Dermatology, J O Wyatt Clinic
- 1411 E Amarillo Blvd
Amarillo, TX 79107
- 1 Office Location
- Email a Friend
- (806) 351-7200
Dr. Arlene E. Hudson has been practicing medicine for 28 years. Dr. Hudson graduated from the Loma Linda University School of Medicine in 1986. She practices medicine in Amarillo, TX and specializes in Dermatology and Internal Medicine. Dr. Hudson is affiliated with The Pavilion Northwest Texas Healthcare System. She speaks English and Spanish.
Gender: Female
Years in Practice: 28 Years
Languages Spoken: English, Spanish
Medical School: Loma Linda University School of Medicine
Graduation Date: 1986
Hospital Affiliations: The Pavilion Northwest Texas Healthcare System
Specialties: Dermatology, Internal Medicine
©2005-2014 WebMD, LLC. All rights reserved.
WebMD does not provide medical advice, diagnosis or treatment. See additional information.


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- Washington Apartments
- Woodbridge Apartments
- York Apartments
Zip Codes Near Cedmont
There are many great communities and cities nearby Cedmont to also consider:
Featured Apartment Rentals Near Cedmont.
- Albemarle Square I 120 S Central Ave Baltimore, MD 21202 Phone Number: (410) 970-6276
- Walker Manor Apartments 1018-K Woodson Road Baltimore, MD 21212 Phone Number: (855) 631-3142
- Canterbury Apartments 9206 Oswald Way White Marsh, MD 21162 Phone Number: (410) 376-7162
- Fox Hall Apartments 8501 Walther Blvd Perry Hall, MD 21128 Phone Number: (410) 988-6336
- Marketplace at Fells Point 622 S Broadway Baltimore, MD 21231 Phone Number: (443) 354-4370
- Skylark Pointe 9150 Parkland Rd Parkville, MD 21234 Phone Number: (410) 941-0425
- The Arbors At Edenbridge 8309 Arbor Station Way Parkville, MD 21234 Phone Number: (667) 401-8047
- Fellowship Court Apartments 5 Fellowship Court Towson, MD 21286 Phone Number: (443) 334-8776
- Towson Crossing 34 Dowling Circle Baltimore, MD 21234 Phone Number: (443) 406-4292
- Loch Bend Apartments 8703 Loch Bend Dr Baltimore, MD 21234 Phone Number: (443) 380-2949
Universities Near Cedmont
- Baltimore City Community College Off Campus Apartments
- Baltimore Hebrew University Off Campus Apartments
- Baltimore International College Off Campus Apartments
- College of Notre Dame Off Campus Apartments
- Community College of Baltimore County, Catonsville Off Campus Apartments
- Community College of Baltimore County, Dundalk Off Campus Apartments
- Community College of Baltimore County, Essex Off Campus Apartments
- Johns Hopkins University Off Campus Apartments
- University of Maryland Baltimore Off Campus Apartments
- University of Maryland Baltimore County Off Campus Apartments
Map & Local Information
Local Talk
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Scappoose Sauerkraut Festival
Features:Age: All Ages Price: Free
Beer isn't the only thing fermenting around here. Experience the majesty of this venerable cabbage dish at tastings and sauerkraut-making demonstrations, as well as diversions like the sauerkraut eating contest and cabbage bowling. Don't forget to grab a Famous Scappoose Sandwich for lunch!
Website: scappoosecommunity....
Event Categories: Food & Drink
September 21, 2013 from 10am to 6pmShow more...
Heritage Park
First St & Columbia Ave,
Scappoose, OR
Scappoose, OR
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VideoRSS feed with Video
Latest news
Here You Can Finally One Direction's Clothes!
Tuesday 2:53 PM, 26/02/2013
Do you wanna get closer to One Direction than everyone else? Well here's your chance! The five boyband stars are now auctioning their cloth...READ MORE ▶
Tags: Hot News / One Direction / Video
Latest news
Video! Jennifer Lawrence Falls Down When Accepting Her Oscar!
Monday 1:01 PM, 25/02/2013
Jennifer Lawrence had both good and bad luck, during yesterday's 2013 Oscars gala. The actress won an award for Best Actress, but when she w...READ MORE ▶
Make Way For The Queen! The Extended Teaster For Beyonces Tour Is Released!
Sunday 12:28 AM, 24/02/2013
Wow, she really puts "The Queen" In Queen Bey with this one! The new extended teaser of Beyonce's selling out world tour is here and she absolutely proves why she deserces her queenly title. In a Marie Antoinette-inspiread number she promotes her upcoming tour in the most beylicious way thinkable! We are not suggesting that you check the video, it's a commanding. Such things can't be missed.
Psst... Notice Jay's face all up in her royal jewels! LOVE!
Psst... Notice Jay's face all up in her royal jewels! LOVE!
VIDEO! One Direction Wants YOUR Help Fight Poverty!
Sunday 7:16 PM, 17/02/2013
We love it when celebrities show off their charitable sides and make an action for change, and right know, we couldn't be prouder of our boys in On...READ MORE ▶
Tags: / One Direction / Video
RiRi, You're Not The First! Here Are All Bathtub Music Videos!
Friday 5:13 PM, 15/02/2013
We were surprised with Rihannas new music video "Stay" since it was very different from what she usually does, and really artistic. But sitting naked in a bathtub? No, that's not something new. We decided we'd make a list of all singers who've done it before her - so click on the pics and check out all music videos shot in a bath tub!
Tags: Music Video / Naked / Video
Latest news
Check Out Jay-Z And Justin Timberlake's New Suit & Tie Video Here!
Thursday 4:36 PM, 14/02/2013
Well here's something brand new - literally! Jay-Z and Justin Timberlake just released their new Suit & Tire music video only minutes ago, a...READ MORE ▶


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- Is A Kobe Bryant Trade On The Horizon? A Few Rumored Scenarios...
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Nick Swisher Was A Lazy Bum During Yesterday's Bonehead Play Of The Day, Bro
Just last week, we found out that Nick Swisher is very possibly the bro-iest athlete in the world, man. Yesterday, we found out that he might be one of the laziest too.
Since the days of Little League, coaches drill the idea of running out every play into the heads of baseball players. Until you're absolutely sure that a ball is foul or that a pop-up is caught, you run. You run because shit happens. You run because sometimes the sun catches an outfielders' eye at the wrong moment and he drops the ball. You run because sometimes a ball slowly rolling along the third-base line takes a little turn and ends up being fair.
That's exactly what happened yesterday on a ball that just barely deflected off of Swisher's bat. Here's yesterday's bonehead play of the day, dude:
Swisher broke one of the cardinal rules of baseball. Brayan Pena made a nice heads-up play when he spotted Swisher's bro-esque laziness. And now you get to laugh at him all day. I can not confirm or deny that when he was called out, Swisher turned to the umpire and said, "Yeah, well, that's just, like, your opinion, man."
- Filed Under:
- baseball
- Nick Swisher
- Video
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FirearmsU.com, a new website built by a retired officer, is helping instructors fill their classes and helping students find exactly what they're looking for in a firearms trainer
Union invited about 60 people, including all of St. Louis' aldermen, civil service commission members, local state representatives and senators to the event
In-person events, such as workshops and conferences, are resources to look into (more about that later) but much of what you really need to know about federal grants (including financial and legal issues) is available through online training
This is about more than your pride — it's about your safety and the safety of the officers and public who depend on you to watch their back
Trooper was fatally wounded when another trooper's gun accidentally discharged