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JTNN’s Environmental Strategies Coalition was first formed in May 2000 in an effort to address the underage drinking problem in Washoe County. Comprised of local business leaders, law enforcement personnel, educators and substance abuse prevention professionals, the Environmental Strategies group works together to reduce underage drinking by limiting alcohol access to those under 21 years of age. In addition, the Environmental Strategies group works toward keeping marijuana illegal as a recreational drug.
Some of the group’s activities include:
- Collaborating with local law enforcement to coordinate alcohol sales compliance checks to insure that local retailers are not selling alcohol to underage youth.
- Working with a number of partners to develop policies at community sporting events this discourage underage drinking.
- Partnering with University of Nevada, Reno Student Services to identify students who may have had difficulty with alcohol and providing them with brief screening, brief intervention, and referral to treatment, as appropriate.
- Partnering with Quest Counseling and Consulting to develop and present an ongoing alcohol retailer and server training program in Washoe County.
- Partnering with various groups, organizations, and individuals to promote a Reno City Social Host ordinance in which landlords and homeowners are held accountable to restrict unruly gatherings (often involving underage drinking) in the properties they own.
- Working closely with local bars and clubs to develop the Real Bar Campaign. Real Bar engages owners and management to insure that their servers and security staff are trained in understanding and complying with state and local laws that prohibit underage youth from drinking in their establishments.
In the coming year, the group is planning to investigate the possibility of advocating for a social host ordinance in Sparks and in Washoe County. In addition, the group is in the process of contacting local judges to encourage them to make retail clerk training mandatory for those clerks cited for selling alcohol to minors.
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There have been rare reports of priapism (prolonged and painful erections lasting more than 6 hours) with the use of oral PDE5 inhibitors such as vardenafil, sildenafil and tadalafil. Patients with blood cell diseases such as sickle cell anemia, leukemia, and multiple myeloma have higher than normal risks of developing priapism. Priapism untreated can cause injury to the penis tissue and lead to permanent loss of potency. If there is prolonged erection (longer than 4 hours), immediate medical assistance should be sought.
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As for the next step, Golombek said "a full-scale clinical trial has to be performed in humans, which is indeed quite expensive and time-consuming. Jet-lag trials might involve laboratory simulations, but we also need 'the real thing,' which means testing pharmacological treatments on long-haul air travel."
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Nocturnal penile tumescence (NPT): This test measures a man's erectile function while he is sleeping. Normally, a man will have five or six erections while asleep. A lack of these erections may indicate there is a problem with nerve function or circulation to the penis. The test uses two methods, the snap gauge method and the strain gauge method. The snap gauge method is performed by wrapping three plastic bands of varying strength around the penis. Erectile function is then measured based on which of the three bands breaks. The strain gauge method works by placing elastic bands around the tip and base of the penis. If the penis becomes erect during the night, the bands stretch, measuring the changes in penile circumference.
Sildenafil is available in 3 doses: 25 mg, 50 mg, and 100 mg. The starting dose depends on the clinical situation. A man in his fifth decade of life with mild sexual dysfunction that is probably related to psychological factors can start on the 25-mg dose. Men with moderate-to-severe ED can begin at the 50-mg dose, and, after testing the effect of the drug on at least 3 occasions (although 5-6 tries is recommended), the dose can be modified. Men with severe ED can start on the 100-mg dose; these men are not likely to achieve a satisfactory response, but they should make 3-4 attempts before starting another form of therapy.
Q. Which injectable medication do you recommend?
However, because people with diabetes also tend to have problems with their heart, these medications may not be appropriate and cause dangerous interactions with your heart medicine. Talk to your doctor to determine what treatment is best.
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