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The Weatherbeeta Original 1680D Detach-a-Neck Heavyweight Turnout Blanket is made with horseplay in mind. It features a rugged Teflon®-coated 1680 denier ballistic nylon outer shell that resists wear and tear. It's waterproof and breathable, with 360 grams of poly fill and a detachable neck cover.
The Weatherbeeta Rain Sheet is a must for your next event! This lightweight, waterproof rain sheet keeps both your horse and tack dry. Styled with a quick, easy front closure system, single belly surcingle, slots for stirrups, a bridle loop and a tail cord.
This Blue Ribbon Custom Lightweight Wool Dress Sheet is well crafted in quality, lightweight wool. It's has a leather front closure, removable belly strap, braided tail cord and hip ornament. Choose the body, trim and piping colors. Allow 4-5 weeks for delivery; increase time by 1-2 weeks if you add an optional monogram.
This item is the custom order form only. Click on the PDF below to view custom options.
The Custom Wrap Around Rain Quarter Sheet by Blue Ribbon Blankets is ideal for wet, drizzly days. Made with a 420 denier, water-repellent outer and a cozy plaid flannel lining, this exercise sheet is easy to put on and take off with its hook and loop closure. Choose your horse's blanket size, body color, trim color and piping. Allow 4-5 weeks for delivery; add 1-2 weeks for a monogram
The WeatherBeeta Fleece Combo Neck Cooler is lightweight and warm. Made of anti-pill polyester fleece with nylon lining in the shoulders and along top of neck. Twin chest straps, 2 heavy-duty hook-and-loop neck closures, low cross surcingles, crown strap and tail cord.


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Carbon monoxide is an extremely poisonous gas. Breathing air that contains as little as 0.1% carbon monoxide by volume can be fatal; a concentration of about 1% can cause death within a few minutes. The gas is especially dangerous because it is not easily detected by human senses. Early symptoms of carbon monoxide poisoning include drowsiness and headache, followed by unconsciousness, respiratory failure, and death. First aid for a victim of carbon monoxide poisoning requires access to fresh air; administration of artificial respiration and, if available, oxygen; and, as soon as possible, expert medical attention. When carbon monoxide is inhaled, it reacts with hemoglobin, the red blood pigment that normally carries oxygen to all parts of the body. Because carbon monoxide is attracted to the hemoglobin about 210 times as strongly as is oxygen, it takes the place of oxygen in the blood, causing oxygen starvation throughout the body. Carbon monoxide detectors for homes are now readily available.
Carbon monoxide from automobile and industrial emissions is a dangerous pollutant that may contribute to the greenhouse effect and global warming. In urban areas carbon monoxide, along with aldehydes, react photochemically to produce peroxy radicals. Peroxy radicals react with nitrogen oxide to increase the ratio of NO2 to NO, which reduces the quantity of NO that is available to react with ozone (see smog). Carbon monoxide is also a constituent of tobacco smoke.
The 3 substrates of this enzyme are CO, H2O, and A, whereas its two products are CO2 and AH2.
This enzyme belongs to the family of oxidoreductases, specifically those acting on the aldehyde or oxo group of donor with other acceptors. The systematic name of this enzyme class is carbon-monoxide:acceptor oxidoreductase. Other names in common use include anaerobic carbon monoxide dehydrogenase, carbon monoxide oxygenase, carbon-monoxide dehydrogenase, and carbon-monoxide:(acceptor) oxidoreductase. This enzyme participates in methane metabolism. It has 4 cofactors: iron, Zinc, Nickel, and Iron-sulfur.
As of late 2007, 13 structures have been solved for this class of enzymes, with PDB accession codes , , , , , , , , , , , , and .

subset: commoncrawl


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Boyner's Beymen Seeks 30% Sales Growth in 2011, Sabah Reports
Jan. 22 (Bloomberg) -- Beymen, the luxury clothing and retail chain owned by Turkey's Boyner Buyuk Magazacilik AS, aims to increase sales by 30 percent this year, Sabah newspaper reported citing Chief Executive Officer Elif Capci.
Beymen is planning to open a store in Cairo and is also examining opportunities in Iraq, Iran and Syria, Capci said, according to Sabah.
Click here for web link
To contact the editor responsible for this story: Ben Holland at email@example.com


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Availability for Nashville, TN (Lebanon) between July 4, 2015 - July 11, 2015
325Nashville, TN (Lebanon)
205 S. Eastgate Ct, Lebanon,TN 37090 | directions
Intersection: I-40 & Hwy 109 (exit 232)
Phone: 615-453-9087
Office Hours: Mon - Fri 9:00 AM - 8:00 PM | Sat 10:00 AM - 4:00 PM | Sun 3:00 PM - 8:00 PM
Located off I-40 and Hwy 109. Twenty miles NW of downtown. Home to numerous colleges. Close to shopping, dining and entertainment. Show Details
Value Place Lebanon, TN, is conveniently located off of I-40 and Hwy 109 (exit 232), approximately 20 miles northwest of downtown Nashville. Known as "Music City," Nashville is home to numerous colleges and universities, as well as a major hub for the music, banking, transportation, publishing, and healthcare industries. The CMA Awards are the most anticipated event of the year—the major Country Music Association awards show held at Bridgestone Arena every November. Guests at this hotel with kitchens in every room, will appreciate the close proximity of dining options in the area.


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Corpus Christi Ride-In Theater presents 'Mixed Nuts' in time for holidays
CORPUS CHRISTI - If traditional holiday hubbub isn't getting you into the spirit, try an alternative approach at Corpus Christi Ride-In Theater's screening of "Mixed Nuts."
A dark comedy focusing on quirky people running a suicide hotline on Christmas Eve, "Mixed Nuts" just might be the seasonal flick that puts you in the holiday mood. Grab your bike, bring a blanket, and head to the Watergarden on Friday night for outdoor entertainment and good company beginning at 7 p.m. The film screening is free and open to the public, but viewer discretion is advised due to mature themes discussed throughout the film.
Orlando's Catering and Corpus Christi Liquor Catering will be on site for those who've worked up an end-of-the-week appetite. Remember: no outside liquor is allowed on premises. Corpus Christi Ride-In Theater will host a toy drive benefiting the Toys for Tots campaign, so bring new and unwrapped toys to contribute for needy children. Don't miss the after party at Cassidy's Irish Pub following the film screening.
The film screening is the last of 2012 and the organization already anticipates a busy 2013 schedule.
"We hope to be able to bring a wider variety of movies in 2013," said Corpus Christi Ride-In Theater spokeswoman Lexi Buquet. "As our audience grows each month, we receive greater city support. We are more likely to get sponsors which allows us to pay for preshow entertainment which in turn enhances the overall movie experience. A larger attendance also means a larger contribution for whatever charity is selected for that night."
Buquet said a lot of thought went into selecting "Mixed Nuts," one of the late director Nora Ephron's offbeat films.
"While the majority of Nora Ephron's movies such as 'Sleepless in Seattle' and 'When Harry Met Sally' can be guilty pleasures, 'Mixed Nuts' is a quirky Christmas stepchild that has never been credited as a 'classic,'" Buquet said. "It was important that we stuck to a movie that isn't shown repeatedly on TV during the holiday season, which removes a lot of the classics. 'Mixed Nuts,' however, fits the Ride-In Theater because it's funny, dark, weird, and it opens with Steve Martin riding his bike on the beach front during Christmas."
Bring your sense of humor and prepare for yet another fun-filled evening at the venue.
If You Go
What: Corpus Christi Ride-In Theater presents "Mixed Nuts"
Where: Water Gardens, 1900 N. Chaparral St.
When: Preshow begins at 7 p.m. and film is at 8 p.m. Friday
Cost: Free
Information: www.facebook/ccrideintheater
Subscribe to the Caller-Times
Need Help? Call us at 1-800-566-8098.
Monday-Friday: 6am-3pm / Saturday: 7am-11am / Sunday: 7am-11am


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EXERPEUTIC 4000 Double Transmission Drive 18" Stride Elliptical with Magnetic Resistance and Heart Rate Control
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Product Details
The Exerpeutic® 4000 elliptical offers a great workout from the comforts of home. Operating with a consistent 2-flywheel and 2-belt design, the double transmission system results in increased momentum and a smoother striding motion. Fourteen levels of magnetic resistance are adjustable via the LCD computer console, which also displays your time, distance, RPM, watts, speed, and heart rate.
Key Specs:
- Model Number: 4000
- Number of Resistance Levels: 14 Levels
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Additional Info
- Dual-action handlebars
- 3-piece cranking system
- Double transmission system operates with a consistent 2-flywheel and 2-belt design
- Extended leg stabilizers


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The Global FlyFisher - The Largest and Best Place to go for Online Fly Fishing and Fly Tying
GFF Videos
Yamamoto's Pheasant Tail Mayfly Cripple
One fly that can express multi stages of mayfly emergence. Also this can tied for different mayfly species by simply changing hook-sizes and colors. Works in both spring creeks and rivers.
For how to fish and fishing results, click http://leftyangler.blogspot.com
For purchase, click http://leftytyer.blogspot.com
Originator:Satoshi Yamamoto
Submitter:Martin Joergensen


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Average Business Operations Analysts in the United States make around $56K per year. Compensation ranges between $40K and $83K per year. Including potential for bonuses and profit sharing — peaking near $8K and $7K, respectively — total cash payment to Business Operations Analysts can bottom out near $40K or peak near $83K depending on individual performance. The particular firm is the biggest factor affecting pay for this group, followed by the particular city and tenure. Male Business Operations Analysts are just a bit more common among those who completed the questionnaire than females ones, with male workers composing 54 percent of the field. Almost all get medical and dental insurance, and a fair number get vision plans, too. Job satisfaction is reported as high by the vast majority of workers. This report is based on answers to PayScale's salary questionnaire.
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Business operations analysts are in charge of conducting extensive, accurate analyses of their organization's existing business operations. Their main duties includes gathering data and developing solutions meet business needs. They write detailed reports based on their recommendations and communicate their findings (in writing and through presentations) to upper management. Business operations analysts perform gap analysis, support data collection, and gather documentation. They also analyze cross-departmental business processes for efficiency.Read More...
In all tasks, business operations analysts must follow strict company procedures and report their progress to the business operations supervisor in their department. Business operations analysts also assist with business development tasks as needed and participate in company meetings, sharing their ideas to improve the current business model and increase profitability. They also ensure that key assignments are completed on schedule and that status reports are turned in on time.
A bachelor's degree in business analysis, management, finance, or a related field is necessary for this position. Previous experience in a similar capacity may be preferred. Business operations analysts must work well with colleagues in a team environment, but also perform well on their own with minimal supervision. They should be organized, as well as able to multitask when handling large amount of information.
Many Business Operations Analysts can be found at The Boeing Company, J.P. Morgan Chase & Co. (JPMCC), Cisco Systems Inc, Dish Network Corporation, and EMC Corporation, firms that are at the top of the field. Cisco Systems Inc offers the largest salaries in town ($81K on average), but the considerable range in workers' salaries creates a rather varied pay scale that stretches from $60K to $113K. Business Operations Analysts will also find cushy salaries at The Boeing Company (+$74K), Navy Federal Credit Union (+$64K), and EMC Corporation (+$63K).
J.P. Morgan Chase & Co. (JPMCC) is infamous for dishing out the smallest paychecks in the area (the median in that office is $50K), but the company pay scale is greatly mixed, meaning that workers on the low end may earn only $32K while workers on the upper end may rake in $66K. Workers also receive paychecks lighter than average at Dish Network Corporation ($52K), Nationstar Mortgage LLC ($53K), and Hewlett-Packard Company ($53K).
Business Operations Analysts seem to wield many skills on the job. Most notably, skills in Supply Chain, Project Management, Business Analysis, and Operations Management are correlated to pay that is above average, with boosts between 4 percent and 17 percent. At the other end of the pay range are skills like Microsoft Access, Microsoft Office, and Microsoft Word. For most people, competency in Data Analysis indicates knowledge of Business Analysis and Process Improvement.
Median of all compensation (including tips, bonus, and overtime) by years of experience.
For Business Operations Analysts, level of experience appears to be a somewhat less important part of the salary calculation — more experience does not correlate to noticeably higher pay. Salaries for the relatively untried average out to around $54K, but survey participants with five to 10 years of experience earn a significantly higher median of $62K. Business Operations Analysts bring in $70K after working for 10 to 20 years. More than 20 years of experience mean a somewhat bigger median paycheck of $75K, but it's not much more than what less experienced people make.
For Business Operations Analysts, San Jose provides a pay rate that is 33 percent greater than the national average. Business Operations Analysts will also find cushy salaries in San Francisco (+22 percent), Washington (+15 percent), Seattle (+13 percent), and Denver (+8 percent). Those in the field find the lowest salaries in Columbus, 14 percent below the national average. Workers in Charlotte and Minneapolis earn salaries that trail the national average for those in this profession (12 percent less and 7 percent less, respectively).
|Highly satisfied
Rated 4 out of 5
based on 229 votes.
46 %
54 %
|Medical: 91%
|Dental: 88%
|Vision: 75%
|None: 7%


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Black Diamond Ahwahnee Vestibule
The Ahwahnee Vestibule was previously known as the Bibler Ahwahnee Vestibule.
Where to Buy
sponsored links
Manufacturer's Description
Visit Black Diamond's Ahwahnee Vestibule page.
Retailers' Descriptions
Here's what other sites are saying:
This vestibule adds 13 sq. ft. of storage space to the Black Diamond Ahwahnee Tent.This product will be shipped directly from Black Diamond and will leave their warehouse in 2-3 business days. Eligible for UPS ground shipping only.
Free Shipping. Black Diamond Ahwahnee Vestibule The SPECS Average Vestibule Weight: 1 lb 6 oz / 612 g
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The Black Diamond Ahwahnee Vestibule is constructed with lightweight waterproof SilPoly fabric and adds 12 square meters 13 sq ft of storage space to the Ahwahnee tentVestibule Area 12 m 13 sq ftAverage Vestibule Weight 612 g 1 lb 6 oz
- Bentgate.com
The lightweight Ahwahnee Vestibule by Black Diamond adds an additional thirteen square feet of living space and gear storage, perfect for backpacking dogs or extra winter gear. Singular Easton aluminum pole provides a ventilated addition Perfect for gear storage and sheltered entrance during heavy storms Stash this detachable vestibule for fast-and light travels
- OMCgear
Black Diamond Ahwahnee Vestibule
currently retails for:


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Women's Reebok
CrossFit Nano 5.0
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CrossFit Nano U-Form
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(1 of 1 customers found this review helpful)
Cute shoe
By Diane
from Westport, CT
Comments about Womens Reebok CrossFit Nano U-Form Cross Training Shoe:
Got so many compliments on these shoes at the gym today! Love the look and feel.
Bottom Line Yes, I would recommend this to a friend
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Reliable basic asics
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Comments about Womens ASICS GEL-Precision TR Cross Training Shoe:
Great for strength training in the gym OR for negotiating rocks, downed branches, muck, and mulch. Bought my regular size--which accommodates medium- to heavy-weight socks with no cramping. Comfy toe box.
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Mynewsdesk report finds Nordic brands ahead of the global curve
Press Releases • Jun 18, 2013 11:33 BST
Benchmark study finds top Nordic brands making good use of online newsrooms but still falling short in a number of areas
Benchmark study finds top Nordic brands making good use of online newsrooms but still falling short in a number of areas
The responsive newsroom design renders perfectly on any mobile device so brands can deliver a seamless experience for audiences on the move.
Mike Spits, Co-Founder of Elephant Parade said: "As a global brand, this is a fantastic opportunity to bring together and manage our international communications distribution from a central platform...
Mynewsdesk has been selected as the official newsroom partner of the Guardian's Changing Media Summit 2013, to be held in March in London. As well as partnering with The Guardian for the event, Peter Ingman, founder and CEO of Mynewsdesk, will be speaking at the two-day event looking at developments impacting the role of the modern day newsroom and how brands are becoming publishers
The best newsrooms are treasure troves of news, content and multimedia assets that can be used by journalists, bloggers, influencers and customers. They are a central hub for all of the brands' communications channels.
Mynewsdesk has integrated an Instagram feed onto their social newsrooms. This has enabled Mynewsdesk users to showcase their stylish Instagram images to make their communications more visual, personal and engaging.
Mynewsdesk has launched a new customer support forum that provides users with quick and easy support in just one click. You won't even have to leave the current webpage you are working on.
Mynewsdesk debuts its new and improved design. The new design will make using Mynewsdesk even easier and more effective for our customers.
#WeArePR is a project is about listening. We are conducting and publishing these interviews in no intentional order and as a result there was no way of knowing what we might find.
Oh what a year we had! The fantastic clients and employees of Mynewsdesk, helped to make 2014 our best year to date.
Today marks the kick off of the EU Summit on Innovation for Active and Healthy Ageing, a discussion on how demographic change can offer new opportunities for innovation and growth - 'the Silver opportunity'.
We wanted to do something different that would stand out, intrigue and attract the flock of marketer attendees, whilst painting a good picture about who we are, what we do and why people should care.
The Public Relations Show is the first event of its kind for the UK public relations profession, dedicated to bringing over 1,000 practitioners together to network, learn and discover the latest tools, trends and solutions taking the industry by storm. Mynewsdesk will be sponsoring, exhibiting and our CMO Adam will be speaking on the Brand Newsroom Approach - a new model for PR impact.
Since Mynewsdesk opened for business in the UK two years ago we've had the chance to meet so many different and interesting people. We thought we'd get some of you together for complimentary drinks and a catch up. So we very much hope you will join us for a lovely summer evening on the river Thames. Say hey @Mynewsdesk_UK : )
Social media campaigns now stretch far beyond marketing or community development. Increasingly, organisations are integrating their social media campaigns into wider communications campaigns, reaching out to a variety of stakeholders. Mynewsdesk, the leading online newsroom provider, along with Communicate magazine, the organisers of the Digital Impact Awards, have invited three companies wh...
'Engage with The World of Social Media Marketing!' Social Media World Forum events are 2 day digital, online and mobile marketing conferences. Providing advice and insight around how to engage customers, manage brand perceptions, empower employees and open new un-tapped audiences through diverse social media channels. Our Mynewsdesk team will be attending Social Media World Forum and will...
Mynewsdesk logo red
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Mynewsdesk logo red reverse out hi res
|Creative Commons Attribution
|Photographer / Source
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Image of our stand being brought to life with art. Read about it in the related blog below.
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Mynewsdesk CEO Peter Ingman talks about how brands are starting to behave like media organisations and how they're setting about publishi...
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Adam in our UK team shows you how the new Mynewsdesk homepage makes it even easier for brands to tell their stories.
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One of the most interesting sessions at the forum was the panel debate on Social Media Engagement, Measurement and Metrics featuring our ...
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Brand journalism is one of 2012's Marketing, PR and communication trends. The concept of brand journalism prompts companies and organisat...
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A Mynewsdesk newsroom supports this by generating fully optimised web pages with smart tagging, rich content and deep linking, helping you rank higher in search. We'll take care of the technical side, then all you have to do is focus on creating the best possible content.
This presentation shows shortly what a digital/online newsroom is, its elements and at the same time explain why a company should invest in increasing its visability with a social media newsroom. Examples from Cisco's Network and Scania etc. The next step for your digital pr?
The journalist goes social – what does it mean for PR-communicators? In this presentation, we share some examples of real-time journalism, the new news gathering process and how it affects the work for both PR communicator and journalists. Will the new playground help close the gap between the two parties so they open up for networking? Presentation by @charlotteulvros, CMCO Mynewsdesk
Mynewsdesk standard rules of promotion.


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The Chinese government has provided health services to those infected by the human immunodeficiency virus (HIV) under the acquired immunodeficiency syndrome (AIDS) care policy since 2003. Detailed research on the actual expenditures and costs for providing care to patients with AIDS is needed for future financial planning of AIDS health care services and possible reform of HIV/AIDS-related policy. The purpose of the current study was to determine the actual expenditures and factors influencing costs for untreated AIDS patients in a rural area of China after initiating highly active antiretroviral therapy (HAART) under the national Free Care Program (China CARES).
A retrospective cohort study was conducted in Yunnan and Shanxi Provinces, where HAART and all medical care are provided free to HIV-positive patients. Health expenditures and costs in the first treatment year were collected from medical records and prescriptions at local hospitals between January and June 2007. Multivariate linear regression was used to determine the factors associated with the actual expenditures in the first antiretroviral (ARV) treatment year.
Five ARV regimens are commonly used in China CARES: zidovudine (AZT) + lamivudine (3TC) + nevirapine (NVP), stavudine (D4T) + 3TC + efavirenz (EFV), D4T + 3TC + NVP, didanosine (DDI) + 3TC + NVP and combivir + EFV. The mean annual expenditure per person for ARV medications was US$2,242 (US$1 = 7 Chinese Yuan (CNY)) among 276 participants. The total costs for treating all adverse drug events (ADEs) and opportunistic infections (OIs) were US$29,703 and US$23,031, respectively. The expenses for treatment of peripheral neuritis and cytomegalovirus (CMV) infections were the highest among those patients with ADEs and OIs, respectively. On the basis of multivariate linear regression, CD4 cell counts (100-199 cells/μL versus <100 cells/μL, P = 0.02; and ≥200 cells/μL versus <100 cells/μL, P < 0.004), residence in Mangshi County (P < 0.0001), ADEs (P = 0.04) and OIs (P = 0.02) were significantly associated with total expenditures in the first ARV treatment year.
This is the first study to determine the actual costs of HIV treatment in rural areas of China. Costs for ARV drugs represented the major portion of HIV medical expenditures. Initiating HAART in patients with higher CD4 cell count levels is likely to reduce treatment expenses for ADEs and OIs in patients with AIDS.
According to the most recent estimates by the Ministry of Health and the Joint United Nations Program on HIV/AIDS (UNAIDS), China had 560,000-920,000 people living with human immunodeficiency virus (HIV) and 97,000-112,000 people living with acquired immunodeficiency syndrome (AIDS) as of the end of 2009. A total of 320,000 HIV/AIDS cases have been reported from the national infectious disease surveillance system from 1985 to 2009 [1]. The first wave of AIDS cases was reported in China around 2002, and the majority of these AIDS patients contracted the virus in the 1990s, through either the injection of drugs or plasma donation. In response, the Chinese government launched the China Comprehensive AIDS Response (CARES) in 2003, a community-based HIV treatment, care and prevention program that provides free HIV treatment, including antiretroviral (ARV) therapy and treatment of opportunistic infections (OIs) to the indigent in urban areas and to everyone in rural areas [2].
China CARES provides first-line ARV regimens, including two nucleoside reverse transcriptase inhibitors (NRTIs) and one non-nucleoside reverse transcriptase inhibitor (NNRTI), the generics of which are produced in China. According to national guidelines, ARV treatment is provided by designated infectious disease hospitals, and patients in rural areas in some provinces may go to village clinics to receive counseling and treatment for OIs. Staff from the local Centers for Diseases Control and Prevention (CDC) provides education on ARV treatment compliance and disease prevention intervention. An estimated 97% of AIDS patients (>50,000) who initiated highly active antiretroviral therapy (HAART) in China received free treatment through this national program by 2008; 3% of these patients received treatment via self-pay or through some nongovernmental organization-sponsored treatment programs that may use different regimens [3,4]. The central government increased funding for HIV prevention and treatment from US$56 million in 2003 to US$142 million in 2008, while local governments increased funding from US$14 million to US$86 million in the same period [1]. Recent analyses of national data from China CARES have shown that it significantly decreased mortality among HIV-infected patients from 27 deaths per 100 person-years before treatment to 4-5 deaths per 100 person-years after 6 months of HAART [3,5].
The Comprehensive International Program for Research on AIDS (CIPRA) is an initiative sponsored by the U.S. National Institutes of Health (NIH). China CIPRA comprises five interrelated projects. The overall goal of China CIPRA is to strengthen the existing HIV research infrastructure in China and to build the capacity to conduct multidisciplinary research to explore promising strategies for HIV prevention, treatment and control. Subproject 4 is "A Feasibility Study of Lamivudine/Zidovudine (3TC/ZDV) plus Efavirenz (EFV) as Initial Therapy of HIV-1-infected Patients in Rural Areas of China." The project was conducted between June 2005 and June 2007. The primary objective of Subproject 4 was to determine the efficacy and safety of a potent combination ARV regimen (3TC/ZDV + EFV) for the treatment of HIV-1-infected patients in a rural area of China. China CIPRA covered all of the costs for patients during the research period.
However, there are no publications on the expenditures and cost-effectiveness of treating HIV-infected patients in China. Considering the fact that treatment providers, targeted clients and economic assistance policies may vary across different areas, the actual expenditures of this program are largely unknown. Such information is needed for future financial planning and possible reform of AIDS-related policies. Therefore, the current study determined the expenditures associated with two ARV treatment programs in rural China.
Study Settings
This retrospective cohort study was conducted in two geographical areas: Dehong Prefecture of Yunnan Province in southwestern China and Wenxi County of Shanxi Province in central China. Enrollment criteria and follow-up periods were slightly different at the two study sites. The HIV/AIDS epidemic in Dehong Prefecture primarily consists of injecting drug users (IDUs) and female sex workers and their clients [5]; Mangshi, Ruili, and Longchuan counties in Dehong Prefecture were also included in the study. Patients were enrolled into the China CARES program in Dehong Prefecture if they met the following criteria: the World Health Organization (WHO)'s clinical stage III or IV, CD4 cell count <200 cells/μL, and ≥18 years of age. Patients were treated following the national guidelines [6] using one of four ARV regimens: AZT + 3TC + nevirapine (NVP), stavudine (D4T) + 3TC+ EFV, D4T + 3TC + NVP or didanosine (DDI) + 3TC + NVP. After initiating ARV therapy, patients were scheduled to have subsequent clinic visits at intervals of 2 weeks and 1, 2, 3, 6, 12, 18 and 24 months.
The HIV epidemic in Wenxi County of Shanxi Province was caused by nonhygienic plasma collection [7]. Wenxi County is the site of China CIPRA Subproject 4. China CIPRA Subproject 4 is a single-arm, open-label clinical trial to evaluate the impact of ARV treatment on the progression of HIV. The eligibility criteria for participating in the trial were as follows: WHO's clinical stage III or IV, CD4 cell count <350 cells/μL and ≥18 years of age. The ARV regimen was combivir (AZT+3TC) + EFV. Patients were scheduled for follow-up clinic visits at weeks 1, 2, 3, 4, 8, 12, 24, 36, 48 and 52 after initiating ARV treatment.
The costs incurred in the first year of HAART were difficult to determine because of the range of signs and symptoms of AIDS. Therefore, participants who had not received HAART at the time of enrollment were included in our analysis. The eligible patients were screened and enrolled at Mangshi, Ruili and Longchuan hospitals as designated by the Dehong Prefecture Health Bureau in the China CARES program, and at Wenxi County Hospital Clinic as designated by China CIPRA.
Data Collection
Data were collected from January to June 2007 in designated hospitals in the four participating counties. Because of the limited budget for our research, patients who had integrated treatment expenditure materials in China CARES were randomly selected based on their treatment identification numbers in Dehong Prefecture. Two researchers were trained to review medical records and billing files using predesigned data collection forms. The following data were collected: demographics (age, gender, marital status, ethnic group, level of education, occupation, residential status and drug use), baseline CD4 cell count, date of antiretroviral medication (ARV) initiation and termination, ARV regimen, adverse drug events (ADEs), OIs and itemized costs. Expenditure data were collected starting from patient entry to ARV treatment until the end of the first year in Yunnan and Shanxi. Our study was approved by the Institutional Review Board of the Institute of Pathogen Biology, Chinese Academy of Medical Science. Written informed consent was provided from all patients when they initiated HAART.
ARV drugs are directly managed by the Provincial Center of Disease Control and Prevention or Medical Politics Division and distributed to the designated hospital. Thus, it is easy to calculate the cost of ARV drugs. However, there is no consistent data management system for Chinese medical insurance. Data collection in our study required substantial effort. To retrieve accurate expenditure data, we printed every patient's bill from the designated hospital financial management computer system. All items in the bills were categorized according to the diagnosis of OIs and ADEs. All patients who needed hospitalization were referred to a county-level hospital within our study sites. Therefore, we were able to obtain all inpatient expense data from the designated hospital. Outpatient expenses for ADEs or OIs at designated hospitals were also obtained in the same manner. Outpatient expenses for ADEs or OIs at township hospitals or village clinics were calculated by the designated hospital. We also separated these expenses according to diagnosis. All the items were classified as follows: medications, laboratory testing and ancillary examinations and medical service charges. The price of every item was based on the medical charge standard established by the local health bureau. The outpatient and inpatient expenses were averaged by the number of patients who experienced ADEs or OIs.
Calculation of expenditures
The expenditures during the first treatment year were included for analyses, which were divided into four parts: (1) ARV medications; (2) other medications for prophylaxis and treatment of ADEs or OIs; (3) laboratory tests at baseline and follow-up for monitoring of ARVs safety and efficacy, such as CD4 and CD8 cell counts, hematologic parameters, chemistries, pregnancy testing, liver function tests, amylase activity, creatine kinase level, urinalysis and radiologic examinations (chest X-ray and abdominal ultrasound); and (4) other items, including nursing, infusions, bed use, counseling, blood transfusions and medical consumer goods.
According to the national treatment guidelines for China CARES and the protocol of China CIPRA Subproject 4, hematologic parameters, chemistries, pregnancy test, liver function tests, amylase activity, and creatine kinase levels are used for monitoring ARV drug safety, and CD4 cell count testing is used for monitoring treatment efficacy. HIV viral load measurement is not recommended because of the lack of laboratory capacity in the majority of geographic areas covered by China CARES. To reflect the actual cost under the national policy, we did not calculate the costs of HIV viral load tests.
All expenditures were calculated in US dollars (US$1 = 7 Chinese Yuan [CNY]). For ARV medications, expenditures were calculated on the basis of negotiated prices between provincial health bureaus and participating pharmaceutical companies. The average daily expense of ARV regimens was calculated using the total amount of the individual drug expenditure in 1 year divided by the total number of treatment days during the same time period, adjusted for standard dosages. The expenditure data over different calendar years were adjusted with a 3% annual inflation rate, using 2004 as the comparison year.
Statistical analysis
We analyzed the expenditures in the first year after starting ARV therapy. We calculated the means and standard deviations (SD) of the total costs, as well as itemized costs for ARV medications, laboratory testing and treatment of ADEs and OIs. We further calculated the costs stratified by study site, demographic variables and baseline CD4 cell count. The CD4 cell count was categorized into three strata as follows: <100 cells/μL, 100-200 cells/μL and ≥200 cells/μL. The Kruskal-Wallis test was used to evaluate the expenditures associated with different CD4 cell count categories. Cochran-Mantel-Haenszel χ2 tests were used to compare the proportions of costs among the three strata of CD4 cell counts. The potential independent factors which may affect the total expenditure included age, gender, treatment site, marital status, ethnic group, level of education, occupation, residential status, drug use, CD4 cell count and incidence of ADEs and OIs. A multivariate linear regression model was fitted to estimate the independent factors associated with total expenditures by eliminating nonsignificant variables in a stepwise manner. Only the factors significant at a level of 0.05 (two-tailed) were reported. R/S plus software version 2.8.1 (Lucent Technologies, Murray Hill, NJ, US) was used for the analyses.
Demographic Characteristics of Study Subjects
Two hundred seventy-six patients were included in the analysis. One hundred seventy-six patients (63.8%) were from Dehong Prefecture of Yunnan Province, including 31 patients (11.2%) from Mangshi County, 32 patients (11.6%) from Ruili County and 113 patients (41.0%) from Longchuan County. One hundred patients (36.2%) were from Wenxi County of Shanxi Province. The average age of the patients at entry into ARV treatment was 39 years (range, 18-71 years). The patients had the following characteristics: 62% (170/276) were male, 71% (197/276) were married, 61% (167/276) were majority Han ethnicity, 21% (57/276) were Jingpo ethnicity, 14% (40/276) were Dai ethnicity, 4% (12/276) were other minority ethnicities, 12% (34/276) were illiterate, 45% (124/276) had an elementary school education, 84% (232/276) were farmers and 88% (242/276) were living with their families. Sixty-four patients (23.6%) had a history of drug use. The means of CD4 cell count to the time ARV treatment initiated was 181 ± 93 cells/μL (Table 1).
Table 1. Demographic characteristics of rural Chinese AIDS patients at entry to antiretroviral therapy, 2004-2006 (N = 276)
ARV Treatment and Compliance
Eighty-five percent of patients (235/276) complied with ARV treatment for 1 year, and 85% of patients (235/276) remained in treatment or obtained prescriptions. Five ARV regimens were used by the patients, as follows: combivir + EFV (36% [100/276]), D4T + 3TC + NVP (23% [65/276]), AZT + 3TC + NVP (21% [57/276]), DDI + NVP + 3TC (13% [35/276]) and D4T + 3TC + EFV (7% [19/276]).
Total expenditures
The mean expenditure per patient during the first year after initiating ARV therapy was US$2,633 (range, US$226-US$8,679). The total expenditure for all 276 patients was US$726,847; 85.1% of the total expenditure was spent on ARV medications, 2.5% on medications for treating ADEs, 1.8% on medications for treating OIs, 7.6% on ARVs laboratory monitoring, 0.4% on laboratory tests for diagnosing ADEs, 0.4% for diagnosing OIs, 1.1% on other medical services related to ADEs and 1.0% on other medical services related to OIs (Table 2).
Table 2. Expenditures for care of rural Chinese AIDS patients in their first year of antiretroviral therapy (US dollars) (N = 276)
The per capita expenditures were inversely associated with CD4 cell count (P < 0.01). On average, patients in Mangshi had higher expenditures than patients at the other three sites (P < 0.01). Non-drug users had greater expenditures than drug users (P < 0.01). The total expenditure was also associated with the level of education, but not associated with age, gender and ethnicity (Figure 1).
Figure 1. Total expenditure among rural Chinese patients in their first year of antiretroviral therapy. *P < 0.05. N = 276.
Expenditures on ARVs and safety and efficacy monitoring
A total of US$618,832 was spent on ARVs among the 276 patients in the first year of ARV therapy. The total expenditure on regular laboratory tests was US$55,281 for all patients, and the per capita expenses were US$200 (range, US$143-US$313). The total expenditure on CD4 cell count monitoring, as a part of regular laboratory tests, was US$39,429 for all patients (Table 2).
Adverse drug event-associated expenditures
In the first year of ARV therapy, 65.6% of the patients (181/276) had at least one documented ADE. The most common ADEs were hepatotoxicity (41.3%), allergic dermatitis (23.9%), gastrointestinal disorders (21.7%) and anemia (10.5%; Table 3).
Table 3. Adverse drug events (ADEs) and opportunistic infections (OIs) associated expenditures among 276 Chinese patients in their first year of ARV therapy
The total expenditure for treating all ADEs was US$29,703. The medical service expenditure per person for ADEs in the first year was US$645 for peripheral neuritis, US$127 for hepatotoxicity, US$95 for anemia, US$72 for allergic dermatitis, US$62 for gastrointestinal disorders and US$36 for dizziness and fatigue (Table 3).
The medications used to treat peripheral neuritis were particularly expensive (US$429 per patient per year). Huganpian and Gansukeli (two types of traditional Chinese medicine), diammonium glycyrrhizinate (capsules or injection) and glucurolactone tablets are commonly used in China to treat hepatotoxicity, with average expenses of US$4.21 per patient per month. The average expenditure of diagnosing ADEs ranged from US$0-US$17, and other inpatient and outpatient medical service charges ranged US$3-206, including medical care for peripheral neuritis (Table 3).
No significant difference was observed in the incidence of ADEs as a function of the CD4 cell count (P = 0.32). Patients with lower CD4 cell counts had significantly higher expenditures for medications (P = 0.04), tests for diagnosing ADEs (P = 0.04), inpatient and outpatient medical services (P = 0.01) and total medical services (P = 0.04) compared to patients with higher CD4 cell counts (Table 4).
Table 4. Adverse drug events (ADEs) and opportunistic infections (OIs) associated expenditures among rural Chinese patients, stratified by CD4 cell count (N = 276)
Expenditures on OIs
Expenditures for AIDS-related OIs that occurred after initiating ARV treatment were also reviewed. Among the 276 patients, 43.84% (121) had at least one diagnosed OI in the first treatment year. The most frequent OIs were respiratory infections (23.6%), diarrhea (7.3%), fungal infections (6.2%), herpes simplex virus and zoster infections (4.7%), tuberculosis (TB; 2.5%) and cytomegalovirus (CMV) infections (1.8%; Table 3).
The total expenditure for treatment of all OIs in the first treatment year was US$23,031. The median of all medical service expenditures per person for OIs in the first year were as follows: CMV, US$1,208 (acyclovir, ganciclovir and foscarnet); tuberculosis, US$245 (isoniaizid, rifampin, pyrazinamide, ethambutol and streptomycin); fungal infections, US$158 (fluconazole, itraconazole and amphotericin B); herpes simplex virus and zoster infections, US$107 (acyclovir, ganciclovir and foscarnet); bacterial respiratory infections, US$85 (oxacillin, efoperazone/sulbactam and clindamycin); and diarrhea, US$58 (Table 3). The high cost of treating CMV was largely due to high expenses associated with medications (median, US$763) and hospitalization expenditures (median, US$349).
Those patients with lower CD4 cell counts were more likely to have at least one OI compared to those with higher CD4 cell counts (P < 0.01). The OI-related expenditures among patients with lower CD4 cell counts were significantly higher for medications (P < 0.01), diagnosing OIs (P < 0.01), inpatient and outpatient medical services (P < 0.01) and total medical expenditures (P < 0.01) compared to patients with higher CD4 cell counts (Table 4).
Total expenditures and associated factors
Finally, multivariate linear regression analysis indicated that the following variables were independently associated with the total expenditure in the first ARV treatment year: CD4 cell count (100-199 cells/μL versus <100 cells/μL: P = 0.02; and ≥200 cells/μL versus <100 cells/μL: P < 0.004), residence in Mangshi (P < 0.0001), ADE incidence (P = 0.04) and OI incidence (P = 0.02; Table 5).
Table 5. Factors associated with total expenditure among rural Chinese patients in their first year of ARV therapy (N = 276)
This is the first study to determine the expenditure data for AIDS treatment in rural areas of China. During the first year, the average annual expenditure for AIDS treatment per person was US$2,633. Expenditures were significantly higher for patients with low CD4 cell counts compared to those with high CD4 cell counts (P < 0.01). The average expenditures for the treatment of ADEs and OIs increased significantly among patients with low CD4 cell counts. Therefore, initiating HAART to patients with higher CD4 cell counts appears to be effective in controlling AIDS treatment-related expenses for ADEs and OIs.
Although funding for HAART has expanded in recent years, the resources are still limited and costs typically increase with time. On the basis of our research, the expenses for ARV medications were the largest component of AIDS treatment. Among first-line agents, only AZT, D4T, DDI and NVP are generic ARVs produced by pharmaceutical companies in China, while EFV is purchased by the Chinese central government. Although 3TC was donated by GlaxoSmithKline, we still added its price into the total expenses to show the actual expenditures for ARVs. The high cost of ARVs has been the main obstacle for China in considering free second-line agents. Indinavir without a booster, Kaletra (lopinavir/ritonavir), tenofovir, emreicitabine and abacavir are used in cases of drug resistance. Some of these ARVs are now available as cost-free treatment. Merito et al. [8] showed that the average annual cost of ARVs increased with the duration of treatment, while inpatient costs decreased. Bruno et al. [9] showed the total expense shifted from inpatient costs to ARV medication expenses. China will also face this same issue, along with the progression of HIV infection and the increasing number of AIDS patients in the near future. Duraisamy et al. [10] showed that the median direct cost of treatment and services was US$610 for 6 months in south India for patients who received HAART in 2001. According to the report from the CDC center of the Health Ministry of Iran [11], the direct cost of HIV treatment was US$1,025 per person in 2005. A Philippines study [12] reported that during the early symptomatic stage, the cost per case per year was US$301, and in the late symptomatic stage the cost increased to US$5,774 in 1996. Compared with these studies, the mean expenditure in this study was a little higher because many patients in the last symptomatic stage received HAART at the inception of China CARES. A greater number of AIDS patients receive HAART because of free ARVs and reimbursement for laboratory tests and transportation. Thus, some insurance policy should be developed to lower the patients' financial burden and promote compliance.
A higher level of education was associated with a higher cost of HAART-related expenses in our study, which was consistent with the results of Bozzette et al. [13]. In rural China, patients with a higher level of education may receive more information about AIDS and related health care policies. Therefore, they may use more health services than patients with a lower level of education.
ADEs contribute significantly to HIV/AIDS treatment costs, which can be mitigated through early symptom assessment and management. The ADEs associated with ARVs have been reported in many studies [14-20]. Besides financial constraints, ADEs are also important factors which affect HAART compliance [21-23], but few studies have determined the monitoring and treatment expenses of ADEs [24]. We explored the expenditures for ADEs in our study and showed that the expenditures for the treatment of peripheral neuritis were the highest because of high costs of medications. Hepatotoxicity was the most common AIDS-related ADE, thus regular laboratory monitoring for hepatotoxicity in many ARV regimens is standard. NVP was more likely to induce hepatotoxicity, which is consistent with studies in China and other countries [14-20]. Expenditures for the treatment of anemia were the third highest among the ADEs. The main components of the increased expenditures for the treatment of anemia were blood transfusion and hospitalization expenditures. More attention should be paid to regular monitoring of the blood cell count. Early detection and early treatment will decrease the expenditure of hospitalization.
HAART has been shown to be effective in increasing the CD4 cell count and reducing the incidence of OIs [25-27]. In the current study, OIs still occurred in some patients who received ARVs. The expenditures for some OIs with a lower incidence, such as CMV and fungal infections, were higher than the treatment costs of other OIs. Long-term hospital stays and higher expenditures for antiviral and antifungal drugs and special laboratory tests result in higher expenditures for OIs. HIV/TB coinfections deserve particular attention because of the high prevalence and cost. The treatment of HIV/TB coinfection was the second highest expenditure of all OIs in this study. China has the second-highest prevalence rate of TB in the world. According to a WHO report [28], the incidence of TB increased at an average rate of 7% per year in those countries with a high prevalence of HIV (≥5%), but the average rate of increase was only 1.3% in countries with a low prevalence (≤5%). HIV-infected patients are at a markedly increased risk for progressive disease following primary TB infection [29-31]. Thus, screening and treatment of TB at the time of HIV infection is beneficial to patients and improves the efficacy of HAART. With respect to the optimal time to initiate HAART, it is worth noting that the immune reconstitution syndrome tends to be worse in patients initiating HAART with lower CD4 cell counts. Some of the patients in our study were in the last symptomatic stage, which may increase the incidence of OIs and sequentially increase the expenditure for treatment.
In this study, we also showed that the incidence of Pneumocystis carinii pneumonia (PCP) was very low and may be attributed to regular prophylaxis using sulfamethoxazole. Because the sample size was limited in our study, the correlation between the use of sulfamethoxazole for prophylaxis and the incidence of PCP should be the subject of study in China.
When to begin HAART is an important issue which has been much discussed in recent years. Studies in high-income countries have verified that initiating HAART in patients with higher CD4 cell counts can improve the efficacy of treatment [32]. However, for resource-limited countries, where viral load testing is often not available for the diagnosis of AIDS, the CD4 cell count and symptoms are the main indicators for initiating HAART. As a result, some patients are not diagnosed in a timely manner. A lower CD4 cell count was associated with higher treatment expenditures. This effect has also been shown in patients with CD4 cell counts <50/μl in other studies [13,33]. In our study, we noted a similar result, although the sample size was limited. Over the long term, initiating HAART to patients with higher CD4 cell counts is likely to effectively control AIDS treatment expenses for ADEs and OIs, but it will also increase the treatment costs over a longer period of treatment. Thus, factors, such as the financial burden of patients, care policy and compliance should be generally considered when initiating HAART.
In our study, we pooled the data from two distinct programs, the only difference in program design of which was the enrollment criteria for CD4 cell counts. However, the CD4 cell count was similar in the two programs after considering the WHO's clinical stages. Pooling data can increase the sample size and yield more information about HAART expenditures. Moreover, the price of medications and medical services was similar in the different sites of the program, although the different frequencies of follow-up may produce heterogeneity in expenses (that is, a greater number of follow-up visits in the China CIPRA).
The main limitation of the study was that the results cannot be extended to all of China because of the differences in the cost of living across China [34]. Second, Chinese public hospitals are classified into three levels according to the national hospital administration standard. Higher-level hospitals had more choice of medications, ancillary examinations and higher medical service prices. In our study, Mangshi Hospital was the highest-level hospital and was associated with a higher cost of HAART-related expenses. However, other AIDS treatment expense data were from county-level hospitals, which were usually second-level hospitals. Thus, our results are likely to have underestimated the costs of hospital care compared with the highest-level hospitals in cities and overestimate the costs compared with township hospitals and village clinics. Third, our research did not address the opportunity cost, expenses outside the hospital system and the association between compliance and cost because of the difficulty of collecting data.
Despite the above limitations, this study is the first to provide important information on the cost of rural AIDS patients in China. The ARVs expense was the largest part of HAART cost, averaging US$2,242 per patient in the first ARV treatment year. These costs appear to increase over time in China, as consequences of the increasing number of possible occurrences of drug resistance in the continuing period of HAART and more second-line regimens are used. Over the long term, initiating HAART in patients with a higher CD4 cell count is likely to effectively control AIDS treatment expenses on ADEs and OIs, but some factors should be generally balanced when initiating HAART.
List of abbreviations
ADEs: adverse drug events; AIDS: acquired immune deficiency syndrome; ARV: antiretroviral; ARVs: antiretroviral medications; AZT: zidovudine; China CARES: China Comprehensive AIDS Response; CMV: cytomegalovirus; CNY: Chinese yuan; D4T: stavudine; DDI: didanosine; EFV: efavirenz; HAART: highly active antiretroviral therapy; IDUs: injection drug use; IDV: indinavir; Kaletra: lopinavir/ritonavir; NRTI: nucleoside reverse transcriptase inhibitors; NNRTI: non-nucleoside reverse transcriptase inhibitors; NVP: nevirapine; OIs: opportunistic infections; PCP: Pneumocystis carinii pneumonia; TB: tuberculosis; WHO: World Health Organization; 3TC: lamivudine.
Competing interests
The authors declare that they have no competing interests.
Authors' contributions
FZ designed the project, collected data and drafted the first version of the manuscript. GFK revised the manuscript. HZQ oversaw the data analysis and revised the manuscript. SD collected laboratory data. JSW participated in data analysis. ZWG collected and analyzed data. XPZ reviewed medical records and collected data at the Wenxi site. All authors read and approved the final manuscript.
This study was funded by China Commonweal Scientific Research Fund grant 2007 IPB06, China Global Fund AIDS Program Round 4 (R036), and U.S. National Institute of Health (NIH) CIPRA grant U19AI51915-04. The authors are grateful for the following individuals for their various supports: Ray Chen (U.S. NIH China Coordinator); Yunzhen Cao, Shan Mei, Xueping Dong and Li Zhang (China CIPRA Subject 4); Xiaochun Qiao (Shanxi Provincial CDC); Zhibin Zhao (Wenxi County People' Hospital); Guorong Shao, Shuming Tian and Bo Li (Dehong Dai and Jingpo Autonomous Region Health Bureau); Haibo Xu and Yusheng Ding (Ruili City Hospital); Haiqin Yang, Yuanwu Xu and Jiping Li (Longchuan County Hospital); and Yindi Zhang and Xingjun Duan (Dehong Dai and Jingpo Autonomous Region Hospital). We also acknowledge Lei Gao, Mark Eliot Goldin and Lu Yin for providing editorial comments and suggestion on data analysis.
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Pre-publication history
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6 posts tagged with toddler and childcare.
Displaying 1 through 6 of 6. Subscribe:
Toddler Won't Even Pick Up a Fork Anymore
My toddler (2 years old) has been regressing big time. She regressed on potty training a while back, but that's not what concerns me. Now she refuses to feed herself, she has stopped making verbal requests, she whispers instead of speaking aloud. I'm not asking why the regression, so much as how do I deal with it? [more inside]
Tips/studies/articles to help put myself in my 1 year old's shoes?
Tips/studies/articles to help put myself in my 1 year old's shoes? [more inside]
Help me wrap my brain around this
I currently work about 20 hours a week at my job while my parents watch my 18-month-old. Today I'm considering whether to apply for a full-time, telecommuting job -- it's kind of my dream job. (And yes, it's a legit work-at-home job with a national org!) Please help me decide! [more inside]
Scaring my kid: dick move?
Question about scaring my two-year-old to get him to obey. Am I being a bad dad? [more inside]
Help me manage the transition to daycare!
My 17-month-old is starting daycare for the first time. Should we send her for two, or three days per week? And what changes should I expect in her personality or our relationship as a result of this? [more inside]
Full time childcare for a toddler
I'm looking for some advice on full time preschool/child care for a 2+ year old. [more inside]
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X800 vs 6800 = Voodoo3 vs TNT2
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Join Date: May 2003
Posts: 446
Re: X800 vs 6800 = Voodoo3 vs TNT2
Originally Posted by
Some of you fail to realize that, to this day, ATi is in a much better position than NVidia. They've secured contracts with all the major PC manufacturers, and they've much better products in the high volume mainstream market. The GeForce 6800 is a fine piece of hardware and I consider it superior to current ATi offerings but it's not enough.
I work in a rather big shop and I've seen the turn of events. The only NVidia card people still ask me for is the 5900XT; as for the rest, we've litterally dozens of Fx5200/5600 nobody wants that we throw in the low end PCs we sell. The 9600 in all its flavours is the best seller and, with the 9800 reaching the same price range of the 5900XT, people are willing to spend a few bucks more to purchase ATi's card. Brand recognition surely has helped NVidia in the past year and saved her from complete disaster with the FX line, but even common people have now accepted ATi as a worth competitor.
I think NVidia needs a good midrange offering as fast as possible to win back OEM contracts and the public opinion confidence.
I think nVIDIA is in the position to switch positions with ATi. nVIDIA has those awesome nForce boards and now AMD has become more popular than Intel.
View Public Profile
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Austin Shop Crawl: Terra Burger
by Sara Osburn
posted Nov 21 2011 4:09PM
I can't believe it is almost Thanksgiving! Don't forget the Austin Shop Crawl kicks off this Friday!!! Sign up for the FREE badge at
and get discounts at participating stores and restaurants!
Terra Burger is "Austin's Original Organic Burger Place." You will not find one artificial ingredient in ANYTHING at Terra Burger…not in their soda….not in their ketchup…not in their ice cream.
Now don't let the word organic scare you. There is still tons of meat and bacon and cheese available to pile on to your bun. Terra Burger just offers real instead of processed food…the way food should be eaten.
Gluten Free buns are also available!
Terra Burger is a fast food drive through joint, but feel free to bring the kids and let them play on the big playground while you watch from the old school trolley!
Sign up for the FREE Austin Shop Crawl Badge and get either 15% off your meal. Or buy a burger with regular hand cut fries and receive a free 32 ounce large drink!
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Affordable Housing...Newly Renovated...Income Restrictions Apply...
Turnleaf is a community of studios, one and two bedroom homes, designed to meet the needs of residents in every phase of life. Each home features large living areas, a private patio or balcony and ample storage. Fully equipped kitchens will delight the gourmet in you. You'll also enjoy the convenience of covered parking. Relax by the sparkling pool, playground and large grassy areas perfect for picnicking. Welcome home to Turnleaf. Our paperwork process will take about 3 - 4 weeks.
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Last Seen Dec 1, 2012
Member Since Nov 08, 2012
Favorite Quote
Politics Anarchist
Horoscope Aquarius
Special day 2-5
Books There are many
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Local Time July 7th, 9:16 AM
I Love Walking Barefoot In the Grass
Barefoot On Grass In the summer I never wear shoes outside unless it is wet. It feels better, until you step on something sharp... [more]
Any Wolves In Pei? I live in Prince Edward Island, Canada. Is there any other wolves around here? It's a really small place so I'm guessing not...… [more]
Extra Tooth I had all four wisdom teeth removed a couple months ago, but when they removed them they realized I had an extra tooth growing beside one of my wisdom teeth. They removed that too, but if I would have… [more]
I Think I'm Too Short I'm a girl and I'm 5'3 but I can't stand it. Both my mom and my dad are taller than me, and most people in my school are taller than me. I don't think I'm getting any taller...… [more]
Evil Cat A couple years ago my aunt gave me a four week old kitten from her cat's litter because she didn't want him, even though he was too young. I had to bottle feed him until he was old enough to eat solid… [more]


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These dogs are all being fostered by ETBCR volunteers and their descriptions are written by their foster parents. Prior to or upon adoption, all dogs in our rescue program are spayed/neutered (there are NO exceptions), fully vaccinated, heartworm negative, started on heartworm prevention, treated with flea and tick preventive, microchipped, and temperament tested. We also strive to crate and house train each dog before placement.
Click on each dog's photo or name for more photos and complete information.
|Please note that as a policy ETBCR does not place puppies in families with children under 6 years of age, as border collies and border collie mixes can be very reactive to the movements of small children.
Please email us if you need more information about one of the above rescued Border Collies, can provide a foster home for a rescue dog, or can volunteer your help for Border Collie Rescue!
Other Adoptable Dogs
Click here to see more dogs available for adoption from other rescues, shelters, and individuals
Top Ten Myths About Adopting a Border Collie
(If you are
interested in adopting a Border Collie, please read this!)
Things to consider...
When considering adopting a Border Collie, please ask yourself these questions:
- Have you done your homework on the breed, so you know what to expect?
- Do you have the time to give the dog the amount and type of exercise he requires, rain or shine?
- Does all of the family want this breed of dog?
- Are you willing to train the dog to be a well-behaved member of your family and of society?


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Fishing Education & Outreach
Mississippi has diverse aquatic habitats that provide a wide variety of angling experiences. It is the primary goal of the Fishing Education and Outreach Program to highlight these opportunities to the public and get more people fishing. We realize that some segments of our state have not had the chance or knowledge to get outdoors. The Fishing Rodeo program offers children the chance to wet a line in a controlled area. Women wanting to get into outdoor activities for the first time or just wanting to brush up on acquired skills can attend the annual Becoming an Outdoors Woman seminar held at a selected state park. Fish biology and aquatic information can be had with a visit to the Mississippi Museum of Natural Science in Jackson or our new North Mississippi Education and Visitors Center in Enid. There you can check out the aquaria, find displays of fish and fishing tackle and see what a fish biologist does.
Do you already know how to fish and just need some information before you go? Up-to-date fishing reports give you the wheres and hows to catch the big ones. These reports are updated weekly from February through November. Looking for a boat ramp? Visit our Ramps & Piers page to find information on ramp locations, type of ramp, and cost, if any. You caught a big fish, but is it a record? Current Mississippi Sport Fish Records and Sport Fish Record Applications can be found here. Planning an upcoming trip and looking for the best spots? Find the hot lakes with the Yearly Bass Tournament Fishing Reports, MSFISH scores, and Mississippi Fishing Reports.
There's a lot of water out there, let's go fishing.
Tom Holman
Program Coordinator
Fishing Rodeo Information
2015 Fish Camp
The Mississippi Wildlife Federation (MWF) is proud to partner with the Mississippi Department of Wildlife, Fisheries, and Parks (MDWFP) to host three Camp Fish events in 2015. The first camp, co-sponsored with the Coahoma County Youth Outreach Program, is scheduled for June 2 and 3 at the Coahoma County Expo Center in Clarksdale. The second camp will be held June 8 and 9 at Percy Quin State Park near McComb, and the last camp will be conducted at the Turcotte Education Center near Canton on June 24 and 25. More information about the 2015 Fish Camps can be found here.
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Reviewed By Michael B (Roseville, CA) Reviewed for a 2008 Mazda CX-9 —11/25/2013 11:48 AM
Easy to order. They fit perfect and look very nice. I would take these over the overpriced weather tech any day.
Reviewed By Steven C (Enumclaw, WA) Reviewed for a 2008 Mazda CX-9 —4/1/2009 7:27 AM
I choose this mat instead of a mat with a lip around the edge because I thought it would be easier to roll up and store behind the third row seating in our CX-9 when we needed to use the third row. It works great. It also fits and matches the black interior well. I did let it air out overnight before I placed it in our car because of some of the comments I read about the smell. My wife never mentioned that she noticed a smell at all.


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What is going on with this girl I like?
Okay, I've been good friends with this girl for a few months now, we always flirt & mess around & spend time together & when we sit next to each... Show More
We have to spend a few hours with each other tomorrow, so hopefully I can show her how much she actually means to me & that I didn't mean to upset her. (Read comment on the 1st reply)
We were just messing around & she was being normal until she left without a hug.
Then she ignored me the whole day & then ripped into me on Skype about 30 min - one hour ago.
All I know is that I'm not giving up & I will do my best to fix this.
What Girls Said 2
its called play flirting and treat hem mean keep them keen. keep being you
That's what I thought until she ripped into me on Skype.
She said she is pissed off with me for insulting her in class, even though we were playing & we never actually insulted her.
We always mess around & stuff, we always flirt & everything, but today has felt like the worst day of my life.
I even got myself drunk which was a bad idea... I just love her so bad. It felt like I got shot when she told me to "F*** off" on Skype, but I understand that she needs her space.
I hope I can fix this.
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Be the first guy to share an opinion and earn 1 extra Xper Point!
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Who bought Palin's clothes? McCain campaign and RNC play the blame game.
After Politico's revealed recently that $150,000 was spent on Gov. Sarah Palin's wardrobe, the McCain campaign and the RNC have been engaged in a blame game, trying to assign responsibility to each other for the decision. A quick recap:
"It was obviously the RNC's call." – McCain aide Nancy Pfotenhauer, 10/22
"They are not my property. Just like the lighting and the staging and everything else the RNC purchased." – Palin, 10/26
"All the people I talk to say it's Nicolle Wallace." – Fox's Fred Barnes, 10/26
"This was a coordinated expense that the campaign asked us to pay for." – RNC Chairman Mike Duncan, 10/27
When asked on Meet the Press this weekend if the money spent on clothes was "a colossal mistake on the part of the RNC," McCain did not deny that the RNC made the purchases.
Nicolle Wallace fires back at Barnes, saying he is "incorrect" that she charged the clothes to her card, and "incorrect that I went to any stores."


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Stop Prawer now!
Submitted by Sydney Levy on Sun, 11/10/2013 - 9:05am
The Israeli Knesset is about to approve the Prawer Plan, which would initiate the forced relocation of 40,000 Bedouin citizens of Israel, and the destruction of dozens of villages. Let Israeli Ambassador Ron Dermer know you are horrified that a transfer plan based on nothing more than ethnic identity is even under consideration: www.jvp.org/StopPrawer


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Olney: So if you're on a flight from Pittsburgh to Los Angeles and you went 0-for-4 and have a couple of strikeouts, what would you most likely be doing on that flight?
McCutchen: Listening to Christian rap, which I do anyway. But sometimes if I had a bad day, I'll get up and sit with people who are in a good mood, people who are happy, singing or laughing. If I just sit by myself for five hours, all I'll be doing is thinking about the game I had -- replaying those pitches and those at-bats over and over. So I might get around somebody who had a better game than I had and talk to them because I know they're going to put me in a good mood.
Olney: When are you mostly likely to draw?
McCutchen: If we have a night game, I have a few hours that day after breakfast and lunch and I'm usually sitting around the hotel with nothing to do. I'll pick up a pencil or something. It helps time go by, and I just relax a little bit before I got to go out. It's really cool when you finish something, and it's like, Man, I did that. [Laughs] That's the reason I like doing it.
Olney: You're famous for your impressions, and when I worked on that piece last year, Neil Walker told me that a guy will come up from the minor leagues and within a day or two you'll have him down: you'll watch him take batting practice and you'll pick up on his stance, his mannerisms. How do you do it? Do you watch people in a way where you're actually trying to pick it up, or do you think it's just something you naturally see and can apply?
McCutchen: I think it's just something I naturally see. The older you get, you start to really figure out where you get certain habits from; more than likely from your parents or someone in your family. Now that I look back, I see that I imitate people -- try to talk like somebody -- because of my mom. If she's ever about to tell a story about somebody, she always tells it exactly like that person talks, in that accent; she doesn't even think about it. One of my best friends' mom is from North Carolina. The other day my mom was telling a story about her, and she says, "Yes, I talked to Miss Kim, and she was like, 'Well, Trina'" -- and she just starts talking like her, in her accent. My fiancée was the first one to point out that I do it, and she told me I get that from my mom. I never noticed until she pointed it out.
Olney: How much does all this help you go through a long season? Is it sort of an escape?
McCutchen: Yes, it helps out a lot. You fail more than you succeed in the game of baseball, so I have a lot of time dealing with the negative. Us as humans, we tend to look for negative things, even in a good situation. So even if I had a really good game and I went 4-for-4 with two home runs and then I hit a line drive off the wall, I'm going to automatically go, "Dang, if I would have just hit that ball a little further, I would have got the other one out too!" But what about those other two home runs I hit? Or another example: I'll read 100 comments on Twitter and 99 people will be "awesome, yay, yay, yay," and one person is negative, and I get upset.


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Growth in its family caregiver program has resulted in Anoka County receiving an increase in federal funding....Read More
Mercy Hospital
Blaine residents Lissa Clair and Shawn Leebens are the proud new parents of Danielle, who was the first baby born in the Twin Cities in 2014 at 12:19 a.m. Jan. 1 at Mercy Hospital in Coon Rapids....Read More
Installation of a 170-foot long skyway span over Coon Rapids Boulevard at Mercy Hospital went without a hitch over the weekend....Read More
When he arrived in America nine years ago from Nigeria, Rev. Peter Yakubu Ali had lost all hope. Now. he's a U.S. citizen....Read More
A ground breaking ceremony for a 50,000 square-foot addition to Mercy Hospital is expected to take place in November....Read More
The Mercy and Unity Hospitals Foundation got a big boost in its three-year "Legacy of Caring" capital campaign to raise $8.4 million for various projects thanks to a $1 million donation from a Ramsey couple....Read More
A 50,000 square-foot addition to Mercy Hospital was recommended for approval by the Coon Rapids Planning Commission Sept. 19....Read More
The final approval needed for the first skyway to be built in Coon Rapids came at the Anoka County Board meeting June 25....Read More
A "minor" fire damaged a modular office space in a "non-patient care area" of Mercy Hospital in Coon Rapids this morning (Wednesday, July 24), according to an Allina Health spokesperson....Read More
Community members from across the Allina Health service area are invited to join Allina Health employee volunteers to package 200,000 healthy meals for neighbors in need tomorrow (Saturday, June 1). ...Read More
The final beam has been placed in the Allina Health medical building under construction on Coon Rapids Boulevard....Read More


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'Bush' boys enjoy a warm reception
Posted: July 12, 2014 at 2:30 a.m.
Playing approximately 3,500 miles away from his hometown, Caden Smeaton has enjoyed his first trip to central Arkansas with the exception of one minor detail.
This story is only available from our archives.
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Mo Martin had a plan for Royal Birkdale, and it's working better than she imagined at the Ricoh Women's Britis... Read »
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Darren McFadden has a one-year contract and that much time to prove himself with the Oakland Raiders. Read »


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Results 1 to 13 of 29
Thread: Meet Francis
February 17th, 2010 #1
Meet Francis
Hello, I've been recommended many to try and post my art on these forums. From childhood I've wanted to be an artist because I believe that's the only thing I'm truly good at.
Here's a link to a completed video sketchbook that I've posted on Youtube
Do I have potential to be a better artist?
- Similar Threads
- SketchBook: Francis' Sketchbook
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- Francis bacon and me
- What's Francis Bacon saying!? Help.
- Art: Francis


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A 2000 photo of Dr. Benjamin S. Carson, director of pediatric neurosurgery at Johns Hopkins Children's Center in Baltimore.(AP Photo/Keith Weller, John's Hopkins Children's Center)
- Filed Under
EDITOR: Recently, Kent Hall wrote a guest column in Stevens Point Journal Media promoting the Affordable Care Act, more commonly known as Obamacare. The Affordable Care Act treats the natural biological process of conception as if it were a disease, creating the legal framework to provide contraception, sterilization and potentially abortion-inducing drugs as preventive health measures to be required in all insurance plans.
President Obama promised he would protect freedom of religion and conscience before the law passed. I want what I was promised. My religion and conscience opposes these things.
I can't believe Obama was elected in 2008, and re-elected in 2012.
In 1947 Jackie Robinson was the first black person to enter baseball's major leagues. Robinson was one of the best black players at the time and he paved the way for others like Roy Campanella, Hank Aaron and even less talented blacks to become major league players. There are several black men who could have done the same for the presidency of the United States. Why the people of this country choose Obama is a mystery. He had long associations with people who hate our country like the Rev. Jeremiah Wright and Bill Ayers, a known communist thinker.
There is one black man who could do for black and white America what Jackie Robinson did for black people and Major League Baseball. His name is Dr. Benjamin Carson. Carson's remarks at the National Prayer Breakfast angered Obama and the national media. He talked about our Judeo-Christian heritage that remains so relevant and needed today. He also talked about our failing education system, the great threat of Obama's socialism and health care plan.
I laughed at the part of Hall's column when he states it's easy to register for Obamacare, all you have to do is bring an ID and other proof of who you are and sign up. Many of Obamacare's defenders are the same liberals who scream when it's suggested you need an ID in order to vote. Tell me, what is more important?
Ray Raflik,
Stevens Point


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Packing for Norway11:51 AM
Tomorrow evening, my boyfriend and me are leaving for a 10-days-adventure in Norway! We plan on hiking and sight-seeing and maybe some wild camping if I'm not scared. I'm really nervous for this trip because I haven't done anything like it — except maybe sleeping in a tent for five days on a camping in my own country, but I've never been to Scandinavia. I don't know if it's just this that causes my nervousness, or maybe the fact that I'll have to make it through ten days with only a 40L bag to hold my stuff. Might be easy for the adventurers amongst you guys, but not for me, it's stressing me out! I'm an over-packer especially when it comes to first aid (it's better to be safe than sorry!). Other than that I'm really curious about Norway because I've heard a lot of people say it's beautiful. I'm also looking forward to no comfort or no Internet although I think the first day will be the hardest to adjust. Luckily I find myself easily settled in circumstances with little comfort. Oh and then there's just one last thing that's scaring me the most: flying. If I survive the flight, I'll survive everything!
4 comments
This is so exciting! I'm doing something similar with my best friends next week but in Ireland :P Hope you're having a great time in Norway :) xReplyDelete
Ana xo anacelinelabod.com
Hope you enjoy !ReplyDelete
Norway is one of the prettiest countries I've visited. I wish I could go back, it really is gorgeous! Have loads of fun and take a lot of pictures!ReplyDelete
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