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The PowerSpec 9262 packs Intel's 3.4GHz Pentium 550 and pairs it with a full 1GB of 400MHz DDR SDRAM memory. Thanks to the Intel 915P chipset and its PCI Express slot, the PowerSpec 9262 also comes with a standalone 128MB GeForce PCX 5300 graphics card--Nvidia's budget card for the next-generation PCI Express interface. With a powerful Intel processor, ample memory, and a new yet affordable graphics card, the fixed-configuration PowerSpec 9262 is fast enough for common business and household tasks, and it can even handle some low-to-medium-intensity 3D gaming.
The PowerSpec 9262 delivers better value than the MPC ClientPro 565 we recently reviewed, even when you factor in that the ClientPro's price includes a 19-inch LCD to the PowerSpec's CRT. Still, if you are looking for a task-oriented, high-end desktop--that is, a speedy PC without ranging into the luxurious gaming end of the market--we still think the Gateway 7200XL is the pick for its overall value and BTX motherboard.
The PowerSpec 9262's unobtrusive 16.5-by-8.0-by-18.5-inch (HWD) black case fits into almost any environment. It won't win any design awards, but it won't offend, either. A pair of USB 2.0 ports mounted on the lower-front edge of the right-side panel comprise the only major external nod to modern PC conveniences. The usual legacy connections adorn the back as well, where youÂ'll find four extra USB 2.0 ports but no FireWire input, a sad omission.
You remove the side panel by way of two Phillips screws and two side latches, although itÂ's easier to take off than it is to put back on because it requires irritatingly precise alignment. Inside, there's ample room for expansion, with a spare 3.5-inch hard drive bay, a free front-accessible 3.5-inch bay, and an extra 5.25-inch bay, although because the power cable is bizarrely tethered to the drive cage, youÂ'll have to cut the plastic cable binding loose to get to the latter bay. Card expansion includes three vacant PCI slots and two empty 1x PCI Express slots. You also have room to add two more memory sticks to the two already present.
Although the PowerSpec 9262 came to us bundled with a 17-inch Samsung SyncMaster 172W LCD monitor and a set of Altec Lansing Select 4100 4.1 speakers, you canÂ't add those parts through the WinBook Web site. WinBookÂ's strategy was to provide them to us from their sister company Micro Center Online, an online retailer. ThereÂ's no reason, of course, why you canÂ't add your own or shop at another vendor. The system itself costs $1,299 before adding a monitor or speakers.
The PowerSpec 9262Â's single 250GB Serial ATA 7,200rpm hard drive will take a long time to fill up, and what you donÂ't store on the drive you can offload to the double-layer, multiformat 16X DVD burner, which is complemented by a straight-up 16X DVD-ROM drive. And as stated above, the PowerSpec 9262 gives you enough power for worry-free basic computing. When we take a closer look at performance, we see that it stands up well when compared to similar systems.
A SysMark 2004 score of 200 places the WinBook PowerSpec 9262 dead in the middle of our comparison set, underlining, as we expected, the WinBookÂ's satisfactory capabilities as a general performer. Gaming performance was less impressive, attributable to the low-end graphics card, PCI Express though it may be. Its Unreal Tournament 2003 result was at the bottom of the pack, although it turned in roughly 60 frames per second on the mainstream 1,024x768-resolution test, meaning that you can play some older 3D games if youÂ're realistic about detail settings. As illustrated by the PowerSpec 9262Â's inability to complete the Far Cry test, however, we donÂ't recommend it for high-end gaming. Fortunately, the PCI Express slot gives you a gateway to better 3D performance, should you decide to upgrade the graphics card later.
In addition to running Microsoft Windows XP Professional, bundled software includes InterVideoÂ's WinDVD package with Creator 2.0 for movie editing, Copy for disc duplication, and Recorder 5.0 for DVD movie watching and DVR software tasks. You also get the Nero 6.3 OEM Suite for CD-burning chores and trial copies of EarthLink and Norton AntiVirus 2005. Sorely missing is a productivity suite.
The PowerSpec 9262 is covered by a one-year parts-and-labor warranty that includes onsite service. Calls for hardware support are toll-free but limited to weekdays from 9 a.m. to 9 p.m. ET. The WinBook user Forum and the Microsoft Knowledge Base are the only support features available online from WinBookÂ's Web site.
(Longer bars indicate better performance)
BAPCo SysMark 2004 rating | SysMark 2004 Internet-content-creation rating | SysMark 2004 office-productivity rating |
To measure application performance, CNET Labs uses BAPCo's SysMark 2004, an industry-standard benchmark. Using off-the-shelf applications, SysMark measures a desktop's performance using office-productivity applications (such as Microsoft Office and McAfee VirusScan) and Internet-content-creation applications (such as Adobe Photoshop and Macromedia Dreamweaver).


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Welcome new members. This is your chance to get in on the founding of a new Kansas based fishing club. Please leave a post describing yourself, name, age, location and interests. We will welcome all new members, but are looking for those that would be willing to take an active part in starting this club. We will need some people with leadership skills and computer skills. We will need to make and distribute fliers to attract new members. I hope that eventually we will be having several small meets and club tournaments. To do this we will need lots of help.
Name is Ryan, live in Wichita can tear up farm ponds but lack the boat to really do much good on the lakes around here. Think I have good skills, they're a little unorthodox but work for me. I like to fish for pretty much anything that is biting but usually stick to Bass and Channel Cat. Early 30's here same as my wife who I also love to take fishing and she can hold her own on the water. Just now getting the youngen out on the lakes, he's 2 1/2 so he's got a lot to learn but he has fun out there. Pretty good with the computer so if you need any help feel free to contact me
Welcome, it's good to have another member, krushand I went to his freinds place today, and had a great time catching bass and even a few crappie. Krush got a four pounder. A great time was had by all.
Welcome Dominic
I'ts good to see a new Wichita member. If we could get the word out, there should be lots of kansan's interested. I'm leaving Wed. morning for a tournament on Grand. Next week we need to get with everyone and finalize a fishing meet. The small lake that I have access to is only available on the weekend of May 31st. There are a few members that can't make that date. But it seems to be the best for most of us. How obout Rodrigo? are you still on for the 31st? I know joe will be there. I will try to round up a few friends that are interested but havn't joined NAFC. Thats it for now. Talk more next week.
Howdy Folks:
I just stopped in to say Hi and wish you all the very best, I have had all my time taken up lately with my wife being in the hospital for the last 28 days with intestinal problems but things are looking up and I hope to be able to spend more time here and try to help get the new club going.
Wish you all a good day to spend fishing !!
Just stopped in to say HI and to wish everyone well, I hope everyone is getting out on the water, I hope to here very soon!!
Let us know where with what and with who and what you came home with!!
Have a good day and may you spend it fishing!!
I live just inside the Mo. border 1 mile from the KS state line. I hope to be a member of an NAFC chapter in both states.
Steve Casteel KC, MO. age 52, .. Self employed - for now in Fishing rod and reel repair, and tackle sales.
Fishing experience 47 yrs+ in both states. Like to fish for Crappie and Walleye the most. LMB, Catfish, and other Panfish follow my two favorites.
Have fished and know the Reserviors of Hillsdale Melvern, & Pomona very good and the power plant at La Cygne, Ks..
Have also fished some at Council Grove, John Redmond, Milford, Perry and Tuttle Creek Res. as well. And know a creek on the KS side I can go to with anyone. Fished it since spring of 1962 [age 5]
On the Mo side, have fished Harry S. Truman Res. above and below the dam since it was opened in the 70's.
Always willing to go out with NAFC members. Would like to fish by boat more than the bank, but will do both. Dislocated an Ankle in Nov of 07' and must watch bank fishing more closely than I used to.
Been with Rodrigo several times, Miles, and a friend of Rodrigo's and was at the Wichita fishing get-to-gether in 2008. May or may not be able to attend this yr.
Contact info email@example.com or home phone # [816] 326-7891.
Unfortuneatly a lot of us must watch the bank more closely than we used to hahaha
I hope that your biz works out well for you and maybe we will run into each other this year somewhere!
I have a sister in law that lives in KCK and I have looked at quite a few places to fish up there but have never had the time to do anything about it.
Wish you a good day and may you spend it fishing!
Just popped in to say HOWDY and to see if there were any updates on anything at all, I hope that you are all doing well and wish you all a good day, may you spend it fishing!!

subset: commoncrawl


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ID | Name (credits) | Time | Instructor |
ART-399E-01 | St: Sculpture - Fire & Ice (3 ) |
Griffith, Robert A |
The workshop/course will introduce students to the dynamics of steel and glass combined for sculpture, lighting or accessories. Students will experience the extraordinary relationship between these two distinct materials as well as the fit for individual interpetations and creative application.
Off campus component required. Permission of instructor required.
For more information, contact the Office of Retention and Advising at (570) 340-6043 or firstname.lastname@example.com.
* You may not be eligible for special summer tuition rates if you receive a scholarship or other financial aid from Marywood.


text: News category Habemus Papam +1: The First Year of Pope Francis On March 27, The Joan and Bill Hank Center for the Catholic Intellectual Heritage is hosting a symposium to mark the one-year anniversary of Pope Francis's election. In his first year as Pope, Francis has initiated Vatican reforms and inspired the Catholic faithful – both committed and lapsed. His influence has been felt outside of the Catholic Church through his dialogues and his ministry to the marginalized. category Elegant Enigmas: The Art of Edward Gorey Elegant Enigmas: The Art of Edward Gorey and G is for Gorey—C is for Chicago: The Collection of Thomas Michalak. Both provide an in-depth look at influential Chicago artist Edward Gorey, whose work was known for cautionary tales, dry wit, and characters costumed in the Edwardian style. Both exhibitions run through June 15, 2014. Don't miss your chance to see them! category New SOC Alumni Magazine One school. Four majors. Endless possibilities. Scroll through the pages of Compass, an online magazine produced by School of Communication students. It profiles alumni who have successful careers in various communication fields including journalism, advertising, public relations, and nonprofit organizations. category President responds to Higher Education Act In this editorial Loyola President Fr. Michael J. Garanzini, SJ suggests reforms for institutions of higher education that will make operations more transparent and institutions more competitive, which should drive a reduction in costs, or at least hold them down. category University Libraries digitize Loyola theses and dissertations The University Libraries have undertaken a project to digitize and make available online all theses and dissertations written by Loyola graduates. The project began with theses and dissertations published in 1924 and staff are currently digitizing documents in the mid-1960's. category LUMA receives accreditation The Loyola University Museum of Art (LUMA) has received accreditation—the highest national recognition for a museum—from the American Alliance of Museums (AAM). Accreditation signifies a mark of excellence to the museum community, government agencies, cultural funders, and the museum-going public. category Dean Yellen named among most influential in education The National Jurist has named Loyola University Chicago School of Law Dean David N. Yellen as one of the "25 most influential people in legal education" in its January 2014 issue. Yellen ranks 17th on the list of those named as having the most influence in 2013.


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Budget Accommodation North America Canada Quebec Hostels HI-Quebec- Auberge Internationale de Québec
Considering the huge volume of people that go through this large hostel, we were very satisfied with our experience. Everything is kept clean and there is a bar area to socialise in. The location was excellent and the staff were well organised and pleasant!
The Auberge Internationale de Quebec is located right in the heart of the Old Quebec city, inside the walls and fortifications. It is by walking distance from the Chateau Frontenac and the main touristic and cultural attractions of the city.
The Auberge is the largest hostel in Canada. We can accomodate close to 280 travellers. We offer dorms as well as private room with or without bathroom. L'auberge is known for his safety. The HI Quebec offers many commodities : We have a cafe Bistro open for breakfast, self- cooking kitchen for individuals travellers, bar, common room with pool table, ping-pong,living room with TV and library , outside yard, a laundry room, internet access, free WiFi etc..Daily activities are organized for travellers ; a good way to meet people from all around the world !
We also offer a discount for Hostelling International members when you show your membership card upon arrival.
L'auberge is an award winner of The Grand prix du Tourisme in 2005 for Accomodation 50 to 149 rooms.
The HI Quebec was the first in the world to receive the Level 2 for HI Quality Program which means that, in addition to meeting the high standards issued by Hostelling International network, we are a major reference to our operations and the quality of our services.
We have 4 stars of the Classification issued by the CITQ in 2012.
The Auberge Internationale de Quebec was the ' Hostel of the year ' in 2009 named by Hostelling Canada and has also received 3 green keys by Green keyy Eco rating Program.
The hostel is more than a comfortable bed ; it also offers a warm ambience, daily activities and encounters with travellers from all over the world . All in the heart of the Old Quebec city !
**Tax of 15% NOT included in the prices listed **
19, Rue Ste-Ursule
Click here to enlarge map
This is a Trusted Review. Why?
This is a Trusted Review. Why?
Considering the huge volume of people that go through this large hostel, we were very satisfied with our experience. Everything is kept clean and there is a bar area to socialise in. The location was excellent and the staff were well organised and pleasant!
Have you stayed here? Write a review
* The Customer Satisfaction score is based on a combination of ratings from Travellerspoint and external websites. The score of 86% for this property is based on ratings provided by 156 guests.
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Compliance (medicine)
In medicine, compliance (also adherence, capacitance or Concordance) describes the degree to which a patient correctly follows medical advice. Most commonly, it refers to medication or drug compliance, but it can also apply to other situations such as medical device use, self care, self-directed exercises, or therapy sessions. Both the patient and the health-care provider affect compliance, and a positive physician-patient relationship is the most important factor in improving compliance,[1] although the high cost of prescription medication also plays a major role.[2]
Compliance is commonly confused with concordance. Concordance is the process by which a patient and clinician make decisions together about treatment.[3]
Worldwide, non-compliance is a major obstacle to the effective delivery of health care. Estimates from the World Health Organization (2003) indicate that only about 50% of patients with chronic diseases living in developed countries follow treatment recommendations.[1] In particular, low rates of adherence to therapies for asthma, diabetes, and hypertension are thought to contribute substantially to the human and economic burden of those conditions.[1] Compliance rates may be overestimated in the medical literature, as compliance is often high in the setting of a formal clinical trial but drops off in a "real-world" setting.[4]
Major barriers to compliance are thought to include the complexity of modern medication regimens, poor "health literacy" and lack of comprehension of treatment benefits, the occurrence of undiscussed side effects, the cost of prescription medicine, and poor communication or lack of trust between the patient and his or her health-care provider.[5][6][7] Efforts to improve compliance have been aimed at simplifying medication packaging, providing effective medication reminders, improving patient education, and limiting the number of medications prescribed simultaneously.
An estimated half of those for whom treatment regimens are prescribed do not follow them as directed.[1] Until recently, this was termed "non-compliance", which was sometimes regarded as meaning that not following the directions for treatment was due to irrational behavior or willful ignoring of instructions. Today, health care professionals more commonly use the terms "adherence" to or "concordance" with a regimen rather than "compliance", because these terms are thought to more accurately reflect the diverse reasons for patients not following treatment directions in part or in full.[6][8] However, the preferred terminology remains a matter of debate.[9][10] In some cases, concordance is used to refer specifically to patient adherence to a treatment regimen that is designed collaboratively by the patient and physician, to differentiate it from adherence to a physician only prescribed treatment regimen.[11][12] Despite the ongoing debate, adherence is the preferred term for the World Health Organization,[1] The American Pharmacists Association,[5] and the U.S. National Institutes of Health Adherence Research Network.[13]
Concordance also refers to a current UK NHS initiative to involve the patient in the treatment process to improve compliance.[14] In this context, the patient is informed about their condition and treatment options. They are involved with the treatment team in the decision as to which course of action to take, and partially responsible for monitoring and reporting back to the team. Compliance with treatment can be improved by:
- Selecting treatments in a way that minimizes side-effects, and discussing management of side effects
- Prescribing the minimum number of different medications
- Simplifying dosage regimen by selecting a drug or using a sustained release preparation that requires as few doses per day as possible[15]
- Having open discussions around medication options, and alternatives if the first option is not tolerated
Societal impact[edit]
A WHO study estimates that only 50% of patients suffering from chronic diseases in developed countries follow treatment recommendations.[1] The figures are even lower in respect to adherence rates for preventative therapies, and can be as low as 28% in developed countries. citation neededThis may affect patient health, and affect the wider society when it causes complications from chronic diseases, formation of resistant infections, or untreated psychiatric illness.
Compliance rates during closely monitored studies are usually far higher than in later real-world situations. For example, one study reported a 97% compliance rate at the beginning of treatment with statins, but only about 50% of patients were still compliant after six months.[4]
The experience of Patient Connect Service Limited in the UK is that medicines prescribed for preventative purposes are especially likely not to be taken as prescribed;[16][not in citation given] perhaps because people do not feel immediately threatened or, in the case of symptomless conditions such as raised cholesterol levels (hypercholesterolaemia) and raised blood pressure (systemic hypertension), feel no obvious benefits at the time of taking the medicines[citation needed] As patients are asymptomatic, they may not see a need to take medication.
Some figures are available from the UK on non-compliance:
- up to 90% of diabetes patients do not take their medication well enough to benefit from that medication.[citation needed]
- 33-50% of some cancer patients take less of their anti-cancer medicine than required.[citation needed]
- only 75% of coronary heart disease (CHD) patients take sufficient medicine for it to be effective.
- Up to 75% of hypertensive patients do not adhere to their medicine.
- 41-59% of mentally ill patients take their medication infrequently or not at all.[17]
- 33% of patients with schizophrenia don't take their medicine at all, and 33% are poorly adherent.[18]
- Less than 27% depressed patients adhere to their medication.[19]
In the UK, it has been estimated that if CHD patients adhered to their medication, each year 40,000 – 50,000 fewer people would have a stroke and 25,000 would not have a heart attack .[citation needed]
The financial cost to the UK National Health Service (NHS), and thus to society, is also high:
- CHD costs the NHS in excess of £2billion on medicines; 50% of which is wasted through poor understanding and poor adherence.[citation needed]
- Economic studies consistently show that the costs incurred with poorly controlled asthma are higher than those for a well-controlled patient with the same severity of disease. For severe asthma, it has been estimated that the savings produced by optimal control would be around 45% of the total medical costs.[20]
Compliance issues[edit]
Health literacy[edit]
Cost and poor understanding of the directions for the treatment (referred to as 'health literacy') are major barriers to completing treatments.[21][22][23] There is robust evidence for a correlation between education and physical health. Poor educational attainment is a key factor in the cycle of health inequalities.[24][25][26]
Educational qualifications help to determine an individual's position in the labour market, their level of income and therefore their access to resources.
Literacy and health in the UK[edit]
One in five adults has a long-standing illness or disability. In 2003, a national study for the UK Department of Health, more than one-third of people with poor or very poor health had literary skills of Entry Level 3 or below.[27]
Low levels of literacy and numeracy were found in 2003 to be associated with socio-economic deprivation. Adults in more deprived areas, such as the North East of England, performed at a lower level than those in less deprived areas such as the South East. Local authority tenants and those in poor health were particularly likely to lack basic skills.[28]
A 2000 analysis of over 100 UK local education authority areas found educational attainment at 15–16 years of age to be strongly associated with coronary heart disease and subsequent infant mortality.[29]
One fifth of UK adults in 1999 (nearly seven million people) had problems with basic skills, especially functional literacy and functional numeracy, making it impossible for them to effectively take medication, read labels, follow drug regimes, and find out more. This was described as:
The ability to read, write and speak in English, and to use mathematics at a level necessary to function at work and in society in general.
— Moser Report (1999)
A study of the relationship of literacy to asthma knowledge revealed that 31% of asthma patients with a reading level of a ten-year-old knew they needed to see the doctors even when they were not having an asthma attack, compared to 93% with a high school graduate reading level.[citation needed]
The elderly[edit]
The elderly often have health conditions, and around half of all NHS medicines are prescribed for people over retirement age, although they represent only about 20% of the UK population.[30][31] The recent National Service Framework on the care of older people highlighted the importance of taking and effectively managing medicines in this population. However, elderly individuals may face challenges, including multiple medications with frequent dosing, and potentially decreased dexterity or cognitive functioning.
Cline et al. (1999) identified several gaps in knowledge about medication in elderly patients discharged from hospital.[32] Despite receiving written and verbal information, 27% of older people discharged from hospital after heart failure were classed as non-adherent within 30 days. Half the patients surveyed could not recall the dose of their medication and nearly two-thirds did not know what time of day to take them.[32]
Barat et al. (2001) found that 40% of elderly patients do not know the purpose of their medication, only 20% know of the consequences of non-adherence, and less than 6% know about possible side effects of the drugs prescribed for them.[33]
A conservative estimate says 10% of all hospital admissions are through patients not managing their medication .[citation needed]
The young[edit]
- Young people who felt supported by their parents and doctor, and had good motivation, were ten times more likely to comply than those who did not.[citation needed]
- Young adults may stop taking their medication in order to fit in with their friends, or because they deny their illness.[citation needed]
- Those who did not feel their condition to be a threat to their social well-being were eight times more likely to comply than those who perceived it as such a threat.[34][35]
- Non-adherence is often encountered among children and young adults; young males are relatively poor at adherence.
People of different ethnic backgrounds have unique adherence issues through literacy, physiology, culture or poverty .[citation needed] There are few published studies on adherence in medicine taking in ethnic minority communities. Ethnicity and culture influence some health-determining behaviour, such as participation in screening programmes and attendance at follow-up appointments.[38][39]
Prieto et al [40] also emphasised the influence that ethnic and cultural factors can have on adherence. They pointed out that groups differ in their attitudes, values and beliefs about health and illness. This view could affect adherence, particularly with preventive treatments and medication for asymptomatic conditions. Additionally, some cultures fatalistically attribute their good or poor health to their god(s), and attach less importance to self-care than others.
Measures of adherence may need to be modified for different ethnic or cultural groups. In some cases, it may be advisable to assess patients from a cultural perspective before making decisions about their individual treatment.
Prescription fill rates[edit]
While a health care provider visit with a patient may result in the patient leaving with a prescription for medication, not all patients will fill the prescription at a pharmacy. In the U.S., 20-30% of prescriptions are never filled at the pharmacy.[41][42] There are many reasons patients do not fill prescriptions including the cost of the medication,[2][5] doubting the need for medication, or preference for self-care measures other than medication.[43][44] Cost may be a barrier to prescription drug adherence, but convenience, side effects and lack of demonstrated benefit are also significant factors to a complex situation. A US nationwide survey of 1,010 adults in 2001 found that 22% chose not to fill prescriptions because of the price, which is similar to the 20-30% overall rate of unfilled prescriptions.[2] However, analysis by health insurers suggest that patient co-payment requirements can be reduced to $0 with little or no improvement in long-term adherence rates.
Prescription medical claims records are commonly used to estimate medication adherence based on fill rate. Patients are routinely defined as being 'Adherent Patients' if the amount of medication furnished to the patient is at least 80% based on days supply of medication divided by the number of days patient should be consuming the medication. This quantity is defined as the medication possession ratio (MPR). However, recent work by several investigators has suggested that MPR of 90% or above may be a better threshold for deeming consumption as 'Adherent'.[45]
Course completion[edit]
Once started, patients seldom follow treatment regimens as directed, and seldom complete the course of treatment.[5][6] In respect of hypertension, 50% of patients completely drop out of care within a year of diagnosis.[46] Persistence with first-line single antihypertensive drugs is extremely low during the first year of treatment.[47] As far as lipid-lowering treatment is concerned, only one third of patients are compliant with at least 90% of their treatment.[48]
As mentioned previously, the World Health Organization (WHO) has estimates that only 50% of people complete long-term therapy for chronic illnesses as they were prescribed, which puts patient health at risk.[49] For example, statin compliance drops to between 25-40% after two years of treatment, with patients taking statins for what they perceive to be preventative reasons being unusually poor compliers.[50]
A wide variety of packaging approaches have been proposed to help patients complete prescribed treatments. These approaches include formats that increase the ease of remembering the dosage regimen as well as different labels for increasing patient understanding of directions.[51][52] For example, medications are sometimes packed with reminder systems for the day and/or time of the week to take the medicine.[51] With the objective to support patient adherence to medicinal therapy, a not-for-profit organization called the Healthcare Compliance Packaging Council of Europe (HCPC-Europe) was set up between the pharmaceutical industry, the packaging industry and representatives of European patients organizations. The mission of HCPC-Europe is to assist and to educate the healthcare sector in the improvement of patient compliance through the use of packaging solutions. A variety of packaging solutions have been developed by this collaboration to aid in patient compliance.
The failure to complete treatment regimens as prescribed has significant negative health impacts worldwide.[1] Examples of the rate and consequences of non-compliance for selected medical disorders is as follows:
Asthma non-compliance (28-70% worldwide) increase the risk of severe asthma attacks requiring hospitalization.
200,000 new cases of cancer are diagnosed each year in the UK. One in three adults in the UK will develop cancer that can be life-threatening, and 120,000 people will be killed by their cancer each year. This accounts for 25% of all deaths in the UK. However:[citation needed]
- 90% of cancer pain can be effectively treated, yet only 40% of patients adhere to their medicines due to poor understanding.[citation needed]
The reasons for non-adherence have been given by patients as follows:
- The poor quality of information available to them about their treatment.[citation needed]
- A lack of knowledge as to how to raise concerns whilst on medication.[citation needed]
- Concerns about unwanted effects.[citation needed]
- Issues about remembering to take medication.[citation needed]
Partridge et al (2002) [53] identified evidence to show that adherence rates in cancer treatment are variable, and sometimes surprisingly poor. The following table is a summary of their findings:
Type of Cancer | Measure of non-Adherence | Definition of non-Adherence | Rate of Non-Adherence |
Haematological malignancies | Serum levels of drug metabolites | Serum levels below expected threshold | 83% |
Breast Cancer | Self-report | Taking less than 90% of prescribed medicine | 47% |
Leukemia or non Hodgkin's lymphoma | Level of drug metabolite in urine | Level lower than expected | 33% |
Leukemia, Hodgkin's disease, non Hodgkin's | Self-report and parent report | More than one missed dose per month | 35% |
Lymphoma, other malignancies | Serum bioassay | Not described | |
Hodgkin's disease, acute lymphocytic leukemia (ALL) | Biological markers | Level lower than expected | 50% |
ALL | Level of drug metabolite in urine | Level lower than expected | 42% |
ALL | Level of drug metabolites in blood | Level lower than expected | 10% |
ALL | Level of drug metabolites in blood | Level lower than expected | 2% |
- Medication event monitoring system - a medication dispenser containing a microchip that records when the container is opened and from Partridge et al (2002)
Other trials evaluating Tamoxifen as a preventative agent have shown dropout rates of around one-third:
- 36% in the Royal Marsden Tamoxifen Chemoprevention Study.[54]
- 29% in the National Surgical Adjuvant Breast and Bowel Project.[55]
According to correspondence in the Lancet in March 1999,[56] the "Adherence in the International Breast Cancer Intervention Study" (evaluating the effect of a daily dose of Tamoxifen for five years in 'at risk' women aged 35–70 years) was:
- 90% after one year
- 83% after two years
- 74% after four years
Coronary heart disease[edit]
In one study, patients who did not adhere to beta-blocker therapy were found to be 4.5 times more likely to have complications of coronary heart disease than those who do comply.[citation needed]
- Diabetes non-compliance (98% in US) is the principal cause of complications related to diabetes including nerve damage and kidney failure.
- Among patients with Type 2 Diabetes, adherence is found in less than one-third of those prescribed sulphonylureas and/or metformin. Patients taking both drugs achieve only 13% adherence.[57]
- Hypertension non-compliance (93% in US, 70% in UK) is the main cause of uncontrolled hypertension-associated heart attack and stroke.
- In respect of anti-hypertensive therapy, only about 50% take at least 80% of their prescribed medications.[58]
Health and disease management[edit]
Patients with diabetes are at high risk of developing coronary heart disease and usually have related conditions that make their treatment regimens even more complex. These related conditions, such as hypertension, obesity and depression are also characterised by poor rates of adherence, and therefore exacerbate treatment outcomes.[59][60]
As a result of poor compliance, 75% of patients with a diagnosis of hypertension do not achieve optimum blood-pressure control.
There is a clear correlation between adherence with medication regimens and factors such as: relapse rates; hospitalisation rates; re-hospitalisation rates; incidence of serious unwanted events, including suicides; assaults or severe violence.
Non-adherent schizophrenic patients are over three times more likely to relapse than patients who take their medication. [61]
Survivors of stroke or heart attack frequently have disability and worse health:
- 15-50% of stroke patients suffer with major depression.[citation needed]
- 20% will go on to develop dementia as a result of the stroke.[citation needed]
- Faecal incontinence is common after a severe stroke, bringing stress to both the individual and the family.[citation needed]
- 5% will have untreatable severe pain, that dominates their life.[citation needed]
Improving compliance rates[edit]
Patients' adherence with their medication is poor across all chronic diseases, including coronary heart disease, mental health, diabetes and cancer. This poor adherence results in significant increase in illness, disability, symptoms and even death.
Care in choice of medicine by the prescribing physician, along with and the provision of greater information to the patient can improve compliance. For example, patients taking typical antipsychotics tend to experience more severe side-effects, and also receive less information about their illness, medicines and side-effects.[62] They were naturally more likely to be non-compliant than those receiving atypicals.
As more patient cohorts become adept at using technology in their daily lives, it will become easier to integrate technology into patient care and compliance. Already there are multiple opportunities to use technology to boost patient compliance rates, and make it easier for patients to become involved in their own care. As part of the push to encourage implementation of electronic health records in hospitals and private practices, the government has set "meaningful use" objectives and benchmarks. One such objective is the use of a patient portal, through which patients can securely view lab reports, request prescription refills, and ask questions of their providers - all of which can increase patient compliance with care plans.
Another medium to boost compliance is mobile technology. Both physicians and patients are using tablets, smartphones, and other devices in increasing numbers, all of which can be equipped with any number of medical apps to help with patient monitoring and compliance. Text-message reminders are increasingly being used to help with patient compliance; studies show that daily text messages sent to remind patients to take their medication have improved compliance rates and patient health - especially in younger patients with chronic illnesses such as diabetes, and young women who take contraceptives. [63] [64]
As telemedicine technology improves, physicians will have better capabilities to remotely monitor patients in real-time and to communicate recommendations and medication adjustments as the situation demands, rather than waiting until the next office visit. Telemedicine using personal mobile devices, such as smartphones, will become increasingly important for monitoring patients with chronic conditions such as cardiovascular disease and diabetes.[65]
Medication Event Monitoring Systems, in the form of smart medicine bottle tops (MEMS or eCAP), smart pharmacy vials (eCAP or GlowCap) or smart blister packages (Med-ic or Cerepak) are frequently used in clinical trial and other applications where exact compliance data are required. Such systems usually work without any patient input, and record the time and date the bottle or vial was accessed, or the medication removed from a blister package. The data can be read via proprietary readers, or NFC enabled devices, such as smartphones or tablets.
Patient information[edit]
In the UK millions of patients are given information at the point of dispensing to help them better understand their medicines, with measurable impact on patient compliance.
In the UK, a literature service and its pharmacy partners have together completed a 200,000 patient study into the effect of pharmacists providing to patients the information that patients want. The results of the survey show that where a pharmacist talks through the leaflet given to the patient, then there is an increase in adherence by between 16% and 33% within three months.[66]
This section does not cite any references or sources. (September 2013) |
Since then, millions of patients have been supported, and had measurable impact across the following therapy areas:
See also[edit]
- ^ a b c d e f g World Health Organization (2003). Adherence to long-term therapies: evidence for action (PDF). Geneva: World Health Organisation. ISBN 92-4-154599-2.
- ^ a b c "Out-of-pocket costs may be a substantial barrier to prescription drug compliance". Harris Interactive. Retrieved May 12, 2010.
- ^ "Medicines concordance (involving patients in decisions about prescribed medicines)". National Institute for Health and Clinical Excellence. 3 March 2008.
- ^ a b "Patient Compliance with statins". Bandolier. 2004.
- ^ a b c d "Enhancing Patient Adherence: Proceedings of the Pinnacle Roundtable Discussion". APA Highlights Newsletter 7 (4). October 2004.
- ^ a b c Ngoh LN (2009). "Health literacy: a barrier to pharmacist-patient communication and medication adherence". J Am Pharm Assoc (2003) 49 (5): e132–46; quiz e147–9. doi:10.1331/JAPhA.2009.07075. PMID 19748861.
- ^ Elliott RA, Marriott JL (2009). "Standardised assessment of patients' capacity to manage medications: a systematic review of published instruments". BMC Geriatr 9: 27. doi:10.1186/1471-2318-9-27. PMC 2719637. PMID 19594913.
- ^ Tilson HH (2004). "Adherence or compliance? Changes in terminology". Annals of Pharmacotherapy 38 (1): 161–2. doi:10.1345/aph.1D207. PMID 14742813.
- ^ Osterberg L, Blaschke T (2005). "Adherence to Medication". N Engl J Med 353 (5): 487–97. doi:10.1056/NEJMra050100. PMID 16079372.
- ^ Aronson JK (2007). "Compliance, concordance, adherence". Br J Clin Pharmacol 63 (4): 383–4. doi:10.1111/j.1365-2125.2007.02893.x. PMC 2203247. PMID 17378797.
- ^ Bell JS, Airaksinen MS, Lyles A, Chen TF, Aslani P (2007). "Concordance is not synonymous with compliance or adherence". Br J Clin Pharmacol 64 (5): 710–1. doi:10.1111/j.1365-2125.2007.02971_1.x. PMC 2203263. PMID 17875196.
- ^ US NIH Office of Behavior and Social Sciences Research (2008). "Framework for adherence research and translation: a blueprint for the next ten years".
- ^ Office of Behavior and Social Sciences Research. "Adherence Research Network". U.S. National Institutes of Health. Retrieved 12 May 2010.
- ^ Marinker and Shaw (15 February 2003). "Not to be taken as directed - Putting concordance for taking medicines into practice". BMJ 326 (7385): 348–9. doi:10.1136/bmj.326.7385.348.
- ^ "Dosing and compliance?". Bandolier 117. Figure 1. November 2003.
- ^ "Home page". Patient Connect. Retrieved 12 July 2013.
- ^ Dolder CR, Lacro JP, Leckband S, Jeste DV (2003). "Interventions to improve antipsychotic medication adherence: Review of recent literature". Journal of Clinical Psychopharmacology 23 (4): 389–399. doi:10.1097/01.jcp.0000085413.08426.41. PMID 12920416.
- ^ Oehl M, Hummer M, Fleischhacker WW (2000). "Adherence with antipsychotic treatment". Acta Psychiatrica Scaninavia 102 (Suppl. 407): 83–86. doi:10.1034/j.1600-0447.2000.00016.x.
- ^ Colom F, Vieta E, Martinez-Aran A, Reinares M, Benabarre A, Gasto C (2000). "Clinical factors associated with treatment non-adherence in euthymic bipolar patients". Journal of Clinical Psychiatry 61 (8): 549–555. doi:10.4088/JCP.v61n0802. PMID 10982196.
- ^ GINA Project (Global Initiative for Asthma) 2002.
- ^ "Enhancing Patient Adherence: Proceedings of the Pinnacle Roundtable Discussion". APA Highlights Newsletter. October 2004.
- ^ Ngoh LN (2003). "Health literacy: a barrier to pharmacist-patient communication and medication adherence". J Am Pharm Assoc 49 (5): e132–46; quiz e147–9. doi:10.1331/JAPhA.2009.07075. PMID 19748861.
- ^ Elliott RA, Marriott JL (2009). "Standardised assessment of patients' capacity to manage medications: a systematic review of published instruments". BMC Geriatr 9: 27. doi:10.1186/1471-2318-9-27. PMC 2719637. PMID 19594913.
- ^ Donald Acheson (1998). Independent inquiry into inequalities in health (Report).
- ^ Tackling health inequalities (Report). HM Government. 2002.
- ^ Park DC, Hertzog C, Leventhal H, Morrell RW, Leventhal E, Birchmore D, Martin M, Bennett J (1999). "Medication adherence in rheumatoid arthritis patients: older is wiser". Journal of the American Geriatric Society 47 (2): 172–183.
- ^ Williams J, Clemens S, Oleinikova K, Tarvin K (2003). The skills for life survey. A national needs and impact survey of literacy, numeracy and ICT skills. London: Department for Education and Skills
- ^ Williams J, Clemens S, Oleinikova K, Tarvin K (2003). "The skills for life survey. A national needs and impact survey of literacy, numeracy and ICT skills". London: Department for Education and Skills.
- ^ Cross-cutting government review, Tackling health inequalities. Department of Health and Treasury. 2000
- ^ UK Department of Health (2001): National Service Framework for Older People, London.
- ^ UK Office of Health Economics (2000): Compendium of Health Statistics, 12th Edition, London.
- ^ a b Cline CMJ, Bjorck-Linne AK, Israelsson BYA, Willenheimer RB, Erhardt LR (1999). "Non-adherence and knowledge of prescribed medication in elderly patients with heart failure". European Journal of Heart Failure 1 (2): 145–149. doi:10.1016/S1388-9842(99)00014-8. PMID 10937924.
- ^ Barat I, Andreasen F, Damsgaard EM (2001). "Drug therapy in the elderly: what doctors believe and patients actually do". British Journal of Clinical Pharmacology 51 (6): 615–622. doi:10.1046/j.0306-5251.2001.01401.x. PMC 2014493. PMID 11422022.
- ^ Mitchell WG, Scheier LM, Baker SA (2000). "Adherence to treatment in children with epilepsy: who follows 'doctor's orders'?". Epilepsia 41 (12): 1616–25. doi:10.1111/j.1499-1654.2000.001616.x. PMID 11114221.
- ^ Otero S, Hodes M (2000). "Maternal expressed emotion and treatment Adherence of children with epilepsy". Dev Med child Neurol 42 (9): 604–8. doi:10.1017/S0012162200001134. PMID 11034453.
- ^ Dolder CR, Lacro JP, Dunn LB and Jeste DV (2002). "Antipsychotic medication adherence: Is there a difference between typical and atypical agents?". American Journal of Psychiatry 159 (1): 103–108. doi:10.1176/appi.ajp.159.1.103. PMID 11772697.
- ^ Nosé M, Barbui C, Gray R, Tansella M (2003). "Clinical interventions for treatment non-adherence in psychosis: meta-analysis". British Journal of Psychiatry 183 (3): 197–206. doi:10.1192/bjp.183.3.197. PMID 12948991.
- ^ Courtenay WH, McCreary DR, Merighi JR (2002). "Gender and ethnic differences in health beliefs and behaviours". Journal of Health Psychology 7 (3): 219–231. doi:10.1177/1359105302007003216. PMID 22114246.
- ^ Meyerowitz BE, Richardson J, Hudson S, Leedham B (1998). "Ethnicity and cancer outcomes: behavioural and psychosocial considerations". Psychological Bulletin 123 (1): 47–70. doi:10.1037/0033-2909.123.1.47. PMID 9461853.
- ^ Prieto LR, Miller DS,Gayowski T, Marino IR (1997). "Multicultural issues in organ transplantation: the influence of patients' cultural perspectives on adherence with treatment". Clinical Transplantation 11 (6): 529–535. PMID 9408680.
- ^ Fischer MA, Stedman MR, Lii J, et al. (April 2010). "Primary medication non-adherence: analysis of 195,930 electronic prescriptions". J Gen Intern Med 25 (4): 284–90. doi:10.1007/s11606-010-1253-9. PMC 2842539. PMID 20131023.
- ^ Norton M (2010). "Many patients may not fill their prescriptions". Reuters Health. Retrieved May 12, 2010.
- ^ Shah NR, Hirsch AG, Zacker C, Taylor S, Wood GC, Stewart WF (February 2009). "Factors associated with first-fill adherence rates for diabetic medications: a cohort study". J Gen Intern Med 24 (2): 233–7. doi:10.1007/s11606-008-0870-z. PMC 2629003. PMID 19093157.
- ^ Shah NR, Hirsch AG, Zacker C, et al. (April 2009). "Predictors of first-fill adherence for patients with hypertension". Am. J. Hypertens. 22 (4): 392–6. doi:10.1038/ajh.2008.367. PMC 2693322. PMID 19180061.
- ^ Watanabe JH, Bounthavong M, Chen T. Revisiting the medication possession ratio threshold for adherence in lipid management. Curr Med Res Opin. 2013 Mar;29(3):175-80. doi: 10.1185/03007995.2013.766164. Epub 2013 Feb 1. PubMed PMID 23320610.
- ^ Mapes RE (1977). "Physicians' drug innovation and relinquishment". Social Science & Medicine 11 (11–13): 619–24. doi:10.1016/0037-7856(77)90044-0.
- ^ Hypertens 11: 2093–2100. Nov 23, 2005.
- ^ Sung JC, et al (Oct 1998). "Factors affecting patient compliance with antihyperlipidemic medications in an HMO population". Am J Manag Care 4 (10): 1421–30. PMID 10338735.
- ^ World Health Organization (2003). Adherence to long-term therapies: evidence for action. Geneva: World Health Organisation. ISBN 92-4-154599-2.
- ^ Jackevicius CA, et al (2002). "Adherence with statin therapy in elderly patients with and without acute coronary syndromes". JAMA 288 (4): 462–467. doi:10.1001/jama.288.4.462. PMID 12132976.
- ^ a b Heneghan CJ, Glasziou P, Perera R (2006). "Reminder packaging for improving adherence to self-administered long-term medications". In Heneghan, Carl J. Cochrane Database Syst Rev (1): CD005025. doi:10.1002/14651858.CD005025.pub2. PMID 16437510.
- ^ Shrank W, Avorn J, Rolon C, Shekelle P (May 2007). "Effect of content and format of prescription drug labels on readability, understanding, and medication use: a systematic review". Annals of Pharmacotherapy 41 (5): 783–801. doi:10.1345/aph.1H582. PMID 17426075.
- ^ Partridge AH, Avorn J, Wang PS, Winer EP (2002). "Adherence to therapy with oral antineoplastic agents". Journal of the National Cancer Institute 94 (9): 652–61. doi:10.1093/jnci/94.9.652. PMID 11983753.
- ^ Powels T, Eeles R, Ashley S, et al (1998). "Interim analysis of the incidence of breast cancer in the Royal Marsden Hospital Tamoxifen randomized chemoprevention trial". Lancet 352 (9122): 98–101. doi:10.1016/S0140-6736(98)85012-5. PMID 9672274.
- ^ Fisher B, Costantino JP, Wickerham DL, et al (1998). "Tamoxifen for prevention of breast cancer: report of the National Surgical Adjuvant Breast and Bowel Projects P-1 Study". Journal of the National Cancer Institute 90 (18): 1371–88. doi:10.1093/jnci/90.18.1371. PMID 9747868.
- ^ Cuzick J, Edwards R (1999). "Drop-outs in Tamoxifen prevention trials". Lancet 353 (9156): 930. doi:10.1016/S0140-6736(05)75043-1.
- ^ Donnan PT, MacDonald TM, Morris AD (2002). "Adherence to prescribed oral hypoglyacaemic medication in a population of patients with Type 2 diabetes: a retrospective cohort study". Diabetic Medicine 19 (4): 279–84. doi:10.1046/j.1464-5491.2002.00689.x. PMID 11942998.
- ^ David l, et al (1975). "Randomised clinical trial of strategies for improving medication compliance in primary hypertension". Lancet 305 (7918): 1205–7. doi:10.1016/S0140-6736(75)92192-3. PMID 48832.
- ^ Lustman PJ, Griffiths LS, Clouse RE (1997). "Depression in adults with diabetes". Seminars in Clinical Neuropsychiatry 2 (1): 15–23. doi:10.1053/SCNP00200015. PMID 10320439.
- ^ Ciechanowski PS, Katon WJ, Russo JE (2000). "Depression and diabetes: impact of depression symptoms pn adherence, function, and costs". Archives of Internal Medicine 27 (21): 3278–85. doi:10.1001/archinte.160.21.3278.
- ^ Fenton WS, Blyler CR and Heinssen RK (1997). "Determinants of medication adherence in schizophrenia: empirical and clinical findings". Schizophrenia Bulletin 23 (4): 637–51. doi:10.1093/schbul/23.4.637. PMID 9366000.
- ^ Hogman G, Sandamas G. A question of choice National Schizophrenia Fellowship. (2000)
- ^ Kurt Ullman, "Texting boosts OC compliance" MedPage Today, January 2012.
- ^ Adherely, "Existing Technologies" video verification tool for medical adherence in pharmaceutical clinical trials., January 2012.
- ^ Marisa Torrieri, "Patient compliance: technology tools for physicians" Physicians Practice, September 2012.
- ^ http://icarehealthit.com/wp-content/uploads/2013/03/White-Paper-Care-Coordination-and-Coaching.pdf


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F1 video special
We have plenty of videos from Sky Sports for you to enjoy ahead of the start of the F1 season in Australia this weekend.
F1 betting for the 2014 season, which starts in Australia on 16 March and finishes in Abu Dhabi on 23 November.
Lewis Hamilton (Mer) (5/2), Nico Rosberg (Mer) (7/2), Fernando Alonso (Fer) (8), Felipe Massa (Wil…
Lewis Hamilton (Mer) (6/4), Nico Rosberg (Mer) (7/2), Felipe Massa (Wil) (9), Valtteri Bottas (Wil…
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We have plenty of videos from Sky Sports for you to enjoy ahead of the start of the F1 season in Australia this weekend.
The Williams team can shock the established order by winning the season-opening Australian GP, says our F1 expert Tom Millard.
Tom Millard says the works Mercedes team can thrive in F1's new hybrid era with Lewis Hamilton our pick for the title.
Max Chilton is ready to end Marussia's points drought after becoming a fitness freak over the winter.
Lewis Hamilton feels his level of maturity will stand him in good stead for a tilt this year at a second F1 world title.
Claire Williams is hoping to strike a blow for Formula One's minnows this season.
Sebastian Vettel has warned his critics to write off at their peril his chances of winning successive world titles.
Pastor Maldonado is determined to prove he can keep his fiery temper in what promises to be a testing season.
Michael Schumacher is showing "small, encouraging signs" following his skiing accident in December.
Lewis Hamilton is itching to prove this is the season he can finally land his second Formula One world title.


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Reader Comments (Page 1 of 1)
@Lohkie: Actually, the tail is in a more accurate place on males than on females.
The tail is a continuation of the spine and would therefore be where a human tailbone is.
This was brought up in the comments of the female customization post. Just as I called it, if the tail were placed lower than how it is on the females, people would complain that it looks like it's coming from the butt:
IMHO, it's fine where is.


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Published December 08, 2010, 03:51 PM
Gattuso Murder Trial: Witness testimony ends after accused murderer is cross-examined for over 4 hours
Fargo, ND (WDAY TV) - After six days, witness testimony wrapped up today in the Fargo dentist murder-for-hire case. It was a discrepancy of stories in the courtroom, where Oklahoma man Michael Nakvinda is standing trial for murdering Philip Gattuso. The prosecution and defense cross-examined Nakvinda for 4-and-a-half hours.


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Family trip with African Sky Safaris
This is a discussion on Family trip with African Sky Safaris within the South Africa Hunting Reports forums, part of the Hunting Reports & Questions About Outfitters/PHs category; Last month my family and I did a Beginners Safari with African Sky Safaris. This was our first trip to ...
10-13-2013, 07:55 AM #1New Member
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Family trip with African Sky Safaris
Last month my family and I did a Beginners Safari with African Sky Safaris. This was our first trip to Africa
and we had an unforgettable time. The PH Jaco, lodge and lodge staff were excellent and they did a great
job putting us at ease after a long flight.
I have mainly hunted in the north east of the US for whitetail deer.
Going to all the different game farms and riding around in our own safari vehicle and seeing all the diversity
of game was a true adventure in itself.
I managed to get all of the trophies that I going for and then some. My seventeen year old daughter surprised
us and succeeded in not only taken her first trophy, a Blesbok, but also took a Blue Wildebeest, both with one
shot kills.
All in all, the entire trip was way too short and we would have liked to spend another week. Even my wife, who
doesn't hunt, loved getting up early every morning and going out on the game drives.
- Member of SCI, NRA, Associated Gun Clubs of Baltimore MD,MD State Rifle & Pistol Assn., MD Rifle Club
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Great to hear your first hunt went so well! You sound a lot like us: it was our first trip this year, we've hunted mainly whitetail & most importantly the trip was successful and fun!
We would like to hear more about African Sky Safaris as both my wife and I like to sightsee & hunt.
PS: would love to see some pictures.Last edited by BigSteve57; 10-13-2013 at 08:08 AM. Reason: clarification
I think, therefore I am paid.
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Congrats on your successful hunt !
Now we wait for the pics......
- Hunted USA , Canada, Botswana
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And you were able to share it with your family...nice!
When I am not hunting, I am thinking about hunting....I think I'll go hunting.
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gday steamman
glad to hear you and your family had a great time in Africa
congratulations mate
when are you going again
10-13-2013, 03:08 PM #6New Member
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Ok here are some pics. Also we stayed at the Bushveld secondary hunting lodge it was clean and very comfortable.
The staff made you feel right at home and like we were on are own private safari. The last day they had a BBQ which
included samples of the game we hunted, plus chicken just incase. African Sky Safaris may not be the cheapest
but we felt it was worth it and would use them again.
Attachment 22886Attachment 22887Attachment 22888Attachment 22889Attachment 22890
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Congrats Steamman on your family's great Safari and a BIG Congrats to your Daughter on her first trophies. The pictures didn't open for me you may have to load them again.
Enjoy life now -- it has an expiration date.
10-13-2013, 06:44 PM #8AH Member
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Congrats on a great safari! Photos will not open for me also.
10-13-2013, 07:30 PM #9New Member
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pictures second try.
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That worked.
Thanks for sharing your trophies.
Congratulations.Practice whispering before you leave for Africa!
A Legend in my own mind!
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nice animals steamman
the girl looks very happy with her prizes
thanks for showing us
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Thank you for posting your hunt report and trophy pictures steamman!
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If you enjoy this site then tell fellow hunters about it!
Our community is a place for seasoned African hunters and those who dream of someday hunting in Africa. I hope that you will find AfricaHunting.com a great place to spend time preparing for or dreaming about your future African hunting safari or reliving your last.
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Bushwack Safaris - South Africa
Mobile: +27 82 773 4099
Mail: email@example.com
Web: http://www.bushwacksafaris.co.za
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Congrats steamman, glad you had a great time!
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Chloë Sevigny, http://www.biography.com/people/chlo%C3%AB-sevigny-9542291 (last visited Mar 11, 2014).
Chloë Sevigny. The Biography Channel website. 2014. Available at: http://www.biography.com/people/chlo%C3%AB-sevigny-9542291. Accessed Mar 11, 2014.
Born in Springfield, Massachusetts, on November 18, 1974, actress Chloë Sevigny made her film debut in the 1995 feature Kids. She followed up with roles in less popular films. Critics related better to her next film, The Last Days of Disco (1998). She emerged in 1999 as one of Hollywood's most critically acclaimed young actresses. Beginning in 2006, she garnered more acclaim for her role as second wife to a polygamist husband in the HBO series Big Love.
Early Life
Chloë Sevigny was born on November 18, 1974, in Springfield, Massachusetts, and raised in Darien, Connecticut. While attending high school in the affluent suburb of Darien, she began spending a good deal of time in New York City's Greenwich Village, including Washington Square Park, a hangout for many rebellious teenagers and creative types.
Sevigny moved to New York City permanently when she was 18, and worked as an intern at the teen magazine Sassy. Sevigny's unconventional beauty and iconoclastic fashion sense led to some modeling jobs, including a gig with the chic design house Miu Miu, and appearances in the music videos of bands like Sonic Youth and the Lemonheads. By the mid-1990s, she had become a fairly recognizable face among members of the hip New York City subculture, culminating in the fall of 1994 with a lengthy feature article in The New Yorker by novelist Jay McInerney (Bright Lights, Big City) dubbing Sevigny the "coolest girl in the world."
Film Debut
She made her film debut in the controversial 1995 feature Kids, written by Harmony Korine, a young screenwriter she had met during her days in Washington Square Park. Sevigny (who provided some of the inspiration for Korine's screenplay) played a virginal teenager who contracts HIV from her first sexual encounter. She followed up on her much-talked-about performance in Kids with a supporting turn opposite actor Steve Buscemi in Buscemi's directorial debut, Trees Lounge (1996). In 1997, she starred--and acted as costume designer--in her on-and-off boyfriend Korine's first directorial effort, Gummo, the dark and disturbing story of Midwestern teenagers who amuse themselves by killing cats.
Critics (and audiences) related better to Sevigny's next film, The Last Days of Disco (1998), a clever chronicle of the active social lives of a group of affluent young New Yorkers in the early 1980s, written and directed by Whit Stillman. Also in 1998, Sevigny appeared in her first major commercial feature, the disappointing Palmetto, starring Woody Harrelson and Elisabeth Shue.
Commercial Success
Sevigny emerged in 1999 as one of Hollywood's most critically acclaimed young actresses, appearing in three films: Korine's characteristically edgy julien donkey-boy; the drama A Map of the World, starring Sigourney Weaver and Julianne Moore; and the emotionally charged Boys Don't Cry, based on a true story and starring Hilary Swank as Teena Brandon, a young Nebraska woman posing as a boy.
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Melissa and Doug's Sandwich Making Set! Stack your sandwich the way you like it, with these 16 wooden sandwich fixin's that make a satisfying ""crunch"" sound when the included wooden knife slices the pieces apart! Wooden storage tray included helps keep it all organized.
Dimensions: 1.75" x 9" x 13" Packaged
Recommended Ages: 3+ years


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It has become another summer rite of passage on Wollaston Beach. You have your typical beachgoers, bathing in the sun, some even venturing into the water. Fitness enthusiasts take advantage of the wide, paved sidewalks to walk, jog, rollerblade or bike next to the sea wall. Seafood lovers line up outside their favorite clam shack, whether it's The Clam Box, or Tony's Clam Shop.
Right in the middle of it all on Quincy Shore Drive is The Beachcomber, where Jim Sylvia wields a guitar most Saturday afternoons, taking a wide variety of requests as patrons sip their favorite beverage while enjoying the ocean breeze on the patio.
On a hot June day, Sylvia is again catering to the crowd, asking what they want to hear. When someone asks for John Mellencamp, Sylvia complies with "Pink Houses." As the song comes to an end, he receives a rousing ovation, but the requestor is not satisfied and has a specific Mellencamp tune in mind.
"What about "Jack and Diane"?" she yells.
"'Jack and Diane'? Sure, we can do that. Why not," Sylvia says with a shrug. And with that he's playing another Mellencamp song, much to the delight of the crowd.
It's all par for the course for Sylvia.
"I do this because I like to, not because I have to," says Sylvia. "If it became work, or something I needed to do, I wouldn't do it."
Sylvia's easygoing demeanor is a big reason why he has such a devoted following, but it appears to be a bit of a contrast to his intense approach to what was his day job. Sylvia served as a teacher at Hanover High School for 36 years, where he coached boys soccer for 27 years, hockey for 33 years, and just completed his 35th season coaching girls tennis.
He was named coach of the year for both soccer and hockey by The Boston Globe on several occasions, leading the hockey team to three state titles in 1997, 2001 and 2007. In 2010, he was inducted into the Massachusetts State Coaches Association Hockey Hall of Fame as part of an impressive class that also included Catholic Memorial's Bill Hanson, BC High's Joe McCabe, Dan Doyle of Lincoln-Sudbury, and Jack Heavey of Needham and Newton North. He stepped down as the coach for the soccer and hockey programs in 2011.
Retirement didn't entirely agree with Sylvia. He still serves as a substitute teacher, and he enjoyed being off in the fall, not having to coach soccer. He missed being away from the rink in the winter of 2011-12 though, so when Marshfield AD Lou Silva was looking for a new girls hockey coach, he asked Sylvia.
"He knew I had been looking to coach," said Sylvia. "So when he asked me if I'd be interested in coaching girls, I said 'Sure'."
Last winter Sylvia returned to the rink with the Marshfield High girls hockey team. Longtime assistant Butch Fonseca joined him behind the bench. The Rams had gone 5-13-2 the previous year, but in Sylvia's first season at the helm, they went 13-7 and qualified for the state tournament. He is already looking ahead to next winter.
"We're looking forward to making the program better and better," said Sylvia. "It's going to be something that takes a while, but we'll get through it together."
The transition from the boys game to girls has been a smooth one. Sylvia had experience coaching girls in the tennis program at Hanover, and his hockey team won the state title in 2001 with Globe All-Scholastic Marissa Hourihan in net. Still, there were minor adjustments to be made.
"It's a little bit different," said Sylvia. "But not much. It's still growing. The enthusiasm and dedication to the game the girls show is unbelievable."
Sylvia credits his love for hockey to his older brother Bob.
"My brother Bob was a big influence on me, as far as the game of hockey goes, and as everything else too," said Sylvia. "My father died when I was 18, and so Bob was like the father figure in the family. He's eight years older than I am, and he'll hate that I told you that," he adds with a laugh.
Until school begins again this fall, he's back playing the guitar. It's been a life-long passion, going back to his days growing up in Roslindale.
"My cousin, Jack McNulty, started playing the guitar, and we were very close," said Sylvia. "So I decided to give it a try."
He's been billed as a Jimmy Buffet cover act, and while he clearly is a big fan and plays a number of Buffet songs, Sylvia's repertoire is actually much more diverse. He can delve into country, playing contemporary artists like Kenny Chesney, Garth Brooks, and Toby Keith.
"I've always been a Jimmy Buffet fan," said Sylvia. "I've been a fan of Jimmy forever." Continued...


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Happy Holidays!!!!!!!!!! 2012 Holidays
Artist description:
May all members of RMD have a wonderful holiday. May you be blessed in the new year with all that is good. May you find joy and abundance!!!!!!!!!!!!!
Created Dec 24, 2012. Unless noted Copyright 2012
jeanette474 .
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Magic tree!Hope you had a groovy xmas and I hope you have a great 2012+1 :O)5/5
nice thoughts... we can only hope and have faith and all this wonderful thoughts back at you...
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- A Triptych - The Landing 2012 - Left Panel
A triptych - is a work of art which is divided into three sections. The middle panel is typically the largest and is flanked by two smaller works. The panel shown below is the left panel. - PLEASE JOIN ME ON MY NEW FACEBOOK PAGE FOR THE LATEST UPDATES ON MY WORK.


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SpacePilot PRO3DX-700036 SpacePilot™ PRO is the ultimate professional 3D mouse, engineered to excel in today's most demanding 3D software environments. Its breakthrough features include second generation QuickView Navigation technology, dual-function Intelligent Function Keys and at-a-glance access to important information via the full-color LCD Workflow Assistant. » Details |
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This page contains a "MLB 2K12 Teaser Trailer" for PSP and has been posted or updated on Jan 31, 2012 by EDF_Admin. Check this page periodically for the latest Video Game Trailers and Gameplay Videos.
- Developer: Visual Concepts
- Publisher: Take-Two Interactive
- Genre: Sports Traditional Baseball
- Release Date: Mar 6, 2012
- ESRB: Everyone
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This Southern Enterprises Chelmsford shoe bench is an organizer's dream. In espresso.
Product Features:
- Pull-out rattan drawers let you store your essentials.
- Machine-washable cotton cover eases cleaning.
Product Details:
- 20 1/2"H x 38"W x 16 1/4"D
- Wood/cotton
- Some assembly required
- By Southern Enterprises
- Manufacturer's 1-year limited warranty
- Model no. KL3104
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State of Conservation (SOC)
Sagarmatha National Park (2004)
UNESCO Extra-Budgetary Funds
International Assistance granted to the property
Requests Approved:0
Total Amount Ap proved:232,097USD
1999 | Donor Meeting for the Sagarmatha National Park | 7,000 USD |
1999 | Training of the Chief Warden of the Sagarmatha National Park | 8,202 USD |
1998 | Upgrading of interpretation displays and visitor amenities at the ... | 15,000 USD |
1983 | Reafforestation programme, improvement of the display at the ... | 10,000 USD |
1982 | Specialist services of an energy adviser and financial ... | 61,995 USD |
1981 | Financial contribution and specialist services for a ... | 54,900 USD |
1980 | Energy adviser, equipment and financial assistance for the ... | 75,000 USD |
Factors* affecting the property identified in previous reports
Tourism Pressure; Logging; Lack of human or financial resources; Lack of institution coordination.
Corrective Measures
Current conservation issues
The Department of National Parks and Wildlife (DNPWC) of Nepal, in a report attached to its letter of 27 January 2004 to the Centre, noted that the Nepal Civil Aviation Authority has confirmed in writing that it will remove equipment and other construction materials from the Syangboche airstrip inside Sagarmatha National Park. The excavator and materials will be airlifted to Kathmandu. The Civil Aviation authority was in the process of hiring an helicopter in late January 2004 to airlift the materials from Syangboche. IUCN has noted the information and has expressed satisfaction with the action taken by the State Party to implement Committee decision 27 COM 7B.10. The report of the DNPWC does not however, address other issues raised by the Committee at its last session, e.g. enhanced co-operation with local stakeholders.
Analysis and Conclusion
Link to the decision
The World Heritage Committee,
1. Commends the State Party for taking the necessary action to halt the construction
of the Syangboche airstrip project and to remove the equipment and construction
materials brought into the Park for the project;
2. Requests the State Party to enhance co-operation with local stakeholders.Draft Decision: 28 COM 15B.16
The World Heritage Committee,
1. Commends the State Party for taking necessary action to halt the construction of the Syangboche airstrip project and to remove the equipment and construction materials brought into the Park for the project;
2. Requests the State Party for taking necessary actions to enhance cooperation with local stakeholders.
Original DocumentsWHC-04/28.COM/15B
Other Documents
View inscribed site documents, nomination file, reports, decisions, ...
Word File
SOC model
* :
The threats indicated are listed in alphabetical order; their order does not constitute a classification according to the importance of their impact on the property.
Furthermore, they are presented irrespective of the type of threat faced by the property, i.e. with specific and proven imminent danger ("ascertained danger") or with threats which could have deleterious effects on the property's Outstanding Universal Value ("potential danger").
** : All mission reports are not always available electronically.


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Average Customer Review: based on 1 reviews. Rating: Great Shirt Reviewer: Chris Garven, - View all my reviews Very nicew ..runs a tad small Did this Review help? No Yes 59 out of 116 people found this review helpful.
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Perhaps people are become more resource aware. I have decided not to put up our Christmas lights this year. Sure, they look nice. But should I really be wasting more resources and pumping more greenhouse gases into the atmosphere just cos 'they look nice'??
And don't even get me started on water. I have turned into a real water nazi in the last couple of months.


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This Luxury HighRise Bldg is on the second round rentals Has any Amenities you can think of. 24 Hr Doorman,
Full Accessorize Fitness center. Lounge. Game room. Available Mac with free Wi-Fi. Conference Room. Dog Park Yoga Room. Sauna. Screening Theater. Laundry Room. Roof Deck with available Grill. Tanning Spots. and More.
Large 2 Bedrooms Apt. Luxury kitchen with Top of the line S/S appliances (Dishwasher)
2 Separate bedrooms with Excellent Closets space.
High windows. Great Natural light! Private Balcony. W/D Hook up. Large coat closets and more.
Located at a busy street less then 2 blocks to the 2 3 trains. Bank, Market, Coffee Shops and more off the block.