text:
Generic atypical antipsychotic drugs offer health authorities opportunities for considerable savings. However, schizophrenia and bipolar disorders are complex diseases that require tailored treatments. Consequently, generally there have been limited demand-side measures by health authorities to encourage the preferential prescribing of generics. This is unlike the situation with hypertension, hypercholaesterolaemia or acid-related stomach disorders.
The objectives of this study were to compare the effect of the limited demand-side measures in Western European countries and regions on the subsequent prescribing of risperidone following generics; to utilise the findings to provide future guidance to health authorities; and where possible, to investigate the utilisation of generic versus originator risperidone and the prices for generic risperidone.
Principally, this was a segmented regression analysis of retrospective time-series data of the effect of the various initiatives in Belgium, Ireland, Scotland and Sweden following the introduction of generic risperidone. The study included patients prescribed at least one atypical antipsychotic drug up to 20 months before and up to 20 months after generic risperidone. In addition, retrospective observational studies were carried out in Austria and Spain (Catalonia) from 2005 to 2011 as well as one English primary care organisation (Bury Primary Care Trust (PCT)).
There was a consistent steady reduction in risperidone as a percentage of total selected atypical antipsychotic utilisation following generics. A similar pattern was seen in Austria and Spain, with stable utilisation in one English PCT. However, there was considerable variation in the utilisation of generic risperidone, ranging from 98% of total risperidone in Scotland to only 14% in Ireland. Similarly, the price of generic risperidone varied considerably. In Scotland, generic risperidone was only 16% of pre-patent loss prices versus 72% in Ireland.
Consistent findings of no increased prescribing of risperidone post generics with limited specific demand-side measures suggests no 'spillover' effect from one class to another encouraging the preferential prescribing of generic atypical antipsychotic drugs. This is exacerbated by the complexity of the disease area and differences in the side-effects between treatments. There appeared to be no clinical issues with generic risperidone, and prices inversely reflected measures to enhance their utilisation.
Keywords:Generics; Antipsychotics; Risperidone; Demand-side measures; Drug utilisation; Cross national study
Health authorities across Europe are increasingly struggling to fund growing drug volumes and their associated costs within available resources, as a result of ageing populations and new premium-priced drugs [1,2]. This is already resulting in some countries no longer funding new premium-priced drugs, which is not in the best interest of any stakeholder group [1-5]. Improved knowledge of pharmacogenomics, leading to improved management of patients with improved targeting of treatments, is one way forward. However, there is a still an appreciable number of challenges to address before such approaches become routine [3].
In the meantime, there are considerable opportunities for authorities across Europe to realise appreciable savings from the increased use of low-cost generics [1]. The availability of generic risperidone provides a further opportunity for authorities to achieve considerable savings. This is because worldwide sales of atypical antipsychotic drugs were over $US 5 billion per year in the early 2000s, reaching $14.6bn in the US alone in 2009 [6,7]. In addition, medicine costs can be an appreciable component of the overall cost of treating patients with schizophrenia, as pharmacological treatments represent the backbone of managing these patients [8-11].
We acknowledge that there is continuing debate about the relative merits of atypical versus typical antipsychotics in the management of patients with schizophrenia [12-16]. Recent studies have suggested that pharmacological treatments should be tailored, in view of the considerable variation in their effectiveness between individual patients [12,17-20]. In addition, there are also considerable differences in side-effects between the different atypical antipsychotic drugs, including weight gain, hyperlipidaemia and type 2 diabetes [12,17,19]. The risk of QT prolongation and subsequent arrhythmia-related events, i.e. torsade de pointes (TdP) and sudden cardiac death, has also become increasingly important [21,22]. Previously, atypical antipsychotic drugs were generally perceived as having a more favourable safety profile in terms of cardiac and extrapyramidal side-effects. However, this is changing, with post-marketing studies and meta-analyses challenging the definition of typical (first generation) or atypical (second generation) antipsychotic drugs [18,23-27]. Recent studies have also shown that the risk of mortality in patients with schizophrenia is highest with quetiapine and lowest with clozapine [28]. However, there have been concerns regarding patient selection in this cohort study. Haloperidol and risperidone had slightly lower adjusted hazard ratios than quetiapine [28].
However, other authors believe the modest health gains achieved with atypical antipsychotic drugs reported in the literature do not adequately reflect the improvement in the quality of life perceived by patients, clinicians or carers [29]. This has resulted in the increasing use of these drugs in recent years, which is likely to continue despite safety concerns [30-37].
As a result, the introduction of generic atypical antipsychotic drugs should be welcomed by European authorities in order to save costs. However, it is recognised by health authorities that schizophrenia and bipolar disorders are complex diseases to treat compared with hypercholesterolaemia, hypertension or acid-related stomach disorders, for instance. In addition, atypical antipsychotic drugs cannot be considered as a single class, because of the heterogeneity of their pharmacological activities. This is unlike the situation for proton pump inhibitors (PPIs), renin-angiotensin inhibitor drugs or statins [1,38-45]. In view of this, as mentioned, there is a greater need to tailor treatments to individual patients. This complexity has resulted in limited demand-side initiatives by national and regional health authorities across Europe to preferentially encourage the prescribing of oral risperidone versus patented atypical antipsychotic drugs once generic risperidone became available [46-48]. Limited measures included physician prescribing quotas for low-cost medicines in Belgium, advice to psychiatrists to consider preferentially starting patients on generic atypical antipsychotic drugs where pertinent in Scotland, and prescribing restrictions for long-acting risperidone injections in Austria and Belgium [46-48].
Consequently, the principal objective of this study was to compare and contrast the effect of the limited demand-side measures instigated by Western European countries and regions to enhance the prescribing of risperidone versus patented atypical antipsychotic drugs once oral generic risperidone became available. A secondary objective was to utilise the findings to provide guidance to health authorities regarding potential measures they could consider to enhance the prescribing of generic atypical antipsychotic drugs if this is practical and feasible. This is because we would expect to see limited change in the utilisation of risperidone following generics with limited demand-side measures and the recognised need to tailor pharmacotherapy. This builds on previous findings across a range of classes, including antidepressants, PPIs, renin-angiotensin inhibitor drugs and statins [1,38-41,47,49,50]. We also investigated the utilisation of generic versus originator risperidone because a universally low utilisation of generic risperidone would represent concerns with generics among either patients or physicians, or both. Finally, we investigated prices for generic risperidone versus pre-patent loss prices to provide guidance to countries that still have high prices for generics.
Only Western European countries and regions were chosen for analysis as generic atypical antipsychotic drugs have been available for a longer time in Central and Eastern European countries [6].
We principally undertook a segmented regression analysis of retrospective time-series analysis to assess the effect of various initiatives in Belgium, Ireland, Scotland and Sweden following the introduction of generic risperidone [51]. The xtmixed command in Stata (version 12) (StataCorp, College Station, Texas, USA) was used to fit a linear random coefficient model with country-specific intercepts. At the time of introduction of generic risperidone into each country, a random shift in intercepts and slopes was allowed to estimate the effect of the introduction. Data on the number of monthly reimbursed prescriptions within each country's health service for all patients prescribed at least one atypical antipsychotic drug (N05AH03 to 06, N05AL05, N05AX08, N05AX011 to 13) [52] up to 20 months before and up to 20 months after the availability of generic risperidone was included. Clozapine was not included in the analysis as it is generally reserved for patients not responding to other atypical antipsychotic drugs because of its side-effect profile [46,53-55]. Ziprasidone (N05AE04) was also not included. This was in view of its different classification and limited utilisation in practice in a number of European countries, including Sweden [56].
A retrospective observational study of the same population dispensed at least one atypical antipsychotic drug was also undertaken in Austria and one of the regions in Spain (Catalonia) from January 2005 (Austria) or January 2006 (Spain) to the end of 2010 (Austria) and September 2011 (Spain). This was because generic risperidone was already available in Austria and Spain in July 2004 and by January 2006 respectively, but only became available later in the four chosen European countries: Ireland in December 2007, Scotland in April 2008, and Belgium and Sweden in January 2009. A retrospective observational study was also undertaken in one English primary care organisation, Bury Primary Care Trust (PCT), between November 2009 and October 2011. The objective was to assess the influence of a request to psychiatrists to consider oral risperidone as first line treatment in new or other suitable patients, where appropriate, now it was available as a generic.
Finally, retrospective observational studies were undertaken on the utilisation of long-acting risperidone injections versus total risperidone (N05AX08) [52], which was available throughout the study period, as well as paliperidone (N05AX13) before and after the availability of generic oral risperidone.
The European countries chosen provide a range of differences in geographical location, population size, different approaches to the financing of health care, and different approaches to the pricing of generics and to enhancing the utilisation of generics versus originators [39,40], which is in line with recommended guidance [57].
Only administrative databases were used in each country to assess the utilisation and expenditure patterns of the atypical antipsychotic drugs. This is because the perspective of the study was that of health authorities, and they typically have the greatest knowledge concerning existing and planned initiatives and reforms in their countries. The databases, which are regularly audited, are included in Box 1. Box 1 also contains details of patients included within the national health service of each country. This typically includes 100% or close to 100% of the population unless stated (Ireland), given the principles of equity and solidarity within European healthcare systems. There are also typically limited patient co-payments.
The utilisation of the different atypical antipsychotics was calculated in terms of defined daily dose (DDD), which is defined as 'the average maintenance dose of a drug when used in its major indication in adults', as this measure is recognised as the international standard to assess utilisation patterns within and between countries [58]. The only exception was Bury PCT, where utilisation was measured in terms of prescription items, which is the typical metric used to assess utilisation patterns in England [59]. 2011 DDDs were used in line with international guidance [58,60,61].
Separate retrospective observational studies were conducted in Belgium, Scotland and Sweden, again using an interrupted time-series methodology. The objective was to assess whether the changes in risperidone utilisation patterns after the introduction generic risperidone in these three countries were significant [46,48,56].
Subsequently, risperidone utilisation in Belgium, Ireland, Scotland and Sweden was converted into a percentage of total selected atypical antipsychotic utilisation (DDD basis) before and after the availability of generic risperidone (time 0). The objective was to enable meaningful comparisons between the four countries, factoring in differences in population sizes, time when generic risperidone became available, and differences in their database characteristics (Box 1). Utilisation patterns and calculations were verified with the relevant co-authors to enhance the robustness of the study findings.
The percentage of oral risperidone dispensed as generics was also calculated in Belgium, Ireland, Scotland and Sweden. We would expect to see considerable differences in utilisation rates between countries in view of the different policies in each country regarding encouraging the utilisation of generics versus originators [39,40,62-65]. However as mentioned, a universally low utilisation of generic risperidone would reflect general stakeholder concerns with generic risperidone.
The percentage reduction in expenditure per DDD for oral generic risperidone versus pre-patent loss originator prices was also calculated in Belgium, Ireland, Scotland and Sweden. We chose to compare relative reductions rather than actual prices for generic risperidone as the price components can vary in each country (for example, there are variations in the extent of VAT and relative wholesaler margins), and this approach also avoids currency conversions, both of which can make cross-country price comparisons difficult, especially during times of economic difficulty. In addition, prices of initial or all generics in an appreciable number of European countries are based on pre-patent loss prices [39,40,62,64,65], and the time periods for the availability of generic risperidone varied considerably between the countries and regions studied. We also did not factor inflation into the calculations because the trend in most European countries is to reduce prices when pharmaceutical expenditure exceeds target budgets [39,66] and, as mentioned, prices of generics in a number of European countries are based on pre-patent loss prices. This is in line with previous studies [39,40,64]. We would again expect to find considerable differences in the prices of generic risperidone between countries, because of the different pricing initiatives and differences in the attractiveness in the generic market [1,38,39,62,64,67].
Finally, we calculated the influence of the availability of generic risperidone on subsequent atypical antipsychotic expenditure where possible.
No ethics approval was needed or obtained because only aggregated drug utilisation data was used, without access to specific patient data.
There was a consistent steady reduction in the utilisation of risperidone as a percentage of total selected atypical utilisation in all the four countries over time following the introduction of generic risperidone (Figure 1).
Figure 1. Percentage utilisation of risperidone (defined daily dose (DDD) basis) versus selected atypical antipsychotic drugs among four European countries. NB. *= No statistical difference in the rate of risperidone utilisation before and after the availability of generic risperidone in separate country analyses.
There were significant differences in the rate of utilisation of risperidone between the four countries before generic risperidone was launched (Table 1, initial slope). However, there was less variation in the utilisation of risperidone between the four European countries after generic drugs became available (Figure 1, Table 1). The average decline in the percentage of risperidone versus the other selected atypical antipsychotic drugs persisted after generic risperidone was introduced but to a lesser extent, with an initial average drop of −0.0774 and a change in slope from −0.144% to −0.00548% per month (Table 1). However, this combined change in the slope after month 0 was not statistically significant.
Table 1. Characteristics of the utilisation of risperidone after generic availability (month zero)
There was variation between the four countries in the rate of decline in the utilisation of risperidone after the introduction of generic risperidone (month 0). Sweden had the fastest decline, while Scotland, already having the lowest levels of risperidone utilisation, had the slowest decline (Table 2). However when combined, there was no statistically significant change in risperidone utilisation patterns following the introduction of generics (Table 1). There was also no significant change in the utilisation of risperidone after the introduction of generic risperidone in separate single country studies conducted in Belgium, Scotland and Sweden [46,48,56].
Table 2. Slope of risperidone utilisation between the four European countries after generic risperidone became available (month 0)
A similar pattern was also seen in Austria (Table 3) and Spain (Catalonia) (Figure 2). In Spain, utilisation of risperidone declined from 35% of selected atypical antipsychotic drugs in 2006 (DDD basis) to 28% by the third quarter of 2011 (Figure 2).In Bury PCT, the prescribing of risperidone averaged between 16% and 21% of the selected atypical antipsychotics dispensed between November 2009 and October 2011 (Figure 3). However, there was no recognised pattern to the prescribing of risperidone, with its utilisation varying randomly between the months. Again, utilisation of selected atypical antipsychotic drugs was dominated by olanzapine and quetiapine.
Table 3. Utilisation of selected atypical antipsychotics in Austria as a percentage of total atypical antipsychotic use between 2005 and 2010 (defined daily dose basis)
Figure 2. Utilisation of selected atypical antipsychotic drugs in Catalonia, Spain, in defined daily doses (DDD) on a quarterly basis from January 2006 to end of September 2011. NB. Generic immediate release (IR) quetiapine became available in Spain from 2008 but generic extended release (ER) quetiapine only became available in September 2011.
Figure 3. Utilisation of atypical antipsychotic drugs in Bury Primary Care Trust (PCT) November 2009 to October 2011.
There was variation between the various European countries and regions in the utilisation of long-acting risperidone injections as a percentage of total risperidone. This ranged from an average of 6% to 7% in Scotland to 18.5% to 20% in Sweden, and over 20% in Belgium, before reducing in later months in Belgium following tightening of the prescribing regulations versus oral risperidone [48]. There was generally low utilisation of paliperidone in all the countries and regions studied (Table 4), despite paliperiodone being available before oral generic risperidone in the four principal countries.
Table 4. Maximum utilisation of paliperidone (oral and injectable) as a percentage of total selected antipsychotic utilisation in the various European countries and regions
There was also considerable variation in the utilisation of oral generic versus originator risperidone by the end of the study period in each of the four principal countries (Table 5). Similarly, there was considerable variation between the four countries in the price reduction of oral generic risperidone (expenditure/DDD) versus pre-patent loss prices by the end of the study period.
Table 5. Percentage utilisation of oral generic risperidone versus total risperidone (DDD basis) and percentage reduction in expenditure per defined daily dose for oral generic risperidone versus pre-patent loss prices by the end of the study period in each country
In both Scotland and Sweden, the high utilisation of generic risperidone at low prices (Table 5) resulted in expenditure for atypical antipsychotic drugs increasing at a lower rate than utilisation. Utilisation of the selected atypical antipsychotic drugs in Scotland increased by 53% between 2005 and 2010, but expenditure increased by only 42%. In Sweden, utilisation increased by 20% after the introduction of oral generic risperidone until August 2011, with expenditure increasing by only 13%.
As expected, there was no increase in the utilisation of risperidone compared with the other atypical antipsychotic drugs after the introduction of generic risperidone in either Belgium, Ireland, Scotland or Sweden (Figure 1), or in Bury PCT (Figure 3). In fact, if anything the reverse was seen, with increased prescribing of patented atypical antipsychotics in the four countries (Figure 1). A similar picture was also seen in Austria and Spain (Table 3; Figure 2) with generic extended release (ER) quetiapine not being available in Spain until near the end of the study. However, there were significant differences in the rate of decline in risperidone utilisation between the four countries before generic risperidone was launched (Table 1). However, there was less variation in the rate of decline after generic risperidone became available (Figure 1; Table 1), with the combined decline in risperidone utilisation falling to −0.00548% per month from −0.144% per month (Table 1). The rate of decline was greater in Sweden than Scotland (Table 2). However, there was overall a reasonable consistency between the four countries, irrespective of their characteristics [39,68], reflected by the lack of a statistically significant change in slope after month 0 (Table 1). This was also no statistically significant difference in the rate of risperidone utilisation after generic risperidone became available in the separate analyses conducted in Belgium, Scotland and Sweden [46,48,56].
The consistent findings between the seven European countries and regions, including Austria (Table 3), Spain (Figure 2) and Bury PCT (Figure 3), regarding risperidone utilisation following the introduction of generics would suggest that following generic availability, there was no increased prescribing of oral risperidone for new patients, for whom risperidone could be one of the treatment options. However, we cannot say this with certainty without analysing patient-specific data. No increased prescribing of risperidone following introduction of generics (Figures 1, 2 and 3; Tables 1 and 3) may reflect the advice from organisations such as the National Institute for Health and Care Excellence in the UK and from various published studies that treatment of patients with schizophrenia should be individualised to maximise patient outcomes [17-19,69,70]. The growing utilisation of the other atypical antipsychotics, especially quetiapine and aripiprazole, in the various countries following the introduction of generic risperidone (Figures 1 and 2; Table 3) may reflect the marketing activities of the manufacturers of patented atypical antipsychotic drugs including ER quetiapine in Spain, influencing the choice of antipsychotic drug prescribed [46,48,71-73]. However, it is more likely to reflect the recognised weight neutrality with aripiprazole versus olanzapine and risperidone, as well as the effectiveness of aripiprazole and quetiapine ER in treating patients with major depressive disorders who have had an incomplete response to antidepressants, and of quetiapine ER in treating patients with bipolar depression [74-76], given the limited utilisation of patented paliperidone in recent years (Table 4). However, this remains to be elucidated in further research. There was also no substantial increase in the utilisation of long-acting risperidone in the four principal countries following the introduction of oral generic risperidone. If anything, the reverse was seen in Belgium in recent years, as reimbursement is denied if the medical adviser appointed by the patient's insurer is not satisfied with the rationale provided by the physician [48].
The findings also potentially suggest there is no 'spillover' or cross-transfer of learning in practice from one disease area to another to produce changes in physician prescribing habits, that is, no crossover of learning to increase the prescribing of generics when available as seen with the PPIs, renin-angiotensin inhibitor drugs and statins [1,38-41,43-45,59,77]. We believe this is an important finding from this research. However, this finding is tempered by the recognised need to tailor pharmacological treatment for patients with schizophrenia or bipolar disease, especially with regard to issues such as weight gain and effectiveness in different patient populations, as well as reluctance among physicians to switch treatments when patients are stable on a particular atypical antipsychotic drug.
We believe a second important finding is that in some disease areas it is difficult for health authorities to encourage the preferential prescribing of multiple sourced versus patented drugs, apart from introducing measures such as prescribing restrictions for different formulations of a molecule [48]. This illustrated by limited initiatives in any of the seven countries and regions to enhance the prescribing of oral risperidone following the introduction of generics. This is unlike the situation for the PPIs, renin-angiotensin inhibitor drugs and the statins [1,38,40,42,77]. We believe, based on our findings (especially those from Bury PCT following its activities (Figure 3) when recently it was very successful in significantly enhancing the prescribing of generic losartan versus patented ARBs (angiotensin receptor blocker) for treating hypertension with multiple demand-side measures [59]), that the influence of measures such as prescribing guidance or guidelines highlighting the preferential prescribing of generic atypical antipsychotic drugs as first line treatments may be limited. This is especially the case if there is a good clinical rationale for prescribing a patented product including concerns with weight gain. Additional measures could include instigating reimbursement restrictions for oral patented atypical antipsychotics, which is similar to the situation for long-acting risperidone injections in Austria and Belgium [47,48]. However, such measures may again be difficult to implement, given the subjective nature of choosing pharmacological treatment options to maximise patient outcomes in these complex disease areas, and may even be counterproductive.
The considerable variation between European countries in the prescribing of oral generic risperidone versus originators (Table 5) reflects the different policies in these countries to encourage use of generics. The high rates seen in Scotland and Sweden suggest that there are no problems with generic risperidone in clinical practice. This is no doubt enhanced by the strict regulations for granting marketing authorisation for generics in Europe, with authorities removing generic products where concerns exist [63,64,78]. Consequently, the differences are down to different demand-side measures between the four countries. The high utilisation of oral generic risperidone in Scotland reflects generally high voluntary INN (International Non-proprietary Name) prescribing rates across classes. This starts with extensive physician education in medical school to prescribe by INN, which is followed up in ambulatory care through pharmacists working for the Health Boards monitoring the prescribing of drugs [40,46,49]. The high rates in Sweden reflect the instigation of compulsory generic substitution, including risperidone, apart from in a limited number of cases [39,40,56,77,79,80]. We believe the high voluntary INN prescribing rates in the UK provides guidance to other countries. This is because such activities reduce patient confusion once multiple sources become available, especially if patients are dispensed different branded generics with different names on each occasion, without adequate explanation. This can happen in Sweden with compulsory generic substitution, apart from a limited number of situations authorised by the Medicine Product Agency [81], and more recently with monthly auctions as the cheapest branded generic secures an appreciable proportion of prescriptions for the molecule the following month [1,38]. The dispensing of different branded generics on each occasion can possibly cause confusion and concern if patients do not receive adequate information about their medicines [82]. This can potentially result in either duplication of medicines, or alternatively, in patients not taking their prescribed treatments as directed, which could be problematic [82,83]. INN prescribing, apart from a limited number of well-known situations, is one way to address this [49,80,84,85].
There were also appreciable differences between countries concerning the price of generic risperidone (Table 4). This reflects the different policies between the four countries with regard to enhancing the utilisation of generics, as well as their different pricing policies. The considerable price reduction for generic risperidone in Scotland, which is similar to those for other generics, follows recent reforms in the UK to enhance transparency in the cost of producing generics, as well as discounts offered by manufacturers to wholesalers and pharmacists to preferentially dispense their generic [41,49]. The price reduction in Sweden, which is also similar to those for other generics, is a result of the introduction of compulsory generic substitution with the lowest priced molecule [1,38,80]. Generic prices are likely to fall further in Sweden with the recent introduction of monthly auctions, with the manufacturer who wins the auction being guaranteed a considerable proportion of dispensed generics the following month [1,38]. The more modest price reduction for generic risperidone in Belgium reflects the current situation, where generic companies only have to lower their prices to the reference price level to be reimbursed. This was only 16% versus pre-patent loss prices until 2002, 20% until 2003, 26% until 2005, and is currently 31% [48,68,85]. The high prices for generics in Ireland reflect the limited measures to date to reduce these, although this is now changing [39,86]. These findings are consistent with other research showing that the lowest prices for generics in Europe are seen in countries with the greatest market share [62,63,67]. Consequently, measures to increase the attractiveness of the generic market, as well as enhance the transparency in their pricing, as seen in Sweden and the UK, provide guidance to countries seeking ways to achieve further savings from the use of generics. This is especially the case where it is difficult to encourage the preferential prescribing of generics versus patented products, for example, atypical antipsychotic drugs.
We are aware there are a number of limitations with this study. This includes no access to patient data to assess whether there has been an increase in the prescribing of risperidone as first line treatment since the introduction of generics. In addition, there is no knowledge of the prescribed indications, especially with risperidone being the only atypical antipsychotic drug currently licensed for asymptomatic treatment in patients with dementia. However, the consistent continued decline in the utilisation of risperidone following the introduction of generics, coupled with increased utilisation of patented atypical antipsychotic drugs (Figures 1 and 2; Table 3), suggests there has been no increase in the prescribing of risperidone following generics. This may be enhanced by increased awareness of the lack of effect on weight with aripiprazole, and the effectiveness of aripiprazole and quetiapine ER in major depressive disorders. We have also not assessed whether there are any differences in outcomes between oral generic and originator risperidone. Previous research findings and the continued high utilisation of generic risperidone in Scotland and Sweden (Table 5) suggest there are no problems with generic atypical antipsychotic drugs in clinical practice [6,46,49,50,87]. However, again, we cannot say this with certainty without specific patient research. Finally, we are unable to determine or comment on the extent of any polypharmacy with atypical antipsychotic drugs.
Generics provide a considerable opportunity for authorities to fund increased drug volumes and new premium-priced drugs within available resources. However, there are disorders such as schizophrenia for which it is difficult to encourage the preferential prescribing of multiple sourced drugs as first line treatments. This is due to the recognised need to tailor pharmacological treatments to the individual patient in order to maximise outcomes. This belief has resulted in limited demand-side measures by the seven European countries and regions to encourage the preferential prescribing of generic versus patented atypical antipsychotic drugs, compared with the multiple measures generally instigated for the PPIs and statins following introduction of generics. We have also shown that authorities across Europe cannot rely on the transfer of learning concerning the prescribing of generics as first line treatment from one class to another in order to affect changes in the prescribing habits of atypical antipsychotic drugs. This is no doubt enhanced in this case by the need to tailor treatments and the heterogeneity of the products in the class. However, we believe that any demand-side initiatives, apart from encouraging one dosage form over another, would have only a limited effect, owing to the complexity of treating patients with schizophrenia or bipolar disease, and the recognised differences in side-effect profiles between the various pharmacological approaches. Consequently, we do not believe the authorities in any of the seven countries or regions studied are planning specific measures in the future. This decision is no doubt helped by more oral atypical antipsychotic drugs now being available as multiple sourced products, helping to lower overall drug acquisition costs.
Finally, we believe countries can learn from each other regarding potential additional ways to further enhance the prescribing of generic versus originator atypical antipsychotic drugs, and to obtain lower prices where pertinent. This includes measures such as increasing INN prescribing and greater transparency in the pricing of generics.
Competing interests
A number of the co-authors are employed by health authorities: MB (Scotland), AM (Greater Manchester Commissioning Support Unit), MP (Stockholm County Council, Sweden), JP (HVB Austria) and CZ (Barcelona Health Region, Catalan Health Authority, Spain). AB is an advisor to MEDEV (an informal group of the pharmaceutical experts of European Health Insurance Organizations). SS holds the European Generic Medicines Association (EGA) Chair of 'European Policy Towards Generic Medicines'. Otherwise, the authors have no other relevant affiliations or financial involvement with any organisation or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript, apart from those already mentioned.
Authors' contributions
BG, AEF, ER and CB devised the concept for the paper and produced the first and subsequent drafts. BG is the guarantor of the paper supported in the scientific content by ER and CB. MP performed the statistical analyses, and critiqued successive drafts. KB, MB, AB, AM, MP, JP, SS and CZ provided the utilisation and expenditure data for their respective countries and regions (Austria, Belgium, Bury PCT, Ireland, Scotland, Spain (Catalonia) and Sweden) as well as details of the various demand-side measures. They also critiqued successive drafts. All authors read and approved the submitted manuscript.
Box 1 – Administrative databases used in the study [39-41,46-48,56,59,68,86,88]
• Austria: Internal data warehouse of the HVB (Hauptverband der Österreichischen Sozialversicherungsträger) – BIG – coupled with Cube HMSTAT, based on the 'Maschinelle Heilmittelabrechnung'. This provides reimbursement data on medicines dispensed in ambulatory care in approximately 98% of the Austrian population.
• Belgium: Pharmanet, a database of reimbursed medicines dispensed in ambulatory care in Belgium. This database is maintained by the National Institute for Health and Disability Insurance and covers the whole Belgian population.
• England (Bury PCT): National Health Service Business Services Division prescription pricing database (ePACT).
• Ireland: the National Shared Services Primary Care Reimbursement Service of the Health Service Executive in Ireland (HSE-PCRS) pharmacy claims database. This database provides details on monthly dispensed medications for each individual within the GMS population. The GMS population covers approximately 30% of the population of Ireland with higher morbidity than the general population, which is reflected in their consumption of approximately 65% of total pharmaceutical expenditure in Ireland.
• Scotland: NHS National Services Scotland Corporate Warehouse, covering the entire population in Scotland.
• Spain (Catalonia): DMART (Catalan Health Service) database, covering the public system in Catalonia.
• Sweden: National Swedish Pharmacy Register covering the entire Swedish population.
The analysis and report writing was in part funded by a grant from the Karolinska Institutet.
No writing assistance was utilised in the production of this manuscript.
Godman B, Campbell S, Suh HS, Finlayson AE, Bennie M, Gustafsson LL: Ongoing measures to enhance prescribing efficiency across Europe: implications for other countries.
Malmström RE, Godman B, Diogene E, Baumgärtel C, Bennie M, Bishop I, Brzezinska A, Bucsics A, Campbell S, Ferrario A, Finlayson AE, Fürst J, Garuoliene K, Gomes M, Gutiérrez-Ibarluzea I, Haycox A, Hviding K, Herholz H, Hoffmann M, Jan S, Jones J, Joppi R, Kalaba M, Kvalheim C, Laius O, Langner I, Lonsdale J, Lööv SÄ, Malinowska K, McCullagh L, et al.: Dabigatran - a case history demonstrating the need for comprehensive approaches to optimise the use of new drugs.
Front Pharmacol 2013, 4:1-19.
Godman B, Finlayson AE, Cheema PK, Zebedin-Brandl E, Gutiérrez-Ibarluzea I, Jones J, Malmström RE, Asola E, Baumgärtel C, Bennie M, Bishop I, Bucsics A, Campbell S, Diogene E, Ferrario A, Fürst J, Garuoliene K, Gomes M, Harris K, Haycox A, Herholz H, Hviding K, Jan S, Kalaba M, Kvalheim C, Laius O, Lööv SA, Malinowska K, Martin A, McCullagh L, et al.: Personalising health care: feasibility and future implications.
Garuoliene K, Godman B, Gulbinovič J, Wettermark B, Haycox A: European countries with small populations can obtain low prices for drugs: Lithuania as a case history.
Taylor L: Australian government blocks subsidies for new drugs.
Available via URL: http://www.pharmatimes.com/Article/11-03-15/Australian_govt_blocks_subsidies_for_new_drugs.aspx webcite [Accessed January 2013]
Wladysiuk M, Araszkiewicz A, Godman B, Szabert K, Barbui C, Haycox A: Patient co-payments do influence atypical antipsychotic choice in Poland; implications once generic atypcials are available.
Leslie D, Rosenheck R: Off-label use of antipsychotic medications in Medicaid.
Zeidler J, Slawik L, Fleischmann J, Greiner W: The costs of schizophrenia and predictors of hospitalisation from the statutory health insurance perspective.
Salize H, McCabe R, Bullenkamp J, Hansson L, Lauber C, Martinez-Leal R, Reinhard I, Rössler W, Svensson B, Torres-Gonzalez F, van den Brink R, Wiersma D, Priebe S: Cost of treatment of schizophrenia in six European countries.
Wang C-C, Farley J: Patterns and predictors of antipsychotic medication use among the U.S. population: findings from the medical expenditure panel survey.
Wheeler A, Crump K, Lee M, Li L, Patel P, Yang R: Collaborative prescribing: A qualitative exploration of a role for pharmacists in mental health.
Gardner D, Baldessarini RJ, Waraich P: Modern antipsychotic drugs: a critical overview.
Lieberman JA, Stroup TS, McEvoy JP, Swartz MS, Rosenheck RA, Perkins DO, Keefe RS, Davis SM, Davis CE, Lebowitz BD, Severe J, Hsiao JK, Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) Investigators: Effectiveness of antipsychotic drugs in patients with chronic schizophrenia.
Lieberman JA, Stroup T: Commentary - The NIM H-CAT IE Schizophrenia Study: What did we learn?
Berkowitz RL, Patel U, Ni Q, Parks JJ, Docherty JP: The impact of the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) on prescribing practices: an analysis of data from a large midwestern state.
J Clin Psychiatry 2012, 73:498-503.
Epub 2011 Dec 13
Tyrer P, Kendall T: The spurious advance of antipsychotic drug therapy.
Edlinger M, Hofer A, Rettenbacher M, Widschwendter CG, Kemmler G, Neco NA, Fleischhacker WW: Factors influencing the choice of new generation antipsychotic medication in the treatment of patients with schizophrenia.
Leucht S, Cipriani A, Spineli L, Mavridis D, Orey D, Richter F, Samara M, Barbui C, Engel RR, Geddes JR, Kissling W, Stapf MP, Lässig B, Salanti G, Davis JM: Comparative efficacy and tolerability of 15 antipsychotic drugs in schizophrenia: a multiple-treatments meta-analysis.
NICE: Schizophrenia - core interventions in the treatment and management of schizophrenia in adults in primary and secondary care. NICE Clinical Guideline 82. Available via URL: http://guidance.nice.org.uk/CG82 webcite (Accessed December 2013)
Leucht S, Wahlbeck K, Hamann J, Kissling W: New generation antipsychotics versus low-potency conventional antipsychotics: a systematic review and meta-analysis.
Titier K, Girodet PO, Verdoux H, Molimard M, Bégaud B, Haverkamp W, Lader M, Moore N: Atypical antipsychotics: from potassium channels to torsade de pointes and sudden death.
Haddad PM, Sharma SG: Adverse effects of atypical antipsychotics: differential risk and clinical implications.
Ray WA, Chung CP, Murray KT, Hall K, Stein CM: Atypical antipsychotic drugs and the risk of sudden cardiac death.
Vieweg WV, Wood MA, Fernandez A: Proarrhythmic risk with antipsychotic and antidepressant drugs: implications in the elderly.
Poluzzi E, Raschi E, Moretti U, De Ponti F: Drug-induced torsades de pointes: data mining of the public version of the FDA Adverse Event Reporting System (AERS).
Meyer-Massetti C, Vaerini S, Rätz Bravo AE, Meier CR, Guglielmo BJ: Comparative safety of antipsychotics in the WHO pharmacovigilance database: the haloperidol case.
Poluzzi E, Raschi E, Koci A, Moretti U, Spina E, Behr ER, Sturkenboom M, De Ponti F: Antipsychotics and torsadogenic risk: signals emerging from the US FDA adverse event reporting system database.
Tiihonen J, Lönnqvist J, Wahlbeck W, Klaukka T, Niskanen L, Tanskanen A, Haukka J: 11-year follow-up of mortality in patients with schizophrenia: a population-based cohort study (FIN11 study).
Magnus A, Carr V, Mihalopoulos C, Carter R, Vos T: Assessing cost-effectiveness of drug interventions for schizophrenia.
Crystal S, Olfson M, Huang C, Pincus H, Gerhard T: Broadened use of atypical antipsychotics: safety, effectiveness, and policy challenges.
Tiihonen J, Haukka J, Taylor M, Haddad PM, Patel MX, Korhonen P: A nationwide cohort study of oral and depot antipsychotics after first hospitalization for schizophrenia.
Alexander GC, Gallagher SA, Mascola A, Moloney RM, Stafford RS: Increasing off-label use of antipsychotic medications in the United States, 1995–2008.
NICE implementation uptake report: Atypical antipsychotic drugs for the treatment of schizophrenia. NICE Technology appraisals 43. Available via URL: http://www.nice.org.uk/media/410/E9/ImplUptakeReportAtypicalAntipsychotics.pdf webcite (Accessed February 2014)
Raschi E, Poluzzi E, Godman B, Koci A, Moretti U, Kalaba M, Bennie M, Barbui C, Wettermark B, Sturkenboom M, De Ponti F: Torsadogenic risk of antipsychotics: combining adverse event reports with drug utilization data across.
Guthrie B, Clark SA, Reynish EL, McCowan C, Morales DR: Differential impact of two risk communications on antipsychotic prescribing to people with dementia in Scotland: segmented regression time series analysis 2001–2011.
Gallini A, Andrieu S, Donohue JM, Oumouhou N, Lapeyre-Mestre M, Gardette V: Trends in use of antipsychotics in elderly patients with dementia: Impact of national safety warnings.
Eur Neuropsychopharmacol 2013.
[Epub ahead of print]
Schulze J, van den Bussche H, Glaeske G, Kaduszkiewicz H, Wiese B, Hoffmann F: Impact of safety warnings on antipsychotic prescriptions in dementia: Nothing has changed but the years and the substances.
Godman B, Bennie M, Baumgärtel C, Sović Brkičić L, Burkhardt T, Fürst J, Garuoliene K, Gomes M, Markovic-Pekovic V, Martin A, Sermet C, Skiold P, van Woerkom M, Voncina L, Gustafsson LL: Essential to increase the use of generics in Europe to maintain comprehensive healthcare?
Farmeconomia Health Econ Therapeutic Pathways 2012, 13:5-20.
Godman B, Shrank W, Andersen M, Berg C, Bishop I, Burkhardt T, Garuoliene K, Herholz H, Joppi R, Kalaba M, Laius O, Lonsdale J, Malmström RE, Martikainen JE, Samaluk V, Sermet C, Schwabe U, Teixeira I, Tilson L, Tulunay FC, Vlahović-Palčevski V, Wendykowska K, Wettermark B, Zara C, Gustafsson LL: Policies to enhance prescribing efficiency in Europe: findings and future implications.
Vončina L, Strizrep T, Godman B, Bennie M, Bishop I, Campbell S, Vlahović-Palčevski V, Gustafsson LL: Influence of demand-side measures to enhance renin–angiotensin prescribing efficiency in Europe: implications for the future.
Bennie M, Bishop I, Godman B, Campbell S, Miranda J, Finlayson A, Gustafsson LL: Are prescribing initiatives readily transferable across classes: the case of generic losartan in Scotland?
Usher-Smith J, Ramsbottom T, Pearmain H, Kirby M: Evaluation of the clinical outcomes of switching patients from atorvastatin to simvastatin and losartan to candesartan in a primary care setting: 2 years on.
Godman B, Schwabe U, Selke G, Wettermark B: Update of recent reforms in Germany to enhance the quality and efficiency of prescribing of proton pump inhibitors and lipid lowering drugs.
Wettermark B, Godman B, Neovius M, Hedberg N, Mellgren TO, Kahan T: Initial effects of a reimbursement restriction to improve the cost-effectiveness of antihypertensive treatment.
Sakshaug S, Furu K, Karlstad O, Rønning M, Skurtveit S: Switching statins in Norway after new reimbursement policy – a nationwide prescription study.
Bennie M, Bishop I, Godman B, Barbui C, Raschi E, Campbell S, Miranda J, Gustafsson LL: Are specific initiatives required to enhance the prescribing of generic atypical antipsychotics in Scotland?: international implications.
Godman B, Buscics A, Burkhardt T, Piessnegger J, Schmitzer M, Barbui C, Raschi E, Bennie M, Gustafsson LL: Potential to enhance the prescribing of generic drugs in patients with mental health problems in Austria; implications for the future.
Frontiers Pharmacol 2012, 3:198.
Godman B, De Bruyn K, Miranda J, Raschi E, Bennie M, Barbui C, Simoens S: Generic atypical antipsychotic drugs in Belgium; their influence and implications.
Godman B, Bishop I, Finlayson AE, Campbell S, Kwon H-Y, Bennie M: Reforms and initiatives in Scotland in recent years to encourage the prescribing of generic drugs, their influence and implications for other countries.
Godman B, Persson M, Miranda J, Skiöld P, Wettermark B, Barbui C, Gustafsson LL: Changes in the utilisation of venlafaxine after the introduction of generics in Sweden.
Wagner AK, Soumerai SB, Zhang F, Ross-Degnan D: Segmented regression analysis of interrupted time series studies in medication use research.
WHO Collaborating Centre for Drug Statistics Methodology: ATC / DDD Index 2011. Oslo: WHO; 2010.
Available from: http://www.whocc.no/atc_ddd_index/.; webcite (Accessed February 2014)
Asenjo Lobos C, Komossa K, Rummel-Kluge C, Hunger H, Schmid F, Schwarz S, Leucht S: Clozapine versus other atypical antipsychotics for schizophrenia.
Cochrane Database Syst Rev. 2010., 11
Leucht S, Heres S, Kissling W, Davis JM: Evidence-based pharmacotherapy of schizophrenia.
Raja M: Clozapine safety, 35 years later.
Godman B, Persson M, Miranda J, Barbui C, Bennie M, Finlayson AE, Raschi E, Wettermark B: Can authorities take advantage of the availability of generic atypical antipsychotic drugs:? Findings from Sweden and potential implications.
Cacace M, Ettelt S, Mays N, Nolte E: Assessing quality in cross-country comparisons of health systems and policies: Towards a set of generic quality criteria.
World Health Organization (WHO): Introduction to Drug Utilisation Research. WHO International Working Group for Drug Statistics Methodology, WHO Collaborating Centre for Drug Statistics Methodology, WHO Collaborating Centre for Drug Utilization Research and Clinical Pharmacological Services. ISBN 92 4 156234 X (NLM classification: WB 330). Available via URL: http://www.who.int/medicines/areas/quality_safety/safety_efficacy/Drug%20utilization%20research.pdf webcite [Accessed February 2014]
Martin A, Godman B, Miranda J, Tilstone J, Saleem N, Olsson E, Acosta A, Restrepo L, Bennie M: Measures to improve angiotensin receptor blocker prescribing efficiency in the UK: findings and implications.
Rønning M, Blix HS, Harbø BT, Strøm H: Different versions of the anatomical therapeutic chemical classification system and the defined daily dose–are drug utilisation data comparable?
Vlahovic-Palcevski V, Gantumur M, Radosevic N, Palcevski G, Vander Stichele R: Coping with changes in defined daily dose in longitudinal drug consumption databases.
Simoens S: A review of generic medicine pricing in Europe.
Dylst P, Vulto A, Simoens S: The impact of reference-pricing systems in Europe: a literature review and case studies.
Godman B, Shrank W, Wettermark B, Andersen M, Bishop I, Burkhardt T, Garuolienè K, Kalaba M, Laius O, Joppi R, Sermet C, Schwabe U, Teixeira I, Tulunay FC, Wendykowska K, Zara C, Gustafsson LL: Use of generics – a critical cost containment measure for all healthcare professionals in Europe?
Vogler S: The impact of pharmaceutical pricing and reimbursement policies on generics uptake: implementation of policy options on generics in 29 European countries–an overview.
Vogler S, Zimmermann N, Leopold C, de Joncheere K: Pharmaceutical policies in European countries in response to the global financial crisis.
Dylst P, Vulto A, Godman B, Simoens S: Generic medicines: solutions for a sustainable drug market?
Simoens S, De Bruyn K, Miranda J, Bennie M, Malmström RE, Godman B: Measures to enhance ARB prescribing efficiency in Belgium following generic losartan: impact and implications for the future.
Komossa K, Rummel-Kluge C, Hunger H, Schmid F, Schwarz S, Duggan L, Kissling W, Leucht S: Olanzapine versus other atypical antipsychotics for schizophrenia.
Cochrane Database of Systematic Reviews 2010.
Parks J, Radke A, Parker G, Foti ME, Eilers R, Diamond M, Svendsen D, Tandon R: Principles of Antipsychotic prescribing for policy makers, circa, 2008. Translating knowledge to promote individualized treatment.
Fisk M, Feeley J, Voreacos D: J&J Said to Agree to .2 Billion Drug Marketing Accord. Available via URL: (http://www.bloomberg.com/news/2012-06-11/j-j-said-to-pay-2-2-billion-to-end-risperdal-sales-probe.html webcite [Accessed November 2013]
Department of Justice settlement agreementAvailable via URL: http://www.justice.gov/usao/pae/Pharma-Device/astrazeneca_settlementagreement.pdf webcite [Accessed February 2014]
Jack A: AstraZeneca faces $520m Seroquel fine. Available via URL: http://www.ft.com/cms/s/0/319e31d4-5251-11df-8b09-00144feab49a.html#axzz26q1gMSgc webcite [Accessed February 2014]
Nelson JC, Papakostas GI: Atypical antipsychotic augmentation in major depressive disorder: a meta-analysis of placebo-controlled randomized trials.
De Fruyt J, Deschepper E, Audenaert K, Constant E, Floris M, Pitchot W, Sienaert P, Souery D, Claes S: Second generation antipsychotics in the treatment of bipolar depression: a systematic review and meta-analysis.
Vieta E, Locklear J, Günther O, Ekman M, Miltenburger C, Chatterton ML, Aström M, Paulsson B: Treatment options for bipolar depression: a systematic review of randomized, controlled trials.
Godman B, Wettermark B, Miranda J, Bennie M, Martin A, Malmström RE: Influence of multiple initiatives in Sweden to enhance ARB prescribing efficiency following generic losartan; findings and implications for other countries.
Baumgärtel C, Godman B, Malmström R, Andersen M, Abuelkhair M, Abdu S, Bennie M, Bishop I, Burkhardt T, Fahmy S, Furst J, Garuoliene K, Herholz H, Kalaba K, Koskinen H, Laius O, Lonsdale J, Malinowska K, Ringerud A, Schwabe U, Sermet C, Skiöld P, Teixeira I, Vitry A, Vončina L, Zara C, Gustafsson LL: What lessons can be learned from the launch of generic clopidogrel?
Andersson K, Sonesson C, Petzold M, Carlsten A, Lönnroth K: What are the obstacles to generic substitution? An assessment of the behaviour of prescribers, patients and pharmacies during the first year of generic substitution in Sweden.
Godman B, Wettermark B, Hoffman M, Andersson K, Haycox A, Gustafsson LL: Multifaceted national and regional drug reforms and initiatives in ambulatory care in Sweden; global relevance.
Medical Products Agency SwedenAvailable at URL: http://www.lakemedelsverket.se/upload/halso-och-sjukvard/forskrivning/utbytbarhet/Utbytbara%20l%c3%a4kemedel%20(hela%20listan)%202014-03-31.pdf webcite (Accessed March 2014)
Olsson E, Sporrong SK: Pharmacists' experiences and attitudes regarding generic drugs and generic substitution: two sides of the coin.
Olsson E, Ingman P, Ahmed A, Sporrong S: Pharmacist-patient communication in Swedish community pharmacists.
Duerden M, Hughes D: Generic and therapeutic substitutions in the UK: are they a good thing?
Dylst P, Vulto A, Simoens S: Where a cheap medicine is not the same as a generic medicine: the Belgian case.
Cahir C, Fahey T, Tilson L, Teljeur C, Bennett K: Proton pump inhibitors: potential cost reductions by applying prescribing guidelines.
Araszkiewicz AA, Szabert K, Godman B, Wladysiuk M, Barbui C, Haycox A: Generic olanzapine: health authority opportunity or nightmare?
Coma A, Zara C, Godman B, Augusta A, Diogenes E, Wettermark B, Haycox A: Policies to enhance the efficiency of prescribing in the Spanish Catalan Region: impact and future direction.
Pre-publication history
The pre-publication history for this paper can be accessed here:


text:
let's do it again and again pt 4/5
let's do it again and again pt 2/5
let's do it again and again pt 3/5
let's do it again and again pt 1/5
She Says Yes pt 5/5
sleeping beauty awakening fuck
She Says Yes pt 2/5
Hot Girlfriend Gets Fucked
She Says Yes pt 3/5
Stephanie squirting and creampied
She Says Yes pt 4/5
Please enter your name.
Please enter your message.
Sorry, could not submit your comment.
Thank you for submitting your comment! All comments are moderated and may take up to 24 hours to be posted.
Loading Comments
Select the details below that best describe this video. We appreciate your assistance and will use this information to improve our service to you.
Recognize a pornstar in this video? Help make pornstars easier to find on YouPorn by telling us who is in this video.
Are you sure you want to remove this video from your favorites?

subset: commoncrawl


text:
Sony Pictures Secures Robotech Rights
- Details
- Written by SIGHUP
- Category: News
- Published: 25 March 2015
- Hits: 58
Move over Warner Brothers, you kept the fans waiting long enough. Sony has announced that it has secured the rights to Robotech and the studio plans to quickly develop a live-action movie. Not only that but views the project as a possible film franchise.
The project will be overseen at Sony Pictures by Sony Pictures Entertainment Group President Doug Belgrad, Columbia Pictures Production Chief Michael De Luca, and Sony Pictures Vice President of Creative Production Matthew Milam.
"'Robotech' is unique in that it has always been a marriage of spectacle with human characters that seem drawn from life," said De Luca. "That's why we are so excited to be working with Mark and Gianni as we move forward on this project. With a history that offers an epic love triangle, a renegade hero, and a world on the brink of extinction, 'Robotech' offers a wide scope and a rich and impressive universe where the story possibilities are endless."
Deadline Reports Robotech Live Action Movie Back Online
- Details
- Written by SIGHUP
- Category: News
- Published: 05 February 2015
- Hits: 246
According to Deadline, Warner Brothers based producers Hollywood Gang have brought in Michael Gordon (300 and G.I.Joe: Rise of Cobra) to revive the Robotech Live Action Movie project. With their sights set on Andy Muschietti to steer the film. We're all thinking the same thing, so lets see how this develops.
Source: Deadline
Robotech Illustrated
- Details
- Written by SIGHUP
- Category: Featured Fandom
- Published: 27 August 2014
- Hits: 1022
Check out the new fan site by Tim Wong www.robotechillustrated.com which is a slight reboot of the old Unofficial Robotech Reference Guide. The website features tons of articles and art work by the author. If you love the technical aspect of Robotech, you will enjoy this website. You can also find Robotech Illustrated's Facebook Page.
Bad Syntax's Robotech RPG Tactics Unboxing
- Details
- Written by SIGHUP
- Category: Games
- Published: 20 August 2014
- Hits: 1133
Check out Bad_Syntax's Robotech RPG Tactics unboxing videos. As you recall, the board game was the result of an overwhelmingly successful Palladium Books Kickstarter. The 1/285th scale game pieces may be used as in conjunction with the Robotech RPG. The package features 34 game pieces, 40 game cards, 12 UEDF faction dice, 12 Zentraedi faction dice, and a full-color, 90+ page, softcover rulebook.
What Happened To The Robotech Invasion Fan Film?
- Details
- Written by SIGHUP
- Category: Featured Fandom
- Published: 19 August 2014
- Hits: 967
So whatever happened to Patricio Mosquera's -- the artist who produced the extra animation for Robotech Love Live Alive -- promising ROBOTECH Invasion fan film? The latest according to him on our forums is that the project was sent to HG as a proposal after the failed Robotech Academy Kickstarter. Currently Patricio is waiting for a favorable decision. However if the project is not accepted by HG, plans are to continue as a fan film. Either way it looks good for Robotech fans as the product should be released. Good luck to Patricio.


text:
From Wikipedia, the free encyclopedia
Rottefella is a Norwegian ski binding manufacturer. The name refers to the three-pin binding invented by Bror With in 1927, more formally known as the 75mm Nordic Norm. The binding was the standard for cross-country skiing for decades. Rottefella also produces one of the two systems that have largely replaced the 75mm, the New Nordic Norm.
Sponsored skiers[edit]
Some skiers who ski on Rottefella bindings include:
- Ole Einar Bjørndalen
- Kati Wilhelm
- Julija Tchepalova
- Halvard Hanevold
- Hilde Gjermundshaug Pedersen
- Olga Zaitseva
- Kateřina Neumannová
- Magnus Moan
- Kris Freeman
- David Chamberlain
- Andrew Johnson
- Leif Zimmerman
External links[edit]
- "Binding maker nails huge deal" – Aftenposten, 23 January 2006
- Rottefella Official Website
- NewTelemarkGuide.com Description of NTN - New Telemark Norm
|This article related to a manufacturing company is a stub. You can help Wikipedia by expanding it.
|This Norwegian corporation or company article is a stub. You can help Wikipedia by expanding it.


text:
the mythic monster of the swiss mountains
Last April, Gato Loco was playing at a music festival in Stans, Switzerland. A small mountain town, our tour van was slowly climbing the winding roads, passing picturesque farm houses Continue Reading →
Last April, Gato Loco was playing at a music festival in Stans, Switzerland. A small mountain town, our tour van was slowly climbing the winding roads, passing picturesque farm houses Continue Reading →
In the silent era, one of the great binary relationships on the silver screen was between Charlie Chaplin and Buster Keaton. Two of the biggest stars of all time, their Continue Reading →
Last night I went to the Nighthawk Cinema to see the midnight showing of Tron. Nighthawk is one of a handful of theaters in the city that relishes in "cinema Continue Reading →
Folks that know me are generally aware of my being a cinephile. If I'm not playing, making, or listening to music, I am watching a movie. And within that side Continue Reading →
Well — the winter slumber of January & February has worn off — and Gato Loco's getting ready to hit the ground running. We have our first Gato Loco Coconino Continue Reading →
As per the new usual, Wednesdays we'll be uploading new videos. Regularly. These will include music videos, interviews with band-members, candid videos from tours, etc. Week 1! A video that Continue Reading →
http://songfromtheuproar.com Saturday night I went to hear "Song from the Uproar: The Lives & Deaths of Isabelle Eberhardt", a new fully staged multi-media opera by Missy Mazzoli. It was staged Continue Reading →
Just 3 weeks til our new album is released in the U.S., and some exciting things are happening over here in Gato Loco land. How Low Can You Go? Gato Continue Reading →
5-weeks to go to the album is officially out in the US. What a great week it's been here in NYC. The spring weather is finally here after what's seemed Continue Reading →
We're doin' a little countdown — I'll be posting every tuesday, leading up to the US release of our new album, on Winter & Winter Records — June 14th. It's Continue Reading →


text:
View jewish Singles in Quinlan
By clicking continue, I agree to receive transactional and promotional emails from Match.com. I understand that I am free to withdraw consent at any time.
By using our site, you agree to the Match.com Terms of Use.
Lone Star State of Texas. We prove that an online dating personals site can really lead to a long-lasting sincere relationship. Who's on Match.com? Your neighbors, coworkers and millions of singles worldwide. Match.com has led to more dates, relationships, and marriages than any other site. Match.com members form a diverse, global community of singles who share common goals - to meet other singles, find dates, form romantic relationships and meet life partners. In the arithmetic of love, one Quinlan profile plus one click can equal the love of your life.
Brashear, Caddo Mills, Campbell, Celeste, Commerce, Copeville, Crandall, Cumby, East Tawakoni, Edgewood, Elmo, Emory, Farmersville, Fate, Floyd, Forney, Fruitvale, Greenville, Heartland, Heath, Heathridge, Josephine, Kaufman, Lavon, Lone Oak, Lucas, Merit, Nevada, Point, Princeton, Rockwall, Rowlett, Royse City, Sachse, Saint Paul, Sunnyvale, Terrell, West Tawakoni, Wills Point, Wylie view all states »
Asian , Black , Catholic , Christian , Divorced , Free Online Dating, Gay Singles, Gay Dating, Jewish , Lesbian Singles, Single Parents, view all communities »


text:
ABLE Accounts: A new law titled "Achieving a Better Life Experience" (ABLE) allows the establishment of tax-free accounts that can be used to save for disability-related expenses. ABLE accounts can be created by individuals...more
In its recently issued opinion in the case of Route 231, LLC v. Commissioner, T.C. Memo 2014-30 (2/24/14), the United States Tax Court (the "Court") held that a transfer of state tax credits to a 1% member who had contributed...more
Conservation easements are an effective tool for tax and estate planning and there are significant tax benefits to implementing them in 2013....more
The Georgia Department of Revenue Income is proposing a change to the Tax Division Rule on conservation tax credits. Interested parties seeking to comment on the proposed Rule should review the notice for further guidance....more
Back to Top
Copyright ©


text:
Pompton people
The Pompton, Pumpton, or Pamapon Indians were a condensed Tribe located in Northern Jersey. A band of Wappingers by invitation from the Minsi at the end of the Esopus War of 1664 joined them. Wappinger was originally the name of a small sachemship on the east side of the Hudson near Poughkeepsie and comprises various bands.
The territory of the Wappangers ran from the east bank of the Hudson River from Manhattan Island to Poughkeepsie and the territory eastward to the lower Connecticut Valley.[1] Other names for the Wappinger were: Highland Indians, Long Reach Indians, Oping (Opine), and Pompton. Some of the names of the villages were Alipkonck, Sinsing, Kestoubniuk, Keskisckonck, Pesquaskeck and Noch Peem. One possible group of Wappinger remain in the region today, the Ramapough Mountain Indians (Ramapo Mountain People) in northern New Jersey.[2][3]
Memerescum, a Pompton Sachem, was the 'sole sachem of all the nations (towns or families) of Indians on Remopuck River(Ramapo), and on the east and west branches thereof, on Saddle River, Pasqueck River, Narranshunk River and Tappan,' gave title to all the lands in upper or northwestern Bergen and Passaic counties.", indicating a combination of clans. His name appears on the Indian Deed of 1710.(otherwise known as the Ramapo Tract or the Schuyler Patent)[4] Chief Catoonah who was the Sachem of the condensed tribe called Ramapoo in Connecticut originated from the tribe of Ramapo/Pamapon(Pompton) Tribe and was forced to move to Connecticut by the encroachment of the Dutch.[5] Tapgow, who was Catonah's uncle signed on the Indian Deed of 1710, the Wawayanda Patent and others.
Pequannock (in the name of the Township and of the Pequannock River) is thought to have been derived from the Lenni Lenape word "Paquettahhnuake", meaning, "cleared land ready or being readied for cultivation".[6] Pompton has been cited by some sources to mean "a place where they catch soft fish."[7]
- ^ http://www.accessgenealogy.com/native/newyork/newyork4.htm, retrieved 9/21/2010
- ^ http://www.angelfire.com/realm/shades/nativeamericans/wappinger.htm, retrieved 4/24/2010
- ^ http://www.twincommonwealth.com/nj/njind.htm, retrieved 4/25/2010
- ^ Ruttenber, Edward., Footprints of the Red Men. Indian geographical names in the valley of Hudson's river, the valley of the Mohawk, and on the Delaware: The location and the probably meaning of some of them. p. 113-114
- ^ http://catalog.nypl.org/iii/encore/search/C%7CSFranklyn+BeArce%7COrightresult%7CU1?lang=eng&suite=pearl, retrieved 1/14/2011, The Bearce family history on file in the NY Public Library
- ^ Morris County profile of Pequannock Township, accessed November 9, 2006.
- ^ Town Information - Pequannock, accessed November 9, 2006.


text:
Loading stream...
Now Playing
Connect with Us
Podcasts & RSS Feeds
|All Content
|View all podcasts & RSS feeds
Most Active Stories
Vox Pop
3:33 am
Mon November 20, 2006
Medical Monday 11/20/06
Albany, NY – Rheumatology is the topic of this Vox Pop Medical Monday. Alan Chartock welcomes Dr. Jonathan Krant. Jonathan D. Krant, MD, directs the teaching service inRheumatology at Berkshire Medical Center in Pittsfield, MA. A busy clinician, he oversees the care of 6,000 patients within a four state radius, and runs the clinical investigation unit at Berkshire Rheumatology Associates


text:
A theft of cash occurred on February 2, at about 3:30 pm at the Safeway fuel station located near the intersection of Martin Way and Kasey Keller Drive NE. The victim arrived at the gas pumps to fill his cans of gas alongside his pickup. While doing so, an unknown suspect approaches the victim's truck, enters the passenger side door and steals an envelope full of money. In the second picture, we have reason to believe that a male near-by in a minivan is also involved in this theft.
If you have any information on the suspect please contact the Olympia Police Department or Crime Stoppers at 1-800-222-TIPS.


text:
Police have released the identity of a dead man found in a ditch near Polaris Mall Wednesday.Columbus police said Friday that the man was Oscar Gonzalez, 22, of Columbus who had been reported missing by his family on March 14.
The Williams Institute at Methodist Theological School in Ohio will welcome Texas Christian University faculty member Melanie Harris for two lectures April 22 and 23.
A Delaware County grand jury returned a 15-count indictment Friday against a Reynoldsburg woman who, prosecutors say, stole items from several homes while she was working as a cleaner.
Delaware City Council will break out of the confines of its City Hall chambers – to hold a more freewheeling discussion than a typical meeting would allow – at a retreat Saturday.
Delaware County sheriff's deputies are asking members of the community to help them identify a woman they say stole several items from a woman's purse.
Two Delaware County men have been convicted on several federal charges related to a scheme to bilk investors of their company out of millions of dollars.
Community Open Table, an outreach of Sunbury United Methodist Church, is typically held on the first Friday of every month when members of the church and other volunteers host a dinner for anyone who is struggling with poverty that needs a hot,...
A band of local musicians performed recently while volunteers prepared to deliver Meals on Wheels with local government officials as part of the Council for Older Adults' March for Meals campaign. From left to right, Isabel Hadden, Peggy Potts...
A $50,000 private matching gift pledge will help the United Way of Delaware County and the Women's Leadership Network open Delaware County's first domestic violence shelter.
Victims of the former Olentangy teacher accused of gross sexual imposition are still coming forward, according to the Delaware County prosecutor.
Columbus police have still not released the name of a dead man found near Polaris Wednesday morning but have said they are no long investigating the death as a homicide.
Delaware police report:
The game of tug-of-war between the village of Galena and Berkshire Township continues.Berkshire Township trustees on Monday took action to inform village officials that they will no longer provide maintenance at Galena Cemetery.
Scioto Township will soon be in the market for a new fiscal officer.Susan Beckley plans to retire due to health reasons before the expiration of her term in 2016.She will officially retire April 30.
A Delaware man has been ordered to pay more than $1.2 million to the Internal Revenue Service for failing to pay employment taxes.
Main Street Delaware's April 3 First Friday event promises an evening of good times, good friends and good health. Sponsored by the Delaware General Health District, the event will be a celebration of "Health with...
A former Delaware resident was arrested in Virginia last weekend on six felony charges.
Orange Township's administrator has filed a complaint with the Equal Employment Opportunity Commission, alleging she has been discriminated against because of her age, her gender and a disability.
The Humane Society of Delaware County is getting a helping hand with its injured animal fund from an online fundraiser with Thirty-One Gifts.
Lynn Pennington (left) and Emily Calvert (right, in green), co-chairs of the event, hand a cup of soup to a customer during the 13th annual "Soups for Shelter" event on Tuesday afternoon in St. Mary School's commons. Pennington said...
Delaware City Schools Superintendent Paul Craft addresses a crowd gathered for a groundbreaking ceremony at Dempsey Middle School on Tuesday afternoon. Craft, along with members of the board of education – (from left to right) Deb Rafeld, Jayna...
Two Hayes High School students recently presented scientific research papers at the Ohio Junior Science and Humanities Symposium.
A Columbus woman is being held on a $500,000 bond after causing a collision on Interstate 70 in Madison County that killed a woman.
Columbus police are investigating a dead body found near Polaris Mall in Columbus.Police discovered the body of a man in his 20s Wednesday morning in a ditch off Interstate 71 near the Polaris Mall entrance.
An Olentangy teacher accused of rape tendered his resignation Tuesday morning in a letter to the Olentangy school board.
Location, ST | website.com
|Delaware Gas Prices provided by GasBuddy.com


text:
WANTED: marsh marigold and others
sandrabeesApril 11, 2013
I just finished my pond a few weeks ago and am trying to stock with some plants. Would love marsh marigold. Also interested in most anything that will add to my pond, floaters, submerged plants, etc.
I have African iris (bog plant) to trade and pothos also have several other non pond plants Asiatic jasmine, English ivy, cast iron plants, etc.


text:
Our special coverage of the closest race for years
Explore the personal stories of Syrian refugees in Lebanon
23 Apr 2012 17:39 GMT | Politics, Europe, France
Both Francois Hollande and President Nicolas Sarkozy have addressed supporters the morning after first-round results in France's presidential election were released.
The two men emerged at the top of the field of 10 candidates, and now face a run-off poll on May 6. Polls held by Harris Interactive, IPSOS and CSA late on Sunday all saw Hollande beating Sarkozy in the second round by a margin of 54-46 per cent.
Hollande, the Socialist Party candidate who secured 28.6 per cent of Sunday's vote, said he would now gather together "all the French people who want change".
Live Box 201242085114263235
"We have to convince the French people who expressed certain messages during yesterday's vote, so I'm going to talk to them," he said.
Veteran leftist Hollande, who has proposed to recruit 60,000 state-employed school teachers if elected, said he would not attempt to convert those who voted for the far-right leader of the National Front, Marine Le Pen.
However, he said he did want to listen to their grievances with the way the country is run.
"I am not going to seek out voters from the extreme right," Hollande said.
"I won't try to seduce them. The far right has strong support at the moment and that's the fault of Nicolas Sarkozy. But some voters voted for the far right because they're angry [at Sarkozy].
"They are the voters who I want to hear from."
Call for televised debates
Sarkozy, the candidate of the centre-right UMP Party, has campaigned on a platform of tightening immigration controls and supporting business by loosening legal rights for workers - calling himself "the captain of a ship caught in a storm".
After coming second to Hollande in Sunday's poll, garnering 27.2 per cent of the vote, Sarkozy challenged his rival, repeating his call for face-to-face televised debates. Hollande has agreed to one such debate.
"This campaign must be about the truth, and I am ready to debate about it," he said.
"I proposed three debates on any subject. This is a crucial moment. The French people need to have all the facts so they can choose and I won't be running away from it or hiding from it."
After many accused the incumbent of veering to the right during his campaign, he too addressed the popularity of Marine Le Pen, who received a record 17.09 per cent of the poll.
"The National Front voters need to be respected, they made a choice, they expressed themselves," Sarkozy said.
"It's a vote of suffering. A vote of crisis. Why insult them because of it? I heard Mr Hollande making remarks on the subject. So Mr Hollande thinks it's fine to talk to [Left Front former candidate] Mr Melenchon - who says if you bump into a rich guy, empty his pockets - that's fine to say, that's normal, that's being a Republican, but the person who is suffering should not be able to express it. I am telling them [National Front voters]: 'I've heard you.'"
Struggle for votes
Al Jazeera's Tim Friend, reporting from Paris, said that Sarkozy would struggle to win votes from the far right.
"Marine Le Pen will not direct her unexpectedly large vote towards Sarkozy," he said. "She wants to see his party weakened and to establish herself as the strong voice of the right."
Polls quoted by AFP news agency show most far-right supporters prefer Sarkozy, but up to a quarter - mainly working-class voters attracted by Le Pen's protectionist trade policies - could switch to Hollande.
A spokesperson for German Chancellor Angela Merkel said in Berlin: "This high score [for Le Pen] is alarming but I expect it will be ironed out in the second round."
Yet Sarkozy appeared to continue to appeal to National Front voters, demonstrating his right-wing values: "These anxieties, this suffering, I know them, I understand them," he said.
"They are about respecting our borders, the determined fight against job relocation, controlling immigration, putting value on work, on security."
'Rude' to far right
Responding to comments that her popularity stemmed from a "protest vote", Marine Le Pen said: "I find that particularly rude in regard to our supporters.
Live Box 2012416175242331433
"We all have our own minds, as do our voters, and if our electorate vote for us it is because they are for more national protectionism, it's because they want less immigration, it's because they want security problems resolved."
She continued to admonish Sarkozy for his apparent appeals to the far right: "To treat my voters like they're fools, I fear his calls will fall on deaf ears."
As Sarkozy struggles to win over the rest of the country's right wing, Hollande looks certain to pick up support from the Green Party and the Left Front, almost certainly guaranteeing him some 42 per cent.
Meanwhile, the uncertainty over France's next leadership appeared to affect financial markets, with a two per cent fall in the country's CAC-40 index as markets opened.
Analysts cautioned, however, about linking these results with the electoral poll, warning that markets may be less worried about a Socialist president as they are about wider financial unrest in Europe at large.
Source: Al Jazeera and agencies
Newspapers predict Sarkozy will struggle in runoff, noting right-wing Marine Le Pen's likely influence on outcome.
Europe, Belgium, France, Italy, Portugal
France's president-elect Hollande rides a scooter to work and says he will be a "normal" head of state.
Politics, Europe, France
Content on this website is for general information purposes only. Your comments
are provided by your own free will and you take sole responsibility for any direct
or indirect liability. You hereby provide us with an irrevocable, unlimited, and
global license for no consideration to use, reuse, delete or publish comments, in
accordance with Community Rules & Guidelines and Terms and Conditions.
In religiously conservative Brazil, women risk jail time and their lives to undergo the procedure that is illegal but commonplace.
Health, Human Rights, Latin America
Trash is a fast-growing import in the Scandinavian country, which turns it into heat for people's homes.
Environment, Europe, Sweden
Critics say the UK's home secretary is using Muslims as a 'political punchbag' in a bid to shore up right-wing support.
Human Rights, Politics, Racism
2014 was the worst year in more than a decade for polio infections, with at least 306 new cases reported.
Polio, Asia, Pakistan
Negotiators try to bridge remaining gaps and hammer out framework deal that would be the basis for a final accord.
Middle East, Iran, US
At least 15 people killed at a camp for internally displaced people in Hajjah province.
War & Conflict, Middle East
It is a source of sustenance but also of tension and new political realities are now increasing uncertainty.
Egypt, Sudan, Middle East
A media post-mortem into the UK's surveillance report. Plus, why five years on in Argentina the media looks so familiar.
Media, Edward Snowden, Security
The untold story of how the Lebanese community overcame the odds and found their place in multicultural Australia.
Asia Pacific, Australia, Lebanon
How to keep a telenovela profitable and demanding sponsors happy while inspiring the production team to stay passionate.
Arts & Culture, Mexico, Latin America


text:
"Fairness for All Marylanders Act" Passes Full Senate
March 4, 2014 by HRC staff
Today the Fairness for All Marylanders Act, a bill that would prohibit discrimination on the basis of gender identity in employment, housing, public accommodations and credit, passed the full Senate after last week having been voted out of the Senate Judicial Proceedings Committee.
"It is critical that the Maryland legislature gets to the unfinished business of protecting transgender citizens from discrimination," said Human Rights Campaign President Chad Griffin. "No one should ever have to worry about losing their job or accessing safe and affordable housing simply because of who they are. We hope Maryland's fair-minded lawmakers will act on this critical bill quickly."
HRC is on the steering committee of the Maryland Coalition for Trans Equality, which has been working toward the passage of this bill and will continue to work together on the Fairness for All Marylanders Act as it moves through to the House. HRC has invested significant resources and on-the-ground support in this effort including $25,000 to Equality Maryland for field organizing and State Legislative Director Sarah Warbelow testified in support of the legislation earlier this month.
Top Posts
HRC Arkansas to Governor Asa Hutchinson: Veto SB202 Now
February 18, 2015
HRC's Time to Thrive Conference Kicks Off in Portland, Oregon
February 14, 2015
Epidemic of Anti-LGBT Violence Continues with Murder of Ohio Youth
February 16, 2015
"Love Has No Labels" Ad Campaign Celebrates Diversity and Inclusion
February 18, 2015


text:
View gay Singles in Nevada
By clicking continue, I agree to receive transactional and promotional emails from Match.com. I understand that I am free to withdraw consent at any time.
By using our site, you agree to the Match.com Terms of Use.
22 - Nevada, TX
Active within 1 week
Lone Star State of Texas. Whether you're looking for Christian singles, Black singles, Asian singles, Jewish singles or local singles, go to the dating site that is responsible for hundreds of thousands of happy couples. Connect with singles in Nevada,Texas for online dating, friendship and romance. On Match.com, surrounded by thousands of Nevada's hottest singles, you'll only stay single if you want to be single.
Allen, Anna, Blue Ridge, Caddo Mills, Celeste, Copeville, Fairview, Farmersville, Fate, Floyd, Forney, Garland, Greenville, Heartland, Heath, Heathridge, Josephine, Lavon, Leonard, Lucas, McKinney, Melissa, Merit, Mesquite, Murphy, Parker, Plano, Princeton, Quinlan, Richardson, Rockwall, Rowlett, Royse City, Sachse, Saint Paul, Sunnyvale, Terrell, West Tawakoni, Westminster, Wylie view all states »
Asian Men, Black Men, Catholic Men, Christian Men, Divorced Men, Free Online Dating, Gay Singles, Gay Dating, Jewish Men, Lesbian Singles, Single Parents, view all communities »


text:
Message-ID: <firstname.lastname@example.com> Subject: Exported From Confluence MIME-Version: 1.0 Content-Type: multipart/related; boundary="----=_Part_1354_1866088007.1427503074727" ------=_Part_1354_1866088007.1427503074727 Content-Type: text/html; charset=UTF-8 Content-Transfer-Encoding: quoted-printable Content-Location: file:///C:/exported.html
Jetty was originally developed by Greg Wilkins of Mort Bay Consult= ing.=20
Mort Bay is at the heart of Balmain, Sydney NSW, Australia. A former wor= king class suburb, now yuppieville in Sydney's close inner-west.=20
Greg was living by Mort Bay when the company was formed, hence the compa= ny name.=20
Jetty was originally called IssueTracker (its original application) and = then MBServler (Mort Bay SERVLet servER). Neither of these were much liked,= so Jetty was finally picked as:=20


text:
Carlos Villanueva has made the Cardinals' roster.
Red Sox placed C Christian Vazquez on the 60-day disabled list with a right elbow injury.
Jake McGee (elbow) is scheduled to throw another bullpen session Tuesday in Rays camp.
Matt Moore (elbow) will throw a bullpen session Tuesday.
Drew Smyly (shoulder) has been cleared to throw live batting practice this Wednesday.
Jaff Decker told reporters Monday morning that his left calf is "feeling a lot better."
Marlins optioned RHP Preston Claiborne to Triple-A New Orleans.


text: Analysing and detailing The Proper Scope of DNA (or "Gene") Patent Claims Posted: August 8, 2012 at 8:20 pm 25 Views To read more, Please visit – http://goo.gl/pdDxx Leave a Reply Click here to cancel reply. Name (required) Mail (will not be published) (required) Website Notify me of follow-up comments by email. Notify me of new posts by email.


text:
item(s) in cart
My Account X
- details & specs
- |
- reviews
details & specsback to top
Product DescriptionDanner bootmakers build the Corvallis by hand. It's the only way to ensure heavy-duty components like the safety toe, leather upper, and GORE-TEX liner come together in a way that ensures uncompromised quality for the craftsmen who wear them.
Danner's rich, full-grain, leather upper provides comfort and superior boot durability. The 100% waterproof GORE-TEX lining adds ultimate breathing comfort. A lightweight, stable TERRA FORCE X platform enhances side-support and performance. The 90° heel from the Danner Landscaper outsole delivers an athletic-inspired performance on the job site while providing superior traction and slip resistance. Abrasion resistant toe and heel. Triple stitched for superior endurance. Wide speed laces for a secure, tight fit. Uninsulated.
product reviewsback to top
Reviewed by 1 customer
- Comfortable
- Durable
- Good Cushioning
- Quality
- Slip resistant
- Stable
- Break-in time
Best Uses
- Wet Weather
- Work
Comments about Danner Mens Corvallis GTX 5" Plain-Toe Work Boot:
I am a big guy that stands on steel decks most of the day, and these boots are still great after two years.
- Sizing:
- Feels true to size
- Width:
- Feels true to width
- Was this a gift?:
- No


text:
"Chocolate Bar" means awesome to Dylan Siegel, the 8-year-old who wrote CHOCOLATE BAR, the book, at just 6 years old to raise money towards a cure for his best friend Jonah's rare liver condition, GSD Type 1b.
Beginning at a school event in November 2012, Dylan sold 200 copies of his book plus 100 custom wrapped chocolate bars (donated by Whole Foods Market), making over $5,000 in just hours. Then, Dylan and best friend Jonah held a book reading and signing at a Barnes & Noble bookstore, attracting attention from local media and landing them appearances on CBS' The Doctors, Headline News' Raising America, Fox News' Fox & Friends, The Today Show in Australia, an interview with Chelsea Clinton for NBC Nightly News with Brian Williams, and ABC World News with Diane Sawyer. The boys have also appeared in print on numerous websites, in newspapers and magazines. To date, nearly 25,000 copies of Dylan's book have sold in over 60 countries worldwide, helping Dylan reach his $1 million goal in just two years. But Dylan says won't stop until Jonah is cured.
All money raised goes directly to Jonah's research fund at the University of Florida where his doctor, GSD expert Dr. David Weinstein, is completing the research phase and preparing for human clinical trials. The cure for GSD will prove that gene therapy works and therefore charts a course for changing the face of health care.
While trying to cure GSD Type 1b, we also hope to show children of all ages that they have power and their actions can change the world.
Affecting literally one in a million, Glycogen Storage Disease Type 1b is an incurable genetic condition. Children born with this disease lack the liver enzyme that turns glycogen into glucose, rendering them unable to regulate their blood sugar levels. Untreated, their blood sugar can drop dangerously low, resulting in severe hypoglycemia, seizures, and even death. Currently, the only known treatment is a mixture of store bought cornstarch and water, which must be consumed every few hours. Cornstarch takes longer for the body to metabolize, maintaining blood sugar levels for an extended period of time. Children with GSD Type 1b also have very low white blood cell counts and therefore struggle with fighting infections. So even mild infections can mean a hospital visit for weeks at a time.
Check out this video to learn more about GSD 1B:


text:
27th Annual Celebration Luncheon Each year over 500 men, women, girls, and community and business leaders gather for an inspiring and uplifting afternoon. The Celebration Luncheon is our signature event, in which we celebrate the accomplishments of our teen Girl Heroes and Women of Achievement. All proceeds from the Luncheon will help us continue to provide a safe and supportive environment, where our girls feel inspired to become the next generation of Strong, Smart and Bold women … [Read more...]
Celebration Luncheon
Notes from Executive Director: All you need is love.
All you need is LOVE… and Girls Inc. of Lynn! During this exceptionally snowy winter, we thought it would warm your heart to hear some quotes from the girls themselves, sharing what they love about Girls Inc. of Lynn! "Girls Inc. just makes me happy, even when I'm sad." Lydia, Middle School "I love circle time because I get to see all my friends." Denva, School Age Child Care "I like all the cool things I do at mentoring." Rosalinda, Middle School "I love it because it's just girls!" Julis, … [Read more...]
Notes from Executive Director: Happy Mentoring Month!
Happy New Year & Happy National Mentoring Month! At Girls Inc. of Lynn, I have come to know a group of truly dedicated staff and volunteers that realize that trusting, mentoring relationships are essential to helping girls reach their potential. As part of the Six Essential Elements of the Girls Inc. Experience, we provide several specific mentoring programs at Girls Inc. of Lynn. Our College Mentoring Program offers juniors and seniors in high school, the opportunity to work with a … [Read more...]
Notes from Executive Director: Lydia and Nikki
I love this season. It helps remind me how lucky I am. Lucky to have bright, resilient and strong girls in our program, dedicated staff, generous donors and exceptional volunteers of all ages. Recently, in the news, there have been several articles about how the next generation is apathetic to the world around them. That has not been the case at Girls Inc. of Lynn. We have young volunteers from all the local colleges and high schools. Two such volunteers, Lydia and Nikki, should lay to rest any … [Read more...]
Notes from Executive Director: AmeriCorps at GIL
As the Executive Director, one of the tasks I enjoy the most at Girls Inc. is our monthly staff meeting. Our last meeting, during staff updates, I was struck by the talent and commitment of all of our staff… in particular, our AmeriCorps members. Year after year, the AmeriCorps members that serve at Girls Inc. of Lynn have not only inspired our girls to be strong, smart and bold, but have also exemplified it through their dedication to service. This year, we are lucky to have six talented women … [Read more...]
Notes from Executive Director: Happy Fall!
On the first day of fall programming, I walked through the building and instantly felt an amazing energy that made my heart sing. There were smiling faces everywhere! As I walked into our library, now called Ruth's Reading Room, I heard one of the girls say to the staff "No, don't stop reading now! You can't stop now… the story was just getting better". I knew that over the summer, 70% of our School Age Program girls improved their reading skills, and that almost all of them did not experience a … [Read more...]


text:
I have good news, someone has called and involved Norwegian scientists. So a couple of weeks to late, you have the sense to ask those with experience and access to the latest technology to recover and plug the well.
Having said this, I also make you aware that an offhore rig also sank last week (Thursday) off the coast of Venezuela. The Blow-Out Preventor ("BOP") worked fine here, as did the evacuation of the platform. Venezuela started offshore without pride and with the intent to protect the marine life in the Carribean. They wanted the same regulations as Norway imposed, received them and translated them to Spanish. The US oil companies called them "Socialistic Regulations" and used them in silly jokes.
If caring for others is "socialism" where does that leave the environmental issues?
I have read that NOAA had guidelines for drilling in the gulf to maintain safety. They too were laughed off.
The US way is to buy is cheap and the hell with the consequences. Other peoples technology doesn't count, even if it is better and safer.
So, the technology is available, its just to ask. They also had a rig sink outside Venezuela. Here the well was shut down, and there was no spill, because their safety regulations are a blue-print of what they use in the North Sea.
The silly thing is that I disagree with y0u on the "US way" - it is not to buy cheap - any price will do. They believe that the more expensive the better. They certainly do not believe that foreign devices that costs a fraction of US equipment is up to it, even though the foreign equipment has proven it can do it, it is much better and vastly more reliable. It is just "foreign".


text:
Tuesday, 19 Jan 2010 06:24 PM
A Monet painting that was cut from its frame 10 years ago at a museum in western Poland and replaced with a copy painted on cardboard has been recovered, police said Wednesday.
Officers also have arrested a suspect who had the French Impressionist's "Beach in Pourville" in his possession and confessed to stealing it, officials said.
Poznan police spokesman Romuald Piecuch said that officers detained the 41-year-old man in the southern city of Olkusz Tuesday.
Fingerprints and other traces left at the site of the theft helped identify the suspect, Piecuch said.
Piecuch said the painting was brought to the National Museum in Poznan, where experts were to verify its authenticity.
"We have great hope that it is our stolen painting," museum spokeswoman Aleksandra Sobocinska said.
The painting, which shows the sea lapping against a beach in pastel blues and greens, was valued at $1 million (euro0.69 million) at the time of its theft. Sobocinska said she did not have an estimate of its current value, but said that "to us it was a priceless masterpiece."
Poznan prosecutor Krzysztof Grzeskowiak said the suspect probably wanted the painting for himself. He could face up to 10 years in prison if convicted.
© Copyright 2015 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
Tuesday, 24 Feb 2015 18:23 PM
Little Rock, Arkansas, gained attention during the Civil Rights movement when nine African-American teenagers entered th . . .
Wednesday, 28 Jan 2015 18:51 PM
Michele Bachmann, a potential GOP presidential hopeful in 2016, seems to be a political target that liberals love to sho . . .
Thursday, 08 Jan 2015 21:02 PM
Imagine walking into Dick's Sporting Goods to make a gun purchase, something that's entirely legal under the Second Amen . . .
First order of business, at 12:01 AM first day of the new President's term:...
God bless you, Sen. Cruz, and the very best of luck! I'm just a disabled vet...
Yes, Bergdahl needs to be charged with desertion and imprisoned . Obama needs...
I used to be a Deputy Sheriff , I can tell you that Reverend Graham is dead...
Reason #13: Cruz can give a powerful speech without using a teleprompter. He...
Newsmax, Moneynews, Newsmax Health, and Independent. American. are registered trademarks of Newsmax Media, Inc. Newsmax TV, and Newsmax World are trademarks of Newsmax Media, Inc.


text:
Shop now and get Free Value Shipping on most orders over $49 to the contiguous 48 states, DC and to all U.S. Military APO/FPO/DPO addresses.
We want to ensure that making a return is as easy and hassle-free as possible! If for any reason you decide that your purchase just isn't for you, simply return the item within 30 days of receipt and we'll cover the cost of return shipping. Learn more about our Return Policy.
Kleen Bore Mops for .30, .38, .357 and 9mm Calibers MOP222 claim to be some of the most absorbent and thickest bore mops on the market. These 100% cotton cleaning kits are highly absorbent and effective against all sorts of dirt and residue. Lubricants and cleaning solvents go on easily and evenly with Kleen Bore Cotton Rifle and Handgun Bore Mops. This Kleen Bore cleaning kit includes #3-48 threads, so you can attach the bore mop to other Kleen Bore products. Protect and clean your rifle or handgun bore with the alLnatural power of Kleen Bore .30, .38, .357, and 9mm Rifle and Handgun Bore Mops.
Connect with OpticsPlanet
Become our fan, follow us, & subscribe for the latest updates and deals
Subscribe to our email list
Sign up and receive $5 Off and get exclusive access to promotions, sales
events, pre-order sales & more!
Contact Information
Toll-Free: 800-504-5897
Intl.: 847-513-6201
Fax: 847-919-3003
Email: firstname.lastname@example.com
Hours of Operation
7AM-8PM CST Mon-Fri9AM-5PM CST Sat-Sun
Our Guarantees


text:
Written on: 06/04/2004 by Mikeb100 (1 review written)
Good Points
Reliable, simple
Bad Points
A little on the large side, dated technology, only single band
General Comments
Having owned 2 of these Nokia 5110 mobile phones, i found that the only major problem i had with them was the screen. The other problem i had which forced me to get a new one was the common fault (or so i believe) of the contact service message. I have since replaced it with a 3410 purely to keep up with the times as it is a bit old now. However it is still a good entry level phone and takes some hard knocks.
As rated by real users
" I got this phone more then 8 years " Read More
Written by davidsilva746
" Best phone I've ever had " Read More
Written by AliceWayte
" This Nokia 9210 mobile phone can be a real boon as it can give you ... " Read More
Written by stuart63
" Johnk777 " Read More
" I bought this nice looking phone in Nairobi-Kenya in July 2003 from... " Read More
Written by Peter Njoroge Mwangi