text:
A British man who had been on a skiing holiday in the French Alps has been found dead in an icy stream after a night out drinking.
Named in French media reports as Louis Robertson, a 26-year-old from Glasgow, he was discovered in a stream at the La Plagne resort in the Tarentaise valley in the Alps today.
Mr Robertson is said to have arrived at the resort – where peaks are as high as 3,250 metres – on Sunday with two friends for a week's holiday.
He went missing after leaving one bar and setting out to another, apparently trying to find a quicker route. A police spokesman said: "It appears to have been an unfortunate accident. He wanted to take a short cut and, in the cold and dark, met his death."
Many British skiers and snowboarders have died in drinking-related accidents in recent years.
An inquest last month heard how a young British holiday rep had died after skiing into a snow cannon in Val D'Isere. He had drunk four beers beforehand.
In January a British teenager drowned in an outdoor swimming pool after a night out with friends in Alpe d'Huez, another French ski resort. A campaign about the dangers of underestimating the risk of drinking at high altitude was launched four years ago by the then British Ambassador to France, Sir Peter Westmacott.
"Over the past years, we've noticed a rise in accidents in resorts linked to alcohol consumption, particularly accidents on the slopes, mostly among young people," Sir Peter said at the time. "We are telling our compatriots to be careful: when you consume too much alcohol at an altitude and it's cold, the danger is greater."
Various contradictory studies have alternately been said to prove and disprove a link between altitude and increased effects of alcohol.
However, what is known is that drinking in colder temperatures can increase the risk of hypothermia as alcohol increases the flow of adrenalin, causing blood vessels to dilate and increasing the flow of blood to the skin. It creates an illusion of feeling warmer while actually decreasing body temperature.
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Just wanted to share my ITBS success story.
6 months ago on my final long distance run for the brighton marathon my knee went and i was struck down by ITBS... even after 4 months i couldnt run more than 1km without the friction kicking in...
Earlier today I ran my first 5km in a respectable 22 minutes ish..
After months of doing clams, leg lifts, accupuncture, foam roller, and a little despair a PT put me onto plyometrics..
Although I would stress the early core work laid the foundation for doing box jumps and hops etc and I returned to running using a fast tracked bupa beginners 5km program - i didnt just go out there and do it!
Anyway my knee no longer wobbles when i do single leg squats and my core stability is in a different league to what it was... confidence is back up and now going to pace myself back up to 10km for xmas followed by the marathon plan - fingers crossed this time!
Good news- do you think it was the break from running, or the core stability that fixed it?
i think it was the core stabilitystrength and going back with an interval runwalk plan..
That's good to hear. I have been suffering for 5 months now (since London marathon) and still can't run more that a few minutes before the pain kicks in. Have been trying to keep fit wirth swimming and spinning instead (although spinning not much better for knee pain to be honest!).
I am also doing endless clams, planks, leg lifts etc and regularly seeing a physio. I recently underwent a biomechanical assessment and discovered that I have one tight hip, 2 tight hip flexors and some misallignment in my back an shoulders. So I am having some manual therapy (it hurts!) to correct it.
Hopefully this will do the trick but I have realised that focusing on the injury site is not the answer, an overall assessment seems to be the key.
Hope I have the same success as you Steven! Which exercises did you find were best for improving your core strength?
Hi all. I'm trying to sort out my problem and this feels right. I was in my 1st marathon two weeks ago (I'm 57, ouch) and at mile 24 my right knee suddenly started to hurt and I had to walk the last 2. Two days later the pain was gone, so I waited 5 more days and did an easy 7 mile. The pain came back at mile 4 or so but not so painful that I had to walk. Yesterday I did 12 mi and the pain was back after 3-4 again, but within 24 hr it's pretty much gone - no issues walking or climbing stairs. All three times, the knee was iced and elevated. No trips to the doc or physio yet so my question is to all of you ITBSers - does this sound like what you had? Do I go to my GP or straight to the PT? Ortho is a last resort because all they want to do is cut. Thanks to all for any advice and good luck with your knees!


text:
|Classification and external resources
|Patient UK
|Premature ejaculation
Premature ejaculation (PE) occurs when a man experiences orgasm and expels semen soon after sexual activity and with minimal penile stimulation. It has also been called early ejaculation, rapid ejaculation, rapid climax, premature climax, and (historically) ejaculatio praecox. There is no uniform cut-off defining "premature", but a consensus of experts at the International Society for Sexual Medicine endorsed a definition including "ejaculation which always or nearly always occurs prior to or within about one minute".[1] The International Classification of Diseases (ICD-10) applies a cut-off of 15 seconds from the beginning of sexual intercourse.[2] Hong argued that rapid ejaculation is an evolutionary adaptation.[3]
Although men with premature ejaculation describe feeling that they have less control over ejaculating, it is not clear if that is true, and many or most average men also report that they wish they could last longer. Men's typical ejaculatory latency is approximately 4–8 minutes.[4] The opposite condition is delayed ejaculation.[5]
Men with PE often report emotional and relationship distress, and some avoid pursuing sexual relationships because of PE-related embarrassment.[6] Compared with men, women consider PE less of a problem,[7] but several studies show that the condition also causes female partners distress.[6][8][9]
The causes of premature ejaculation are unclear. Many theories have been suggested, including that PE was the result of masturbating quickly during adolescence to avoid being caught by an adult, of performance anxiety, of an unresolved Oedipal conflict, of passive-aggressiveness, and having too little sex; but there is little evidence to support any of these theories.[4]
Several physiological mechanisms have been hypothesized to contribute to causing premature ejaculation including serotonin receptors, a genetic predisposition, elevated penile sensitivity, and nerve conduction atypicalities.[2]
The nucleus paragigantocellularis of the brain has been identified as having involvement in ejaculatory control.[10] Scientists have long suspected a genetic link to certain forms of premature ejaculation. In one study, 91 percent of men who have had premature ejaculation for their entire lives also had a first-relative with lifelong premature ejaculation. Other researchers have noted that men who have premature ejaculation have a faster neurological response in the pelvic muscles.[citation needed]
PE may be caused by prostatitis[11] or as a drug side effect.
The physical process of ejaculation requires two actions: emission and expulsion. The emission is the first phase. It involves deposition of fluid from the ampullary vas deferens, seminal vesicles, and prostate gland into the posterior urethra.[12] The second phase is the expulsion phase. It involves closure of bladder neck, followed by the rhythmic contractions of the urethra by pelvic-perineal and bulbospongiosus muscle, and intermittent relaxation of external urethral sphincters.[13]
Sympathetic motor neurons control the emission phase of ejaculation reflex, and expulsion phase is executed by somatic and autonomic motor neurons. These motor neurons are located in the thoracolumbar and lumbosacral spinal cord and are activated in a coordinated manner when sufficient sensory input to reach the ejaculatory threshold has entered the central nervous system.[14][15]
Intromission timeEdit
The 1948 Kinsey Report suggested that three-quarters of men ejaculate within two minutes of penetration in over half of their sexual encounters.[16]
Current evidence supports an average intravaginal ejaculation latency time (IELT) of six and a half minutes in 18- to 30-year-olds.[17][18] If the disorder is defined as an IELT percentile below 2.5, then premature ejaculation could be suggested by an IELT of less than about two minutes.[19] Nevertheless, it is possible that men with abnormally low IELTs could be satisfied with their performance and do not report a lack of control. Likewise, those with higher IELTs may consider themselves premature ejaculators, suffer from detrimental side effects normally associated with premature ejaculation, and even benefit from treatment.
When deciding the appropriate treatment, it is important for the physician to distinguish PE as a "complaint" versus PE as a "syndrome".[20] About 20 years ago, PE was classified into "lifelong PE" and "acquired PE".[21] Recently, a new classification of PE was proposed based on controlled clinical and epidemiological stopwatch studies,[20] and it included 2 other PE syndromes: "natural variable PE" and "premature-like ejaculatory dysfunction". Only individuals with lifelong PE with IELT shorter than 1–1.5 minutes should require medication as a first option, along with or without therapy. For those who fall into one of the other categories, treatment should consist of patient reassurance, behavior therapy, and/or psychoeducation to explain that irregular early ejaculation is a normal variation.[22][23]
Several possible sub-classifications have been discussed, but none is in universal usage. Primary premature ejaculation refers to lifelong experience of the problem (since puberty), and secondary premature ejaculation reference to the problem beginning later in life. It has also been subdivided into global premature ejaculation, when it occurs with all partners and contexts, and situational premature ejaculation, when it occurs in some situations or with specific partners.[24]
Several treatments have been tested for treating premature ejaculation. A combination of medication and non-medication treatments is often the most effective method.[25]
Many men attempt to treat themselves for premature ejaculation by trying to distract themselves, such as by trying to focus their attention away from the sexual stimulation. There is little evidence to indicate that it is effective, however, and it tends to detract from the sexual fulfilment of both partners. Other self-treatments include thrusting more slowly, withdrawing the penis altogether, purposefully ejaculating before sexual intercourse, and using more than one condom. Using more than one condom is not recommended as the friction will often lead to breakage. Some men report these to have been helpful.[4]
By the 21st century, most men with premature ejaculation could cure themselves, either on their own or with a partner, using self-help resources, and only those with unusually severe problems had to consult sex therapists, who cured 75 to 80 percent.[26][27]
Freudian theory postulated that rapid ejaculation was a symptom of underlying neurosis. It stated that the man suffers unconscious hostility toward women, so he ejaculates rapidly, which satisfies him but frustrates his lover, who is unlikely to experience orgasm that quickly.[28] Freudians claimed that premature ejaculation could be cured using psychoanalysis. But even years of psychoanalysis accomplished little, if anything, in curing premature ejaculation.[28]
There is no evidence that men with premature ejaculation harbor unusual hostility toward women.[29]
Sex therapyEdit
Several techniques have been developed and applied by sex therapists, including Kegel exercises (to strengthen the muscles of the pelvic floor) and Masters and Johnson's "stop-start technique" (to desensitize the man's responses) and "squeeze technique" (to reduce excessive arousal).[25]
To treat premature ejaculation, Masters and Johnson developed the "squeeze technique". Men were instructed to pay close attention to their arousal pattern and learn to recognize how they felt shortly before their "point of no return", the moment ejaculation felt imminent and inevitable. Sensing it, they were to signal their partner, who squeezed the head of the penis between thumb and index finger, suppressing the ejaculatory reflex and allowing the man to last longer.[30][31][32]
The squeeze technique worked, but many couples found it cumbersome. From the 1970s to the 1990s, sex therapists refined the Masters and Johnson approach, largely abandoning the squeeze technique and focused on a simpler and more effective technique called the "stop-start" technique. During intercourse, as the man senses he is approaching climax, both partners stop moving and remain still until the man's feelings of ejaculatory inevitability subside, at which point, they are free to resume active intercourse.[33][34][35][36][37] To help the man increase awareness of his sexual experience, he is encouraged to create an excitement scale of 1-100. Successful completion of this scale will include paying attention to his heart rate, when (and if) he squeezes his inner thighs, and sensations in all parts of his body. By creating this scale, he will be more able to pace himself as he uses the "stop-start" technique.
In addition to the stop-start technique, other sexual adjustments help men develop and maintain ejaculatory control, among them: focus exercises, mind/body coordination exercises, masturbation exercises, deep breathing, and whole-body massage.
Sex therapists estimate that the refined last-longer program teaches effective ejaculatory control to 90 percent of men.[38][39][40][41][42] The authors of one study concluded that sex therapy "has a remarkable therapeutic effect on premature ejaculation".[27]
Drugs that increase serotonin signalling in the brain slow ejaculation and have been used successfully to treat PE. These include selective serotonin reuptake inhibitors (SSRIs), such as paroxetine or dapoxetine, as well as clomipramine. Ejaculatory delay typically begins within a week of beginning medication. The treatments increase the ejaculatory delay to 6–20 times greater than before medication. Men often report satisfaction with treatment by medication, and many discontinue it within a year.[2] However, SSRIs can cause various types of sexual dysfunction such as anorgasmia, erectile dysfunction, and diminished libido.
Dapoxetine is a short-acting SSRI which appears to work when taken as needed for PE.[43] It is generally well tolerated.[44] Tramadol, an atypical oral analgesic, appears to be effective.[45]
Desensitizing topical medications that are applied to the tip and shaft of the penis can also be used. These are applied "as needed", 10–15 minutes before sexual activity and have fewer potential systemic side effects as compared to pills.[46] Use of topicals is sometimes disliked due to the reduction of sensation in the penis as well as for the partner (due to the medication rubbing onto the partner).[47] Penis insensitivity and transference to the partner are practically eliminated when using topical anesthetic sprays based on absorption technology[48] which enable the active ingredient to penetrate through the surface skin of the penis (stratum corneum) to the sensory nerves which reside in the dermis.
Several notable medical institutions suggest Promescent as a viable topical medication.[49][50][51] Promescent is an ejaculation-delaying topical agent that appears to be effective in increasing the time to ejaculation and the overall quality of the sexual experience in men with premature ejaculation. Authored by leading industry experts Dr. Kristen Mark, a noted sex and relationships researcher at the University of Kentucky, and Dr. Ian Kerner, a nationally recognized sexuality counselor and bestselling author of She Comes First, found that participants' average time from penetration to ejaculation was 11.16 minutes during sexual events when Promescent was used and 6.81 minutes when it was not used, representing a 64% increase. The study[52] also found that Promescent is effective in closing the "orgasm gap," or the difference in the amount of time it takes a man to reach orgasm compared to a woman. Study participants reported that 65.6% of sexual events resulted in both partners having an orgasm when the product was used, versus 44.1% when the product wasn't used.[53]
In 2005, researchers at the Australian Centre for Sexual Health in Sydney measured the ability of sildenafil citrate (a treatment primarily used to medicate erectile dysfunction) to treat subjects experiencing premature ejaculation. Even though it did not significantly lengthen ejaculatory latency, sildenafil reportedly 'increased confidence, the perception of ejaculatory control, and overall sexual satisfaction' in those studied, and aided in the achievement of a second erection following premature ejaculation.[54]
Premature ejaculation is a prevalent sexual dysfunction in men;[55] however, because of the variability in time required to ejaculate and in partners' desired duration of sex, exact prevalence rates of PE are difficult to determine. In the "Sex in America" surveys (1999 and 2008), University of Chicago researchers found that between adolescence and age 59, approximately 30% of men reported having experienced PE at least once during the previous 12 months, whereas about 10 percent reported erectile dysfunction (ED).[56] Although ED is men's most prevalent sex problem after age 60, and may be more prevalent than PE overall according to some estimates,[57] premature ejaculation remains a significant issue that, according to the survey, affects 28 percent of men age 65–74, and 22 percent of men age 75–85.[56] Other studies report PE prevalence ranging from 3 percent to 41 percent of men over 18, but the great majority estimate a prevalence of 20 to 30 percent—making PE a very common sex problem.[6][11][55][58][59][60][61][62]
There is a common misconception that younger men are more likely to suffer premature ejaculation and that its frequency decreases with age. Prevalence studies have indicated, however, that rates of PE are constant across age groups.[2]
Other mammals ejaculate quickly during intercourse, prompting biologists to declare that rapid ejaculation had evolved into men's genetic makeup to increase their chances of passing their genes.[63]
Ejaculatory control issues have been documented for more than 1,500 years. The Kamasutra, the 4th century Indian sex handbook, declares: "Women love the man whose sexual energy lasts a long time, but they resent a man whose energy ends quickly because he stops before they reach a climax."[64][non-primary source needed] Waldinger summarizes professional perspectives from early in the twentieth century.[65]
Sex researcher Alfred Kinsey did not consider rapid ejaculation a problem, but viewed it as a sign of "masculine vigor" that could not always be cured.[66] The belief that it should be considered a disease rather than a normal variation has also been disputed by some modern researchers.[67]
See alsoEdit
- ^ Sharlip, I. D., Hellstrom, W. J., & Broderick, G. A. (2008). The ISSM definition of premature ejaculation: A contemporary, evidence-based definition. Journal of Urology, 179(suppl), 340, abstract 988.
- ^ a b c d Althof, S. E. (2007). Treatment of rapid ejaculation: Psychotherapy, pharmacotherapy, and combined therapy (pp. 212–240). In S. R. Leiblum (Ed.), Principles and practice of sex therapy (4th ed.). NY: Guilford.
- ^ Hong, Lawrence K. (2010). "Survival of the fastest: On the origin of premature ejaculation". The Journal of Sex Research. 20 (2): 109–122. doi:10.1080/00224498409551212. ISSN 0022-4499.
- ^ a b c Strassberg, D. S., & Perelman, M. A. (2009). Sexual dysfunctions. In P. H. Blaney & T. Millon (Eds.), Oxford textbook of psychopathology (2nd ed.), (pp. 399–430). NY: Oxford University Press.
- ^ Jern Patrick; et al. (2007). "Premature and delayed ejaculation: Genetic and environmental effects in a population‐based sample of Finnish twins". The journal of sexual medicine. 4 (6): 1739–1749. doi:10.1111/j.1743-6109.2007.00599.x.
- ^ a b c Barnes T.; I. Eardley (2007). "Premature Ejaculation: The Scope of the Problem". Journal of Sex and Marital Therapy. 33 (3): 151–170. doi:10.1080/00926230601098472. PMID 17365515.
- ^ Byers, E.S.; G. Grenier (2003). "Premature or Rapid Ejaculation: Heterosexual Couples' Perceptions of Men's Ejaculatory Behavior". Archives of Sexual Behavior. 32 (3): 261–70. doi:10.1023/A:1023417718557. PMID 12807298.
- ^ Limoncin, E.; et al. (2013). "Premature Ejaculation Results in Female Sexual Distress: Standardization and Validation of a New Diagnostic Tool for Sexual Distress". Journal of Urology. 189 (5): 1830–5. doi:10.1016/j.juro.2012.11.007. PMID 23142691.
- ^ Graziottin, A.; S. Althof (2011). "What Does Premature Ejaculation Mean to the Man, the Woman, and the Couple?". Journal of Sexual Medicine. 8: 304–9. doi:10.1111/j.1743-6109.2011.02426.x. PMID 21967392.
- ^ Coolen LM, Olivier B, Peters HJ, Veening JG (1997). "Demonstration of ejaculation-induced neural activity in the male rat brain using 5-HT1A agonist 8-OH-DPAT". Physiol. Behav. 62 (4): 881–91. doi:10.1016/S0031-9384(97)00258-8. PMID 9284512.
- ^ a b Althof, S.E.; et al. (2010). "International Society for Sexual Medicine's Guidelines for the Diagnosis and Treatment of Premature Ejaculation". Journal of Sexual Medicine. 7 (9): 2947–69. doi:10.1111/j.1743-6109.2010.01975.x. PMID 21050394.
- ^ Böhlen D, Hugonnet CL, Mills RD, Weise ES, Schmid HP (2000). "Five meters of H(2)O: the pressure at the urinary bladder neck during human ejaculation". Prostate. 44 (4): 339–41. doi:10.1002/1097-0045(20000901)44:4<339::AID-PROS12>3.0.CO;2-Z. PMID 10951500.
- ^ Master VA, Turek PJ (2001). "Ejaculatory physiology and dysfunction". Urol. Clin. North Am. 28 (2): 363–75, x. doi:10.1016/S0094-0143(05)70145-2. PMID 11402588.
- ^ deGroat WC, Booth AM (1980). "Physiology of male sexual function". Ann. Intern. Med. 92 (2 Pt 2): 329–31. doi:10.7326/0003-4819-92-2-329. PMID 7356224.
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- ^ Kinsey, Alfred (1948), Sexual Behavior in the Human Male, Philadelphia: W. B. Saunders Co
- ^ "Ejaculation delay: what's normal? [July 2005; 137-4]". Retrieved 2007-10-21.
- ^ Waldinger MD, Quinn P, Dilleen M, Mundayat R, Schweitzer DH, Boolell M (2005). "A multinational population survey of intravaginal ejaculation latency time". The journal of sexual medicine. 2 (4): 492–7. doi:10.1111/j.1743-6109.2005.00070.x. PMID 16422843.
- ^ Waldinger MD, Zwinderman AH, Olivier B, Schweitzer DH (2005). "Proposal for a definition of lifelong premature ejaculation based on epidemiological stopwatch data". The journal of sexual medicine. 2 (4): 498–507. doi:10.1111/j.1743-6109.2005.00069.x. PMID 16422844.
- ^ a b Waldinger, MD. "Changing paradigms from a historical DSM-III and DSM-IV view toward an evidence based definition of premature ejaculation. Part II: Proposals for DSM-V and ICD-11". Proposals for DSM-V and ICD-11. J Sex Med.
- ^ Godpodinoff, ML (1989). "Premature ejaculation: clinical subgroups and etiology". J Sex Marital Ther. 15 (2): 130–4. doi:10.1080/00926238908403817. PMID 2769774.
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- ^ Godpodinoff M.L. Premature Ejaculation: Clinical Subgroups and Etiology Journal of Sex and Marital Therapy 1989; 15(2):130-134
- ^ a b LeVay, S., & Baldwin, J. (2009). Human sexuality (3rd. ed.) (pp. 532–534). Sunderland, MA: Sinauer.
- ^ McCabe, M.P. (2001). "Evaluation of a Cognitive Behavior Therapy Program for People with Sexual Dysfunction". Journal of Sex and Marital Therapy. 27 (3): 259–71. doi:10.1080/009262301750257119. PMID 11354931.
- ^ a b Chen, G.H.; et al. (2009). "A Clinical Study on Psycho-Behavioral Therapy for Premature Ejaculation". Zhonghua Nan Ke Xue. 15 (10): 929–31. PMID 20112744.
- ^ a b Kaplan, Helen S. (1989), PE: How to Overcome Premature Ejaculation, Brunner Mazel/New York Times, p. 28
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- ^ Kaplan, Helen S. (1989), PE: How to Overcome Premature Ejaculation, Brunner Mazel/New York Times, pp. 48–58
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- ^ Silverberg, S. (2010) [1978], Lasting Longer: The Treatment Program for Premature Ejaculation, Physicians Medical Press, pp. 44–57
- ^ Birch. R.W. (2007), A Short Book About Lasting Longer, PEC Publishing, pp. 27–38
- ^ Castleman, M. (2004), Great Sex, Rodale, Inc., pp. 122–141
- ^ Kaplan, Helen S. (1989), PE: How to Overcome Premature Ejaculation, Brunner Mazel/New York Times, pp. 43–61
- ^ Metz, M.; B. McCarthy (2003), Coping With Premature Ejaculation, New Harbinger Publications, pp. 105–133
- ^ Silverberg, S. (2010) [1978], Lasting Longer: The Treatment Program for Premature Ejaculation, Physicians Medical Press, pp. 42–57
- ^ Birch. R.W. (2007), A Short Book About Lasting Longer, PEC Publishing, pp. 16–44
- ^ Hutchinson, K; Cruickshank, K; Wylie, K (May 1, 2012). "A benefit-risk assessment of dapoxetine in the treatment of premature ejaculation.". Drug safety : an international journal of medical toxicology and drug experience. 35 (5): 359–72. doi:10.2165/11598150-000000000-00000. PMID 22452563.
- ^ McMahon, CG; Althof, SE, Kaufman, JM, Buvat, J, Levine, SB, Aquilina, JW, Tesfaye, F, Rothman, M, Rivas, DA, Porst, H (February 2011). "Efficacy and safety of dapoxetine for the treatment of premature ejaculation: integrated analysis of results from five phase 3 trials.". The journal of sexual medicine. 8 (2): 524–39. doi:10.1111/j.1743-6109.2010.02097.x. PMID 21059176.
- ^ Wong, BL; Malde, S (Jan 2013). "The use of tramadol "on-demand" for premature ejaculation: a systematic review.". Urology. 81 (1): 98–103. doi:10.1016/j.urology.2012.08.037. PMID 23102445.
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- ^ Mark, K. P.; Kerner, I. (2016-11-01). "Event-level impact of Promescent on quality of sexual experience in men with subjective premature ejaculation". International Journal of Impotence Research. 28 (6): 216–220. doi:10.1038/ijir.2016.31. ISSN 1476-5489. PMID 27557610.
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- ^ Mathers, M.J.; et al. (2013). "Premature Ejaculation in Urological Routine Practice". Aktuelle Urology (German). 44 (1): 33–9. doi:10.1055/s-0032-1331727. PMID 23381878.
- ^ Serefoglu E.C.; T.R. Saitz (2012). "New Insights on Premature Ejaculation: A Review of Definition, Classification Prevalence, and Treatment". Asian Journal of Andrology. 14 (6): 822–9. doi:10.1038/aja.2012.108. PMC 3720102 . PMID 23064688.
- ^ Tang, W.S.; E.M. Khoo (2011). "Prevalence and Correlates of Premature Ejaculation in a Primary Care Setting: A Preliminary Cross-Sectional Study". Journal of Sexual Medicine. 8 (7): 2071–8. doi:10.1111/j.1743-6109.2011.02280.x. PMID 21492404.
- ^ Porst, H.; et al. (2007). "The Premature Ejaculation Prevalence and Attitudes (PEPA) Survey: Prevalence, Co-morbidities, and Professional Help-Seeking". European Urology. 51 (3): 816–824. doi:10.1016/j.eururo.2006.07.004. PMID 16934919.
- ^ Rowland, D.; et al. (204). "Self-Reported Premature Ejaculation and Aspects of Sexual Functioning and Satisfaction". Journal of Sexual Medicine. 1 (2): 225–32. doi:10.1111/j.1743-6109.2004.04033.x. PMID 16429622.
- ^ Birch, Robert (16 November 2007). "Did you orgasm?". Sexualhealth.com. Archived from the original on 16 July 2011. Retrieved 21 April 2010.
- ^ Vatsyayana, M. (translators) Doniger, W. and Kakar, S. (2009), Kamasutra, Oxford University Press
- ^ Waldinger, Marcel D. (2013). "History of Premature Ejaculation": 5–24. doi:10.1007/978-88-470-2646-9_2.
- ^ Kaplan, Helen S. (1974), The New Sex Therapy, Brunner Mazel/New York Times, p. 292
- ^ Puppo, Vincenzo; Puppo, Giulia (2016-01-01). "Comprehensive review of the anatomy and physiology of male ejaculation: Premature ejaculation is not a disease". Clinical Anatomy. 29 (1): 111–119. doi:10.1002/ca.22655. ISSN 1098-2353. PMID 26457680.
Further readingEdit
- Hamblin, James (2012). "When Is Ejaculation 'Premature,' and When Should a Penis Be Made Numb?". The Atlantic. Retrieved 6 March 2017.
According to [Dr. John Mulhall], when we talk casually about premature ejaculation ... we're usually talking about what the medical community would consider 'premature-ejaculatory-like syndrome,' or simply 'rapid ejaculation.' ... Mulhall says it comes down to whether the guy lasts long enough. If his partner is made wholly replete in 90 seconds, then a man who lasts 95 seconds can be fine. But if another guy lasts 15 minutes, and that's not cutting it, then it's a problem and can be considered rapid.
External linksEdit


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Let's Talk Coffee in Nicaragua
by Aaron DeLazzer
I recently had the pleasure of traveling to Nicaragua, with sales team member Michelle, to attend an event called "Let's Talk Coffee." The conference is utterly unique, providing an opportunity to create dialogue between importers, producers and roasters.
In addition to the conference, we took a side-trip to an area outside of Jinotega, requiring an aggressive three hour drive along pot holed roads past the humidity of the city into the cooler, elevated climes of coffee country.
Dense green blurs past the window as do the occasional corrugated metal topped home with curious eyes peering from inside the doorstep. A wave and a smile is always met with a wave and a smile.
There are a surprising number of families here, tucked up into the verdant hills. Some hard-scrabble yards, wash on the line and chickens going about their business, acting casual and trying not to become lunch. Coffee trees are often not far from their front door. It is in places like this that the coffee farmers of Nicaragua call home.
One such farmer is Flora del Scorro Montenegro Blandon. Visiting with her before lunch we ask if she finds it hard to be patient, preparing all year in anticipation for the single event of the harvest. She laughs acknowledging that yes, patience is part of it, but there is just a lot of hard work involved. Very matter of fact. We push her to reveal the secret to her growing award winning coffee. She laughs again and declines us – on two separate occasions. She's not telling.
Pre-lunch we collect in the front yard and gather oranges tossed down to us from her husband, who's shimmied up their orange tree. Green, tough-skinned beauties that are a balance of tart and sweet, their flavour is utterly vivid.
Lunch is graced by fragrant cups of coffee and begins with thick corn tortillas centered with a dollop of homemade cheese. The main course is a large bowl of rustic chicken soup, with shimmering broth, root veggies and moist tender chicken that would've been roaming the yard only hours ago. Dessert is fresh squeezed orange juice – as many tall glasses as you can drink.
When you take a sip of our Nicaraguan coffee, pause for a moment, embrace it with a warmth and zest for life shared by the people whose nurturing made it possible and in doing so honour them, their hands and the land it came from. Each coffee a distinctly unique expression, with a distinctly unique story.


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Or just fire both....
This is a discussion on Just some thoughts about the .357 sig vs .40 S&W within the Defensive Carry Guns forums, part of the Defensive Carry Discussions category; I just figure that the 357sig took out some of the humanity problems we may have seen in some other somewhat 'effective rounds'. Statistics can ...
I just figure that the 357sig took out some of the humanity problems we may have seen in some other somewhat 'effective rounds'. Statistics can become whatever the reporter wants from the subject. A more powerful 9mm came with the 40S&W?....why put a 9mm in a 40S&W case and open a new door for dispute? Bottleneck cartridge feeds better?
Or just fire both....
Ed Brown Alpha Carry | Sig P238, P938, P232, 1911 C3 | Colt Defender, Mustang Pocketlite, 1911 | Rohrbaugh R9 | Browning, Buckmark 22LR(suppressed) | Kahr PM9 Black Rose | S&W|M&P C.O.R.E RMR Trijicon | Dan Wesson ECO
But, I don't think it's ever been shown, much less proven, that the .357 mag is better than a .40 S&W, .357 sig, or 9mm +P for that matter.
I'm too young to be this old!
Getting old isn't good for you!
I'm too young to be this old!
Getting old isn't good for you!
I wasn't saying that the rounds were in the foot etc. I was asking if they were. I would have asked the same question if it was 20 rounds from a 380. I thought the original post was stating that it took 20 .45 rounds to bring him down, not that he simply ended up with 20 in him. I said nothing at all about the 9mm being inefficient. To the contrary, my remark regarding the 9mm was to ask why it is suddenly considered so enemic when just a few years ago it was the golden boy. It just seems like every few years a new 'golden boy" comes along and suddenly yesterdays ammo falls from favor and the consensus is that it was never any good anyway. None of this is to say that the .357 Sig isn't a great cartridge. Only that it's existance does not mean that everything that came before is no longer valid.
Just found out that H&K stopped producing any gun in .357sig. Food for thought maybe.
Retired LEO
H.R.218 Qualified
SA XD45C, XD40sc (SA Combat Trigger Job, XS Big Dot Sights)
The #1 goal of police work is to go home at the end of your shift!
As for the .357 sig, it seems to be powerful. I'm not sure what 'powerful' means, but I've read a lot of findings that indicate there's something to the .357 sig. E.g. the Ammo Lab where the 10mm and .357 sig were the only rounds to crack the plates; a marked difference in the way a .357 sig dispatched a deer(s) compared to a .40 S&W.
But yeah, it does seem like the 'new' round some how nullifies the effectiveness of previous rounds. Although, that's pretty much what happened with the .357 mag when it started replacing the .38 spcl.
I'm too young to be this old!
Getting old isn't good for you!
They did move the USP compact in .357 to special order only. I have one and I love it. I did buy a .40 barrel in case the .357 ever gets hard to find around here.
Glock 36, 30SF, 31, 32, 21 Gen4 - Carry guns
Ruger Mini-14 and Remington 870 by the bed both wearing Surefire lights.
Always carry a knife-they are handy to have
Always carry a reload-You probably won't need it but it is good insurance .
Always carry a light- To see in the dark
My opinion and analogy:
.357Sig = A knockout hit from Mike Tyson in his prime, super fast and powerful.
.45acp = A knockout punch from the older and wiser George Foreman, slow, heavy, and powerful.
Both will knock you down and out cold !!! God Bless
There seems to be only two places that .40S&W round is not good enough
1.)On the internet when compared to a .357sig
2.)On the internet when compared to a .45ACP
Ask all the LEO's and CCer's that have used a .40S&W to save a life. I'm sure it worked then....
This debate on the .357sig is silly.... test all you want. Shot placement wins... and I'll take a hit from a .22cal in the face over a gut shot with a .357sig any day on an attacker.
Accuracy ALWAYS WINS! So carry what you can hit with.
NRA Certified Rifle/Pistol Instructor
Accuracy ALWAYS WINS! So carry what you can hit with.
If you find yourself in a fair fight your tactics stink.
My research lead me to select 40 S&W and that is what I carry. The 357Sig is a little hotter & if you need to shoot into/through cars, walls etc. it penetrates better. However, it has a sharper recoil & is a little harder to get back on target for the second round. .... Always double tap.
I'm a big believer in Muzzle Energy.
Other than the 357SIG - Name me one semiauto handgun caliber that gives you 500 foot pounds of energy from a 4" barrel - and that can be found
at Walmart.
-SIG , it's What's for Dinner-
know your rights!
"If I walk in the woods, I feel much more comfortable carrying a gun. What if you meet a bear in the woods that's going to attack you? You shoot it."
{Bernhard Goetz}
So 357 sig is the caliber of choice for a SD round? I have been thinking of getting one for my next pistol. I have a 40 cal glock now...


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Washington, Jan 21: A high-level American trade mission is set to visit India next month with the aim of increasing bilateral trade focussing on technologies, systems and services in key sectors like security, transportation and power, the US Department of Commerce said on Jan 20.
US Deputy Secretary of Commerce Bruce Andrews would lead the delegation of 18 American companies on a Smart Cities Infrastructure Business Development Mission to India from February 8-12.
With stops in New Delhi, Mumbai and Chennai, Director of the US Trade and Development Agency (USTDA) Lee Zak and Vice President of Global Business Development at the Export-Import Bank Ray Ellis will also participate in the mission.
"The trade mission will help US companies launch or increase their business in India, focusing on technologies, systems and services in the safety and security, intelligent transportation, water, wastewater, and power sectors," the US Department of Commerce said in a statement.
This engagement will drive and enhance the sustainable growth of India's infrastructure sector while making India's growing urban centers more attractive to business and providing a better quality of life for India's citizens, the statement said.
"By joining the global consensus agreed to in Paris last month, India made clear that it will be an important part of the world's solution to a truly global problem," said Andrews.
"US industry stands ready and able to help India make its cities more sustainable - an effort that will greatly benefit India's economic growth and our world's ability to address a changing climate," he said.
The companies part of the trade mission include Alcoa Inc, Aquatech International, Black & Veatch Pvt Ltd, Convalt, Danaher Holding (DHR), Ecolab/NALCO, EI Technologies, MasterCard, Smart Cities Council among others.
As the world's third largest economy in the world in terms of purchasing power parity, India has the second largest population and is projected to add 500 million people to its urban population over the next four decades, the Department of Commerce said.
The Indian government has made infrastructure development a priority, along with a plan to develop 100 smart cities - developed urban areas that would create sustainable economic development and high quality of life through efficient and innovative energy, transportation, digital and social platforms.
To connect these proposed cities with existing air and sea ports, India needs infrastructure upgrades and technologies, it said.


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text:
From Houston Methodist Hospital (Drs Zimmerman and Shen); and Weill Cornell Medical College (Dr Zimmerman), New York, NY.
Correspondence to: Janice L. Zimmerman, MD, FCCP, Houston Methodist Hospital, 6550 Fannin, Ste 1001, Houston, TX 77030; e-mail: email@example.com
Financial/nonfinancial disclosures: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.
We thank Drs A. E. Mirrakhimov and E. M. Mirrakhimov and Drs Nobre and Thomas for their letters in response to our review article on rhabdomyolysis.1 We agree that elevations of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) concentrations can be excellent clues for the astute clinician to recognize the possibility of inapparent rhabdomyolysis and to order additional testing.2 Of note, the AST to ALT ratio > 2:1 usually seen in acute rhabdomyolysis may not be present with more indolent forms of muscle breakdown, such as in inflammatory myositis.3 Unexpected elevations of lactate dehydrogenase concentrations may also be another nonspecific clue suggesting rhabdomyolysis.2
Measurement of cardiac-specific troponins is useful for cardiac injury screening, but as Drs Nobre and Thomas point out, there are still limitations of these biomarkers to diagnose acute coronary syndrome. An early study found that troponin I and troponin T levels may be elevated in patients with rhabdomyolysis.4 Other studies have suggested that troponin T level is more commonly elevated than troponin I in rhabdomyolysis due to several different etiologies.2,5 Interpretation of an elevated troponin concentration in patients with rhabdomyolysis may be difficult because of limitations of the assay itself5 or concomitant risk factors that could predispose to cardiac muscle injury. Further evaluation for acute coronary syndrome in patients with rhabdomyolysis and an elevated troponin concentration is best left to the judgment of the clinician caring for the patient. We strongly agree that exposure to contrast agents for diagnostic testing should be avoided if at all possible in patients with rhabdomyolysis.
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text:
Card system
Customer data
Exec don't understand why, Originally smart card was special, gut feeling is that it is a backward step to go to magnetic or barcode card
Quick fixes, Don't need to change card to centralise, Currently don't use Adcard to identify customer at till
Transition could be an issue, From chip to contactless
£0.5 per card
Also looking at using mobiles for this function
Look to launch with a credit card company so costs can be shared
Cheaper to buy
Don't need smart card for centralisation
Would make step change in value of card scheme
Widen scheme to family membership
Would improve benefit to the wife
Customers don't understand 4 points per £1, but do believe it is more generous than competitors
Should use other customer databases to drive new membership
Need to visit kiosk first to active this now
This team will be "by the book"
Can't be seen to link offers to conditions explicitly
Can be done with clever wording!
E.g. Vouchers on-line v on card, different process (and tech)
Can be done but not straight forward
Has been done as one-off, but not captured as a repeatable process
Top request from customers
Have to pick up points at a kiosk, when spending on-line, As points are physically on the card only, 5-day delay for points update, but used as a control so points issued only when product delivered (also could spend points twice)
However, is this driving increased foot-fall as have to visit store to gather points
Slows tills down
Replacement of card readers twice as high as elsewhere
365k hours wasted per year at till
400m till transactions per annum
Worse still if credit card fails (as process has to be repeated)
No kiosks in ROI stores
Three mailing on joining
Ad card, Parent and Health club communications potentially all at the same time (only if joined these all at the same time)
If points have an age and they are warned, this encourages spending of these points
Only of value cost-wise, in being able to write off value of unspent points
Points liability is a risk
But not linked to till
Need a near real time communication to the store of this data
£0.25 per smart card
£0.08 per magnetic strip card
Replace 750k cards per year, Of 2m new cards
Some customers like the experience of seeing the offers at the kiosk
This the downside of centralisation as kiosks would not be required
Only 5% of Adcard customers use Kiosks
Not profit but sales increase only
Tailor the scheme to customers use
Opportunity: Identifying customer at the till
Targeted offers at POS
Expands redemption opportunities (airmiles or other partners)
Better policing of customers who "use" the system, Web sites that tell you how to do this
Decrease till time (saves staff having to spend time selling clubs)
Potential store staff savings, But store staff cheaper
But DM communications are happening anyway
Selection of customers for clubs is not done via analysis of what they spend
Speed up transaction
Customer expectation
Improves longevity of card readers
Reliability supposed to be better
Business case not good short term, Effectively similar to magnetic card but costs currently 5 times per card
Cost saving on managing staff card
May be issues with staff not wanting company to know some data on their spending e.g. pregnancy tests


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Hiatus Hernia Treatment
Upon Endoscopy I was diagnosed with "Grade II hiatus hernia with prolapsing gastropathy with antral gastritis". I feel ok, except for some heartburn sometime. There were 3 instantces over 1 year period where I had coffee ground color vomit when I did not get enough sleep(~3 hours only). So should I sit in for a surgery for the hernia? Also I want to gain weight(BMI:19.0) and planning to go for gym workout, will that be o.k. or will I worsen the hernia? Please suggest. Thanks in advance.
Answers (1)
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Is the adidas' Futurecraft 4D the future of sneakers? by SneakerNews
Head Porter x adidas NMD Chukka Releases On June 9th
May 27, 2017 BY Sneaker News / 3.62 / 5
Japanese bag and accessories brand Head Porter is teaming up with adidas Originals to bring back one of the more unheralded adidas NMD models – the adidas NMD Chukka. The shoes f...Read More
Preview All 11 adidas NMD Releases For Tomorrow
May 19, 2017 BY Sneaker News / 4.02 / 5
This Saturday, May 20th is yet another unofficial adidas NMD Day as eleven different releases from the NMD lineage are release in stores worldwide. Four adidas NMD R1 Primeknits, four ...Read More
adidas NMD R1 "Sea Crystal"
May 18, 2017 BY Patrick Johnson / 4.59 / 5
The adidas NMD series continues to bring the heat for the Spring/Summer 2017 seasons recent updates ranging from the women's exclusive "White Rose" and "Icey B...Read More
- $259.00 1 bids 3hr 48mins
- $200.00 BUY IT NOW 13hr 26mins
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adidas NMD R2 "Tokyo" Releases This Saturday
May 18, 2017 BY Patrick Johnson / 4.09 / 5
This adidas NMD Tokyo offering could low-key pass as a collaboration with Virgil Abloh's OFF-WHITE imprint given the signature diagonal stripes showcased on the heel and tongue....Read More
The adidas NMD R1 "White Rose" Releases Exclusively for Women In June
May 17, 2017 BY Patrick Johnson / 4.5 / 5
Fresh off the preview of the "Icey Blue" women's exclusive (which is available right now at select retailers by the way) the adidas NMD continues to receive some rat...Read More
adidas NMD R1 "Icey Blue" Releases For Women
May 17, 2017 BY Patrick Johnson / 3.77 / 5
The adidas NMD is back with a brand new women's exclusive colorway that you can get your hands on today for $130 USD. The adidas NMD R1 "Icey Blue" skips out on Prim...Read More
adidas NMD CS2 Releases This Saturday In Three Colorways
May 16, 2017 BY Zack Schlemmer / 4.18 / 5
Since its debut early this year, the adidas City Sock 2 has seen a relatively small amount of releases compared to the other members of the adidas NMD family. But that's about to...Read More
adidas NMD R1 "Gum Pack" Restocks This Saturday
May 15, 2017 BY Patrick Johnson / 4.63 / 5
Who remembers the adidas NMD R1 "Gum Pack" from February? The simple, refined aesthetic of the Primeknit offering paired an all black or all white NMD upper with a classic ...Read More
The adidas NMD R1 Primeknit "Oreo" And "Khaki" Release Next Week
May 13, 2017 BY Sneaker News / 4.38 / 5
The adidas NMD R1 Primeknit in its original form is returning this Saturday, May 20th in two eye-catching colorways. One options brings in the popular Oreo-esque mix of whites and blac...Read More
Spurs Fans Would Love This adidas NMD XR1
May 12, 2017 BY Zack Schlemmer / 4.37 / 5
The San Antonio Spurs just closed out their series against the Rockets to move on to the Western Conference semifinals last night, so now's the perfect time to preview this upcom...Read More
adidas NMD XR1 "Pearl Grey" Is Just For Women
May 12, 2017 BY Zack Schlemmer / 4.56 / 5
The adidas NMD XR1 gets a light and soft look just in time for summer with this upcoming colorway in "Pearl Grey". But sorry fellas, these NMD's are for the ladies on...Read More
Stadium Goods Auctions Pharrell's Friends & Family adidas NMDs For ACLU
May 12, 2017 BY Sneaker News / 3.96 / 5
In a time where human rights awareness and concern is at an all-time high, there couldn't be a better moment for the sneaker world to step up and incite some change. Pharrell...Read More
Detailed Look At The adidas NMD R1 Primeknit "Zebra"
May 12, 2017 BY Zack Schlemmer / 3.98 / 5
Chances are, you missed out on the super-limited "Zebra" colorway of the adidas Yeezy Boost 350 v2 when they dropped earlier this year. While there's no substitute fo...Read More
adidas Is Dropping A Pink NMD R2
May 11, 2017 BY Zack Schlemmer / 4.67 / 5
There's no doubt that the biggest color trend in the sneaker industry right now is pink. Pastel shades of pink are showing up pretty much everywhere this spring and summer, so it...Read More
Preview Upcoming adidas NMD Releases For The Remainder Of 2017
May 11, 2017 BY Patrick Johnson / 3.72 / 5
The adidas NMD series shows no signs of letting up throughout the remaining 7 months in 2017. Today we get a look at 17 upcoming NMD offerings that will release sometime later this yea...Read More


text:
Times of India is India's national newspaper and has the largest circulation among all English-language newspapers in the world. It was simply stellar getting featured on the business page on Wednesday. I sprung out of bed when I read Manish's tweet in the morning and went straight for the papers. Website traffic, signups, emails from potential recruits, and partnership requests starting pouring in all day.
You can read the online version here.


text:
My network scan stop responding after 32% with no error. I've tried canceling and restarting the service and continue to have the same problem when I rescan.
1 Reply
· · ·
Mar 30, 2011 at 3:27 UTC
Perhaps your scan is getting stuck on a particular computer? Did you check the finder_child.log for error messages?
Have you tried running your scan with the scan speed set to slow?


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Your results within of Coldstream, BC
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eavestrough cleaning coldstream bc
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Serving the Okanagan Valley, John's Eavestrough Service is here to provide you with premier gutter cleaning, power washing and minor roof repair services. When you call John's Eavestrough Service, you can always expect honest service for your Coldstream, Vernon, and Kelowna eavestroughs at a fair price. Roof and Gutter Services At John's Eavestrough Service, we can perform minor roof repairs, gutter maintenance services and repairs to aging soffits. If your soffit is sagging due to rot or age, we can help! John's Eavestrough Service has years of experience in completing qualified soffit repairs. Exterior Siding and Window Cleaning Get your home's vinyl or aluminum siding looking like new again with John's precision power wash services! To make your home's transformation complete, we offer professional window washing services throughout the Okanagan Valley. Bird Control Birds can wreak havoc on your roof and attic. We offer humane bird control techniques to prevent further damage caused by nesting and roosting in your eavestroughs in Kelowna or surrounding areas. Ice and Snow Control John's Eavestrough Service also provides ice and snow control services to prevent ice dams and snow loads. If ice or snow buildup is a common occurrence, a de-icing system is a worthy investment to protect your home's roof. Power Washing Is dirt, grime, mildew or moss bringing down your home's curb appeal? With John's Eavestrough Service's precision power washing techniques, that grimy stuff doesn't stand a chance. Specialties General Maintenance Contact us today for more information.
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This page should give you some key essentials learned in the past year that will:
- Help make your SEO content writing rank.
- Avoid your SEO content from getting penalized by major search engines.
- The 1st SEO tip – is to make sure you use your desired keywords more early on within your content, than later. Ideally, you should have your keyword within the first 100 words of your written content. In addition, it isn't absolute necessary to have your keyword the very first word within your content.
- The 2nd SEO tip – is to avoid keyword stuffing! What is keyword stuffing? It can be simply defined as an unethical method regarding SEO ranking desirability, and occurs when the writer intentionally over utilizes his or her keywords either within the content of his page, or in the provided meta tags.
- The 3rd SEO tip – is to take into consideration your use of meta tags. Thus, despite the consequences involved with keyword stuffing, that should not scare you away, in anyway whatsoever, to utilize keywords properly! (Just remember not to over-utilize, and you're set.) Hence, every time you've written a new page or post, you should remember there are 2 aspects involved: #1- the visible on-page copy of content, as you can see here, and the #2-the second is your SEO Title & Description Tags.
- The 4th SEO tip – is to utilize variations of your main targeted keyword in the same post or page of content. Let's take any keyword example: "SEO traffic training tips," and see how we can use this keyword phrase to help you avoid any possibility of keyword stuffing:
- "SEO training traffic"; "Advice on SEO and traffic"; "Tips on SEO traffic."
- Little do most content writers know, this alone will help in doing wonders for much better rankings of your website!
- The 5th SEO tip – deals with the word count number of your content. Ideally it should be at a minimum of 300 word length. In terms of maximum, there really is no upper limit. My only advice here would be to make sure the word count number of your content is enough to keep your reader engaged, and not bore them!
The real point of this page is more so to help other content writers like myself, to not allow the use of keywords and ranking potential, become a compromise to your natural writing style, since there is nothing more important. As long as you follow the advice and tips given above, the more valuable content you begin to write and provide your readers, the higher your ranking will tend to become on its own. As a result you will see, lower bounce rates, more visitors remaining on your website, and reading through your content, as a result of better engagement, which on its own will become as powerful, if not more, to the rankings and overall popularity of your amazing website!
Cheers, and I hope this has been helpful. Thanks for reading!
Make sure to share with all your friends.. After all, sharing is caring :)
Peter G.


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Skaters Plan B Demo with Ryan Sheckler , Chris Joslin , Felipe Gustavo & More
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text: Okay, I've got a problem here. How on earth is it possible, that I have by accident been able to change my startup sound into something horrible? I read a little about changing the startup sound, and it sounded VERY complicated to a simpleton like me, but... In any case, my startup sound is NOT the original one, and I remember changing it in a window of some kind, just for fun. Now I can't find that window anymore, and I'm completely stuck with that horrible, loud sound. Help? Edit// I also tried changing it back to normal with that ResHacker program, but according to it the startup sound is the original, and hasn't been changed at all. Whatta? And I can't even just turn off the startup sound with the checkbox-thing - it has no effect, the awful sound is played anyway when I reboot.


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ED Magedson – Founder
Ripoff Report
North Mississippi Medical Center830 South Gloster st Tupelo, Mississippi United States of America
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This report was posted on Ripoff Report on 01/14/2013 01:06 PM and is a permanent record located here: http://www.ripoffreport.com/reports/north-mississippi-medical-center/tupelo-mississippi-38801/north-mississippi-medical-center-nmmc-poor-patient-care-on-6th-floor-total-lack-of-care-i-996680. The posting time indicated is Arizona local time. Arizona does not observe daylight savings so the post time may be Mountain or Pacific depending on the time of year.
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Pack less. Be more.
@susansLocale: South Central WA
Small or medium will work. Prefer in good shape. I have PayPal. Thanks!
@walkingandyLocale: NE Ohio
but there is a small on ebay right now. If it was a medium I'd be saying I just bought on off of ebay. ;)
@susansLocale: South Central WA
I'm watching that G, I see two here that don't have "sold" marked and am interested in those too. I've emailed one of the owners here but haven't heard back.
@mcdcrookLocale: Southeast
Mine is still for sale – email sent.
@leadfootLocale: Middle Virginia
I have the older G pack with the mesh pocket on the front. Size small, excellent condition. In fact, I think it's what I am using in my avatar
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Olympics means the sporting venues of London are packed with the fittest
women in the world in both senses of the word.
From tennis and track to beach volleyball, the hottest babes in sport are
getting into the Games.
To get into the spirit of the massive competition kicking off later this
month, we bring you the ten hottest competitors set to keep the Olympic
torch burning over the summer.
Leryn Franco
MODEL and Miss Paraguay runner-up, this stunning javelin thrower became an
internet sensation at the Beijing Olympics in 2008 and caused a stir when
she graced the pages of the 2011 Sports Illustrated Swimsuit Edition.
Now 29, the brunette beauty was the South American Junior Championship in 2001
but missed out on a medal at Beijing. She can grace our rostrum any day.
Francesca Piccinini
THE sexy volleyball player has already represented Italy in three Summer
Olympics and has won several gold medals in the World Championships.
She has also posed naked for a calendar for Men's Health and posed for Playboy
The 33-year-old athlete is clearly a Game girl.
Stephanie Rice
SPECTATORS might want to cool off in the pool after watching Australian
swimming sensation Stephanie showcase her skills.
The 24-year-old won three golds at the 2008 Olympics in Beijing and broke
three world records in the process.
And the Brisbane-born beauty is one hell of a water babe.
Jessica Ennis
THE home competition are the first Olympics for British hopeful Jessica.
A former World Champion in the heptathlon, the Sheffield-born stunner chose
not to defend her European title at this year's Helsinki games because she
wanted to concentrate on the Olympics.
And the 26-year-old blonde is on track to bag the gold at London 2012.
Yelena Isinbayeva
RUSSIAN pole vaulter Yelena, 30, took gold medals at the last two Olympics and
is trying for a third this summer.
A former officer in the Russian army, she has a masters degree and is still
studying at a university in Ukraine.
Her looks, brains and athletic achievements have made her a worldwide legend
and when it comes to Russian heroines, golden girl is in pole position.
Victoria Pendleton
AT the last Olympics, sexy cyclist Victoria toook gold for Britain in the
Women's Individual Sprint event.
She also won the heart of team coach Scott Gardner, now her fiancé, but later
admitted she lost the friendship of the rest of the cycling team over the
Now 31, the biking beauty is one of Team GB's biggest hopes for glory.
Ana Ivanovic
WHEN it comes to looks, Serbian tennis No1 Ana has the advantage.
The glamorous brunette only got to the fourth round at Wimbledon this summer
but she is a winner in the beauty stakes on and off court.
The 24-year-old is know for her aggressive play but she looks ace to
Caroline Wozniacki
THE Danish tennis player is a former No1 on the WTA tour and a real smasher.
A sporting all-rounder, she relaxes by playing handball and soccer as well as
going swimming.
The 22-year-old blonde is also a keen Liverpool football supporter and is
currently dating golfer Rory McIlroy.
And she has recently announced her own range of underwear.
Melanie Adams
AUSTRALIAN pole vaulter Melanie will have pulses soaring as she launches
herself over the bar at the 2012 Games.
Competing since the age of 11, the pretty athlete lost out on a chance to
compete in Beijing due to a foot injury.
But she's going for gold in London and will no doubt pole-axe a few
male admirers while she's here.
Misty May-Treanor
WITH the beach volleyball teams threatening to cover up in the cold weather,
Misty's fans will be praying for a heatwave.
The American beauty, 34 married to baseball player Matt Treanor
is a two-time gold medallist and the world's most successful player in the
And she doesn't look bad in a bikini either.


text:
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I've been running for a couple of months now and am still trying to get to grips with when to eat. I was eating a meal a couple of hrs before heading out but this made me, shall we say, need the loo ( Since making this connection i have started eating a lunch then have nothing for 3hrs prior to a run, then eating a meal (sometimes) when i get back in (depending on the time.) All, in all, i guess that there is a better way of dealing with this but not sure what. Was wondering if anyone had any advice please? Thanks
If I run after work, I have lunch at 1-ish then perhaps a banana on the way home and have a meal afterwards.
Weekends, porridge or muesli an hour or two before I go is usually ok.
I try and run on empty regardless of what time of day I run. I used to feel that I had to have something before track sessions with the club. I get a stitch if I've had anything to eat or drink before running.
2-3 hrs should be enough for most people but I like it to be much longer than that. Sometimes it's a matter of finding the right food. i can't drink black tea as it makes me feel really bloated, so does orange juice.
Thanks guys, some real food for thought! (sorry about that lol). Guess i'm gonna have to play about with different foods. Must admit though, ran my first 10k a few weeks back and was so worried i took some anti diarrhea tablets before the race in case i needed to go! Didn't actually have a problem, just didn't want to have to go to the loo half way round! Not sure if anyone else does this!?!


text:
33 Questions 4 Areas Judicial Reviews Checks and Balancing Federalism Individual Rights - Most Important (1/2 Questions)
Constitution, federal law, treaties
ambassadors, public ministers
US a party
between factors
between state and citizen of another state
Case or controversy, real disputes, adverse parties, can be resolved by judicial decree
standing, Third Party, Association, Elements, redressability, Injury in fact, causation
political question
Original Jurisdiction
Appellate Jurisdiction
Must have a source of power to legislate which is either Enumerated powers Enabling clause (13-15) Necessary and Proper Clause (help execute another power)
Powers, Commerce Power, Taxing Power, Spending Power, War and Defense Power, Other Powers
Chief Executive, Enforcement Power, Appointment Power, Removal Power, Veto Power, Pardon Power, Executive Privilege
Commander in Chief, Military Powers
International Affairs, Treaty Power, Executive Agreement
Congressional Limits on the Executive
Presidential Limits on Congress
Judicial Limits on congress/President
Federal Govt cannot be sued Federal law is supreme ove state law
A state is immune from federal taxation of [1] essential government function or [2] Unique State Activities Anti-commandeering Doctrine - 10th amendment - Fed govt cannot force states to [1] pass a law or [2] enforce a law. It is not commandeering to forbid the states from doing something
Dormant Commerce Clause, State Tax - interstate, Market Participant Exception
In conflicts between state and federal laws, federal will win.
Public Function Theory Significant State Involvement theory
STATE ONLY severity of imparement vs government interest Article I, Sec 10 - "No state shall pass any law impairing the obligation of the contracts" EXCEPTION: A private k may be modified by a state legislation under its police power when [1] necessary to serve an important and legit. pub interest AND [2] the regul. is reasonable and narrowly tialored to promote the interest.
not a crime when committed greater punishment decreases the amount of evidence required extends the statute of limitation
Specifically naming someone/gropu
State = 14th Amendment Federal = 5th Amendment
Procedural Protection, Life Liberty or Property, What Process is Due
Substantive Protection - CAMPER, Economic Regulation, Fundamental Rights, Abortion with Undue Burden, Family Relations, Sexual Orientation, Other Rights, Right to Vote
Govt proves Substantially related Important Interst Includes [1] Sex [2] Illegitimacy [3] education for illegal alien children
Strict Scrutiny, Race, State - Alienage, Due Process, Exception - Neutral on Its Face
Intermediat Scrutiny, Illegitimacy, Gender, Illegal Alien Children, Affirmative Action
Rational Basis, Federal - Alienage, Age
14th Amendment
Commity Clause, Article 4
Establishment Clause, Strict Scrutiny or Lemon Test, Religious Activities conducted at public School, Government Aid to School
Free Exercise Clause, Beliefs, Conduct
Permissible Regulation of Speech, Strict Scrutiny, Content Based, View Point Based, Exceptions, Conduct regulation, Govt as Speaker, Unprotected Speech, Rational Basis, Quasi Protected Speech, Commercial Speech, Sexual or Indecent Speech, Time, Place, and Manner
Public Employment
Prior Restraint, Overbreadth, Vagueness, Unfettered Discretion by licensing official
10th = State/City police powers to health safety, morals, and welfare
NOTE: Make sure it is "out of state citizen vs. state" and not "in state citizin vs. state" States cannot discriminate against out of state actors. If - there is an undue burden on interstate commerce then use one of these two tests: [A] facially discrimination -Least Restrictive Means Test - Must [1] serves a compelling interest and [2] no other ways to meet the interest. [B] incidentally burdens -must be balanced Exceptions Congressional Authorization or Market Participation Rule
Due Process
A state may not be sued in federal court by its own citizen or citizen of another state Exceptions: [1] state may be sued by another state [2] Congress may waive states 11st amendment immunity under the enforcment clause if (civil rights violation or fundamental rights violation)
Racial Discrimination
Enabling Clause
States DPC
Right to Vote