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Many visitors to our website Potty Training and Bedwetting Solutions wonder what the different treatment options are between bedwetting and potty training. This article explores the causes and some treatment options for bedwetting. Causes of bedwetting The most common reasons for a child suffering from bedwetting are as follows: developmental delays (as mentioned earlier), genetics (same here), sleep disorder (such as sleeping too deeply), behavior and psychological disorders, anatomy, antidiuretic hormone levels. The most commonly accepted, but also hardest to prove, cause of primary nocturnal enuresis is maturational delay of the central nervous system. Basically meaning that the child’s nervous system doesn’t sense that the bladder needs to be held, and the urine is released during sleep. Sleeping disorders make up a very large percentage of children who suffer from bedwetting, and there has been extensive research done on the subject, but there have been such varying results, that it is hard for researchers to determine a primary sleep disorder that can be determined as the main cause for bedwetting. Some people believe that bedwetting is mainly caused behaviorally, which leads to the issue of psychological consideration- some studies have shown that psychologically children who suffer from nocturnal enuresis have essentially the same behaviors as children who don’t, while other studies have concluded the opposite. In those studies that show psychological differences between the two groups, the differences have mainly been that a child who has a bedwetting problem is less social and has more self-esteem issues than the other group. This begs a question though: do the low self-esteem and social issues go hand in hand with bedwetting children, or does the bedwetting lead to these types of psychological situations in these children? Family history is also very important, and many studies have shown results that deem it almost conclusive that if a parent suffered from bedwetting as a child, there is a very strong chance that their child will. In fact, one study showed that in a family where both parents suffered from this condition, there was a 77 percent chance that their child would do the same. This is a helpful finding, because it helps dispel the theory that enuresis is a behavioral problem. In turn, this makes it more acceptable, and causes slightly less frustration and guilt, which can lead the way for a better outcome following therapy. Treating bedwetting In the beginning of trying to deal with a bedwetting situation, you may opt to try different methods of battling it without the interference of doctor or medical care. Whether or not medical intervention will be necessary depends largely on many factors, including such issues as the child’s age, how often they actually wet the bed, and the perceived severity of the problem by the child’s family, and most children actually do outgrow bedwetting, never needing treatment for it by a physician at all. Many parents use night time diapers to battle bedwetting, and while these work great in preventing the bed from getting wet due to the accident, they actually do very little in the way of helping resolve the issue. Although it is obviously very important to focus on this part of bedwetting, it is also very important to try to prevent future occurrences. This is why is a good idea to try and step in as early as possible to use many basic methods of prevention. Then, when these don’t work, you may decide to take your child to the doctor. You should know, though, that children younger than six years of age are usually not treated by doctors if bedwetting is the only problem. Once you have decided to take your child to a physician concerning bedwetting, it is important to know that it may take a long time to actually reach the ultimate goal of completely accident-free nights. It is a long process in which both the parent and the child must remain dedicated. There are two methods which doctors utilize to deal with bedwetting problems: behavioral therapy and medicine. It is extremely important that the parent and child be as cooperative as possible, and be willing to try the doctor’s suggestions. If anyone has a bad attitude about the situation, it can make solving the problem a whole lot harder, if not impossible. When you first take your child to the doctor, they will most likely want to rule out any medical conditions in the very beginning. While most of the children who are seen by physicians regarding bedwetting are perfectly healthy, some actually do have a medical condition. So, before a doctor will approach it as if they don’t, they will want to make sure that this really is the case. The evaluation the doctor does on your child should be geared toward ruling out anatomic abnormalities of the urinary tract or bladder. These can include such situations as posterior urethral valves, an ectopic ureter, or an epispadiac urethra, which is a urethral opening on the dorsum of the penis. When the doctor does a thorough exam, which will include gathering family medical history, a physical exam, and a urine evaluation, they are usually able to determine whether or not there is a medical condition and, if there is, what that condition might be. When, and even before, your child is being medically treated for enuresis, it is an excellent idea to keep a diary of bedwetting episodes. Along with this diary, if the child’s bedwetting does not occur repetitively on a nightly basis, it is a good idea to write down anything that might have occurred that day to upset your child’s normal psychological balance. Once the doctor has determined whether there is, or is not, a medical condition contributing to your child’s bedwetting situation, they can determine which methods of treatment will best help them. Again, it is important to remember that consistent follow-up can be a key to improvement in bedwetting (it is also good to know that improvement is usually defined by most doctors as a 50 percent decrease in the frequency of bedwetting episodes). Your doctor may decide to use just one method of treatment or both in conjunction with one another. The behavioral methods can, and usually do, include the following: an alarm system, a reward system, asking your child to change the sheets, and bladder training. An alarm system Bedwetting Alarms can be an excellent tool for helping by retraining your child’s sleeping patterns so that they sleep more lightly, and wake up more often during the night, allowing less time for an accident to occur. You can set these for a certain amount of time and have your child get up and try to use the restroom every time the alarm goes off. A reward system can also be a very successful method of behavior therapy, especially once the child has learned new sleep patterns and is having less frequent accidents. Giving them either a small reward each day after a dry night, or a large reward at the end of a certain length of time, such as an entire week of dry nights, can help give your child even more incentive to try to wake up at night. Having your child change the sheets is also an excellent way to help keep them from having as many bedwetting nights. While it is never good to punish a child for something they have little to know control over, this is not punishment, and is instead a way for them to learn that they have to be responsible for their actions, even if those actions occur while they are sleeping. This also works well because they are having to get up out of bed and be pulled from the deep sleep more often, which in turn can lead them to sleep more lightly on a regular basis. Bladder training is another form of behavioral therapy that can help limit bedwetting nights. This is defined by, during the day, having your child hold their bladder for longer and longer periods of time. They may always go to the restroom immediately when they feel the urge to go, and so when they are in a deep sleep, that is how their body reacts when that urge hits them. If you teach your child to hold it for as long as they can when the urge comes while they are awake, they are more likely to be able to hold it subconsciously while they are asleep. If behavioral therapies do not work, and only if the child is 7 years of age, or older, medicines may be prescribed. Medicines work best in conjunction with behavioral therapy, because they are not a cure for bedwetting. They also may have side effects. If you do decide to go with medicines as a treatment option for your child, there are two common kinds, one of which your doctor will likely prescribe. One of these helps the bladder hold more urine, and one helps the kidneys make less urine. Obviously, these are not the types of drugs you will want your child to have to take consistently for the rest of their life. Instead, they are best when used temporarily in conjunction with the behavior therapy mentioned earlier. Helping your child cope with bedwetting Not only should you try to help your child overcome their bedwetting problem, but you should also focus on helping them to understand it and not feel quite so bad about it, if at all possible. Your child likely feels very ashamed at being a bedwetter. They may also feel guilt for not being able to control their body in a way that they feel they should. This is very likely in older children. You should never punish your child for this problem. It is very important to remember that your child cannot help it. Again, the older the child is, the more this applies, and your child is likely even more irritated about it than you are. You should try to not make your child feel any more guilt about it than they already do. It may also help your child to know that no one really knows the exact cause of bedwetting, because there are too many factors that have to be considered in each case. Explain to them the many different causes that might be affecting their situation, and the fact that these reasons are not their fault, and that you will help them overcome it. Tell them as much information as is necessary to help them be able to deal with it without thinking less of themselves. For instance, if you wet the bed as a child, be sure and explain this, while also informing them that it can run in families. This might help take some of the pressure off and relieve some of their guilt. Just remember, this is a rough time on both you and your child, and you should use whatever methods necessary to dispel your bedwetting difficulties. Keeping the right no-fault attitude can definitely help, as well as having an open mind to suggestions for treatments, and being dedicated to whatever ways you decide to treat bedwetting and/or potty training. do penis enlargment pills work pnis enlargement review penis enlargement surgery cost do pnis enlargement pills work vimax penis enlargement surgery penile enlargement program penis enlargment operation pnis enlargement information cheap penile enlargment

The activities which an individual performs and environment in which he grows are responsible for the personality that he exhibits. Friend circle plays a very important role. For instance if most of your the friends are intelligent and serious about their career you will probably be as hard working as any of his friend. But the opposite is also true. In other words, if all the friends are party animals and drug addicts and least concerned about their career or studies. The person is more prone to adopting this unhealthy life style which involves late night parties in pubs and irregular sleeping hours. One can blame pubbing on disposable income or peer pressure as discussed above. With more then 80% of the pub bills made for alcohol, getting high is plainly in fashion. From being a social taboo in the past, now a days drinking has almost become a way of life for many individuals in cities all across the globe. This is not over; drinking has crept into homes of many households as fathers boast of drinking with their sons and call it openness in their relationship. They often forget or pretend to forget the problems associated with drinking like cancer, kidney failure, liver problems and heart disease to name the few. All of them are very common as far as their association with excessive drinking is concerned. Here I would like to create awareness about another affliction that can be a caused by frequent drinking. I am pointing my finger towards sexual problems like erectile dysfunction or ED. Under this a male is unable to hold penis erection and thus cannot have a satisfying sexual intercourse with his partner. But this is not end of life for such poor individuals as various treatment of erectile dysfunction are available in the market that too in generic form. Generic viagra is one of the most trusted anit-impotency drugs and is sold with names like kamagra, sildenafil citrate to name the few. It enables Erectile Dysfunction patients to attain hard and proper erection by relaxing their penis muscles. This perhaps is best and least expensive option to eliminate sexual problems from your precious sex life. herbal natural pnis enlargement male penile enlargment penile enlargement herb homemade penis enhancement vimax review vimax penis enlargement herb penis enlarement tip penis enargement surgeon cheap penile enlargment

Many people assume they need to consume Alcohol to have Good Sex? For most Americans, consuming alcohol seems to be part of our cultural heritage. We drink at weddings, funerals, birthdays, and pretty much to celebrate anything and everything. We learned from a young age by watching our parents and other adults, that drinking is a sign of maturity. Many people, especially young adolescents, expect that alcohol use will lower tension and anxiety and increase sexual desire and pleasure in life (Seto & Barbaree,1995). About 1 in every 7 adults in the United States meet criteria for alcohol dependency, according to a large NIMH epidemiological study (Grant, 1977). Men are four times more likely than women to be heavy drinkers and are twice as likely to be alcohol abusing or alcohol dependant. Most males and many females find it difficult to imagine not drinking any alcohol at least on weekends and find it almost impossible to think of having sex without previously having a few drinks. These fundamental values appear to be deeply embedded in our culture. Somewhere along the line, we got the message that we need alcohol to have good sex. Does Alcohol Enhance or Hurt our Sexual Performance? I recently heard a stand-up comedian refer to the term, “Whiskey – Dick” when describing his “friends who had drank too much and had difficulties with orgasm even while using Viagra. Shakespeare once said that excessive drinking, “provokes the desire but takes away the performance.” Alcohol reduces inhibitions and gives us a mellow feeling. It makes us more relaxed and more talkative. It can make shy people fe//el confident and bold. These effects can facilitate our sexual desires by developing our social skills. However, these positive effects are only present in the early stage of intoxication i.e. when we’ve consumed 1-2 drinks (assuming you haven’t already developed a tolerance for alcohol). Sexual Impotence On the other hand, alcohol’s negative effects on sexual performance have been widely documented. Men and women who have several drinks may find it very hard to achieve orgasm. Difficulties with achieving orgasm after alcohol consumption can be understood because alcohol dilates small blood vessels all over the body so that there is less engorgement of blood in the sexual organs. This leaves the penis flaccid or only partially erect so that sexual penetration is difficult. Women may find that they have decreased vaginal lubrication making sexual intercourse unpleasant and sometimes painful (Raff, 2006). Impotence is the constant inability of a man to maintain an erection for sexual purposes. It is estimated that impotence affects over 30 million men in the United States (NIHCS, 1992). Masters and Johnson, identified alcohol as a common factor in impotence in their monumental work on human sexual inadequacy. Alcohol damages the central nervous system and destroys brain cells, and if the damage is prolonged enough, it can result in irreversible sexual impotence even while a person is sober. Alcohol is also a factor in loss of sexual control or premature ejaculation. Even a couple of beers before sex can spoil a man's erection and ruin his ejaculatory control. Up to 80 percent of men who drink heavily are believed to have serious sexual side effects, including impotence, sterility, or loss of sexual desire. Heavy drinking over a long period of time can irreversibly destroy testicular cells, leaving men with shrunken testicles. Both sexual drive and sexual capacity can be damaged. Alcohol also suppresses testosterone levels even in social drinkers by suppressing the secretory activity of the Leydig cells (Flatto, 1990). Alcohol and High-Risk Sexual Behaviors A history of heavy alcohol use has been correlated with a lifetime tendency toward high-risk sexual behaviors, including multiple sex partners, unprotected intercourse, sex with high-risk partners (e.g., injection drug users, prostitutes), and the exchange of sex for money or drugs (Windle,M.,1997). There may be many reasons for this association. For example, alcohol can act directly on the brain to reduce inhibitions and diminish risk perception (MacDonald,T.K.,2000). However, expectations about alcohol’s effects may exert a more powerful influence on alcohol-involved sexual behavior. Studies consistently demonstrate that people who strongly believe that alcohol enhances sexual arousal and performance are more likely to practice risky sex after drinking (Cooper,M.L.,2002). Some people report deliberately using alcohol during sexual encounters to provide an excuse for socially unacceptable behavior or to reduce their conscious awareness of risk (Derman,K.H.,1998). According to McKirnan and colleagues (McKiran,D.J.,2001), this practice may be especially common among men who have sex with men. This finding is consistent with the observation that men who drink prior to or during homosexual contact are more likely than heterosexuals to engage in high-risk sexual practices (Avins,A.L.,1994). Alcohol and AIDS People with alcohol use disorders are more likely than the general population to contract HIV (human immunodeficiency virus) - the agent that causes acquired immunodeficiency syndrome (AIDS). Similarly, people with HIV are more likely to abuse alcohol at some time during their lives (Petray,N.M.,1999). Alcohol use is associated with high-risk sexual behaviors and injection drug use, two major modes of HIV transmission. What are signs of problem drinking? The primary signs of problem drinking are: Having health, legal, social, academic or financial problems as a result of drinking. For example, missing class or work because of drinking or hangovers, not be able to have fun or express oneself without drinking, fights or problems with roommates or significant others, spending excessive amounts of money on alcohol, blackouts/passing out, trips to the ER, being defensive when someone mentions your drinking, needing to drink more to achieve the same effects (tolerance), frequently drinking with the primary purpose of getting drunk, and/or repeatedly driving under the influence. These are only guidelines and each case is different. If you're concerned about your drinking or a friend's drinking, get more information! Screening for Alcohol Dependence Screening tools are available to assist counselors and therapists with diagnosing alcohol abuse and dependence such as the SMAST below. Short Michigan Alcoholism Screening Test (MAST) 1. Do you feel you are a normal drinker? (By normal we mean you drink less than or as much as most other people.) 2. Does your wife, husband, a parent, or other near relative ever worry or complain about your drinking? 3. Do you ever feel guilty about your drinking? 4. Do friends or relatives think you are a normal drinker? 5. Are you able to stop drinking when you want to? 6. Have you ever attended a meeting of Alcoholics Anonymous? 7. Has drinking ever created problems between you and your wife, husband, a parent, or other near relative? 8. Have you ever gotten into trouble at work because of drinking? 9. Have you ever neglected your obligations, your family, or your work for two of more days in a row because you were drinking? 10. Have you ever gone to anyone for help about your drinking? 11. Have you ever been in a hospital because of drinking? 12. Have you ever been arrested for drunken driving, driving while intoxicated, or driving under the influence of alcoholic beverages? 13. Have you ever been arrested, even for a few hours, because of other drunken behavior? Individuals that answer – Yes to three or more questions indicate probable alcoholism, two yes answers indicate probable alcoholism, and fewer than two yes answers indicate that alcoholism is not likely (Selzer, M., Winokur, A. & Van Rooijen, C.; 1975). Note: If after reading the above, you started rationalizing to yourself, “Well, I can stop drinking anytime I want to, but I usually stop when I run out of money.” (As my old graduate professor use to say) STOP BULL-SH#%ting yourself and go see a certified alcohol counselor. Co-morbidity & Alcohol Dependence Alcohol abuse and dependence are among the most destructive of the psychiatric disorders (Volpicelli, 2001). Addictions such as alcohol dependence and other addictions as a rule do not develop in isolation. Over 37 % of alcohol abusers suffer from at least one coexisting addiction and/ or mental disorder (Rovner, 1990). Individuals can shift from one addiction to another or sustain multiple addictions at different times. The National Co-morbidity Survey (NCS) that sampled the entire U.S. population in 1994, found that among non-institutionalized American male and female adolescents and adults (ages 15-54), roughly 50% had a diagnosable Axis I mental disorder at some time in their lives. This survey’s results indicated that 35% of males will at some time in their lives have abused substances to the point of qualifying for a mental disorder diagnosis, and nearly 25% of women will have qualified for a serious mood disorder (mostly major depression). A significant finding of note from the NCS study was the widespread occurrence of co-morbidity among diagnosed disorders. It specifically found that 56% of the respondents with a history of at least one disorder also had two or more additional disorders. These persons with a history of three or more co-morbid disorders were estimated to be one-sixth of the U.S. population, or some 43 million people (Kessler, 1994). Poor Prognosis We have come to realize today more than any other time in history that the treatment of lifestyle diseases and addictions such as alcoholism are often a difficult and frustrating task for all concerned. Repeated failures abound with all of the addictions, even with utilizing the most effective treatment strategies. But why do 47% of patients treated in private treatment programs (for example) relapse within the first year following treatment (Gorski,T., 2001)? Have addiction specialists become conditioned to accept failure as the norm? There are many reasons for this poor prognosis. Some would proclaim that addictions are psychosomatically- induced and maintained in a semi-balanced force field of driving and restraining multidimensional forces. Others would say that failures are due simply to a lack of self-motivation or will power. Most would agree that lifestyle behavioral addictions are serious health risks that deserve our attention, but could it possibly be that patients with multiple addictions are being under diagnosed (with a single dependence) simply due to a lack of diagnostic tools and resources that are incapable of resolving the complexity of assessing and treating a patient with multiple addictions? New Proposed Diagnosis Since successful treatment outcomes are dependent on thorough assessments, accurate diagnoses, and comprehensive individualized treatment planning, it is no wonder that repeated rehabilitation failures and low success rates are the norm instead of the exception in the addictions field. Treatment clinics need to have a treatment planning system and referral network that is equipped to thoroughly assess multiple addictions and mental health disorders and related treatment needs and comprehensively provide education/ awareness, prevention strategy groups, and/ or specific addictions treatment services for individuals diagnosed with multiple addictions. Written treatment goals and objectives should be specified for each separate addiction and dimension of an individuals’ life, and the desired performance outcome or completion criteria should be specifically stated, behaviorally based (a visible activity), and measurable. To assist with resolving this problem a multidimensional diagnosis of “Poly-behavioral Addiction,” is proposed for more accurate diagnosis leading to more effective treatment planning. This diagnosis encompasses the broadest category of addictive disorders that would include an individual manifesting a combination of alcohol and substance abuse addictions, and other obsessively-compulsive behavioral addictive behavioral patterns to pathological gambling, religion, and/ or sex / pornography, etc.). Behavioral addictions are just as damaging - psychologically and socially as alcohol and drug abuse. They are comparative to other life-style diseases such as diabetes, hypertension, and heart disease in their behavioral manifestations, their etiologies, and their resistance to treatments. They are progressive disorders that involve obsessive thinking and compulsive behaviors. They are also characterized by a preoccupation with a continuous or periodic loss of control, and continuous irrational behavior in spite of adverse consequences. Poly-behavioral addiction would be described as a state of periodic or chronic physical, mental, emotional, cultural, sexual and/ or spiritual/ religious intoxication. These various types of intoxication are produced by repeated obsessive thoughts and compulsive practices involved in pathological relationships to any mood-altering substance, person, organization, belief system, and/ or activity. The individual has an overpowering desire, need or compulsion with the presence of a tendency to intensify their adherence to these practices, and evidence of phenomena of tolerance, abstinence and withdrawal, in which there is always physical and/ or psychic dependence on the effects of this pathological relationship. In addition, there is a 12 - month period in which an individual is pathologically involved with three or more behavioral and/ or substance use addictions simultaneously, but the criteria are not met for dependence for any one addiction in particular (Slobodzien, J., 2005). In essence, Poly-behavioral addiction is the synergistically integrated chronic dependence on multiple physiologically addictive substances and behaviors (e.g., using/ abusing substances - nicotine, alcohol, & drugs, and/or acting impulsively or obsessively compulsive in regards to gambling, food binging, sex, and/ or religion, etc.) simultaneously. New Proposed Theory The Addictions Recovery Measurement System’s (ARMS) theory is a nonlinear, dynamical, non-hierarchical model that focuses on interactions between multiple risk factors and situational determinants similar to catastrophe and chaos theories in predicting and explaining addictive behaviors and relapse. Multiple influences trigger and operate within high-risk situations and influence the global multidimensional functioning of an individual. The process of relapse incorporates the interaction between background factors (e.g., family history, social support, years of possible dependence, and co-morbid psychopathology), physiological states (e.g., physical withdrawal), cognitive processes (e.g., self-efficacy, cravings, motivation, the abstinence violation effect, outcome expectancies), and coping skills (Brownell et al., 1986; Marlatt & Gordon, 1985). To put it simply, small changes in an individual’s behavior can result in large qualitative changes at the global level and patterns at the global level of a system emerge solely from numerous little interactions. The ARMS hypothesis purports that there is a multidimensional synergistically negative resistance that individual’s develop to any one form of treatment to a single dimension of their lives, because the effects of an individual’s addiction have dynamically interacted multi-dimensionally. Having the primary focus on one dimension is insufficient. Traditionally, addiction treatment programs have failed to accommodate for the multidimensional synergistically negative effects of an individual having multiple addictions, (e.g. nicotine, alcohol, and obesity, etc.). Behavioral addictions interact negatively with each other and with strategies to improve overall functioning. They tend to encourage the use of tobacco, alcohol and other drugs, help increase violence, decrease functional capacity, and promote social isolation. Most treatment theories today involve assessing other dimensions to identify dual diagnosis or co-morbidity diagnoses, or to assess contributing factors that may play a role in the individual’s primary addiction. The ARMS’ theory proclaims that a multidimensional treatment plan must be devised addressing the possible multiple addictions identified for each one of an individual’s life dimensions in addition to developing specific goals and objectives for each dimension. The ARMS acknowledges the complexity and unpredictable nature of lifestyle addictions following the commitment of an individual to accept assistance with changing their lifestyles. The Stages of Change model (Prochaska & DiClemente, 1984) is supported as a model of motivation, incorporating five stages of readiness to change: pre-contemplation, contemplation, preparation, action, and maintenance. The ARMS theory supports the constructs of self-efficacy and social networking as outcome predictors of future behavior across a wide variety of lifestyle risk factors (Bandura, 1977). The Relapse Prevention cognitive-behavioral approach (Marlatt, 1985) with the goal of identifying and preventing high-risk situations for relapse is also supported within the ARMS theory. Conclusions Considering the wide range of alcohol abuse and sexual behaviors in our world today, one should always take into account an individual’s ethnic, cultural, religious, and social background prior to making any clinical judgments, and it would be wise to not over-pathologize in this area of Dependency. However, since successful treatment outcomes are dependent on thorough assessments, accurate diagnoses, and comprehensive individualized treatment planning - poly-behavioral addiction needs to be identified to effectively treat the complexity of multiple behavioral and substance addictions. Since chronic lifestyle diseases and disorders such as diabetes, hypertension, alcoholism, drug and behavioral addictions cannot be cured, but only managed - how should we effectively manage poly-behavioral addiction? The Addiction Recovery Measurement System (ARMS) is proposed utilizing a multidimensional integrative assessment, treatment planning, treatment progress, and treatment outcome measurement tracking system that facilitates rapid and accurate recognition and evaluation of an individual’s comprehensive life-functioning progress dimensions. The ARMS hypothesis purports that there is a multidimensional synergistically negative resistance that individual’s develop to any one form of treatment to a single dimension of their lives, because the effects of an individual’s addiction have dynamically interacted multi-dimensionally. Having the primary focus on one dimension is insufficient. Traditionally, addiction treatment programs have failed to accommodate for the multidimensional synergistically negative effects of an individual having multiple addictions, (e.g. nicotine, alcohol, and obesity, etc.). Behavioral addictions interact negatively with each other and with strategies to improve overall functioning. They tend to encourage the use of tobacco, alcohol and other drugs, help increase violence, decrease functional capacity, and promote social isolation. Most treatment theories today involve assessing other dimensions to identify dual diagnosis or co-morbidity diagnoses, or to assess contributing factors that may play a role in the individual’s primary addiction. The ARMS’ theory proclaims that a multidimensional treatment plan must be devised addressing the possible multiple addictions identified for each one of an individual’s life dimensions in addition to developing specific goals and objectives for each dimension. Partnerships and coordination among all service providers, government departments, and health insurance organizations in providing treatment programs are a necessity in addressing the multi-task solution to Alcohol Abuse and Poly-behavioral addictions. I encourage you to support the addiction programs in America, and hope that the (ARMS) resources can assist you to personally fight the War on poly-behavioral addiction. References Avins, A.L.; Woods, W.J.; Lindan, C.P.; et al. HIV infection and risk behaviors among heterosexuals in alcohol treatment programs. JAMA 271(7):515–518, 1994. Boscarino, J.A.; Avins, A.L.; Woods, W.J.; et al. Alcohol-related risk factors associated with HIV infection among patients entering alcoholism treatment: Implications for prevention. Journal of Studies on Alcohol 56(6):642–653, 1995. Cooper, M.L. Alcohol use and risky sexual behavior among college students and youth: Evaluating the evidence. Journal of Studies on Alcohol (Suppl. 14):101–117, 2002. Dermen, K.H.; Cooper, M.L.; and Agocha, V.B. Sex-related alcohol expectancies as moderators of the relationship between alcohol use and risky sex in adolescents. Journal of Studies on Alcohol 59(1):71–77, 1998. Dermen, K.H., and Cooper, M.L. 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Lately I've found myself wondering just what kind of junk mail existed before the daily avalanche of penis enlargement fodder. Every day, without fail, messages like ‘Increase your member’ and ‘Three inches in a week!’ or ‘Satisfy her!’ land in my junk box. Not to mention some of the more absurd ones: ‘Smash through walls with your massive dong!’ or ‘Missile in your pants!’ It's endless. And it's not limited to junk mail either - the entire net is strewn with ads for pills, cremes, powders and techniques to make you 'the man you've always wanted to be'; the pages of every sex-rag out there - as well as numerous 'high-brow' men's magazines - are littered with them. 'Give her the gift she's always wanted!' All this really got me to thinking. Are there men out there who really DO want a missile in their pants? And how far is too far? I mean, at what point do things leave the realm of pleasure and enter the absurd - is there such a thing as TOO big? Mystified, I decided to do a little research and find out once and for all. Despite all the humour, there is a very real undercurrent to this topic that dates back longer than any one of us can imagine. If there is one issue that is of nearly universal concern to all men (and women), it’s this. The last thing any male wants is to come up short – literally – in that department. As with breast size for women, this topic is under never-ending scrutiny in the media. Shows like ‘Sex And The City’ and ‘Ally McBeal’, which have depicted women crying in bed and leaving their lovers over inadequate penis size, only add to the furor. How else could a billion-dollar enlargement industry continue to grow and thrive? It hasn’t always been this way. Although surely somewhat of a concern from the very beginnings of civilized culture, we’ve survived. Size has nothing to do with whether or not the parts work correctly – it’s merely an issue of aesthetics, and pleasure. Only in the last thirty-five years has it reached the level of omnipotent urgency we see today – everything has to be bigger, better, hotter, stronger… In the seventies we saw the penis-pump come to light. Not openly spoken of, ordered by teenagers and lonely men from the backs of mattress-magazines and destined to end up collecting dust in the corner of the closet, they’re basically considered a relic today. In the eighties we began to hear a little about something called ‘traction’, rightly deserving of it’s S&M image-provoking name. This is a process by which you lengthen your penis by hanging weights from it for prolonged periods of time. Enough said. It wasn’t until the mid nineties that we began seeing ads for things such as pills and solutions, and penile surgery, known as phalloplasty, was a commonly known technique. Then of course there’s ‘jelqing’, the so-called ‘natural and ancient’ manner of enlargement which basically consists of fifteen-minute daily sessions during which you repeatedly squeeze your penis as if it were a freezie that you were trying force the last drops of juice from. As far as I could find, there is no scientific evidence to support the notion that any of these techniques really work. On the contrary, some of the side effects are down-right frightening, ranging from burst blood vessels to blisters to scarring, deformity, infection and even impotence. In the case of the pills, analyses performed by the University of Maryland and Flora Research of California have uncovered harmful contaminants including mold, yeast, E. Coli, pesticides, and lead, not to mention “heavy fecal contamination”. (Michael Donnenburg – U of Maryland.) Is all of this really worth it? How many ‘small’ penises are actually out there and – here we come to it – what actually constitutes ‘small’ and ‘large’? Putting aside personal preferences for a moment, lets look at the statistics. According to Wikipedia, several studies have been conducted regarding the length of the fully erect adult penis. Amusingly enough, “those studies that relied on self-measurement consistently reported a higher average than those that had staff take the measurements.” Out of five separate studies from different parts of the world, the average length was between 5.1 and 6.1 inches. When it comes to girth, the average out of four separate studies was a lot closer – between 4.7 and 5.0 inches in circumference. So, how does that sound to everyone? Correct? And, if so, good enough? Or has nature cut us all short on this one, being more concerned with the mechanisms of reproduction than the intricacies of pleasure? Appararently, according to some women, certain men can be too big. What? Too big? Who ever heard of such a thing! Don’t be ridiculous. More is better, remember? This brings to mind another fascinating issue. I am not an avid porn watcher, but I’ve done my share and seen some eye-opening things in my time. When it comes to the extremely well-endowed male (9 to 12 inches), I’ve often wondered exactly how it is that the women in these movies are able to take that much. As far as I knew, the cervix simply dosen’t leave enough room for someone like John holmes to get all the way in – so what, exactly, is happening? After a little research the answer became clear. Unlike the penis, which is fairly simple, the vagina is an extremely complex piece of biological machinery. (Kinda like their owners!) Women are capable of having four different types of orgasm: vulval (clitoral), vaginal (g-spot), uterine (epicentre), and blended, the latter being any combination of the prior three. Researchers have also apparently found another hot-spot inside the vagina recently, known as the ‘Anterior Fornix Erotic’, or ‘AFE Zone’. Now, if the vagina is a complex piece of machinery, then female orgasm, as one site put it, is an extrememly complex phenomenon. I’m not going to get into all the details here, but the one thing I did learn is that the vagina, which is capable of expanding to a size large enough to deliver an infant, is capable of accomodating nearly any size of penis. The key? Foreplay. The more physiologically aroused a woman is the more the vaginal walls – which are normally touching – will dilate, and the deeper inside the cervix will ascend. When a man thrusts in at a certain angle, the cervix, along with the entire uterus is stimulated either from the top or bottom, eventually enabling the uteral – or ‘epicentre’ – orgasm. However, you apparently have to be at least seven inches or more to achieve this, with the ideal length being nine inches. Of course, there are certain physiological limitations – as with penis size, some women are naturally much ‘deeper’ than others. An extremely petite woman, for example, is simply not going to be able to accommodate a full twelve inches, no matter how deep her cervix may ascend. However, given the above information, it would still seem that nature has reserved certain pleasures for the more well-endowed man. Is this fair? Of course not, but then, whoever said life itself was?