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This study was designed to examine the relationships between problem-solving skills, hardiness, and perceived stress and to test the moderating role of hardiness in the relationship between problem-solving skills and perceived stress among 500 undergraduates from Malaysian public universities. The analyses showed that undergraduates with poor problem-solving confidence, external personal control of emotion, and approach-avoidance style were more likely to report perceived stress. Hardiness moderated the relationships between problem-solving skills and perceived stress. These findings reinforce the importance of moderating role of hardiness as an influencing factor that explains how problem-solving skills affect perceived stress among undergraduates.
Suicide is a serious and growing public health problem and remains an unnecessary cause of death globally. In Iran, the highest prevalence of acute and chronic suicidal ideation is among young people aged 16-24. This study investigates the relationship between coping style, two types of perfectionism, and suicidal ideation among undergraduates, and examines coping style as a moderator of the relationship between perfectionism and suicidal ideation. Multi-stage cluster random sampling was employed to recruit 547 undergraduate students aged 19-24 years from the Islamic Azad University of Karaj. Structural Equation Modelling indicated that suicidal ideation was negatively associated with adaptive perfectionism and task-focused coping but positively associated with emotion-focused coping, avoidance coping, and maladaptive perfectionism. Coping style (including the three styles of task-focused, emotion-focused, and avoidance coping) was found to moderate the relationship between perfectionism and suicidal ideation. The study advances understanding of the importance of coping style in this context and explains how perfectionism affects suicidal ideation.
Because it remains one of the third leading causes of death among adolescents around the world, suicide is a major public health concern. This study was designed in response to this concern by examining the relationships among perceived stress, emotional intelligence, and suicidal ideation and to test the moderating role of emotional intelligence in the relationship between perceived stress and suicidal ideation. A sample of depressed adolescents (n = 202) was recruited from five hospitals in Tehran, Iran, and then asked to complete measures of patient health, suicidal ideation, perceived stress, and emotional intelligence. Structural Equation Modeling showed that depressed adolescent in-patients with high levels of perceived stress and low levels of emotional intelligence were more likely to report suicidal ideation. Multi-group analysis indicated that depressed in-patients high in both perceived stress and emotional intelligence had less suicidal ideation than others. The findings support the notion that perceived stress acts as a vulnerability factor that increase suicidal ideation among depressed inpatients. Suicidal history moderated the relationship between emotional intelligence and suicidal ideation. These findings also highlight the importance of emotional intelligence as a buffer in the relationship between perceived stress and suicidal ideation.
Recent evidence suggests that test anxiety is increasing among students; however, relatively little is known regarding the related factors of test anxiety. The purpose of this study was to (1) examine the relationships between two forms of perfectionism, academic hardiness, and test anxiety, and (2) examine the moderating role of academic hardiness on the association between two types of perfectionism and test anxiety. This study included 520 students ranging from 15 to 21 years of age from eight high schools in Tehran, Iran completed the self-administered questionnaires. The results of Structural Equation Modelling (SEM) revealed that students with high levels of personal standards perfectionism and high levels of academic hardiness were less likely to experience test anxiety, while students with high levels of evaluative concerns perfectionism were more likely to experience test anxiety. A multi-group analysis revealed that academic hardiness moderated the relationship between evaluative concerns perfectionism and test anxiety. These findings enhance existing literature by revealing moderating processes that explain how perfectionism effects test anxiety.
One of the biggest barriers in treating adolescents with mental health problems is their refusing to seek psychological help. This study was designed to examine the relationships between two forms of perfectionism, self-concealment and attitudes toward seeking psychological help and to test the mediating role of self-concealment in the relationship between perfectionism and attitudes toward seeking psychological help among Malaysian high school students. The participants were 475 Malaysian high school students from four high schools in Kuala Lumpur, Malaysia. Structural equation modelling results indicated that high school students with high levels of socially prescribed perfectionism, high levels of self-concealment, and low levels of self-oriented perfectionism reported negative attitudes toward seeking psychological help. Bootstrapping analysis showed that self-concealment emerged as a significant, full mediator in the link between socially prescribed perfectionism and attitudes toward seeking psychological help. Moderated mediation analysis also examined whether the results generalized across men and women. The results revealed that male students with socially prescribed perfectionism are more likely to engage in self-concealment, which in turn, leads to negative attitudes toward seeking psychological help more than their female counterparts. The results suggested that students high in socially prescribed perfectionism were more likely to engage in self-concealment and be less inclined to seek psychological help.
Recent evidence indicates an elevated risk of suicidal ideation for undergraduate nursing students. This research was designed to enhance the understanding of suicidal ideation in nursing students by investigating the relationships between problem-solving skills, perceived stress, hardiness, and suicidal ideation, with the possibility of hardiness acting as a moderator in the relationships between problem-solving skills appraisal and perceived stress with suicidal ideation. A multi-stage cluster random sample of Malaysian nursing undergraduate students (N = 204) completed self-report questionnaires. The results of structural equation modeling revealed that poor problem-solving skills, greater levels of perceived stress, and low levels of hardiness predicted greater levels of suicidal ideation. Also, hardiness emerged as a moderator in the links between problem-solving skills appraisal and perceived stress with suicidal ideation. The findings incrementally improve our understanding about the importance of hardiness as a moderator in explaining how problem-solving skills and perceived stress affect suicidal ideation. The results of this study are obtained from Malaysian nursing students and possible generalization to other populations should be verified by further studies.
Background: Suicidal ideation and depression are prevalent and costly conditions that reduce quality of life. This study was designed to determine the efficacy of exercise as an adjunct to cognitive behavioural therapy (CBT) for suicidal ideation and depression among depressed individuals.
Methods: In a randomized clinical trial, 54 mildly to moderately depressed patients (54% female, mean age=48.25) were assigned to a combined CBT and exercise group or to a CBT only group. Both groups received one weekly session of therapy for 12 weeks, while the combined group also completed exercise three times weekly over the same period. Self-reported suicidal ideation, depression, and activities of daily living were measured at the beginning and the end of treatment.
Results: Multilevel modelling revealed greater improvements in suicidal ideation, depression, and activities of daily living in the combined CBT and exercise group, compared to the CBT only group.
Limitations: No follow-up data were collected, so the long-term effects (i.e., maintenance of gains) is unclear.
Conclusions: The findings revealed that exercise adjunct to CBT effectively decreases both depressive symptoms and suicidal ideation in mildly to moderately depressed individuals.
The role of genetics for predicting the response to cognitive behavior therapy (CBT) for social anxiety disorder (SAD) has only been studied in one previous investigation. The serotonin transporter (5-HTTLPR), the catechol-o-methyltransferase (COMT) val158met, and the tryptophan hydroxylase-2 (TPH2) G-703Tpolymorphisms are implicated in the regulation of amygdala reactivity and fear extinction and therefore might be of relevance for CBT outcome. The aim of the present study was to investigate if these three gene variants predicted response to CBT in a large sample of SAD patients.
Participants were recruited from two separate randomized controlled CBT trials (trial 1: n = 112, trial 2: n = 202). Genotyping were performed on DNA extracted from blood or saliva samples. Effects were analyzed at follow-up (6 or 12 months after treatment) for both groups and for each group separately at post-treatment. The main outcome measure was the Liebowitz Social Anxiety Scale Self-Report.
At long-term follow-up, there was no effect of any genotype, or gene × gene interactions, on treatment response. In the subsamples, there was time by genotype interaction effects indicating an influence of the TPH2 G-703T-polymorphism on CBT short-term response, however the direction of the effect was not consistent across trials.
None of the three gene variants, 5-HTTLPR, COMTval158met and TPH2 G-703T, was associated with long-term response to CBT for SAD.
Inom det sociala arbetets praktik ser vi en ökad närvaro av internetrelaterade problem. Samtidigt föredrar allt fler människor webbaserad hjälp, samt råd och stöd i relation till mer traditionella behandlings- och preventionsprogram, vilket öppnar för nya möjligheter för det sociala arbetet.
Introduction: Numerous randomized controlled trials have been conducted on internet interventions. In addition to the effects observed in these trials immediately after treatment there are several long-term follow-ups. The aim of this talk is to review the long-term effects of internet-delivered CBT (ICBT) with a focus on results at 1-year or later following treatment termination.
Methods: We were able to locate examples of enduring effects for a range of conditions including mood and anxiety disorders and somatic disorders. The longest follow-up period has been five years.
Results: Large within-group effects have been documented in most trials, with effects sizes being moderate to large for anxiety and depression studies.
Discussion: Studies have failed to document how much the treatment is used during the follow-up period and in the case of depression it is unclear if episodes of depression have occured during the period covered. We conclude that the effects of ICBT appear to be enduring but that more research is needed.
Numerous controlled trials have been published on the effects of internet-delivered psychological treatments for a range of problems and disorders. Generally, trials adhere to the CONSORT statement and include control groups. Often this is attention control, waitlist but also alternative treatments. In experimental psychology factorial designs is the common way to investigate research questions but in psychotherapy research this is rare given the need for large samples in order to have sufficient power to detect differntial effects of independent variables (like for example different versions of a treatment). With the advent of internet-delivered CBT (ICBT) this has changes and it is now possible to run trials with larger samples. At the same time there is really no need for more studies showing that a treatment is better than just waiting (for some areas at least like depression). In this talk we will present result from three completed factorial design trials in which we have manipulated support form (on demand versus scheduled in one trial and chat-support versus just email in another), and also other aspects like learning support and choice of treatment. The talk will end with a discussion on future directions of ICBT research with regards to design of trials.
Internetbaserad KBT ger tillgång till fungerande behandling för psykisk ohälsa på patientens villkor. Metoden har utvecklats i snabb takt genom utbredda forskningsinsatser, där Sverige kan betraktas som världsledande inom området.
Internetbehandling med KBT ger en grundlig genomgång av behandlingsarbetet med betoning på praktiska aspekter och tillämpningen i olika verksamheter. Särskilt fokus ligger på att skapa ett fungerande behandlingsupplägg, praktiska förberedelser, behandlarens roll och viktiga terapeutfärdigheter samt hur vanliga svårigheter hanteras. Läsaren får också en teoretisk orientering, kunskap om befintligt forskningsstöd och vilka fördelar metoden har för patienter, behandlare och verksamheter. Fallexempel, checklistor och annat praktiskt material gör boken till ett mycket användbart hjälpmedel.
The Internet, including modern information technology, has had a dramatic impact on many areas of life, including health care and psychological treatment. In particular, cognitive–behavioral therapy (CBT) has been found to be a form of psychological treatment that has been possible to transfer to other modes of delivery than regular face-to-face and group formats. The Internet is not only useful for providing CBT, but has a significant role in providing information about CBT and conditions that are treated using CBT. In addition, modern information technology also has a major role in assessment procedures, such as online administration of self-report mea- sures. In this article, we focus mainly on Internet-supported treatments, although another emerging format is to use video conferencing systems and conduct real- time face-to-face CBT, CBT training, or supervision.
Under de senaste 15 åren har en intensiv forskning bedrivits kring internetbaserad psykologisk behandling och svenska forskare har i hög grad deltagit i utvecklingen. Här ger Gerhard Andersson och Per Carlbring, båda professorer i klinisk psykologi, en introduktion till internetbaserad psykologisk behandling och en bild av kunskapsläget just nu.
In this chapter we review the literature on internet-delivered treatment for social anxiety disorder (SAD). There are several different treatment programs that have been tested in randomized controlled trials and evidence now suggests that guided internet-based cognitive behavior therapy (ICBT) can be as effective as face-to-face therapy, that therapists may need less training than in face-to-face treatment, and that ICBT works in representative clinical settings, thereby supporting effectiveness. Moreover, there are studies to suggest that ICBT has enduring effects up to five years after treatment and that it is cost-effective. Since there are advantages with internet treatments, this treatment option should be considered as a complement or alternative to face-to-face treatments for SAD. Treatment mechanisms, including moderators and mediators of outcome, remain to be investigated.
Internet-based cognitive behavior therapy (ICBT) is an evidence-based form of CBT. Most programs include text, video, and audio files and are similar to face-to-face CBT in terms of content and duration of treatment. Most often ICBT includes some guidance from a therapist, although automated self-guided ICBT programs also exist. Studies suggest that guided ICBT can be as effective as face-to-face CBT for anxiety and mood disorders as well as for distress associated with certain somatic disorders. Transdiagnostic programs, either relying on presentation of common strategies for, or tailoring of treatment to, disorders have generated strong outcomes in controlled trials. Interventions for problems like procrastination also show promise. Studies on predictors and mediators of outcome are emerging, but there is a need to develop intervention-specific theories in order to better understand change mechanisms. In the future, blending of face-to-face CBT and modern information technology are expected to be more common and attractive to therapists.
We begin this chapter with a discussion of the history of ICBT and its roots in bibliotherapy and computerised CBT. We then provide a brief description of one way of administering guided ICBT, including the role of the therapist and data security issues. This description is followed by examples of conditions that are not covered later in the book, such as specific phobias and addictions. We end this chapter with a discussion of technical developments, cost-effectiveness and implementation.
The Internet has become a part of most people's lives in many parts of the world. Since the late 1990s there has been an intensive research activity in which psychological treatments, such as cognitive behavior therapy (CBT), have been found to be effective when delivered via the Internet. Most research studies indicate that the effects are larger when some form of guidance is provided from a therapist, and unguided treatments tend to lead to more dropout and smaller effects. Guided Internet treatments often consists of book length text materials, but can also include other components such as audio files and video clips. Homework assignment is often included and feedback is given for completed homework. Guided Internet-based CBT (iCBT) has been found to work for problems such as depression, panic-, social anxiety-, and generalized anxiety disorders. There are many research trials in which participants have been recruited via media, and there has been less research conducted in representative clinical settings. Most research has been conducted on adults and in university settings with nationwide recruitment. There is a need for treatments and studies on older adults, children and adolescents. In conclusion, dissemination of the research findings on guided iCBT to regular clinical settings is warranted.
Background: Internet-delivered cognitive behavior therapy (ICBT) was developed over 20 years ago and has since undergone a number of controlled trials, as well as several systematic reviews and meta-analyses. However, the crucial question of response rates remains to be systematically investigated. The aim of this individual patient meta-analysis (IPDMA) was to use a large dataset of trials conducted in Sweden to determine reliable change and recovery rates across trials for a range of conditions.
Methods: We used previously collected and aggregated data from 2,866 patients in 29 Swedish clinical trials of ICBT for three categories of conditions: anxiety disorders, depression, and others. Raw scores at pre-treatment and post-treatment were used in an IPDMA to determine the rate of reliable change and recovery. Jacobson and Truax's, (1991) reliable change index (RCI) was calculated for each primary outcome measure in the trials as well as the recovery rates for each patient, with the additional requirement of having improved substantially. We subsequently explored potential predictors using binomial logistic regression.
Results: In applying an RCI of z = 1.96, 1,162 (65.6%) of the patients receiving treatment were classified as achieving recovery, and 620 (35.0%) were classified as reaching remission. In terms of predictors, patients with higher symptom severity on the primary outcome measure at baseline [odds ratio (OR) = 1.36] and being female (OR = 2.22) increased the odds of responding to treatment. Having an anxiety disorder was found to decrease the response to treatment (OR = 0.51). Remission was predicted by diagnosis in the same direction (OR = 0.28), whereas symptom severity was inversely predictive of worse outcome (OR = 0.81). Conclusions: Response seems to occur among approximately half of all clients administered ICBT, whereas about a third reach remission. This indicates that the efficacy of ICBT is in line with that of CBT based in prior trials, with a possible caveat being the lower remission rates. Having more symptoms and being female might increase the chances of improvement, and a small negative effect of having anxiety disorder versus depression and other conditions may also exist. A limitation of the IPDMA was that only studies conducted in Sweden were included.
Internet-delivered cognitive behaviour therapy (ICBT) has existed for 20 years and there are now several controlled trials for a range of problems. In this paper, we focused on recent meta-analytic reviews of the literature and found moderate to large effects reported for panic disorder, social anxiety disorder, generalized anxiety disorder, posttraumatic stress disorder, and major depression. In total, we reviewed 9 recent meta-analytic reviews out of a total of 618 meta-analytic reviews identified using our search terms. In these selected reviews, 166 studies were included, including overlap in reviews on similar conditions. We also covered a recent review on transdiagnostic treatments and 2 reviews on face-to-face v. internet treatment. The growing number of meta-analytic reviews of studies now suggests that ICBT works and can be as effective as face-to-face therapy.
Internet-delivered cognitive behaviour therapy (ICBT) has been tested in many research trials but to a lesser extent been directly compared against face-to-face delivered cognitive behaviour therapy (CBT). We conducted a systematic review and meta-analysis on trials in which guided ICBT was directly compared against face-to-face CBT within the same trial. Studies on psychiatric and somatic conditions were included. Systematic searches resulted in 13 studies (total N=1053) that met all review criteria and were included in the review. There were 3 studies on social anxiety disorder, 3 on panic disorder, 2 on depressive symptoms, 2 on body dissatisfaction, 1 on tinnitus, 1 on male sexual dysfunction, and 1 on spider phobia. Face-to-face CBT was either in the individual format (n=6 ) or in the group format (n=7). We also assessed quality and risk of bias. Results showed a pooled effect size at post-treatment across of Hedges g = -0.01 (95% CI, -0.13 to 0.12), indicating that ICBT and face-to-face treatment produce equivalent overall effects. Study quality did not affect outcomes. While the overall results indicate equivalence, there are still few studies for each psychiatric and somatic condition and many for which guided ICBT has not been compared against face-to-face treatment. Thus, more research is needed to establish equivalence of the two treatment formats.
Internet-delivered cognitive behavior therapy (ICBT) has been tested in many research trials, but to a lesser extent directly compared to face-to-face delivered cognitive behavior therapy (CBT). We conducted a systematic review and meta-analysis of trials in which guided ICBT was directly compared to face-to-face CBT. Studies on psychiatric and somatic conditions were included. Systematic searches resulted in 13 studies (total N=1053) that met all criteria and were included in the review. There were three studies on social anxiety disorder, three on panic disorder, two on depressive symptoms, two on body dissatisfaction, one on tinnitus, one on male sexual dysfunction, and one on spider phobia. Face-to-face CBT was either in the individual format (n=6) or in the group format (n=7). We also assessed quality and risk of bias. Results showed a pooled effect size (Hedges' g) at post-treatment of −0.01 (95% CI: −0.13 to 0.12), indicating that guided ICBT and face-to-face treatment produce equivalent overall effects. Study quality did not affect outcomes. While the overall results indicate equivalence, there are still few studies for each psychiatric and somatic condition and many conditions for which guided ICBT has not been compared to face-to-face treatment. Thus, more research is needed to establish equivalence of the two treatment formats.
Guided internet-delivered cognitive behaviour therapy (ICBT) has been found to be effective in the treatment of mild to moderate depression, but there have been no direct comparisons with the more established group-based CBT with a long-term follow-up.
Participants with mild to moderate depression were recruited from the general population and randomized to either guided ICBT (n=33) or to live group treatment (n=36). Measures were completed before and after the intervention to assess depression, anxiety, and quality of life. Follow-ups were conducted at one-year and three-year after the treatment had ended.
Data were analysed on an intention-to-treat basis using linear mixed-effects regression analysis. Results on the self-rated version of the Montgomery–Åsberg Depression Scale showed significant improvements in both groups across time indicating non-inferiority of guided ICBT, and there was even a tendency for the guided ICBT group to be superior to group-based CBT at three year follow-up. Within-group effect sizes for the ICBT condition at post-treatment showed a Cohen′s d=1.46, with a similar large effect at 3-year follow-up,d=1.78. For the group CBT the corresponding within-group effects were d=0.99 and d=1.34, respectively.
The study was small with two active treatments and there was no placebo or credible control condition.
Guided ICBT is at least as effective as group-based CBT and long-term effects can be sustained up to 3 years after treatment.
Lars-Göran Öst is one of the most eminent clinical researchers in the field of cognitive behaviour therapy (CBT) and a founder of CBT in Sweden. He has recently retired from his position as professor in clinical psychology at Stockholm University, Sweden. In this paper, we sketch a brief description of the body of work by Öst. Examples of his innovative and pioneering new treatment methods include the one-session treatment for specific phobias, as well as applied relaxation for a range of anxiety disorders and health conditions. While Öst remains active in the field, he has contributed significantly to the development and dissemination of CBT in Sweden as well as in the world.
Guided internet-delivered cognitive behaviour therapy (ICBT) has been tested in many trials since the early studies dating back to the late 1990's. The aim of this review was to investigate the most recent literature on guided ICBT for depression. We identified 11 controlled studies published between January 2013 and September 2014. Overall, large treatment effects were observed with a few exceptions. A majority (7 studies) provided some information regarding unwanted effects such as deterioration. Three studies directly compared guided ICBT against face-to-face CBT. We added an earlier study and calculated meta-analytic summary statistics for the four studies involving a total of 336 participants. The average effect size difference was Hedges g = 0.12 (95% CI: -0.08~0.32) in the direction of favouring guided ICBT, but with no practical importance. We conclude that guided ICBT is a promising treatment for depression and mood disorders and that the research is rapidly expanding.
Introduction: Internet-supported and therapist-guided cognitive behaviour therapy (ICBT) is effective for a range of problems in the short run, but less is known about the long-term effects with follow-ups of two years or longer.
Areas covered: This paper reviews studies in which the long-term effects of guided ICBT were investigated. Following literature searches in PubMed and other sources meta-analytic statistics were calculated for 14 studies involving a total of 902 participants, and an average follow-up period of three years. Studies were from Sweden (n = 11) or the Netherlands (n = 3). Long-term outcome studies were found for panic disorder, social anxiety disorder, generalized anxiety disorder, depression, mixed anxiety and depression, obsessive-compulsive disorder, pathological gambling, stress and chronic fatigue. The duration of the treatments was usually short (8–15 weeks). The pre-to follow-up effect size was Hedge's g = 1.52, but with a significant heterogeneity. The average symptom improvement across studies was 50%. Treatment seeking in the follow-up period was not documented and few studies mentioned negative effects.
Expert commentary: While effects may be overestimated, it is likely that therapist-supported ICBT can have enduring effects. Long-term follow-up data should be collected for more conditions and new technologies like smartphone-delivered treatments.
Internet-supported and therapist-guided cognitive behaviour therapy (ICBT) is effective for a range of problems in the short run, but less is known about the long-term effects with follow-ups of two years or longer.This paper reviews studies in which the long-term effects of guided ICBT were investigated. Following literature searches in PubMed and other sources meta-analytic statistics were calculated for 14 studies involving a total of 902 participants, and an average follow-up period of three years. Studies were from Sweden (n = 11) or the Netherlands (n = 3). Long-term outcome studies were found for panic disorder, social anxiety disorder, generalized anxiety disorder, depression, mixed anxiety and depression, obsessive-compulsive disorder, pathological gambling, stress and chronic fatigue. The duration of the treatments was usually short (8–15 weeks). The pre-to follow-up effect size was Hedge's g = 1.52, but with a significant heterogeneity. The average symptom improvement across studies was 50%. Treatment seeking in the follow-up period was not documented and few studies mentioned negative effects.While effects may be overestimated, it is likely that therapist-supported ICBT can have enduring effects. Long-term follow-up data should be collected for more conditions and new technologies like smartphone-delivered treatments.
Internet interventions, and in particular Internet‐delivered cognitive behaviour therapy (ICBT), have existed for at least 20 years. Here we review the treatment approach and the evidence base, arguing that ICBT can be viewed as a vehicle for innovation. ICBT has been developed and tested for several psychiatric and somatic conditions, and direct comparative studies suggest that therapist‐guided ICBT is more effective than a waiting list for anxiety disorders and depression, and tends to be as effective as face‐to‐face CBT. Studies on the possible harmful effects of ICBT are also reviewed: a significant minority of people do experience negative effects, although rates of deterioration appear similar to those reported for face‐to‐face treatments and lower than for control conditions. We further review studies on change mechanisms and conclude that few, if any, consistent moderators and mediators of change have been identified. A recent trend to focus on knowledge acquisition is considered, and a discussion on the possibilities and hurdles of implementing ICBT is presented. The latter includes findings suggesting that attitudes toward ICBT may not be as positive as when using modern information technology as an adjunct to face‐to‐face therapy (i.e., blended treatment). Finally, we discuss future directions, including the role played by technology and machine learning, blended treatment, adaptation of treatment for minorities and non‐Western settings, other therapeutic approaches than ICBT (including Internet‐delivered psychodynamic and interpersonal psychotherapy as well as acceptance and commitment therapy), emerging regulations, and the importance of reporting failed trials.
In this study, the authors compared guided Internet-delivered self-help with one-session exposure treatment (OST) in a sample of snake phobic patients. A total of 30 patients were included following a screening on the Internet and a structured clinical interview. The Internet treatment consisted of four weekly text modules which were presented on a web page, a video in which exposure was modelled, and support provided via Internet. The OST was delivered in a three-hour session following a brief orientation session. The main outcome was the behavioural approach test (BAT), and as secondary measures questionnaires measuring anxiety symptoms and depression were used. Results showed that the groups did not differ at post-treatment or follow-up, with the exception of a significant interaction for the BAT in favour of the OST. At post-treatment, 61.5% of the Internet group and 84.6% of the OST group achieved a clinically significant improvement on the BAT. At follow-up, the corresponding figures were 90% for the Internet group and 100% for the OST group (completer sample). Within-group effect sizes for the Snake Phobia Questionnaire were large (d = 1.63 and d = 2.31 for the Internet and OST groups, respectively, at post-treatment). It is concluded that guided Internet-delivered exposure treatment is a potential treatment option in the treatment of snake phobia, but that OST probably is better.
Background: Social Anxiety Disorder (SAD) is a disabling psychiatric disorder, associated with high co-morbidity. Previous research on structural brain alterations associated with SAD has yielded inconsistent results concerning changes in gray matter (GM) in various brain regions, as well as on the relationship between GM and SAD-symptomatology. These heterogeneous findings are possibly due to limited sample sizes. Multi-site imaging offers new possibilities to investigate SAD-related GM changes in larger samples.
Methods: An international multi-center mega-analysis on the largest database of SAD brain scans to date was performed to compare GM volumes of SAD-patients (n=174) and healthy participants (n=213) using voxel-based morphometry. A hypothesis-driven region of interest (ROI) approach was used, focusing on the basal ganglia, amygdala-hippocampal complex, prefrontal cortex and parietal cortex.
Results: SAD-patients had larger GM volume in the dorsal striatum when compared to healthy participants. This increase correlated positively with the level of social anxiety symptoms. No SAD-related differences in GM volume were present in the other ROIs.
Conclusions: The results suggest a role for the dorsal striatum in SAD, but previously reported SAD-related changes in GM in the amygdala, hippocampus, precuneus, prefrontal cortex and parietal regions were not replicated. Thereby, our findings indicate that sample size matters and stress the need for meta-analyses like those performed by the Enhancing NeuroImaging Genetics through Meta-Analysis (ENIGMA) Consortium and its working groups. Actually, the collaborative effort for this work has resulted in the start of the ENIGMA-Anxiety workgroup.
Social anxiety disorder (SAD) is a prevalent and disabling mental disorder, associated with significant psychiatric co-morbidity. Previous research on structural brain alterations associated with SAD has yielded inconsistent results concerning the direction of the changes in gray matter (GM) in various brain regions, as well as on the relationship between brain structure and SAD-symptomatology. These heterogeneous findings are possibly due to limited sample sizes. Multi-site imaging offers new opportunities to investigate SAD-related alterations in brain structure in larger samples.
An international multi-center mega-analysis on the largest database of SAD structural T1-weighted 3T MRI scans to date was performed to compare GM volume of SAD-patients (n = 174) and healthy control (HC)-participants (n = 213) using voxel-based morphometry. A hypothesis-driven region of interest (ROI) approach was used, focusing on the basal ganglia, the amygdala-hippocampal complex, the prefrontal cortex, and the parietal cortex. SAD-patients had larger GM volume in the dorsal striatum when compared to HC-participants. This increase correlated positively with the severity of self-reported social anxiety symptoms. No SAD-related differences in GM volume were present in the other ROIs. Thereby, the results of this mega-analysis suggest a role for the dorsal striatum in SAD, but previously reported SAD-related changes in GM in the amygdala, hippocampus, precuneus, prefrontal cortex and parietal regions were not replicated. Our findings emphasize the importance of large sample imaging studies and the need for meta-analyses like those performed by the Enhancing NeuroImaging Genetics through Meta-Analysis (ENIGMA) Consortium.
This study has explored therapists' experiences of conducting cognitive behavioural therapy (CBT) online and face-to-face. Eleven therapists partook in semi-structured interviews, which were thematically analysed using an abductive approach. The results indicate that the therapists viewed face-to-face therapy as a stronger experience than Internet-based CBT (ICBT), and the latter as being more manualised, but providing more work-time control. Several participants also thought that working alliance may be achieved faster and more easily in face-to-face therapy, and might worsen with fewer modalities of communication. Clinical implications in need of investigation are whether working with ICBT might buffer therapist exhaustion, and whether this therapy form can be improved by becoming less manual dependant in order to be easier to individualise.
Introduction: In mental health comorbidity is common, both physical and psychiatric. Normally studies on cognitive behavior therapy (CBT) protocols do not exclude comorbid patients but leave the comorbidity to improve without being addressed, or remain unchanged without being identified. since most cognitive behavior treatment protocols are diagnosis-specific. Based on the idea that several problems can be targeted at once, individually tailored CBT protocols have developed. Including patients' specific symptom profile and preferences, and the knowledge from established disorder-specific programs these protocols opens for individualization both before and during treatment based on individual progress. Tailoring can also be done to target different age groups and include for example the interface of the treatment program and the clinical examples used.
Methods: Most programs have been tested in randomized controlled trials against active waitlist conditions. Specific symptom measures served as primary outcome measures and measures of life quality as secondary. Some studies also included economic evaluations of cost- effectiveness and ratings of therapeutic alliance. Our samples have been both self-recruited and referred by health care professionals. Most of the studies have measure-points not only directly at post treatment, but also at one- and two-year follow-up.
Results: Taken together the tailored programs show, on average, a medium to large effect size (Cohen's d) on primary outcome measures regarding both anxiety and depressive symptoms, and small effect sizes on life quality measures. Effects were sustained at follow-up. The tailored treatment proved to be cost-effective administered in regular care. We also found patient ratings of therapeutic alliance to correlate with outcome.
Discussion: Individually tailored internet-administered CBT show promising results. Based on the available data, it might be a feasible approach in treating anxiety and depression. Acceptability, for whom it is most beneficial, and if some components are more powerful than others, are questions left to be answered.
Background: Internet-based cognitive behavioral therapy (ICBT) is a form of guided self-help that has been found to be effective for addressing several problems. The target for this type of therapy is usually restricted to one specific disorder. Tailoring the treatment widens the scope of ICBT in that it can address comorbid conditions directly. Objectives: The working, or therapeutic, alliance has been found to predict outcome in studies of face-to-face therapy. The extent to which these findings apply to ICBT is largely unknown. We therefore decided to find out whether the working alliance could predict outcome in tailored ICBT for anxiety disorders. Methods: Data were obtained from the treatment group (n=27) in a randomized controlled trial aiming to test the effects of tailored ICBT for anxiety disorders. The forthcoming study was designed to test the hypothesis that the working alliance measured both pre-treatment and early in treatment (week 3) can predict treatment outcome as measured by the Clinical Outcomes in Routine Evaluation–Outcome Measure (CORE-OM) in a heterogeneous group of patients with anxiety disorders (n=27). Results: Working alliance measured at week 3 into the treatment correlated significantly with the residual gain scores on the primary outcome measure (r=-.47, P=.019, n=25), while expected working alliance pre-treatment did not (r=-.17, P=.42, n=27). Conclusions: These results raise questions about the importance of working alliance in ICBT treatments, and suggest that the working alliance could be important in ICBT.
Goals: To investigate the effectiveness of therapist-guided internet treatment for panic disorder (PD), and major depression (MD), in a routine care setting, the eMeistring clinic, within the public health care in Norway. Methods: Approximately 300 patients are included in two effectiveness studies, one per treatment (PD, MD). Assessment points are pretreatment, posttreatment and 6 months follow-up. Within group effect sizes, responder and remission rates are investigated. All analyses are Internet to treat. Results: Effect sizes for PD were large, d = 1.24 pre - post and 1.39 pre - 6 months follow-up. 56 % had recovered or were improved at posttreatment. Results for MD are preliminary and will be presented at the conference. Conclusion: Final conclusions will be presented at the conference. Results so far indicate that the treatments, after implementation into routine care in Norwegian public health care, are equally effective as in preceding effectiveness and randomized efficacy trials. The results so far thereby strengthen the notion that therapist guided Internet-based treatments are a viable alternative to other modes of treatment delivery.
Romantic relationships have been argued to function as attachment relationships, and the level of satisfaction with the relationship have been associated with one's attachment style. Both attachment avoidance and anxiety have shown to be reliable predictors of relationship dissatisfaction. In this study, which were part of a screening process for couples' therapy, 660 participants (330 both heterosexual and homosexual couples) completed a questionnaire regarding their attachment style (Experience of Close Relationships) and relationship satisfaction (Dyadic Adjustment Scale). Through structural equation modelling we found that relationship satisfaction was linked to both attachment avoidance (? = -.26) and anxiety (? = -.15) of one own, but only to partner avoidance (? = -.12). These findings are to some extent contradictory to previous research regarding the effect of partner attachment, by showing that specifically avoidance but not anxiety is linked to dissatisfaction.
Background: Guided Internet-based cognitive-behavioral therapy (ICBT) has been found to be effective for social anxiety disorder (SAD) by several independent research groups. However, since the extent of clinically significant change demonstrated leaves room for improvement, new treatments should be developed and investigated. A novel treatment, which has generally been found to be effective, is cognitive bias modification (CBM). This study aims to evaluate the combination of CBM and ICBT. It is intended that two groups will be compared; one group randomized to receiving ICBT and CBM towards threat cues and one group receiving ICBT and control training. We hypothesize that the group receiving ICBT plus CBM will show superior treatment outcomes.
Methods/design: Participants with SAD (N = 128), will be recruited from the general population. A composite score combining the scores obtained from three social anxiety questionnaires will serve as the primary outcome measure. Secondary measures include self-reported depression and quality of life. All treatments and assessments will be conducted via the Internet and measurement points will be baseline, Week 2, post-treatment, and 4 months post-treatment.
Discussion: There is no direct evidence of the effects of combining CBM and ICBT in SAD. Adding attention-training sessions to ICBT protocols could increase the proportion of participants who improve and recover through Internet-based self-help.
Psychological treatments help patients overcome mental health problems. Thousands of studies document the positive effects of psychotherapeutic interventions. The potential of these same interventions to cause harm, on the other hand, has scarcely been subject to scientific investigation. The nature and frequency of side effects of psychological treatments are largely unknown. The present symposium aims at shedding light on some important questions concerning negative effects: How should side effects be defined? What are typical side effects? How frequent are side effects in different treatment formats? And how can side effects be effectively measured?
In the first presentation, Michael Linden will speak about side effects in group therapy and will report data from two different group therapy formats. Johanna Boettcher will focus on side effects of individual therapy for depression. She will present data from a large trial of Internet-based therapy and will summarize a qualitative analysis of the patients' experience of negative effects. Steve Hollon will talk specifically about one particular side effect, the deterioration of targeted symptoms. He will report results of an individual patient data meta-analysis and compare rates of deterioration in cognitive-behaviour therapy and pharmacotherapy. Finally, Alexander Rozental will present a new questionnaire for the assessment of negative effects and will demonstrate its psychometric properties in a Rasch analysis.
Internet-based interventions hold specific advantages and disadvantages in the treatment of social anxiety disorder (SAD). The present review examines different approaches in the internet-based treatment of SAD and reviews their efficacy and effectiveness. 21 studies investigated the potential of guided and unguided internet-based cognitive-behavioral treatments (ICBT) for SAD, comprising a total of N = 1,801 socially anxious individuals. The large majority of these trials reported substantial reductions of social anxiety symptoms through ICBT programs. Within effect sizes were mostly large and comparisons to waitlist and more active control groups were positive. Treatment gains were stable from 3 months to 5 years after treatment termination. In conclusion, ICBT is effective in the reduction of social anxiety symptoms. At the same time, not all participants benefit from these treatments to a sufficient degree. Future research should focus on what makes these interventions work in which patient populations, and at the same time, examine ways to implement internet-based treatment in the routine care for socially anxious patients.
Social anxiety disorder (SAD) is a very common and disabling mental disorder. Cognitive-behaviour therapy (CBT) is first-line treatment and has a strong empirical basis. However, not all patients benefit from CBT. About one third of the treated patients do not respond to a sufficient degree (Rodebaugh, Holaway, & Heimberg, 2004). Additionally, access to CBT is often limited. Only a small minority of patients with SAD receives adequate, evidence-based treatment (e.g. Issakidis & Andrews, 2002). Hence, there is a pressing need to optimize existing treatment approaches and to lower treatment barriers. The planned symposium will present different approaches on how to make CBT more efficient and more available for patients with SAD. Treatments that are facilitated via the Internet have the potential to reach patients who are otherwise unlikely to receive adequate treatment (e.g. patients in remote areas, patients fearing stigmatization, patients too shy to initiate face-to-face contact). At the same time, technology-based interventions also help to bring important therapeutic techniques into practice. The first two talks will therefore focus on innovations in the field of Internet-based CBT for SAD and will present strategies to facilitate exposure exercises. Johanna Boettcher will present two studies on a newly developed app for SAD. In a gamified approach, the app guides and motivates patients to conduct exposure exercises in their natural environment. The second presentation will introduce virtual reality (VR) exposure therapy for social fears. Per Carlbring will present data on a RCT, evaluating the impact of a three-hour VR exposure session on public speaking anxiety. The third talk will present a different angle on how to improve treatment outcomes. Emma Warnock- Parks will outline how video-feedback can be optimized in the treatment of socially anxious patients in order to increase its impact on patients' symptomatology. She will present data on the beneficial effect of video feedback on patients' distorted self-images and will show ways how to make this technique even more powerful. Optimizing intervention techniques and contexts is one way to improve treatment of SAD. It is also important to consider external factors that may influence treatment adherence or outcome. In the last talk, Ulrike Willutzki will present data on a long-time neglected topic in SAD. She will demonstrate how the well-meant support of patients' spouses can contribute to the maintenance of the disorder. She will discuss how partners can be educated and become involved in treatment helping the patient to overcome anxiety in difficult social situations. The planned symposium will offer four different strategies that can be implemented to improve cognitive-behavioural treatment techniques and to further the access to CBT. The symposium therefore contributes to a better understanding on how CBT for SAD can become more efficient in alleviating patients' suffering.
Guided Internet-based cognitive-behavioural self-help (ICBT) has been proven to be effective for social anxiety disorder (SAD) by several independent research groups. However, as the proportion of clinical significant change has room for improvement, new treatments should be developed and investigated. A novel treatment is attention bias modification (ABM). This study aimed at evaluating the combination of ABM and ICBT. We compared two groups, one group receiving ICBT and ABM targeting attentional avoidance and the other group receiving ICBT and control training. ABM and control training tasks were both based on the dot-probe paradigm. A total of 133 participants, diagnosed with SAD, were randomised to these two groups. The attention training group (N = 66) received 2 weeks of daily attention training followed by 9 weeks of ICBT. The control group (N = 67) received 2 weeks of daily control training, also followed by 9 weeks of ICBT. Social anxiety measures as well as the attention bias were assessed at pre-assessment, at week 2, and at post-treatment. Results showed no significant differences between the attention training group and the control group. Both groups improved substantially on social anxiety symptoms from pre- to post-assessment (dwithin = 1.39–1.41), but showed no change in attention processes (dwithin = 0.10–0.17). In this trial, the attention modification training failed to induce differential change in attention bias. Results demonstrate that the applied ABM procedure with its focus on the reduction of attentional avoidance was ineffective in the Internet-based setting. The results do not suggest that adding ABM targeting attentional avoidance to ICBT results in better outcomes than ICBT alone.
Biases in attention processes are thought to play a crucial role in the aetiology and maintenance of Social Anxiety Disorder (SAD). The goal of the present study was to examine the efficacy of a programme intended to train attention towards positive cues and a programme intended to train attention towards negative cues. In a randomised, controlled, double-blind design, the impact of these two training conditions on both selective attention and social anxiety were compared to that of a control training condition. A modified dot probe task was used, and delivered via the internet. A total of 129 individuals, diagnosed with SAD, were randomly assigned to one of these three conditions and took part in a 14-day programme with daily training/control sessions. Participants in all three groups did not on average display an attentional bias prior to the training. Critically, results on change in attention bias implied that significantly differential change in selective attention to threat was not detected in the three conditions. However, symptoms of social anxiety reduced significantly from pre- to follow-up-assessment in all three conditions (d(within) = 0.63-1.24), with the procedure intended to train attention towards threat cues producing, relative to the control condition, a significantly greater reduction of social fears. There were no significant differences in social anxiety outcome between the training condition intended to induce attentional bias towards positive cues and the control condition. To our knowledge, this is the first RCT where a condition intended to induce attention bias to negative cues yielded greater emotional benefits than a control condition. Intriguingly, changes in symptoms are unlikely to be by the mechanism of change in attention processes since there was no change detected in bias per se. Implications of this finding for future research on attention bias modification in social anxiety are discussed.
Internet-based interventions are effective in the treatment of various mental disorders and have already been integrated in routine health care in some countries. Empirical data on potential negative effects of these interventions is lacking. This study investigated side effects in an Internet-based treatment for Social Anxiety Disorder (SAD).
A total of 133 individuals diagnosed with SAD took part in an 11-week guided treatment. Side effects were assessed as open formatted questions after week 2 and at post-treatment after week 11. Answers were independently rated by two coders. In addition, rates of deterioration and non-response were calculated for primary social anxiety and secondary outcome measures (depression and quality of life).
In total, 19 participants (14%) described unwanted negative events that they related to treatment. The emergence of new symptoms was the most commonly experienced side effect, followed by the deterioration of social anxiety symptoms and negative well-being. The large majority of the described side effects had a temporary but no enduring negative effect on participants' well-being. At post-treatment, none of the participants reported deterioration on social anxiety measures and 0–7% deteriorated on secondary outcome measures. Non-response was frequent with 32–50% for social anxiety measures and 57–90% for secondary outcomes at post-assessment.
Results suggest that a small proportion of participants in Internet-based interventions experiences negative effects during treatment. Information about potential side effects should be integrated in patient education in the practice of Internet-based treatments.


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4 Ways the London Classic Will Differ from the Sinquefield Cup
While my Sinquefield Cup preview from earlier this year describes the achievements and chances of many of the London Classic competitors, there have been a few notable changes since then:
1. Fabiano Caruana is the top seed and clear number 2 in the world.
In the months since the Sinquefield Cup, Caruana's rating has risen to 2823, within 17 points of Magnus Carlsen. This incredible progress is due to his Olympiad gold victory on the American team in Baku and his 2900+ performance at the chess.com Isle of Man International, where he tied for first with Pavel Eljanov.
2. Wesley So has set the pace of the Grand Chess Tour.
Because of his Sinquefield Cup victory, So is in the clear lead for the Grand Chess Tour. In fact, the only player who can pass So is his Olympiad teammate, Hikaru Nakamura, and they face off in the very first round.
So has been nearly invincible this year. His Sinquefield Cup victory is his strongest tournament victory to-date, and he won gold on both the American team and as the Top Board 3 at the Olympiad.
3. Vladimir Kramnik and Michael Adams will be joining the field.
Former World Champion Kramnik will add another 2800+ to the competition, giving the London Classic every player in the top ten except for Carlsen and Karjakin. Adams, who went undefeated last year, is another nice addition to the field.
4. There are more events to watch than the super-GM tournament.
The London Classic is part of an entire festival with many opportunities to view great games or even compete yourself:
- The British Knock-out Championship features eight grandmasters, including Nigel Short, Gawain Jones, and Luke McShane.
- The FIDE Open, Super Rapidplay, and Weekday Tournaments offer the chance for any player to join in the competitive atmosphere.
- Grandmaster Simuls will be given by Jon Speelman and John Nunn.
Games start tomorrow, December 9th. For more information, visit the London Classic and Grand Chess Tour Official Websites.

subset: commoncrawl


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Terry is committed to celebrating love in all its beautiful facets. Here, you will find warmth, compassion, and a passion to transform your day into an occassion of elegance, grace, and visions of your future!
"If you are looking for someone to make your day truly unique, look no further. Terry helped us create an incredible wedding day experience. She was extremely attentive to detail, took the time to learn who we are as a couple, and created a ceremony that fit us perfectly. We highly recommend Terry for anyone looking for an officiant. We are happy to still call her our friend today." ~Ashley & Ben
"Best choice besides my husband and I made was choosing Terry, She traveled very far and helped us on more ways then even expected. She even went the extra mile and made our honeymoon unforgettable, we think of her as family now." ~Donna & Dan
"Our wedding was simply perfect and truly a reflection of the love that my husband and I share. We knew we wanted something unique that spoke about what our marriage really meant to us. Terry crafted a beautiful ceremony that was more than we ever dreamed of and her words echo in our hearts and minds every day." ~Bridget & Ian


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My Menuism Chinese Restaurant Articles are at http://www.menuism.com/blog/author/davidchan/
Saturday, February 22, 2014
What We Ate In Hong Kong, Part IV - The Pictures
As regular readers know from reading this this blog, I am not a foodie and do not photograph my meals. However, the descriptions of the food we had in Hong Kong last month has led to requests to see what some of the items described look like. Fortunately my daughter, Supertina, is a foodie and does photograph her meals. So since she was on the trip, we do have photographic coverage on my Picasaweb page. The pictures are at https://picasaweb.google.com/117066920837972224028/HongKongFood
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product.id: 2369111228521
yard(s) available: *0
All the favorites of Charlie Harper's collection. These prints all have a geometrical take on nature adorned with beautiful colors.
Width: 44 inches
Weight: 3.6 oz / sq yd
Content: 100% organic cotton printed with low impact dyes
Choose this fabric for handkerchiefs, shirts, and bags, plus so much more!


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The Trendy Tech Banks Want To Fight Financial Crimes — BizTech
ByUncategorized— — Posted in
Many people undoubtedly marvel at the beautiful shower heads that we find in elegant inns and houses. Tidy up and fix up. Your present home equipment can look virtually new again in case you clear them with cleaning soap and water or different particular cleaning options, removing dirt, grime and different stains that have gathered over time and diminished their appearance.
For a few of the hotel teams and brands corresponding to CitizenM and Aloft, an reasonably priced, tech-centric experience is part of the brand providing, targeted in the direction of Millennial customers who typically choose self-service and know-how similar to keyless entry via smartphone app.
According to greater than 10 years of Apple Lecture rooms of Tomorrow analysis, to effectively combine technology in education, academics must learn not only how one can use computer systems, however particularly easy methods to use computers for instructing and studying.
Dengan Sony Vegas Pro, dapat menggambar dengan device yang bermanfaat seperti zoom, rotation dan kemampuan untuk melihat foto dalam format widescreen yang memungkinkan film untuk bergerak meskipun berupa gambar, memungkinkan format movie dalam kecepatan tinggi, yang mana kemudian person dapat berbagi terhadap situs internet seperti YouTube atau MySpace, serta terukir dalam bentuk DVD, dimana user dapat membuat menu yang bergerak dan navigasi sendiri.
At minimum, until such an optimum mannequin is found, a holistic examination of people's forms of life has to involve analysis on the cultural similarities in folks's biological and psychological wants for effectively-being, as well as the variations of their ideas and actions concerning ethics and aesthetics.


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Capital Kia encourages all drivers in the Columbus, Ohio area to contact us with your questions, comments or concerns! We always looking for ways to make your Kia Optima shopping process an enjoyable one and welcome all suggestions, so don't hesitate to use our online form to connect with our new and used Kia dealership today. As your local Kia dealer, we're committed to providing for all your on-road needs and look forward to reading your comments about our sales, finance and service assistance.
Feel free to ask us about the Sportage lineup, pose a financing question, tell us about a Capital Kia team member that was particularly helpful or inquire about our professional auto maintenance services! Should you ask a question, or leave a comment we'd like to respond to, we'll use the preferred method of contact you supplied to get in touch with you shortly. We thank you for taking the time to communicate with our new and used Kia dealership in Columbus, Ohio, and our professionals look forward to hearing from all our Ohio neighbors soon!


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Movie Marathons
This is a new thing, as I have already been reviewing movies with mini blurbs, but have not done full-scale reviews on.
That is going to change in 2016 as I stretch my legs and put my opinions further out there. And review movies, television shows, and all manner of screen-worthy gems.
Is there a reason for this?
No. I just am going to do it.
Is there a need for this?
Not really.
But it is fun to do, and as opinionated as I am (just ask anyone who knows me in real life), those opinions need an outlet. And this is it.
Looking forward to watching, marathoning, and putting in my two-bits worth.


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Goodbye Party: White T-Shirt
Fri, 2019-05-24 22:00
Saying goodbye is always tough. However, now we have the perfect party for enjoining a great time with your friends and creating a shirt full of memories - The ESN Erasmus White T-Shirt Party! Join the party in a white shirt and bring your favorite colored marker for writing the best memories on each others's shirts!
Where: Thalia, Opernring 5a
When: Fr, 24th of May 2019, 10.00 P.M.
PLEASE NOTE: When you take part in one of our events, you do so at your own risk and your own responsibility! We do not take any responsibility! Make sure that you have an appropriate insurance!


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Hi there!
It's been a little bit since I posted about how to make aloe vera juice, and I really want to elaborate about the health benefits of aloe.
Aloe is a superfood when you consume it; aiding in digestion, immune system, and even weight loss. In addition to this, it's amazing for your skin. Yes, yes, yes – we've all bought the crap in the bottle when we are sunburnt to a crisp. HOWEVER, sunburn is only one of the many ways aloe can be used. Aloe vera has been used for more than 5,000 years – to the Egyptian times. Aloe vera has been used to treat burns (not just sunburn!), cuts, eczema, psoriasis, and even acne. Yes, ACNE.
I've always struggled a bit with acne. I've never had very problematic acne, however I've never had a very clear face, and though I had to admit it, I get the few random pimples on my back, and chest, and worst of all.. arm pits! A little over a month ago I started breaking out really bad in my underarms, due to a few different reasons. With all of the lifting I've done over the past 6 months, my body has changed. A lot of my shirts no longer fit; they're so tight on my arms that the seam is right in my arm pit — causing an acne-like rash. My sports bras were not helping this matter either, in fact they were just making it worse. I became so self conscious of it that I wouldn't wear a tank top to the gym like I typically would. In addition to feeling like a hideous creature from this rash, it hurt.. and it hurt bad.
For weeks I had tried everything; various dermalogica (which is what I typically use on my face since I have extremely sensitive skin) products, scrubs, astringent, masks, toothpaste, the list could go on and on. I tried different variations of all of these products and nothing worked, I wasn't getting ANY relief. So after no prevail, I decided to use the aloe on my skin as well. I put it on my face, neck, chest, and underarms twice a day.
When I say that after one day I could already tell a difference, I'm not kidding. I couldn't believe it. After a week of using aloe vera the rash in my underarms was gone, and my face was very clear. My face was not only clear, but very soft as well. Last week I was told that I have such a good complexion.. I was in shock, I've NEVER been told that before.
After using aloe vera on my skin I feel so much better about myself. I've never been one to wear very much makeup, however I nearly always put at least a little foundation on the "problem spots," even though the makeup is one of the things that makes me breakout in the first place. Now, I rarely use any foundation (except for maybe for the big, dark spots under my eyes) because my face is that clear!
We spend so much money on all of these "beauty" products that are full of all kinds of garbage that aren't good for your body. We spend all of this money on beauty products that sometimes, and when I say sometimes I mean most of the time, don't even work. So then we spend more money buying other products to cover up blemishes, etc.. Where is the logic in this?! Simple answer, there is none.
Food for thought: When you put lotion on, your skin soaks it. Have you ever thought of where it's going? It's absorbed into your skin, and goes into your body; to your blood, organs, etc. Now, have you ever really taken the time to look at the ingredients in your lotion? I encourage you to take a look at it, and google the ingredients that you aren't familiar with. Are they ingredients you would want to eat? No? You wouldn't want to consume these ingredients? Then why are you putting them on your skin, to be absorbed into your body.. just as if you ate it. Gross, right?


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Kuwait Finance House, a leading Islamic bank in Bahrain, is collaborating with Golden Gate to provide off-plan consumer financing for its freehold residential tower at Bahrain Bay.
The project, situated in the heart of Bahrain Bay, consists of two towers containing 746 luxurious apartments and it is set to be the highest residential tower in Bahrain. It features residential, commercial, retail, tourism, and public amenities, all cooled from an innovative and environmentally sound central facility.
Khalid Marrafi, executive manager and head of retail banking group at KFH-Bahrain, said: "Our collaboration with Golden Gate comes in line with the bank's efforts to provide suitable financing for our customers who wish to own their dream apartments, in addition to supporting future real estate projects in Bahrain. We look forward to continue this approach and expand our partners' base in the future."
Khalifa Ahmed AlQoud, head of Signature segment at Golden Gate, said: "Golden Gate is considered the first international joint venture partnership between Kooheji Golden Gate and India's Ajmera Realty and Mayfair Housing, and we are proud to be in partnership with Kuwait Finance House - Bahrain, one of the leading establishments in the region with a long-standing history of innovation and professionalism. Golden Gate is set to become a leading landmark in the region and create value to owners and residents, as well as being a means of attracting foreign investments to Bahrain." – TradeArabia News Service


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Saturday, April 04, 2009
Video Time: Feeling a little Flush?
Fort Wayne Site-of-the-Day
Friday, April 03, 2009
Not a Shy Guy Anymore
Dumb Little Man - tips for life
How to Build Your Social Circle
Posted: 02 Apr 2009 06:26 AM PDT
They say it's not what you know but who you know, and when it comes to getting the most out of life and having fun, I think friends play a huge part in that. If I think back to some of the happiest and craziest moments in my life, there's no doubt that they involved some of my closest friends.
I've already written a guide on how to make friends and being a social person is obviously going to help with this aspect of your life. Additionally, these five points below should definitely help you in the process of growing your social circle.
Adopt an Abundance Mentality
One key reason people struggle to make great friends or build a social circle is because they are coming from a scarcity mindset. They don't realize that there are literally billions of potential friends out there and lots of people that you are going to meet on your journey through life.
Knowing that there are lots of opportunities to make friends, you should realize that you don't have to 'change' to get other people to like you. In other words, don't lie about your interests and don't agree with things you disagree with. Be yourself, be your best self.
Actively Pursue Your Passions
Think of some things that you really enjoy doing right now, off the top of your head. To help, some of mine include:
The point here is that you will find people who like the same things as you, so you already have some common interest which tends to quickly build rapport. Meetup is a great site to find people getting together around topics that may interest you.
Organize Events
People like to keep in touch with the person who is always throwing cool events. Whether it is a trip to a nearby city, a house party or a day out go-karting, make some plans. You don't have to do all the work, but get people together and put new people in touch with each other.
When you do organise some events, it's likely that your friends will also bring their friends that you haven't met, which gives you a great chance to expand your 'network'.
Be a Genuinely Fun Person
There will be times when you are feeling low and you want to talk about this feeling to others and that's fine, that's normal. However, if that is your default state then it's going to feel draining to others who spend time with you, constantly feeling they are going to be brought down with you.
A genuinely fun person tends to keep a positive outlook, see problems as situations or opportunities, rather than problems. Look at ways you can help to make other people happy without relying on your own happiness to come from your environment.
This is a geniunely fun person and this is the type of person that people want to be around.
Be Open to Making New Friends
If I look at some of my best friends, I've met most of them through education (i.e. school, college, etc.) and through my job which seems to be a common thing. However, I've also met people that later became close friends at the likes of running clubs, speaking clubs and even standing in the line for a nightclub.
You don't 'just' have to make friends through your current friends and the people they know. You walk past amazing people every single day and you never know when you might come into conversation with someone. Don't assume that just because you're not talking to someone in normal context it doesn't mean you can't arrange to meet up with them at another time.
Building a social circle is definitely one of the best ways to get the most out of life in my opinion, and experience more of our time here. Hopefully these tips will help you expand yours.
Fort Wayne Site-of-the-Day
Thursday, April 02, 2009
Video Time: 50 States in 2 Minutes
Fort Wayne Site-of-the-Day
I appreciate the visual arts. Not that I'm any good at it, but this lady is. Click here to go there.
Wednesday, April 01, 2009
Video Time: I See You
Fort Wayne Site-of-the-Day
Tuesday, March 31, 2009
Video Time: Burger Lisa
Fort Wayne Site-of-the-Day
Monday, March 30, 2009
First Date?
Dumb Little Man - tips for life
10 First Date Tips for the Modern Gentleman
Posted: 25 Mar 2009 09:07 AM PDTCourting a lady isn't as straight forward as it used to be. Back in the day, dating etiquette was well-established and everybody played by the same rules. Men would open doors for women, help them with their coats, and have them home by nine. Couples would go to the soda shop for the first date, to the drive in for the second, up to "old make out point" for the third, and would most likely be getting married on the fourth.
The rules of the road have changed. Somewhere between Say Anything, and MTV's Next bus, we throw out the rulebook completely and just started winging it. Our individual quests for love and sex have become as varied and strange as life itself. This was a good and necessary change, but it has made dating... well, terrifying. Without any concrete guidelines, how is the novice romantic supposed to navigate those first few dates?
It's not so hard, really. As far as dating goes, the one thing that hasn't changed over the years is the simple fact that guys should be gentlemen. What follows are some suggested guidelines to help you be a true gentleman despite the weird modern reality in which we find ourselves.
- Don't take her out to dinner on the first date
These days, the most popular first date is the weeknight 'getting-a-couple-drinks' date. And, for good reason. It's non-committal, relatively brief by necessity, and the drinks help to calm everybody's nerves. So, don't try to impress with a 4-star restaurant when you barely know the person. This way, you'll keep your wallet intact and she won't feel beholden. Plus, if the sparks don't fly, it's easy to retire the evening early.
- Hug her at the beginning of the date
Breaking down the physical barrier at the beginning of the date makes the rest of the date so much easier. At the beginning of the date, give her a hug, and tell her how delightful she looks. Also, by showing your attraction to her early on, you free her to reciprocate gestures of attraction throughout the date, making it easier for you to judge how well the date is going.
- Look your best
Well, duh. But, a lot of the times when guys try to dress up for a date, they end up wearing something they aren't truly comfortable in. You should dress up a little, sure, but, try to wear something that makes you feel like a million bucks. If you don't have any clothes that make you feel like George Clooney in Ocean's 11, go out and find some.
- Be a class act
Chivalry may be dead, but she'll like you more if you try to revive it just a little. Open the door for her, pull out her chair, support her on icy sidewalks, etc... Despite the obvious self sufficiency of the modern woman, courtesy is still courtesy. A dash of chivalry shows your attraction and ability to protect and nurture. But, it's important not to take this too far. You don't want to seem old fashion, or as though you're trying real hard to impress. Just be be a good, considerate guy who knows the pleasure of treating a lady as such.
- Compliment her and others
When you're on a date it's good to toss out a few genuine compliments. But, unless you're Dennis Leary, you probably already knew that... So, let me say that it's a good idea, not only to compliment your date, but to also talk nicely about people that you both know, or people that you've met throughout the night. By projecting kindness towards people that aren't around, you'll show that you tend to see the positive side of things, which is a very attractive characteristic.
- Embrace your inner weird
A lot of people tend to go all glossy on dates. Sort of like a job interview, you really just want to seem appealing. This is a mistake. First, you actually become less attractive by paving over what sets you apart... But, more importantly, if you highlight your idiosyncrasies, you've got a better shot of finding a girl that compliments you, and tolerates your obsession with minimalist free jazz .
- Change your sheets
Be prepared... The Boy Scouts know what they're talking about. When you go out on a date with someone, there is always the possibility that you'll end up back at your place. So, change the sheets, and get rid of any debris that is usually strewn about. If, in the end, the date was totally awkward, at least you've got a clean place to come home to.
- Pay for the date
That's right... Beyond it being a kind gesture, offering to pay is a good way to get information on how the date is going. When the check comes, beware if she really does seem to want to pay her share. If she wants to pay, it's because she really doesn't want to feel obligated to you in any way shape or form. But, the single fake-wallet-grab is a good sign. Don't worry, she's gonna let you pay this time... She knows you're going to be eating all the ice cream out of her fridge in about two weeks :)
- Kiss Her
If the first date has gone reasonably well, go for the kiss at some point towards the end. A so-so date that ends with a great kiss can = an awesome date. Sometimes you just gotta get the kiss out of the way before you can really feel comfortable with someone. So, man up and kiss her. Just do it. She'll be glad you did. Hopefully.
- Don't try to sleep with her
Despite the advice from 20 seconds ago (you should still tidy up your place, it's starting to smell a little), having sex on a first date is not a good idea if you think you might want a relationship with the person. Studies have shown that people who have sex on a first date have a lot more trouble developing a good date into a relationship than those who are content delaying gratification. So, even if the date is going really, really well, don't push for the sleep over. After all, it's always nice to have something to look forward to, and, when all is said and done, she'll fancy you a gentleman.
|Written on 3/25/2009 by Michael Brandon. Michael is an editor and contributor at Creative Dating Ideas.
|Photo Credit: dutchtl
Fort Wayne Site-of-the-Day
Sunday, March 29, 2009
Remembering Paul
As a guy who has worked in the radio business since he was 16, you might think that Paul Harvey may have been one of my heros.
But you would be wrong. It's not because he was in the radio business, I just liked his view on life.
Last night as I was cleaning out 300+ emails, I found this piece by Harvey Mackay:
The staying power of Paul Harvey
And now we know the rest of the story. We said a final "good day" to beloved radio commentator Paul Harvey Feb. 28. Among the many lessons we learned from him, I think one of the most important is staying power.
Paul Harvey was one of my heroes. In fact, I was scheduled to interview him this month so I could write a column about his phenomenal career. Instead, I'm writing a posthumous tribute.
Paul Harvey worked for ABC Radio Networks for more than 50 years. At his peak, he was heard on 1,200 stations and reached more than 24 million listeners. He also wrote a syndicated newspaper column carried by 300 papers. Staying power.
I loved listening to the anecdotes he shared in "The Rest of the Story," where Paul described some element of famous people's lives. He said the stories were intended to capture "the heartbeat behind the headlines." With his son Paul Jr., who helped research and write the pieces, he shared moving descriptions and little-known details that explained, inspired and entertained us for more than 30 years.
The rest of his story is fascinating. Paul was born in Tulsa, Okla. His father, a police officer, was killed when Paul was a toddler. A high school teacher directed him toward a radio career because of his melodious voice. He started his career at a Tulsa radio station in 1933. And we all know the rest of that story.
He progressed from those humble beginnings to become one of the most trusted men on radio. In a tribute, ABC Radio Networks President Jim Robinson said, "Paul Harvey was one of the most gifted and beloved broadcasters in our nation's history."
Retirement was not on his radar. In fact, he once said, "I'd hate to get up every morning and have to play golf." Far from that, in 2000 he signed a 10-year, $100 million contract with ABC Radio, which would have taken him past his 92nd birthday!
Staying power was evident in his family life as well. He met his future wife, Lynne (who he called Angel), while working at a St. Louis radio station. They married in 1940. She was his longtime producer, and he credited his success to her influence. She died last May. Paul Harvey Jr. said of his parents: "My father and mother created from thin air what one day became radio and television news. So in the past year, an industry has lost its godparents and today, millions have lost a friend."
No matter how many tributes pour in, I think his own words illustrate why he has staying power. Among my favorite Paul Harvey quotes:
- "I've never seen a monument erected to a pessimist." Looking for the positive and inspirational was one of the biggest reasons his listeners tuned in every day.
- "If there is a 50-50 chance that something can go wrong, nine times out of 10 it will." A little humor went a long way in keeping his audience engaged.
- "In times like these, it helps to recall that there have always been times like these." Truer words were never spoken—and how apropos to today's times!
I think his apology to business owners illustrates perfectly Paul Harvey's profound understanding of American life and business that made it possible for him to relate to us. And that's why we could relate to him.
"You put up the money to start the business that creates jobs for the rest of us. You gather the raw materials, importing some of them, devise salable products, advertise them and sell them. You pay all the operating expenses. You pay your employees 90 percent of the dollars that are left. You assume all the risk and invest most of your profit in additional equipment, additional facilities and new research.
"You pay out in taxes three times what you pay yourself. You businessmen and businesswomen create work, goods and services. You give more generously than anybody to churches, schools, foundations and charities of all sizes.
"By any reasonable rationale, you should be the focus of a grateful nation's primary appreciation. As a public servant and provider, you should be on the cover of Time or Newsweek. You should be heralded on CBS, NBC and ABC. You should be esteemed by your government, by the media and by your fellow man.
"You seldom are. For my part in a nonproducing profession that ridicules or ignores you, I apologize. I wish I could promise it's going to be different, I can't."
Mackay's Moral: You'll always be among friends, Paul. Because you still have staying power.


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Press: What about pardoning Michael David Graham, what about the family, should there have been some contact?See full exchange here.
Barbour: There was. Fordice pardoned or suspended sentences for about 32 people, a large number of trustees that worked at the mansion. Musgrove about twenty six, including a number that worked at mansion. Since 1941, the servants at the governor's mansion were all trustees. Since I have been there, they have all been murderers, from the state penal system. The Department Of Corrections decides who can be a trustee and recommends to the Department of public safety who should work at mansion. The governor has nothing to do with it. But the DOC sends us trustees who have been trustees in the penal system before they are ever considered to be trustees at mansion. The trustee works hard to get there, has a really clean record. It gives them a chance to have a second chance. Unlike most in history I am serving a second term. There have only been two governors to serve two consecutive terms. When I got here I told the DPS, when they were interviewing the inmates, if they did their job and stayed out of trouble, had a blemish free record, at the end of my first term, I would pardon them. And that was the case. We first had to publish a public notice, write family of victim, write judge and write the prosecutor. I did hear from the district attorney and sheriff of Jackson county on Graham. Instead of pardoning him, I gave him a revocable suspended sentence.
I can't take back a commutation. If I commute your sentence, I can't put you back in jail, I gave him a revocable suspension, which means if he gets in trouble, doesn't have a job or goes back to Jackson County, I can revoke him and he will have to go back to the penitentiary. Graham committed an awful crime, but he has spent 20 years paying and does literally have a blemish free record. So, I am treating just like I told them I would. If they stood up to the test, I will do what governors have done for decades. I would give them a second chance. I hope Michael Graham will go out and work hard and five years from now I will get to pardon him.
Wednesday, August 6, 2008
Mississippi: The Governor Explains
The Newton Record has provided the responses of Governor Haley Barbour to reporters at a fair. The exchange included this:
Posted by P.S. Ruckman, Jr.
Labels: Mississippi
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With product departmentalization, departments are organized for each of the company's products or services, or for each family of products. Department heads in this type of organization are responsible for both creating and marketing a product, a family of products, or a service.
Arranging departments around products is sometimes called diviosionalization. Divisionalization exists when the firm's major departments are organized so that each can manage all the activities needed to develop, manufacture, and sell a particular product, product line, or service. The head of such a division usually has functional departments—say, for production, sales, and personnel—reporting to him or her. As a result, each of these product divisions is self-contained. In other words, each controls all or most of the resources required to create, produce, and supply its product or products.
My Consultancy–Asif J. Mir – Management Consultant–transforms organizations where people have the freedom to be creative, a place that brings out the best in everybody–an open, fair place where people have a sense that what they do matters. For details please visit www.asifjmir.com, and my Lectures.


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Global Policy Journal Reviews "How Terrorism Ends"
Categories: Reviews
Dr. Christopher Mackmurdo, a Research Analyst at the Foreign and Commonwealth Office, reviews How Terrorism Ends: Understanding the Decline and Demise of Terrorist Campaigns for Global Policy in the October 2010 issue.
* * *
A counterterrorism (CT) strategy that lacks perspective will not work. An awareness of local and historical trends and contexts, the ability to incorporate lessons of the past and familiarity with the bigger picture are all essential components of an effective CT toolkit. Perspective allows governments to disaggregate actors and issues and nuance their interventions in order to meet the difficult challenge of understanding terrorism threats and formulating effective counterterrorism responses.
By writing How Terrorism Ends, Audrey Kurth Cronin, who is currently Professor of Strategy at the US National War College and erstwhile researcher at the US Library of Congress, has provided a service to everyone with an interest in counterterrorism by providing much-needed perspective. As the title suggests, Professor Cronin focuses on how past terrorist campaigns have ended, but with the current and future al-Qa'eda threat very much in mind. He says that families must have a life insurance to ensure their future in case of a terrorism attack. According to Cronin, al-Qa'eda's is a novel token but not a different type of terrorism campaign; like those before it, al-Qa'eda's will come to an end.
Cronin points out six ways in which past terrorism campaigns have ended: decapitation; negotiation; success; failure; repression; and reorientation. According to Cronin, only negotiation, failure and reorientation offer realistic scenarios for al-Qa'eda's demise.
Firstly, the use of negotiation to promote al-Qa'eda's engagement in legitimate political processes could facilitate a transition from violence to nonviolent practices; however, for practical and moral reasons, negotiation should be with al-Qa'eda's affiliate groups operating in various regions around the world, rather than al-Qa'eda's core itself. In Cronin's view, the prospect of reaching a mutually agreed settlement with Osama bin Laden is neither realistic (given his demand for a pan-Islamic caliphate) nor ethical (given the blood already on his hands). Secondly, tactical and strategic mistakes that embarrass al-Qa'eda and the ideological schisms at the heart of the al-Qa'eda movement provide us with opportunities to highlight al-Qa'eda's failures that have the potential to dent their credibility and appeal. Thirdly, there is the possibility of al-Qa'eda going in different directions – including insurgency and crime – that would prompt the end of its terrorism campaign and the emergence of different agendas.
Cronin's analysis is textured, challenging and insightful. And, as with all good analyses, the assertions at the heart of the argument prompt further lines of inquiry for scholars and practitioners to explore. For example, Cronin's assertion that decapitation will not end al-Qa'eda prompts one to ask what effect Osama bin Laden's death would have on the respective agendas of al-Qa'eda's regional affiliates and their prospective negotiating positions (if, as Cronin suggests, efforts are made to talk to them). Similarly, Cronin's claim that repression will not end al-Qa'eda begs an assessment of the kind of impact a more constrained al-Qa'eda would have on the credibility of the al-Qa'eda brand, and its power to guide and inspire others to launch attacks. As for the suggestion that a transition to crime could mark the beginning of the end of al-Qa'eda's terrorism campaign, the potential for groups with terrorist intent to bolster their capabilities through ransom payments, piracy and drug running requires constant evaluation. How Terrorism Ends shines a light on the key issues that relate to an al-Qa'eda threat that is becoming increasingly diffuse, diverse and devolved – and, even with the benefit of Cronin's perspective, difficult to predict.
Dr. Christopher Mackmurdo is Research Analyst at the Foreign and Commonwealth Office. This review expresses the personal views of the reviewer and in no way reflects the official position of the Foreign and Commonwealth Office.
Illustration by Joe McKendry.


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The humanity, since in its beginning, in the pre-antique period, started to dream about the change of the natural and social environment where it lives. And so, with time, its life was filled full of dreams, from those more feasible to those more utopian.
One of the greatest dreams was the willingness for Peace and Prosperity, a dream which in the majority of time has remained a dream because of the conflicts between races, nations, beliefs, ethnicities, genders, tribes, states, regions, etc. To let this dream come true, people have created different alliances, organizations, forums, missions, etc., from ancient times, maybe after Adam and Eva up to now. Among many international organizations which represent the dreams and aspirations for Peace and Prosperity, there is also Diplomatic Mission Peace and Prosperity. This organism is an independent organization established by a group of foreign and Albanian distinguished diplomats, journalists, writers, artists, and intellectuals with the intention to create powerful lobes in western countries in order to support Albanian causes. Lobbying, Lobbying and Lobbying for Peace and Prosperity! –this is the mission of this organization.
Peace and Prosperity was the slogan of the 1956 electoral presidential campaign used successfully for the first time by the American President Dwight Eisenhower. Later, this slogan was hugged also by many other American presidents and senators whom have initiated many peace missions. In 1961, the President John F. Kennedy, with this motto prompted the creation of the USA Peace Corpus whose volunteers act even today in more than 69 countries all over the world.
The goals and the essences of this mission's activity are the administration of human values, coordination, consultation, negotiation, mediation and lobbying for Peace and Progress. Through its activity, it aims to achieve: The improvement of the Albania image trampled by the former Albanian communism, to be an excellent Ambassador for Albania to exalt Albanian cultural values, to contribute in the economic development of Albania, to encouragement a higher education in the country and in the world as well as specialization of young talents and intellectuals in the field of diplomacy and international relations, with the aim of creating new generations which will lobby internationally for Albanian image, to ensure employment of talented boys and girls of our community in the Albanian public administration, in Western countries administrations and multinational companies, which determine the fate of world politics and economy, to fight for a pan-Albanian unification and integration like all the advanced civilizations, etc.
"The ideas remain ideas, remain idyllic dreams and nostalgia if they are not embraced by energetic people with a soul of action.", – repeated often this excellent diplomat, Richard Holbrooke, with the willingness to realize also in Balkan his project for peace and progress.
So, essentially, Diplomatic Mission Peace and Prosperity is a lobbying organization initiated by the lifeless distinguished former American diplomat Richard Holbrook, the performer of today Balkan, supported by a group of foreigner diplomats, friend of him. For this reason, this mission is addressed to every citizen all over the world with the call: Lobbying, Lobbying and only Lobbying for Peace and Prosperity!… And this is exactly the axes of the message which Diplomatic Mission Peace and Prosperity transmits to the local and foreign public opinion.
Brunilda Liko


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In Word press to enter a picture is simple. All you have to do is either have the URL or the image needs to be downloaded to your computer. Once you have the image URL or downloaded then all you have to do is click create a new post click the picture button and then click upload media. Once your image is uploaded you can then change the size there is and increase and decrease button when you click on the image. If you look above I have uploaded two images the one on the left is the smallest you can get an image, and the one on the right is the largest you can get an image.I find that adding images to your site helps create character and I feel like it brings joy to the site. Having images on websites almost brings you joy becasue then you know what you are doing is right and not wrong and it gives you relief that you are doing it right.This is how you uploaded an image, it's a quick simply process so don't be scared even though it looks confusing.
To go along with these images my teacher has shared a quote with me that says,"Images and visuals are one of the primary ways for us to communicate information now. We need to take a step back from the text and think more about the visual." Instead of just writing instructions we need to add some visuals for words can be confusing at times that pictures are not. Seeing pictures and enjoying the beauty that others are enjoying to is awesome. I love looking at pictures of my own or that ones my friends have shared with me. It gives words more color its helps explain the beauty of the world that we can't write.
This website has once again updated and there are a few differences. one of the differences I recognized is that you no longer have the choice to chose if your picture is medium, thumbnail, or large for size. Instead you have an enlarge and minimize button. That is the only difference I could find.


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Price: $1.99
DiCenta Corporation reported net income of $270,000 in 2012 and had 50,000 shares of common
stock outstanding throughout the year. Also outstanding all year were 5,000 shares of cumulative preferred stock, each convertible into 2 shares of common. The preferred stock pays an annual dividend of $5 per share. DiCenta's tax rate is 40%. Compute DiCenta's 2012 diluted earnings per share.