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As you've probably guessed, I don't run Windows: I run Linux with the XFCE windows manager. It looks a bit like this:
[xfce.org...]
I HATE icons all over the desktop. I use the quick launch bar for stuff I do every day including links to sites I hit daily, and the Start Menu (which I have also heavily customized) for everything else. On occasion, I even have to go into Program Files, find the relevant program folder, and double click the executable. Or sometimes I use Run....
My Documents (Windows)
My Computer (Windows)
Internet (Folder)
Media (Folder)
Works (Folder)
Pinball (Shortcut)
CD Drive (Shortcut)
Check Mail (Internet Shortcut)
Scanner Wizard (Shortcut)
Switch User (Shortcut)
Ulead Photo Express (Shortcut)
Works Word (Shortcut)
Recycle Bin (Windows)
Unused Desktop Shortcuts (Folder)
All my Windows icons are customized in occordance with my current theme and I use Quick Launch for the rest, much more accessible.