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Cat Insurance Will Get You The Appropriate Feline Care
If your cat is like most, then she has a mind of her own and is probably not likely to "come on command" for you. However, you know there would be a hole in your life without her as part of your family. Such sentiments are one reason why cat lovers also become distressed when their feline companion becomes ill or injured and needs to have the professional attention of a veterinarian. When these kinds of situations occur, having a cat insurance policy can provide not only financial benefits, but the emotional comfort of knowing that your cat will be able to receive the care he/she needs.
When an adorable cat becomes ill or is somehow injured, most cat owners will worry and stress over the cost of proper veterinary care. Because all health costs have been soaring in both the animal welfare segment of the market, as well as in the case of human health care, there has been an increase in interest in pet health insurance. Because felines are one of the most popular types of house pets, insurance for health and wellness care has become very much sought after.
One of the things about cat insurance that is most important to cat owners, is the fact that they can enjoy a level of security knowing that their feline companion will be taken care of if he/she becomes ill. This helps to reduce stress overall and alleviates panic if the pet does fall ill, is in some type of accident or is injured in some way.
If covered by insurance, then this means that the animal will receive treatment more quickly. This is because the cat owner can immediately take action by getting the animal to the veterinary pet office, when there is an indication of illness or in the event of injury. Unfortunately, some pet owners must delay veterinarian visits because of the financial aspect of the office call.
With feline insurance coverage in place, you will not need to delay the visit and can relax knowing that the majority of the costs will be taken care of by the pet health insurance policy. The ability to quickly get the animal in to see the vet can make the difference between a quick and full recovery, or possible long-term health problems and even death.
In the worst case scenario, when a pet owner does not have insurance to help with the high expenses of animal care, it could mean having the cat put down to sleep. This occurs when there is simply no way that the family can bear the cost of expensive veterinary pet treatment or surgery that might be needed to extend the life of the animal. While pet health insurance cannot guarantee that your cat will never succumb to a fatal illness, the best pet insurance benefit is knowing that your pet will be guaranteed proper treatment.
There are many options that you can choose from regarding cat health insurance, which will have a direct impact on the cost of the pet insurance premium you will pay. You can find a policy that will cover general wellness care as well as preventative health care procedures, for instance vaccinations as well as routine health screenings.
In order to reduce the cost of the cat insurance coverage, you might want to select a plan that will only pay in the instance of disease, sickness or some type of accident, as opposed to covering the wellness visits. It is often helpful to discuss the coverage options with your veterinarian as he/she can offer insights about what might be the best coverage for your family pets based on their overall health and age.
To learn extra informative knowledge go here Best Pet Insurance Policy also head on over to ASPCA Pet Insurance and more information at Pet Insurance Quote
Cat Ramps Are The Perfect Solution For Aging Cats


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New K - 5th grade students to the Clarkston Community School District must enroll at their home boundary elementary school. New 6th – 7th grade students must enroll at Sashabaw Middle School, 5565 Pine Knob Lane, Clarkston, MI 48346. Please call 248-623-4200. New 8th -9th grade students must enroll at Clarkston Junior High School, 6595 Waldon Road, Clarkston, MI 48346. Please call for an appointment 248-623-5600. New 10th -12th grade students must enroll at Clarkston High School, 6093 Flemings Lake Road, Clarkston, MI 48346. Please call 248-623-3600. |
The following information is intended to help you through the enrollment process. An original birth certificate is required. A copy will be made and the original will be returned. For your convenience and to expedite the enrollment process, the required forms are available for printing from the Clarkston Community Schools Forms web page or from the links below. |
Release of Student Records (Grades 1-12) Immunization Checklist (Grades K-12) Technology Agreement (Grades 1-12) Elementary New Student Survey (Grades 1-5) Student Code of Conduct (Grades 6-12) New Student Athletic Transfer Information (Grades 9-12) Authorization to Administer Medication (If Applicable) |
In addition to the above forms, the following documents are required for enrollment:
Questions about enrollment....Please contact Curt Barnum at 248-623-5411. |

subset: commoncrawl


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Topic Review (Newest First) |
trcy | The training class I go to is for all ages of dogs. They are all on leashes and at the end they can socialize a bit, but on leash. Also, it's a non treat based training. | |
bellske |
First puppy class I went to the instructor regularly let the pups off leash and to free roam, my girl got swamped and really didn't like it with 10+ puppies up in her face, she'll come out of her shell by the end of the course the instructor kept saying but it didn't feel right to me. Ohh and she wanted me to dominate my 10 week old pup which sent alarm bells ringing for me, and then when she wanted everyone to handle everyone's pup and my girl wouldn't go to a lady and the lady grabbed her front legs and started to drag her towards her and I had to say something, I thought I'm out because ever since I was kid my grandfather told me never pull a dog by its front legs its not good for them. We went to another puppy school with only 5 people after I spoke to one of their instructors and found out how their classes work, it was much better for her the pups didn't play with each other and everyone stuck to their mats with the odd sniffing of the neighbours but it was all very controlled not regular 5min free for alls and the class were also told that my girl might be a little afraid due to what happened at the other school, so the class knew and actually tried to help her overcome uneasiness, I still think she's affected by it a little because she's fine with larger/adult dogs, but pups and small dogs shes cautious of. And if there were any issues like the dog that was guarding his pig ear then trying to take his neighbours ear, the instructor stepped in and moved the troublesome pup and actually spent time discussing the issue and ways to help the pup learn, so we all learnt even if we weren't having the problem. So I guess my advice is to speak to the instructors find out how they do their courses before spending the cash, wish I had done it first oh well lesson learnt lol |
Msmaria | Although my puppy class had some play. It was only for the last 10 mins of class and only 5 puppies in the class. The class was an hour long. Older dogs were not allowed in the puppy class. | |
Sunstreaked |
I completely disagree with the trainer who thinks dogs of any age, but particularly during the formative ages, should be allowed to be bullied. |
Lucy Dog |
There is no interaction between dogs in my puppy class. It's strictly training and learning to listen to commands with a room full of other dogs (distractions). There is no play time. I'd recommend you find a better class. One that actually focuses on training and not play time. |
Dudes mom | No, you should not let your puppy get bullied. It is your job to protect your puppy, she needs to know she can depend on you in order to build a healthy relationship. | |
Mikey |
First Puppy Class This morning was a very tiring day for my 14 week old. First around 9am she got stung in the mouth by a bee which started to swell just a little. After doing some research in a panic I found 1 sting shouldn't be too bad. I watched her close and decided around 1pm we would still go to her first day of puppy training at a local club. First thing we did was take our dogs around the yard they would be in to smell everything. Then we took them into a smaller yard and took them off their leashes and let them play with one another. Every 5 minutes or so we would call them to us, give them a treat and make them stay by us for 5 minutes or so. After about 45 minutes of this we walked them around a little course with a bridge, a sea saw and some other items. And that was it. My question: I honestly felt bad, there is all types of dogs in the class and my dog was fine watching them and running around but wasn't too into playing or getting played with. They had a golden retriever that is bigger than her that was just bullying her and all the other dogs there. Would chew on her, would jump on her..was super hyper active. When my dog would cry the trainer would have the lady hold her dog and then wouldn't let me comfort mine because she didnt want my dog to learn that if she cries i come running. Is this normal? Should I let my dog get bullied? |


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Name |
News International Tourism Fair Ready to LaunchIn its 33rd year, this international tourism event will be held at Madrid's IFEMA Convention Center from January 30th to February 3rd, 2013.. Fitur is kicking off in Madrid tomorrow with its usual fanfare and packed schedule of events. |
News Albacete Celebrates Jewish-Manchego Gastronomic HeritageOn June 30th, the city of Albacete in Castile La Mancha hosted the first gastronomic event to celebrate the history and heritage of the city's Jewish-Manchego cuisine.. Organized by the renowned knife-making firm, Arcos, the purpose of this |
News Chorizo de Cantimpalos Added to RegistryOn May 31st, the Official Journal of the European Union (OJ) published the inscription of the name "Chorizo de Cantimpalos" in the registry for the protection of geographical indications and designations of origin for agricultural |
News Eleven Spanish "Revelations"This September 30th, Madrid Fusión will again reunite the previous winners of the "Revelation Chef" award, a prestigious recognition that is awarded during the annual Madridfusión symposium to the year's biggest up and comer |
News More than 400 Spanish Food Companies Will Attend AnugaThe 32nd Anuga will run from 5th to 9th October 2013 in Cologne with a strong presence of Spanish food companies.. Anuga is one of the top leading trade fairs in the food sector and will occupy the entire... |
News Gastronomic SecretsThe Guadalajara City Hall is inviting people to uncover the city's gastronomic secrets, in two different sessions that will take place on the 30 and 31st of October, and the 13th and 14th of November.. The purpose of this... |
News Route of the Cocido MadrileñoFrom February 18th to March 31st, it will be a lot easier to enjoy the hearty and delicious taste of 'Cocido Madrileño' in the Spanish capital city, thanks to the celebration of the first ever Route of the 'Cocido Madrileño'..... |
News Spanish Primer Minister Dinner at Martin Berasategui's in ShanghaiDuring the Spain National Pavilion Day of Shanghai Expo 2010, on August 30th, Spanish Prime Minister, Jose Luis Rodriguez Zapatero, had dinner at Basque 3-star Michelin chef Martin Berasategui's restaurant in Shanghai.. The dinner was also |
News 34 Years Celebrating LambMesón de la Villa Restaurant in Aranda de Duero (Burgos) has kicked-off the 34th annual celebration of its most traditional and beloved dish, roasted suckling lamb.. From May 6-29th, 2011, this classic establishment will once again be paying |
News Fitur 2011In its 31st year, this international tourism event will be held at Madrid's IFEMA Convention Center from the 19th to the 23rd of January, 2011.. Primarily focused on tourism and gastronomy, the purpose of Fitur is to provide a... |
News Still Spanish Cooking in BierzoIt's time once again for the annual Gastronomic Festival of Bierzo, which is celebrated ever year from mid October thru early December.. > > For the 28th year in a row, the region of Bierzo in Castile-Leon , is gearing... |
Out of Spain Estragon Tapas BarLocated in Boston's South End, Estragon Tapas Bar is the creation of Madrid-born Chef Julio de Haro, who serves a cuisine reflecting the fresh simplicity of traditional Spanish fare and many family recipes. Classical pintxos include pan tumaca with ... |
News Cascajares Wins Canadian AwardSpanish food producer continues its American expansion.. Québec's Conseil de la Transformation Agroalimentaire et des Produits de Consommation (CTAC- Canada's Council for the Transformation of Agrofoods and Consumer Products) has awarded |
News Memories of A Taste of Spain in PerúJournalist shares Spanish culinary experiences.. Nora Sugobono arrived in Barcelona when she was 17 and even though she missed Perú, she soon started to love Spain through its Mediterranean flavors and a table full of creations as fideuá , pa |
News Ángel León and Frank Camorra at Melbourne Food and Wine Festival 2014Spanish chef Ángel León, famous for his seafood creations is the right chef for the event, the theme of which is water, river and ocean fare.. With 2014 right around the corner, foodies in Melbourne, Australia are already talking about... |
News Gastronomy Awards Shine in MadridThe gastronomic blog "Salsa de Chiles", which appears in Spanish national newspaper ABC, presented the sixth edition of its annual awards last night in the Spanish capital.. Created by Spanish food critic Carlos Maribona , these annual |
Out of Spain Bodega Las TablasA long communal table welcomes a frantic audience of tapas lovers who have conversation as the most important menu item. A centerpiece of Spanish cheeses , chorizo , Serrano and lomo embuchado sparkles a new lifestyle amongst Puerto Rican diners... |
Spain for foodies M.BCuisine advised and managed by Martín Berasategui, who has placed one of his trusted chefs, trained at his Lasarte restaurant, as head of kitchen. In this restaurant, located in a luxury hotel complex on the island of Tenerife, Martín Berasategui... |
News Quench Demystifies EVOO CookingSpanish specialists discuss how to Extra virgin olive oil (EVOO) can be both healthy and hot.. Much has been discussed about the wellness flavors and healthy benefits of extra virgin olive oil . Rich in polyphenols and other antioxidants, EVOO |
News A Flying Touch of SpainIn Spain or abroad, a little bite of Spain can make your airport wait more relaxing and enjoyable.. La Moraga and Porta Gaig , in Spain, and Piquillo, at JFK's International Airport in New York, have made it to The... |
News Sherry, Dream-Wine for Food PairingsFood is a vehicle to introduce diners to the ample flavor spectrum of Sherry wines.. Maximiliam Kast is the sommelier at Fearrington House in North Carolina and also a Sherry devotee. Convinced that Sherry is greatly misunderstood and |
News Gastronomic Capital of Spain 2014The cities of Huesca (Aragon), Sant Carles de la Rápita (Catalonia), Valencia and Vitoria Gasteiz (Basque Country), have presented their candidacies for the 2014 Gastronomic Capital of Spain.. Selected by the Spanish Restaurant Industry Federation ( |
News Spanish Chef Francis Paniego Sees Michelin StarsFrancis Paniego's restaurant, El Portal de Echaurren in Ezcaray, has just received its second Michelin star, bringing this Spanish chef's total up to three stars.. In addition to this coveted, second Michelin star for El Portal de Echaurren |
Features index Extra Virgin by Aceites MaevaAccording to the Spanish Association of Edible Oil Bottling and Refining Companies (ANIERAC), Andalusian company Aceites Maeva bottles more extra virgin olive oil than any other in Spain, accounting for 20% of the total and leading its closest competitor by... |
Spain for foodies VillenaRestaurant owned by the chef Julio Reoyo who also owns El Mesón de Doña Filo (Madrid). His business in Segovia surprises with its creative gastronomy that gives center stage to the quality produce of the region (Castile-León), of which Julio... |
Spain for foodies TierraRestaurant with Santi Santamaría as gastronomic director since 2004 to 2011, located in the five-star Valdepalacios hotel. Santi Santamaría named the second chef of the Santceloni (Madrid) as head of kitchen, Ismael Delgado, who shared his work with Óscar Velasco... |
Spain for foodies AlejandroIn 2001, Alejandro Sánchez opened the doors of this distinguished restaurant on the Paseo Marítimo de Roquetas de Mar (Almería, Andalusia), after having worked alongside great chefs in a various kitchens in this country, including Doña Filo, Casa Solla and... |
Spain for foodies ZarandaThis restaurant received the first Michelin star in the 2001 guide, and its success with the public has obliged them to leave their small space in Calle San Bernardino street to open a new much larger business on the Paseo... |


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03-14-2013 #1
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Sony: Developers Requested x86 Architecture for PS4
uuummmmm...Fried Beer iis a reality.
03-14-2013 #2
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Well they got what they wanted so they better put their games on the PS4.
Rest In Peace Paul Walker ;_;7
03-14-2013 #3
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Sony: Developers Requested x86 Architecture for PS4
I guess we can finally conclude that the Cell and Blu-Ray didn't have much of an impact as many people were led to believe.
mistercrow wishes they had posted this first.
03-14-2013 #4
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No not really, it just gave PS3 some of the nicest looking games this gen and removed disc swapping, something I haven't done for over a decade.
Sony should have gone x86 this gen but it doesn't matter...it has learned from its mistake. Dev friendly tech + Sony's passion for providing bar raising content will make for a good 8th gen on PlayStation.
KungMartin90 , INFAMOUS8 wishes they had posted this first.
03-14-2013 #5
03-14-2013 #6
I'm sure developers would of taken anything over Cell again, x86 is just a nice bonus not that most developers will even get that close to the hardware level to really concern them.
03-14-2013 #7I don't need no stinkin' signature!
03-14-2013 #8
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Now that Sony isn't running like a 3 legged dog, I suspect they are going to smash it, 70% market share for the generation.
03-14-2013 #9
DeRaddyoMoFo wishes they had posted this first.
03-14-2013 #10
03-14-2013 #11
03-14-2013 #12
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dont blame blu-ray blame cell. now third party devs cant complain. if crazy ken was still at sony he would have picked some hard cpu to work with again that guy was nutz
03-14-2013 #13
that's exactly what would have happened. Obviously the PS1 was so easy to develop for I think, it had a slew of games, the PS2 from what I remember reading was a tiny bit harder to develop for and the PS3 was just a "what the fuck is this". Every single system was getting more and more difficult.
03-14-2013 #14
Are you saying 70% of all gaming will be on a Sony device when the next consoles are out, or are you talking only about the consoles? Either way, that's a mighty big figure.
My knee-jerk reaction is great hardware but people don't have as much disposable income as they used to, thus it follows that sales won't be great until the price point is low (same as the PS3, really). I couldn't possibly put a % on it but I think as time goes on, the basics are becoming much more important than the luxuries.
03-14-2013 #15
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Guy, you all got virus of NextGeniosis Hope Sony and MS hurry up and cure you
( _)>⌐■-■
Currently playing GOW:A
Next : Last of Us, One Piece : Pirate Warriors 2
03-15-2013 #16
Ps1 was the best of a bad lot really, it was easy enough to code on and code required to make it work was very stream lined but it was by no means an easy machine. Compared with Saturns multi CPU/GPU configuration it was a dream and you didn't have to worry about the odd ball restrictions of the N64's RAM & cartridge setup.
Ps2 was easily the worst of the lot, not only was it lacking in development tools the CPU was an absolute mess, a powerful chip mess but still a mess. Technically the Emotion engine was eight separate programmable processors and all of them had to coordinated as such. I heard of cases in the opening months of development on the machine that it took some programmers weeks to get even the first images on screen and I'm talking just simple squares and circles.
Ps3 while not inherently difficult to program for at a processor level, each processor on it was very well thought out. The issue was what was asked of it in term of software design. Splitting game code 8 ways is incredibly hard at the best of times and even worse when you are trying to make it run efficiently. I can see where they where heading with the design but the rest of the industry wasn't following in it's lead.
03-15-2013 #17
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In hindsight most people in the industry agree that the Cell was a bad move in the end. Maybe this was a result of mass incompetence and an unwillingness for developers and the industry to adapt. Still, it seems things would have rolled much smoother with Sony and the PS3 had they taken a more typical and expected route. I'm happy they did. Developing will be faster and easier, and we gamers benefit in the end as a result.
03-15-2013 #18
03-15-2013 #19
That moment of truth when:
Goku takes off his weighted clothing.
03-15-2013 #20
03-15-2013 #21
03-15-2013 #22
03-15-2013 #23
03-15-2013 #24
03-15-2013 #25
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Sent from the WarlockLast edited by D3seeker; 03-15-2013 at 06:15.
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Program Alerts
Provider Downloads and News
Treatment Options in Acute Pain February 2007
Patient-Centered Medical Home Project
The Health Care Agency Web Site includes several features designed to improve accessibility for users with disabilities. In addition to the features that make the graphics version of the site more accessible, a text-only version provides added convenience for users. Because of the complex nature of some documents on this page, not all information has been provided in a text format. If you require more information than is available, please contact us at (714) 834-3166 for assistance.


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recipe reviews for:
"Ready in less than 30 minutes, this spicy, garlic lime chicken is perfect for a weeknight meal."
My Profile | Cooks I Like Reviews | Photos | Recipes | Menus | Blog
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Cooking Level: Expert
Cooking Level: Intermediate
A new recipe revealed each day until Christmas. Check it out!
Get time-saving recipes to save your busy life.
Get the season's best recipes for holiday feasting.
See how to make 5-star sautéed chicken that's great for fajitas.
See how to make incredibly quick-and-easy garlic chicken.
See how to make tender breaded chicken breasts in a lime and butter sauce.


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…This development cycle methodology enables the client to evaluate the end product at an early stage of the process, and for 'on the go' modifications and decision making to take place.
Comwise provides solutions for a wide range of clientele including banks, government, insurance, software vendors, Start Up companies - and many others.
...This unique collaboration methodology enables Comwise to reduce expenditure and offer attractive rates, specifically designed to fit each of its client's needs.


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Dictator High is a school that exists in another plane of existence, time means next to nothing here, and the boys who attend school at DHS exist from many eras in our Earth's timeline. The school is overseen by one man, Gandhi, who seeks to form his charges into the best that they can be. Classes are focused on real world applications, and meaningless courses such as history or math are discarded in favor of "Dressing for Success" or the extra-curricular offering, "Painting for the Inept." As all students must be well rounded, an introduction to polemics is required within the first two years of school. The sky is truly the limit as students are able to work one-on-one or in small groups to design student-centric courses with the teachers. But of course, classes are not the only part that sets Dictator High apart from other institutions of learning. Although it is an all-boys school, DHS has a partnership with the all-girls Stepford Preparatory School. Joint events are often held, from theater programs to dances.
OOC Information:My number one rule in this is to leave any personal political beliefs at the door; you disobey this and you will be kicked. This is meant to be comedic in nature, let's keep it that way. If you've seen Clone High, that's the kind of atmosphere I'm aiming for. If you haven't seen it, go youtube it, it's pretty hilarious.
My standards for this will vary a little bit from site standards. Post a few sentences (minimum, no one-liners) up to about a paragraph. Correct spelling and grammar is required. No text-talk unless it is in the format of being a text sent or received. Also, because this is a personal pet peeve, please use the third person (not the first, so "he" instead of "I").
I may consider allowing you to create a female character from the all-girls school as a side character. Possibly. Not a definite.
Not sure where to start in picking your dictator? Check out this or this.


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Difference between revisions of "Madona"
Latest revision as of 23:56, 28 November 2012
Madona [1] is a city in Latvia. [edit] Understand
[edit] Get in[edit] By planeThere are no airports with regular air traffic in vicinity.
[edit] By carThere are two main roads going to Madona from capital Riga - one through Sigulda and Bērzakrogs, other through Pļaviņas. Road through Pļaviņas is slower due to traffic and inhabited areas with speed limitations but the road conditions are slightly better. [edit] By Hitch-HikingIt is pretty popular to hitch-hike in Latvia and if you can get to Madona as well. If you come via Pļaviņas, make sure you get off on the bypass road at roundabout before crossing the railway bridge in direction of Jēkabpils. From there the branch road P37 to Madona starts. [edit] By busMadona is well connected by bus service with Riga and other smaller cities in eastern Latvia. Ticket price from Riga to Madona is about 5LVL and it takes usually 3 - 3,5 hours to get there. From Madona you may also catch direct buses to Cēsis, Daugavpils, Gulbene, Alūksne, Sigulda, Rēzekne, Aizkraukle, Jēkapils and numerous small villages within Madonas novads. For bus timetables and prices please check www.1188.lv
[edit] By trainGoing by train is a relatively cheap and quick option (3 LVL, <3hrs) Unfortunately train runs only once per day (evenings departs from Riga and early mornings returns) and are often crowded with students on Fridays. No advance booking of seats is available. As of summer 2011, there is also a morning train from Riga on Saturdays, leaving at 08:29. [edit] Get around[edit] By carTown is small and getting around by car is an easy task, without traffic jams and takes minutes. Beware that due to ongoing pipeline replacement works the surface quality on some of the streets may be really bad. Free public parking places are available in many places in the centre. [edit] By public busThere are 3 public bus lines in the town. Ticket (0,50LVL) can be purchased on board. [edit] By bicycleIn late spring/summer/early autumn probably the best way to get around is bicycle. Do not leave your bike unlocked on the street as bicycle thefts are not uncommon. Bicycle rental is available at Smecere's Sport Complex [3]. [edit] On footGetting around the center by walking is good option in any season.
[edit][add listing] See
[edit][add listing] Do[edit] In winter
[edit] In summer
[edit] LearnMadona is a home for 2 high schools and a branch of public university RPIVA. Check the international exchange programs for possibility of studying. Basics of Latvian language are essential to study and live. [edit] WorkCurrent economic situation and high unemployment rates in general do not offer many possibilities to find a job, however finding a seasonal job in tourism may still be possible. For EU/EEA citizens no permits and no lengthy paperwork is required. [edit][add listing] Buy
Credit and debit cards are accepted almost everywhere.
[edit][add listing] Eat
[edit][add listing] Drink
[edit][add listing] Sleep[edit] Stay safe
[edit] Cope[edit] Stay connectedGSM/3G coverage is virtually everywhere.
[edit] Get out


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Has anyone here won a fairly good jackpot in the same night. I would figure the odds of that happening would be next to nothing. I know personally I have never hit twice in one night.
Has anyone here won a fairly good jackpot in the same night. I would figure the odds of that happening would be next to nothing. I know personally I have never hit twice in one night.
I never have either. But this past weekend, I saw someone at the Trum Taj Mahal in Atlantic City that did. She won the $14,000+ progressive on a $5 machine. About an hour later, she came back into the area to play, sat down, and hit for $20,000 on her first hand. While waiting for them to come pay her, she played the machine right next to her winning one, and hit again for $5,000. I couldn't believe her luck!
Oh my goodness, that is just no fair. I am lucky if I hit a jackpot once, but that is three times. I can't believe it. She must be doing something right. You should have nudged her and asked what her trick is.
She wasn't very approachable. The first she won, I walked over to see how much, I smiled and said, "Wow... very lucky" and she ignored me, so I didn't want to pester her the second and third time. She acted like "whatever" which suprised me... I would have been literally jumping up and down!
3 time winner in less than 24 hours at Cherokee Casino in Tulsa on the same machine, a $5 Money Bags:
Friday: $1,600
Saturday $ 4,000
Saturday $ 2,400
The last jackpot was hit within a few minutes of the second.
Nice! Those are the kinds of stories I like to hear!
Originally Posted by rocketslots
Slotty McSlots
We play a lot, and there are very few 'Rain Main' moments, but here are a few
A) Seneca Niagara- Went in with just $1,500 and hit
$30,000 Triple Double Star $10.00 machine
$16,000 Triple Double Diamond Mix $10.00 machine 10 minutes later
$1,500 Quick Hit Progressive five minutes later
$5,000 10X 5X =(Two Bar) 15 minutes later
$5,000 Ten Times Gold
All in all, we cleared about $38,000 about two years back
B) Yonkers- Playing 10 Dollar Double Diamond $30 max bet, put $4,000 in first and then within 30 minutes
$4,800 (One Double Symbol and Red 7)
$4,800 (One Double Symbol and Red 7)
$4,800 (Two Double Symbol and Three Bar)
$4,800 (Two Double Symbol and Three Bar)
$3,000 (Double Double Two Bar)
C) Mohegan Sun Scranton
$7,500 $10 5 Times Pay
$8,000 $25 Double Diamond
$4,500 $5 Red Hot 7
$3,200 $5 Double Diamond
and a few smaller ones
D) Mirage Las Vegas
$25,000 Triple Diamond ($10 machine)
went accross the street to the Venetian and 30 minutes later
$15,000 5 times pay $10 machine
That being said, don't get so excited when you see this as there lots of bad days in the middle and suffering, but when it works, it really works
There are also about 10 or so instances with two $6,000- $8,000 hits the same day
If people bet more, winning more makes sense. It is easiest to relate things in terms of the line bet vs the amount won.
For example:
IGT's Price Check - 5-cent denomination, 9-lines, 45-cent total bet (1 line):
Won 10000 ($500) -- which is 10000x line bet.
WMS Seal Slide - 5-cent denomination, 9-lines, 45-cent total bet (1 line):
Won 10000 ($500) -- which is 10000x line bet.
Won both within the same hour one night.
My best nickel slot win was -5-cent denom, 9-lines, 2 lines (.90 cents)
Won 43000 nickels ($2150) - "Hot Dawgs" - Konami-- which is 20000x line bet
I've also won jackpots (Price Check 10000x -- 2 more times), Telephone Tag 15000x, Yukon Gold (10000x), Bally Blazing 7's Video (12000x).
Those are the ones I can remember right now.
/\/\/\/\ the Shamus /\/\/\/\
PS - I've definitely spent more than I have won (over the past 10 years) or so.
how about two jackpots in a row on the same machine. i was at tropicana playing the $5 red, white and blue when 3 sevens came up and paid $1,200.00. after the attendant paid me and reset the machine he asked me to play it off and on the next spin 3 sevens came up again and paid another $1,200.00, i was hoping that the third time was the charm but was not fortunate.
One time I saw a lady on the Casino Queen casino in E. St. Louis, she was playing the $1 double diamond, she was playing 3 coins, hit the progressive, won about $4 grand, they came out and paid her, then they had to reset the machine, told her to play again, this time she only played 1 coin, and would you believe the 3 double diamond's came up agin, well she didn't win the progressive, but she did winn $800. I just couldn't understand why she didn't play the 3 coins again. She was happy!!!!


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NFL Uniforms Football
Tuesday, April 03, 2012 3:41 PM
The new Pittsburgh Steelers uniform is displayed on a mannequin in New York, Tuesday, April 3, 2012. NFL has unveiled its new sleek uniforms designed by Nike. While most of the new uniforms are not very different visually, they all are made with new technology that make them lighter, dryer and more comfortable. (AP Photo/Seth Wenig)
Related articles
- Browns' new Nike uniforms look like old ones April 03, 2012, 11:57 AM
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You're watching...
Mitt Romney gains some momentum
Talking Points 4/25
Apr 25, 2012
You're watching...
Talking Points 4/25
Apr 25, 2012
Also in this playlist...
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-- Bill O'Reilly thanks for watching us tonight Mitt Romney gain some momentum that is the subject of this evening's talking points memo the governor had a good night last night winning all the primaries and getting primetime exposure to tell -- country.
Just why President Obama is misguided.
It's at the center of his vision it dispenses the benefits.
Borrows what it can't take.
Consumers are greater and greater share of the economy.
You know with Obama carefully installed.
Government would have control of almost half of the economy.
And we would have effectively ceased to be a free enterprise society.
This president's putting us on a path where our lives will be ruled by bureaucrats and boards commissions is ours.
He's asking us to accept that Washington knows best and can provide all.
And that.
Will be the theme of Romney's campaign throughout the rest of the year that mr.
Obama is a far left guy who wants to constrain.
Individual freedom.
For his part the president knows he's gonna be defined as a militant progressive but doesn't seem to bother him.
He's seen this week is a college loan should be capped a 3.4.
Michelle and I we finance -- our entire college and law school educations -- With loans and debt and for.
The first ten years of our marriage we were still paying stuff off he even when we -- supposed to be saving for Malia and Sasha.
His back story and that 2007 the democratic congress okayed the low college interest rate.
But a lot of collapse.
In 2000 well so the president's run around college campuses saying he wants to keep the rate well -- At this point nobody -- there's no wish you the rate is gonna be kept down 3.4 percent.
But mr.
Obama uses any and all opportunity to tell Americans that he's there for us that his administration will profile and therefore.
It is a race between a self reliance guys run on eight and a provider.
-- voices said this before.
Mitt Romney will model his campaign on the 1980 Ronald Reagan run.
Back -- Jimmy Carter was a progressive guy in the economy was in big trouble governor Reagan defying -- far left and asked a compelling question are you better off.
Then you were four years ago.
Guess what Romney -- last night.
Four years ago Barack Obama dazzled us in front of Greek columns with sweeping promises of hope and change.
But after we came down to earth after all the celebration of the parades.
What do we have to show for three and a half years of President Obama.
Today -- Romney running as Reagan.
Obama running ads Obama.
And the American people forced to decide whether they want unfettered capitalism.
Or a federal provider.
And some.
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Hello from Melbourne Australia!!! We loved all of our USA holiday, but our FAVOURITE place was NEW YORK!! We never received the fantastic service, hospitality anywhere like the Smyth!! thanks to you especially Ela,!! & William, The two Kyles ( DOUBLE TROUBLE) !!! and The manager Kevin!! thank you all so much for all your attention and kindness, it made... More
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- Smyth Hotel a Thompson
- Official Description (provided by the hotel):
- Custom tailored to its Tribeca location, Smyth celebrates the neighborhood's vibrant history and contemporary lifestyle, offering an intimate hideaway with 100 guestrooms. Smyth Tribeca represents a modern vision of sophisticated elegance as imagined by designers Yabu Pushelberg, mixing sleek design with vintage accents to create a truly bespoke hotel. Guestrooms include rich, walnut paneling, chrome accented furniture, and hallways textured with maroon, ostrich-embossed leather walls. Signature suites boast striking Manhattan views with floor to ceiling windows and private terraces. Marble bathrooms, amenities galore, and first class concierge services provide a unique experience for an eclectic and savvy clientele. Guests can enjoy specialty cocktails in the lobby's Smyth Bar, or dine in Restaurant at Smyth featuring Chef Julie Farias. ... more less
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text: I am driving in an unfamiliar neighborhood, looking for a parking spot. It's a narrow residential street, and everybody's got their three garbage cans (one for recycling, one for yard waste, and one for regular garbage) pulled out to the curb. It's still relatively early in the day, and I don't know if the …High-five for one


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02-25-12 – Atlanta, GA>Birmingham, AL – Hi, I'm a 29 yr. old guitarist seeking a talented and driven vocalist for an original project. I have a lot of experience and some material already written. I have great equipment and a practice space with a PA and drum set. Some of my influences musically or lyrically include John Mark McMillan, Jars of Clay, Josh Garrels, Matt Nathanson, Jon Foreman, Bleach (their later stuff), Wade Bowen, and Charlie Hall. I'm a Christian and my faith is a huge part of who I am. I'm open to writing about life and love but a large part of what I want to focus on in writing is my faith. I'm looking for someone who shares that passion. I'm hoping to find someone around my age. Previous band or performing experience is a plus. I'd love to find someone who writes lyrics, melodies, or both. I'd also like to find someone who has a unique voice. I like raspy voices and I'd like to play with someone who has a good range. I have great connections and have plenty of talented musician friends to play with in a full band setting. I'm open to becoming a band with multiple members but first want to focus on finding a singer that I click with. I'm not going into this just to "make it big" or "get signed". I love the creative process or writing, recording, and performing. My focus is to be creative, write, seek out opportunities to play, and see where it goes. If things go well enough to pursue it professionally then that'd be great but that's not my reason for putting this together. I'm located about 30 minutes west of Atlanta but I'm open to driving some as long as you are as well. If this sounds like something you're interested in please email me with info about yourself. Thanks for reading my posting.
— Submit Yourself To This Role Now: 1
Click Here To Apply To This Casting Call


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4 bedroom detached house for sale Springfield Gardens, Morganstown
An exceptional detached family home with four double bedrooms and four reception rooms, a very large garden and two double garages, set well back from this pleasant quiet road in this sought after village. Morganstown is a very popular residential village and a seamless continuation o (cont.) More details ›
5 bedroom detached house for sale Main Road, Morganstown
**GATED WITH A SWEEPING DRIVE**A rare opportunity to acquire this modern detached five bedroom house situated in its own grounds at the end of a gated driveway surrounded by woodlands. The house benefits from underfloor heating to the basement and ground floor, it is fitted with a SMART central... More details ›
5 bedroom detached house for sale Clos Y Gwyddfid, Morganstown
This improved and extended detached property in the ever popular Radyr Gardens in Morganstown offers an exclusive gated entrance and paved driveway for up to 5/6 cars with views over woodland. Accommodation briefly comprises; hallway, lounge, dining room, kitchen/breakfast room, utility/storage... More details ›
3 bedroom detached house for sale Maes Yr Odyn, Morganstown, Morganstown, Cardiff
A DELIGHTFUL DETACHED family home placed in this sought after development. Offering Radyr School catchment, situated within close proximity to A470 & M4, Cardiff city centre bus and rail links and is just under two miles the heart of Radyr village. The residence boasts: Two Reception Rooms, Cloak... More details ›
4 bedroom semi-detached house for sale Chapel Road, Morganstown, Cardiff
A nicely positioned semi detached property offering beautiful views of Castell Coch. Accomadtion comprises: two reception rooms, three bedrooms, family bathroom and downstairs cloak room and large south facing garden This property requires modernisation in order to bring it up to modern standards. More details ›
3 bedroom terraced house for sale Maes Y Crofft, Morganstown, CARDIFF
An immaculate three bedroom end link property tucked away at the end of a quiet cul de sac on this elevated modern development with good rural views. Easily maintained front and rear gardens with two allocated parking spaces to the front of the house. A great location with easy access to Juncti... More details ›
£170,000Offers in Excess of
Offers in Excess of £170,000
2 bedroom terraced house for sale Teamans Row, Morganstown, Cardiff
A beautiful period cottage full of charm and character set in this sought after location in Morganstown offering fantastic panoramic views including Castel Coch the property has been tastefully renovated with direct links to the M4 and A470 and being in the catchment area for Radyr schools. More details ›
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2 bedroom maisonette for sale Springfield Gardens, Morganstown, Cardiff
A well presented ground floor two double bedroom maisonette situated in this very sought after location of Morganstown set in this position within close proximity to the local amenities, primary school, parks, restaurants, leisure facilities, Catchments to Radyr high school, Radyr golf club. More details ›
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2 bedroom flat for sale Graigwen, Morganstown, Cardiff
Enjoying its own entrance, this well presented ground floor maisonette in popular Morganstown comprises of; a generous entrance hallway, lounge, kitchen, two double bedrooms and a bathroom. To the rear is its own garden that is laid to patio and lawn. The property enjoys views of Castle Coch and ... More details ›


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Department of Counseling
& Psychological Services
West Chester University
Julie Perone, Ph.D.
241A Lawrence Center
West Chester, PA 19383
610-436-2301(Phone #)
610-436-3114(Fax #)
Spring Group Offerings are Now Available on the Group Counseling tab (at left)!!!
Triage Hours: Monday - Friday, 1:00 - 3:00pm 241 Lawrence CenterWest Chester, PA 19383 Phone: 610-436-2301 Fax: 610-436-3114 There is no charge for a triage assessment or counseling with a psychologist at the Counseling Center. Disaster Distress Helpline is a national service available 24/7 for individuals dealing with anxiety, trauma, or emotional distress. Call 1-800-985-5990 or text 'TalkWithUs' to 66746 for support. Website: http://disasterdistress.samhsa.gov/ Choosing the Right Mental Health Therapist |
Final Week of Classes and then Final Exams -- Best wishes to all for a strong finish to Fall Semester!!! *** *** *** *** *** *** *** No Appointment Necessary! Walk in Monday through Friday between 1 p.m. and 3 p.m. At that time, you will be given a brief (15 - 20 minutes) face-to-face session with a provider to assess your needs and determine the best course of treatment. All students must arrive at least 15 minutes early to complete necessary paperwork! ----------------------------------------- ******** Missing your furry little friends at home? Come see the pups for some stress relief in Sykes! Darla: Monday, Dec 9th, Noon - 2pm Tucker: Wednesday, Dec 11th, 6 - 8pm Follow them on Twitter @WCUDogTherapy Dog Therapy Visits! |


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Take a look at the Ghostbusters, Peter Venkman, jacket!
Click HERE for more!
WWE Tag Team Champions Goldust & Cody Rhodes visit 98ROCK and have a private lunch with listeners
View Gallery
Avenged Sevenfold and Deftones at the Amway Center 10/15/13
View Gallery
10.02.13 - Red Light King meet and take pics with 98ROCK listeners
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That is some P-Jam dedication!
#4's gonna sit this one out...
From Blabbermouth...
STONE SOUR guitarist Jim Root will sit out the band's upcoming
tour with
BABIES in order to focus on the songwriting process for SLIPKNOT'S
long-awaited new studio album.
STONE SOUR says in a statement:
"Everyone involved is okay with the decision and our mutual friend Christian
Martucci will be filling in on guitar.


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The Lady 'Dawgs took Oxford down to the wire but were unable to complete their rally, falling 6-5 Friday night.
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The Dismal Science Really Is
July 2, 2010
There's a reason economics is called the dismal science, and weeks like this just give it further meaning. In economics, there is what you see and what you don't. This week we are going to examine the headline data we all see and then take a look for what most observers do not see. Then we'll try to think about what it all really means. With employment, housing, and the ISM numbers, there is a lot to cover. And this letter will print out longer than usual, as there are a lot of charts. Warning: remove sharp objects from the vicinity and pour yourself your favorite adult beverage. This does not make for fun reading.
But first, a very quick three-paragraph commercial. In the current market environment, there are money managers who have not done well and then there are managers who have done very well. My partners around the world would be happy to show you some of the managers they have on their platforms that we think are appropriate for the current environment. If you are an accredited investor (basically a net worth over $1.5 million) and would like to look at hedge-fund and other alternative-fund managers (such as commodity traders), I suggest you go to www.accreditedinvestor.ws and sign up - and someone from Altegris Investments in La Jolla will call you if you are a US citizen. Or you'll get a call from Absolute Return Partners in London if you are in Europe (they also work with non-accredited investors). If you are in South Africa, then someone from Plexus Asset Management will ring. And in Canada it is Nicola Wealth Management. And Fynn Capital Management in South America. (In this regard, I am president and a registered representative of Millennium Wave Securities, LLC, member FINRA.)
If you are not an accredited investor, I work with CMG in Philadelphia. We have created a platform of money managers who specialize in the alternative management space. By this I mean they do not need a bull or bear market in order to have the potential for profits. (Past performance is not indicative of future results.) You can go to http://www.cmgfunds.net/public/mauldin_questionnaire.asp and quickly read about the past performance of a manager we recently added to the platform, and then sign up to get more information.


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Relocating from a large city in a distant land to a small town halfway around the world was just one of the adjustments that Adel El-Adawy had to make when he first arrived at The College of Wooster in 2007. A resident of Cairo, El-Adawy also had to get used to differences in cuisine, climate, and cultural traditions. Fortunately, communication was not a problem. His fluency in four languages, including English, made the transition much easier and enabled him to settle in more quickly than most.
The son of an Egyptian diplomat, El-Adawy first heard about Wooster from Sarah Fuller, a 1995 graduate, who was working for AMIDEAST, an organization that helps international students find education options in the United States.
"I met with her personally, and she told me about the liberal arts experience," said El-Adawy, who attended German-speaking schools in Berlin, Montevideo, Stockholm, and Cairo while growing up. "She also explained the I.S. program and it truly interested me," he said. "I really liked the idea of having that kind of competitive edge."
El-Adawy, who began studying English in fifth grade, also liked the fact that he could combine his passion for learning with his love for swimming — something he could not easily do in his own country. The deal was sealed when Fuller introduced El-Adawy to Wooster's Ambassadors Program, through which selected international students research the customs and traditions of their native country and share their knowledge at events on campus and in the community at large. "I was excited about the opportunity to represent my country in a formal way," he said. "The Ambassadors Program looked like a great platform to better understand Americans and to help Americans better understand my culture."
Since arriving on campus two years ago, El-Adawy has blazed a trail of achievement in the classroom and in the water. He has also become heavily involved in a number of campus activities, including Model U.N., the Ambassadors Program, and First-Year Program Council. He is an academic mentor for first-year students, president of the Communication Club, and treasurer of the Student Athletic Advisory Committee. On top of that, he works in the library and holds an R.A. (Resident Assistant) position.
Academically, El-Adawy, a double major in communication studies and German, has made the Dean's List three times in the past four semesters. For his junior I.S., he is analyzing President Obama's speech to the Muslim world, which was delivered in his home city of Cairo this past summer. Unfortunately, El-Adawy was not able to see the speech in person. "It shows the complexity and bureaucracy involved in the relationship between the West and the Muslim world," he said. "It was another first-hand experience for me to see how sensitive the relationship between the two cultures has become. I tried every conceivable way to gain access to the speech, but I couldn't do it."
If El-Adawy has his way, bridging the gap between the West and the Muslim world will someday be achieved. He is hoping to have a role in improving communication and relations between the two cultures. "There is a major gap between the West and the Muslim world," said El-Adawy, who speaks Arabic, Swedish, and basic French, in addition to English and German. "I think I could play a role in bridging that gap. Like my father, this is my passion. I think it is a prerequisite to development in my beloved country."
After graduation, El-Adawy is thinking about going to graduate school and eventually becoming a communication expert. "Working at an international media organization would be one of the things that would interest me," he said. He is also contemplating public office and may pursue government positions in his native country. Before that, however, he has a few other goals, including breaking school records in the 100- and 200-yard backstroke, which are well within his reach.
Regardless of where he is or what he is doing, El-Adawy is likely to have a smile on his face and a word of gratitude on his lips. "I feel very lucky to be here," he said. "Wooster has a really good professor-student relationship and so many resources. Everyone knows each other, and you can do a lot of different things that you couldn't do at a big school. Every student matters. I would not be here without my family and background, and I am very grateful for these opportunities."


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Shop National Geographic logo gear to support the Society while donning the signature images of an internationally recognized and respected brand. Our iconic gear with the yellow rectangle logo is classic, durable, and practical. Logo gear items include everything from clip watches to binoculars to rucksacks. National Geographic logo gear includes unique gifts and practical travel necessities.
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Outside of the U.S. and Canada:
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March 25, 2008
The Unhappy Fate of The Three Arts Club
From the Chicago Reader today: Mission Diminished by Deanna Isaacs.
Three Arts Reaches out to 'Underrepresented' Artists reported in the Chicago Tribune March 12, 2008.
The new and improved Three Arts website...
3 comments:
- Holly said...
Just recently I found myself in Chicago walking past my former home, The Three Arts Club. To my sadness, it was vacant and unalive. I had such fond memories of this place and had hoped to take a tour...no luck. What is the latest on this, I hope the City of Chicago does not allow the demolition of this, what a great loss!
- February 20, 2009 at 8:41 AM
- Sharon said...
Unfortunately, I haven't read anything about the Three Arts for a long time. It really would be devastating to many people if this wonderful old building is lost.
- February 25, 2009 at 3:06 PM
- Sunspot said...
See this newly created source for info about the Three Arts Club Chicago and add your voices! - May 25, 2009 at 7:25 AM
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Very close to metro station. Location is very good - 5 minutes walk to Avenida da Liberdade, in 15 minutes you can reach Bairro Alto or Baixa. The hotel is really oldfashioned but if you don't care is really good for short stay. Staff very nice and helpful. Worth the money paid.
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Chicagoans discuss their first time
Chicagoans share their sexy firsts, from the everyday (we've all done it in public, right?) to the less, uh, universal (who knew glory-hole etiquette frowns upon "slowpokes"?). Our erotic experts even spill their titillating tips so you can start sexploring the minute you put this magazine down.
One reader explains how she got into phone sex.
One reader cops to her first time having sex with a stranger.
One reader explains how she became a prostitute.
One reader's first time getting it on orgy-style.
One reader's first time donning leather.
One reader's first time wearing latex.
One reader confesses how she became a sugar baby.
The lowdown on the partner-swapping lifestyle.
Putting the sex back in Texas and testing out a Sqweel sex toy-all in a week's work for this sex professor.
Some helpful highlights from TOC sex columnist Debby Herbenick's new book, Because It Feels Good.


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I'm married, mom to teenage twin girls and love to read. In fact, both my husband and my girls love to read too and the dog would probably read too--if it was possible. Reading is like breathing--I must do it. In fact, I get cranky when I don't get to read much. As you can tell from my shelf, I'll read just about any genre. In fact, I've been...
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Leonardo DiCaprio takes on the trying role of the FBI's first director J. Edgar Hoover in Clint Eastwood's biopic. The film follows Hoover's life and career, including his oft-questioned relationship with his right hand man, Clyde Tolson (Armie Hammer). While DiCaprio's performance is inspired and the cast is chock full of star power, the story itself proves to be pretty dull. If you're interested in the DVD, you can look forward to the extra "J. Edgar: The Most Powerful Man in the World," where DiCaprio and Eastwood sit down to discuss the complicated life of Hoover.
Tower Heist
In this Bret Ratner flick, luxury apartment manager Josh (Ben Stiller) puts together a rag-tag team — including Casey Affleck, Matthew Broderick, and Eddie Murphy as a petty criminal named Slide — to take revenge on a swindling mogul Arthur Shaw (Alan Alda) who has robbed the apartment's staff of their savings. While the heist seems pretty convoluted, there are some funny moments that make it an entertaining watch. The DVD extras include deleted scenes, two alternate endings, bloopers, a making-of featurette, and audio commentary with Ratner and two of the film's writers.
See one more new release after the jump.


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Agamon Hula: A Paradise for Birds and People
A photo tour of Israel's famous bird sanctuary, located in one of the most significant bird migration routes and boasting more than 400 species.
By Gloria Dawson
It's easy to see why Agamon Hula Wildlife Preserve is called "a paradise for birds and people": Some 500 million birds of 400 species, including these white pelicans, migrate through this valley in Israel every migration season. The valley is surrounded by the Golan, the Korazim, and the Metulla Heights and the Lebanon and the Naphtali mountain ranges in the northern part of Israel and is in the center of the Afro-Syrian Rift one of the most significant bird migration routes in the world.
In the 1950s the Israeli government worked to drain the valley to allow for agriculture. But as the landscape changed, the birds and other animals declined in the area. The government then divided the land, reserving some space for preservation and agriculture. The Agamon region represents a unique model of cooperation between nature and agriculture in Israel.
These injured donkeys were rescued by the Agamon Hula Wildlife Preserve.
Bee-eaters are one of the many species of birds that migrate through the valley. These bright-colored birds catch bees and other insects when the bugs are in flight.
At the Hula Valley Ringing Station, birds (like this blackcap warbler) are studied. A small metal ring is attached to one of their legs so they can be tracked throughout their life. The process of adding the rings is called branding.
A swallow is fitted with a small identification ring.
This blackcap warbler is studied before being released back into the wild. The Hula Valley is an important resting area for migrating birds. Many fly from Africa and rest in Israel before they travel on to Europe and Asia.
Visitors can help release birds back into the wild — an amazing experience.
Water buffalos were brought to Israel during the times of the Ottoman Empire by refugee tribes from Sudan.
The noisy plover is a common sight in the Agamon Hula.
My approaching bike sent a flock of cranes into flight. Visitors can tour the park by bike, golf cart or safari vehicle.
For more park information, visit Agamon Hula's Website.


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HOME RNTL NATOMAS & VIC: This beautiful home has 4 or 5 bedrooms, 4 full baths, large Bonus or Media Room with 3,397 feet of living space. The Formal Living Room, Formal Dining Room and Master Suite are all warmed with fireplaces. The Kitchen with granite counters, Butlers Pantry, and Island will be perfect for family gatherings. Enjoy summers entertaining with your own pool, spa and built in BBQ. All of this comes living in the gated Westlake Community which allows you and your family access and use to the Clubhouse, Pool, Tennis Courts, multiple parks and walking trails More info Email a friend |
A 2bd 1ba + bonus room...
HOME RNTL ARCADE CRK & VIC: A 2bd 1ba + bonus room. Beautiful wood floors, fresh paint, $1095/mo + dep. 2520 St Francis Dr 916-486-0707 More info Email a friend |
HOME RNTL SO LAND PK/GRNHAVEN: A GREAT LOCATION!!! 3 bedroom, 2 bath home in Greenhaven/Pocket Area. Walking distance to Bel Air shopping center. Cathedral ceiling in the living room w/fireplace and spacious extending dining off the kitchen. Kitchen has lots of counter space, large breakfast bar and all built in plus pantry. Master bedroom suite offers cathedral ceilings, bathroom vanity. Inside laundry and a two car garage with remote controls. Kitchen over looks large backyard and patio slider leads to a deck. Automatic sprinklers and gardening services. $1,295/month, $1,300/deposit. No Pets, 7499 Windbridge Drive, 408-568-3404 or 916-962-6556 More info Email a friend |
Property Management
PROPERTY MANAGEMENT: Home Pointe Property Management The Place to be for Professional Property Management: Single Family Homes, Duplexes & Apartments. Call us at (916) 429-1205 or visit us at www.HomePointe.com Rental Hotline (916) 429-1302 More info Email a friend |
AVAIL NOW 3br 2ba, granite...
HOME RNTL ELDER CRK/FRUITRIDGE: AVAIL NOW 3br 2ba, granite kitchen, ch/a, dual pane windows. $1095/mo No pets. (916) 939-8280 or 990-3187 More info Email a friend |
COMPLETE Remodel, Showplace...
HOME RNTL ROSEMONT/COLL GRNS: COMPLETE Remodel, Showplace no pets $1295, 1st/last, 916-723-1984 More info Email a friend |
A LG Rm w/Pvt Bath- Greenhaven Area
SHARE RENTALS-SOUTH LAND PARK/GREENHAVEN: Utilities included, Fully equiped large Kitchen, great living/dining area, complete laundry area w/Washer-Dryer-a big sink; Near Bus, Rail, Colleges and Shopping areas but in a quiet/private cul-de-sac, cable-rdy. Clean, n-smk drug male pref., female welcome. Deposit-Proof of income, references required 916-393-2309 $550 Per Mo. Thanks for your time. More info Email a friend |
$390 per month Includes Utilities (West Sacramento)
SHARE RENTALS-WEST SACRAMENTO: Bedroom for Rent in Clean, Quiet, 3 Bedroom, 2 Bath West Sacramento Home. Available January 1. NO alcohol. NO pets. NO drugs. Near IKEA and Wal-Mart. $390 per month. $250 Security deposit required. Call 916-372-3807. More info Email a friend |
SHARE RENTALS-ELDER CREEK/FRUITRIDGE: 2 QUIET adults to share 3br/2ba hm $465/mo + -1/3 util. 916-470-6324 More info Email a friend |
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Received July 12, 2009; revised September 4, 2009; accepted September 4, 2009. Dr. Wise is affiliated with the Department of Psychiatry at Fairfax Hospital in Falls Church, Virginia, and with the Department of Psychiatry and Behavioral Science at the Johns Hopkins School of Medicine in Baltimore, Maryland. Address correspondence to Thomas N. Wise, M.D., Fairfax Hospital, Department of Psychiatry, 3300 Gallows Rd., Falls Church, VA 22042-3300; email@example.com (e-mail).
Copyright © 2010 Academic Psychiatry
Objective: The author describes a program for psychiatric residents in evaluating patients with paraphilic disorders. Methods: The program curriculum offers clinical education in paraphilic disorders and is organized by various perspectives within psychiatry, including the disease model, the life story, the dimensional perspective, and the behavioral perspective. Results: Graduates of this program generally find this clinical and educational rotation very useful in their future work. Conclusion: To develop an effective teaching module for paraphilic disorders, programs need an interested and knowledgeable faculty and an adequate clinical experience.
During the past three decades, there has been extraordinary growth in teaching human sexuality to both medical students and postgraduate physicians (1, 2). Yet educational challenges remain. A recent survey assessed the educational needs for teaching human sexuality in both undergraduate and postgraduate medical programs. The study reported that 88% of medical schools taught a course on human sexuality focusing upon sexual dysfunctions with no mention of paraphilic disorders (3). Most psychiatric residency programs (60%) offer some training in the diagnosis and treatment of sexual dysfunctions but have limited opportunities in clinical experience with paraphilic disorders (4). This report describes a program that trains residents in evaluating and developing treatment plans for patients with paraphilic disorders in a sexual behaviors clinic.
Third-year psychiatric residents spend half a day per week at the Sexual Behaviors Consultation Unit for 6 months. The unit was established in 1971 to evaluate and treat individuals with a broad range of sexual disorders and dysfunctions (5). The clinic is part of the ambulatory psychiatric services within the Department of Psychiatry at the Johns Hopkins Medical Institutions.
During the clinic's existence there has been a shift from seeing patients with common sexual dysfunctions, which are now often managed by primary care physicians, urologists, or other mental health professionals, to seeing more patients with paraphilic and gender disorders. Although percentages vary from year to year, about half of the clinic patients present with paraphilic and gender disorders, and the remaining patients primarily have dysfunctions such as erectile problems or anorgasmia.
Each clinic session begins with a 1-hour seminar followed by the clinical encounter. The patients may be self-referred or referred by other physicians or governmental agencies. Patients may be accompanied by a significant other or a parent if the patient is a minor. The resident interviews the identified patient for 75 minutes. If available, the partner is also interviewed by another resident. Residents, students, and faculty often observe interviews through a one-way mirror, if the patient consents. After the formal interview, an attending faculty member discusses the case and briefly interviews the patient with the resident present. The clinic concludes with a case conference with a patient again interviewed in front of the clinic faculty and residents.
The formal didactic seminars are divided into four areas. They begin with a basic module discussing the history of psychosexual disorders as a psychiatric construct. Then the basic physiology of sexual behavior is outlined. Discussions on sexual orientation and gender identity development are included, as is information on diagnostic approaches to sexual dysfunctions and disorders. Module 2 includes male and female sexual dysfunctions. Modules 3 and 4 include gender identity disorders and paraphilic disorders. The section on paraphilias reviews diagnosis, etiologic factors, and the treatment of specific paraphilic disorders.
This curriculum has been developed with the goals of teaching psychiatric residents about paraphilic disorders including diagnoses, common comorbidities, and current approaches to diagnose and treat these disorders. Another goal is to recognize the socially constructed approach to understanding such behaviors with attention to issues of psychopathology versus normality. Objectives include offering psychiatric residents clinical experience with such patients, a didactic basis for their evaluations, and clinical supervision and case conferences about their patients with paraphilic disorders. A final objective is to introduce what evidence-based data exist regarding treatment options. Evaluations are based on the clinical faculty's observations of clinical interviewing skills, mastery of case formulation during supervision, and participation in didactic seminars.
The organizing principles of the rotation reside in the concurrent perspectives of psychiatry as discussed by McHugh and Slavney (6). The specific perspectives utilized within psychiatry are the disease model, the life story, the dimensional perspective, and the behavioral model (7). Perspectives of Sexuality (8), a monograph by Dr. Peter Fagan, a senior faculty member, provides an in-depth discussion of such perspectives when evaluating and understanding patients with sexual disorders. Each approach has strengths and weaknesses and is discussed as it pertains to paraphilic disorders.
The disease model is most familiar to physicians and medical students. It categorizes through signs and symptoms a coherent syndrome to allow reliability in a diagnostic label that can correlate such with pathophysiology. It is built on a comprehensive history and examination.
In the early stages of the rotation, residents are often anxiously hesitant about taking a comprehensive sexual history from a patient with paraphilic disorder. Such histories demand careful questioning about unusual sexual repertoires.
The disease model becomes complicated when dealing with paraphilic disorders. Some residents may view such behaviors as demonstrating the diversity of human sexual preferences. They may view the pathologizing of behaviors such as fetishistic preferences as overly judgmental. Postmodern constructs eschew the labels of "abnormality" denoted in the DSM iterations that define paraphilias. Social constructionism, a postmodern philosophy, views behaviors and phenomenon from a nonjudgmental perspective (10). From a socially constructed view, paraphilic behaviors that do not take advantage of or harm another person are considered to exemplify the diversity of human behavior and not be a "disease" (11).
Such discussions are useful, but residents need to be reminded that the patients they see are usually distressed. Such emotional pain may be a reaction to the paraphilia itself or, more commonly, to their significant others or society.
A practical approach is to consider whether paraphilic behavior is "normal" as defined by Offer and Sabshin (13), who note five definitions of normality (Table 1).
The DSM exemplifies the disease perspective (14). Paraphilias are classified as recurrent and intensely sexually arousing fantasies, urges, or behaviors that involve nonhuman objects, suffering, the humiliation of others, or children and nonconsenting individuals. Such phenomena must occur over a period of at least 6 months and not be caused by another disorder such as a coarse brain disorder. These two criteria may be part of additional diagnostic elements, as in pedophilia, where age is specified to be at least 16 years with the abused victim at least 5 years younger or a child. For paraphilic entities such as sexual masochism, the fantasies or behaviors of being humiliated, bound, or made to suffer in a sexually arousing manner must be accompanied by distress or impairment in personal, social, or occupational domains.
In addition to diagnosing the paraphilia, it is imperative to assess comorbid psychiatric disorders. Fagan et al. (15) found that 38% of their paraphilic patients were suffering from another comorbid axis I disorder in addition to the paraphilic complaint.
The life story approach to psychiatry is familiar to psychiatric residents. The life story is the patient's biography, which outlines his or her developmental history from a psychological perspective (16). The patient's unique vicissitudes should be outlined to give the clinician an understanding of the salient events of his or her life. The accuracy of such a history may be limited, but as Spence (17) has noted, narrative truths are equally as important as historical truths.
For paraphilic behaviors, a careful history of sexual development is necessary. A clinician should inquire about sexual abuse and trauma, sexual education, initial sexual events, and masturbatory behaviors and fantasies in particular. Such histories illuminate the unique aspects of each patient. Transference—repetitive patterns of reaction to important figures in one's past, whether parents or other authoritarian figures—is an important element of clinical work (18). The life story can help the clinician understand such reactions. Nevertheless, it is essential to fully understand an individual's life history, both to have a framework in which to understand the patient and also to understand countertransference phenomena (19).
The problem with using theoretical constructs, such as behavioral theory (24), to explain life stories is that although they may have some sensitivity, they are not particularly specific for etiologic factors in various paraphilic behaviors (23). For example, an individual with a fetish who becomes aroused by using feminine garments in an experimental manner as a teenager may reinforce such stimuli during a period of emerging sexual arousal during puberty, and this becomes a required or preferred stimuli for such arousal. Thus, the life story is an essential element in understanding paraphilic behaviors but must be viewed as one perspective with strengths, such as understanding individuals as unique, and significant limits, such as the difficulty of empirically "proving" any such hypotheses.
Dimensions are quantitative measures that use arbitrary cutoff points to demarcate normal values from abnormal values. Dimensions of personality are useful descriptions of temperaments and personal characteristics that describe an individual's characteristic reaction to stress (25). Although residents frequently use categorical descriptions of axis II disorders, the use of various dimensions of personality better illuminate the characteristics of the patients and how they relate to provocative stressors. The Sexual Behaviors Clinic has long taught dimensional approaches to personality characteristics on the basis of the five-factor model, which quantitatively describes individuals by the five major personality dimensions of neuroticism, extroversion, openness, conscientiousness, and agreeableness (26). Individuals with paraphilic disorders are often found to have elevated neuroticism and decreased agreeableness, which makes dyadic relationships more complicated. This "psychological fingerprint" can identify personality profiles that bring characteristic responses when faced with a stressor and can be very useful in understanding a patient's current presentation.
Behaviors are the hallmark symptom of paraphilic disorders. Although some individuals have paraphilic fantasies that are preferred, the actual action or behavior of the individual is what distresses either themselves or others. Sexual functioning may be best described as a motivated behavior such as eating or sleeping. For the individual with paraphilic disorder, the behavior is goal-oriented to seek out the preferred paraphilic object to allow enjoyable sexuality to occur. Careful behavioral analysis is necessary to best understand the actual behavior and then to develop treatment approaches to modify or interrupt such phenomena (28). This requires thorough documentation of the antecedents leading to the behavior, such as a sense of emptiness, depression, or anxiety. The actual behavior and its consequences must be understood in detail by careful history. Response prevention paradigms can then be developed.
At the end of each rotation, residents are asked about the benefits and criticisms of the experience, which often leads to changes in the rotation. In addition, regular departmental assessments of the clinic rotation are conducted. Finally, a survey was conducted to assess the utility of the clinic experience. The 120 respondents were residents of the Hopkins program who completed the rotation from 1988 to 1998. They reported that the knowledge and skills acquired were very helpful clinically in conducting a sexual interview in a nonjudgmental manner. They also felt that the experience increased their appreciation of the role of comorbid psychiatric disorders upon sexuality. Some suggested adding seminars about legal issues in paraphilias and more discussion of childhood gender disorders. These comments led to curricular additions (29).
Each case requires understanding of the various perspectives, but often one or more of these approaches will better illuminate the situation for case formulation and treatment suggestions. Some individuals with paraphilias will present with clear elements that make their diagnosis simple but will have limited ability to report their life history in detail. A significant other may often provide important corollary information. Personality dimensions are best identified through psychometric testing using the five-factor model or the Esyenck Personality Inventory (30). Behaviors require careful historical documentation. In attempting to develop a treatment plan it is necessary to initially stop certain behaviors such as coercive sexuality. Use of antiandrogen medications can lower libidinal drive to aid in such behavioral cessation (26). Only then can the physician and patient consider earlier life events, which can offer some understanding of the individual's unique introduction to sexuality and subsequent development.
Financial challenges are ever-present in ambulatory academic programs due to the overhead inherent in a hospital setting. Nevertheless, generous departmental support and a cadre of voluntary faculty have allowed the program to continue.
An educational challenge is to allow sufficient time for trainees to treat patients in ongoing therapy. This is available for all residents who can manage such patients in a supervised setting. Due to many competing educational and clinical demands, only a few residents do this during their third year. A popular fourth-year elective is available for ongoing treatment of patients evaluated in the clinic.
As Sir William Osler noted, "He who studies medicine without books sails an uncharted sea, but he who studies medicine without patients does not go to sea at all" (31). This embodies what is necessary for programs to develop an effective teaching module for paraphilic disorders. The essential elements include an interested and knowledgeable faculty and an adequate clinical experience.
Dr. Wise is a Consultant and on the Speaker's Bureau for Eli Lilly.
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