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Traditional methods of carrying out a customer satisfaction survey make it difficult for the customer or client and easy for the supplier. So most customers avoid doing it, and you lose customers without even knowing it.
Want to REALLY know what your customers really think of you? Send them a Customer Thermometer instead.
Your customers get a unique customer satisfaction survey in the form of a traffic light email and click a single button to let you know how they're feeling.
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It shows your customer how much you value their time and feedback. And since it's so flexible, you can use it to measure almost anything – from staff satisfaction through to internal customer feedback.
Customer Thermometer is a beautifully designed traffic light email, an email merging system, a customer alert system and a customer satisfaction survey system all rolled into one.
SAN FRANCISCO- The 5 winners of the coveted Demo God award are Kinsa, PanaCast, Volio, MakerSwarm, and Beer Hunt. The… Continue reading 〉
This year, Silicon Valley had a few big moments of clarity and cooperation between entrepreneurs and digitally-savvy patients and doctors.… Continue reading 〉
For the longest time, mobile devices came in clear, separate categories: laptops, phones, handheld game players, and music players. But… Continue reading 〉


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Blogs : Harvey Steiman At Large
Posted: May 28, 2013 By Harvey Steiman
The National Transportation and Safety Board recently recommended lowering the maximum allowed blood alcohol concentration (BAC) for drivers to 0.05 from its current 0.08. Beer and restaurant industry groups called foul. So far official voices of the wine industry have been silent.
For me it's simple: I don't want to be the cause of someone's death if I can help it, and I can minimize that risk if I don't get behind the wheel buzzed. If I am driving, I simply won't take that extra drink. That's my choice. The sticky issue is whether the law should be tightened.
Blogs : Harvey Steiman At Large
It's a whole different non-trendy world
Posted: May 24, 2013 By Harvey Steiman
It was in Barcelona that I realized why they call it a tapas bar. You know what it's like in a crowded pub, the crush of humanity trying to get the bartender's attention over the happy buzz of the drinking crowd? The shoulder-to-shoulder throng pressed together in tiny El Xampanyet, near the Picasso Museum in Barcelona's Barrì Gotic, had the same vibe on a rainy Saturday afternoon. I could not fathom how a barmaid, er, waitress, could possibly get plates of croquetas and pintxos, not to mention glasses of cava, to those who ordered them.
Somehow Barcelona denizens, happily regaling each other in Spanish and Càtalan, navigate these treacherous scenes with aplomb. Here are my notes of five of the more popular tapas bars.
Blogs : James Laube's Wine Flights
Posted: May 23, 2013 By James Laube
The summer 2008 wildfires in Sonoma County have claimed another victim: Marcassin Pinot Noir.
The winery has decided not to release its 2008 vintage, it announced in its latest newsletter. "We are passing on the 2008 Pinot Noirs," wrote John Wetlaufer, who owns the Sonoma winery with his wife, winemaker Helen Turley.
Blogs : Mixed Case: Opinion and Advice
That's one reality-TV program I would stay tuned to
Posted: May 23, 2013 By Jennifer Fiedler
A disclaimer first: Reality TV is generally not my bag. But I happened to catch some of The Voice recently, and despite not being involved in the worlds of a cappella/musical theater/pop vocals (I can't sing to save my life), I have to admit that I found it super compelling. Then I started wondering what it would look like as a wine show.
Blogs : Exploring Wine with Tim Fish
Summer is finally here, so don't fret over your wines for the holiday
Posted: May 22, 2013 By Tim Fish
Memorial Day is not the time to over analyze your wine. Save that for a first-growth tasting or the next natural wine seminar. Summer is finally here, so just relax and enjoy.
Two words come to mind when I think of Memorial Day wine: easy and familiar. By "easy," I mean user-friendly, a good quaff to share with friends and family that doesn't cost a lot. And "familiar" means an old favorite, a wine you can trust not to disappoint you … or your guests or host.
I can't help you with the "familiar"—to each his own—but I'll share a few of my own later. I'll start with "easy," because there is no shortage of good, tasty value wines on the market right now. Here are 13 wines to kick off summer this Memorial Day weekend.
Blogs : Mixed Case: Opinion and Advice
The challenges of the Millennial winemaker play out in sharp relief in this most traditional region
Posted: May 21, 2013 By Ben O'Donnell
The wine biz has spent several years now wringing its hands over What to Do About Millennials. Not so long ago, it was a received truth of this big, problematic, new generation of wine drinkers that they dismissed Bordeaux as an old man's game. But stop in at any Bordeaux walk-around tasting and it's immediately obvious that both sides of that formulation are wrongheaded today: More and more, what young Americans drink, young Frenchmen (and women) made. I asked a few of these young Bordelais what it's like trying to fit 2,000 years of tradition into our modern wine climate.
Blogs : Harvey Steiman At Large
An emerging category is missing a moniker
Posted: May 16, 2013 By Harvey Steiman
Near as I can tell, Ridge Vineyards started the trend. Saxum does it too. Andrew Will pioneered it in Washington, where Cadence followed suit, and Owen Roe is the latest to jump in. These are all first-class wineries, and they independently came to the same conclusion: That for these wines they would rather blend grape varieties from a single vineyard to a site-specific wine than make a series of vineyard-designated varietals.
It struck me, as I removed the bag in yesterday's blind tasting from Owen Roe's Cabernet Sauvignon-dominant blend simply called DuBrul Vineyard, that this is becoming a separate category. And yet, we don't have a name for it.
Blogs : Mixed Case: Opinion and Advice
Posted: May 16, 2013 By Mitch Frank
Like most wine regions, Bordeaux has an annual rhythm. When the grapes ripen, it's time for harvest, or vendange. After the wine ferments, they pour it into oak barrels for élevage. With February, blending, or assemblage, begins.
May brings another annual Bordeaux ritual. Sadly, I don't know the French word for whining.
Blogs : James Laube's Wine Flights
Wine scores seem to get bigger every year. Are the wines better? Or is something else at play?
Posted: May 15, 2013 By James Laube
Anyone who pays attention to wine ratings knows one thing: Critics are giving more 100-point scores than ever before. Are there really so many more "perfect" wines today than in the past?
It's indisputable that wines are better now than a generation ago. Vineyard management, winery technology, winemaker skill – all have progressed. And as wines have improved, ratings as reflected by scores have risen. Simply put, there are more 90-point wines, those wines of outstanding quality, today than in the past.
Yet there is something else going on. The surge of 100-point ratings is about much more than wine quality. In fact, it has little to do with the wine in the bottle. Awarding a wine a perfect rating is a powerful statement. It brings attention to the wine and the winemaker – and also to the critic.
Blogs : Exploring Wine with Tim Fish
Posted: May 15, 2013 By Tim Fish
In California wine country, Mendocino County is out in left field in more ways than one. Not only is it the Golden State's most remote and northernmost wine region, but the attitude there is different compared to places like Sonoma or Santa Barbara. Life moves at a slower pace and the mindset is more unconventional, some might even say eccentric.
It's not quite like any wine region you'll ever visit, which is just what we discovered while researching "A Wine and Food Tour of Mendocino" in the June 15 issue of Wine Spectator.
Blogs : Mixed Case: Opinion and Advice
Trinchero rolls out a compostable capsule
Posted: May 14, 2013 By Dana Nigro
In my last post, I discussed the dilemma that eco-oriented wineries face when it comes to stoppering their bottles: Corks, which are natural and renewable, or screw-caps and synthetics, which can be more reliable? The same potential conflict between sustainability and efficiency crops up with the foil and plastic capsules that top bottles.
Some wineries eschew the capsule altogether, maybe opting for a little foil or wax top over a natural cork, but then miss out on a branding opportunity. Now, however, a wine-industry supplier has brought a new option to the market.
Blogs : James Laube's Wine Flights
Posted: May 13, 2013 By James Laube
Wine Spectator senior editor James Laube catches up with Ted Bennett of Navarro winery, a roadside institution in California's Anderson Valley where loyal fans lineup to buy everything from Pinot Noir to Gewürztraminer.
Blogs : Mixed Case: Opinion and Advice
Posted: May 13, 2013 By Dana Nigro
I just want to say one word to you. Just one word. Are you listening?
If you were remaking The Graduate in wine country this decade, there might be a great future in bioplastics. When organic, biodynamic and sustainable vintners look to bring their low-impact philosophies to their packaging, they often end up torn over what to do about closures.
Cork is the traditional choice, and it is a renewable material, unlike the alternatives: screw caps are made from mined metals, while synthetic corks are typically derived from petrochemicals. On the other hand, if some of your wine ends up flawed because even a small percentage of corks fail, that's outright waste—not exactly a sustainable practice either.
Blogs : James Laube's Wine Flights
Posted: May 9, 2013 By James Laube
Within wine industry circles, there's often debate about style. Winemakers talk about scaling up or down in ripeness or alcohol. Restaurateurs and sommeliers consider which wines are better-suited for their eatery, or different cuisines, or occasions.
I never hear much of anything from consumers about wanting different styles. In fact, when I'm on the road, visiting with or drinking with friends and readers, the concerns I hear most often relate to where people live and which wines are (and are not) available to them there.
Blogs : Exploring Wine with Tim Fish
The new hipster restaurants of Portland, Ore., are emblematic of a national phenomenon
Posted: May 8, 2013 By Tim Fish
I spent a few days in Portland, Ore., last week, and you can't deny it has a distinctive personality, a combo of the laidback vibe of the West Coast with the rusty sneer of an old East Coast port city. It's also one of the hipster capitals of America. Every generation has its young, counter-culture crowd, from the beatniks and hippies to the punks, rappers and beyond, but today's hipsters have created a lifestyle. You may have seen it parodied on The Simpsons and Portlandia on TV.
One thing that distinguishes this new generation of hipsters is its passion for serious food and wine and, in the past five years, dozens of hip restaurants and wine bars targeting that crowd have sprung up in Portland. These aren't places you just stumble upon. They're generally smallish and quirky, hidden away in one of the city's numerous neighborhoods. You have to go looking for them.
Blogs : James Laube's Wine Flights
The BottleRock music, wine and food festival will welcome 40,000 visitors a day to the city of Napa
Posted: May 6, 2013 By James Laube
Tens of thousands of visitors are expected to descend on the city of Napa (pop. 76,915) this week, but, oddly enough, that has little to do directly with wine. They're coming for BottleRock, a five-day music festival featuring more than 60 bands on three stages, headlined by the Black Keys, the Kings of Leon, Jane's Addiction, Train, Alabama Shakes and the Zac Brown Band.
It would be a big event anywhere; it's truly seismic for Napa. BottleRock promoters expect to draw 35,000 to 40,000 music lovers each day to the Napa Valley Expo, a 26-acre plot of state-owned property best known for the annual Napa Town & Country Fair in August, which might draw 40,000 people in a week. To get a grasp on the scale of BottleRock, think Bonnaroo Music and Arts Festival in Manchester, Tenn., or Coachella Valley Music & Arts Festival in Southern California's Indio, two big outdoor music festivals with scores of big-name acts and huge crowds.
Blogs : James Laube's Wine Flights
Posted: May 3, 2013 By James Laube
Some things need fixing at the recently sold Mayacamas Vineyards.
Some vineyard parcels are ancient by California standards. The late-1800s Zinfandel vines are gone, but some of the Chardonnay dates to the 1950s, along with Cabernet vines planted in the 1960s. Many of the vines have the girth of a tree trunk.
But the essence of Mayacamas is best left alone.
Blogs : Mixed Case: Opinion and Advice
Direct-to-consumer wine sales jumped dramatically again in 2012, to the tune of $1.46 billion
Posted: May 2, 2013 By Robert Taylor
The numbers are in and, as expected, 2012 was another banner year for winery direct-to-consumer shipping. American wineries shipped nearly 3.2 million cases of wine directly to consumers' front doors in 2012, at a value of $1.46 billion.
That's a 7.7 percent increase in volume and a 10 percent increase in value over 2011. Not only are Americans buying more wine straight from the cellar, we're buying more expensive wine—at an average price of $38.42 per bottle, up from $37.63 in 2011 and $36.56 in 2010.
$1.46 billion, with a B, is an eye-popping sum. But these numbers, presented in an annual report issued in April by ShipCompliant and Wines & Vines, shouldn't surprise anyone who's been following the decade-plus-long fight to make winery direct shipping legal across the United States. Today it's permitted in 39 states, and a look at a few newcomers confirms that wine lovers love having the option to buy straight from the winery, especially smaller wineries that aren't carried by local wholesalers.
Rep. Theodore Speliotis has introduced House Bill 294, which would allow local and out-of-state wineries, after applying for a $100 state permit, to ship up to 24 cases of wine a year to Massachusetts residents. Sen. Daniel Wolf has co-sponsored the bill, crafted with the assistance of the Wine Institute, a winery advocacy organization.
And now the bill's proponents have a new secret weapon: former Patriots quarterback-turned-Washington vintner Drew Bledsoe.
Blogs : Exploring Wine with Tim Fish
Don't let the been-there, done-that attitude ruin the experience
Posted: May 1, 2013 By Tim Fish
The curmudgeon gene runs deep in my family, so I'm always trying to look at things through fresh eyes. I was reminded of this last week during that Wine Spectator Grand Tour tasting in San Francisco.
I ran into a group of friends at the tasting and stopped to chat. These folks love wine but have gone to few large tastings. One asked if I was having a good time. Of course, I said, with more than 200 wineries pouring, how could I not be? And yet they were clearly having an even better time, and it wasn't because they were guzzling. They were just excited to be there.
Blogs : Bruce Sanderson Decanted
San Marcellino vineyard Sangiovese makes for outstanding, mineral-driven Chianti Classico
Posted: April 30, 2013 By Bruce Sanderson
Marco Ricasoli-Firidolfi grows Sangiovese from the majority of 49 acres of vineyards surrounding his Rocca di Montegrossi cellar located in Monti, part of the Chianti Classico commune of Gaiole in Tuscany.
The soil here is very rocky, a mix of the friable schist called galestro and the harder albarese, a form of limestone, plus some clay. Sangiovese from this area possesses a very strong backbone and mineral expression, and is capable of long aging.
The vineyards are farmed organically, based on Ricasoli-Firidolfi's philosophy and personal observations since taking control of the estate in 1990. "The more careful you are with nature—organic farming, for example—the more nature responds," he said. "It's not scientifically proven, but my opinion."
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Received October 8, 2009; revised October 27 and November 27, 2009, and February 5, March 12, and March 31, 2010; accepted April 14, 2010. Dr. Wylie is affiliated with the University of Sheffield in Sheffield, United Kingdom and with the University of Sydney in Sydney, New South Wales, Australia; Dr. Weerakoon is also affiliated with the University of Sydney in Sydney, New South Wales, Australia. Address correspondence to Kevan Wylie, Porterbrook Clinic, Michael Carlisle Centre, 75 Osbourne Road, Sheffield, South Yorkshire S11 9BF, UK; firstname.lastname@example.com (e-mail).
Copyright © 2010 Academic Psychiatry
Objective: The authors outline international training programs in human sexuality. Methods: The authors reviewed the international literature and Internet resources to identify key training opportunities and curricula, with particular emphasis on training opportunities for psychiatrists. Results: The authors outline key resources and training courses outside the United States. Conclusion: Training in human sexuality, sexology, and sexual medicine is evolving across many clinical disciplines, but courses remain limited in number and far apart geographically.
Human sexuality has limited representation in undergraduate and postgraduate health training programs. One of the earliest accounts of sex education within the medical curriculum was published four decades ago (1), and even earlier, the Todd Report in 1965–1968 identified deficiencies that may still exist in training programs (2). This article describes how human sexuality is taught outside the United States.
A United Kingdom study (3) identified that student doctors received only 1–2 hours teaching about sexuality at five medical schools, and only 12 medical schools offered an integrative course of more than 12 hours in the clinical years. A review of medical schools in North America found that the majority provided fewer than 10 hours of human sexuality education (4).
A review of the literature (5) from between 1970 and 1995 suggested several obstacles that prevent sexual health from being adequately addressed in health professionals' curriculum, including low priority given to the topic and lack of standardized objectives and means for evaluating current curriculum. Since then, several publications have described changes to undergraduate programs in the United States and Europe (6–9).
Given raised awareness that medical conditions can result in sexual dysfunction and the fact that sexual problems may be the presenting symptom for significant underlying disease, the argument for adequate training in the field is apparent (10). Wagner (11) has summarized why the new field of sexual medicine has changed the training needs and focus for primary care physicians. Yet a review of 1,700 medical schools globally revealed that only a minority had a multidisciplinary teaching curriculum, and more than 60% of the responding schools had fewer than 6–10 hours devoted to the topic. To adequately meet patients' needs will require that the sexual medicine curriculum move between the boundaries of somatic- and nonsomatic-inclined sides and provide an integrated curriculum that includes psychology and medicine as well as sociology, anthropology, and other related disciplines.
This need for an interdisciplinary curriculum as a basis for individual and population health is supported by other research on sexuality, including negative views about homosexuality and how this may affect treatment of certain minority populations (12–14) and gender-specific perspectives recommended by WHO regional office for Europe (15). Further, new guidance from the General Medical Council in the United Kingdom (16) mentions the need to protect patients and improve care (presumably across all areas of health, including sexual health and sexual well-being) by "promoting individual and population health."
Giami (17) conducted a "Euro-Sexo" study in Denmark, Finland, France, Italy, Norway, Sweden, and the United Kingdom. Most people working in sexology and sexual health were nonmedical health professionals, including psychologists, nurses, midwives, physiotherapists, and social workers. Most of these professionals mentioned sexology as a second career (i.e., their primary career was as a physician, nurse, teacher, etc.). Interest in sexology developed later, thus explaining the finding that the average age of sexologists is higher than that of other, nonsexological health professionals. Giami (17) commented that most correspondents who received training in sexology, sexual health, and/or psychotherapeutic techniques had undergone personal therapy and supervision, which suggests that they were active seekers of further education (18).
A special edition of the journal Sexual and Relationship Therapy was commissioned in 2006 to review sexological training in Europe. Amid the current emphasis on medical solutions for sexual dysfunction, the articles explored training in the intrapsychic, interpersonal, and social dimensions of sexual conduct, which so often lie beneath patients' sexual problems. One paper (19) looked at the institutional context and strategic perspectives from both historical and current viewpoints. Recent therapeutic advances and the diversification of professionals are argued as a particular area where training should be reviewed and consolidated if possible. Porto (19) distinguishes the medical research training in urology, endocrinology, pharmacology, and psychiatry from a second category inspired by behavioral sciences from psychology, sociology, physiotherapy, and sex educators.
The Nordic Association for Clinic Sexology was founded in 1978, and in 2000 it agreed on a three-level educational program for sexologists with identical rules for authorization in Nordic countries. Rischel and Kristensen (20) describe the progress of 12 employees who entered the program at different points, including one junior doctor who graduated in 2004. Specialist teachers from non-Nordic countries linked the Nordic traditions to orientations in other parts of the world.
The sexological clinic in Copenhagen, Denmark, was established in 1986 as a separate unit of the psychiatric department. A group of therapists in the outpatient psychiatric clinic started to offer sex therapy in 1973. The current team is a mixed group of specialists in psychiatry, psychology, physiotherapy, and social work. The three main fields of treatment are sexual dysfunctions, gender dysphoria, and sexual offenders.
New courses under development include a postgraduate program in Stockholm. Likewise, a freestanding university course in andrology focuses on sexual health at a specialized sexual disorder clinic and Ersta Skondal University College in Sweden. The course is intended to give fundamental theoretical knowledge of andrology (the medical specialty that deals with male health, particularly relating to the problems of the male reproductive system and urological problems that are unique to men) and to initiate and develop methods of confronting and working with men's sexual problems and queries. While the andrological field forms the base, psychological and cultural perspectives are also considered.
The course comprises three sections: basic andrology; sexology and methods, covering sexual physiology, various functional disorders (e.g., premature ejaculation, erectile dysfunction, and lack of sexual desire), medication, and exposing oneself or others to risk; and men's sexuality in connection with aging.
Even within countries there are often several alterative training routes for sexual health and sexual medicine and no national certifying body responsible for accreditation. For example, in the United Kingdom it is not necessary to have any specific training in sexology or related fields to practice medicine where treatment of sexual dysfunction may occur. Most urologists, gynecologists, psychiatrists, and primary care physicians (general practitioners) do not have any specialist training as mandatory within postgraduate training programs. Even when it is specified, for example in gynecology, clinical experience is often minimal, and there is no specific training in place to achieve the competencies specified (21).
In postgraduate gynecology, within the module on women's sexual and reproductive health, skill requirements include history taking, psychosexual counseling, and learning referral pathways. Knowledge is expected in fertility, sexually transmitted infection, sexual dysfunction, and anatomy and physiology of the sexual response cycle. It extends to include the principles of psychosexual counseling, sexual problems in special needs groups (e.g., people with physical and learning disabilities), and covert presentations of psychosexual problems and childhood sexual abuse (22).
For general practitioners working in primary care, the Royal College of General Practitioners Curriculum Statement 10.1 has a greater focus on sexual health than earlier documents within the women's health section under sexual dysfunction including psychosexual conditions, with advice that a "patient-centered, nonjudgemental approach" should be adopted when discussing sexual/psychosexual problems. Likewise for men, there is a focus in sexual dysfunction including premature ejaculation and erectile dysfunction (23). The general medicine curriculum focuses on history-taking skills and the ability to interpret laboratory investigations pertinent to sexual health (24).
The Institute of Psychosexual Medicine (London) offers 2-year training on basic skills for clinicians (12 hours of seminars per term and 3 terms a year provide a total of 72 hours of training). A further 2 years of seminar training allow physicians to then accept referrals as accredited specialists, should they be successful in passing the membership examination. In essence, this is another 72 hours of seminars over 2 years.
Doctors trained in this approach of psychosexual medicine use counseling skills such as active listening and reflection to understand patients' feelings and barriers to sexual performance and enjoyment. The inclusion of physician examination of the genitals is seen as an important tool by which Institute of Psychosexual Medicine-trained psychosexual doctors understand the negative links between mind and body in relation to sex. Physical examination in these circumstances is used as a "psychosomatic tool," not simply as a clinical procedure. The attitudes, anxieties, and fantasies revealed during the consultation and physical examination are all relevant to understanding the sexual problem and the possibility of change.
The training is only offered to doctors who are licensed to practice by the U.K. General Medical Council. The training process provides an opportunity to increase skills rather than knowledge, and the method of training is concerned with practice rather than theory. The doctors undergoing such training are likely to be working in general practice, family planning, gynecology, genito-urinary medicine, or psychiatry. Other health professionals can join the seminars to improve their skills but cannot take the examinations.
In postgraduate surgery, the focus for urologists in training includes andrology—the assessment and treatment of patients with conditions affecting sexual and reproductive function, including male factor infertility and other benign disorders of penile function. As expected, there is considerable detail contained in the syllabus, including knowledge about normal female sexuality, including genital function and orgasm; central nervous control of micturition and sexual function; physiology and neurophysiology of sexual function in men and women; and pharmacology of drugs used to treat male and female sexual dysfunction. Other topics include pathophysiology of sexual dysfunction in congenital and acquired diseases of the central and peripheral nervous system, understanding the effects of neurological diseases on bladder and sexual function, and conservative management including medical therapy of urinary incontinence and sexual dysfunction. Embryology of the male genitalia with particular emphasis on congenital anomalies and their effects on male sexual function and drugs and their effects on male reproduction and sexual function are also mentioned (25).
The functional anatomy (blood supply and venous/lymphatic drainage of the penis), physiology, and neurophysiology of penile erection including neurotransmitters involved in penile erection; cardiovascular function relevant to sexual dysfunction; and endocrinologies of male sexual function (hypothalamic-pituitary function and testosterone metabolism) are all mentioned. Desire, orgasm, physiology of ejaculation, and the role of the prostate in sexual function are also mentioned. Likewise, the physiology of female sexual function is included. Specific clinical skills include appropriate assessment of the man with erectile dysfunction, penile deformity, or prolonged erection.
Low sexual desire is a recognized symptom of depression (26), and estimates of sexual dysfunction in patients with unipolar depression range from 25% to 47% (27). Sexual dysfunction has been reported in other psychiatric disorders, such as posttraumatic stress disorder (28) and anxiety disorders (29, 30).
Sexual dysfunctions and related adverse effects are a significant factor in nonadherence of patients on antidepressant medication. Researchers report that 60%-75% of adverse event-related treatment discontinuations are due to the side effects of sexual dysfunction, weight gain, and sleep disturbance (31, 32). Another study reports a 45% incidence of sexual dysfunction in patients stabilized on antipsychotic medication relative to 17% of healthy control subjects (33). Estimates of sexual dysfunction associated with selective serotonin reuptake inhibitors vary, ranging from small percentages to more than 80% (25).
In addition to the general review of the literature, a search of journals using www.psychiatryonline.org and employing the term sex education to articles from 1980–2009 did not result in a single study on specific training programs on sexuality for mental health professionals. However, five articles did mention training (34–38).
In a U.K. study, although 65% of psychiatry trainees felt comfortable taking a detailed psychosexual history, only 24% reported routinely doing so. Despite the high risk of sexual side effects with psychotropic medications, only 30% asked patients about this issue. Unfortunately, 81% of trainees reported inadequate training in psychosexual disorders. Only 30% reported asking patients for potential sexual side effects from psychotropic medication (39).
Although 88% of U.K. psychiatrists agree that good sexual function is important to patients, only one-third routinely inquire about sexual dysfunction (40). Most practitioners (82%) have had no training in this area but would like to acquire more knowledge (40). Not surprisingly, only 17% of psychiatrists feel competent assessing sexual dysfunction (40).
Patients in Turkey with bipolar disorder and schizophrenia were found to often be unaware of effects of their medication on their sexual life, and clinicians were found to pay insufficient attention to the sexual problems of psychiatric patients (41).
A review of residency training programs in psychiatry by Zisook et al. (42) identified sexology training in only a minority of the 10 countries considered. In the Czech Republic, there is mention of subspecialty training in sexology for 3 years following a 3-year training in general psychiatry. Recent changes in the curriculum allow for an elective period of 2 months of sexology in a 60-month training scheme. More recently, a 5-year postgraduate training program has been introduced for all disciplines in the Czech Republic. In India, as part of residency training, sexual disorders within specialty clinics may form part of the psychiatric training program. Sexual problems are not mentioned for the other countries in the article (i.e., United States, Canada, Chile, United Kingdom, Brazil, Sweden, China, and Korea). In Armenia, a 2-year, full-time training program is available to graduates in medicine and culminates in the specialty of medical sexologist.
In the United Kingdom, sexual dysfunction is not specifically mentioned in the syllabus for general adult psychiatry (43), although the core curriculum mentions sexual development, including the development of sexual identity and preferences within the section on human development.
U.K. postgraduate training courses in psychiatry aim to prepare the trainee for the Royal College (of Psychiatrists) examinations and to acquire the factual basis for sound clinical psychiatric practice. Most of the examination process is clinically based rather than dependent on recall of factual knowledge. This inevitably restricts the time available on postgraduate training programs for specialty subject areas where clinical examination will be minimal. Because sexual problems do not form a substantial part of clinical workload for psychiatrists, overall clinical exposure is minimal.
In the United Kingdom, accreditation as a specialist may be sought from either an interdisciplinary approach, such as through training courses accredited by the British Association for Sexual and Relationship Therapy (e.g., the postgraduate diploma and masters program at Sheffield Hallam University), or within a specific specialty (i.e., qualified medical practitioners) offered by the Institute of Psychosexual Medicine. Wylie (44) has reviewed these courses. It has also been reported that in psychology there is little sex education and training during graduate school and internship (45). In an Internet-based study (46), 105 clinical and counseling psychologists responded to a questionnaire on whether they were receiving continuing education that may assist them in providing intervention to clients with sexual issues. The results suggested that observational opportunities were underutilized and more training related to sexual problems than healthy sexuality appeared to be the norm.
A curriculum for sexual medicine has recently been developed as a joint venture between the European Society for Sexual MEDLINE and the European Federation for Sexology. Initially under the auspices of the European Academy for Sexual Medicine and now under the union of European Medical Specialists, a short syllabus has been devised. Eardley (47) points out that regions and countries have very different views on the needs of their particular health care system and suggests that the curriculum can perhaps be viewed as a starting point.
The curriculum is clearly defined and provided through lectures at summer school in Oxford, England, with subsequent training opportunities adjunct to European Society for Sexual MEDLINE and European Federation for Sexology meetings. Clinical placements are also mandatory in recognized clinical facilities. Eventually an examination will entitle individuals to become fellows of the European Academy of Sexual Medicine.
Providing information outside of the traditional classroom setting is also necessary. Typically, online content of educational packages have been restricted to individuals who are enrolled with particular academic institutions or through instructional material from a particular scholar. A free online curriculum in sexual health has been available for several years by the Archive for Sexology at Humboldt University, Berlin, Germany, (www2.hu-berlin.de/sexology). Plans to use the curriculum and free material within this site and attendance at professional congresses continues to be negotiated and may provide an entry-level certification. This site also lists all of the training courses available worldwide for practitioners (http://www2.hu-berlin.de/sexology/TRAIN/index.htm).
A major development of online sexuality education has been produced at the University of Sydney, Australia. Modern technology offers an excellent opportunity and means for developing skills in sex-related issues (48, 49). The pedagogic model must be based on a sound curriculum and instructional design appropriate to learning sexual health (48). Learning activities need to foster attitudes, values clarification, and collaborative team learning and include opportunities for skills development in counseling and delivery of sexual health care.
The Graduate Program in Sexual Health uses the Blackboard learning management system to provide a competency base in sexual health as core units of study, followed by the choice of streamed learning in therapy/counseling or education/research, with the flexibility to develop specialist skills in areas of particular interest. The program is built on a constructivist learning paradigm with activities that encourage collaborative learning and the development of community.
Medical and health curricula should be revised to reflect current best practice and evidence in sexual health and encompass the multidisciplinary, interprofessional, and cross-culture nature of the science. Training and promotion of family and community health professionals at all levels of the health system should develop their capacities to understand and apply holistic sexual health perspectives in a life cycle context in all aspects of their work. Ensuring that both undergraduate and postgraduate medical and health professional curricula envelop such perspectives and agree to a core international curriculum will involve collecting data from providers around the world. Technological advances have provided the tools for such training to be provided in an accessible and affordable form globally.
At the time of submission, the authors reported no competing interests.
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In 1858, Reverend Louis Nollau accepted the first child in the German Protestant Orphan's Home with the goal to offer children a place where they could heal and feel safe. Today, 150 years later and now known as ECH, we are still striving to keep Reverend Nollau's dream alive.
With over 1,300 individuals served each year, Christmas can be a huge undertaking. We believe that every child, youth and family should have a Happy Holiday. So are asking you to Give Hope...Support ECH Every Child's Hope.
Whether you adopt a child or family or make a monetary donation, your support will go a long way in giving hope to someone who feels there is no hope anymore.
Take the time to learn more about some of the children and families we support and see how you can be a part of their joy this holiday season.
ECH Success Story: See the Video!
Success at ECH is a relative term. Young people experience success in many different forms. One young lady, Melissa, has worked her way through our Steppingstone program and now has her two children at the Early Education Center.
Here is her story:
ECH Every Child's Hope: Melissa,A Success Story
All Rights Reserved. © 2009 ECH Every Child's Hope
St Louis Campus: 8240 Saint Charles Rock Road, St Louis, MO 63114 Phone: (314) 427-3755 Community Based Programs:1220 N. Lindbergh Blvd., St. Louis, MO 63132 Phone: (314) 427-3832Kansas City Campus: 5100 Noland Road, Kansas City, MO 64133 Phone: (816) 356-0187


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Scout 1000 with Arc figures distance based on terrain angle to give you accurate "shoots-like" distance to 1,000 yards. In rifle mode, it even tells you where to hold. All with the tap of a button-in a vertical units small enough to fit in your shirt pocket. In capability and ease of use, nothing else even comes close. Scout 1000 is the ultimate pocket-sized rangefinder, spitting out exact distances from 5 to 1,000 yards, with selective targeting modes and a rugged, weather-resistant housing.


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475 Broad Street
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Whaling City Ford Lincoln Mazda in New London, CT. treats the needs of each individual customer with paramount concern. We know that you have high expectations, and as a car dealer we enjoy the challenge of meeting and exceeding those standards each and every time. Allow us to demonstrate our commitment to excellence!
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If you don't see a particular vehicle,in our inventory, click on CarFinder and complete the form. We will gladly inform you when a matching vehicle arrives. If you'd like to see a vehicle in person, click on Dealership: Directions for step-by-step driving instructions to our dealership, or give us a call. We look forward to serving you!
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To celebrate the opening Nelson, Navy, Nation – a new National Maritime Museum (NMM) permanent gallery that tells the story of the Royal Navy and the British people between 1688–1815 on Trafalgar Day, 21 October 2013 – the English Folk Dance and Song Society (EFDSS) and NMM have co-curated Music of the Sea, a season of rousing, traditional maritime folk music events.
Celebrate Christmas this year with a variety of festive performances and events at Cecil Sharp House.
The Aspire Programme aims to provide professional and structured development primarily for emerging English folk music artists to help them become more equipped to manage a career as a professional artist. Funded by the Paul Hamlyn Foundation, this programme comprises a development conference, one to one mentoring, residential bursaries and professional support.
Sharing our passion for folk! Our learning programmes draw on the diverse and vibrant traditional folk arts of England, the British Isles and beyond, and focus on song, music, dance, storytelling, arts and crafts, drama, and traditions.
Folk Song in England Study Days, taking place across the country from September to January 2014. Explore the roots, development and social impact of English folk song and singers, with a focus on The Full English collections.
Fri 29th Nov 2013, 10:00


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Image: SALLY ANSCOMBE Getty Images
In Brief
Relax to Learn
- Psychological stress affects even very young children and can substantially shape the course of their cognitive, social and emotional development.
- Stresses that accompany low income directly impair specific learning abilities in children, potentially setting them back in many domains of life.
- Children from more affluent backgrounds can also encounter stressful situations that weaken their capacity to learn. Reducing stress in young people could improve the well-being and cognitive performance of large numbers of schoolchildren.
Stress can be toxic at any age. It rattles us when it strikes, shaking up our relationships and narrowing our focus. When it becomes chronic, it ravages our health. Physically, emotionally and intellectually, stress can drag us down.
An even more insidious effect is the assault it can launch on a child's brain, impeding the development of critical cognitive skills. A number of researchers, including myself, have discovered that psychological stress affects the thinking skills and brain development of even very young children, likely beginning prenatally. It is no mystery that stress thrives in difficult situations, but research is now showing that a disadvantaged upbringing may set back children in profound, lasting ways. In fact, stress may be one important mechanism through which poverty adversely affects children's ability to perform well in school.


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Preface. Table of Cases. Table of Statutes and Statutory Instruments. 1. Introduction. 2. The Duties of Financial Intermediaries in English Law with Particular Reference to Conflicts of Interest. 3. Conflicts of Interest in Japan. 4. Imputation of Knowledge. 5. Duties of Adviser and Information Provider. 6. Insider Dealing Regulation in the U.K. 7. Insider Dealing Regulation in Japan. 8. Money Laundering in the U.K. – Potential for Conflict. 9. Anti-Money Laundering Legislation and its Implications for Financial Institutions in Japan. 10. The Chinese Wall. 11. A Conclusion – to Conflict? Bibliography. Index.
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Welcome to AUTOMATION Schweiz 2012
Exhibiting at AUTOMATION Schweiz 2012 is a must for anyone supplying equipment, services, consultancy or products around automaton: impulse technology, control, recognition and industrial handling!
It's a perfect opportunity to present your company's offerings to a high-calibre Swiss audience composed of serious trade professionals who need the kinds of solutions you deliver.
The show will highlight the following key topics:
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- Sensors
AUTOMATION Schweiz 2012 appeals to decision-makers seeking straightforward information about the latest products, solutions and services in these areas. It offers the visitor a quick and compact overview of what's on offer and easy, direct contact with the suppliers -- without requiring huge time or travel investment -- in the great tradition of the trade show as marketplace


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CPAverify provides online reports to employers, professionals and the general public,
allowing anyone who may need to verify a CPA's status to check the designation and
find out CPA licensing information provided by participating State Boards
of Accountancy.
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license status. CPAverify, with support from participating State
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check the status of multiple licenses a professional holds at
one website – CPAverify.org.


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The perspective doesn't look quite right at the moment, but I guess it's at an early stage.
The only suggestion I have is to make the characters a bit bigger.
I've scrapped the mark vs omni man pic for now, that background is driving me nuts, so I decided to do this instead. This is a really early sloppy stage. Looking for comments and critiques to make it better
Last edited by Conman; 05-11-2004 at 01:15 AM.
The perspective doesn't look quite right at the moment, but I guess it's at an early stage.
The only suggestion I have is to make the characters a bit bigger.
I think it look pretty good so far. It really gives off the sense that they are flying, but I agree that the perspectives are off in places. I don't think all of the buildings are following the same perspective rules. If you can get that right then this pic will rock.
bring eve closer to us! don't keep her in the midground like that
*agrees with jacon
Great so far!
"This job's not worth losing my job."
-Haziz - 40 Year-Old Virgin
sketchgangbang My art page. Partial AIM High archive.
anyone know if theres any specific way to get that curvy perspective with mathematics as opposed to just using your eye?
I got a small booklet by Dick Termes which is helpful.
I haven't seen very much information on curvilinear perspective for the artist. If someone else knows of some good resources, I'd be interested in knowing what they are as well.
"I've got a fever, and the only prescription... is more cowbell!"
I got a few perspective books, but none of them to the curve thing. I think the pros might just eyeball it too. I've also wondered how to draw rows gradually getting smaller in perspective. I can do it with like 5 lines, but its a little harder for drawing a 50 story building
Last edited by 50%grey; 05-13-2004 at 02:12 PM.
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Dr Helen Cox is a consultant paediatric allergist in Harley Street, and is one of the few recognised UK specialists in paediatric allergy. She has extensive experience in assessing and treating children with a wide range of allergic diseases including food allergy, eczema, asthma, rhinitis / hayfever, drug and insect sting allergy. She also assesses children with recurrent infection where immune deficiency is suspected.
Dr Helen Cox read medicine at Cape Town University, followed by specialist training in paediatrics, immunology and allergy at Guys, Great Ormond Street and the John Radcliffe Hospital. She was awarded her medical doctorate for research into eczema genetics from the University of London.
She is clinical lead consultant in Paediatric Allergy at Imperial College NHS Trust, and clinical course leader for the MSC in Clinical Allergy.
She is an author of the NICE guideline for eczema and the Royal College of Paediatrics and Child Health national care pathway for children with allergic disease. She is a commissioning editor for the journal Paediatric Allergy and Immunology.
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News » Published 3 days ago
Is this Arsenal the Sports Person?
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Related Celebrity: Sports Person - Arsenal
10 December 2013
Paul Pogba is a man very much in demand with Arsenal now joining the race for the player
5 December 2013
Arsenal defender Thomas Vermaelen could be tempted to leave the club in January
26 November 2013
Will Karim Benzema leave Real Madrid in the January transfer window and join Arsenal?


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While I sympathize with her feelings her constant bashing of American food and American culture leaves me ambivalent.
Way to go Clarissa!! Loved their show. I knew that Jennifer had passed away; Glad to know that Clarissa is still fighting the good fight. (The TRUTH hurts)Thanks for posting!
Sic ´em, Clarissa. Loved their show...still catch reruns sometimes on the Cooking Channel.
Clarissa might do well to avoid that ´´Asian´´ curry.A couple of cases of honor killed female humans ended up in it over the years.
I loved their show but was always somewhat leery of what they were cooking, especially pigeons. Jennifer smoked to the end and lived to be 70. I see nothing to take offense here. She described how she felt. Is that a crime now?
Sorry for screwing up the header. It doesn´t matter that much because the DM has changed it to:´I felt like a pariah in my own country´: Two Fat Ladies chef in race row after saying visit to Muslim area of Leicester was ´most frightening experience of her life´And it looks as if the Mail has screwed up the header this time, writing "her" instead of "my."
Always loved their show. Glad to see she is still anti-PC. Loved her answer to the thought police.
They had a great show. Witty banter and some good recipes that we are not familiar with here in the US.The pigeons they talk about cooking are wood pigeons not the statue-pooping feathered rats that we have here in our cities.Clarissa is not PC. A refreshing change from the usual mealy-mouthed apologists on the air.
Looks like the Religion of Peace isn´t so happy about the truth. Repeat after me: There is no such thing as a muslim moderate.
Very rare for a Brit celebrity like Clarssa to not only voice the obvious but NOT BACK DOWN. The scene she describes now all over England.
Nice to see someone telling the truth for once.The Brits are rapidly losing control of their own country, and pretty soon it is the native British who will be crammed into ghettos.A recent stroll around the neighborhood of the British Museum reminded me of nothing so much as the pictures I have seen of Peshawar.
Reminds me of how Churchill was treated like a pariah for speaking the truth in the 1930s. At the 11th hour they suddenly embraced him.
As you can see, she is now the bad chef for saying something about their ghetto.It´s those darn numbers.
The good news is that it is only Mexicans who have immigrated in large numbers to the US--so far, anyway. At least they are Christians.
I loved their show and good for her for having the guts to speak the truth!


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NEW YORK (December 12, 2012)--Jane Lubchenco, the head of the National Oceanic and Atmospheric Administration, said Wednesday she will leave her post at the end of February.
"I have decided to return to my family and academia," Lubchenco wrote to NOAA employees.
Lubchenco became well known to the public when she played a prominent role in the government's response to the 2010 BP oil spill in the Gulf of Mexico.
Some scientists accused her agency of downplaying the magnitude of the spill.
No successor was immediately announced.
Drought Texas Drought Info Lake Information Current Lake Levels Park and Facility Closures Miscellaneous Air Quality Monitoring Official U.S. Time National Weather Service NWS - Homepage NWS - Dallas/Fort Worth Office Local Weather Records Archived U.S. Climate Data Climate Prediction Center National Hurricane Center Storm Prediction Center Preparing For Severe Weather Severe Weather Safety Flood Safety Tips NOAA Weather Radio Travel Information Texas Road Conditions U.S. Flight Delays Weather Projects Rusty's Classroom Weather Lon's Weather Page |


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Diabetes is a common problem that can occur during pregnancy. This form of diabetes usually develops after the 28th week and goes away after your baby is born. This video discusses how gestational diabetes can affect you and your baby and how you can manage the condition.


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GREENSBORO - Eight wrestlers from Jack Britt won their opening-round matches at the NCHSAA individual championships to put the Bucs in second place with 21 points in team standings.
Winston-Salem Parkland, with 10 wins in the first round, leads with 29 points.
Defending champion Pinecrest is tied for fifth place with Northern Durham at 11 points.
In the 3-A classification, Union Pines is only a half-point out of the top spot, trailing Orange County 18.5-18.
Competition will continue today, and the championship matches in all classifications will be held Saturday.
At Greensboro
Cape Fear region results
First round
106 pounds: Wanovich (Jack Britt) won by forfeit over Kimmerly (Leesville Road)
113 pounds: Tolston (JB) tech fall Cornish (Athens Drive) 17-2; Paul (Terry Sanford) dec. Bhatta (Panther Creek) 10-7
126 pounds: Jamison (NW Guilford) p. Williams (Scotland) 4:52; Stern (JB) dec. Fuentes (W Forsyth) 5-3
132 pounds: Lateef (Scotland) dec. Beane (High Point Central) 3-1 (OT); Benfield (Sun Valley) dec. Silver (South View) 11-4
138 pounds: Roemer (Pinecrest) p. Harris (Ragsdale) 5:18; Palmer (JB) dec. Inouye (Sun Valley) 10-3
145 pounds: Alex Ledford (East Gaston) dec. Shelton (Pine Forest) 9-2; Nivens (Hough) p. Conreras (Pinecrest) n/a; McGrail (Lake Norman) dec. Mikaele (JB) 6-2
152 pounds: Lumpkin (Parkland) Hlavacek (Cape Fear) 12-3; Dickson (JB) tech fall Pabon 16-0; Tucker (Glenn) dec. Minton (Hoke County) 4-2 (OT)
160 pounds: Cook (Holly Springs) dec. Excell (Pinecrest) 11-7; Artis (SV) dec. Mulligan (Cary) 7-5; Soto-Perez (Scotland) maj. dec. Brawner (W-F Rolesville) 13-1
170 pounds: Caliri (Pinecrest) de. Camp (SW Guilford) 2-1; Kee (Scotland) p. Abdoulaye (Dudley) 2:18
182 pounds: Macchiavello (Sun Valley) p. McGuire (Pinecrest) 3:19; McDonald (SV) p. Stringer (Porter Ridge) 0:51; Gobble (Davie County) p. McClean (Hoke) 1:01
195 pounds: McDowell (JB) dec. Diabe (Dudley) 4-2 (OT); McKoy (Cape Fear) dec. Brinkley (W Forsyth) 12-10
220 pounds: Fetia (Pinecrest) dec. Pickard (East Forsyth) 5-3; Cain (SV) dec. Rodriguez (Parkland) 4-1; Roberson (JB) dec. McLean (High Point Central) 4-0
285 pounds: Patterson (E.E. Smith) p. Allen (Mallard Creek) 5:48
Top 5 team scores
1. Parkland 29; 2. JACK BRITT 21; 3. Hough 18.5; 4. Lak Norman 13; T5. Pinecrest 11; T5. Northern Durham 11
- Monica Holland
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text: I found out recently that Christian Focus magazine published articles of mine in their last two issues. "She Made Change - In Me" appeared in the June/July issue and "Every Other Wednesday Therapy Dog" was published in their Aug/Sept edition. The latter article originated as a FW Challenge winner titled "10:00 - Belle!!" Very humbled, very grateful FW's. And of course, To God Be the Glory.


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Counter Top 40 Worktop Saver
- Glass.
- Measures 12 inches in diameter.
- Dishwasher safe.
- Lifetime guarantee against breakage. Heat resistant up to 280 degrees. Odor and stain resistant. Knife is not included
- Imported


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Your #lovecapetown Weekend: Things to do from Friday 6 to Sunday 8 December, 2013
Fazielah Williams
There's nothing I love more than great live music in my groovy hometown and #lovecapetown friends, let me tell you, this weekend the Mother City is going to rock! -
Summer School Holidays in Cape Town: What to do with the kids
Fazielah Williams
School's out, #lovecapetown Moms and Dads, and these summer holidays, there is plenty to see and do with your little ones in the Mother City. Get out into the sunshine and enjoy a variety of fun activities, take in a show or spend the day at the beach with the little people in your life: -
Twilight Team Run 2013 in Cape Town: Photos
Fazielah Williams
They came in their thousands, dressed in outrageous costumes, braving the rain to raise funds for a worthy cause… the vibe was electrifying at the 2013 Twilight Team Run on Tuesday 3 December, 2013. -
Instameet Bakoven: Join in, capture and share your #lovecapetown photos with us
Calling all passionate Instagramers! We're getting together this weekend for another epic instameet to show the world how much we #lovecapetown.
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Cape Town welcomes #MeetSouthAfrica travel bloggers
Bloggers love South Africa – we know this from our #LoveCapeTown campaign. This campaign saw us bringing four international travel bloggers (@traveldudes @velvetescape @landlopers and @wildjunket) to Cape Town in July 2012 during a social media drive in which Capetonians interacted with the bloggers and their followers, telling the stories of Cape Town and her people.
Discovering Langa – a photo essay
Langa, South Africa's oldest township, was established in 1923 as part of the then Urban Areas Act. Similar to Nyanga, Gugulethu and Khayelitsha, Langa is one of the areas in South Africa that was designated for black Africans before the apartheid epoch. The name Langa means "sun" in Xhosa, but the name of the area is actually derived from the name Langalibalele – a famous chief who was imprisoned on Robben Island for rebelling against the government.


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What is Photofrin?
Porfimer makes your body's tissues more sensitive to the effects of light.
Porfimer is used together with "photodynamic" laser light therapy to reduce the size of tumors in the lungs or esophagus (the tube that connects your mouth and stomach).
Porfimer may also be used for purposes not listed in this medication guide.
In This Section:
What is the most important information I should know about Photofrin (Porfimer)?
You should not receive this medication if you are allergic to porfimer, or if you have porphyria (a genetic enzyme disorder that causes symptoms affecting the skin or nervous system).
Before you receive porfimer, tell your doctor if you have liver or kidney disease.
Porfimer may increase the sensitivity of your skin and eyes to sunlight, bright light, or car headlights. Avoid exposing your eyes and skin to natural sunlight and bright indoor lights for 30 to 90 days after you are treated with porfimer.
This medication may cause your eyes to be more sensitive to oncoming headlights while you are driving. Avoid driving at night until this effect wears off.
What should I discuss with my healthcare provider before taking Photofrin (Porfimer)?
You should not receive this medication if you are allergic to porfimer, or if you have porphyria (a genetic enzyme disorder that causes symptoms affecting the skin or nervous system).
To make sure you can safely receive porfimer, tell your doctor if you have any of these other conditions:
- liver disease
- kidney disease; or
- a history of stroke or blood clot
FDA pregnancy category C. It is not known whether porfimer will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while being treated with this medication.
It is not known whether porfimer passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are receiving porfimer.
How much does Photofrin (Porfimer) cost?
What conditions might Photofrin (Porfimer) treat?
No information available | |
Photofrin Side Effects
What are the possible side effects of Photofrin (Porfimer)?
Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have a serious side effect such as:
- pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating
- cough with yellow or green mucus, stabbing chest pain, feeling short of breath, coughing up mucus or blood
- tight feeling in your throat, trouble swallowing
- fever, chills
- sudden numbness or weakness, problems with vision, speech, or balance
- pain, swelling, warmth, or redness in one or both legs
- feeling very thirsty or hot, being unable to urinate, heavy sweating, or hot and dry skin; or
- anxiety, sweating, pale skin, severe shortness of breath, wheezing, gasping for breath, cough with foamy mucus, fast or uneven heart rate
Less serious side effects may include:
- increased sensitivity of your eyes to light
- nausea, vomiting, stomach pain
- constipation
- back pain
- sleep problems (insomnia); or
- sore throat, mild cough
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Back to TopPhotofrin Interactions
In This Section:
What other drugs affect Photofrin (Porfimer)?
Tell your doctor about all other medicines you use, especially:
- allopurinol (Zyloprim)
- griseofulvin (Fulvicin)
- thalidomide (Thalomid)
- an antibiotic such as ciprofloxacin (Cipro), gemifloxacin (Factive), levofloxacin (Levaquin), moxifloxacin (Avelox), ofloxacin (Floxin), norfloxacin (Noroxin), and others
- a tetracycline antibiotic such as doxycycline (Doryx, Oracea, Periostat, Vibramycin), minocycline (Dynacin, Minocin, Solodyn), or tetracycline (Ala-Tet, Brodspec, Panmycin, Sumycin, Tetracap)
- a diuretic (water pill) such as chlorothiazide (Diuril), hydrochlorothiazide (HCTZ, HydroDiuril, Hyzaar, Lopressor HCT, Vasoretic, Zestoretic), chlorthalidone (Hygroton, Thalitone), indapamide (Lozol), metolazone (Mykrox, Zaroxolyn), and others
- heart or blood pressure medicine such as amlodipine (Norvasc, Caduet, Exforge, Lotrel, Tekamlo, Tribenzor, Twynsta, Amturnide), diltiazem (Cartia, Cardizem), nifedipine (Nifedical, Procardia), verapamil (Calan, Covera, Isoptin, Verelan), and others
- medication used to prevent blood clots, such as abciximab (ReoPro), bivalirudin (Angiomax), cilostazol (Pletal), clopidogrel (Plavix), dabigatran (Pradaxa), dalteparin (Fragmin), dipyridamole (Persantine, Aggrenox), eptifibatide (Integrelin), fondaparinux (Arixtra), ticlopidine (Ticlid), tirofiban (Aggrastat), and many others
- medication used to treat blood clots such as alteplase (Activase), tenecteplase (TNKase), urokinase (Abbokinase)
- an oral diabetes medication such as glipizide (Glucotrol, Metaglip), glimepiride (Amaryl, Avandaryl, Duetact), glyburide (DiaBeta, Micronase, Glucovance), and others; or
- a phenothiazine such as chlorpromazine (Thorazine), fluphenazine (Permitil, Prolixin), perphenazine (Trilafon), prochlorperazine (Compazine, Compro), promethazine (Pentazine, Phenergan, Anergan, Antinaus), thioridazine (Mellaril), or trifluoperazine (Stelazine); or
- a sulfa drug (Bactrim, Septra, Sulfatrim, SMX-TMP, and others)
This list is not complete and other drugs may interact with porfimer. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.
Back to TopWhat should I avoid while taking Photofrin (Porfimer)?
Avoid exposing your eyes and skin to natural sunlight and bright indoor lights for 30 to 90 days after you are treated with porfimer.
This medication may cause your eyes to be more sensitive to oncoming headlights while you are driving. Avoid driving at night until this effect wears off.
Back to TopPhotofrin Dosage
In This Section:
How should I take Photofrin (Porfimer)?
Porfimer is injected into a vein through an IV. You will receive this injection in a clinic or hospital setting.
Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when porfimer is injected.
You will receive laser light treatment within 40 to 50 hours after your porfimer infusion. A second laser light treatment may be given within 96 to 120 hours after your porfimer infusion.
Porfimer will make your skin and eyes more sensitive to light and severe sunburn may result. For at least 30 days after you are treated with porfimer, you must protect your eyes and skin from natural sunlight and bright indoor lights (such as lights in a doctor's or dentist's office, operating room lamps, tanning beds, bright halogen lights, or unshaded light bulbs).
To avoid exposing your skin to sunlight, keep all parts of your skin covered with clothing and wear dark sunglasses when you are outdoors. Sunscreen will not prevent a severe skin reaction to sunlight during the 30-day period after your treatment with porfimer.
You may be more sensitive to sunlight and bright light for up to 90 days or longer. To determine when this effect has worn off, you may test your skin to see if it is still sensitive to sunlight.
To test your skin for sun sensitivity:
- Expose a small area of skin to direct sunlight or bright indoor light for about 10 minutes
- Do not use the skin on your face or around your eyes to test for light sensitivity
- If the exposed skin develops redness, swelling, or blistering within 24 hours, wait another 2 weeks before testing the skin again
- If your exposure to sunlight will increase because of travel or relocation within the 90-day period after you receive porfimer, test your skin again
Exposure to indirect sunlight (sun shining through a window) is not as harmful and will actually help your body eliminate porfimer from your tissues. Follow your doctor's instructions about the best amount of light exposure.
Back to TopWhat happens if I overdose on Photofrin (Porfimer)?
Since this medication is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.
Back to TopWhat happens if I miss a dose of Photofrin (Porfimer)?
Call your doctor for instructions if you miss an appointment for your laser light therapy. The timing of your laser light therapy in relation to your porfimer infusion is important for the treatment to be effective.
Back to TopWe don't currently have any reviews for Photofrin. You can be the first to
.Bear with us as we complete our drugs database. We are working hard to provide you with the best information possible so please check back soon for the latest updates. We apologize for any inconvenience.
- Drugs A-Z teamCopyright 1996-2013 Cerner Multum, Inc. Version: 3.01. Revision date: 2012-02-15.
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My partner and I stay at La Casa Dei Limoni Saturday night, Was a great place to stay at, the staff were so friendly and helpful. The rooms were nice/ new and comfortable, we also got a room with a beach view which was a bonus :) Overall we enjoyed out stay.
- Also Known As:
- La Casa Dei Limoni Hotel Monterosso Al Mare
- La Casa Dei Limoni Hotel
- La Casa Dei Limoni Monterosso Al Mare, Cinque Terre, Italy
- Reservation Options:
- TripAdvisor is proud to partner with Booking.com and Priceline so you can book your La Casa Dei Limoni reservations with confidence. We help millions of travellers each month to find the perfect hotel for both holiday and business trips, always with the best discounts and special offers.


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7500 more Alpha Trial Keys have been made available for the Facebook Method! https://www.facebook.com/NVIDIAGeForce/app_433401813391421 Fileplay also has more keys available as of now.
You didn't understand my English, I created 2 fake Multiplay account in order to get 2 more keys, but they where given to my Clan mates, not for my self!
More Crysis 3 Alpha keys available right now. Register an account here http://www.fileplay.net/ Request the Crysis 3 Alpha key here http://www.fileplay.net/keys/55/crysis3-alpha
I hate to ask for things, but if anyone has an extra alpha key there not using, I could give 2 Planetside 2 beta keys in return.
Played till level 5. Lags a lot and I hate auto armor with a passion, every time I'd go and hit armor auto armor turns it on and I end up turning it off. Not sure if you can turn it on or off. Other than that I feel as though its what Crysis 2 should have been. Detailed Environments, nice graphics improved UI and new machines and weapons.
can somebody give me a key too, i am not able to get the key from any of the links and please can anybody show pic or better make a video of gameplay, would be really nice to see
yeah i wondered what all the fuss was about and was pleased it selected mine as very high but when i actually got in game i was horrified lol, setting to medium solves it all and it plays great. 1 major bad point so far is the zoomed mouse speed, it's way to fast and I can't aim at all as I play low sens. Other than that it's just a clone of crysis 2 with some minor differences.
I'm not too impressed with this so far. Controls are rather clunky. Seems more of a generic mediocre FPS with no feel of the original game. Like SpookyWillow says, it's a lot like Crysis 2 with a few tweaks here and there that doesn't improve the experience.
For those who haven't grabbed a key yet, consider jumping into my giveaway contest, courtesy of the_mad_shot
id have a key if anyone can spare one, there gone as its been stated, but, thanx for posting anyway, wish id seen it sooner lol,


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In Brief
- Fringe frenzy: As many at 75 percent of autistic children are receiving alternative treatments not developed by conventional medicine, which are often bogus.
- Risky medication: Some practitioners prescribe drugs that are approved only for other conditions, have serious side effects and have never been tested for safety or efficacy in autism.
- More science: In the past decade U.S. research funding for autism has increased by 15 percent a year, in part because of rising demand by parents for proved treatments and increased public awareness.
- Genetic promise: Recently discovered genetic variations in children with autism could reveal a cause, but related therapies may be years away.
More In This Article
When Jim Laidler's oldest son, Benjamin, was diagnosed with autism, he and his wife started looking for help. "The neurologists were saying, 'We don't know what causes autism, and we don't know what the outcome for your son will be,'" Laidler relates. "No one was saying, 'Here's what causes it; here's what treats it.'"
But when the Laidlers, who live in Portland, Ore., searched the Web, they found dozens of "biomedical" treatments that promised to improve or even cure Benjamin's inability to talk, interact socially or control his movements. So the parents tried them on their son. They began with vitamin B6 and magnesium, the nutritional supplements dimethylglycine and trimethylglycine, vitamin A, gluten- and casein-free diets, the digestive hormone secretin, and chelation, a drug therapy designed to purge the body of lead and mercury. They applied the purported treatments to Benjamin's little brother, David, who also was diagnosed with autism. Chelation did not seem to help much. Any effect from secretin was hard to tell. The diets showed promise; the Laidlers hauled special food with them everywhere. And Mom and Dad continued to feed the boys dozens of supplements, calibrating doses up and down with every change in behavior.
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Stay informed with the latest breaking forex news from all over the world with our comprehensive news coverage.
FX Snips
Forex Insights
4:58 am | Last Month (762) | Last Week (176) | Yesterday (0) | Today (0) |
Rebound in Data, Turn Lower in Equities Could Help Ailing Yen
11:30am yesterday (Christopher Vecchio, Currency Analyst)
The Japanese Yen has been struggling of late, and even a midweek turn higher couldn't last in the face of renewed optimism over the world's largest economy's labor market. What hope remains for the Japanese Yen amid an onslaught of economic developments abroad? »
How to Trade Euro Pound Wedge Forex Breakout
8:08am yesterday (Gregory McLeod, Currency Analyst)
Is it too late to trade the Euro Pound breakout? Learn how to trade this once sleeping currency pair. »
Weekly Forex Trading Forecast: Coming Days Key for Dollar, Forex Majors
07/12/2013 03:19 (David Rodriguez, Quantitative StrategistJohn Kicklighter, Chief Currency StrategistIlya Spivak, Currency StrategistMichael Boutros, Currency StrategistChristopher Vecchio, Currency Analyst)
The US Dollar tumbled versus the high-flying Euro and the Yen fell even further on a busy week of price action. What could bring big volatility in the days ahead? »
Australian Dollar Finds a Temporary Lifeline in Seasonal Forces
07/12/2013 03:10 (Ilya Spivak, Currency Strategist)
The Australian Dollar dipped to a three-month low last week. »
Euro Avoids Stimulus-Led Collapse but a Strong Rally Unlikely
07/12/2013 03:08 (John Kicklighter, Chief Currency Strategist)
It was a sense of relief that rallied the euro this past week. »
Gold Slumps Amid Improving US Outlook- November Range in Focus
07/12/2013 01:35 (Michael Boutros, Currency Strategist)
Gold prices were softer on the week with the precious metal shedding 1.8% to trade at $1230 ahead of the New York close on Friday. »
US Dollar Falls Despite Strong Payrolls Data - What Could Save it?
07/12/2013 01:31 (David Rodriguez, Quantitative Strategist)
A strong run of US economic data and a particularly positive November employment report wasn't enough to lift the US Dollar as it fell against most major counterparts. »
Forex: Dollar Destined for Breakout Next Week, But Trend?
07/12/2013 00:26 (John Kicklighter, Chief Currency Strategist)
Not only did risk trends not tumble on a strong US employment showing last week as Taper fears grew corporeal, but the USDollar wouldn't even break from a 12-day, 70-point range. »
Forex Strategy Video: When Event Risk Like NFPs is Not Market Moving
06/12/2013 23:19 (John Kicklighter, Chief Currency Strategist)
If the November US unemployment rate has dropped to the level the Fed would correspond to an end to stimulus, why didn't the dollar rally - or even break out of a tight range? »
US Dollar Falls Despite Strong Payrolls Data - What Could Save it?
06/12/2013 23:00 (David Rodriguez, Quantitative Strategist)
A strong run of US economic data and a particularly positive November employment report wasn't enough to lift the US Dollar. What could reverse its fortunes in the week ahead? »


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Custom Media, Inc. (CMI) is a custom commercial and residential audio/video installation company. We provide a wide array of services including: Surround Systems, Media Rooms, Home Automation Systems, Multi-Room A/V, Structured Wiring, Outdoor Living Systems, and Surveillance Camera Systems.
Our primary objective is to fulfill the visions of our client's very important wants and needs for each custom installation.
The founders of CMI have over a decade of experience in the custom commercial and residential audio/video industry from an array of well-recognized sources.
We are a company that prides itself on three main principles; Customer Satisfaction, Quality, and Workmanship. To keep these principles alive and active we have a unique team of experts, as well as top of the line manufactures, to ensure the unsurpassed quality.
Our technicians are required to have extensive previous experience as well as endure intense training with us to guarantee you are getting the service you deserve.


text:
Orlando Camp Jurassic Hotels + i will go back
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"At first we were a little unsure about the hotel because the hallways seemed a little... Read more"
"Loved the veiws from the room and balcony. Rooms were nice. Other reviews were helpf... Read more"
"The site indicates that they provide free transportation to all sites INCLUDING Disne... Read more"
- 2.0 5
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0.93 mi/1.49 km from search point
"I checked out of this place before I checked-in. I was propositioned one in the parki... Read more"
"This place was horrible. I know I got what I paid for but still. Asked to change roo... Read more"
"Nasty hotel. Honestly! we decided we couldnt stay here and went to The Castle by Do... Read more"
- 2.0 5
- 132 Reviews
0.99 mi/1.60 km from search point
"after reading all the bad reviews i wasnt sure if this is were we wanted to stay but ... Read more"
"Stay here if you like the smell of smoke and enjoy beds that have been urinated in an... Read more"
"As a Travel Agent, I look for Hotels that can serve all my clients at an affordable r... Read more"
Note: The nightly rates shown above do not yet include Tax Recovery Charge & Service Fees or (if applicable) Extra Person Fees, Child Fees, Additional Mandatory Hotel Charges or optional incidentals, such as parking, room service or movies.


text:
We've updated the story slightly to clarify a couple of things and we also understand that mobile wallet limits are slightly higher - up for £150 in some cases. eDigitalResearch have also admitted however that some respondents may have answered the question wrongly or misinterpreted it slightly too.
@heshv17028 @simonhunter87 hI GUYS - here's a link through to the release where this info came from - questions being put to eDigitalResearch too.
@ladynellington but if it's provided by a blue chip brand most consumers probably due have high expectations of a quality experience. I think they have a right to those expectations too.
Thanks for your points of view guys - appreciate both. It's a huge topic that I hear a lot about - with pricing the main gripe with agencies cutting their own throats. I doubt we'll see an upturn in general happiness within the sector around this topic anytime soon however.
Well today's the day that we'll find out. With so many phone releases at the moment, this one does feel pretty important for one reason or another.


text:
Depression has become leading cause of disability burden amongst U.S. and Canadian teens
Image: Flickr/mynameisharsha
More In This Article
"As a sex writer, Jesse Bering is fearless—and peerless." —Dan Savage "You are a sexual deviant. A pervert, through and through." We may not want to admit...
Read More »
From Spoonful of Medicine
The recent tragedy in Newtown, Connecticut, perpetrated by 20 year-old Adam Lanza, has intensified the discussion about how mental health is handled and documented in the US. Officials have not provided information about Lanza's motivation and state of mind, and many are rightfully quick to point out that it is wrong to equate mental illness with the fatal sociopathic actions of a small group of individuals. The conversation about access to mental health care should, however, take into account new data showing an increasing contribution of mental and behavioral disorders to deterioration in the health-related quality of life among teenagers in the US and Canada over the last two decades, and increases elsewhere around the globe.
The estimation of 'years lived with disabilities', or YLDs, is used as a collective metric to determine how much a particular disorder deprives the population of healthy years of life during a particular window of time. In 2010 just as in 1990, depression ranked as the number two contributor of YLDs, affecting 4% of the global population, eclipsed only by back pain that affected almost 10% of population worldwide. Among 10 to 14 year olds, the top contributor worldwide is iron deficiency. Asthma had been the largest contributor to YLDs for youths in that age range in the US and Canada in 1990, but the study published in The Lancet on Thursday led by researchers at the Institute of Health Metrics and Evaluation (IHME) at the University of Washington, Seattle showed that in this group depression surpassed asthma to claim the number one spot in 2010. In that group, the collective number of 'years lost to disability' grew from about 140,000 in 1990 to almost 180,000 in 2010, a 30% increase. Notably, global figures for the same age group show that the number of years lost to disability from depression grew from 4.9 million in 1990 to 5.5 million in 2010, a 13% increase as shown in the graphs below.
A question remains as to whether the change in numbers reflects an actual increase in children who develop depression, or better diagnosis, documentation and the way healthcare practitioners and policy makersview mental health now compared with 1990. "There is a good possibility that the rise in disease burden related to mental health in some regions is due to better diagnosis, at the same time, the magnitude of the rise in some areas should draw policymakers attention, as should the very high level of the burden from mental health problems across regions," says Mohsen Naghavi, an author of the study and a health expert at IHME.
Whereas depression accounted for the most YLDs among adolescents, the disease burden from anxiety, schizophrenia and bipolar disorder in the US and Canada of all ages ranked 5, 10 and 18, respectively. By comparison, anxiety, schizophrenia and bipolar disorder ranked 7, 16 and 18, respectively, among the world population of all ages. "When you are seeing more years lived with disability from depression and anxiety than you are from most injuries, chronic diseases and infectious diseases, then you need to start thinking about addressing them by borrowing from lessons we have learned from those other areas or by innovating new tools," Naghavi says.


text:
Performing Arts Library Director Speaks Event
The series is usually held in Kent State University's Performing Arts Library (Center for the Performing Arts, Room D-004) and is a free event open to the public. Light refreshments will be provided.
Spring 2014 Events:
Details TBA.Other Events: Annual Open House | Careers for Performing Arts Majors | Colloquium Series | Open Mic Lunch | Performing Arts Live


text:
Wat Saphan Hin
Walk the ancient bridge
What we say:
King Ramkamhaeng is believed to have climbed the stone bridge at Wat Saphan Hin on a white elephant to pay homage to the striking image on every Buddhist sabbath.
Two kilometres to the west of the main park in the western zone, Wat Saphan Hin translates to "temple of the stone bridge", and was named after the raised stone walkway that rises from the ground to meet the large standing Buddha image perched on a hill some 300 metres high.
When walking up the stone bridge, surrounded by forest, it's easy to imagine ancient pilgrims doing the same thing in the same place.
Depending on what kind of shape you're in, it's a somewhat tiring walk up to the top, but once there you're rewarded with some lovely views of the historical park from above.
Don't forget to bring some water as no one sells it out this way.
More details
Sukhothai Historic ParkLast updated: 3rd September, 2012
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