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Access to, and uptake of, antiretroviral therapy in a developing country with high HIV prevalence: a population-based cohort study in rural Uganda, 2004–2008
Article first published online: 30 JUL 2012
DOI: 10.1111/j.1365-3156.2012.02942.x
© 2012 Blackwell Publishing Ltd
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How to Cite
Kazooba, P., Kasamba, I., Baisley, K., Mayanja, B. N. and Maher, D. (2012), Access to, and uptake of, antiretroviral therapy in a developing country with high HIV prevalence: a population-based cohort study in rural Uganda, 2004–2008. Tropical Medicine & International Health, 17: e49–e57. doi: 10.1111/j.1365-3156.2012.02942.x
Publication History
- Issue published online: 30 JUL 2012
- Article first published online: 30 JUL 2012
- Abstract
- Article
- References
- Cited By
- antiretroviral therapy;
- Uganda;
- access and uptake;
- cohort study
Objectives To investigate antiretroviral therapy (ART) uptake after its introduction in 2004 in a longitudinal population-based cohort and its nested clinical cohort in rural Uganda.
Methods A HIV serosurvey of all adults aged ≥15 years is conducted annually. Two intervals were selected for analysis. Interval 1 (November 2004–October 2006) provided 2 years of follow-up to prospectively evaluate access to HIV services. Interval 2 (November 2007–October 2008) was used to evaluate current coverage of services. Logistic regression was used to identify sociodemographic factors associated with ART screening within 2 years of diagnosis. ART coverage was assessed using Weibull survival models to estimate the numbers needing ART.
Results In Interval 1, 636 HIV-positive adults were resident and 295 (46.4%) knew their status. Of those, 248 (84.1%) were screened for ART within 2 years of diagnosis. After adjusting for age, those who were widowed, separated or never married were more likely to be screened than those who were married. In Interval 2, 575 HIV-positive adults were residents, 322 (56.0%) knew their status, 255 (44.3%) had been screened for ART and 189 (32.9%) had started ART. Estimated ART coverage was 66%.
Conclusions In this cohort, ART access and uptake is very high once people are diagnosed. Owing to intensive screening in the study clinic, nearly all participants who were eligible initiated ART. However, this is unlikely to reflect coverage in the general population, intensified efforts are needed to promote HIV testing, and ART screening and uptake are needed among those found to be HIV-positive.
Antiretroviral therapy (ART) has led to the improved health of many HIV-infected people and is a cost-effective intervention, as it makes HIV infection a chronic manageable disease, allowing HIV-infected people to live well and to be socially and economically active (Badri et al. 2006). While globally, the number of adults and children living with HIV increased from 29 million in 2001 to 33.4 million in 2008, the number of HIV-related deaths rose only from 1.9 million to 2 million over the same period, largely due to ART scale-up (UNAIDS/WHO, 2009).
There are many challenges in meeting the demand for ART in sub-Saharan Africa (Loewenson & McCoy 2004), the region most badly affected by HIV, with 70% of the world's HIV-related deaths (UNAIDS/WHO, 2009). At the end of 2008, an estimated 44% of adults and children (nearly 3 million people) in need of ART in sub-Saharan Africa were receiving it (UNAIDS/WHO 2009). Barriers to ART access and uptake in Africa include misperceptions, distance to the ART providers and fear of side-effects of divorce or rejection by spouses, of stigma following HIV serostatus disclosure to friends and relatives, and of taking medicines for life (Murray et al. 2009).
Information on ART access and uptake is important in planning comprehensive HIV care services. Overcoming particular barriers to ART access among hard-to-reach populations, including those in rural areas (Zachariah et al. 2006), is critical if countries are to achieve universal access to ART. A longstanding population-based cohort in rural Uganda and its nested clinical cohort provided the opportunity to assess ART access and uptake and to investigate possible associated demographic factors.
Study setting
Adult HIV prevalence in Uganda fell from a peak of around 15% in 1991 to 5% in 2001 (Uganda STD/AIDS Control programme 2002) with recent signs of a possible resurgence (Uganda AIDS Commission 2007). An open general population cohort in rural southwest Uganda was established in 1989 for HIV surveillance, and now comprises approximately 20,000 residents of 25 neighbouring villages about 30 km from Lake Victoria. There are no tarmac roads, and access may be difficult during the rains. The population is ethnically homogeneous with most people belonging to the Baganda tribe and 15% being of Rwandese origin (Nakibinge et al. 2009). Half the population is under 15 years of age. HIV prevalence in the study area declined from 8.5% in 1990 to 6.2% in 1999/2000, but thereafter rose to 7.7% in 2004/2005 (Shafer et al. 2008).
Population cohort and annual HIV serosurvey
Full details of the population cohort and annual HIV serosurvey have been published elsewhere (Mulder et al. 1994; Mbulaiteye et al. 2002). In brief, household surveys of consenting participants aged at least 13 years have been conducted annually since 1989, with all study village residents eligible for inclusion. Consenting residents are interviewed at home in the local language by trained survey staff and provide a blood sample for HIV testing. Survey rounds begin in November and end in October the following year. Participants are also encouraged to attend one of the five free voluntary counselling and testing (VCT) centres provided by the research programme in the study villages and at the study clinic. During the survey, participants are asked if they would like to receive their HIV test results, and if they have ever received their results in the past. Participants who indicate that they would like to receive their test result are referred to the VCT centres, where they are informed of their result and counselled. Diagnosis of HIV infection (i.e. having a test and learning the result) is the first step in access to ART.
Clinical cohort
The clinical cohort has been described in detail elsewhere (Morgan et al. 1997). In brief, in 1990, a random selection of one-third of the HIV-positive adults identified in the first population cohort HIV serosurvey were invited to join a clinical cohort as prevalent cases. In addition, all adult HIV seroconverters identified during subsequent annual serosurveys were invited to enrol in the clinical cohort as HIV incident cases. HIV-negative controls randomly selected from the population cohort to match the age and gender of the HIV prevalent and incident cases, were also invited to enrol. Study clinicians were initially blinded to the participants' HIV serostatus and were un-blinded in 2004 when ART was introduced. As participants who consent to the annual HIV serosurvey may opt not to know their HIV serostatus, some of those invited to enrol are unaware of their HIV serostatus and are therefore encouraged to access VCT at the centres in the study area and at the study clinic. Consenting individuals are enrolled in the clinical cohort and attend medical follow-up visits at the study clinic every 3 months. In January 2004, HIV care in the clinical cohort was extended to include ART provision for eligible and consenting participants.
Other HIV-positive individuals from the population cohort who present at the study clinic with symptoms and signs of HIV infection and those identified through the VCT centres are offered ART care, if eligible. These individuals are also invited to enrol in the clinical cohort. The study clinic is the only ART provider in the area (ART is not provided at the local government health centre or at the VCT centres). It is likely that very few individuals from the study population who are eligible for ART obtain it from other providers, as these are outside of the area (the nearest about 10 km away), and reaching them requires substantial efforts in time and transport costs.
ART initiation
HIV-positive participants in the clinical cohort who know their HIV status undergo regular 3 monthly follow-up, including screening for ART eligibility according to national guidelines: CD4 count ≤200 cells/mm3 regardless of WHO clinical stage, WHO clinical stage 4 irrespective of CD4 count; persistent or recurrent WHO clinical stage 3 disease irrespective of CD4 count; and pregnant women with CD4 count ≤250 cells/mm3 (Uganda Ministry of Health 2003).
Intensive preparations for HIV-positive patients eligible for ART include three counselling visits, a medical examination and identification of a treatment adherence supporter. On starting ART, patients are seen at the clinic after 2 weeks, 4 weeks and then at 3-monthly intervals, or more often in case of interim illnesses or drug side-effects. First line treatment consists of a combination of zidovudine (AZT), lamivudine (3TC) and nevirapine (NVP), with the possibility of switching to stavudine (d4T) in case of AZT toxicity, and to efavirenz (EFZ) in case of NVP toxicity or concurrent tuberculosis treatment. Participants who are not yet eligible for ART start cotrimoxazole prophylaxis and receive an appointment for re-screening for ART eligibility.
Laboratory methods
HIV serostatus was determined by two independent enzyme immunoassays (EIA) 5 (College of American Pathologists, 325 Waukegan Road, Northfield Illinois 60093-2750 USA) using a parallel set algorithm, with Western blot to resolve discordance between EIA results (Nunn et al. 1993). CD4 cell counts were measured using the FACS Count machine (Becton Dickinson, San Jose, CA, USA).
Statistical methods
Data were analysed using Stata 10 (StataCorp, College Station, TX, USA). All adult participants (defined as aged ≥15 years) were included in the analysis if they had tested HIV-positive at any annual HIV survey, and were resident in the study area during the selected survey. Two intervals were selected for analysis: Interval 1 from November 2004 to October 2006 (i.e. the 2004/5 and 2005/6 surveys) and Interval 2 from November 2007 to October 2008 (i.e. the 2007/8 survey). As complete data on HIV services were not available after 2008, Interval 1 was chosen as a period after the early phase of ART introduction which allowed at least 2 years of follow-up to prospectively evaluate access to HIV care. Interval 2 was chosen as the most recent period for which complete information was available to estimate the current number who were HIV-infected, and who had accessed care and treatment.
Records were obtained from all VCT centres in the study villages of all participants who had received their HIV test results between January 2004 and the end of 2008. ART screening records from the clinical cohort were used to identify those participants who had received their HIV results from the study clinic, as all persons who receive their results in the clinic are screened for ART eligibility.
HIV diagnosis was defined as receiving one's positive test result (either through a VCT centre or the study clinic). Individuals who reported receiving their results since testing HIV-positive in a serosurvey, but for whom there was no record at the VCT centre, were also considered to have been diagnosed. The date of diagnosis was defined as the earliest of the date of recorded VCT, ART screening or reported receipt of a positive result.
Interval 1 was used to explore factors associated with ART screening within 2 years of diagnosis. HIV-positive participants who had been diagnosed (i.e. received their positive test result) by end 2006 were followed prospectively to assess those who had been screened within 2 years of their diagnosis. Participants who died or moved away after their diagnosis were included in the analysis.
Cross-tabulations and chi square tests were conducted to assess associations between socio-demographic characteristics and being screened for ART within 2 years of diagnosis. Logistic regression was used to estimate crude and adjusted odd ratios (OR) and 95% confidence intervals (CI) for the associations between socio-demographic characteristics and ART screening. Age was included as an a priori confounder. Factors whose age-adjusted association with screening reached P < 0.20 were included in a multivariable model; those that remained associated at P < 0.10 were retained.
Interval 2 was used in calculating the proportion of HIV-infected participants still alive who had been diagnosed since the introduction of ART in 2004, and the proportion of those diagnosed who had been screened for ART eligibility. ART uptake was calculated as the proportion of those diagnosed and found eligible after screening who initiated ART. HIV-infected participants who had died or moved away before the 2007/8 HIV survey were excluded from the analysis.
Interval 2 was also used in estimating ART coverage relative to ART need, based on the 2003 Uganda Ministry of Health treatment guidelines (CD4 count threshold of 200 cells/mm3). Coverage is defined as the number of individuals receiving ART at a point in time divided by the number of individuals who are eligible to receive treatment at the same point in time (including those who are already receiving ART) (Mahy et al. 2010). A Weibull model was used to estimate age-specific mortality among all HIV-positive adults in the population cohort in the absence of ART. The Weibull regression parameters were used to construct an age-based model life table to calculate the conditional probability of survival to the age of ART need from the age at seroconversion, or from the age at the first positive HIV test in prevalent cases (Zaba et al. 2012). The date of seroconversion was calculated as the midpoint between the last documented negative HIV test and the first documented positive HIV test. Estimates of the number of participants needing ART at the end of 2008 were generated using survival time post-infection with the assumption that HIV-positive participants need ART approximately 3 years before otherwise expected death in the absence of ART (Schneider et al. 2004; Zwahlen 2008).
Ethical approval
The study was part of a programme of research approved by the Science and Ethics Committee of the Uganda Virus Research Institute and the Uganda National Council of Science and Technology, and all participants gave informed consent.
During Interval 1 (the 2004/5 and 2005/6 surveys), 636 HIV-positive adults were resident in the study area, and by the end of 2006, 295 (46.4%) had been diagnosed (received their test results). Most (N = 201, 68.1%) had first received their positive result at the study clinic – the other 94 (31.9%) had received their result at a VCT centre (Table 1). However, 36 of those who reported receiving their results at a VCT centre had no confirmed record of diagnosis. The majority of those diagnosed were women (N = 178, 60.3%), aged between 25 and 44 years at the time of diagnosis, and had completed primary education or higher. Among those diagnosed, 248 (84.1%) had been screened for ART eligibility within 2 years of diagnosis. Of the 47 who had not been screened within 2 years, 10 (21.3%) had moved out of the study area after their diagnosis and 7 (14.9%) had died.
| |
Gender | |
Men | 117 (39.7) |
Women | 178 (60.3) |
Age (years) at diagnosis | |
<25 | 30 (10.2 |
25–34 | 105 (35.6 |
35–44 | 106 (35.9) |
45+ | 54 (18.3 |
Marital status at diagnosis | |
Never Married | 14 (4.7) |
Married | 136 (46.1) |
Divorced/separated | 77 (26.1) |
Widowed | 62 (21.0) |
Not known | 6 (2.0) |
Education level at diagnosis | |
None | 34 (11.5) |
Primary 1–4 | 61 (20.7) |
Primary 5–7 | 114 (38.6) |
Secondary or higher | 54 (18.3) |
Unknown | 32 (10.8) |
Tribe | |
Baganda | 191 (64.7) |
Non-Baganda | 95 (32.2) |
Unknown | 9 (3.1) |
Location of first HIV diagnosis | |
Study clinic | 201 (68.1) |
VCT centre | 94 (31.9) |
Has confirmed record of diagnosis | |
Yes, from study clinic | 240 (81.4) |
Yes, from VCT centre | 19 (6.4) |
No (self report only) | 36 (12.2) |
Year of first diagnosis | |
<2004 | 14 (4.7) |
2004 | 188 (63.7) |
2005 | 40 (13.6) |
2006 | 53 (18.0) |
Screened for ART eligibility within 2 years of diagnosis | |
No | 47 (15.9) |
Yes | 248 (84.1) |
CD4 count category at first ART screening† | |
<=250 | 143 (57.7) |
251–600 | 67 (27.0) |
>=601 | 38 (15.3) |
Among the 295 HIV-positive participants in Interval 1 who were diagnosed by end 2006, there was some evidence in the unadjusted analysis that participants who were married were less likely to be screened for ART within 2 years of diagnosis (Table 2). No other sociodemographic factors were associated with screening in the unadjusted analysis. After adjusting for age as an a priori confounder, there was still some evidence of an association with marital status. Widowed, separated or never-married participants were more likely to be screened than married participants (adjusted OR = 2.72, 95% CI = 0.98–7.58, for widowed vs. married; adjusted OR = 4.97, 95% CI = 0.57–43.5 for never married vs. married). There was no evidence of an independent association between other the socio-demographic factors and screening for ART. Furthermore, the unadjusted and adjusted ORs were similar, indicating no important confounding of sociodemographic factors.
n screened/total HIV-positive & diagnosed (%) | Crude OR (95% CI) | Adjusted OR (95% CI)† | |
| |||
Gender | P = 0.66 | P = 0.78 | |
Men | 97/117 (82.9) | 1 | 1 |
Women | 151/178 (84.8) | 1.15 [0.61, 2.17] | 1.10 [0.56, 2.17] |
Age (years) at diagnosis | P = 0.70 | P = 0.65 | |
<25 | 23/30 (76.7) | 1 | 1 |
25–34 | 88/105 (83.8) | 1.58 [0.58, 4.25] | 1.86 [0.65, 5.33] |
35–44 | 91/106 (85.8) | 1.85 [0.67, 5.05] | 1.97 [0.66, 5.85] |
45+ | 46/54 (85.2) | 1.75 [0.56, 5.42] | 2.06 [0.62, 6.88] |
Marital status at diagnosis | P = 0.09 | P = 0.08 | |
Never married | 13/14 (92.9) | 3.37 [0.42, 26.9] | 4.97 [0.57, 43.5] |
Married | 108/136 (79.4) | 1 | 1 |
Divorced/separated | 64/77 (83.1) | 1.28 [0.62, 2.64] | 1.23 [0.59, 2.56] |
Widowed | 57/62 (91.9) | 2.96 [1.08, 8.07] | 2.72 [0.98, 7.58] |
Education at diagnosis | P = 0.49 | P = 0.43 | |
None | 27/34 (79.4) | 0.48 [0.15, 1.58] | 0.44 [0.13, 1.50] |
Primary 1–4 | 52/61 (85.3) | 0.72 [0.24, 2.18] | 0.69 [0.22, 2.11] |
Primary 5–7 | 92/114 (80.7) | 0.67 [0.20, 1.38] | 0.49 [0.18, 1.32] |
Secondary or higher | 48/54 (88.9) | 1 | 1 |
Tribe | P = 0.66 | P = 0.79 | |
Baganda | 159/191 (83.2) | 1 | 1 |
non-Baganda | 81/95 (85.3) | 1.16 [0.59, 2.30] | 1.10 [0.54, 2.24] |
During Interval 2 (the 2007/8 survey), 575 adults had tested HIV-positive in any annual HIV survey and were still alive and resident in the study area. Of those, 322 (56.0%) had been diagnosed (received their test results) and knew that they were HIV-positive. By the end of 2008, 255 of those diagnosed (79.2%) had been screened for ART. Among those screened, 191 (74.9%) had ever been eligible to initiate ART, and of those who were eligible, 189 (99.0%) had initiated ART. The proportion of participants diagnosed, screened and started ART by gender and age group are shown in Figures 1a,b.
Among the 575 HIV-positive participants resident in Interval 2, it was estimated that 274 (48%) were in need of ART, of whom 189 (69%) had initiated treatment by end 2008 (Table 3). Coverage was slightly lower in males than females (64%vs. 72%, respectively). Coverage varied with age, from 55% in those aged 15–24 years to 86% in those aged 35–44 years. However, among those aged 45 years and above, coverage was 63%. Coverage also varied with marital status, with the highest coverage in widowed persons (91%) and the lowest among the currently married (58%).
Number HIV-positive and resident | Number on ART | Estimated number needing ART | Estimated coverage (%) | |
| ||||
Overall | 575 | 189 | 274 | 69 |
Gender | ||||
Men | 214 | 70 | 109 | 64 |
Women | 361 | 119 | 166 | 72 |
Age (years) | ||||
15–24 | 79 | 11 | 20 | 55 |
25–34 | 188 | 47 | 81 | 58 |
35–44 | 186 | 84 | 98 | 86 |
45+ | 122 | 47 | 75 | 63 |
Current marital status | ||||
Never Married | 42 | 9 | 12 | 75 |
Married | 288 | 80 | 138 | 58 |
Divorced /separated | 158 | 57 | 77 | 74 |
Widowed | 87 | 43 | 47 | 91 |
Current education | ||||
None | 38 | 14 | 20 | 70 |
Primary 1–4 | 161 | 38 | 49 | 78 |
Primary 5–7 | 245 | 73 | 115 | 63 |
Secondary or higher | 131 | 42 | 62 | 68 |
Tribe | ||||
Baganda | 404 | 131 | 191 | 69 |
non-Baganda | 171 | 58 | 83 | 70 |
Based on 2003 Uganda national treatment guidelines (Uganda Ministry of Health 2003), estimated overall ART coverage in our rural programme was 69%, reflecting a high level of ART access and uptake, once people were diagnosed with HIV infection, but a low level of HIV diagnosis. Diagnosis of HIV infection was the main bottleneck in the successive steps that determine overall ART coverage: diagnosis of HIV infection, screening for ART eligibility and receiving ART. Our cross-sectional analysis of HIV-positive participants who were still resident in 2008 shows that slightly over half (56%) had been diagnosed (i.e. knew their HIV status). However, among those who were diagnosed, most (79%) had been screened for ART eligibility. Our prospective analysis of HIV-positive participants who were resident in 2004–2006 showed a similar picture – less than half had been diagnosed by end 2006, but among those who were diagnosed, 84% had been screened within 2 years of diagnosis.
The estimated 69% ART coverage in our programme is higher than the estimated 53% coverage for Uganda nationally in 2009 (WHO/UNAIDS/UNICEF, 2010) using the previous WHO guidelines that recommended ART initiation at CD4 count ≤200 cells/mm3 (WHO 2006). The results from our research programme with a long presence in the local community and an intensive screening approach represent 'best practice', and are therefore unlikely to be representative of those obtained nationally through routine service provision. A comparative analysis of ART access in four population-based HIV cohort studies in Africa found that coverage was higher in Masaka than in sites in Malawi, Tanzania and Zimbabwe (Wringe et al. 2012). A study in Malawi showed that those accessing care are those with the most advanced disease and the highest mortality in absence of treatment (Jahn et al. 2008). In our cohort, most people who were diagnosed with HIV attended the study clinic, and so were screened for ART eligibility at the time of diagnosis. However, in the general population, both HIV diagnosis and access to ART screening may be important bottlenecks in the coverage of HIV services. Further pressure on ART coverage will come with changes in policy, recommending that people living with HIV should start on ART with a CD4 count of 350 or 500 cells/mm3. Using a CD4 count of 350 as the threshold for treatment, an estimated 73% of HIV-positive individuals in our cohort in 2008 would be in need of ART, and coverage would be only 45%.
In designing interventions to improve ART coverage, it is important to know about the demographic factors affecting ART access and uptake, but there have been few studies. We have identified various factors associated with uptake of ART screening after diagnosis that could be targeted in developing strategies to improve HIV care programmes. After adjusting for age, we found that among people who had learned their HIV-positive status, married people were less likely to be screened for ART within 2 years than those who were never married, or who had been separated, divorced or widowed. Studies have demonstrated spousal barriers in the uptake of HIV services (De Paoli et al. 2004; Muula & Kataika 2008). Neither disclosure nor domestic violence was examined, but these concerns could contribute to the lower uptake of ART and screening services among married couples. The relatively low uptake of ART services among young people and married people indicates the scope for efforts to provide services that meet the needs of these groups. The need for ART is high among people with HIV who are married, in whom HIV prevalence is high (Government of Uganda 2010).
The main strength of our study is the ability to link population-level HIV data with information from the only ART provider in the study area, enabling us to assess the proportion of HIV-infected persons who have been diagnosed, screened and started on ART. Information on age-specific mortality and HIV incidence also enables us to estimate ART need among the HIV-infected population, providing a denominator, against which ART coverage can be calculated, disaggregated by socio-demographic variables of interest.
A limitation is that, unlike data collection in the clinical cohort study, data in the VCT centres are not routinely collected for analysis purposes, and so, the VCT data may be incomplete. Hence, we may have underestimated the proportion of participants who know their HIV status. An additional limitation is that our estimate of current access to HIV services is based on HIV-positive adults who were still alive during 2007/8, the most recent survey for which complete data on services was available. Thus, we will have missed people who died or moved away before the 2007/8 survey, and may be overestimating the proportion of adults in the study area who access HIV services.
The roll-out of free ART in Uganda started in 2004 and achieved an estimated 39% national coverage by 2009 (WHO/UNAIDS/UNICEF 2010) based on 2010 WHO guidelines that recommend ART initiation at a CD4 count of 350 cells/mm3 (World Health Organization 2010). The standard definition of ART coverage depends on set criteria for unmet need (Mahy et al. 2010), enabling comparison of coverage estimates that use the same eligibility criteria. However, the change in the WHO recommended CD4 count threshold for ART initiation from 200 to 350 cells/mm3 results in changes in coverage estimates, which may decrease even as countries enrol greater numbers of patients onto ART. Measures to complement the existing UNGASS definition of ART coverage may be useful, e.g. the enrolment ratio, in which the numerator is the number of individuals starting ART in a given year, and the denominator is the number of individuals becoming eligible for ART in the same year, according to the ART guidelines that are in place during that year (Johnson & Boulle 2011). This ratio of ART initiation to HIV progression provides a better reflection of recent programme performance and a robust measure that is less sensitive to changes in ART eligibility criteria.
Overall, ART coverage after 4 years of this rural programme was 69%, reflecting high ART access and uptake once people are diagnosed with HIV infection, but a low level of HIV diagnosis. At least half of HIV-infected participants may not know their status, even though in this setting, people have more opportunities to learn their status than in other rural areas in Uganda. However, once diagnosed, nearly all participants who were eligible for ART were started on treatment, owing to the intensive screening procedures in the study clinic. This very high uptake of ART is unlikely to reflect coverage in the general population. Intensified efforts are needed to promote HIV testing and ART screening and uptake among those found to be HIV-positive.
We are grateful to Sian Floyd, Jim Todd, Ally Wringe and Basia Zaba for their helpful comments on the manuscript. We acknowledge the contribution of the Alpha network in bringing together researchers to analyse their data and write up their results. The Alpha network is funded by Welcome Trust (grant 075886/Z/04/Z). The General Population Cohort receives financial support from the Medical Research Council (UK) through its core funding for the MRC/UVRI Uganda Research Unit on AIDS. The funders had no role in the design of the studies, data analysis, interpretation of results or writing of the manuscript.
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Five seniors may spearhead Mercy's basketball team, but lately head coach Keith Baisch has asked junior point guard Jessica Laemmle to take more of a leadership role.
Laemmle answered her coach Thursday night when she piled up 14 points, four assists, three rebounds and two steals while helping the host Jaguars defeat Bullitt East 64-54 in the 24th District championship game. It's the Jaguars' third straight district title and 19th in school history.
"I had to ge

subset: commoncrawl


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This was the first time I used PartsGeek. I was skeptical of ordering an auto part online at first. But after no luck finding one locally I thought I would chance ordering online. I was extremel...


text:
so apperantly there's a downside to being as fabulous, charming, handsome, smart, skilled and wise as i am, you have the ability to realize how wonderfully shallow and empty your life is.
i don't really want to say a lot today, just don't go thinking i'm some emo fucker who hates himself.
Cheer up emo boy. If your life had meaning aged 19 then it would probably mean you'd die when you were 25. Or it would mean you'd spawned and were obligated to your mewling kidlets for life. Or that you were being sent off to war.
I send virtual hugs to all emos in the world today.
It's a beautiful rainy day outside!
I decided to take a peek in the closet.
What a suprise to find myself hiding inside!
No one can make you feel inferior without your consent-Eleanor Roosevelt
Well the search for meaning is terribly overrated. I'd still sleep with you, and that is all that matters
"Sexual intercourse began in nineteen sixty-three (which was rather too late for me)"


text:
Iron Door Club
Plaque commemorating The Iron Door Club
Location | 13 Temple Street, Liverpool |
Owner | Geoffrey Hogarth and Harry Ormesher |
Type | Music club |
Genre(s) | Entertainment/night club |
Capacity | 1,650-1,900 |
Opened | 1960 |
Closed | 1964 |
Website | |
www.irondoorclub |
Coordinates: 53°24′25″N 2°59′17″W / 53.407°N 2.988°W
The Iron Door Club was a music venue at 13 Temple Street, Liverpool founded by Geoff Hogarth and Harry Ormesher.[1] It opened in May 1960 and closed in 1964.[2] The Searchers played there regularly[3] and it was the first venue where The Beatles played under that name (strictly, the name they used there on 15 May 1960 was "Silver Beetles", having played at Liverpool's Lathom Hall as the Silver Beats on the previous night).[4]
When the club first opened as licensed premises in 1960, it had a capacity of some 1,650 people. In 1963, the adjacent warehouse was acquired. The basement and the ground floors of the two buildings were opened up into single spaces.[1] After the club closed in 1964 the premises became the Pyramid Club.[1]
The Iron Door Club is also the name of a Derby-based band[5] which is inspired by 1960s bands such as The Searchers, who played at the original venue during its existence.
- ^ a b c McCormack, Peter. 'Just The Facts', Iron Door Club (3 October 2004). Retrieved 4 August 2007.
- ^ McCormack, Peter. 'The Iron Door Club Timeline', Iron Door Club (March 2007). Retrieved 4 August 2007.
- ^ McCormack, Peter. 'The Searchers History', Needles & Pins (2005). Retrieved June 18, 2005.
- ^ McCormack, Peter. '"Silver Beetles" Pass The Audition', Iron Door Club (19 October 2004). Retrieved 4 August 2007.
- ^ Iron Door Club (band) website
This article on a music performance venue is a stub. You can help Wikipedia by expanding it. |


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"They've turned over a lot of supervisors, and there has been discontinuity on the project. They haven't been able to put the manpower on the project they've needed."
Jim Widman
"You know you're old if they have discontinued your blood type"
Phyllis Diller
"When I was a boy on the Mississippi River there was a proposition in a township there to discontinue public schools because they were too expensive. An old farmer spoke up and said if they stopped building the schools they would not save anything, because every time a school was closed a jail had to be built."
Mark Twain
"He is so old that his blood type was discontinued."
George William Curtis
"We took a big hit when we discontinued our affiliate program in April."
Kristi Kaspar
"There were several times when it almost got discontinued."
David Dahlquist
"That was the one major factor that, when they discontinued its use, the numbers recovered."
Valerie Fellows


text: My family regularly goes here usually a big group of us for a celebration of some sort. We all love the atmosphere and food. There is a brilliant choice and all of our party is easily able to find something that they love. The staff here provide an excellent service and the price is very reasonable.


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Delevan Scout Building
Learn all aspects of the management of fish and wildlife.
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text: This airport is poorly laid out. After going through security, we were stuck in a very small round area with several gates. There was literally no where to go once past security. The food choices were poor and there was no where to sit. Also, we could not find a single charging area. In this day... read more


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Pronunciation: 洗浄剤
Added on: 2012-10-02
Listened: 1 times
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A work in progress
Jack ventured out of the hatch and into the harsh unforgiving wasteland, wondering what was ahead on the trail to Philadelphia. He knew this wasn't going to be easy and he still continued on. That, my friends, is the true example of a hero.
Submitted:Oct 15, 2009 Reads: 74 Comments: 0 Likes: 2
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Other writing by unitedairforce1 The aftermath (i might make a better title soon)
Action, Adventure, Fiction, Story, Death, Short, War, Fantasy, Romance, Life, Science, Thriller, Mystery, Murder, Guns, Love, Hero, Humor, Girl, Man, Blood, Survival, Violence


text:
Raiders get on roll late to pull back to .500 on season
An up-and-down season ended with an upswing for the Lake Park-Audubon volleyball team, as the Raiders were able to win their final five games of the regular season and eventually finish at .500 with a 13-13 mark.
"It was literally a team effort," said LP-A head coach Mike Summers. "I was pleased how the girls were able to fight back at the end of the season and start playing well."
The Raiders had six seniors in the lineup and all contributed in their own ways.
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12.04.2006—Organizers of the Sakai Foundation have said—and Blackboard Inc. itself now confirms—that a Blackboard representative will speak at the upcoming Sakai conference in Atlanta. Matthew Small, Blackboard's senior vice president and general counsel, will speak Dec. 6 at the conference in what is described as an "open discussion" with Eben Moglen of the Software Freedom Law Center.
As we reported previously, the Software Freedom Law Center (SFLC) last month filed a request with the United States Patent and Trademark Office (USPTO) to reexamine Blackboard's patent on "technology used for Internet-based education support systems and methods." It had filed that request on behalf of Sakai, Moodle and ATutor, developers of open-source e-learning solutions.
The SFLC has alluded to the threat of a monopoly on e-learning solutions with the Blackboard patent, and the organization's clients—including Sakai Foundation Chairman Joseph Hardin—have said that such a patent could stifle innovation in the education community.
Blackboard in July used its patent as the basis for a patent-infringement suit against competitor Desire2Learn, a commercial software developer. However, Blackboard's Matthew Small has said that his company does not have any desire to target open-source developers with such suits and that Blackboard is supportive of organizations like Sakai and Moodle.
Small told us last week, ""Because we brought a lawsuit against a for-profit competitor, people are worried that we'd bring lawsuits elsewhere. We've been very proactive in telling schools and the open-source community that we're not interested in them. [We] support Sakai and Moodle. We'd like to talk to them, engage with them, but they've said that they don't want to talk to us."
Now Blackboard and Sakai will have their chance. Wednesday Blackboard's Small and the SFLC's Moglen will meet in a discussion Dec. 6 during the lunch hour at S=the sixth-annual Sakai Conference in Atlanta.
Sakai's Hardin sent out a note to its developer list this weekend announcing the event.
"We are fortunate to have Matthew Small, attorney for Blackboard Inc, agree on short notice to attend the Atlanta Sakai conference. He will be speaking on Wednesday, [Dec. 6], at an open discussion session over the lunch hour with one of our keynote speakers, Eben Moglen, from the Software Freedom Law Center. We hope to have an open and informative discussion of the Blackboard patent and the recently filed SFLC re-examination petition that seeks to have it revoked."
We'll bring you more information on the event as it becomes available. In the meantime, you can read our previous coverage of the Blackboard/SFLC issue—with exclusive quotes from Blackboard—by following the link below.
More info:
About the author: Dave Nagel is the executive editor for 1105 Media's educational technology online publications and electronic newsletters. He can be reached at firstname.lastname@example.com.
Have any additional questions? Want to share your story? Want to pass along a news tip? Contact Dave Nagel, executive editor, at email@example.com.
About the Author
Executive Producer David Nagel heads up the editorial department for 1105 Media's education publications — which include two daily sites, a variety of newsletters and two monthly digital magazines covering technology in both K-12 and higher education.
A 21-year publishing veteran, Nagel has led or contributed to dozens of technology, art and business publications.
He can be reached at firstname.lastname@example.com. You can also connect with him on LinkedIn at linkedin.com/profile/view?id=10390192 or follow him on Twitter at @THEJournalDave (K-12) or @CampusTechDave (higher education). A selection of David Nagel's articles can be found on this site.
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Just what we were looking for. With two boys (7 & 5 years old) we were wanting a small, family place that was peaceful, secure with a kid-friendly pool. More than that we wanted a two bedroom self-contained apartment and a restaurant on-site, with fabulous Tuscan food and all you have to worry about is whether it should be red... More
Italy >
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San Vincenzo
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Number of rooms: 5


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Welcome to MountainViews
Find information for Irish hillwalking. Shared tracks, summit information etc.
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Showing 13 items:
Seefingan 722.9m,
Seahan 647.3m,
Corrig Mountain 617.1m,
2401, 53km
2383, 22km
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Knockmoyle: Highpoint of the plateau east of Coomavoher
Summit Summary
Collaborative entry
Last edit by: Onzy
a week ago
The highpoint of the western end of the Dunkerrons, situated to the north west of the vast plain overlooking Coomavoher. Knockmoyle also overlooks Coomura to the north east. It is an uninspiring t...
Survey of Greenane West, no longer a marginal Arderin.
Track 2874
3 weeks ago
Accessing the summits of Greenane West and Greenane from the walk, Length:15.5km, Climb: 719m, Area: Greenane, Galty Mountains (Ireland) Greenane, Gr
Mullaghmore.... or less..
Forum: Suggestions
a week ago
Pepe, having some jurisdiction over the addition of Local, Cultural and Historical Hills on this site, I can confirm that Mullaghmore would seems a worthy addition. This category of hills is somet...
Glendoo Mountain: Scenic loop around Glencullen
Summit Comment
a week ago
Saturday 31 May, 10.15am, as part of training for the HeadsUp 5 peaks challenge, decided to do Captain Vertigo's Track 2035 starting at Johnny Fox's pub. I can't match his poetic style but just a ...
Track 2810
a month ago
Iceland has many excellent trekking routes. But in winter a walk, Length:5.4km, Climb: 394m, Area: Iceland, East ()
Knocknagantee: Hill of the Conversations
Summit Summary
Collaborative entry
Last edit by: Onzy
a week ago
Knocknagantee is a high perch which looks out over Sneem to the Beara Peninsula and the Caha Mountains. The hill is particularly impressive to the east, where it looms over the peaceful Eagle's L...
Forum: General
2 weeks ago
I just thought this might interest some people.
A Summit Survey
Track 2836
a month ago
Passing through Kilkenny this will take an hour of your time walk, Length:4.5km, Climb: 119m, Area: Knockmannon Hill, South Midlands (Ireland) Knockm
Seefin: Megalithic Fallout Shelter
Summit Comment
a week ago
Wicklow Mountains - Megalithic tomb on Seefin Mt. http://youtu.be/u--BKEqB-JM
South West Iveragh
Track 2834
a month ago
Route over Eagles Hill and Mullaghbeg starting from partking walk, Length:12.9km, Climb: 575m, Area: Eagles Hill, Dunkerron Mountains (Ireland) Eagle
Mullaghclogha: There
Summit Comment
a week ago
I walked Mullaghlogha recently despite some difficult conditions. I parked near the cattle grid at the top of the Park Rd as most other spots had grit and salt piles set in them. From here it was ...
Coum Country North of Sneem
Track 2833
a month ago
A route from north of Sneem in Iveragh taking in four VLs; C walk, Length:13.9km, Climb: 915m, Area: Coomnacronia, Dunkerron Mountains (Ireland) Coom
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Dublin Mountains
More detail
Maximum height for area: 925 metres,
Summits in area: 111,
Maximum prominence for area: 905 metres,
OSI/LPS Maps: 28B, 49, 50, 55, 56, 61, 62, Extent1
For all tops
Highest summit:
Lugnaquilla, 925m
Summits in area Dublin/Wicklow:
Ballinacorbeg 336m
Ballinastraw 284m
Ballycurry 301m
Ballyguile Hill 188m
Ballyhook Hill 288m
Bray Head Hill 240m
Carrickgollogan 276m
Carrigeen Hill 298m
Carrigoona Commons East 242m
Cloghnagaune 385m
Corballis Hill 258m
Cupidstown Hill 379m
Dunranhill 342m
Eagle Hill 296m
Killeagh 249m
Killiney Hill 153.5m
Kilmichael Hill 267m
Kilnamanagh Hill 217m
Knockannavea 400.8m
Knockree 342m
Mount Kennedy 365.9m
Slieveroe 332m
Westaston Hill 270m
Dublin Mountains:
Corrig Mountain 617.1m
Glendoo Mountain 586m
Kippure 757m
Knocknagun 555m
Prince William's Seat 555m
Saggart Hill 395m
Seahan 647.3m
Seefin 620.6m
Seefingan 722.9m
Tibradden Mountain 467m
Two Rock Mountain 536m
Wicklow Mountains:
Annagh Hill 454m
Ballinacor Mountain 531m
Ballinafunshoge 480m
Ballineddan Mountain 652m
Ballycumber Hill 431m
Ballycurragh Hill 536m
Ballyteige 447m
Baltinglass Hill 382m
Barranisky 280m
Benleagh 689m
Black Hill 602.2m
Brockagh Mountain 557m
Brockagh Mountain SE Top 470m
Camaderry Mountain 698m
Camenabologue 758m
Camenabologue SE Top 663m
Carrick Mountain 381m
Carrickashane Mountain 508m
Carrigleitrim 408m
Carriglineen Mountain 455m
Carrigshouk 572.5m
Carrigvore 682m
Church Mountain 544m
Cloghernagh 800m
Collon Hill 238m
Conavalla 734m
Corriebracks 531m
Corrigasleggaun 794m
Croaghanmoira 664m
Croghan Kinsella 606m
Cushbawn 400m
Derrybawn Mountain 474m
Djouce 725m
Duff Hill 720m
Fananierin 426m
Gravale 718m
Great Sugar Loaf 501m
Keadeen Mountain 653m
Kirikee Mountain 474m
Knocknacloghoge 534m
Lakeen 357m
Little Sugar Loaf 342m
Lobawn 636m
Lugduff 652m
Lugduff SE Top 637m
Luggala 595m
Lugnagun 446m
Lugnaquilla 925m
Maulin 570m
Moanbane 703m
Moneyteige North 427m
Mullacor 657m
Mullaghcleevaun 849m
Mullaghcleevaun East Top 790m
Muskeagh Hill 397m
Preban Hill 389m
Scarr 641m
Seskin 344m
Silsean 698m
Sleamaine 430m
Slieve Maan 547.8m
Slievecorragh 418m
Slievefoore 414m
Slievemaan 759m
Sorrel Hill 599.5m
Spinans Hill 409m
Spinans Hill SE Top 400m
Stoney Top 714m
Stookeen 420m
Table Mountain 701.7m
Tinoran Hill 312m
Tomaneena 681m
Tonduff 642m
Tonelagee 817m
Tonelagee NE Top 668m
Trooperstown Hill 430m
War Hill 686m
Centre on map.
A name in Irish
(Ir. Suíochán [PWJ*], 'seat' )
, in
Arderin, Vandeleur-Lynam
, Dark slate-schist, quartzite & coticule
OS 1:50k
Mapsheet: 56
Grid Reference:
This summit has been logged as climbed by
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More detail
Longitude: -6.382208, Latitude: 53.216951
, Easting: 308120, Northing: 219697
Prominence: 93.8m,
Isolation: 1km
, Has trig pillar
, GPS IDs, 6 char: Seahan, 10 char: Seahan
Bedrock type: Dark slate-schist, quartzite & coticule, (Butter Mountain Formation)
Seahan has two megalithic cairns on its summit. Liam Price noted that Seahan appears on the Down Survey maps as Seavick na bantree and rightly interpreted this as Ir. Suidhe Mhic na Baintrighe, 'seat of the widow's son'. However, he believed that the story behind the name would never be understood: This curious name must have some reference to old traditions about the ancient burial cairns which crown the top of this mountain. All such traditions about this place have long ago disappeared (The Antiquities and Place Names of South County Dublin, Dublin Historical Record, vol. ii, no. 4, 121-33). While the precise story may never be recovered, it should be noted that Mac na Baintrí, the widow's son, is a common figure in Irish folktales whose characteristics are eternal persistence and ingenuity in the face of adversity. Seahan is the 200th highest summit in Ireland. Seahan is the third highest point in county Dublin.
Trackback: http://mountainviews.ie/summit/200/
COMMENTS for Seahan
Next page >>
Airy views over Kildare from this well positioned peak.
Short Summary created by simon3, wicklore, YoungJohn, 6 Nov 2011
Seahan is one of the four hills in the so called 'Circuit of Kilbride'. Kilbride Rifle Range is an Army range on the Dublin/Wicklow border and it is nestled in a valley surrounded by Seahan, Corrig, Seefingan and Seefin. In fact these summits mark the boundary of the Rifle Range (Although strictly speaking the boundary passes within 150 metres of Seahan's summit)
A minor road leads from Bohernabreena in Dublin past the entrance to the Range. Seahan can be reached from this road at
for example. At about 480 metres altitude this leaves a 160 metres climb to Seahan. There are remains of several megalithic tombs on Seahan. There are also good views towards Dublin and across to Seefingan and Seefin.
Because of the rather featureless nature of these hills it could be easy to become disoriented in poor weather which could mean an unintended descent into the Rifle Range. Seahan itself is generally ok underfoot, but the wider circuit includes some very wet and boggy cols. Also scramblers and quad bikes have churned up the bog in many places.
Trackback: http://mountainviews.ie/summit/200/comment/4960/
Picture from padodes : Faraway Hills
Faraway Hills
padodes on Seahan, 2009
1 Feb 2009
Looking southwards from Seahan, the hazy planes of several hills seem to overlap in the distance: Seefingan, Seefin, Sorrel. In reality, they form, together with Seahan, a wide arc, with Seefingan at 2.67 kms distance, Seefin at 3.52, and Sorrel at 8.70, as the crow flies. They are all linked, too, through the presence of megalithic cairns on each one. The distant mounds are perfectly visible in the photo, at least at full resolution, and are not exactly on the summit of each hill but slightly lower down to the west, facing out across the fertile plain that laps up against the hills of north-west Wicklow, along the borders with Kildare and Dublin.
The picture that archaeology provides of this area gives enormous added interest to walking in these hills. It takes us back to the development of farming in neolithic times, when organised communities cultivated here the lowland fringes of the central plain, yet buried their eminent dead in elaborate hilltop tombs. The similarities in construction and symbolism all point to a common social and religious outlook that one would love to be able to grasp.
As far as the hills themselves are concerned, one thing that leaves me pensive is the fact that, even at that early stage, the human impact on the terrain was already quite notable. From an examination of the pollen record preserved deep in the bog (and one such study was made precisely in the area between Seefin and Seefingan), there is evidence of the prehistoric clearance of trees for pasture and of the later burning of the moorland that replaced the woods. Today we complain of the ugly clear-felling of forest and the recurring summertime ritual of turning the heather to ashes, but, for better or for worse, these are things that have been carried on here in the hills for well over four thousand years!
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Picture from padodes : Sitting room
Sitting room
padodes on Seahan, 2009
2 Feb 2009
The name Seahan is said to come from 'Suíochán'. On the Down Survey map of 1655 and on Rocque's map of 1760, the mountain is called "Seavick na Bantree", an anglicisation that suggests the translation 'Seat (Suí) of the Widow's Son'. The word "Suí" in one combination or another keeps coming up in other hilltop names in this area as well (Seefin, Seefingan), and it clearly refers in each case to the large megalithic tombs on those mountains. If we remember that the old Fenian Cycle in Irish literature situates some of the heroic feats of Finn MacCool and the Fianna in nearby Glenasmole and the hills around, I think it's easy to understand how the popular imagination would see in these giant 'seats' the haunts of our Celtic supermen. Seefin (Suí Finn), just 3.5 kms to the south of Seahan, makes the association explicit.
There are no less than three megalithic tombs on Seahan. The cairn to the east is a passage tomb, over 21m in diameter, with a kerb of elongated granite stones. On top of the cairn can be seen the capstone (visible in the photo) over the central chamber. The second cairn, now topped with a trig pillar, is almost 24m in diameter and 2m high. It appears never to have been opened. A short distance further west lie the shattered remains of a wedge tomb – a kind of burial that is considered unusual above 300m.
Seahan can easily be included in a circuit that includes Corrig (the only top without a megalithic monument), Seefingan and Seefin. It's a walk I have recorded as being approximately 12 kms. The route practically follows the boundary line and, indeed, the stumpy granite boundary markers (one of which sits atop the cairn on Seefingan) around the military firing-range of Kilbride and loops back along the stretch of road in front of it. To enjoy this walk, you definitely need either a good dry spell beforehand, or preferably hard frost. Otherwise, be prepared to get an unpleasant sinking feeling along many a stretch.
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Picture from padodes : Resting in peace
Resting in peace
padodes on Seahan, 2010
9 Mar 2010
The OS sheet only indicates a cairn and megalithic tomb on top of Seahan, but there is also a wedge tomb only a stone's throw just west of these two. To my mind, it's the most photogenic of all three, despite the few shattered slabs that remain. It has had perhaps four thousand years of history wash over it and still resists. It has seen off the heroic huntsmen of the Fianna who allegedly roamed these hills and will see off too the mud-bespattered bikers who now rake up the earth around it. If you are looking for a little taste of timelessness, why not nestle down in the tomb and think yourself back into the mysterious world of the Neolithic chieftain who was once laid in it? Maybe the whisper you hear will not only be the rustle of the wind in the heather… Well, it's just a suggestion.
Normally such tombs were not built above 300m, but this one lies at twice that height. Considering the many other tombs that bedeck all of these hills, one might sometimes feel like being in a necropolis here. In the photo, you can see Seefingan on the left, with its cairn, and Seefin on the right, with its impressive passage grave. Those living in the plains below could never have felt that their dead were far away.
In the photo you can also make out in the distance the snowy top of Mullaghcleevaun, with its north-facing corrie.
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Picture from Harry Goodman : Seahan summit cairn
Seahan summit cairn
Harry Goodman on Seahan, 2010
Harry Goodman
5 Apr 2010
As I was in Dubin over the week-end I decided on Sat 6 Mar 2010 to tackle two of the 600m mountains in Dublin/Wicklow that I had not yet climbed, Seahan and Corrig Mountain. I followed the R114 towards Brittas and at the top of the incline at approx
turned left onto the L7462. As I did not have this reference before setting out I had some difficulty in locating this side road. I therefore give above directions for those who, like myself, are not regular walkers in the area. The start point for my walk was a forestry track some 3k along this side road, on the left at O 0
with parking for several cars. The track was covered in snow and ice and undulated along to a T junction
at a less well defined path where I turned right, steeply uphill, for a short walk to a fence and open hillside. From here I turned right along the track following the forest edge and made for Ballymorefin Hill, a "bump" on the way to Seahan. I was suprised to find the track was fence deep in snow and sought to make easier progress by moving across to more open ground on the hillside with less snow cover. There were constant views SE to Corrig as I climbed. At a point where the fence and forest edge swung to the right I continued SE to the cairned top of Seahan. The views south were dominated by Kippure and Seefingan, while Dublin and the lower hills above it were to the NE. From here it had been my plan to walk out and back to Corrig Mountain and then descend to the road by the forest edge and back to the start. However given the fine conditions on the day I decided, when I reached Corrig Mountain, to continue on and complete the full Circuit of Kilbride with walks over Seefingan and Seefin, two tops that I had previously climbed.
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Picture from Dessie1
Seahan Summit
25 May 2010
A very quick hike up Seahan starts the first of 4 mountains.Seahan,Corrig mt,Seefin and Seefingan
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Written by Michael Snyder
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Dec. '07
Branding for a new office block development in Perth, Western Australia
Studio: Braincells
Status: Nothing set
Commenting: Actively seeking critiques
ryantoyota said on Dec. 19 '07
You pulled this off nicely. I didn't even see the 18 at first, which I think is a good thing.
dache said on Dec. 20 '07
"Second result on google images":http://www.jcparra.com/EIGHTEEN-logo.jpg
Same, obvious concept with another font.
Same, obvious concept with another font.
smartinup said on Dec. 20 '07
while i think this is great, being a golfer, i have seen this before as well, sorry b3nder
bpotstra said on Dec. 21 '07
If this is for a logo to be used in Australia, there are already two similar logos in North America, so I'd say not to worry.
OcularInk said on Dec. 27 '07
To me, this concept has been used far too much to be appreciated. You've done a nice job creating it, but as a designer, it's our job to think outside of the box.
ddd said on Oct. 29 '08
This number to letters and back thing has been done to death. I like it and it is cool and all. But it is now way to cliche'.
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PlantFiles: Bulb Fennel, Sweet Fennel, Anise, Florence Fennel, Finnochio
Foeniculum vulgare var. azoricum 'Zefa Fino'
Family: Apiaceae (ay-pee-AY-see-ee) (Info) Genus: Foeniculum (fen-IK-yoo-lum) (Info) (fen-IK-yoo-lum) (Info) Species: vulgare var. azoricum Cultivar: Zefa Fino Synonym:Foeniculum azoricum One vendor has this plant for sale. 9 members have or want this plant for trade. Category: Height: Spacing: Hardiness: Sun Exposure: Danger: Bloom Color: Bloom Time: Foliage: Other details: Soil pH requirements: Patent Information: Propagation Methods: Seed Collecting: | Click thumbnail to view: By Weezingreens By Weezingreens By Michaelp By Xenomorf By Xenomorf By Xenomorf By Xenomorf There are a total of 14 photos. |
2 positives
1 neutral
No negatives
Gardeners' Notes:
This plant has been said to grow in the following regions:
Seward, Alaska
Phoenix, Arizona
Cape Coral, Florida
Baton Rouge, Louisiana
Hernando, Mississippi
Tualatin, Oregon
Clarksville, Tennessee
Boerne, Texas
Bryan, Texas
Fort Worth, Texas
Houston, Texas


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BoT urged to weaken rising baht
Big-business coalition cites harm to exports
- Published: 5 Feb 2013 at 00.00 | Viewed: 5,798 | Comments: 8
- Newspaper section: Business
- Writer: Piyachart Maikaew
The private sector is stepping up its pressure on the Bank of Thailand to ease the baht's strength, saying the central bank should look at the possibility of an interest rate cut and tax measures to cope with foreign capital inflows.
The Joint Standing Committee on Commerce, Industry and Banking (JSCCIB), which comprises the Federation of Thai Industries (FTI), the Thai Chamber of Commerce and the Thai Bankers' Association, met yesterday to discuss the impact of the strong baht, which was quoted yesterday at 29.75 baht against the US dollar.
JSCCIB chairman Payungsak Chartsuthipol said strong foreign capital inflows had strengthened the baht and short-term fluctuations had adversely affected exporters.
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She was there to collect an award for her outstanding humanitarian work. But all eyes were on Eva Longoria's stunning red dress as she as attended the Taomina Film Festival awards ceremony in Sicily on Tuesday evening. The 39-year-old actress stepped out to collect her award in a glamorous floor length red gown, the sweetheart neckline contrasted with a black mesh back which only served to emphasise the stars petite frame. ...read
Quite the sweetheart: Eva Longoria steps out in sweeping floor length red dress to collect award for humanitarian work at Taormina Film Festival
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Eva Longoria proved she is looking better than ever as she showed off her pins at an airport in Los Angeles on Thursday.
She wears it well! Eva Longoria dazzles in Victoria Beckham dress as she cosies up to the designer herself (and her BFF) on Global Gift Gala red carpet
And just like any best friend would do, Victoria Beckham could not help but come to show her support at the charity event at ME London on Tuesday evening.
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Over the weekend, Eva Longoria accidentally bared all in a teeny orange bikini on the beaches of Puerto Rico. So when she went back to New York City on Monday, she made sure to cover up her figure with two dresses that concealed her from neck to knee.
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text: POPSUGAR Pets POPSUGAR Celebrity The First Dog's First Press Conference The First Dog's First Press Conference by Pets 4/14/09 0 Shares Like us on Facebook Previous Photo 1 of 21 View on One Page ADVERTISEMENT ( more slides) Next Share This Link Copy 1 The First Dog's First Press Conference Previous Photo 1 of 21 View on One Page ADVERTISEMENT ( more slides) Next Get inspired with our daily newsletter Enjoy gorgeous decor ideas, fast and easy recipes, and more in your inbox. Vegetarian DIY Love & Sex Tech Home Food Sign up with 5 years Don´t he looks like a teddy bear? I love him :-) ThePerfectScore 5 years that is the cutest dog on earth! Great choice for our first dog, but I think they need another one. Two dogs are better than one, plus they have two children. And its not like they cannot afford to take care of him and the presidents dog has no risk of being neglected. Karelynn 5 years Awww. Cute dog! flowergirl 5 years I love it! He is so excited! xoxoCarly 5 years Aw, Bo is so adorable! Link Love Get exclusive details on Joe and Sofia's nuptials — Us Weekly Neil Patrick Harris would probably not host the Oscars again — HuffPost Celebrity How does Jennifer Lawrence fare in her latest film? — Lainey Gossip Patrick Schwarzenegger and Miley Cyrus might be having a rocky time — Dlisted Yep, Jessica Simpson can still pull off those Daisy Dukes — ET Adam Driver reveals why he's terrified of the Internet — JustJared Which reality star might be making a comeback? — Hollywood Tuna Iggy Azalea didn't want that Grammy anyway — Pink Is the New Blog Justin Bieber is begging Seth Rogen to roast him — The Superficial Kourtney Kardashian opts for a different kind of trainer — I'm Not Obsessed Latest Pets


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Songkran, I've been told, is all about purging the misfortune and evil of the previous 12 months and starting anew, usually after being splashed with water (and lots of it, depending on how much alcohol partiers consume at the festivities). I'm all in favor of getting properly purified, but I'll pass on the water sports, thank you. As an alternative, I wouldn't mind cleansing my mind and body with something intense and fiery, such as the crispy basil-chicken wings served at the Thailand Café. Those addictive bird wings have a deceptively sweet, caramelized exterior that masks the peppery punch that hits a few bites later. It's sinus-clearing stuff, baby. And maybe mind-expanding, too.
This appetizer is one of the many excellent dishes I enjoyed at the one-year-old restaurant before blowing my top (in a deceptively sweet but peppery manner) over one of its bizarre eccentricities -- the fact that no one answers the phone. Not very often, anyway.
You might think that in the 21st century, with phones as readily available as oxygen, modern communication wouldn't be a problem. But I actually had to call Ann Liberda, who owns Kansas City's Thai Place restaurants, to find out why her firstborn son, Michael Napaisan -- the young owner of the Thailand Café -- didn't answer his damned phone. All I wanted to know was what hours the place was open, but in more than a dozen attempts to get someone, anyone, on the line -- calling in the morning, during the lunch shift, at night -- the phone was picked up only once. "It's probably not the best business practice," I suggested to Ann. "Maybe an answering machine with a message explaining the restaurant's location and hours could come in handy."
Liberda didn't understand why her son felt no need to communicate with potential patrons, but after dining in his restaurant twice, I think I get the picture: Michael Napaisan is charming, handsome and a very good cook, and he has his own way of doing things. It's not just eccentric; it's downright weird.
There's a bar in the restaurant, for example, and a pretty decent wine list, but at the moment, no one can order any wine or beer, because Napaisan hasn't renewed his liquor license. (He says he's working on it.) He has mounted TV sets around the mirrored dining room and hung a sign at the front door advertising karaoke, but if you ask Napaisan if he hosts karaoke nights, the answer is no. "Part of the reason is that, with the Martin City Melodrama & Vaudeville Company next door, we can't be too loud in here until very late at night," Napaisan explains. "And right now, we don't have the staff to do it."
Or booze to ease the inhibitions of potential songbirds, I thought as I looked around the dining room, which was kind of attractive in a dimly lighted-1970s-Vegas-lounge way. The surfaces are shiny and cool: smoky, mirrored panels; brassy light fixtures outfitted with colored lights; vinyl tablecloths; banquettes upholstered in soft leatherette. It's an ambience that practically begs for vintage Nancy Sinatra or Tom Jones over the sound system instead of the tinkly dulcimer music that actually gets played.


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TD-Complete Submission
What to expect when you're expecting (an acceptance letter)
4.15 / 5.00 4,514 ViewsA strange solution to a simple problem.
That was kind of like...
gross. He needs to wash his face, lol, and put some cream on those spots of his own.
This is how shall I put it weird and it was pretty coll but it could of been longer and sound:p
I still am wondering what those things r that he popped...but i do like the randomness (thats y i gave it 10 style :D).... so next time i guess more randomer and longer and more humor. overall i give it a smiley of ~.~
Fairly weird
I think the worst part about this is that there is little sound. It would have been nice to keep some constant sound effects or maybe even a little song. Another weak point was that the animation was not that good. The strongest point, however, is the fact that it is in fact an original punchline and that is hard to hate. I do find it unlikely that puss that comes out of your acne would be orange, as I would know, uh, yeah. It could have also worked better if it was just a little bit longer.
very strange indeed.....and it could've been longer, but nice graphics though.


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We stayed 2 nights at the hotel and also had dinner at the restaurant. We had a Junior Suite with King bed and small sitting area with a soft and table/chairs. The room was very clean and while not huge, was still fairly spacious. The bed was quite comfy. The room was quiet. The price was very reasonable, so this... More
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Of late I should possible change my title as I am not as active at the time being. I do not write as much, but I haven't forgotten about my way of visiting the imaginary word to further understand the real one. Thnakyou for your little message, and may poetry and role playing always follow us wherever we go ^^
Hello there, "RPG Lord and Master/ Poet"... (lol) Since I am a fan of your poetry... I felt it is sort of the duty of any good groupie... to be sure I wish a happy birthday to somenoe whos work I admire so much. Happy Birthday!