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The Effect of Fish Oil Plus Fenofibrate on Triglyceride Levels in People Taking Highly Active Antiretroviral Therapy (HAART)
- Full Text View
- Tabular View
- No Study Results Posted
- Disclaimer
- How to Read a Study Record
|HIV Infections Hypertriglyceridemia
|Drug: Fenofibrate Drug: Fish Oil
|Phase 2
|Study Type:
|Study Design:
|Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
|Official Title:
|A Phase II Trial of the Effect of Combination Therapy With Fish Oil Supplement and Fenofibrate on Triglyceride (TG) Levels in Subjects on Highly Active Antiretroviral Therapy (HAART) Who Are Not Responding to Either Fish Oil or Fenofibrate Alone
|Estimated Enrollment:
|Study Completion Date:
|September 2005
Although highly active antiretroviral therapy (HAART) has decreased the morbidity and mortality caused by HIV infection, its use has been associated with lipid abnormalities, particularly elevations in serum triglycerides. Hypertriglyceridemia is a risk factor in the development of cardiovascular and cerebrovascular disease as well as pancreatitis. Lipid-lowering drugs called fibrates have been part of the recommended treatment for elevated triglycerides, but the response to fibrates is incomplete in a large proportion of people. Fish oil capsules containing large amounts of omega-3 fatty acids have been shown to decrease serum triglycerides. However, fish oil supplements or fibrates alone are often inadequate for treating hypertriglyceridemia in people taking HAART. This study will determine whether the combination of the two therapies will lower serum triglycerides in people on HAART more effectively than either therapy alone.
This study comprises two steps. In Step I, participants will be randomly assigned to receive either fish oil supplements or fenofibrate. Participants will be evaluated for treatment response at Week 8. Those who have responded to their treatment will remain on their original single agent therapy through Week 18. Those who have not responded to treatment at Week 10 will move on to Step 2 and begin combination therapy with both fenofibrate and fish oil until Week 18. All participants will return at Week 22 for a follow-up visit. Except at the Week 10 visit, participants will be expected to fast prior to all study visits. Participants will remain on their individual HAART regimens for the duration of the study.
|Ages Eligible for Study:
|18 Years and older (Adult, Senior)
|Sexes Eligible for Study:
|Accepts Healthy Volunteers:
Inclusion Criteria:
- HIV infected
- Fasting LDL <= 160 mg/dL and fasting serum triglycerides >= 400 mg/dL within 28 days prior to study entry
- Willing and able to adhere to a lipid-lowering diet and exercise program for at least 28 days prior to study start and for the duration of the study
- Treatment with HAART for at least 3 months prior to study entry. Participants must be on stable HAART for at least 4 weeks immediately prior to study entry. Participants who have changed from a protease inhibitor (PI)-based regimen to a non-PI-based regimen in the previous 3 months must be on stable HAART for at least 8 weeks immediately prior to study entry.
- Willingness to remain on current HAART regimen for the duration of the study
- Women of reproductive potential must use an acceptable method of contraception while receiving study drugs and for at least 4 weeks after stopping the study drugs
- Men on testosterone replacement therapy must have been on stable therapy for at least 3 months prior to study entry and must be willing to continue stable therapy for the duration of the study
- Participants on hormone replacement therapy other than testosterone replacement therapy and participants using oral contraceptives must have been on stable therapy for at least 28 days prior to study entry and must be willing to continue stable therapy for the duration of the study
Exclusion Criteria:
- Use of investigational antiretroviral drugs within 28 days prior to study entry. Investigational therapies allowed by the study chairs or given in an AACTG study or expanded access trial are permitted, as long as the treatment can be continued for the duration of this study.
- Coronary heart disease
- Atherosclerotic disease risk
- Congestive heart failure
- Uncontrolled hypertension within 28 days prior to study entry
- Active bleeding disorder or active peptic ulcer disease
- Diabetes mellitus that requires pharmacological, dietary control, or diabetic medication within 28 days prior to study entry
- Untreated hypothyroidism. Participants who are currently being treated for hypothyroidism are not excluded if the treatment was initiated at least 28 days prior to study entry.
- Use of levothyroxine or liothyronine, except for treatment of hypothyroidism, within 90 days prior to study entry.
- Active or symptomatic gallbladder disease within 1 year prior to study entry
- Use of systemic cancer chemotherapy within 60 days prior to study entry
- Cancer within 5 years prior to study entry. Skin cancers not requiring systemic treatment are allowed.
- Pregnancy or breast-feeding
- Use of any lipid-lowering agent within 28 days prior to study entry
- Use of hormonal anabolic therapies within 6 months prior to study entry
- Use of systemic steroids
- Use of immune modulators within 28 days prior to study entry
- Use of anticoagulants within 14 days prior to study entry
- Allergy or sensitivity to study drugs or their formulations
- Active drug or alcohol use or dependence that would interfere with adherence to study requirements
- Decreased mental capacity that would interfere with adherence to study requirements
- Active AIDS-defining opportunistic infection (OI) within 28 days prior to study entry. Participants who have no evidence of active disease and are receiving maintenance therapy for AIDS-related OIs will be eligible.
- Any acute illness within 28 days prior to study entry that would interfere with participation in the study
Please refer to this study by its ClinicalTrials.gov identifier: NCT00076518
|United States, California
|Ucsf Aids Crs
|San Francisco, California, United States, 94110
|United States, Georgia
|The Ponce de Leon Ctr. CRS
|Atlanta, Georgia, United States, 30308
|United States, Ohio
|Univ. of Cincinnati CRS
|Cincinnati, Ohio, United States, 45267-0405
|Case CRS
|Cleveland, Ohio, United States, 44106-5083
|United States, Rhode Island
|The Miriam Hosp. ACTG CRS
|Providence, Rhode Island, United States, 02906
|Study Chair:
|John G. Gerber, MD
|University of Colorado Health Science Center
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
|Responsible Party:
|National Institute of Allergy and Infectious Diseases (NIAID)
|ClinicalTrials.gov Identifier:
|NCT00076518 History of Changes
|Other Study ID Numbers:
10686 ( Registry Identifier: DAIDS ES )
|Study First Received:
|January 26, 2004
|Last Updated:
|May 17, 2012
Keywords provided by National Institute of Allergy and Infectious Diseases (NIAID):
Treatment Experienced
Additional relevant MeSH terms:
HIV Infections
Lentivirus Infections
Retroviridae Infections
RNA Virus Infections
Virus Diseases
Sexually Transmitted Diseases, Viral
Sexually Transmitted Diseases
Immunologic Deficiency Syndromes
Immune System Diseases
Lipid Metabolism Disorders
Metabolic Diseases
Hypolipidemic Agents
Molecular Mechanisms of Pharmacological Action
Lipid Regulating Agents
ClinicalTrials.gov processed this record on September 21, 2017


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Good call Terez. It of course makes the interview quote you provided at least partially relevant to the discussion.
Interview: Nov 14th, 1998
TPOD Signing Report - Matthew Hunter (Paraphrased)
Someone asked how he chose the cover artist, and we got a nice long spiel with some previously unknown information. Jordan and his wife went through bookstores picking out books based on their (if they liked it) cover art and finding out who did the cover. It came down to two artists, Darrell K. Sweet and Michael Whelan. The deciding factor was that Whelan wants the manuscript to read for a year before he will deliver a cover, and they just couldn't wait that long.
They are apparently considering a later reissue of the entire series with different covers, perhaps by Whelan, once it is complete.

subset: commoncrawl


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The Key to Making Money in the Market
After Monday's selloff, I found all the chatter on social media about the coming end of days amusing. With the market barely 2% off the recent highs, there was talk of a huge pullback in stocks and preparations for a potential crash-type move. It was, after all, the worst day in the market in three whole months. While people were tweeting and blogging about how hard they were looking at charts and keeping track of Asian indices, I was enjoying a nice glass of wine and a book and ignoring the overnight stock markets. I suspect some felt insulted that I disparaged those who were charting stocks at 11 p.m. on a Monday night.
But I am not naïve. Problems in Italy could certainly cause trouble for global stock markets. While the actual sequestration cuts in the U.S. are not that bad ($85 billion is about a week of spending in the $6 trillion budget and the equivalent of what is spent monthly to buy mortgage bonds), the lack of political will to prevent it is troubling. I wrote on Monday about how the economy is still in a state of "better but not good." Consumers are scared, job growth is anemic and a lot can go wrong in the stock market....591 more words left in this article. To read them, just click below and try Real Money FREE for 14 days.
There's no substitute for a trading floor to get great ideas, so Jim Cramer created a better one at Real Money and blogs there exclusively. We then added legendary hedge fund manager, Doug Kass, with his exclusive Daily Diary and best investing ideas. Staffed with more than 4 dozen investing pros, money managers, journalists and analysts, Real Money Pro gives you a flood of opinions, analysis and actionable trading advice found nowhere else, and allows you to interact directly with each expert.
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How much time do we really spend on choosing the best shampoo for our hair? Apparently not much at all based on this funny graph I found on Facebook. And, for good reason! I mean, how interested are we really about getting the right shine, bounce, or texture for our hair? Usually … [Read more...]
You are here: Home / Archives for thickening shampoos


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In a house without an efficient heating system, a cup of hot coffee cannot suffice warming people using laptops or computers when hands and feet go numb from the cold. Meeting the need for warmth, USB gadgets capture the hearts of computer (or any device with a USB port) users quickly.
Characterized by unbeatable prices, convenient technical support (any powered device with a USB port is ok), fashionable designs and excellent workmanship, USB warming gadgets are heating up the electronic market. Usually the USB warming gadgets can reach up to 53 degrees Celsius (℃), which can warm the user without scalding him/her.
As the saying goes, cold rises from the feet, so people attach great importance on keeping their feet warm. With cozy designs, gentle wools, and separate USB warmers, a pair of warming slippers rank top on the list of warming gadgets loved by electronics fans alike. These shoes are a great idea especially for ladies who are vulnerable to the cold and the allure of browsing, chatting and shopping on the internet. Read More


text: Lauren Conrad is a California blonde through and through — except this weekend, when she tried out a short brunette bob created by star hairstylist Ken Paves while shooting in Los Angeles. Conrad took to her Twitter page to tell fans about the experience, twittering "Just finished our shoot. I got to wear a brown wig all day. It fun… Kinda like playing dress up." The star struck poses outside the Marc Jacobs store in West Hollywood for Harper's Bazaar looking a bit more Posh than her normal self. As sophisticated as Lauren looks as a brunette, we have to say that we prefer her with her normal long blonde locks. Tell us: What do you think of Lauren as a brunette? Should she dye her hair for real?


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Soil Temperature and Moisture Model (
Java program to simulate soil temperature and moisture conditions
Purpose: The
1. A general soil characterization (soil texture and organic matter content)
2. Daily weather information limited to maximum and minimum air temperatures with daily precipitation.
There is a help file that describes the program included in the file list below (
Disclaimer . Disclaimer. Disclaimer
The USDA-ARS makes no warranties as to the merchantability or fitness of


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found a new home!
Plenty of my friends are looking
for one too. Find a pet to adopt.
I am already spayed, up to date with shots, good with kids, and good with cats.
All of ours cats have been Feline leukemia and feline aids tested negative, spayed or neutered, vaccinated with FVRCP and FELV, rabies vaccinated, dewormed and microchipped. Tabitha has an adoption fee of $75.
The first step to adopting any feline is to fill out an application at http://acadianaanimalaid.org/adopt/cat-adoption/application/
Tabitha, a Carencro Domestic Shorthair kitten was adopted! Here's how you can benefit by looking at adoption as an option to buying a Domestic Shorthair for sale in Carencro, or seeking a Domestic Shorthair kitten from a breeder in Carencro.


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Moderators: Timko, Fritz, Solty, Booter, Blake_T, Frank Delicious
Dogma wrote:Sorry about the leg. Sounds like you were doing something wrong. Somehow jamming your leg instead of pivoting. On the positive side, once you're healed if you can figure out what caused it you may have even more distance. BTW, thats impresive LH distance. File this post under unhelpful but supportive.
Marauder wrote:I googled the symptoms of the pain I'm getting in my upper front ankle and shins on my plant foot (RHBH) and found this forum topic and another one from this site. I really didn't start noticing the sharp pains until I really started to work on my jump putting. All the shifted weight landing on that sore shin probably isn't helping.
On the other forum post ( viewtopic.php?f=17&t=19257 ), they said the pain is rooted from too much friction from the foot to the tee pad.
I'm personally going to take a week off and let it heal. Then go back to the basics.
aDave wrote:Having this issue today after getting new shoes. I got some nice boots with aggressive soles for the muddier stuff that I play in. It may have been a mistake! Don't know if it's a fracture but it's definitely from
not pivoting correctly. I had this same injury early this summer when using running shoes. I switched to flat soled "casual" shoes with less traction and it went away. Oh well back to the drawing board.
It would help if I wasn't a fatass.
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I know this might be an odd sort of question and I am also not quite sure what forum to put it under. I put it under this one because I am still fairly new and I haven't studied too much of the texts yet so I thought it might fit.
Is spiritual progress possible in the lower realms (animal, hungry ghosts, etc)? By this I mean specifically progress down the path to nibbana with it being continued in later lifes or possibly (I don't know) achieving the goal in that life. I know that it is possible in higher realms as Buddha taught gods the path but wasn't sure about whether beings in the lower realms possesed the power to follow it or if they would just have to wait until they got reborn into a higher state.
Again I am not sure if this is the currect sub-forum or if this was known at all.


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^_^ _()_
I am a Asian guy and I want to be ordained in a theravada monestery.
My english is mediocre, so please excuse this poor writing.
I have definately chose a meditation method which is the Anapanasati in the system of Ven. Buddhadasa.
So perhaps it would be ideal if I could be ordained in the Wat Suan Mokkh which doesn't receive foreigners.
Does anyone know his successor who could eventually become my teacher?
I don't mind in which country he resides, though I prefer a monastery in forest for my ordination and monk life.


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Safety, Reliability, Efficiency Anchor Honeywell Vision
Honeywell Talks About Its Ongoing Commitment to Life-Cycle Preservation and Low Total Cost of Ownership at the User Conference 2008
Jason Urso, Honeywell Process Solutions vice president for technology, displayed an entirely new alter ego, Super Urso—complete with cape and x-ray vision goggles—as he guided the Honeywell User Group 2008 crowd through a swooping and soaring vision of the technology roadmap Honeywell is following.
"The three pillars of the Honeywell vision are safety, reliability and efficiency. These are the pillars of operational excellence," Urso said. "And the first of these is process safety."
"We have a history of capturing new operational benefits while preserving intellectual property." Honeywell's ongoing commitment to life-cycle preservation and low total cost of ownership were highlights of Jason Urso's wide-ranging tour of the company's technology roadmap.
The next pillar is reliability, and Urso showed a feedback loop: "Design the process right, improve life-cycle maintenance, improve operational efficiency, design the process right…"
The last of these three pillars, Urso explained, is efficiency. To Honeywell, this means supply chain optimization, improving process efficiency, improving people efficiency and best practices. But how to do this? Honeywell's answer is "I-MAC" or "integrated Main Automation Contractor." By acting as the I-MAC, Honeywell believes it can deliver operational and business readiness on day one in three dimensions. The PKS process knowledge system provides a best-in-class platform, while Honeywell's 8,000 people in over 90 countries provide the significant global people presence necessary. And Honeywell's abilities in work process allow it to capture and re-use best practices.
The Grand Tour
From there, Super Urso leapt into the grand tour. Experion PKS, he said, "provides best-in-class platforms and applications with operations integration to optimize your business, not just your process."
Experion PKS is the most modern DCS and is designed for continuous evolution, he said. It is designed to integrate all modern field networks including Foundation fieldbus, HART, Modbus, Profibus, DeviceNet, ControlNet and Honeywell's own DE protocol. "And, importantly, Experion was designed to be secure from the ground up," Urso said.
So Urso introduced Experion R310, the latest release of Experion PKS. The latest goodies include complete integration of Safety Manager R131, communications directly to C300 over fault-tolerant Ethernet and overseen by a single HMI—yet without the common-cause failure mode common to most integrated safety systems.
"R310 Batch Manager is a new era in tight integration of batch control in the control system. Batch Manager now runs in the C300 controller directly. This allows a faster batch with 80% reduction in phase translation time, higher reliability with a redundant controller and ease-of-use with common tools and HMI," Urso said.
Then there's the Peer Control Data Interface which allows a C300 to use Modbus to communicate with any Modbus TCP device over fault-tolerant Ethernet.
"R310 has more new capabilities," Urso said, "like SimC300, which allows you to simulate your control strategies before you have your devices installed. Other new features include DISOE, permitting 1-millisecond sequence-of-events recording, alarm shelving and lower latency function blocks, and Wood Group-based turbine controls designed for the power industry.
"And then there's wireless." Specifically, Release R110 of OneWireless. "R110 is now standards-ready," Urso said. "When SP100 is ratified, all we will need to do is to give you a software upgrade, and you will have ISA 100.11a-compliant wireless."
The next release of Experion will be in 2010, and will include support for Windows Vista and Windows Server 2008, as well as Batch Manager extensions and some other nifty features.
Safety Manager R131
The next new product Urso detailed was Safety Manager R131. This is the safety system that is integrated with the Experion HMI, using C300 communication and including an update to a higher performance processor. "The most important update," Urso said, "is the SIS tools and the PVST partial-stroke valve testing tools—and the certified experts to help you increase your layers of safety protection."
Honeywell Process Solutions is partnering with Honeywell Life Safety to offer integrated fire-and-gas detection, a unique feature to Experion PKS. Honeywell Life Safety provides a full portfolio of sensors for flame and smoke, toxic gas, camera systems, sounders and beacons, all functioning through a single Experion human interface. In yet another layer of protection, Honeywell is partnering with other divisions to provide video surveillance, radar surveillance, access control and intrusion detection, all through a single common user interface, the Experion HMI.
The current release of Safety Manager supports HART and SafeNet SIL4. In future releases, remote I/O will be added, as will Foundation fieldbus SIS.
Moving higher in the supply chain, Urso turned to PHD, Honeywell's process historian. "We're introducing Uniformance Process Studio," he announced, "with an entirely new engineering environment for the enterprise PHD historian. It is brand new, completely refreshed, web-based, with a drag-and-drop environment, and permits re-use of Experion graphics to run histories."
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What do you recommend? I'm also doing a tummy tuck and lipo as I've lost 65 lbs within the last yr through lifestyle change and walking/exercising.I am contemplating IF I need to go bigger? or w/the lift and tummy tuck I'll look proportioned and still voluptuous? I want my high profiles back to where they were 8 yrs ago :L
I'm 5'4" 150lbs Medium (pear Shaped Frame.I'm on 3rd BA & Possible Lift Exchange.Currently 510cc's in Left 550cc's in my Right?
Doctor Answers 1
Best Breast Operation for Me?
Thank you for the question. Despite good intentions, online consultants will not be able to provide you with meaningful specific advice. Ultimately, in person consultation with well experienced board-certified plastic surgeons will be necessary. Careful measurements, dimensional planning, and careful communication will be key.
Generally speaking, the best online advice I can give to ladies who are considering revisionary breast augmentation surgery ( regarding breast implant size/profile selection) is:
1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you're looking for. Ask to see lots of examples of his/her work.
2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals. In my practice, the use of photographs of "goal" pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as " voluptuous", "natural" or "C or D cup" etc means different things to different people and therefore prove unhelpful. Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate.
3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery.
him focuses
I hope this (and the attached link) help.
Learn more: http://www.poustiplasticsurgery.com/Procedures/procedure_revisionarybreastsurgery.htm
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.


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Have always admired these stitches and thought they were totally out of my reach. QA has featured quilt artist Ana Buzzalino and her work and clear tips encouraged me to give it a try.
My first approach at free motion quilting. This is after 2 days non stop practicing. Its been a bit of a challenge but have to admit I've enjoyed learning this.


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The Greater Chiefland Area Chamber of Commerce sponsored a ribbon cutting for The Law Office of Kenton Whitmer. The practice is located at 117 N.E. 1st Street.
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text: Last Friday the newspaper Vedomosti reported that a Russian firm, NGI, has purchased a controlling interest in Mandriva. The Quintura blog published a short English language summary of the article today. NGI had previously purchased a 5% stake in Mandriva in July for an undisclosed sum as part of the €3 million financial rescue of the company according to the Vedomosti article. NGI and Ceychas Fund are investing an additional €2 million to acquire controlling interest, including purchasing shares currently held by two other investors.


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Fermer [x]
PO2880VProduct Description
2880VThe new Flex sidesFor this feature, the hinge is not sunk into the side but screwed in, polished and then galvanized. Unlike other Persol models, the new Flex sides have flexibility in the hinge and the Meflecto is simply for continuity of style.Squared linesThe production of these models differs specifically in the smoothing of the acetate because the corners are kept more visible and less rounded.
Autres Couleurs
La Qualité
Le Meflecto
Le Lenses
Le Confort
La Flèche


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Jon Walsh
Jon has been putting up new climbs in Canada and abroad, for the better part of the last decade. An insatiable appetite for exploring steep mountains, with either skis, rock shoes or crampons on, has helped him accumulate dozens of first ascents and wild adventures in many corners of the globe. He always pursues alpine style, light and fast free climbing, the steeper and more technical the better. Besides "big game" hunting in hills, he enjoys margaritas, fine scotch, living in the moment, living close to the edge, and laughing with his friends who know him as Jonny Red - often abbreviated to JR. When not in the alpine, Jon finds that training outdoors on skis, mountain-bikes, rock climbs, frozen waterfalls or anything fun is obligatory, as many days a week as possible, and even bad conditions can be surprisingly enjoyable, i.e. "It doesn't have to be fun to be fun." Attitude is everything.
Jon has lived in several B.C. mountains towns since 1992, but has called Golden home since 1999. His three favorite ranges are at his doorstep: the Rockies, the Purcells, and the Selkirks, and he makes a living mainly as a finish carpenter and part time photographer. "There's so much to do here locally in the mountains, that there's really no need to get on airplane. However, foreign travel has taught me so much about the potential that exists in my "backyard", and enabled me to see lines and conceive ideas that might have otherwise been missed."
In the past twelve years, Jon has travelled extensively in pursuit of alpinism including five trips to Chamonix, three to Alaska, three to Patagonia, two to the Himalayas, and one to Baffin Island. Some of his most memorable and highly recommended alpine climbs include: The north face of Mt. Alberta (Rockies); Dirty Love on Mt. Wilson (Rockies); The Wild Thing on Mt. Chephren (Rockies) The East Face of Mt. Asgard (Baffin Island); Sendero Norte (Bugaboos); and Cerro Fitz Roy by either the Cassarotto Pillar or the Canadian Route (Patagonia). Favorite rock climbing ares include: Ceuse, France; Rodellar, Spain; Taghia Gorge, Morocco; Yosemite Valley, California; and The Bugaboos which remain the favorite "backyard" zone to session in. He looks forward to many more trips and expeditions in the near future.
Check out Jon's blog at www.alpinestyle.ca.


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Lead the way: 7 steps to boost acceptance of your medical recommendations
Part of that defensiveness stems from the unspoken and unpleasant connotations that veterinarians associate with pet owners and the word compliance: "I told you what to do. You chose to ignore me, and now look where we are. I guess you don't care what's best for your pet."
In their book Skills for Communicating with Patients, the authors, Jonathan Silverman, Suzanne Kurtz, and Juliet Draper, present alternatives to the unfriendly terms compliance and noncompliance and introduce instead the terms concordance, implying understanding and agreement, and adherence, implying consistent follow-through. I suggest that veterinarians adopt these terms in their thinking and professional dialogues about their recommendations to clients and their clients' abilities to follow through.Nevertheless, whether we call it compliance or concordance and adherence, all of us, veterinarians and pet owners, need to realize that we have a virtually identical concern: doing what is best for pets to the best of our ability. And we must do this in a time of economic difficulty and fragmentation wherein veterinary care, services, and products are available from a number of competing sources such as low-cost, not-for-profit, mobile, and emergency care clinics; human or online pharmacies; and pet stores and big-box and online retailers.
To veterinarians, it often seems as if we are giving recommendations or prescribing treatments that would benefit pets—but "the clients just don't listen." Unfortunately, pet owners often feel as if they are given confusing and sometimes conflicting recommendations and are left asking themselves, "What am I supposed to do?" The vital step veterinarians often skip is communication, which is different from simply talking or giving pedantic directions.
I have often caught myself saying, "I care about your pet as much as you do," because I believe that most pet owners who seek veterinary services care deeply. However, pet owners often do not understand the issues at hand, and frequently their ability to provide care is affectd by concerns veterinarians are not aware of. I have come to realize I should have been saying, "I care as much as I think you care." Veterinarians frequently make judgments about clients' commitments without knowing what factors may be behind their decisions. At the same time, we may not always convey the reasoning behind our recommendations.
Most failure by pet owners to follow veterinary recommendations is not willful defiance or even indifference. Failure occurs as a result of a lack of clarity from veterinarians, a lack of understanding by clients, and a lack of joint commitment to achieving the best healthcare outcome.
So what is the solution?
The first step toward concordance is forming a consensus recommendation and having all doctors and staff members repeat that recommendation regularly. Frequently, the doctors in a practice have not agreed on wellness care recommendations, and the technicians may ultimately deliver discordant messages about pet healthcare. The greatest barrier to client acceptance of a recommendation is the confusion brought about by inconsistent recommendations. We cannot expect clients to understand and accept inconsistent recommendations.
Some practices I have visited routinely stock all available parasite preventives, all available nonsteroidal anti-inflammatory products, and three or four virtually identical antibiotics. Why? Because stocking inventory is easier than reaching a consensus recommendation.
If a client requests a particular parasite control product, it is either because he or she been guided by an advertisement or because we introduced a new product that we believe is superior but we did not take the time to convert the client. Pet owners generally won't recognize that chemical compositions are often very similar or even identical. The product they request may very well be identical to the one we dispense. We just need to explain it to them.
Tell your clients why you support certain products. Brand recognition is important, but not as important as professional advocacy. The positive influence of professional advocacy on consumer purchasing decisions is why advertisements make statements such as "this product is preferred by nine out of 10 dentists."


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Hi. I'm Chris.
I was diagnosed with type 1 diabetes in October 2002. You can read more about that here. This blog started in 2009 as a way to share, and mostly vent my frustrations with, my life with diabetes. Over the years it has expanded into a daily chronicling of whatever is going on in my life. For the most part that has been my life with diabetes – there's a post tag for that. But there's more to me than my diabetes, like life with my lovely wife and these two cats, so for everything else, there's a post category for that.
Over the years my creative efforts have expanded in a variety of directions. Including, a weekly podcast that I host and produce called "Just Talking" that features the stories and experiences of a different guest each week. The goal is a casual yet informative conversation that anyone can approach which you can find at justtalkingpodcast.com.
Additionally, I'm building a platform that encourages the sharing of thoughts, feelings, and experiences about the impact of chronic diseases and illness through the safety of anonymity called My Disease Secret. This platform includes a number of community-specific sites reaching different patient communities.
There will also be posts and tidbits from my other social media outlets. You can find them all here, if you're really that curious. I do what I can to keep those audiences segmented unless there's something major that merits cross-posting.
I'm still trying to find and define my voice as a patient advocate, both through this blog and in person at conferences like Stanford's Medicine X. I'm not an authority on any one particular matter, but when I have strong feelings about a particular topic or advocacy effort, you'll certainly know it.
At the end of the day, I believe in storytelling. I believe that the stories we, the diabetes community, share strengthen our community and improve our capacity for greatness by an exponential margin. I believe that every story is worth telling, no matter how ordinary it appears to be on the surface. I believe all of "this" is best served to help remind others that they aren't alone with their diabetes, their cancer, their rheumatoid arthritis, or whatever else you may be dealing with. I believe that every patient community has something to teach, and something to learn.
Right now I have a lot to learn, and if I'm lucky a few things I can help teach in the process.
At this point in the game, this blog exists because I want to connect with other people with diabetes, share and promote stories of patient advocacy, and naturally post pictures of my cats. Welcome to my madness.
This is a personal blog – funded wholly by me, myself, and I. The views expressed here are mine alone and do not necessarily reflect the views of my employer.
Further, I am not a doctor. If you have any questions regarding details or treatment of diabetes or any other medical condition, please talk to a professional.
If you're reading this, I'm going to assume you personally know me, you are living with diabetes, or someone you love has diabetes. If you came here looking for actual consequences or symptoms of hypoglycemia, 1. I apologize for capitalizing on a little Search Engine Optimization and B. I'll refer you to the American Diabetes Association on that one.
Last Updated: 6 January 2016


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Mining and exploration companies are swarming the upper Great Lakes, especially Michigan's Upper Peninsula, northern Wisconsin and the arrowhead region of northern Minnesota.
Lake Superior is in the bull's eye. Mining companies are seeking -- and finding -- deposits of minerals including copper, nickel, gold and other metals. This mining rush must be checked to protect Lake Superior and it's tributaries. In addition to state agencies, the U.S. Environmental Protection Agency must step-up its oversight and protect the Great Lakes from the exceptional risks of sulfide mining.
The threat of sulfide mining looms across the Upper Peninsula's backwoods. The proposed Copperwood Mine beside the Porcupine State Park plans to leave a huge mine waste tailings pond just feet away from Lake Superior and its tributaries, yet the Michigan Department of Environmental Quality has issued preliminary approval. HudBay's Back Forty project on the Menominee River is expected to submit applications any day. Rio Tinto has started constructing its Eagle Mine in the Upper Peninsula of Michigan where it will seriously harm wildlife and natural areas in the Great Lakes basin.
Watch our award-winning documentary film, "Mining Madness, Water Wars: Great Lakes in the Balance" to see the story of people and wildlife in the Lake Superior basin under threat from the Rio Tinto mine.
The Eagle Mine was the first test of new Michigan laws governing sulfide mining, and so far, the State of Michigan has failed.
Despite voluminous expert testimony stating the danger of the sulfide mine to people, wildlife and natural areas, the Michigan Department of Environmental Quality and the Michigan Department of Natural Resources issued Kennecott Eagle Minerals permits in 2007 to perform sulfide mining on the public lands National Wildlife Federation and its partners now await a decision from the Michigan Court of Appeals where they have sought leave to appeal.
In Wisconsin, the closed Flambeau Mine site is causing contamination in a stream and intense industry pressure there is prompting efforts at weakening the state's mining laws. In Minnesota, several mines are on the drawing board with one huge open pit mine, the NorthMet Mine, having proceeded through a significant portion of the permitting process. Like Wisconsin, the mining industry in Minnesota is lobbying continually for more industry-friendly laws.
The history of sulfide mining is rife with contamination, Harmful acid mine drainage is an inescapable byproduct of sulfide mining and results in miles of decimated streams and rivers. The Great Lakes region must carefully protect its most precious resource, fresh water. We hope you will join and support our efforts.
Metalic Sulfide Mining: A Threat to Coaster Brook Trout
Acid Mine Drainage: A Threat to Michigan's Water Quality
Metalic Sulfide Mining: Impacts on Michigan's Wildlife
Mining Madness, Water Wars: Great Lakes in the Balance Documentary Film
Why we need to act swiftly to protect our fishing heritage: Check out NWF's report, Swimming Upstream: Freshwater Fish in a Warming World >>


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This star rating is the opinion of the property owner only. A Self-Rated hotel has not been assessed by the AA or Visit Britain, whose official star ratings we use across LateRooms.com.
Varley House4 Self rated
13 Chambercombe Park Terrace, ,, Ilfracombe, EX34 9QW
Price FromView Rooms
- Excellent
- 1 guest reviews
"Such a lovely place to stay. Rod and Helen were lovely, nothing was too much trouble...."
About the hotel
Welcome to Varley House, a 4* Guest House, delightfully situated overlooking a nature reserve and the spectacular North Devon coast of Ilfracombe. Varley House was built at the turn of the 19th Century to revitalise and refresh officers returning from the Boer War. The elegance of its generously proportioned rooms and stylish furnishings are typical of the gracious age in which it was built.
We have our own car park and sunny garden and are situated opposite Hillsborough Nature Reserve, which overlooks the harbour, where you can now visit Damien Hirst's Statue "Verity" itself a short stroll away. There are plenty of attractive and exciting things to see and do locally. Varley House is perfectly complemented by the quality, courtesy and warmth of the hospitality you will enjoy here from the moment you arrive, whether you are planning a really active few days or a restful break. Varley House offers you a unique, friendly atmosphere and the soothing surroundings essential for a relaxing holiday. All of our rooms are en-suite except for the single, which has its own private bathroom. Wireless internet access is now available. Please note that we are a no-smoking property. Check-in time: 15:00 and Check-out time 10. 00. Family rooms are based upon children under 14 years of age. Save 10% on weekly bookings. We offer a 3 NIGHT BREAK from the 1st October to the 31st May for £90. 00 per person (excluding bank holiday weeks. ) Many attractions can be found nearby including Museum, Gallery, Aquarium, Hele Corn Mill, Chambercombe Manor, Cinemas and Theatre offering a wide choice of entertainment throughout the year. NORTH DEVON & EXMOOR WALKING FESTIVAL. The North Devon and Exmoor Walking Festival has a good choice of guided walks on offer. The walks range from about 4 miles to 10 miles long, taking in our beautiful coast.
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- Between 15:00 and 22:00
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- Up to 14 years old
- The price shown is based on the occupancy and dates you have searched for. Prices and availability are subject to change based on the arrival date, number of nights and occupancy searched for. All prices are inclusive of all local taxes.
- Pets are not allowed
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Such a lovely place to stay.
Rod and Helen were lovely, nothing was too much trouble....
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Who Do You Call When Safety Can't Wait?
In life there are things that just can't wait. And if we wait… accidents happen. However, when it comes to workplace safety, things are often put off for one reason or another, and sometimes accidents happen. But are they really accidents if we can prevent them? In reality, safety can't wait; although, we have control over …Read More


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Christmas Comes Early for Income Investors
The market continued to sink post-election on Thursday as confidence wanes that both sides can come to agreement quickly to deal with the fiscal cliff. Stocks that had huge run-ups in the past year and high-dividend stocks have led the decline as investors sell to avoid higher capital gains and dividend taxes in 2013. Investors are justifiably rattled, as the market's fate seems to be in the hands of politicians.
But this pull back provides opportunities. I particularly like the position of income investors who were prudent or fortunate enough to keep plenty of cash on hand. Many high quality income plays are selling 10%, 15% or even 20% lower than they were two weeks ago. For yield players, it is as if Christmas came early. This is especially true if you hold income investments in tax-deferred vehicles since the higher dividend taxes on the way are not relevant....293 more words left in this article. To read them, just click below and try Real Money FREE for 14 days.
There's no substitute for a trading floor to get great ideas, so Jim Cramer created a better one at Real Money and blogs there exclusively. We then added legendary hedge fund manager, Doug Kass, with his exclusive Daily Diary and best investing ideas. Staffed with more than 4 dozen investing pros, money managers, journalists and analysts, Real Money Pro gives you a flood of opinions, analysis and actionable trading advice found nowhere else, and allows you to interact directly with each expert.
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text: As TeeJay will no doubt point out, other nations are not in compliance with UN resolutions or UN Security Council resolutions. Israel comes to mind, yet there's no US intervention on the scale that we have seen in Iraq. And let's not forget about the politics going on inside the UN -- the resolut


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LifeSouth and the Chiefland community invite you to be a part
of saving lives when they team up to host a blood drive at Walmart on Friday and Saturday between the hours of 9 a.m. and 5 p.m.
Or, you can choose to donate at the LifeSouth Donor Center on Friday from 9 a.m. to 5:30 p.m. or Saturday between the hours of 9 a.m. and 2 p.m. The donor center is located across the U.S. Highway 19 from Walmart in the Winn-Dixie Shopping Center, 2201 N. Young Boulevard.
A free fishing clinic for ages 6 to 16 will take place July 11, 12, 13, 19, 20 and 21 at the George Kirkpatrick Marine Lab in Cedar Key from 9 a.m. to 2 p.m.
Participants will learn about angling techniques, fish identification, catch and release techniques and habitat identification. Participants completing the clinic will also get a free rod and reel combo and tackle box courtesy of Fish Florida.
The Williston Public Library will have a South Beach Diet Weight-Loss Program at 6 p.m. on Tuesday, June 21.
The first 30 people to arrive at the program will receive a free South Beach Diet book. Join in on the great tips, proven tricks and taste delicious diet food. Participants also will receive the support they need to make healthy changes in their diet and lifestyle.
For more information, call your local library or the Levy County Public Library System at 352-486-5552.
Cross Brand Cowboy will be starting its 3rd Annual Kids Ranch Rodeo Series on Saturday. This is a four-month series which you are able to come to one of them or all.
Jamerson-Sheffield Post 91 meeting
The Jamerson-Sheffield Post 91 of the American Legion has its June meeting. It will begin with the E-Board meeting at 5 p.m., followed by dinner at 5:30. All members, both the Legionnaires and Auxiliary members, are encouraged to attend. The auxiliary needs to elect new officers, but its members need to be there to participate. The post is located next to the FFA Arena on U.S. Highway 129 between Trenton and Bell.
Ombudsman program needs volunteers
Vacation Bible School at Parsons Presbyterian
Withlacoochee Area Residents Inc. is sponsoring a series of Florida folk artist concerts in Yankeetown, Dunnellon and Crystal River to support efforts to protect and preserve the Nature Coast.
The 2011 Summer Reading Program by the Levy County Public Library System will help readers travel the globe this summer,
Through Sunday
The Santa Fe College Teaching Zoo is hosting a celebration of the world's oceans for the entire family from 9 a.m. to 2 p.m. on Saturday and Sunday. There will be activities for both kids and adults, including crafts and fun, informative sessions about the oceans and Florida-specific animals such as the manatee.
Learn about sustainable seafood and ways to protect and preserve the world's oceans. This year's theme is based on the Dr. Seuss book, "One Fish Two Fish Red Fish Blue Fish," and there will be colorful illustrations throughout the zoo.
Copyright © 2017
The Chiefland Citizen is your source for local news, sports, events, and information in Levy County and Chiefland Florida, and the surrounding area.


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It's an undeniable fact: the way we're currently dealing with our waste (both human and animal) is not sustainable in the long term. Consider the following:
- Each of the U.S.'s estimated 100 million cattle produce an average of 27 pounds of manure per day = 2.7 billion pounds of manure PER DAY = over 985 billion pounds of manure per year.
- Each pig produces an average of 8 pounds of manure per day. With an estimated 70 million pigs, American farmers deal with over half a billion pounds of pig manure per year.
- The nation's 68 million pet dogs and 73 million pet cats produce an average of 100 pounds and 50 pounds of waste per animal, per year, respectively.
- Americans flush away an average of 60 billion gallons of toilet waste per year.
That's a whole lot of waste, and it's not even counting waste from other animals such as goats, sheep, horses, or chickens. The way we are handling it: overwhelming our sewage systems, sequestering animal wastes in "manure lagoons," and throwing cat and dog waste in the garbage — none of it is sustainable. The odor and methane from improperly handled livestock waste is harmful to those who have to live nearby, and to the environment as a whole. Our landfills are full of plastic bags of dog and cat waste, producing yet more methane. And all of that flushing takes an obvious toll on our fresh water ecosystems as well.
There has to be a better way. Farmer, author, and manure advocate Gene Logsdon wants us to recognize that we need to change the way we deal with waste. His book, Holy Sh*t: Managing Manure to Save Mankind (Chelsea Green, 2010) is nothing more, and nothing less, than a crash course in all things manure. And I'm surprised (and pleased) to tell you that it is fascinating. Maybe not something you want to read at the breakfast table, but definitely an interesting read. Any eco-minded person who produces waste (that would pretty much cover the audience here at Planet Green, right?) would do well to read this book.
Logsdon suggests that it's time to do away with the chemical fertilizer industry, which is, (as we've seen over and over and over again) doing more harm than good, and start using all of our waste (yes, all of it — livestock, pet, and human manure) to enrich our soil instead. If we put all of that waste to use, we'd effectively kill two birds with one stone: rid the country's farmland of synthetic chemical crap and put the waste that is currently harming our environment to good use. This means no more manure lagoons to stink up rural areas, no more endless bags of cat poo being trucked to the landfill. Gardeners and farmers alike would compost their manures to enrich the soil they grow on. He calls for the end of factory farming, because in all ways (including waste management), these operations are not sustainable.
Logsdon does it all in this book: he instructs us in how, exactly, manures should be handled for proper composting, tells us how that composted manure can be best used, and (perhaps most importantly) opens up an important discussion about our aversion to something as natural as waste. If we confront this aversion, really start to talk about it, and think — non-emotionally — about how we can handle all of the manure we produce, then and only then can we start to change how we deal with it.
This was a great read — entertaining and informative, and full of actionable advice that any gardener or small farmer can put in place right now.
Read the original review on Planet Green.
Gene Logsdon is the author of, most recently, Holy Shit: Managing Manure to Save Mankind.


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Chiefland Middle School was lucky to start the school year with new landscaping. Just one week before school started, the northeast corner of CMS's main building was bleak and barren.
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Sensus offers inspiration for tomorrow's health with the innovative food ingredients Frutafit® inulin and Frutalose® oligofructose. Consumers are getting more focused on their food choices. Healthier lifestyle and healthy food choices therefore go hand in hand. At Sensus we partner with food companies to offer solutions to satisfy this rapidly growing demand.
Besides being a manufacturer of high-quality food ingredients we are also a dedicated and inspired team of food specialists. We work closely with our customers and business partners, providing effective support in developing and marketing the foods of today and tomorrow and these healthier food products will be even more successful if they taste great. We are inspired by inulin and this inspiration is our drive to create great tasting healthier products.
Frutafit® inulin and Frutalose® oligofructose are prebiotic, soluble dietary fibers with texturizing properties and a great taste that provide added health benefits. Frutafit® comprises a range of powdered inulin products with different technological properties. Frutalose® is partially hydrolyzed inulin: oligofructose. With these innovative ingredients, we believe that we can make the world a little healthier by helping you develop value-added products, ones that meet the growing consumer demand for healthy and tasty food and beverages worldwide
Sensus' Frutafit® inulin and Frutalose® oligofructose product range:
Our ambition is to make the world a little healthier. That's why we're committed to deeply understanding our rapidly changing world. And it's why we're dedicated to helping our customers develop tasty food products that contribute to healthier lives.
For more information about Sensus and the possibilities of inulin, please visit our website www.inspiredbyinulin.com. Feel free to contact us.


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Olympic Greens: London's Eco-Friendly Sports Tech
Officials at the first modern Olympics rely on analog stopwatches to determine winners.
Analog stopwatches yield to electronic ones, but finishes are still hand-timed. The margin of error is 0.2 second—almost 2 meters in a typical 100-meter dash.
Gear for the Chic Geek on the Beach


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Create Binder Title Pages using Design & Print Online
Start your presentation on the right note with a title page for your binder cover. Follow these step-by-step instructions on how to create a professional-looking "welcome" for your next presentation using Avery Design & Print Online -- no downloads required!
Instructions: Go to Avery Design & Print Online. Click on Create Project by Product Type to get started. Under Product Category, select Binders. Then under Product Number, select 00000 - Binder Cover Inserts. Click Next.
Instructions: You'll find a variety of options to choose from. Click on the template you want to use, then click Next.
Instructions: Customize your title pages by replacing the placeholder text with your information. You can also replace the placeholder graphic by importing your own or selecting from our gallery. Then click Next.
Instructions: You can also change the font style, size, color, and alignment of your text.
Instructions: Review your creation. If you need to add or make any changes, click either Edit Your Content or Change Font and Style. When you're ready to print, click Next.
Instructions: Before you print, we recommend that you click View Instructions first. When you're done, click Print Your Project.
Instructions: After you print, click Next and click the Save Your Project button. Your project will be saved in the Avery Design & Print Online format. This allows you to open and edit the project in the future using Avery Design & Print Online. If you are renaming the project when saving, be sure to include .avery at the end of the new file name.


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Anyone here bought it yet? Is it worth buying? Is the difference between it and the Fusion that noticeable?
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Anyone here bought it yet? Is it worth buying? Is the difference between it and the Fusion that noticeable?
I can't believe someone would even buy the Fusion. Those blade refills are crazy expensive.
My face always used to break out when I shaved and my Dad told me (I thought he was joking) to try to the Gillette disposable Venus razors for women. They're actually really good if you have sensitive skin and they're pretty cheap. I do use specialty $25 shaving cream but I only have to replace it a couple times a year as opposed to the Fusion refills which would cost me a lot more because the blades go dull on me fast.
I get a lot of milage on a fusion blade. Plus bying them at Costco save a little. I have not tried the new razor yet. Still have a bunch of the Costco blades left.
I get a lot of mileage out of my fusion blade too, and I shave quite frequently. The key is to dry the blade off after shaving as the water speeds up the corrosion process. I've greatly increased the lifespan of my razors since I started doing that.
I think the Fusion is great and therefore am reluctant to buy the Proglide. Then again, I thought the Mach 3 was great until I used the Fusion...
Last edited by Sollozzo; 06-21-2010 at 01:19 AM.
What's the difference?
"I had to take her down like Chris Brown."
-Lance Stephenson
I don't know if I'll make the leap. I'm perfectly happy with the Fusion and I have several blades left for it...
Edit Signature
Strong language so surf accordingly as this may be NSFW.
Well crap, I don't know how to defeat PD's swear filter here. Just replace the **** with the real deal when you follow the link and refresh.
Last edited by travmil; 06-21-2010 at 07:43 AM.
I use the Fusion, too. I also get a few months out of a cartridge.
dcpacersfan is right, the Venus razor is great for people with sensitive skin. When I start to break out after shaving I get one and it works like a charm.
My wife bought replacement cartridges for my Fusion this week, and got ProGlide by mistake.
It may not be an apples-to-apples comparison, since I'm comparing it to a dull Fusion blade, but the ProGlide was insanely impressive.
That said, I'm sick of paying for refills. I'm looking at perhaps moving to a safety razor.
This space for rent.
How I love having a beard I only need to trim once a week or so...
while Piggy is trimming only once a week cause of his beard - I shave only once a week/10 days cause I just don't really grow facial hair...makes life easy thats for sure.
Must be nice Belli. I shave every day when working. Now that i am on break, usually only on church days or when my wife decideds I've gone from "rugged" to scruffy.
Do the proglide cartridges fit on the old fusion razors?
I have very sensitive skin and every time I deviate from the simple and cheap Schick Slim Twin disposable razor I waste insane amounts of money, hack myself up, or both. The Slim Twin has the "clean out" bar. Use it, and dry it out, and it lasts at least a week. Other brands seem too sharp and I get nicks all over.
I've tried fancier freebies that seem to work but don't clean out as well, so the third time around the shave gets worse.
The poster "pacertom" since this forum began (and before!). I changed my name here to "Slick Pinkham" in honor of the imaginary player That Bobby "Slick" Leonard picked late in the 1971 ABA draft (true story!).
I've found the Fusion to be too large, too clunky for me, and so I've stuck with the Mach 3. I also don't like that sideburn razor because I shave in the shower, and that thing is like a little razor blade just waiting to slice me if I turn the wrong way while shampooing.
My problem is that I'm pretty sure they've discontinued the Mach 3 Power razor, so once mine breaks I'll likely have no choice but to step up to the Fusion. Hopefully the Proglide will be better than the Fusion, or hopefully they've gone back to a more minimalist approach with razors by then.
for those that shave in the shower, how can you do that without a mirror to see yourself.
Try it. It's really not hard.
This space for rent.
This space for rent.
Are you not familiar with your own face?
It's either you're a vampire or you've never looked at yourself in a mirror.
Just bought one o' these on the way home.
I'll write a report comparing it to the Fusion and Shick Quattro when I get out of the shower. And tomorrow I'll write another report for how well it works when I only shave my face.
No, but The Onion is a hilarious news parody website.
Okay, I just put the Proglide through my normal shaving routine (face only - creepers).
For most of you, this probably is something that takes about 30 seconds every day and involves no real effort. I was fortunate enough to be born with facial skin sensitive enough that I can shave every-other-day at best, and typically every three days unless I'm workin'. One of life's little ironies is that my facial hair is a pain in the *** to shave as well - while I don't have exactly the opposite of belli's issue, it's not super easy. These two issues combine for a non-regular shaving schedule with an absurd number of shaving products so as to not bleed every time. Having painted a picture of a 12 year old girl with steel wire facial hair who also owns far too many bathroom products, I move on to the razors.
I've used this in the past. I had no real issue with it. I got a decent number of shaves out of it before having to replace it OR before I was having to go over any one area ninety-seven times to get a solid shave. Back when I used this, I only used shaving gel so I don't know if I would encounter the problems I had with later razors dealing with the shaving products I have to use. For reasons I fail to recall, I switched to the Schick Quattro at some point.
Schick Quattro
By far the best "first shave" I've ever gotten from a razor. Smooth, easy and only had to go over any area one time. In fact, if I wasn't careful, I might take a little skin with it by pressing too hard. After switching to this razor, I started using the shaving routine I use now. The Quattro was infuriating to no end with this. I use a pre-shave oil and a combination of shaving gel and cream every time I shave. The Quattro could handle this once before copping out. Keep in mind that I only shave every few days, so it's not exactly an easy shave. The blades would be completely packed and unusable after two shaves, maybe three. The cost of replacement at this rate is certainly prohibitive.
Used it once so far. Good shave. The grip is a little unwieldy, but I'm also used to a smaller razor at this point. No issues with blades getting clogged, but we'll see after a couple shaves. I'll update at some point there. Replacement cost is a lot.


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Capsaicin-Evoked Pain in Patients With CRPS
This study has been completed.
Danish Pain Research Center
Information provided by:
Danish Pain Research Center
ClinicalTrials.gov Identifier:
First received: May 1, 2007
Last updated: October 10, 2008
Last verified: October 2008
- Full Text View
- Tabular View
- No Study Results Posted
- Disclaimer
- How to Read a Study Record
To evaluate the effect of capsaicin in patients with Complex Regional Pain Syndrome.
|CRPS (Complex Regional Pain Syndromes)
|Study Type:
|Study Design:
|Observational Model: Case Control
Time Perspective: Prospective
|Official Title:
|Capsaicin-Evoked Pain in Patients With Complex Regional Pain Syndrome
Resource links provided by NLM:
MedlinePlus related topics: Complex Regional Pain Syndrome
Drug Information available for: CapsaicinU.S. FDA Resources
Further study details as provided by Danish Pain Research Center:
|Ages Eligible for Study:
|18 Years and older (Adult, Senior)
|Sexes Eligible for Study:
|Accepts Healthy Volunteers:
|Sampling Method:
|Non-Probability Sample
Study Population
Primary care clinic
Inclusion Criteria:
- Age: 18 or older.
- Pain in arm or hand > 3 months.
- Diagnosed with CRPS acc. to diagnostic research criteria (Harder et al., 2005)
- Inclusion of healthy subjects: age-, gender-, and BMI-matched.
Exclusion Criteria:
- Other significant disease affecting the parameters measured, including cardiovascular disease.
- Treatment with anticholinergics, sympathomimetics and parasympathomimetics, and alpha- and beta-adrenergics.
Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.
Please refer to this study by its ClinicalTrials.gov identifier: NCT00468390
Please refer to this study by its ClinicalTrials.gov identifier: NCT00468390
|Danish Pain Research Center, Aarhus University Hospital
|Aarhus, Denmark, 8000
Sponsors and Collaborators
Danish Pain Research Center
|Study Chair:
|Troels S Jensen, MD, DMSc
|Danish Pain Research Center, Aarhus University Hospital
More Information
Additional relevant MeSH terms:
ClinicalTrials.gov processed this record on September 21, 2017
|ClinicalTrials.gov Identifier:
|NCT00468390 History of Changes
|Other Study ID Numbers:
Capsaicin in CRPS
|Study First Received:
|May 1, 2007
|Last Updated:
|October 10, 2008
Additional relevant MeSH terms:
Complex Regional Pain Syndromes
Reflex Sympathetic Dystrophy
Pathologic Processes
Autonomic Nervous System Diseases
Nervous System Diseases
Peripheral Nervous System Diseases
Neuromuscular Diseases
Dermatologic Agents
Sensory System Agents
Peripheral Nervous System Agents
Physiological Effects of Drugs
ClinicalTrials.gov processed this record on September 21, 2017


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NEW ORLEANS—At the Zulu Lundi Gras Festival at Woldenberg Park, Kermit Ruffins belted out "It's gonna be a bright, bright sun-shiny day." It wasn't, and wasn't going to be — but many poncho-draped people in the smaller-than-normal crowd couldn't help but optimistically sing along.
Umbrella sales were up, reported a souvenir store employee on Canal Street, and a man passing by with a cart full of plastic ponchos said he'd started the business for the very first time about "20 minutes ago."
For Mardi Gras day, forecasters with the National Weather Service predicted a warm front to move north into the city sometime Tuesday morning, potentially bringing thunderstorms and likely to be followed by sporadic showers throughout the rest of the day. As of Monday evening--Tuesday's chance of rain was at 80 percent.
King Logan said that the Krewe of Rex would be closely monitoring the weather data very closely as they stage their floats around 9 a.m. on Tuesday morning. Unless the safety of those in or watching the parade are at stake, Logan said they will roll as scheduled at 10 a.m.
On Monday afternoon, the rain let up for several hours as more people arrived in downtown New Orleans, migrating toward the riverfront for the end of the Zulu festival, setting up camp along the parade route, and waiting for King Rex's arrival at the Spanish Plaza.
At 4:30 p.m. Uptown, the Krewe of Porteus rolled early, followed by Orpheus—their schedules amended on Saturday for earlier start times and shortened routes in anticipation of the bad weather.
At 6 p.m., when King Rex stepped off the boat, there was a cold but light drizzle, doing little to damper the spirits of revelers as King Rex proclaimed that schools, businesses and city government close, and that "pleasure must rule both day and night."
Monday morning in Kenner, the meeting of the Argus and Zulu royalty went on as planned, though the toast and proclamations were moved indoors, the band cancelled and outdoor festivities cut short.
"Considering the weather, it went very, very well," Kenner Mayor Mike Yenni said. Yenni said that it wasn't until just before the 11 a.m. press conference that they decided the weather would not permit the band to play, and he said the arts and crafts vendors were told that it was all but cancelled, but they could stay on if they wanted.
At a booth selling fried chicken and fried shrimp on a stick, vendor Mike Bucalan, whose family also runs a booth in downtown New Orleans, said that he enjoyed the Kenner crowd because there were more locals. But Monday, he said it was "only the diehards," and business was considerably slower than usual.
In terms of weather cancellations, you have to wait until the last minute before pulling the plug, Yenni said—otherwise it's not fair for the krewes, the parade goers or the economic impact felt by the community. However on Sunday afternoon, the Krewes of Zeus and Heras made the decision to cancel their Monday parades in Metairie, a decision Yenni said he did not understand.
During a break from the rain, Yenni said they went ahead with a "mini-parade," circling the block about one and a half times on foot and throwing beads to the crowd of a couple hundred people.
Since the event started in 1999, Yenni said it has grown every year, with several thousand people attending in 2012.
Sarah Wambsgans, a Mid-City resident who spent time living near Rivertown in a trailer after Hurricane Katrina, said that she has attended event every year since 2006. Seeing the royalty in full regalia and the two courts meet was something she was more than happy to brave the weather to see. "It's just in our blood," Wambsgans said.
Back on the riverfront in New Orleans, Shirley Wilfred, a mask-maker from Folsom, said that the rain fell hard during the morning, but that by mid-afternoon, "We still did pretty good—it wasn't a bust." Wilfred said she was one of the first vendors when the Zulu Fest started about 20 years ago and only recalls heavy rain during one other year.
St. Louis residents Michael and Sarah Connelly and their two kids danced with smiles to Mardi Gras Mambo, undeterred by the cool weather and prepared for more rain. The Connellys said they have been coming to Mardi Gras every year for the past decade, and their kids—ages 14 months and 5, were in fact "souvenirs" from New Orleans. The oldest was a result of a 2006 Halloween trip, while the youngest was conceived during Carnival in 2011, they said.
"It's important to us to share this with our kids," Sarah Connelly said. "People think up north think we are crazy to bring our kids to Mardi Gras, but they don't understand that it is so much more than Bourbon Street."
One-year-old Lucy sat under a blanket in her stroller with several strands of beads around her neck, smiling and moving her head back and forth to the music. Michael Connelly said they would try to catch some of the Proteus parade before bedtime, and mom noted that 5-year-old Jack had been practicing catching beads at home.
In the CBD, Picayune resident Tom Andrews said he'd been setting up his Port-a-Potty in a pickup near the same corner at St. Charles Avenue for the past 30 years. "Everyone knows I'm here," he said. Whether locals or out-of-towners—"They come find me."
Andrews said he was prepared for anything with a rain suit and tarp — and the refuge of his truck.
"If the parade rolls, I'm there," Andrews said.


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The Soweto Gospel Choir, a South African Choir, will perform Feb. 26 at E.J. Thomas Hall in Akron in a concert themed "A Musical Celebration of its Rainbow Nation and the Life of Nelson Mandela."
Akron is one stop in a tour which will include more than 30 cities in three months. The choir celebrates its 10th anniversary and recently released the recording Divine Decade.
The recording opens with an address from the choir's patron, Archbishop Desmond Tutu, and features collaborations with a wide range of guest artists that exhibit the Choir's breadth of repertoire, including: U2, Robert Plant, The Soil, Joepraize, Zahara, Elvis Blue, Yvonne Chaka Chaka, Ladysmith Black Mambazo, Solly Mahlangu, Corlea Botha, Eric Wainaina, Johnny Clegg, Paul Ruske, and HHP. Amongst the featured tracks include the choir's popular hits such as "Sedilaka," Sarah McLachlan's "Angel," The Jackson 5's "I'll Be There," and the Fish Out of Water remix of "Put On Your Boots", their collaboration with U2.
Founded in November 2002, the Soweto Gospel Choir first saw international success within one month of inception when its first single "Voices of Heaven" reached No. 1 on Billboard's World Music Chart. In October 2006, the choir performed as invited guests for their patron Archbishop Desmond Tutu's 75th Birthday Celebration in front of an audience that included former President Nelson Mandela, Zanele Mbeki, Tokyo Sexwale, Samuel L. Jackson, Alfre Woodard and Carlos Santana. The choir has made television appearances on Conan, Leno, and the Today Show, and has garnered honors including two American Gospel Music Awards in 2003, and the Grammy Award for "Best Traditional World Music Album" two years in a row--in 2006 for Blessed, and in 2007 for African Spirit.
For more details about the album and Soweto Gospel Choir's 2014 tour, visit sowetogospelchoir.com.


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I'll keep it short and simple, since I'm burnt out right now and need a hot shower. [b][i]Postcards From The Future: The Chuck Palahniuk Documentary[/i][/b] is back. Mirka convinced me I needed to take it out of the cellar and make it available back on the site again. So you have her to thank for this. The demand for it from people who missed out on the initial runs was overwhelming. And with Chuck on tour in May and a new book due out, it was just wrong not be offering it anymore, when I now live so close to someone who can split the burden of packaging and shipping all these things. (Mirka has no idea what she's in for. ::evil laugh::). That, and the fact that some asshole's been selling them on eBay for like $150, which pisses me off. Nobody should have to spend that much on this thing.
The DVDs are being replicated (not duplicated) starting tomorrow. This means we won't have the playback issues we had with some of our customers DVD players we had in the last run. This is a much higher quality disk than we saw on previous runs. [b]And since the pre-order begins today, and we'll be shipping them out starting the last week of April, you should definitely have them in time for the tour.[/b] That means you've got one more item for the Chuckster to autograph.
[b][url=http://www.chuckpalahniuk.net/store/documentary/]Pre-Order The Chuck Documentary DVD Here![/url][/b]


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Fall Shoe-spiration: 100 Must-Buy Shoes
We all have areas to which we don't want to draw extra focus — thighs, stomach, upper arms, whatever. Patterned scarves immediately shift attention to the face, add color, and dress up the most basic jeans-and-tee combos. "Go with a gauzy scarf that you can wrap around once or twice and that has some drape to it," advises Gleason. "You don't want it to be all on your chin." Steer clear of silk scarves, which while lovely are seemingly a magnet for stains.
Arianna Zebra Print Scarf, $49.50, Banana Republic.
Simple to wear, soft to the touch, and available in an endless number of color combinations, these shirts have certainly earned their stripes. For those worried about horizontal lines adding bulk, Gleason advises choosing thinner, brighter stripes on dark color bases. (She likes blue on black and pink or white on navy blue). Stick with a crewneck to avoid embarrassing spillage every time you scoop something off the floor.
Supersoft Striped Crew, $22.95, Gap.
Rachel Roy Reworks Your 9-5 Wardrobe


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Originally Posted by Jay@Section204
It's not so much the complaining about JO's staredown and false bravado, but saying that we can't win a championship because of it. Sorry but that's silly to me.
You, Never? Did the Kenosha Kid?
Fooling Yourself (The Angry Young Man)
by Styx
You see the world through your cynical eyes
You're a troubled young man I can tell
You've got it all in the palm of your hand
But your hand's wet with sweat
And your head needs a rest
And you're fooling yourself if you don't believe it
Why must you be such an angry young man
When your future looks quite bright to me
And how can there be such a sinister plan
That could hide such a lamb
Such a caring young man
And you're fooling yourself if you don't believe it
You're killing yourself if you don't believe it
Get up, get back on your feet
You're the one they can't beat and you know it
Come on let's see what you've got
Just take your best shot and don't blow it.
Go watch the Pistons play old man.Originally Posted by Harmonica
Hits? WE ARE THE CHAMPS! hELL YEAH!
Good one, Sassanasikevicius.Originally Posted by Jermaniac
Am I supposed to be mad?You just called me a loyal Pacers fan.Originally Posted by Harmonica
U no madOriginally Posted by Jermaniac
You, Never? Did the Kenosha Kid?
Mad? Heck no. But you (and Sassan, for that matter) must be pretty angry at Reg with all those "negative" remarks he made last night about his old team. I mean, how dare he pick Detroit to win the East.Originally Posted by Jermaniac
No I wasnt, Reggie was doing his job and its up to this team to prove him wrong. But did you see this game tonight?I'm sure you did you can tell that Reg still loves these guys and that he is a Pacers homer. Reggie wants us to win.Originally Posted by Harmonica
Maybe one doy well be able to have a conversation after a Pacers win about how the Pacers played good instead of where the head band was positioned on Jamaal Tinsleys head.Originally Posted by vapacersfan
As do we all, as do we all.Originally Posted by Jermaniac
I hope so.Originally Posted by Harmonica
Maybe next time.Originally Posted by vapacersfan
I dont think so eitherOriginally Posted by vapacersfan
LOL Hicks might as well delete the whole thread
I'll post here since it's all going here.
IMO you three guys just need to be a little more considerate of each other. I know Harm and VA probably feel Jerm is causing most the ruckus but you're all being awfully snide.
You, Never? Did the Kenosha Kid?
Half my posts going to get moved here lol
Whoa. That was a trip. I was in the main forum when I got up from my computer a few minutes ago, came back and refreshed my browser and wound up here in the shout box. It's as if Hicks put me in the Star Trek Transporter.
haha, i like how the only first post is in reply to mine
!!!Originally Posted by Harmonica
ya, zo's a dick, everytime he did a lil thing, he would flex, and give a lil elbow or something, dirty player if you ask me
I thought you meant "Hater."
Come to the Dark Side -- There's cookies!


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On my morning RSS read through my favorite pro-audio sites Synthtopia re-posted some photos from Ken Macbeth's Facebook page. The photos show Ken's idea for a small synth to compete with the Doepfer Dark Energy, Vermona Lancet and other mini boutique desktop modules. Ken the man behind Macbeth Studio Systems created what could be the best synth of all time the Macbeth M5. I know it could be the best because I've played with one in Berlin and never heard anything as good before or after. He gets the core stuff right like the speed of the envelope's, etc… So if this little box makes it into the world count me in.
"?…as well as the 5U stuff that I'm working on…..I play with the idea of designing some very small (42HP in 3U) midi driven analogue! Whay just have one oscillator and one envelope generator when you could have three oscs and two independant envelopes?!" – Ken Macbeth
I don't follow synth makers on Facebook. Who else is worth friending there? Any recommendations?
For more info: macbethstudiosystems.com


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|May 14, 1999, 11:44 PM
Senior Member
Join Date: February 12, 1999
Location: Ohio, USA
Posts: 467
Last Sunday I made it to an IDPA match in Copley, Ohio. Good match with 4 stages. All practical and educational.
Wednesday evening shot in a local club "Practical Defensive Pistol" match in South Amherst, Ohio. Again a good match.
This evening I shot at another club match at the Erie County Conservation Club. Centerfire handguns for one stage and .22 handguns for another. Again, a good match. Tomorrow morning I'm going to the Ashland Lake Gun Club for an IDPA classifier match. And Sunday to Milan, Ohio for a bowling pin shoot.
The old Dillon is getting a workout lately. I'm lucky to be living so close to these clubs. I keep trying to support the sport even as our rights are being taken away.
I'm gonna shoot until they take the guns from me, or I'm underground.
Keep shooting.
|May 15, 1999, 10:19 PM
Senior Member
Join Date: February 12, 1999
Location: Ohio, USA
Posts: 467
I went to the Ashland Lake Gun Club IDPA Classifier match today. The weather was beautiful and I believe there were about 45 new shooters that went through the 90 round, three stage match. The club did a really decent job trying to handle that many shooters in an expeditious manner. (Imagine, over 4,000 rounds fired and no one got hurt! That's not news though.)
They put on a feed afterwards and everyone seemed to enjoy the day.
Next Sunday they will have a regular IDPA match.
This is a good place to shoot.
|Thread Tools
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Why theravada over mayanyan?
How long can you (yup you) sustain your attention on a singular object for?
Why is there no glossary of terms on this forum (pali) it appears to be the forum with the most traffic.
Is it possible to get significantly proficient in meditation without being a hermit or living a monastic life?
Anyone go to Chithurst monastery in Sussex?


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Jury Finds Loose Lug Nuts and Near-Crash Caused Injuries
Santos v. Zrams $991,038 Verdict
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What's being said
Whenever a wheel is removed, it is imperative that the lug nuts be torqued to the proper minimum value as shown in the operators manual and the vehicle maintenance manual. Apparently this was not done. In these cases, as the vehicle travels, the lugs loosen and eventually the wheel comes off. Additionally the vehicle should be re-torqued after approximately 500 miles, during which time the wheel and lug nuts seat themselves. These nuts were so loose, the vehicle didn't even make it to 500 miles.
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AOL's famous "You've Got Mail" catchphrase seems so quaint these days, left over from a not-too-distant era when e-mailing felt relatively novel and fresh. That's not to suggest that e-mail is no longer relevant. It remains the go-to way most people communicate in business and in their personal lives. But more and more folks prefer to communicate by text or tweet, or by posting an update to Facebook.
Personal Tech
Sponsored Links
E-mail might never be hip again (to the degree that it ever was hip). But two of the most venerable providers of mail through the years are freshening what had become stale franchises.
Today, Microsoft unleashed the preview of its new Outlook.com mail service, one that's intended to lure people away from Google's Gmail while shoving Microsoft's own Hotmail to the back burner. Microsoft is letting people choose an Outlook.com e-mail address while ditching Hotmail or Live.com. And last week, AOL completed the rollout of a streamlined interface of AOL Mail that was begun months ago.
There's no mystery behind the redesigns. Research firm comScore says Hotmail has 41 million monthly unique visitors; AOL, 24 million. That makes them the No. 3 and No. 4 e-mail providers in the U.S., behind Yahoo Mail, with 84 million unique visitors, and Gmail, 68 million. Worldwide, more than 324 million people still use Hotmail monthly, making it the top provider globally. But Hotmail's user base is on the decline.
The changes that AOL and Microsoft are implementing bring a more modern feel to their webmail. But I'm not persuaded that either provider will convince people tied to another e-mail service to shift loyalties. Overall, Microsoft's changes are more appealing.
Microsoft Outlook.com
Microsoft will downplay ads in its new service. You'll still see them, such as when receiving a newsletter. But you won't be subjected to ads while reading person-to-person e-mails. Overall the new look is clean and attractive. Microsoft says the interface displays 30% more messages than you're accustomed to seeing in webmail. It's minimalist compared with Gmail. Mouse over a message to summon instant icons for deleting, flagging or marking a message as read.
You can opt to exchange your Hotmail.com or Live.com for an Outlook.com account. Outlook, of course, is the familiar name of the e-mail/contacts program that's part of Microsoft's Office productivity suite. You can still take advantage of new mail features if you continue to use Hotmail or other accounts —at least for now. If you don't already have Hotmail or Live.com, you can choose an outlook.com address from the company's website.
Social integration is a big part of the revamped experience. Microsoft lets you populate your address book with friends from Facebook, LinkedIn, Google, Twitter and others. When you get mail from, say, a Facebook friend whose e-mail has been made public on the social network, you'll see their Facebook picture when they send you a new message. Status updates and tweets are also visible in a side panel. Microsoft plans to let you do Skype video calls from your inbox, but the feature hasn't been implemented yet.
Several features I like are holdovers from earlier iterations of Hotmail. For example, you can keep the messages you've flagged as important at the top of your inbox, even as new messages come in. You can unflag messages when they no longer require top billing.
As before, "quick views" visible in a side pane collect all the mail with documents, photos, newsletters, shipping updates, social updates and so on into discrete folders. Microsoft distinguishes "graymail" (newsletters, shopping deals) from actual junk, and says graymail actually makes up about 80% of the 15,000 messages the average person receives in a year. A previously introduced "sweep" feature makes it easy to delete or move mail and otherwise clean up your inbox. Handy tools let you save only the last daily deal from, say, Groupon so that you're not bogged down with older offers that are no longer relevant.
Outlook.com is tied into free Web versions of Word, Excel, PowerPoint and OneNote, letting you make edits from your inbox. Microsoft is giving Outlook.com users unlimited e-mail storage and up to 7GB of storage on its SkyDrive cloud service. But that's down from the 25GB folks used to get through Hotmail on SkyDrive.
AOL Mail
I'm one of the many people who still have an AOL account but rarely rely on it anymore. AOL's changes are mostly cosmetic and in my view relatively modest. You still hear the You've Got Mail greeting when logging in. It's like hearing from an old friend from whom you've grown apart.
You can customize your inbox with more than 70 decorative themes and backgrounds or have a different one appear randomly each time. You can choose how tightly your message lines are spaced apart and whether a reading panel, which lets you peek at messages while others are displayed, appears. You can turn labels on or off, and start composing a new message with a single click.
Buttons at the top left corner of your screen let you begin an instant message conversation. Your AIM and other contacts appear in a pane down the lower left side. As before, you can chat with Facebook friends through AIM; the refresh makes it a little easier. You can also send a text message from your inbox. Start typing a name in the "To" field when sending a message, and AOL starts auto-completing the address. But AOL's screen struck me as more cluttered than Microsoft's, with advertising more prominently displayed.


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- Doctors
- California
- Sunnyvale
- Oral Surgeons
- Dr. Kevin V. Jeworski
You may also like
Ratings for Dr. Kevin V. Jeworski
This doctors office is nothing but a moneymaking sham we were given an estimate at the beginning of treatment and have gone over 2K over the 4400.00 estimate he charges for consultations in the middle of treatment
I haven't had an appointmnet there, but have concalled mine because I have already waited 4 weeks to get an appointment and the office just called to cancel because Dr. Jew orski is going to be busy that day. When i asked questions about what sorts of TMJ treatments this dentist does, I got rude, impatient, and inaccuate answers. I won't go there.
Dr. Jeworski and the other doctor he works with are EXTREMELY rude to patients and even more so their staff. ALl I heard is the woman doctor yelling at staff members. Their office is way to crowded and overbooked. Dont recommend this office.
Dr. Jeworski pulled all my wisdom teeth and it was the worst experience of my life. During the procedure he hit my sinus which caused a hole in which air from my sinus cavity flowed into my mouth. I also had other medical complications due to the procedure including vertigo which kept me out of work and school for three weeks. I would not recommend him.
I did check this site out when I was looking for orthodontist and I am glad that I chose doctor Jeworski. He proved to be very knowledgeable and attentive at all stages of my treatment. The treatment went very well and he even called me over the weekend to ask how I was feeling. I highly recommend Kevin to everyone who is in need of dental surgery, you won't regret! And the prices are reasonable given excellent service.
Great guy, comes *very* highly recommended
I had all four of my wisdom teeth removed by Dr. Jeworski in one session. The entire operation took no longer than 15 minutes (with local anesthesia) and it was *completely* painless. After the surgery I had a little bit of swelling on one tooth, but it went away in about one day. I fully recovered in less than a week.
I had an implant done and my wisdom teeth extracted by Dr. Jeworski. I was VERY happy with how the surgeries were conducted, I had almost no pain at all, no swelling, and all my friends were amazed at how quickly I had recovered. I simply can't recommend Dr. Jeworski more.
I am a teenager, and Dr. Jeworski was the best doctor I have ever gone too. He made me feel comfortable right away, and was extremely patient with me when I was nervous and had second thoughts. He was the exact opposite of creepy, instead, he was pleasant and reassuring. You could tell he knew what he was talking about, and he went to one of the most prestigious graduate schools in dentistry, Johns Hopkins. My operation was quick and painless. I would strongly recommend this doctor to children, teenagers, and adults. He is unbelievable.
Dr. Jerworski maybe good with adults, but he is TERRIBLE with children. Children and Teens find him impatient and creepy!!!
Dr. Kevin V. Jeworski's Credentials
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Manufacturing Sponsored by
The power of positive performance cannot be overstated, particularly in these tough economic times. Consequently, companies that stick to their word and keep their commitments are following the philosophy of traditional U.S. winning companies, and small businesses often exemplify these traditional practices because they're still able to touch their customer base on a personal level.
The following are top customer service practices that have proven themselves for Lightning Labels over the past decade.
1. Communicate and clarify procedures, parameters and protocols with customers, retailers, vendors and suppliers. Uncertainty and confusion are two of the biggest customer service killers out there. Generally, even when customers aren't thrilled about something, they will handle it reasonably well when they're clear on the rules of engagement ahead of time.
For example, a customer needing rush turnaround when running out of inventory will be much more content knowing what to expect long before the challenge arises. By setting expectations, the vendor can guide the process much more efficiently. And if rush jobs can be completed in the needed timeframe but require additional charges, the well-informed customer can make a reasoned decision—instead of frantically trying to figure it out on the spot.
2. Make customer retention paramount, even over customer recruitment. To bolster balance sheets, many companies today focus chiefly on customer acquisition, sometimes at the expense of customer retention. In the end analysis, it's vitally important to make present customers feel as special as prospects.
If you're offering a new customer special to ramp up short-term growth, what can you offer existing customers—particularly long-time ones—to demonstrate that you still value their business? Even if it's not the same offer, make it comparable, and make it clear to present customers that you're doing this as a way of showing gratitude for their continued business.
There's an important dynamic at work here. Often, customer loyalty correlates to how loyal one company feels another company has been to them. If they feel suckered in by a great come on and then ignored, they will likely look around for a new suitor. If, conversely, they feel truly valued, there often will be a strong tendency to stay put—even if you're not the cheapest option around.
3. Understand that happy customers have big mouths, but unhappy customers have bigger mouths. Word-of-mouth always has been a major business-builder, and negative reports can prove nightmarish, even more so with today's high-profile social media reviews.
Between social media forums tied directly to the company and independent review mechanisms such as Google Reviews, would-be customers can assemble a pretty or not-so-pretty picture quickly. While fans on social media sites likely will be supportive, reviewers elsewhere will tend to post negative views more quickly than positive. For many, being well-treated is normal and expected. Being poorly treated is an insult and a trigger to vent one's wrath. That's why many review sites are populated more heavily by the negative.
Bottom line, keep your customers happy using any reasonable means.
4. Be a problem solver, not problem justifier. Akin to nails on a chalkboard, companies trying to justify a screw-up or perceived screw-up instead of addressing concerns will drive customers nuts. This isn't about the customer always being right. It's about honoring the customer's right to be upset—and doing everything reasonably possibly to solve the problem. If the customer is not pleased with your proposal to correct the error, there is nothing wrong with directly asking what resolution is desired.
Because problems are sometimes logistical and other times emotional, it's important first to find out what the customer wants in the way of resolution. Too often, customer service reps have a scripted set of responses that may or may not apply to specific circumstances. For example, is the customer upset about a quantity mistake on an order because of that occurrence? Or, is the response really tied to cumulative frustration about a number of errors or miscues? Often, it's the latter. Without investigating further, a customer service rep may be at a loss to explain a customer's extreme anger over what is considered a relatively minor mistake.