text:
April 21, 2006
Sheraton Golf Parco de'Medici, 6 April 2006, Rome
[Note: This is a revised and expanded version of remarks I gave yesterday at the Boehringer Ingelheim symposium on HIV past and future. The two-day symposium is taking place at a business-style 'hotel and resort' called the Sheraton Golf Parco de'Medici some 20 minutes outside of Rome in a complex which includes conference facilities, a golf course, and sprawling mall-like commercial structures more typical of Las Vegas than of the Eternal City. The symposium includes an overview of the evolution of AIDS treatment with an emphasis on resistance to antiretroviral treatment and provides a venue for the introduction of Boehringer Ingelheim's protease inhibitor, Aptivus® brand tipranavir.]
Buon giorno.
First, I would like to apologize that the organizers of this symposium did not invite an Italian person living with AIDS or treatment activist to speak here.
Second, I thank the organizers for allowing me to give these remarks.
I am going to talk about AIDS activism and the broken social contract.
AIDS activism is a response to a global public health emergency.
It is a response to inequality and discrimination, and to the lack of human rights for women, men who have sex with men, injecting drug users, sex workers, prisoners, children, and others.
The United States, though among the richest countries in the world, has greater social and economic inequality than any other developed country. We spend 15% of our national product on health care, yet health outcomes are worse than those in many developing countries. In the US, infant mortality is higher than it is in Costa Rica. A person of color born in Harlem or the Bronx has a lower life expectancy than a person born in the Indian state of Kerala.
The economic inequalities in the United States are as great as those in some developing countries such as Brazil and South Africa, all three of them much richer than many countries stricken by AIDS.
The United States has more cases of HIV than any other developed country.
Over 1.2 million people in the US are living with HIV. Over 600,000 have died of AIDS. In New York City, where I live, 80,000 people have died of AIDS.
AIDS activism began when the epidemic first appeared in the gay communities of New York and San Francisco in the early 1980s. Now it is a worldwide movement for human rights, public health, high-quality and free medical care, and social justice.
AIDS activism built on a foundation of organizations formed by and for people with AIDS. Activists conducted demonstrations and direct action to build public awareness and political support and to mobilize resources to respond to the epidemic by creating legal protections, social programs, HIV prevention, health care, medical research, treatment access, lower drug prices, and informed and educated communities.
People with AIDS and activists were too weak to change the social inequalities in the US which denied rights to gay people, women, racial and ethnic minorities, drug users, prisoners, and others. But we were able to develop the skills and abilities to contribute meaningfully to medical research, and to mobilize public support to create strong AIDS research programs funded by the Federal government.
Treatment activism builds on a series of targeted campaigns to transform medical research, speed access to and approval of treatments to treat HIV and its opportunistic infections, subsidize access to medical care for people living with HIV/AIDS, and increase support for AIDS care and treatment in developing countries.
In 1988, activists demonstrated at the US Food & Drug Administration (FDA) for access to experimental treatments and for faster approval of new drugs for AIDS. In 1990, we demonstrated at the National Institutes of Health to demand full participation in the clinical trials networks which carried out studies of new treatments.
Activists demanded to participate in the design of clinical trials directed by the National Institutes of Health and pharmaceutical companies. Inspired by the activists' example, breast-cancer patient-advocacy groups made similar requests. The AIDS groups interrupted meetings and staged "dieins" at the NIH, and, eventually, the physicians in charge of planning the clinical trials agreed to their demands. Laypeople now routinely sit on committees at the NIH, and on hospital's institutional review boards, which assess the ethicality and scientific merit of clinical trials, particularly those involving experimental drugs or procedures.1
By 1992, the FDA had codified new regulations for accelerated approval for new drugs to treat AIDS and other life-threatening diseases, by allowing drugs to be approved based on beneficial changes in surrogate markers, such as CD4 cell counts or later viral load levels, which were thought to predict clinical benefit.
By reducing the time it took to develop new drugs, and thus making it less expensive to invest in AIDS research, these changes drew more companies into developing treatments for HIV.
But activists also realized that the discoveries which led to new drugs and drug classes came from fundamental basic research on the biology of HIV and its interaction with the human immune system. Activists therefore fought to increase support for basic research on HIV/AIDS and to strengthen the planning, coordination, and evaluation of AIDS research at the National Institutes of Health (NIH) by creating a strong Office of AIDS Research (OAR) with the ability to draw on the advice and input of external scientists, with community involvement, in developing a comprehensive strategic plan for AIDS research, linked with the annual budget, to address the highest scientific priorities, fill gaps in research, and develop innovative approaches.
Activists succeeded in securing major increases in funding for AIDS research by the NIH. Last year NIH spent $2.9 billion on AIDS research.
By 1996, the combination of political pressure, increased basic science, a more flexible regulatory requirement, greater industry involvement, and accelerated approval led to the approval of protease inhibitors and the non-nucleoside reverse transcriptase inhibitor (NNRTI) nevirapine, the introduction of highly accurate viral load tests to assess the prognosis for progression of HIV to AIDS and to directly measure the impact of ART on HIV levels, and thus to the advent of highly active antiretroviral therapy (HAART).
Within two years, the death rate from AIDS in developed countries -- including the United States -- dropped by over 2/3 due to the extraordinarily rapid introduction, dissemination, and uptake of HAART and viral load testing. The US death rate dropped from over 50,000 per year to about 16,000, where it remains today. In some countries with universal health care, mortality dropped even more.
But inequalities in the US health care system have persisted and worsened. Millions more Americans lack health insurance than even ten years ago. Huge corporations like General Motors are desperately shedding workers, shredding benefits, canceling pensions, and slashing health coverage. Hundreds of people with HIV who need therapy in the US are on waiting lists in states which do not adequately support their AIDS Drug Assistance Programs. Recent changes in Federal programs such as Medicaid and Medicare have made access to treatment more difficult for some. The Medicare drug benefit law actually prohibits the US government from negotiating lower drug prices with industry. This makes a travesty of the free-market system. In a truly free market, buyers and sellers each have access to accurate information about prices, quality, and alternatives. There is little or no access to information about what prices each company provides to different health care providers for different drugs. Oftentimes industry fails to meet its postmarketing commitments, and so it is not always clear which therapeutic alternative is best. Health insurance companies spend billions on administration, marketing, and cost shifting rather than on providing care. Poor people routinely go without needed diagnostics, drugs, care, and treatment because they are treated poorly in our fragmented health care system.
It is difficult for people in European countries with national health care systems to understand the deeply unjust, inequitable, and discriminatory health care system in the United States. But, conversely, European countries are not adequately funding the science base which leads to new treatments. Europeans must make larger contributions to medical research and international treatment access than they currently do. European countries do not spend as much as the US on publicly funded basic and applied research. This means, despite the accessibility of health care in most European countries, that drug companies have an even more disproportionate effect on medical research, since there is inadequate publicly funded biomedical research. Researchers and clinicians depend on industry for funding, information, and gratuitously lavish junkets just as much or even more than they do in the United States. This week's Boehringer Ingelheim symposium, a thinly disguised promotional tipranavir jamboree, made this abundantly clear. But more on that in a moment.
Now I am going to first briefly sketch the changes which have occurred in global treatment access as a result of treatment activism around the world. Community-based political activism has created momentum for significant scale-up of ART access in a number of countries around the world, including major advances in Brazil, South Africa, Thailand, Uganda, Ukraine, and other countries.
Where community mobilization for ART access in developing countries has taken place, it has been due to strong civil society linked in many cases with democracy movements. Brazil, South Africa, and Thailand all moved towards democracy in the 1990s after decades of dictatorship. AIDS activists in those countries used the new structures of democratic accountability to demand access to ART. Even in countries which are not fully democratic, such as Uganda, strong civil society mobilization has made remarkable changes.
Brazil was the first developing country to adopt a policy of universal access to ART, in the mid-90s, and expanding to cover 87,500 people living with HIV by 2000,2 when the Brazilian government began to promote its universal access program at international fora such as the International AIDS Conference at Durban in June 2000.
Influenced by the massive mobilization of South Africa's Treatment Action Campaign, the controversy over President Mbeki's denialist views about the HIV/AIDS link, and South African judge Edwin Cameron's dramatic opening speech calling for international distributive justice and a right to ART care for all, Durban marked the point at which the international consensus began to shift in favor of global treatment access. Soon after, generic companies began manufacturing ARVs at greatly reduced prices and making them available to individuals or countries who could pay. Drug prices for some first-line combinations came down from $10,000 per year to less than $300.
In 2002 the Global Fund to Fight AIDS, Tuberculosis, and Malaria was established. In 2003, the US announced the President's Emergency Plan for AIDS Relief (PEPFAR), and the World Health Organization (WHO) announced the target of supporting developing countries to treat three million HIV infected people by the end of 2005.
By the end of December 2005, according to the latest update from WHO, 1.3 million people in developing countries were receiving ART.3 While this is just 12% of the global need, it also represents a three-fold increase in ART access in just two years. In sub-Saharan Africa, the increase was eight-fold (800%). Yet the road ahead is far from clear. Without new contributions, the Global Fund cannot fund new or continuing programs past the current round. It is unclear whether the ongoing, UNAIDS/G8 led initiative to promote universal access to HIV/AIDS prevention, treatment, care, and support by 2010 has a chance of succeeding in mobilizing the resources necessary to build health systems capable of delivering life-long chronic care in the developing world.
First, I should make it clear that I believe the R&D based pharmaceutical industry has an indispensable role to play in discovering and developing diagnostics, drugs, and vaccines to improve human health. I mentioned above that industry plays a vital role in taking the discoveries made in fundamental research supported by public agencies such as the NIH and taking them to develop lead compounds and to bring new drug compounds and classes to market. A classic example of this process is the NIH-funded discovery in 1995-96 of the role of CCR5 and CXCR4 as HIV coreceptors and the role of industry in taking this basic science breakthrough and developing lead compounds and candidate drugs and testing them pre-clinically and in humans. Thus basic science advances ten years ago led to the ongoing clinical trials of drugs such as the CXCR4 inhibitor from Anormed (AMD-070) and the CCR5 inhibitors from Pfizer (maraviroc) and Schering (vicroviroc). Whether they will actually work is still an open question.
Second, I believe that pharmaceutical companies are entitled to make a reasonable return on investment. If they do not make a profit they will not be able to stay in business. But drug companies must be part of a larger social contract to ensure that all people who need the benefits of new therapies receive them, regardless of whether they live in rich or poor countries or which kind of health system they have access to. And currently the drug companies are part of the broken social contract, rather than part of the solution.
Third, in spite of the detailed criticism which follows, I believe that Boehringer Ingelheim has made important contributions to HIV treatment, has the potential to make further discoveries, and can improve its performance by designing more informative clinical trials, responding more rapidly and effectively to scientific and community concerns, and assuring access to all who will need its therapies.
Boehringer Ingelheim is a privately-held, family-owned global R&D pharmaceutical company with its headquarters in Germany. According to a company press release4 quoted in yesterday's Financial Times,5 last year,
Net sales grew by 17% to 9.5 billion euros (2004: EUR 8.2 billion). Operating income, comparable to EBIT, was 40% higher at over 1.9 billion euros (1.4 billion). The number of employees worldwide rose by some 1,900 to total 37,400 ( 5.3%). Dr Alessandro Banchi, Chairman of the Board of Managing Directors, with responsibility for Pharma Marketing and Sales, said the financial year 2005 was clear confirmation 'that Boehringer Ingelheim has entered the group of leading international pharmaceutical companies, not only in terms of sales growth, but also in terms of profits'. 'We look back on a most satisfactory financial year,' Dr Banchi said ... [BI] achieved an operating return (operating income in relation to net sales) of 20.2%, which Professor Marbod Muff, responsible at Boehringer Ingelheim for the Corporate Board Divisions Finance and Human Resources, described as 'exceptionally good' ...
According to figures from the market analysts IMS, which all pharmaceutical companies use, Boehringer Ingelheim was last year the fastest growing company among the major international pharmaceutical groups. Boehringer Ingelheim grew by 23% (sales in constant euros), while the pharmaceutical market average could only add 6%. This growth dynamic was particularly marked in the USA, where Boehringer Ingelheim's 33% growth clearly outstripped the US market ( 5%). The company, which for the sixth time in a row has grown faster than the pharmaceutical company average, has in the meantime secured a world market share of around 2%, ranking it as No. 14 internationally. Dr Banchi expects distinctly faster than average pharmaceutical market growth again in 2006. 'We trust in our own strengths and are confident that we can extend our position further in our market segments," the Chairman said. Simultaneously, Dr Banchi underlined that successful growth and good profits are no end in themselves, but are the "preconditions for developing innovative medicines to benefit people' ...
The highlight of the last year was the market launch of the AIDS drug Aptivus®, a novel protease inhibitor which offers additional treatment options for patients with multiple resistance to other HIV drugs ...
For years, the company's biopharmaceutical production has here been particularly successful, with net sales last year growing by 40% to 550 million euros ..."4
Clearly the unique advantages R&D based pharmaceutical companies have in the distorted and fragmented US health care system are yielding concrete benefits for BI, as its 4 April 2006 press release indicates:
The most important regions for Boehringer Ingelheim last year were once again both American continents with 4.6 billion euros net sales. Europe contributed 3.1 billion euros to sales and Triple A (Asia, Australasia, Africa) 1.9 billion euros... The good development of net sales led to markedly higher income after taxes. This amounted to 1.5 billion euros, corresponding to an increase of almost 70% compared to the previous year. However, this result contains only part of the overall tax burden. The position regarding the taxation of partnerships in Germany -- and the family-owned company Boehringer Ingelheim is such a partnership -- includes only the trade tax, but not the income tax also incurred. This has to be shown on the balance sheet as 'capital withdrawn', said Prof. Muff."4
In Germany, the families who own BI must, alas, pay income taxes on their profits. Perhaps they should relocate to the United States where the Bush administration derides such injustice to the rich and promotes an end to this allegedly unjust "double taxation." Since BI does not have to report to public shareholders, or comply with legal and regulatory requirements which apply to publicly-listed companies, it benefits from the current system without having to play by rules which affect publicly-traded companies.
Dr Banchi und Prof. Muff drew attention to Boehringer Ingelheim's peculiarity as a company independent of the capital market. 'We can plan really long term,' said Dr Banchi. 'The development of our business is characterised by stability and continuity.' This also has a decisive influence on our vibrant corporate culture.
For the future, the company presents a positive picture. The product pipeline contains a number of promising candidates in various therapeutic areas. In 2005, almost 1.4 billion euros was invested in Research & Development Medicine. That is 10% higher than the previous year. However, due to the very positive development of net sales the R&D+M expenditure as a share of net sales in Prescription Medicines slightly declined to 18.2% (2004: 19.3%).
Many of Boehringer Ingelheim's successful products will be patent-protected or will enjoy exclusivity for a significant number of years. New market launches and indication extensions are to come in 2006, including pramipexole (Sifrol®/Mirapex®) in the indication restless legs syndrome -- RLS. For Dr Banchi the goals for 2006 are clearly defined: 'We will maintain our dynamic growth in 2006 too.'4
BI's independence from capital markets and its ability to plan for the long-term may well benefit people suffering from restless legs syndrome.
Viramune® was approved in 1996, but sales were never as robust as for the more potent protease inhibitors. Nonetheless the drug achieved a niche; by 2002, it was awkwardly wedged no. 8 between two forms of abacavir (Trizivir and Ziagen) in IMS health's list of the top ten U.S. antiretrovirals by sales:9
|2002 Top 10 HIV Antiviral (J5C) Products By Global Sales*, 12 months ending
|Date of 1st Launch
|October 1997
|GlaxoSmithKline (GSK)
|March 1997
|August 1994
|Bristol-Myers Squibb (BMS)
|September 1998
|November 1995
|September 2000
|December 2000
|June 1996
|Boehringer Ingelheim
|January 1999
|March 1996
|Merck & Co.
|Source: IMS Monthly MIDAS, 2002
* Retail pharmacy markets in the U.S., Can, Ger, Italy, France, Spain, U.K., Braz, Mexico, Arg, Aus, New Zealand, Japan.
Perhaps more important from a global perspective, the NIH-sponsored HIVNET 012 study, completed in 1998, was the first study to show that single-dose nevirapine, administered during childbirth, could dramatically reduce the transmission of HIV from mother to child.10 While previously ACTG 076 showed that twelve weeks of AZT had greater effects, single-dose NVP obviously had greater public health implications for prevention of mother-to-child transmission (PMTCT) in resource-poor settings, and indeed it provided the first impetus for previously treatment averse United Nations agencies such as UNAIDS and UNICEF to begin sluggishly advocating for a more treatment-oriented approach to AIDS in poor countries.
While HIVNET 012, conducted in Uganda by NIH and without full regulatory support from BI to meet standards for FDA approval, had some deficiencies with respect to record-keeping and other administrative matters, numerous scientific reviews and rigorous retrospective analyses, as well as other controlled studies, have demonstrated that the underlying scientific conclusion is correct.11
By Durban in mid-2000, activism to demand nevirapine access for pregnant HIV-positive women was a core demand for South Africa's Treatment Action Campaign (TAC).12 Perhaps it was just a coincidence then -- or more likely the presence of the global media and AIDS research elite -- that elicited BI's announcement on 7 July 2000 of a five year free nevirapine donation program for PMTCT in developing countries.13 The program generated oceans of good publicity for BI, while actual supplies of free nevirapine slowly trickled to poor countries, hampered by logistical difficulties at every turn.
In addition the findings of the early Richman study of rapid development of resistance to nevirapine were followed by the evidence for the rapid emergence of resistance to even single-dose nevirapine. As James McIntyre told the 12 CROI in 2005, quoting Polly Clayden of UK's I-Base, "It's time to move on" from the single-dose nevirapine.14
Ultimately, despite the development of generic forms of nevirapine by many companies around the world, its price as the lowest of any generic NNRTI either as a single drug or in fixed-dose combinations (FDCs),15 seven years of promises by BI, UNAIDS, UNICEF, and others, and massive increases in resources for HIV/AIDS prevention and care programs through GFATM, PEPFAR, and others, uptake of nevirapine for PTMCT remains pathetic. According to the 28 March 2006 WHO 3x5 update, "In most low- and middle-income countries ... less than 10% of pregnant women living with HIV/AIDS [are] estimated to be receiving antiretroviral prophylaxis. As a result, 1800 infants are infected with HIV every day ..." (3, p. 36)
Clearly, while victory has a thousand parents, defeat is an orphan. It is not Boehringer Ingelheim's fault, or that of GFATM, PEPFAR, UNAIDS, UNICEF, or WHO that uptake of PMTCT is so pathetic -- it is all of their responsibility, and that of governments that do not take care of their people. And it demonstrates the need for better infrastructure, human resources for health, robust supply chain management systems, and all the rest -- but it is striking that eight years after its discovery, PMTCT appears to be progressing even more slowly than ART scale-up, which is much more complicated.
Meanwhile further complications of nevirapine when used as therapy (rather than in single dose PMTCT) emerged in 2004-2005. These concerns centered around sometimes-fatal hepatotoxicity associated with NVP, which had always been a known side-effect, but received renewed concerns after several women died in a clinical trial of emtricitabine (FTC) being conducted by Triangle (later bought by Gilead), which included AZT and nevirapine in both arms and was comparing FTC to its established cousin FTC.
The FDA asked Boehringer Ingelheim to conduct intensified reviews of the post-marketing database.
BI sponsored a special supplement on "Hepatic Safety and HAART" in the 2 March 2004 Clinical Infectious Diseases, and the title page noted, "This supplement is sponsored by Boehringer Ingelheim International." The editors of CID published an unusual disclaimer stating, "The opinions expressed in this publication are those of the authors and are not attributable to the sponsors or to the publisher, editor, or editorial board of Clinical Infectious Diseases"21 A lead article by guest editor Douglas Dieterich and colleagues reviewed cohort studies rather than randomized trials or post-marketing FDA safety reporting. They stated:
HIV infected patients frequently present with elevated levels of serum transaminases (alanine aminotransferase [ALT] and/or aspartate aminotransferase [AST]). This has often been attributed to the hepatic effects of antiretroviral (ARV) drugs, including nonnucleoside reverse-transcriptase inhibitors (NNRTIs). A review of cohort studies investigating the incidence of hepatotoxicity among patients receiving ARV therapy suggests that the overall rate of ALT and/or AST elevations is similar among all ARVs.22
This comparison looked at elevations in liver function tests (LFTs) rather than at the severe, life-threatening hepatotoxicity observed with NVP (but not with all other ARVs).
The rate of severe hepatotoxicity, ALT and/or AST levels >5 times the upper limit of normal (ULN), during therapy with NNRTIs is relatively low but may be significantly higher in patients with concurrent chronic viral hepatitis (hepatitis B or C). A comprehensive analysis of 17 randomized clinical trials of nevirapine demonstrated that 10% of all nevirapine-treated patients developed elevated levels of ALT and/or AST >5 times the ULN; however, almost two-thirds (6.3% of nevirapine-treated patients) of these elevations were asymptomatic. Symptomatic hepatic events were seen in 4.9% (3.2% 8.9%) of nevirapine-treated patients.22
The article leaves one with the impression that all ARVs have similar hepatic toxicity profiles at least when it comes to elevated LFTs. However, it did not look at comparative rates of severe, life-threatening, or fatal hepatotoxicity.
In the meantime, the FDA, after a post-marketing safety database review, required BI to change the Viramune package insert, which now begins with a prominent black box.
WARNING. Severe, life-threatening, and in some cases fatal hepatotoxicity, particularly in the first 18 weeks, has been reported in patients treated with VIRAMUNE®. In some cases, patients presented with non-specific prodromal signs or symptoms of hepatitis and progressed to hepatic failure. These events are often associated with rash. Female gender and higher CD4 counts at initiation of therapy place patients at increased risk; women with CD4 counts >250 cells/mm³, including pregnant women receiving VIRAMUNE in combination with other antiretrovirals for the treatment of HIV infection, are at the greatest risk. However, hepatotoxicity associated with VIRAMUNE use can occur in both genders, all CD4 counts and at any time during treatment. Patients with signs or symptoms of hepatitis, or with increased transaminases combined with rash or other systemic symptoms, must discontinue VIRAMUNE and seek medical evaluation immediately (see WARNINGS). Severe, life-threatening skin reactions, including fatal cases, have occurred in patients treated with VIRAMUNE. These have included cases of Stevens-Johnson syndrome, toxic epidermal necrolysis, and hypersensitivity reactions characterized by rash, constitutional findings, and organ dysfunction. Patients developing signs or symptoms of severe skin reactions or hypersensitivity reactions must discontinue VIRAMUNE and seek medical evaluation immediately (see WARNINGS). It is essential that patients be monitored intensively during the first 18 weeks of therapy with VIRAMUNE to detect potentially life-threatening hepatotoxicity or skin reactions. Extra vigilance is warranted during the first 6 weeks of therapy, which is the period of greatest risk of these events. Do not restart VIRAMUNE following severe hepatic, skin or hypersensitivity reactions. In some cases, hepatic injury has progressed despite discontinuation of treatment. In addition, the 14-day lead-in period with VIRAMUNE 200 mg daily dosing must be strictly followed (see WARNINGS).23
The revised prescribing information was released on 11 January 2005, just nine months after the misleading coverage in the March 2004 CID, and was followed by an "FDA Public Health Advisory for Nevirapine (Viramune)."24
Unfortunately the politics of HIV denialism in South Africa and elsewhere seized on the newly clarified safety concerns -- as they had previously on the unrelated issues regarding record-keeping in the HIVNET 012 study -- to cast doubt on the underlying safety and efficacy of nevirapine for either PTMCT or on ART regimens.
Nonetheless BI's support for the CID supplement and what some have suggested was its less than forthright response to safety considerations raised by FDA and others in the decade since the licensing of nevirapine clearly provide an opportunity for the company to reflect on its behavior and commit to addressing future safety concerns in a more pro-active, transparent fashion. This means taking an aggressive approach to studying the toxicities associated with their drugs in well-designed long-term safety studies, investigating the interactions between their drugs and other commonly used treatments, trying to understand the pathogenesis of hepatotoxicity, providing clinicians and patients with clear, accurate information about the detection and management of severe adverse events, and fulfilling their postmarketing commitments to FDA and other regulatory authorities.
In many places where nevirapine is now used as the most common anchor drug in first-line ART regimens in countries scaling up ART programs, lab and clinical capacity needs to be made available to monitor liver function tests (LFTs) when possible, and people on ART, providers, and the health system need to be trained and encouraged to be vigilant for clinical symptoms which may suggest NVP hepatotoxicity.
Nothing is ever simple in HIV treatment.
After giving a talk on "the Making of an AIDS Activist" at the European Community Advisory Board (ECAB) in November 1998 -- coincidentally held in Rome, albeit in more congenial activist surroundings -- I attended the ECAB meeting with Pharmacia where TPV was first discussed. Pharmacia decided to leave HIV research before being swallowed up by Pfizer in 2002. TAG's ARV pipeline report from 2002 lists two other P&U drugs as casualties of its decision to leave the field and two Parke-Davis compounds as casualties of the latter's merger with Pfizer; these were just a few victims of the merger-mania massacre.17
Tipranavir got a reprieve -- just barely; in 2001, Boehringer Ingelheim decided to take up PNU 140690 for development; we reported on it after the Buenos Aires IAS conference in 2001:
Despite prophecies of imminent doom periodically uttered by paranoid activists -- some of whom recently claimed that activist pressure to lower antiretroviral prices in developing countries was leading drug companies to flee the HIV field -- the IAS conference reflected a rather healthy, if underwhelmingly inventive or innovative, drug pipeline. ... After a long hiatus, tipranavir has been transferred from Pharmacia & Upjohn, which left the HIV field, to Boehringer-Ingelheim (which passed on P&U's other antiretroviral, delavirdine). Tipranavir is structurally different from other protease inhibitors and hence exhibits activity against most PI-resistant HIV. On the downside, tipranavir has a daunting pill count.
The tipranavir data presented in Argentina were somewhat confusing, as the formulation changed mid-study. In addition, tipranavir was given in combination with low-dose ritonavir in order to boost the drug's less than overwhelming pharmacokinetics ...
Boehringer held a spirited community meeting where they were questioned aggressively on these results, although some of the problems with the development plan were the legacy of the previous sponsor. For example, the dose-ranging study included efavirenz, which is likely to affect the drug's pharmacokinetics. Despite its intriguing resistance profile, the combination of high pill count, bizarre pharmacokinetics and significant toxicity poses a trinity of major obstacles for this drug.18
Over the subsequent years BI conducted two studies of tipranavir in highly treatment experienced patients, RESIST-1 and RESIST-2. The studies allowed participants to use T-20 (enfuvirtide) and generally those who added both TPV and T-20 to their regimen did better. However the results of the RESIST studies were difficult to interpret due to the complex nature of the patients and their HIV in the studies, because of early treatment switches, and other confounding variables. As Keith Alcorn reported in AIDSMap after the FDA hearing,
The United States Food and Drug Administration's Antiviral Drugs Advisory Panel voted 11-3 in favour of accelerated approval for the new protease inhibitor tipranavir (Aptivus) after public hearings yesterday in Washington DC.
Tipranavir is being recommended for approval in protease inhibitor-experienced HIV-positive patients, although the final labelling and approval must be decided by the FDA by June 22nd. The panel voted to recommend a twice daily dose of 500mg of tipranavir boosted by 200mg of ritonavir, as studied in phase III trials of the drug.
Tipranavir has been studied in two large trials in patients with protease inhibitor resistance (RESIST 1 & 2 studies), which showed that the drug was more effective than other boosted protease inhibitors when combined with at least two other drugs chosen after resistance testing (an optimised background regimen).
Although the panel voted to approve tipranavir, they expressed caution and asked for further studies to be carried out to guide use of the drug.
In particular the FDA highlighted problems with potential drug interactions and liver toxicity. They noted that interaction studies looking at a wide range of cytochrome p450 enzymes and drugs metabolised through those pathways have not yet been carried out, despite the fact that tipranavir also inhibits CYP1A2, CYP2C9, CYP2C19 and CYP2D6. Grade 3 or 4 liver toxicity was noted in 10% of tipranavir treated patients, and emerged significantly more quickly in both RESIST studies. The same was true for triglyceride and cholesterol elevations.
A higher rate of rash was also seen in women than men treated with tipranavir in phase I and phase II trials, but no difference between the tipranavir group and the control group was seen in the RESIST studies. However the FDA says that the small number of women included in these studies makes it impossible to draw definitive conclusions.
"I clearly would urge the pharmaceutical sponsor, since we know that there is this persistent elevation in liver function studies, to generate data that lets us know the baggage with elevation over time," committee member Lauren Wood (Uniformed Services University of Health Sciences) said.25
Thus, four years after the first BI meetings with the community on TPV, the "trinity of obstacles" noted in the September 2001 TAGline remained of concern, as Bob Huff recounted in his update from the fall 2005 Dublin satellite symposia:
Tipranavir (Aptivus) is a recently US-approved protease inhibitor that has been targeted for salvage therapy. Jurgen Rockstroh from Germany reviewed the results from the RESIST studies of tipranavir versus best available therapy in highly treatment-experienced individuals. At 24 weeks, 34% of patients in the tipranavir group had HIV RNA below 400 copies/mL compared to only 15% of those in the comparison group. Subsequently, during a scientific session at the conference, 48 week RESIST results were reported that continued this theme, with about 30% of the tipranavir group below 400 copies versus 13.8% in the comparison group. Clearly there is an advantage to having tipranavir on board, but these low numbers speak to the pressing need for overall improvements in salvage therapy. For patients who included Fuzeon in their regimens, the prospect of success was brighter, with 50% of those on tipranavir having a protocol-defined treatment response. This demonstrates the importance of including at least two active drugs when constructing a salvage regimen; if only one active drug is added to a failing regimen, then the benefit will likely be short lived.
Most dropouts in this study were due to viral failure in the comparison arm and were switched to tipranavir after 8 weeks, which necessarily limits any comparative safety data after that point. The selection of Jurgen Rockstroh, widely known as a hepatitis expert, to present the tipranavir data speaks to concerns about the drug's potential for liver toxicity. In the 24-week RESIST data, grade 3 or 4 ALT elevations were reported in 5.9% of those receiving tipranavir and in 1.8% of those in the comparison arm. Rockstroh acknowledged that the risk of liver toxicity is higher in patients receiving tipranavir, especially those with HBV or HCV coinfection. He recommends routine monitoring and discontinuation if elevated liver enzymes are accompanied by symptoms. Aside from this issue, Rockstroh said, the safety profile of tipranavir was comparable to other PIs used in RESIST.
David Back from the UK addressed one of the other difficulties with boosted tipranavir: how to use it in combination with other drugs. An early study of tipranavir in combination with several protease inhibitors revealed that it could dramatically lower the levels of saquinavir, amprenavir, and Kaletra, which effectively ruled it out for use in a dual boosted-PI strategy. Back, one of the world's experts in drug interactions walked through what else is known about how tipranavir interacts with others. There seems to be no relevant interaction between tipranavir and efavirenz or nevirapine or with the NRTIs, including tenofovir. Coadministration with the PIs, of course, is not recommended. There are also likely significant interactions with certain TB drugs, some statins, some antifungals, and probably other drugs. The bottom line is that the net effect of tipranavir is difficult to predict and clinicians should be mindful of other, unrecognized potential interactions.19
The FDA-approved labeling for Aptivus included a now-familiar black-box warning on tipranavir's hepatic side-effects:
APTIVUS co-administered with 200 mg ritonavir has been associated with reports of clinical hepatitis and hepatic decompensation including some fatalaties. Extra vigilance is warranted in patients with chronic hepatitis B or hepatitis C co-infection, as these patients have an increased risk of hepatotoxicity.26
FDA required BI to complete or conduct at least 18 post-marketing studies, including reporting the 48-week results of RESIST-1 and RESIST-2; studies in children and adolescents; drug-drug interactions studies of TPV/ritonavir twice daily and atazanavir, buprenorphine/naloxone, carbamezipine, tadafil, ribavirin/pegylated IFN alpha 2a, methadone; carcinogenicity studies in mice and rats; long-term 48 week safety and efficacy of TPV/RTV in ARV naïve patients in study 1182.33 including drug resistance analyses from patients with virologic rebound and metabolic changes; a 48-week "prospective observational diversity cohort study with tipranavir/ritonavir twice daily stratified by race and gender in HIV-positive patients to assess efficacy and safety, including potential risk parameters such as CD4 cell count; a "48- week prospective observational cohort study with tipranavir/ritonavir twice daily in patients co-infected with HIV and HBV or HCV to assess efficacy and safety. BI will discuss potential therapeutic drug monitoring substudy for this protocol with the FDA'; TPV/rtv pharmacokinetics in HIV-negative subjects with Child-Pugh B liver disease; a "CYP/P-gp mechanistic study to determine effect of tipranavir/ritonavir on individual CYPs"; and "a formal QT prolongation study."27
It is fortunate that FDA is requiring such detailed and extensive post-marketing studies under its accelerated approval authority; however, past experience shows that many companies do not fulfill their post-marketing commitments. A recent FDA study showed that 154 drug sponsors had 1,231 open postmarketing commitments. By 30 September 2005, two thirds (797, 65%) were still "pending", 231 (19%) "ongoing", 28 (2%) "delayed", 3 (<1%) "terminated, and just 172 (14%) "submitted".29 This is a rather dismal performance by industry and reflects the need for stronger FDA authority to compel sponsors to fulfill their commitments, as well as the need for more robust post-marketing pharmacovigilance.
Hence, FDA and the community must be vigilant in ensuring that BI fulfills its promises here.
Thus, it is hard to know how useful TPV will really be in the clinic. With its plethora of side effects, serious liver toxicity, and bizarre pharmacokinetics, it may be reserved for individuals able to tolerate it and who need a stopgap protease inhibitor before the introduction of possibly more forgiving alternatives such as Tibotec's forthcoming protease inhibitor darunavir, or -- still speculatively as they are in earlier phases of study -- the Pfizer or Schering CCR5 inhibitors, the Gilead or Merck integrase inhibitors, or other potential new ARV candidates.
Perhaps fearing that its brief moment in the sun would quickly be eclipsed by these rapidly advancing alternatives, BI decided to price Aptivus at a record $13,410 per year wholesale in the United States, the highest price for any protease inhibitor. This certainly betrayed, at the very least, a dismaying indifference to the plight of U.S. HIV-infected people who might fall between the cracks in the fragmented health system, or even a more cynical urge to gorge on excess profits as quickly as possible due to fears of a vanishingly small window of opportunity to obtain market space.
The AIDS Treatment Activists Coalition (ATAC) responded to BI's unprecedented pricing move with a public warning that drug companies were engaging in a "steady onslaught of unreasonable, unacceptable, and unjustified' increases in the prices of therapies to treat HIV... 'Sadly, Boehringer-Ingelheim failed to realize that the size of the potential Aptivus market is directly tied to patients' access through publicly funded programs, and they just made that market a lot smaller,' said Lei Chou," a respected HIV community expert on drug pricing and reimbursement in the US.27
On 23 February 2006, BI held a conference call with US treatment activists to announce that it was dropping the 500/200 mg tipranavir/ritonavir arm from the ongoing 1182.33 study in ARV naives which was comparing two doses of TPV/rtv (500/200 and 500/100) to Kaletra. "Following a thorough review of the 48-week data in this study, and with the recommendation of the DSMB, Boehringer Ingelheim has decided to close the Aptivus /ritonavir 500 mg/200 mg study arm. Safety in treatment-na?ve patients in both Aptivus /ritonavir study arms was generally similar to the comparator lopinavir/ritonavir arm. However, the rate of asymptomatic liver enzyme elevations reported in the Aptivus /ritonavir 500 mg/200 mg study arm was higher than in the other study arms and thus presented a less favorable benefit-risk profile for these treatment-naive patients."30 BI refused to disclose the number of events which occurred, the relative risks between study arms, or to describe in any detail the reasons other than what they stated in their press release, saying fuller disclosure had to wait until an unspecified future scientific conference. This continuing evasive behavior stood in stark contrast to Pfizer's detailed disclosure regarding a single, severe adverse event in its ongoing maraviroc study in ARV naive individuals. The fact that the dose combination which is FDA approved for use in treatment experienced individuals was now deemed too toxic for treatment naive ones indicates the alarming degree to which BI has failed to clearly define a dose which is both safe and effective for use in diverse HIV infected individuals.
In conclusion, Boehringer Ingelheim has failed to live up to the best practices which should be expected for the world's fifteenth-largest R&D based pharmaceutical company. In its interactions with treatment activists in the US or Europe, BI clings behind the excuses of being small, family owned, and privately held, to justify its small studies, inadequate research into side effects or resistance, and failure to fulfill post-marketing study commitments. Similarly, when activists or from developing countries or NGOs such as MSF implementing ART and PMTCT programs in developing countries complain about difficulties accessing BI, obtaining regulatory information, or obtaining promised discounted or free drug donation programs, BI claims that it lacks the capacity to respond to the myriad of requests coming from places where it is understaffed or relies on intermediates. Yet at the same time, in its annual reports to investor, BI trumpets its unparalleled growth, intention to join the big leagues, commitment to groundbreaking innovative research, and brags that being privately-held enables it to plan long-term, while simultaneously complaining its profits are doubly-taxed in Germany.
BI needs to decide which role it intends to play. If it really wants to be a global player, it must be more accountable, transparent, scientifically rigorous and respectable, and let community activist networks have access to the most timely and accurate scientific information. It must make its products accessible to all who need them without pricing entire countries or populations out of its markets. It must meet and exceed its commitments to FDA. It must conduct solid research into the reasons for drug toxicities and how to manage them in diverse population groups affected by HIV, HBV, HCV, drug substitution therapy, and other combinations.
The social contract between drug companies and the public sector is broken, especially in the US. While companies make their greatest profits in the US, they deny public information about pricing schemes, extract maximum short-term profits, while failing to address the need for universal health care in the world's richest country.
Companies are not meeting their post-marketing commitments to find out how best to use drugs licensed under accelerated approval mechanisms for which AIDS activists fought and without which many people with AIDS would have died. But accelerated approval demands that industry continue rigorously studying their drugs after approval, and in this many companies -- BI among them -- have failed woefully. Companies also need to contribute more effectively to the global movement for universal access to ARV treatment by the year 2010. Instead of seeking to file pre-emptive patent applications in all poor and middle-income countries, they should explore innovative ways of making their products more widely available, including the use of voluntary licenses to generic manufacturers, assisting the latter in regulatory filings, working with GFATM, PEPFAR, UNAIDS, UNICEF, WHO, the World Bank, and other funding and technical partners to maximize available treatment resources without bankrupting the system or diverting funds needed to strengthen health systems in developing countries into the pockets of wealthy families in rich countries.
Companies need to commit to rapid and full disclosure of emerging safety concerns and conduct follow-up studies to elucidate the causes and define the management of adverse events.
We need a global movement for universal access to public health, free medical care, human rights, and social justice.
In the early 1990s, the political system which had dominated Italy since World War II collapsed in a wave of corruption scandals known as "Tangentopoli." According to Wikipedia,
Tangentopoli (Italian for bribeville) was the name used to indicate the corruption-based system that dominated Italy until the Mani pulite [clean hands] investigation delivered it a deadly blow in 1992. Whether things have really changed since then, or whether only the names of those involved have, is a matter of debate.32


text:
|PostgreSQL 7.4.30 Documentation
|Fast Backward
|Chapter 5. Data Definition
|Fast Forward
Let's create two tables. The capitals table contains state capitals which are also cities. Naturally, the capitals table should inherit from cities.
CREATE TABLE cities ( name text, population float, altitude int -- (in ft) ); CREATE TABLE capitals ( state char(2) ) INHERITS (cities);
In this case, a row of capitals inherits all attributes (name, population, and altitude) from its parent, cities. The type of the attribute name is text, a native PostgreSQL type for variable length character strings. The type of the attribute population is float, a native PostgreSQL type for double precision floating-point numbers. State capitals have an extra attribute, state, that shows their state. In PostgreSQL, a table can inherit from zero or more other tables, and a query can reference either all rows of a table or all rows of a table plus all of its descendants.
Note: The inheritance hierarchy is actually a directed acyclic graph.
For example, the following query finds the names of all cities, including state capitals, that are located at an altitude over 500ft:
SELECT name, altitude FROM cities WHERE altitude > 500;
which returns:
name | altitude -----------+---------- Las Vegas | 2174 Mariposa | 1953 Madison | 845
On the other hand, the following query finds all the cities that are not state capitals and are situated at an altitude over 500ft:
SELECT name, altitude FROM ONLY cities WHERE altitude > 500; name | altitude -----------+---------- Las Vegas | 2174 Mariposa | 1953
Here the "ONLY" before cities indicates that the query should be run over only cities and not tables below cities in the inheritance hierarchy. Many of the commands that we have already discussed -- SELECT, UPDATE and DELETE -- support this "ONLY" notation.
In some cases you may wish to know which table a particular row originated from. There is a system column called TABLEOID in each table which can tell you the originating table:
SELECT c.tableoid, c.name, c.altitude FROM cities c WHERE c.altitude > 500;
which returns:
tableoid | name | altitude ----------+-----------+---------- 139793 | Las Vegas | 2174 139793 | Mariposa | 1953 139798 | Madison | 845
(If you try to reproduce this example, you will probably get different numeric OIDs.) By doing a join with pg_class you can see the actual table names:
SELECT p.relname, c.name, c.altitude FROM cities c, pg_class p WHERE c.altitude > 500 and c.tableoid = p.oid;
which returns:
relname | name | altitude ----------+-----------+---------- cities | Las Vegas | 2174 cities | Mariposa | 1953 capitals | Madison | 845
Deprecated: In previous versions of PostgreSQL, the default behavior was not to include child tables in queries. This was found to be error prone and is also in violation of the SQL99 standard. Under the old syntax, to get the sub-tables you append * to the table name. For exampleSELECT * from cities*;
You can still explicitly specify scanning child tables by appending *, as well as explicitly specify not scanning child tables by writing "ONLY". But beginning in version 7.1, the default behavior for an undecorated table name is to scan its child tables too, whereas before the default was not to do so. To get the old default behavior, set the configuration option SQL_Inheritance to off, e.g.,SET SQL_Inheritance TO OFF;
or add a line in your postgresql.conf file.
A limitation of the inheritance feature is that indexes (including unique constraints) and foreign key constraints only apply to single tables, not to their inheritance children. Thus, in the above example, specifying that another table's column REFERENCES cities(name) would allow the other table to contain city names but not capital names. This deficiency will probably be fixed in some future release.
To second \"Fra. 219\", inheriting referential integrity contraints would be a nice feature, the same goes for primary key indices (It\'s possibly to insert a duplicate \"primary key\" into an inherited table, when the primary key was inherited from a supertable).
But there is a simple, but ugly, work-around:
CREATE TABLE super ( id serial primary key, ref int references main);
CREATE TABLE sub ( value text, primary key(id), foreign key(ref) references main) INHERITS(super);
This example for inheritance is not very good, in my humble opinion - it would be easier to add a boolean toggle in the cities table to indicate if it is or not a capital. A much better example, in my opinion, is this :
CREATE TABLE baseinfo (
name text,
address text,
zipcode text
CREATE TABLE regularclient (
client_id char(25)
) INHERITS (baseinfo);
CREATE TABLE supplierclient (
supplier_id char(25)
) INHERITS (baseinfo);
Replicating PRIMARY KEY in child tables allows only referencing 'em from other tables. It doesn't solve the "duplicated primary key" problem in the parent table. The only way I could find is adding :
CREATE OR REPLACE FUNCTION base_notexists(integer)
RETURNS boolean
AS 'SELECT NOT EXISTS(SELECT id FROM base WHERE id=$1)';
and the constraint
CHECK (base_notexists(id))
If only it could be possible to reference an already existing index...
if a boolean were added to cities to indicate that it is a capital, you then don't know the state. You could add a state column (you might want that anyhow) but a nice thing with the example is that you could also enforce that there is only one capital per state.
the example is OK to make the point though.

subset: commoncrawl


text:
Latest in Nogales
Crash shuts down L-202 Red Mtn at 32nd Street
The Arizona Department of Transportation said the westbound lanes of L-202 at 32 nd Street were closed shortly after 9 p.m. when…
FORECAST: Windy, dusty Thursday
An Air Quality Health Watch is in effect Thursday for dust. Find out when we could see some rain to wash it all away.
Accused 'yearbook flasher' breaks his silence
Hunter Osborn admitted to the prank and said he was "disgusted" by it, according to court paperwork.
PHX auto shop finds marijuana hiding in Mustang
An auto body shop owner found over 100 pounds of marijuana packed into the bumper, fender and truck of a car, shocking the man who just…
PHX police searching for man who grabbed girl
Officials said the 12-year-old victim was walking to Copper Canyon Elementary School, near Tatum Boulevard and Bell Road, around 8 a.m. when…
APRIL LIST: 12 restaurants fail inspection
On the first Wednesday of every month, ABC15 takes action to share restaurant report cards from around the Valley.
Ohio police adopt stray dog as their own
After weeks of searching for a stray dog's owner, members of an Ohio police department decided to adopt the pup themselves.
Celebrate Mom with Diamond-rated dining
This Mother's Day, pull out all the stops and dine with a AAA Diamond-rated restaurant.
8 luckiest Powerball spots in Valley
If you want to feel lucky heading into Wednesday's $348 million Powerball there are some spots around the Valley you should plan on visiting…
Mama, ducklings take annual walk through school
Every year, a mother duck and her babies take a walk through a Michigan elementary school in order to get to the lake.
Starbucks sued for having too much ice in drinks
A federal lawsuit claims Starbucks regularly overfills its cold drinks with ice instead of using the advertised amount of coffee or other…
A 'Space Jam' sequel is actually happening
Space Jam 2 with LeBron James is one step closer to becoming a reality.


text:
I'm doing art just for fun; as a hobby. Not really that good (right now at least) or plan to go professional -- Well, wanting to be a Graphic Artist/Illustraor for Wizards of the Coast counts lol. I do highly enjoy looking at others' art as well as the evolution of art throughout the centuries. I'm trying to get back into my mediocre drawing and improve on it as well as open myself to as many different forms of art as possible, but honestly I don't have that much time so I work when I can. Wish I had a lot more time for this than I currently do lol.
All signatures are added via Photoshop to authenticate it if I haven't already signed it. I CAN tell if it has been tampered with to erase the signature, so don't waste your time or mine.
School is certainly keeping me busy... >.< but then again, so is my laziness, lack of motivation, and procrastination So sorry if I'm under the radar for a long while when that's going on
Um... that's about it Enjoy!
Icon by Kattling
Comments, criticism, tips, etc much appreciated! ^^


text:
11,434 shares
A Real Best Friend
51,596 shares
A Dog's life...
22,177 shares
I think Noah is going to have a little trouble breeding the lions...
22,626 shares
Element of surprise!
36,069 shares
Black Friday
21,543 shares
They're Not Quite As SMART As They Think They Are
17,587 shares
Get to tha shoppar!
25,359 shares
Important meeting taking place across the street...
17,290 shares
When the waiter asks how the food is...
19,623 shares
I love manatees because they are so majestic.
17,262 shares
Laugh more daily


text:
Kanawha magistrate to hold criminal litigation class
CHARLESTON, W.Va. -- Kanawha County Magistrate Julie Yeager will host a criminal litigation class for Kanawha Valley Community and Technical College students from 3 p.m. to 4:50 p.m. Wednesday.
The students will tour the Kanawha County magistrate court facilities, participate in a mock trial and watch hearings in the magistrate court courtroom.
The students will be from a class taught by Craig Giffin, paralegal studies program director at the college.


text:
Event Details
Public Program
Date: October 4, 2012
Time: 12:00 pm - 1:00 pm
Venue: Third floor auditorium
EPISODE 3 - BECOMING AMERICAN (29 mins)
Recent Mexican immigrants, although poorer, tend to be healthier than the average American. They have lower rates of death, heart disease, cancer, and other illnesses, despite being less educated, earning less and having the stress of adapting to a new country and a new language. In research circles, this is sometimes called the Latino paradox.
But the longer they're here, the worse their relative health becomes, even as their socioeconomic status improves. After only five years in the U.S., they are 1.5 times more likely to have high blood pressure – and be obese – than when they arrived. Within one generation, their health is as poor as other Americans of similar income status.
In Kennett Square, Pennsylvania, about 40 miles south of Philadelphia, Mexican immigrants like Amador Bernal now make up a quarter of the town's population. After almost 25 years in the U.S., Amador has never been to a doctor. And he's not alone.
© California Newsreel 2008
Free and open to the public. Sponsored by UNH Manchester's Communication Arts Program, Minority Health Coalition, and Southern New Hampshire Area Health Education Centers.
Continuing Education Information
Nurses: The Southern New Hampshire Area Health Education Center is an approved provider of continuing nursing education by the New Hampshire Nurses' Association Commission on Continuing Education, an accredited approver by the American Nurses Credentialing Center's Commission on Accreditation.
7.0 contact hours. Activity Number: 1057
Physicians: The Southern New Hampshire Area Health Education Center designates this live activity for a maximum of 7.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


text:
Welcome to the County of Ventura Board of Supervisors home page. Click on one of the images below to go that Supervisor's home page. The map at the right shows the geographic area covered by each supervisorial district. Click directly on the map, or on one of the District links, to transfer to a Supervisor's homepage.
View larger map


text:
Starpulse News
Your Entertainment Destination
Starpulse Mobile
Starpulse App
Olivia Munn's Reason For Turning Down 'Deadpool' Is Kind Of Confusing
Pulse Patrol: The 'Weakly' Round-Up Of User Comments
8/12/2008 10:00am EDT
Google Plus
Stumble Upon
Each week the editors at Starpulse will be highlighting the best responses and remarks to news stories and celebrity topics that we've come across.
News Highlights
= This week's most mesmerizing and intelligent comments were made on "Jenna Jameson is Knocked-up " story, The latest story on the Lohans, and The Mystery surrounding Heath Ledger's death saga, as well as another story about the Chin that is attached to a Celebrity Offspring .
Topic Highlights
=There was some perceptive observations made about president Bush's and A-Rod's reputations and some enthralling comments made about the personal appearances of Kevin Bacon and Julie Newmar, as well as a lot of love and respect for Sharon Stone, of all people.
Top Commenter
=This week's MVC (Most Vicious Commenter) award goes to Hambrookart for her very humorous and Perceptive comments.
News Comments
Lindsay Lohan's Dad Won't Walk Her Down The Aisle
By: Fried Chicken( 743)
amazing how his faith wont keep him from lying, or drinking and driving, or being a big ol dirtbag..
By: taralynn ( 663)
who's gonna wear the dress?
By: GlobeTravlinGirl( 1)
This guy is SUCH a LOSER! He is nothing more than a drunken, brawling, philandering, adulterer who abandoned his family and now he wants to profess that he has CHRISTIAN PRINCIPLES???! WTF!?! What FAITH does he align himself with that makes his heinous and reprehensible behavior acceptable?? How dare he point a disparaging finger and judge anyone else, especially his own child! WHAT AN IMBECILE!
By: mystica97( 15)
really it shouldn't surprise ANYONE how hypocritical his "Christian" self is. Frankly, I don't care who she marries, she's not screwing me, and I'm tired of the bible thumping. Her destination afterlife is not impacting MINE so why should I care??
Everyone just needs to respect the HUMAN right to love, regardless of faith. Maybe if people weren't so busy judging, they'd actually IMPROVE the earth.
Lindsay Lohan Uses A 'Sober Companion'
By: tvjunkie( 276)
Where can I sign up to become a sober companion to celebrities? Talk about job security.
Tila Tequila Pulls Out Of Dating Show After Finding Real Love
By: Tom Sizemore ( 11121)
Tila Tequila Pulls Out? I think it's normally the other way around.
By: 2sugha( 604)
Not in her case, Tom S. You know she's strapped. I heard she's made a video, though. "RODENTS GONE WILD"
Toby Keith Defends Himself Against Blogger
By: Felix Lassiter( 2128)
Ha Ha So I guess it was right to hang a man for stealing a stinking *@@##! horse in the so called wild west. The old western days were full of savages and I don't mean the Native American's I mean the white butchers and robber baron cutthroats. As for Toby Keith's song "Beer for my Horses" Nothing but redneck claptrap.
Slideshow: Native American Actors
By: Guy Nacolojist( 757)
And Wayne Newton... aaahh, that explains it. No wonder he's performed at a casino all his life.
Jenna Jameson Is Pregnant
By: chunky lover 53 ( 7630)
That baby's gonna shoot out of there like it's on a Flume ride.
By: tan4007( 289)
Career day at school is going to be interesting.
The Jonas Brothers To Rewrite Show
By: Marcus Garvey( 1416)
which ones the gay one? my money is on the one in the middle
Tom Cruise Named In Scientology Lawsuit
By: MarkS( 11)
Kirk Cameron is looking smarter all the time!
Brooke Hogan Apologizes For False Abuse Claims
By: matty304( 10)
she looks like a tree
Lawyer Says Mary-Kate Olsen Is Co-Operating With Ledger Investigation
By: taralynn ( 663)
i thought he took pain pills not diet pills.
By: lovetheweasel( 898)
sounds like she got her immunity, but couldnt she just slip between the bars to get out of jail?
Bono Hails The Edge As Music's Van Gogh
By: Marcus Garvey( 1424)
i feel like van gogh when i listen to u2 because i want to cut my ears off
Nick Jonas And Selena Gomez 'First Date Kiss'?
By: Hambrookart( 1302)
I think selena will be better than Miley who"vowed" to stay a virgin.(hello, she promoted condoms!)
Matthew McConaughey To Plant Placenta Tree
By: tatejackson( 30)
I dont think its gross, I think its cool. It is a great furtilizer. all flesh and bodily fluids furtilize the earth and a placenta is pack with vitamins. It kept a baby alive for 9 months, why shouldn't it furtilize a tree? Good for you! I have 5 kids from 13 to 23 years old and i still have all thier belly bottons!
Artie Lange Checks Into Rehab
By: Bill Brasky( 104)
By: Tom Sizemore( 11054)
A sad day. We're losing one of the greats. Don't do it Artie!
Kim Kardashian Ready For Pussycat Dolls Debut
By: Nittanylionheaven( 19)
If this girl is talented, I have some real, nice swampland in Florida I'm selling real cheap, so cheap, it's a steal! All this girl's talent is strut around stage half - naked, whine and think she is God's gift to man. What a spoiled, narcissitic, self - serving, untalented and arrogant wench she is.
Rumer Willis Wants To Be A Jazz Singer
By: Squints ( 2195)
The Girl From Inchinema
By: taralynn ( 683)
she kinda looks like the chimp from the tang commercials.
Kiefer Sutherland Dropped The Soap In Jail
By: Marcus Garvey( 1469)
it takes a certain caliber of man to joke about #@@##! rape. kudos kiefer
Mr. T Doesn't Believe Commercial Was Homophobic
By: Felix Lassiter( 2140)
Ha Ha I always thought Mr T was Gay as a matter of fact I still do.
Paris Hilton Pokes Fun At McCain In Spoof Campaign Ad
By: tommy ross( 14)
I think Paris makes a lot more sense than that BELL-BOTTOM FACE McCAIN....
By: The H8R ( 546)
I'd give her the ol' John McCain
By: 666_Steinbrener ( 808)
Valtrex will fund her campaign.
'New York Goes To Hollywood' Is Obnoxious
By: Guy Nacolojist( 748)
wow, I didn't even read this past the headline because the headline drips with over-saturated obviousness
By: 2sugha( 602)
The B^tch needs to get a real job. Paper or plastic?
Gluteus Maximus: A Starpulse Salute To The Celebrity Booty
By: nelly31( 3)
beyonce looks good her a-- is 100% real, fergie has no a--, Paris Hilton has a flat pancake , mayra has a wide big flat a--! ive seen other pics and it damn sure doesn't look like that, jlo a--, kim whoredashian a-- is fake! Fake ! Fake! she has butt implants and she also wears padded spanxs underwear to make butt appear rounder than it really is! She's a fake butt, nose , lips. Breast implants having a--! And last but not least coco the hoe is the most fake a-- looking white girl ive ever seen! She's had head to toe plastic surgery from her obviously fake breast, fake ultra pointy nose , fake blond weave, lipo to waistline and thighs and body conturing! She's has the most fake looking butt ive ever seen.. She has the biggest butt implants the surgeon has to offer lmao... She looks like a plastic blow-up doll! Ive seen her in person and her a-- doesn't look anything like this! Google her before and after pics and you'll see just how flat coco's a-- was! And she was really small breasted as well . She's a fake!
Eliza Dushku Boasts About Hunting Elk, Upsets PETA
By: tan4007( 294)
I love animals too; I can appreciate ASPCA and other worthy organizations that represent fair and ethical treatment of animals. PETA is nothing more than thugs with a bad attitude most likely brought on by a tofu and bean sprouts diet.
Paris Hilton Set For Superhero Stardom
By: Hambrookart( 1302)
The character's based on HER?She probably had to sleep with Stan to be able to get THAT
Topic Comments
Alex Rodriguez
By: couldntgetabettername( 1)
Not too friendly. Went to Tony's Italian Grill on Park Row in Arlington, Texas (next to Pantego Christian Academy) yesterday with my sister and my girls(6 & 8). We were the only ones in the restaurant except a party of four (4) guys. Two (2) guys wearing white polo style shirts with "Derek Jeter Foundation" printed on them, Derek Jeter and Alex Rodrigutez.
I'm not a big sportsfan myself, but I wanted to get a picture for my husband, Mike. After they were finished eating, and preparing to leave, I asked if I could get a picture of them with my two (2) girls. A-Rod kept on walking and got into their chauffer driven black Escalade, but Jeter stopped, turned around and posed. Oh well, A-Rod has a reputation for not being known as a nice guy but Jeter was a perfect gentleman. Thanks, Mr. Jeter. Boo, A-hole...er A-Rod.
Kevin Bacon
By: missjoejonas01( 74)
he has a pig face
George Bush
By: MassieKur( 408)
Bad stupid evil president.
Right Said Fred
By: chunky lover 53( 7567)
Not Sexy Enough
Tokio Hotel
By: Hambrookart( 1242)
this is why you should never leave your kids unatended with your makeup bag.they'll end up looking like these emo freaks.
Sharon Stone
By: kelbo54( 1)
I think that freedom of speech is in the constitution and we can all exercise that. She is a class act and I wish she would star in more recent movies so I can see her on the big screen. You go girl! Your hot and great for statements about women appreciating there sex. Also owning up to there rights. Love, ya, Kelbo
The Rolling Stones
By: Marl( 83)
I have always loved The Stones. I have been a fan of theirs since I was about 11 or 12. Really wish I could afford their concerts tickets. Would be so happy to see them live in concert. To Mick, Keith, Charlie, Ron, keep rocking!
Julie Newmar
By: tommy ross( 14)
absolutely the most perfect face to ever grace the planet Earth! So beautiful, she 's a freak!
Connie Hines
By: tommy ross( 11)
What a beautiful actress! She stole the show on "Mr. Ed". If I was that horse, I would have had her do ALL my brush-downs...I wouldn't care if she rode me hard and put me up wet,either!
Angelina Jolie
By: chelsea9018( 2)
First, I'm sick of tired of Jolie being betrayed as the only women on earth who's having twins. Plenty of women around the world going through the same experience.
Second, she's not mother teresa or princess diana so why all the hype. She doesn't possess the qualities, grace, and morales to be compared to them. She's nothing more than a backdoor c0nt.
They are using their biological babies to get the highest buck for their own self-servicing purpose....to keep their faces on cover page and to keep their careers alive. The charity thing is only to legitimize their so-called good deed. So tired of their scripted media hype.
Jolie-Pitt, you should be ashamed of using your babies and I pity those adopted kids. Those kids will always be second-class - biological vs adopted.
Sign up for our daily newsletter with great stories like this and more!
Google Plus
Stumble Upon
Alex Rodriguez
Angelina Jolie
Artie Lange
George W. Bush
Jenna Jameson
Julie Newmar
Kevin Bacon
Lindsay Lohan
Mary Kate and Ashley Olsen
Mr. T
Right Said Fred
Sharon Stone
The Rolling Stones
Tokio Hotel
One Way Coco Handles Motherhood: Putting The Baby In The Sink!
Coco Poses With Infant Daughter...Naked
Ice-T And Wife Coco Welcome First Child
Coco Admits To Being Worried About Her Small Baby Bump
Coco Accused Of Faking Her Pregnancy
This One Thing Really Scares Coco About Giving Birth
It's A Girl For Coco & Ice-T, And You Won't Believe What They'll Name Her!
Happy Birthday!
15 Celebrities Who Desperately Need Makeovers
Sexy Celeb Instagrams: Kim Completes A Workout, Bieber Thinks He's Indiana Jones, Aly Michalka In A Bikini & More!
Jason Gallagher
The Best Titus Andromedon Quotes From 'Unbreakable Kimmy Schmidt'
Heather Tooley
'B&B' Spoilers: Julius Reads Sasha The Riot Act
Cheryl Phillips
Grab Your Ticket! Here Are Tonight's Winning Powerball Numbers
Stacy Carey
'Criminal Minds' Spoilers For The Season 11 Finale Tease Trouble For Hotch
Kaylin Neely
Caitlyn Jenner To Do First Nude Shoot
Mary Jane
Lisa Rinna Admits She Needs To Hold Herself Accountable: But What About Vanderpump?
Mike Flanagan
Fantasy Football: Upside/Downside For Each Of The Top Four WR's, QB's, TE's
Brent M Faulkner
Keith Urban's 'Ripcord' Leads Albums To Check Out
Jeffrey Malone
'New Girl' Recaps: 'Dress'/'Return To Sender'
More Starpulse bloggers & articles
Write For Us
Terms Of Use
Privacy Policy
See All
© 1999-2016 Starpulse.com™


text:
|LightItUp Baja Mexico 2005
Permlight LED Applications Retreat
Carnival Cruise Line
October 7-10, 2005
Janet Hansen of Enlighted presented a talk entitled "LEDs in Fashion" as one of the LED lighting applications featured at the 3-day meeting. Enlighted was also commissioned to create wearable versions of Permlight's commercial and residential lighting products, which were modeled by Permlight employess throughout the event.
home - gallery - custom orders - ready to wear - FAQs - about us - contact
copyright ©2000-2015 enlighted designs inc. all rights reserved.
enlighted® is a registered trademark of enlighted designs, inc.


text:
Cloud Computing: A brief introduction into the basics
Cloud computing cuts down the operational management for a business; however, the firm is still held responsible, even though operational obligations are held with several third parties. Hence, when using cloud solutions the seller or cloud supplier you choose must be one you can rely on, one that is honest in dealings, with all the material you're looking for and has solutions to all your issues.
Businesses need to be meticulous; they should employ this technology after careful consideration. Not only do they require a trustworthy partnership with the supplier or cloud company but should also gain as much details about the 3rd-party businesses involved that may potentially gain access to their personal files. One should also check out the hosting company employed by the supplier and possibly seek a private security audit on their security condition. In a cloud processing system, there's a substantial workload shift. Computers do not need to do major lifting in terms of running programs. The network of systems that comprise the cloud takes care of them instead.
For example you are a professional employed at a large business. Your particular duties include ensuring all of your workers have the right software and hardware they will need. Buying desktops for everyone is not enough — you need to buy software programs or software permits to give staff the tools needed. Whenever a new guy is hired, you need to buy more computer software's or ensure your current software permit allows another person. It's so demanding that you can hardly sleep with your cash in the night.
Soon, there is an alternative for professionals like you. Rather than setting up a software program for each computer, you would simply load one program. That would allow staff to sign into an internet based program which serves all the applications the user would want for the job.
Remote devices owned by a different company would operate everything from word processing to e-mail to sophisticated data analysis applications. It's referred to as cloud computing, and can change the faith of entire computer industry. So, what are you waiting for employ this technology to improve the efficiency of your employees.
Instance is leading provider of Cloud Computing, Grid Hosting, and Grid Computing. If you would like more informaiton on pricing and plans be sure to visit their website.
Author: robertduncan2This author has published 28 articles so far. More info about the author is coming soon.


text: Metadata record for International Social Survey Program: Environment II, 2000 4104 Inter-university Consortium for Political and Social Research ICPSR metadata records are licensed under a Creative Commons Attribution-Noncommercial 3.0 United States License . 2016-05-06 International Social Survey Program: Environment II, 2000 4104 10.3886/ICPSR04104.v1 International Social Survey Program (ISSP) Please see full citation. Inter-university Consortium for Political and Social Research 2004-11-17 International Social Survey Program (ISSP). International Social Survey Program: Environment II, 2000. ICPSR04104-v1. Cologne, Germany: Zentralarchiv fur Empirische Sozialforschung/Ann Arbor, MI: Inter-university Consortium for Political and Social Research [distributors], 2004. http://doi.org/10.3886/ICPSR04104.v1 attitudes conservation energy conservation environment environmental degradation environmental hazards environmental protection hazardous substances health nuclear reactors pollution public opinion science scientific research The International Social Survey Program (ISSP) is an ongoing program of cross-national collaboration. Formed in 1983, the ISSP group develops topical modules dealing with important areas of social science as supplements to regular national surveys. This data collection is the second survey exploring the topic of environment. Participating countries in the 2000 survey included Austria, Bulgaria, Canada, Chile, Czech Republic, Denmark, Finland, Germany, Great Britain, Ireland, Israel, Japan, Latvia, Mexico, Netherlands, New Zealand, Northern Ireland, Norway, Philippines, Portugal, Russia, Slovenia, Spain, Sweden, Switzerland, and the United States. Respondents were queried on topics regarding nature and the environment, the role of science and scientific solutions to environmental problems, the effects of population and economic growth on the environment, protection of the environment through higher prices of goods or higher taxes, and the role of government, businesses, industries, and citizens in protecting the environment. Respondents were asked if they belonged to any groups whose main aim was to preserve or protect the environment, if they donated any money to environmental groups, and if they had ever protested, demonstrated, or signed a petition concerning environmental issues. Respondents were also asked questions about the greenhouse effect, the use of animals for medical testing, and health issues like exposure to chemicals, pesticides, and pollution. Respondents also expressed their views on the priorities of their nation. Demographics include sex, age, ethnicity or nationality, marital status, level of education, current employment status, family income, number of people living in household, religious denomination, trade union membership, political party affiliation, and region of the country and size of community where currently residing. 2000 Please see geographic coverage. Austria Bulgaria Canada Chile Czech Republic Denmark Finland Germany Global Great Britain Ireland Israel Japan Latvia Mexico Netherlands New Zealand Northern Ireland Norway Philippines Portugal Russia Slovenia Spain Sweden Switzerland United States Persons aged 18 years and older living in the countries Austria, Bulgaria, Canada, Czech Republic, Chile, Germany (West and East), Great Britain, Israel, Latvia, Mexico, New Zealand, Northern Ireland, Philippines, Portugal, Slovenia, Spain, and the United States with the exceptions of Finland (ages 15-75), Switzerland (ages 15 and older), Ireland, Japan, Netherlands, and Russia (ages 16 and older), Denmark (ages 18-75), and Norway and Sweden (ages 18-80). survey data The sampling frame varied by country. Variations of the following sampling techniques were used: simple random sampling, systematic random sampling, (two- or multi-stage) clustered or area probability random sampling, and (two- or multi-stage) stratified random sampling. personal interviews, self-enumerated questionnaires, and mail-back questionnaires The variable locations and lengths indicated in the codebook do not correspond to the variable locations and lengths indicated in the SAS and SPSS setup files, which directly correspond to the ASCII data file. Users should consult the setup files for variable locations and lengths that match the ASCII data file. A weight variable is provided for use in analyzing data for the following countries: Austria, Canada, Chile, Czech Republic, Finland, Great Britain, Ireland, Northern Ireland, Philippines, Portugal, Russia, Slovenia, and Switzerland. Please see study descriptions for these countries for additional information on weighting procedures. All country-specific frequency distributions in the codebook documentation are calculated from unweighted data. Some value codes may have country-specific meanings. Moreover, the date of collection, source of data, sampling design, and weighting procedures varied by country. Users should consult the country-specific study descriptions in the codebook for further information regarding each. Users are also strongly encouraged to visit the Web site for the International Social Survey Program at http://www.issp.org/ for additional information about this data series. Ann Arbor, Mi.: Inter-university Consortium for Political and Social Research Additional special permissions, where applicable, are described in the restrictions field. These data were supplied by the Zentralarchiv fur Empirische Sozialforschung in Cologne, Germany. To provide funding agencies with essential information about the use of archival resources, and to facilitate the exchange of information about research activities based on the Zentralarchiv's holdings, each user is expected to send two copies of each completed manuscript to the Zentralarchiv. All manuscripts utilizing data made available through the Zentralarchiv should acknowledge that fact. RESTRICTED. This study is no longer distributed by ICPSR. The original collector of the data, ICPSR, and the relevant funding agency bear no responsibility for use of the data or for interpretations or inferences based upon such uses.


text:
Fast Facts 2015
800 Florida Avenue, NE
Washington, DC 20002-3695
Founded:Gallaudet University, the world's only university with programs and services specifically designed to accommodate deaf and hard of hearing students, was established in 1864 by an Act of Congress, and its charter was signed by President Abraham Lincoln.
President's Cabinet:
|Roberta J. Cordano, J.D.
Profile/Bio | website
|Dr. Carol Erting
Profile/Bio | website
|Nicole Sutliffe
Interim Vice President, Laurent Clerc National Deaf Education Center
Profile/Bio | website
|Paul Julin
Vice President, Institutional Advancement
Profile/Bio | website
|Paul Kelly
Vice President, Administration and Finance
Profile/Bio | website
|Dr. Isaac Agboola
Dean, School of Education, Business and Human Services
Profile/Bio | website
|Dwight Benedict
Dean, Student Affairs and Academic Support
Profile/Bio | Website
|Dr. Genie Gertz
Dean, College of Arts and Sciences
Profile/Bio | website
|Dr. Gaurav Mathur
Dean, Graduate School and Continuing Studies
Profile/Bio | website
|Earl Parks
Executive Director, Gallaudet Technology Services
Profile/Bio | website
|Fred Weiner
Assistant Vice President, Administration
Profile/Bio | website
Board of Trustees:
The Gallaudet University Board of Trustees, whose members serve on a volunteer basis, has the authority to make University-wide policy including financial and academic policies. The board is also responsible for assuring the proper management of the University and actively participating in the provision of necessary funds. Gallaudet's trustees have an active role in supporting advancement activities by working with the University administration to set fundraising targets, approve campaign priorities, and contribute to fundraising activities through identification of prospects, monetary or in-kind donations, and service.
Gallaudet University trustees:
Chair—Heather Harker
Vice Chair—Duane Halliburton, '85
Secretary—Claire Bugen
Member-at-Large—Dr. Tom Humphries, '68 & G-'72
Member-at-Large—Lawrence R. Kinney
Jameson Crane, Jr.
Dr. Jorge L. Díaz-Herrera
Dr. Charlene Dwyer
Dr. Harvey Goodstein, '65
Claudia L. Gordon, Esq.
Jeffrey L. Humber, Jr.
Nancy Kelly-Jones, '72
Dr. Richard Ladner
James R. Macfadden, '62
Wilma Newhoudt-Druchen, '92, G-'05, & H-'09
James F.X. Payne
Tiffany Williams, '89
Voting trustees public members:
The Honorable Sherrod Brown (D-Ohio)
The Honorable G.K. Butterfield (D-N.C.)
The Honorable Kevin Yoder (R-Kan.)
Deaf and hard of hearing undergraduate students can choose from a wide variety of majors leading to a bachelor of arts or bachelor of science degree. The University also admits a small number of hearing, degree-seeking undergraduate students—up to five percent of an entering class. Undergraduate students have the option of designing their own majors, called "self-directed majors," in which they select classes from a variety of departments at Gallaudet. All students may take courses offered at 13 other institutions of higher learning that are members of the Consortium of Universities of the Washington Metropolitan Area.
Graduate programs, open to deaf, hard of hearing, and hearing students, include master of arts or master of science degrees, specialist degrees, certificates, and doctoral degrees in a variety of fields involving professional services to deaf and hard of hearing people.
Gallaudet University offers exemplary educational programs to deaf and hard of hearing students at all learning levels. The Kendall Demonstration Elementary School (KDES) serves infants and their parents and continues service through the eighth grade. The Model Secondary School for the Deaf (MSSD) offers programs for students in grades nine through 12. Both of these schools are part of the Laurent Clerc National Deaf Education Center (Clerc Center), which has a federal mandate to develop and disseminate innovative curriculum, materials, and teaching strategies to schools and programs nationwide.
University Mission Statement:
Gallaudet University, federally chartered in 1864, is a bilingual, diverse, multicultural institution of higher education that ensures the intellectual and professional advancement of deaf and hard of hearing individuals through American Sign Language and English. Gallaudet maintains a proud tradition of research and scholarly activity and prepares its graduates for career opportunities in a highly competitive, technological, and rapidly changing world.
The Vision of Gallaudet is to:
- Provide the highest quality liberal and professional education through undergraduate and graduate programs for deaf, hard of hearing, and hearing students.
- Offer a welcoming, supportive, and accessible bilingual educational environment for teaching and learning through direct communication.
- Embrace diversity within the University community by respecting and appreciating choices of communication while guiding students through their process of linguistic and cultural self-actualization.
- Pursue excellence in research, pedagogy, scholarship, and creative activity.
- Lead the advancement of intellectual, social, linguistic, and economic vitality in deaf people through educational, outreach, regional, international, and leadership development programs.
- Preserve deaf history and use visual media to promote the recognition that deaf people and their signed languages are vast resources with significant contributions to the cognitive, creative, and cultural dimensions of human diversity.
- Position our community to reach its full human potential and assume its role as a progressive global entity committed to civic responsibility and social justice.
Enrollment (as of fall 2014):
Undergraduate and Graduate enrollments:
|Undergraduate (degree/non-degree, full- and part-time)
|Graduate (degree/non-degree, full- and part-time)
|English Language Institute
|Professional Studies
|University Subtotal
Clerc Center
|Kendall Demonstration Elementary School
|Model Secondary School for the Deaf
|Clerc Center Subtotal
|TOTAL Fall Academic Year 2011-12 Enrollment
International students comprise eight percent of the degree-seeking student body. The University's undergraduate program also admits a small number of hearing students.
Gallaudet University has more than 21,000 alumni around the world. The Gallaudet University Alumni Association, organized in 1889, has 53 chapters.
According to a survey conducted by the University, 97 percent of the Gallaudet undergraduate student respondents who graduated between December 2011 and August 2012 are either employed or furthering their education. Ninety-eight percent of the survey respondents who graduated with graduate degrees during the same time frame are employed or furthering their education.
During the same period, 76 percent of the MSSD graduates were in advanced education or training programs within one year following graduation.
The University and the Clerc Center have 890 employees, 461 of whom are deaf or hard of hearing. A total of 230 employees are faculty members or teachers.
Annual University Tuition and Room and Board (Academic Year 2014-2015):
Tuition and room and board are charged as follows. Additional charges are applied for student activities and health-related fees. For a full explanation of the details of all charges, refer to the Gallaudet University website.
|U.S. student tuition
|$ 14,498
|$ 15,956
|International student tuition (non-developing countries)
|$ 28,996
|$ 31,912
|International student tuition (developing countries)
|$ 21,747
|$ 23,934
|Room and Board
|$ 12,360
|$ 12,360
No tuition is charged for students at KDES or MSSD.
Note: These numbers may have been updated since Fast Facts was published. The Finance Office maintains the most up to date fee schedule.
Total revenues and other support for FY 2014 were $174,611,958.
As of the end of FY 2014, the University's endowment was approximately $194 million.
Gallaudet welcomes tax-deductible contributions from individuals, businesses, foundations, and organizations in support of University initiatives and priorities, including scholarships, program enhancements and development, and renovation projects. For more information about philanthropic support for Gallaudet, including opportunities to make a gift in memory or in honor of a loved one, please visit giving.gallaudet.edu.
Gallaudet University is accredited by the Middle States Commission on Higher Education. Many of the University's professional preparation programs are also accredited by their respective nationally recognized, specialized professional association organizations. MSSD and KDES are dually accredited by the Middle States Association of Colleges and Schools and the Conference of Educational Administrators for Schools and Programs for the Deaf.
Community Impact:
Gallaudet is one of the area's largest businesses, with direct salaries, wages, and benefits totaling more than $107.8 million in FY 2014. The University spent another $61.3 million on goods and services and $12.5 million on capital improvements.
Gallaudet is a leader in the use of technology in its academic programs and services. Approximately 94 percent of courses at Gallaudet have an online component and virtually all students take at least one course using an online learning system. Such technology integration is double the average of universities nationwide. Many courses make extensive use of video, including video recordings of classes. Students are encouraged to bring a computer to campus, and popular software is available at a discounted price.
For students interested in technology careers, majors in graphic arts, digital media, and information technology are available. Students have access to two central computer labs, as well as more than 15 departmental computer labs. Most classrooms are outfitted with computers, projectors, DVD/VCRs, and other technologies. All buildings on campus have wireless network access.
Gallaudet has a unique obligation to contribute knowledge and scholarship likely to benefit deaf and hard of hearing people, especially in the areas of education and human services. Accordingly, the Gallaudet Research Institute conducts studies related to demographics and assessment of deaf and hard of hearing people in the educational system, as well as language and learning processes, and engages students in research, while stimulating and supporting work directed towards priorities consistent with Gallaudet's national mission and internal strategic objectives.
Research is a key component of Gallaudet's mission as a university. Faculty pursue a full range of research interests related to their own academic disciplines. Major grant support includes research, development, and training programs in visual language and learning, access to communication for deaf and hard of hearing people, genetics, and technology assessment.
Public Service:
Last year, Gallaudet served tens of thousands of individuals through conferences, leadership institutes, professional studies and extension courses, sign language classes, American Sign Language/English bilingual education, enrichment and youth programs, international programs, and its regional centers:
Southeast-Gallaudet University, Washington, D.C.
Midwest-John A. Logan College, Illinois
Northeast-Northern Essex Community College, Massachusetts
Pacific-Kapi'olani Community College, Hawaii
Southwest-Austin Community College, Riverside Campus, Texas
West-Ohlone College, California
In fulfilling its national mission role via training and technical assistance, information dissemination, and exhibits and performances, the Clerc Center served approximately 37,500 individuals and disseminated more than 31,000 products and publications last year


text:
Bedroom Reveal
this post and you can also see how the bed was before in that post. Below that, I stacked two very old apple boxes for a rustic nightstand!
gun cabinet turned china cabinet. I just moved it up here from the dining room a couple days ago.
union jack sign on top along with an old, rusty bed spring and little bird cage tag.
I just used my rubber stamps and some of the old piano roll paper to make the "Tweet Tweet" and birdcage pictures to go in the frames.
Treasure Trove Tuesday post on the chair seat.
reclaimed fence board wall! I am still in love with this :o)
11 comments
I love it Tania! So crisp and clean and eclectic! I love all the different things you decorated with. My sister has that exact same painting of the little girl on the mantel. I love it! Have you researched it? It's called Spring Song and the little girl is supposed to be blind. I think it is such a pretty painting. My favorite part of your room is the plank wall....LOVE it! I still want one. Have a great week!ReplyDelete
Blessings, VickyReplies
Thank you Vicky, the two things you pointed out in the room are my favorite as well... the little girl painting and the reclaimed fence wall :o)Delete
All I have to say is you're the most energetic person I know! There are so many things I want to do around my house, but (ahem) they're not getting done. Your house just keeps getting better and better! I have a very small bedroom too and it is possible to make them lovely; I love that yours has so much white!ReplyDeleteReplies
Lol, thank you Joy! I do seem to have an abundance of energy at times... might have something to do with the A.D.D. but on the other hand I also have trouble actually finishing something too!Delete
It turned out great, but that plank wall is my favorite element. How did you attach the wood? Did you glue it or staple gun it?ReplyDeleteReplies
Thank you so much Kim! The wood is attached with construction adhesive and small nails.Delete
I adore your bedroom! There are SO many fun and quirky touches that I love! Great job! :)ReplyDelete
Thank you Susan!Delete
How pretty and sweet! I don't know whether I love the bird salt and pepper shakers or your puppy more!ReplyDeleteReplies
Thank you!Delete
Pongo is so cute and the room looks great!ReplyDelete


text:
HOLY CRAP I WAS TOTALLY BLOWN OUT BY THAT MAP SELECTOR. Nice job.
Adam Jensen was hand-picked to safeguard the secrets of America's top biotech firm. But when a black ops team breaks in and kills the scientists he was hired to protect, using a security plan he developed, he is thrust into a conspiracy shrouding mankind's future evolution.
Disables the very long and unskippable intro title sequence, unlocks the developer debug menu, and unlocks a map selector that was used to give press demos.
HOLY CRAP I WAS TOTALLY BLOWN OUT BY THAT MAP SELECTOR. Nice job.
Cool map selector and awesome debug menu. Thank you. =)
Great upload, thanks man. For anyone downloading this, click on "read more" in the description for how to install, as the file is not an executable.
What's the debug menu for? Is that kind of like a console with commands?
Yeah.But instead of typing commands,it tells you what does what and you either set it to false or true.My only gripe with it is that the Debug Menu is difficult to set options but it's only a minor gripe with the menu itself.
Seems that the game's second patch overrides this mod. It no longer has any effect.
damn, I was wondering why it wasn't working for me... thanks
For anybody wondering, there is an update for this on the Eidos thread that is linked in the extended details of this page.
Nice !
Works perfect & the Map Selector is very useful.
But it only shows controller-buttons in it - so what are the keyboard buttons L, A and B ?
love it, but i am concerned, is this stuff allowed?
i mean custom mods would be cool
Hah, that's a map of New York.
Can u make a Debug menu for The Missing Link too?