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Direct Primary Care

Direct primary care is primary care offered direct to the consumer, without insurance intervention. It incorporates various health care delivery systems that involve direct financial relationships between patients and health care providers. One niche variant of direct primary care is concierge medicine. Direct primary care can remove many of the financial barriers to accessing care when needed. Often, there are no insurance co-pays, deductibles or co-insurance fees thus avoiding the overhead and complexity of maintaining relationships with insurers. Under this model, patients may pay a combination of visit fees and/or fixed monthly fees, which grant them access to a set of medical services, including same and next-day appointments, both in the form of house calls and office visits. A direct primary care arrangement benefits from pairing with either: a high-deductible health plan, as direct primary care alone will not cover catastrophic health care such as most surgeries, a health savings account, or health reimbursement account as the associated tax-benefits can generally be applied to direct primary care and other medical expenses. Direct primary care practices do not typically accept insurance payments, thus avoiding the overhead and complexity of maintaining relationships with insurers, which can consume as much as $0.40 of each medical dollar spent. Direct primary care payments are over time, rather than in return for specific services, the economic incentives are such that the long-term health of the patient is the most lucrative situation for the doctor. Preventative care gains greater emphasis under direct primary care. Because the primary care physician compensation is better than it would be under insurance billing, doctors can afford to spend more time with the patient, rather than simply referring them to a highly paid specialist after a short consultation. Boutique medicine is a type of medical practice now found in many metropolitan areas across the country. Also known as, concierge health care, concierge medicine, or retainer medicine, the concept has come to represent a higher level of healthcare for those who want a more personalized relationship with their physician. This model has proven successful for those physicians who want to see a fewer number of patients on a day to day basis, thus allowing them to spend more time nourishing individual patient relationships.

Breast Bondage

Breast bondage is a bondage technique which involves the tying of rope around a woman's breasts in a visually intricate and decorative pattern. Breast bondage most commonly uses rope, but webbing, straps or a harness may also be used. A karada Japanese for body is a rope dress or a rope body harness used in Japanese bondage and other BDSM activities.

Breast bondage often focuses on the decorative, aesthetic and erotic aspects of the result, and not on immobilization of the female subject. However, breast bondage can be combined with other techniques which restrict the subject's mobility and can provide securing points for other bondage plays, such as crotch rope and tit torture.

Breast bondage can be applied over clothing or directly to the skin, and can be worn under clothing or in full view. 1/4 inch rope, ribbon, or leather straps can be used.

The basic breast bondage technique involves tying ropes around the base of the breasts, causing them to bulge outwards. Usually, the same rope is used for both breasts so that the rope harness is automatically held together at the front. The rope may then also be fixed behind the back, to make a sort of bra. For this to work, the tied person needs large breasts.

Sometimes, breast bondage is combined with other bondage techniques. For example, the woman's arms can be tied behind her back, in an elbow or box tie or in a reverse prayer position. When combined with breast bondage, bound arms force the woman's chest and breasts to protrude further. When combining breast and arm bondage, the ropes can draw the ropes above and below the breasts together at the sides of the breasts as they pass under the shoulders and behind the neck, thus resulting in rope effectively surrounding the breasts.

When fully bound, other BDSM techniques can be used. For example, nipple clamps can be placed on the nipples to enhance the visual erotic impact; or other techniques, such as tit torture, can be used to further enhance the erotic impact. Chains can also be hung from the breasts, having the advantage of increased sensational awareness through their coldness which can be increased by prepping in a freezer. In breast binding, it is also common for bandages, plastic wraps, and duct tape to flatten breasts, nipples, and areolas. Along with these forms of painful pleasure or pleasurable pain, there is breast spanking. A rare occurrence, but enjoyed by some where the breasts are spanked, much like the buttocks.

Breast bondage can play an integral part in suspension bondage. If the subject is being suspended, particularly in a horizontal position such as a suspended hogtie, breast bondage is used as the main supporting area under the chest. If there are ropes above and below the breasts at the upper chest, the weight of the upper body is taken by these ropes. With so much pressure in this area, the rope must be precisely placed or once again blood flow could be reduced see safety.

Apart from the visual appearance of the breasts being lifted, the pressure that is applied results in a reduction in blood flow, and a further swelling and firming of the breasts. This makes them very sensitive, especially the nipples and surrounding areas, and it can be quite pleasurable to the bound person when they are stimulated. Conversely, if nipple clamps are used, the nipples will be particularly sensitive to this and the degree of pain significantly greater. Rubber bands around the breasts have also been used with breast bondage to increase this effect still further, but can lead to a dangerous restriction in blood flow.

Voice over auditions

Do people always say you should do something with that great voice of yours? Do you listen to the voices on TV and radio and think: That sounds like fun. I'd like to do that! What talent should do is make themselves "stick out" at an audition. Be on time, prepared and have several different voices for each character. Versatility and the ability to take direction are the key ingredients! Voice over work can be extremely lucrative and many actors make a living solely from voice over work. If you would like to get into the voice over business, but aren't sure how to get a demo or find a reputable company, go to Voice Over Work. A voice over audition is a tryout by a voice over artist in order to secure work in television, film or commercials.

Do people always say you should do something with that great voice of yours? Do you listen to the voices on TV and radio and think: That sounds like fun. I'd like to do that! What talent should do is make themselves "stick out" at an audition. Be on time, prepared and have several different voices for each character. Versatility and the ability to take direction are the key ingredients! Voice over work can be extremely lucrative and many actors make a living solely from voice over work. If you would like to get into the voice over business, but aren't sure how to get a demo or find a reputable company, go to Voice Over Work.

Safe sex

Safe sex means taking precautions during sex that can keep you from getting a sexually transmitted infection (STI), or from giving an STI to your partner.

STIs are also referred to as sexually transmitted diseases, or STDs. These diseases include genital herpes, genital warts, HIV, chlamydia, gonorrhea, syphilis, hepatitis B and C, and others.
Information

A sexually transmitted illness (STI) is a contagious disease that can be transferred to another person through sexual intercourse or other sexual contact. Many of the organisms that cause STIs live on the penis, vagina, anus, mouth, and the skin of surrounding areas.

Most of the diseases are transferred by direct contact with a sore on the genitals or mouth. However, some organisms can be transferred in body fluids without causing a visible sore. They can be transferred to another person during oral, vaginal, or anal intercourse.

Some STIs can also be transferred by nonsexual contact with infected tissues or fluids, such as infected blood. For example, sharing needles when using IV (in the vein) drugs is a major cause of HIV and hepatitis B transmission. An STI can also be transmitted through contaminated blood transfusions and blood products, through the placenta from the mother to the developing baby, and sometimes through breastfeeding.

The following factors increase your risk of getting an STI:

Not knowing whether a partner has an STI or not
Having a partner with a history of any STI
Having sex without a male or female condom
Using drugs or alcohol in a situation where sex might occur
If your partner is an IV drug user
Having anal intercourse

Drinking alcohol or using drugs increases the likelihood that you will participate in high-risk sex. In addition, some diseases can be transferred through the sharing of used needles or other drug paraphernalia.

Abstinence is an absolute answer to preventing STIs. However, abstinence is not always a practical or desirable option.

Next to abstinence, the least risky approach is to have a mutually monogamous sexual relationship with someone you know is free of any STI. Ideally, before having sex with a new partner, each of you should get screened for STIs, especially HIV and hepatitis B, and share the test results with each another.

Use condoms to avoid contact with semen, vaginal fluids, or blood. Both male and female condoms dramatically reduce the chance you will get or spread an STI. However, condoms must be used properly:

Keep in mind that STIs can still be spread, even if you use a condom, because a condom does not cover surrounding skin areas. But a condom definitely reduces your risk.
Lubricants may help reduce the chance a condom will break. Use only water-based lubricants, because oil-based or petroleum-type lubricants can cause latex to weaken and tear. Polyurethane condoms are less prone to breaking, but cost more than latex condoms. Using condoms with nonoxynol-9 (a spermicide) can help prevent pregnancy, but may increase the chance of HIV transmission because the spermicide can irritate the vaginal walls.
The condom should be in place from the beginning to end of sexual activity and should be used every time you have sex.
Use latex condoms for vaginal, anal, and oral intercourse.

Here are additional safe sex steps:

Be responsible. If you have an STI, like HIV or herpes, advise any prospective sexual partner. Allow him or her to decide what to do. If you mutually agree on engaging in sexual activity, use use latex or polyurethane condoms and other measures to protect the partner.
If pregnant, take precautions. If you have an STI, learn about the risk to the infant before becoming pregnant. Ask your provider how to prevent the developing baby from becoming infected. HIV positive women should not breastfeed their infant.
Know your partner. Before having sex, first establish a committed relationship that allows trust and open communication. You should be able to discuss sexual histories, any previous STIs or IV drug use. You should not feel coerced or forced into having sex.
Stay sober. Alcohol and drugs impair your judgment, communication abilities, and ability to properly use condoms or lubricants.

In summary, safe sex requires prior planning and good communication between partners. Given that, couples can enjoy the pleasures of a sexual relationship while reducing the potential risks involved.

For information about preventing pregnancy, see birth control and family planning.