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To develop and validate a shortened version of the Valued Life Activities disability and accommodations scale (VLA) for individuals with rheumatoid arthritis (RA).
To develop and validate a shortened version of the Valued Life Activities disability and accommodations scale (VLA) for individuals with rheumatoid arthritis (RA).
To shorten the existing VLA measure, item response theory analyses were conducted using data from 449 patients with RA. Next, the resulting 14-item shortened version of the VLA scale (S-VLA) was evaluated by structured interviews among 20 RA patients. Lastly, the S-VLA was administered to 150 RA patients along with other measures, including the Health Assessment Questionnaire (HAQ) and Short Form 36 (SF-36). A random sample of 50 patients completed the S-VLA 2 weeks later to assess reliability. Item statistics were calculated to evaluate correlations between individual items and the S-VLA total score. Correlations between the S-VLA and other measures were used to evaluate validity.
Test–retest reliability was 0.91, while Cronbach's alpha for the S-VLA was 0.95. None of the 14 items was associated with improved alpha coefficients when omitted. All of the items were strongly correlated with the S-VLA total score. S-VLA scores were highly positively correlated with the HAQ (r = 0.81, P ≤ 0.001), patient-reported disease activity (r = 0.71, P ≤ 0.001), satisfaction with abilities (r = 0.82, P ≤ 0.001), and number of days with activity limitations (r = 0.65, P ≤ 0.001). In addition, as hypothesized, the S-VLA was inversely correlated with the SF-36 physical component summary score (r = −0.78, P ≤ 0.001) and the physical functioning (r = −0.80, P ≤ 0.001), role physical (r = −0.67, P ≤ 0.001), and social functioning (r = −0.72, P ≤ 0.001) subscales.
The S-VLA is a short, valid, and reliable instrument that may prove useful for monitoring disability among individuals with RA.
Functional impairment and disability are primary manifestations of rheumatoid arthritis (RA). Functioning is most commonly measured among individuals with RA by the Health Assessment Questionnaire (HAQ) (1). Evidence generally indicates a high degree of reliability and validity for the HAQ (2, 3), although it has demonstrated questionable response to change in some groups (4, 5). Additionally, some have suggested that the HAQ has limited relevance to day-to-day life because difficulty with specific physical actions is queried rather than difficulty with activities. Finally, the HAQ measures fairly low-level functioning such as toileting and eating, whereas functional goals of most persons with RA are to maintain high-level functioning such as participating in social and recreational activities.
Use of assistive devices or equipment and personal assistance has been shown to reduce disability (6–8), and both assistive devices and personal assistance appear to be widely used by individuals with arthritis. The importance of assistive devices and personal assistance to functioning among individuals with RA is reflected by the assessment of accommodations in the HAQ. However, other behavioral accommodations to improve functioning or reduce disability, such as limiting activities or taking more time to perform them, may be more commonly used than assistive devices or personal assistance (6–10). Therefore, there is a need for a measure that can address a wide range of functioning, and also address behavioral accommodations that are frequently adopted by individuals with RA to improve their function.
The Valued Life Activities disability and accommodations scale (VLA) measures a broader range of activities than traditional disability measures, such as the HAQ (11, 12). The theoretical basis of the VLA is the disablement model proposed by Verbrugge et al (13–15). Verbrugge et al proposed that life activities be grouped into 3 categories: obligatory activities, required for survival and self-sufficiency, including activities such as hygiene and self-care, walking inside, walking outside, and using transportation or driving; committed activities, associated with one's principal productive social roles, such as paid work, household responsibilities, and child and family care; and discretionary activities, such as socializing, exercising, engaging in leisure time activities and pastimes, pursuing volunteer work or hobbies, or other activities in which individuals engage for relaxation and pleasure. The VLA assesses difficulty in this broad array of activities. Items can also be included in the VLA to assess use of behavioral accommodations in each activity (10).
To date, more than 1,200 persons with rheumatic diseases have completed the VLA, but its length (15–20 minutes to complete) may inhibit application in large clinical trials and routine practice. A brief version of the VLA might be more feasible to use in both clinical settings and as an outcome measure for intervention studies. Therefore, the primary objective of this study was to develop and validate a shortened version of the VLA (S-VLA) for RA, while maintaining the coverage of the broad spectrum of activities included in the VLA.
The Valued Life Activities disability and accommodations scale (VLA) measures a broader range of activities than traditional disability measures, such as the Health Assessment Questionnaire, is more closely related to satisfaction with functioning and psychological well-being than other measures of function, and items can also be included to assess the use of behavioral accommodations in these activities.
However, to date, the VLA scale has been used predominantly as an academic research instrument mostly because the VLA requires approximately 15 minutes to complete.
We developed a short version of the VLA, the S-VLA, that is valid, reliable, and conducive to use in clinical settings, as it requires only 2–4 minutes to complete.
This was a 3-phase project. Phase 1 focused on item reduction to shorten the existing VLA. Phase 2 consisted of a pilot test to ensure readability, relevance, and comprehension of items and instructions of the new shortened measure. In Phase 3, a formal test of the new measure was conducted to estimate reliability and validity in a clinical setting.
Development of the VLA has been described in detail previously (11). Briefly, the VLA scale was developed based on time/budget studies to determine the impact of arthritis (16), and has been modified and refined over the past decade. Respondents have been asked over multiple waves to identify activities or activity domains in addition to those queried that have been affected by their condition. Revisions have been made to the VLA scale based on those accumulated responses as well as analysis of previous versions of the scale. The version of the VLA scale used in the current analyses includes 34 activity domains. Respondents rate the difficulty of performing each activity, using a 4-point scale corresponding to the response scale of the HAQ (0 [no difficulty] to 3 [unable to perform]). Activities that participants deem unimportant to them or activities that they do not perform for reasons unrelated to RA are not rated and are not included in scoring.
In addition to rating the difficulty in performing each activity, the participants are also asked whether they make 4 types of behavioral accommodations for the activity: limitations in the amount or kind of activity within the domain, taking more time to perform activities, needing help from another person, and using special devices or aids. A scoring method for the VLA incorporating the use of accommodations has been developed and reported (10).
In the present study, scoring on both long and short versions took into account use of behavioral accommodations, as previously reported (10). Items with no difficulty and no accommodations received scores of 0, items with no difficulty but with use of any accommodation received scores of 1, and items with a little difficulty, with a lot of difficulty, or that participants were unable to perform received scores of 2, 3, and 4, respectively, regardless of use of accommodations. The total S-VLA score is calculated as the mean difficulty of all activities rated.
Phase 1 entailed analysis of existing data from 2 waves of the University of California, San Francisco RA Panel. RA Panel members were originally recruited in 1982–1983 from a random sample of rheumatologists practicing in Northern California (n = 822). There were subsequently 4 additional enrollment periods in 1989–1990, 1995, 1999, and 2003, during which 203, 131, 122, and 169 individuals were enrolled, respectively. Retention from year to year has averaged 93%; the 7% attrition includes deaths. The principal data source for the RA Panel is an annual telephone interview. In years 1 and 2 of the current analyses there were 449 and 421 participants, respectively. Characteristics of the RA Panel during year 1 are shown in Table 1. Analyses were first conducted with year 1 data and then validated with year 2 data.
|Phase 1: UCSF RA Panel (n = 449)
|Phase 3: validation sample (n = 150)
|Women, % (no.)
|85.1 (382)
|74.0 (111)
|Age, mean ± SD years
|59.2 ± 12.9
|55.7 ± 14.6
|White non-Hispanic race/ethnicity, % (no.)
|74.8 (336)
|62.0 (93)
|Duration of RA, mean ± SD years
|18.3 ± 11.7
|12.7 ± 11.5
|HAQ score, mean ± SD
|1.09 ± 0.74
|1.09 ± 0.77
Item response theory (IRT) analyses using ConQuest were conducted to reduce the number of items while still covering the range of activity "difficulty" (e.g., from low-level activities such as self-care to high-level activities such as physical recreation). Items were deleted based on misfit (weighted mean square statistic <0.75 or >1.34 and t-statistics less than −2 or greater than +2), logit values that duplicated information provided by other items at similar logit values, and substantive considerations.
Psychometric properties of the S-VLA were compared to those of the original longer version. Internal consistency of each version was assessed with Cronbach's alpha. Analyses were conducted to establish construct validity by examining correlations of VLA and S-VLA with the following 3 measures, each of which is theoretically related to the construct of valued life activity disability.
The HAQ was developed specifically for and validated in patients with arthritis (1). Respondents rate the difficulty posed by specific actions on a 0–3 scale (where 0 = no difficulty, 1 = some difficulty, 2 = much difficulty, and 3 = unable to perform). Items also assess the need for assistance from others and use of assistive devices. A score ranging from 0 to 3 can be calculated.
The overall impact of RA was measured with a single item ("Considering all the ways your arthritis affects you, rate how well you are doing"), rated from 0 (very poorly) to 100 (very well).
Each of the questions for the extent to which RA affects "things you NEED to do" and the extent to which RA affects "things you LIKE to do" was rated on a 0–3 scale (where 0 = not at all, 1 = a little, 2 = a moderate amount, and 3 = a great deal).
Twenty RA patients from the University of Medicine and Dentistry of New Jersey Robert Wood Johnson Medical School (UMDNJ-RWJMS) rheumatology clinic completed the S-VLA questionnaire. All of the participants met the American College of Rheumatology (ACR) criteria for RA (17), had a diagnosis of RA for at least 6 months, had no alternate diagnosis that contributed significantly to disability (e.g., Parkinson's disease, multiple sclerosis, metastatic cancer), were fluent in English, and were present at the clinic for a routine visit to their rheumatologist. Study-related procedures were carried out by trained research assistants.
Subjects were asked to read the directions associated with the S-VLA and complete the questionnaire. No other explanations about completing the questionnaire were offered, although subjects could ask questions if the instructions were unclear. Inquiries related to the S-VLA were recorded and considered before the larger validation study (phase 3) was initiated. Once the questionnaire was completed, the subject participated in a structured cognitive debriefing interview, which queried instruction clarity, item clarity, adequacy of response options, opinion regarding how well each item addressed the activity in question, and whether the S-VLA, as a whole, adequately measured activity limitations. Patients were paid for participation in the phase 2 interview. Procedures were approved by the UMDNJ-RWJMS Institutional Review Board, and all of the participants provided written informed consent.
Phase 2 analyses focused on the clarity of the S-VLA instructions and items, adequacy of response options, relevance and comprehensiveness of the items, and appearance and format of the questionnaire.
For phase 3, 150 patients with RA were recruited from the UMDNJ-RWJMS rheumatology clinic and several other clinics in the community; characteristics are shown in Table 1. All of the patients met ACR criteria for RA (17), had a diagnosis of RA for at least 6 months, had no alternate diagnosis that contributed significantly to disability, were fluent in English, and were at the clinic for a routine visit to their rheumatologist. No patients who participated in phase 2 participated in phase 3. All study-related procedures were carried out by trained research assistants. Patients were paid for participation in phase 3. Procedures were approved by the UMDNJ-RWJMS Institutional Review Board, and all of the participants provided written informed consent.
Subjects completed the S-VLA, in addition to several other questionnaires, described below, and a demographics form. The S-VLA was administered first with the additional questionnaires in random order. Subjects were asked to read the directions associated with the questionnaires and complete them. No other explanations about completing the questionnaires were offered, although the subjects were allowed to ask questions if the instructions were unclear. A random sample of 50 respondents was asked to complete the questionnaires 2 weeks later, to assess test–retest reliability. Questionnaires were mailed to these individuals.
Formatting of the S-VLA was modified prior to phase 3 based on subject feedback during phase 2. The S-VLA is shown in Supplementary Appendix A (available in the online version of this article at http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)2151-4658).
To assess the construct validity of the S-VLA, the HAQ (described above) and several additional questionnaires were administered.
The Short Form 36 health survey (SF-36) is a self-report questionnaire consisting of 36 items aggregated to score 8 subscales related to physical and mental health (18, 19). The subscales can be combined to yield a physical component summary (PCS) score and a mental component summary score. The PCS and 3 subscales, i.e., role emotional, social functioning, and role physical, were used in this study because they were judged by the investigators to possess properties associated with VLA disability and general role functioning. The SF-36 summary scales and subscales have demonstrated excellent reliability and validity (18, 19).
The Rheumatoid Arthritis Disease Activity Index (RADAI) is a patient-assessed measure of RA disease activity (20, 21). It queries global disease activity in the past 6 months, current disease activity in terms of swollen and tender joints, arthritis pain, duration of morning stiffness, and painful joints rated on a joint list. Scores range from 0–10, with higher scores reflecting greater disease activity. Ample evidence exists supporting the reliability and validity of the RADAI (22).
The Satisfaction with Abilities and Well-Being Scale (SAWS) is a 13-item self-report questionnaire developed to assess satisfaction with abilities and well-being in patients with RA (23). It assesses 13 domains (e.g., work, home maintenance, social participation) and has a total score plus subscales scores for satisfaction with activities and satisfaction with well-being. The overall SAWS has demonstrated good validity and internal consistency (Cronbach's α = 0.93), as have the 2 subscales (activities: α = 0.91 and well-being: α = 0.82).
Two questions are included in the Activity Participation Questionnaire (APaQ): "During the past 30 days, on about how many days did your rheumatoid arthritis keep you from doing your usual activities?" and "During the past 30 days, how often were you able to perform your usual activities completely, in spite of your rheumatoid arthritis?" (24). We included only the number of days with activity limitations in our analyses. The APaQ has been found to have good internal consistency (Cronbach's α = 0.70) and acceptable test–retest reliability (intraclass correlation coefficient 0.60). Construct validity and sensitivity to changes in patient activity levels have also been demonstrated.
Internal consistency was determined with Cronbach's alpha. Unidimensionality was assessed using an exploratory bifactor model, which features a comparison of a single-factor model to a model with a general factor and group factors (25). Test–retest reliability was evaluated in the subgroup of participants that completed the 2-week followup questionnaires by correlating S-VLA scores from the 2 administrations and by calculating Krippendorff's alpha coefficients of reliability for individual item responses (ordinal scale) (26). Item statistics were then calculated to examine the correlations between individual items and the total S-VLA score, while also correcting for overlap and scale reliability. Construct validity of the S-VLA was assessed via correlations with the other measures. T-tests compared responses of men and women and of individuals with early (<25 months) and later (≥25 months) RA.
Partial credit and rating scale models were both tested; the partial credit model had fewer item and step misfits (G2 likelihood ratio = 623.881, P < 0.0001). Item deletions were made progressively, resulting in a 21-item version, a 14-item version, and 4 12-item versions. For both analytic and conceptual reasons, the 14-activity version of the VLA questionnaire was selected as the final S-VLA version. The 14-item S-VLA had 0 misfitting steps; 2 items had potential misfit but were retained to provide logit spread and for substantive reasons, specifically, to ensure that a balance of items measuring obligatory, committed, and discretionary activities and that items representing the full range of activity difficulty were included. Expected a posteriori prediction reliability was excellent for both versions (0.949 for the VLA, 0.932 for the S-VLA) (Table 2).
|EAP reliability†
|Cronbach's α
|Correlation with
|Overall rating of RA impact§
|RA affects things you NEED to do¶
|RA affects things you LIKE to do¶
Correlation between the VLA and S-VLA scores was 0.97. Internal consistency was excellent for both measures (VLA: 0.97, S-VLA: 0.94) (Table 2). Correlations of the S-VLA with other measures of functioning and RA impact were similar in magnitude to correlations of the VLA with the same measures; all of the correlations were in the expected directions. All analyses were repeated with year 2 data, and all results were confirmed.
Twenty patients with RA completed the cognitive interviewing process. Participants were largely women (80%) and married (55%), with a mean ± SD age of 52 ± 13 years. Twenty percent of the participants were Hispanic, 15% were African American, 5% were Asian, and 55% were white. Just over one-half (55%) were employed full time and 70% reported a household income of more than $50,000 a year. The mean ± SD duration of illness was 9 ± 8 years.
Overall reaction to the S-VLA was positive; only 1 patient indicated that he/she did not like the instrument. Because 2 of the first 5 patients reported that the instructions were not clear and another found the response options confusing, the instructions and formatting were slightly modified for interviews with the remaining 15 patients. After modification, 14 of 15 patients interviewed reported the instructions to be clear and the response options to be clear and adequate; all 15 reported that the items were easy to understand. Respondents were also asked to rate whether each item assessed the ability to engage in the activity in question. All items were rated as addressing the activity domain well or extremely well.
Internal consistency of the S-VLA was excellent (Cronbach's α = 0.95) (Table 3), item-total correlations ranged from 0.64–0.83, and alpha coefficients did not improve after omitting any of the 14 items. Time needed to complete the S-VLA ranged from 2–4 minutes, with older patients and those with impaired ability to write taking longer than younger and/or less impaired patients. Forty-two (84%) of 50 subjects asked to complete the S-VLA for test–retest analysis returned their questionnaires. Krippendorff's alpha for individual items ranged from 0.58–0.85. Correlation between initial and 2-week responses was 0.92; the corresponding Krippendorff's alpha was 0.91.
|Total (n = 150)
|Duration of RA
|Women (n = 111)
|Men (n = 39)
|<25 months (n = 18)
|≥25 months (n = 132)
|S-VLA score, mean ± SD
|1.42 ± 0.92
|1.52 ± 0.92
|1.16 ± 0.88
|1.21 ± 0.92
|1.45 ± 0.92
|No. of S-VLA activities rated, mean ± SD
|12.9 ± 1.4
|12.8 ± 1.3
|13.0 ± 1.5
|13.0 ± 1.3
|12.8 ± 1.4
|Cronbach's α
Results from bifactor assessment of unidimensionality showed that, in comparison to the single-factor model, loadings for the general factor in the bifactor model shrank somewhat (a phenomenon also observed by Reise et al [25]), but no loading of a variable differed by more than 12%. The ratio of the eigenvalue of the general factor to the largest eigenvalue of the group factors was 7.2. The only group factor loadings above 0.4 were on items 8 and 9, the 2 walking items. Together, these results support the use of the mean item score as the S-VLA score.
Ratings for all items spanned the response scale, indicating adequate variability in responses (Table 4). Respondents reported accommodations on 29–52% of activities. Reported use of accommodations for specific activities ranged from 0–10% among individuals reporting no difficulty.
|No. rating item
|Difficulty rating response frequency, %
|% reporting an accommodation
|Mean score (adjusted for accommodations)†
|0 (no difficulty)
|1 (some difficulty)
|2 (a lot of difficulty)
|3 (unable to perform)
|Of those reporting no difficulty
|1. Basic needs
|2. Meal preparation
|3. Light housework
|4. Heavier housework
|5. Gardening or yard work
|6. Caring for family members
|7. Attending social events
|8. Getting around in home
|9. Walking around outside
|10. Leisure outside of home
|11. Hobbies
|12. Physical recreation
|13. Traveling out of town
|14. Working at a job
The S-VLA demonstrated excellent construct validity. Significant correlations with all other measures in hypothesized directions were found (Table 5). While these correlations were strong, ranging from 0.65–0.82, they indicated that, at best, the correlated measures accounted for approximately 66% of the variation in S-VLA scores.
|SAWS total
|SAWS abilities
|SF-36 physical functioning
|SF-36 role physical
|SF-36 social functioning
|Total sample
|By sex
|Women (n = 111)
|Men (n = 39)
|By RA duration
|<25 months (n = 18)
|≥25 months (n = 132)
A significant difference in S-VLA scores was noted between men and women (Table 3). This difference paralleled a significant difference between men and women on other measures of functioning, such as the HAQ and the physical function subscale of the SF-36. Overall, there was no significant difference in the number of items rated "I don't do this for reasons unrelated to my RA" by sex. For specific items, bias by sex did not appear to be present, with one exception: a larger proportion of women did not rate the item querying difficulty with work (women: 32%, men: 15%; P = 0.06). There were no substantive differences in the construct validity analyses between men and women (Table 5).
S-VLA scores of individuals with early and longer duration RA were also compared; no significant differences were noted (Table 3), nor were differences noted in scores on other measures of functioning between these 2 groups. Only 1 item appeared to be rated differently by the 2 groups: "taking care of family members" was rated not applicable by a larger portion of those with longer disease duration (early RA: 0%, longer duration: 19.7%; P = 0.04). Construct validity analyses yielded correlations with other measures in the expected directions, although for 2 measures (APaQ and SF-36 physical functioning), the correlation coefficients were quite different for individuals with early compared with longer duration RA. The reason for this difference is unknown, but may be at least partially due to the small number of individuals with early disease.
A short version of the VLA has been developed, which can provide a brief assessment of disability in a broad range of life activities in individuals with RA. Based on phase 1 analyses, the S-VLA accurately represents results obtained with the longer version of the VLA scale. Phase 2 analyses indicate that S-VLA items were comprehensible to individuals with RA and accurately represented the impact of RA on their functioning in a number of key areas ranging from work and self-care to travel and hobbies. Phase 3 analyses support the reliability and validity of the S-VLA. Both internal consistency and 2-week test–retest reliability were high. Correlations with other measures support the construct validity of the S-VLA.
One primary goal in constructing the S-VLA was to maintain coverage of the spectrum of obligatory, committed, and discretionary activities. The final version of the S-VLA taps functioning in 3 obligatory activities (taking care of basic needs, getting around inside home, walking just to get around outside the home), 5 committed activities (meal preparation, light housework, heavier housework, caring for family members, working at a job), and 6 discretionary activities (gardening or yard work, attending social events, leisure outside the home, hobbies, physical recreation, and traveling out of town). The inclusion of discretionary activities is particularly important, as these are typically not measured in other disability instruments, but appear to be the areas of functioning that are affected earliest in the disablement process (11).
An important innovation of the VLA, and by extension the S-VLA, is incorporation of the use of accommodations. The HAQ measures 2 forms of accommodation: use of assistive devices and personal assistance. Use of other behavioral accommodations, such as limiting activities or taking more time to perform them, to improve functioning or reduce disability appears to be even more common than use of devices or assistance (10), yet no other disability measures include assessment of such behavioral accommodations. The importance of including accommodation use is underscored by the finding that individuals may report the use of accommodations without reporting difficulty in an activity, and that such "subclinical disability" identifies individuals who are at high risk for functional decline (27–29).
One limitation to the current analysis is that no estimates of responsiveness or sensitivity to change can be made. The long form of the VLA questionnaire demonstrated a high degree of sensitivity to change in a lupus sample (12), and other studies have found that VLA disability is more strongly linked to quality of life, satisfaction with functioning, perceived health status, and changes in psychological status than basic levels of functioning, such as that measured by the HAQ (30–34). While the S-VLA has yet to be tested in this fashion, its extremely high correlation with VLA scores suggests that similar performance and relationships may be found. As the S-VLA queries difficulty in a broad range of activities, particularly discretionary activities that may be affected earliest in the disablement process, in addition to the use of behavioral accommodations that may signal preclinical disability (35), it may be especially sensitive to early changes in functioning. We could not examine this question directly in the current study, however, because of the relatively small number of individuals in phase 3 who had earlier disease. It may also be useful in the future to examine the performance of the S-VLA in relation to other measures of functioning, such as the Rheumatoid Arthritis Outcomes Score (36), and other measures of RA disease activity, such as the Disease Activity Score (22).
The items measured by the S-VLA may be closer to the functional expectations of individuals with RA, especially those with early disease, than measures such as the HAQ. For example, when persons with RA were asked what activities were affected by RA that most bothered them or what activities they most wanted to improve, only approximately one-half of the functions or activities mentioned were covered by the HAQ (37). In addition, disability in discretionary activities, specifically social and recreational activities, appears to be strongly linked to the onset of depressive symptoms (31). Advances in pharmacologic treatment have led to higher expectations regarding functioning and overall quality of life. Patients want to move beyond moderate symptom relief and regain independence and valued activities such as physically demanding hobbies and recreation. This very point was made in our phase 2 interviews in which the item pertaining to participating in physical recreation activities received a higher rating of relevance than any other activities queried, including basic activities of daily living.
In summary, the S-VLA is a short, valid, and reliable instrument assessing a broad range of life activities and use of behavioral accommodations that may prove useful for monitoring disability among individuals with RA. The brevity of the S-VLA makes it "user friendly" for both clinical and research settings, and the current analyses support its use in early and later disease. While additional studies are needed to assess its validity and responsiveness to change, it appears to be a promising new, brief measure of disability among individuals with RA that addresses important aspects of functioning not currently measured by other instruments.
All authors were involved in drafting the article or revising it critically for important intellectual content, and all authors approved the final version to be published. Dr. Katz had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Study conception and design. Katz, Allen, Maclean, Hassett.
Acquisition of data. Katz, Radvanski, Schiff, Hassett.
Analysis and interpretation of data. Katz, Allen, Buyske, Nadkarni, Rosenblatt, Hassett.
Bristol-Myers Squibb personnel were involved in initial discussions regarding the conception and potential design of this project, but were not actively involved in data collection or data analysis. Authors from Bristol-Myers Squibb offered comments on manuscript drafts and approved the final version, but publication was not contingent on the approval of Bristol-Myers Squibb.


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"a tad muddy, but it can be easily fixed with abit of equalizing they're louder then stadium speakers with duel drivers there is a woofer and tweeter in each can, so that= loads of bass and tremble bass tons of bass to go around treble it has it, but that about all I can say sound they favor highs over mids, but 'they're still well balanced sound stage love it deep and rich Comfort fine..." --voodoo do-er
Stanton Dynaphase Fifty
" What can I say, vintage. Honestly well worth the $30 I payed for these. They have a nice sound to them in the $30 price range, not Hi-Fi by any means, but fun to wear around. " --GrandZechs
Stanton Dynaphase Sixty-A Headphones
I've been looking for someone that has these or has seen them before, I have a pair and have looked in many places but can't find these headphones ANYWHERE. No info, no pics, nothing...If anyone knows of these headphones or at least seen them in the past, please contact me ASAP. They were my dad's when he was younger. THESE ARE NOT STANTON DYNAPHASE SIXTY HEADPHONES, THEY ARE...
SonoCore Bryan COA-803+
It's rare to see a dual dynamic driver earphone in the sub $100 range, and that's exactly what we will be taking a look at today. After reviewing top tiered IEM's, I thought it would be good to take a step back and look at some budget IEM's, tailored for all the mid-fi people wandering around on the market. The SonoCore COA-803+ is a dual dynamic driver earphone that...
New Stereo Headset Hands-free Earphone with build-in Microphone for Apple iPhone - Compatible with iPod Touch, iPod Classic, iPod Nano 3G 2G 1G, iPod Shuffle and MP3 MP4 - White
The 3.5mm Plug of iPhone is different with the normal 3.5mm Audio output Plug, this stereo headset is compatible with iPhone and any device with a standard 3.5mm jacket: include iPod Touch, iPod Classic, iPod Nano and iPod Shuffle and more.
Stanton DJ Pro 60 DJ Pro 60 Headphones (Silver)
The new DJ PRO 60 compact, lightweight stereo headphones feature a comfortable self-adjusting headband and exceptional low end response. They come packaged with a free carrying pouch.
Stanton DJ Pro 2000S Swivel Cup Headphones with Carry Bag
The DJ Pro 2000 delivers high output without compromising on sound quality. It features a unique folding design with a rotating ear cup and padded shoulder rest for more comfortable monitoring. The choice of top DJs like Tiësto
Stanton DJ Pro 60 Compact Stereo Headphones with Carry Bag - Silver
The new DJ PRO 60 compact, lightweight stereo headphones feature a comfortable self-adjusting headband and exceptional low end response. They come packaged with a free carrying pouch.


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Find online courses made by experts from around the world.
Take your courses with you and learn anywhere, anytime.
Learn and practice real-world skills and achieve your goals.
"When you eat rubbish you feel rubbish" - Unknown.
Learn how to create your own bespoke nutritious and delicious meal plan that works only for you to become healthy and thin. There is no need to torture yourself any more with off the shelf diets from other people. Other diets tell you what to eat for a short period of time so you can quickly lose some weight. Once you are back eating your normal food the lost weight is back in places where you want it the least. When you learn about nutrition and observe how each food affects your body you will be able to put together a food plan that is both delicious and waistline friendly. You will learn to make up your own mind when finding the truth about food advertised on TV and food you put into your body.
The purpose of this course is to give you the tools to make better decisions about food you eat. This well-organised and easy-to-follow 8 step program "The Healthy Lean Body" is created specifically for women who care about what they eat, for women who are ready to put in the time to learn about food and its effect on the body to become energised and healthy. A consequence of a healthy lifestyle is the ideal body. A healthy body just can not be overweight. Get healthy first and the lean body will follow. The course is not for women who rely on slimming pills and liposuction to do the hard work for them. Please note the course is not suitable for men because of the gender differences in storing and burning fat.
I survived a 5
year struggle against being heavy and my realisation was that it is
not about weight but keeping a healthy diet with weight loss as a by-product. Only when I
realised this did I finally lose the 2 stone I hoped for but best
of all was the confident way I have kept to a BMI of 22. During my
mission I came across countless women losing the same battle
and getting more frustrated with temporary results or the lack thereof. If you are one of them take charge of the food you eat by learning about food nutrition and creating your own healthy food plan.
Not for you? No problem.
30 day money back guarantee.
Forever yours.
Lifetime access.
Learn on the go.
Desktop, iOS and Android.
Get rewarded.
Certificate of completion.
|Lecture 1
What you will get from the course and what is covered.
|Lecture 2
Hopefully after watching this video you will be able to recognise the "food traps" straight away and avoid them.
|Section 1: Part 1 "All About the Body"
|Lecture 3
Short summary of what is covered in Part 1 of the course.
|Lecture 4
How the human body evolved physically.
|Lecture 5
How the human body evolved emotionally.
|Lecture 6
Is there a connection between genes, lifestyle and longevity?
|Lecture 7
What happens to our body when we eat bad food.
|Lecture 8
Food Cravings and how to deal with them.
|Lecture 9
Are you a food addict?
|Lecture 10
Limits of Modern Medicine
|3 pages
|Lecture 11
Short summary of what was covered in Part 1 of the course.
|Quiz 1
Quiz Part 1
|5 questions
|Section 2: Part 2 "All About the Food"
|Lecture 12
Short summary of what is covered in Part 2 of the course.
|Lecture 13
|How nutritional value of food changed over years.
|Lecture 14
What a balanced diet looks like.
|Lecture 15
What a balanced diet looks like.
|Lecture 16
How food calories work and how to count a daily consumption of calories if necessary.
|Lecture 17
How to read American, European and Australian food labels to identify whether the food is healthy or not.
|Lecture 18
Learn about differences between refined and natural sugars.
|Lecture 19
Learn the differences between white and brown refined sugar and sweeteners.
|Lecture 20
Is low fat product healthier than full fat? You will find out after watching this video.
|Lecture 21
|2 pages
Food supplements are very popular and considered to be the answer to the malnutrition problems.
Are they as good as they are advertised?
|Lecture 22
|3 pages
Insects do not eat margarine. Why do we? What is better for us butter or margarine?
|Lecture 23
|42 pages
Food preparation affect its nutritional value. Learn how to preserve nutrients in cooked food.
|Lecture 24
Short summary of what was covered in Part 2 of the course.
|Lecture 25
|3 pages
Practice to read food labels.
|Section 3: Part 3 "Your Own Food Plan"
|Lecture 26
Short summary of what is covered in Part 3 of the course.
|Lecture 27
|2 pages
History of fitness and how many calories are burnt by different sport activities.
|Lecture 28
|4 pages
What happens inside the body when you exercise and when you do not exercise.
|Lecture 29
|4 pages
Good pain vs bad pain. Damage exercising can cause.
|Lecture 30
Steps 1-4 of the Healthy Lean Body system.
|Lecture 31
Steps 5-7 of the Healthy Lean Body system.
|Lecture 32
Step 8 of the Healthy Lean Body system.
|Lecture 33
|1 page
Keep a food diary for the next two weeks (Step 2 "Set the Record"). You can use the food diary example provided in the course or find one online or just create your own.
Tatiana was born and raised in Russia near Syberia. She moved to Ireland 13 years ago and has been enjoying her life there ever since.
Tatiana's personal journey to healthy food started when she realised that it was time to lose two stone of excess weight accumulated over a couple of years by eating pizzas for dinner and chocolate biscuits for dessert. She started exercising more and stopped eating pizzas. It took her a year to lose excess weight but she managed to gain every single pound back in half of the time it took her to lose it once she started eating rubbish food again. She was disappointed with herself. She could not bear looking at herself in the mirror. The last thing she wanted was to start all over again. But there was no other choice if she wanted to be slim.
The second time Tatiana decided to make a more permanent change by learning about food and how her body was affected by different foods. She found out that she consumed too many calories because of eating foods with obvious and hidden added sugars. Once she reduced sugar in her diet she started losing weight again. She tracked other nutrients in her diet like fat, fibre and salt as well to improve her health. She adjusted her diet to stay healthy and slim permanently.
Tatiana worked as an accountant for years until she discovered her passion for health and wellness. She retrained and became a professional trainer specializing in health and wellbeing. Tatiana has been training people and speaking about health and wellness since 2010. Currently Tatiana, besides running online courses, teaches women about nutrition in one-to-one and group environments.


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We were able to view this cliff dwelling from across a narrow canyon. It was fascinating to see, although I wish we could have seen it up close. Well worth the visit. We had our...
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We were able to view this cliff dwelling from across a narrow canyon. It was fascinating to see, although I wish we could have seen it up close. Well worth the visit. We had our dog with us, but dogs are not allowed in this area, so we had to take turns visiting.
One more beautiful site in mesa Verde National Park. These are small villages that wre built in the cliffs above the canyon. Absolutely beautiful.
The trail to the best viewpoint was closed due to rock slides so we were very disappointed. However we could walk part way and still enjoyed the views that we had.
The trail to Spruce House is actually a loop...a little exertion and you're there. The ruins are stunning...no two ways about it! The petroglyphs are likewise unworldly. The information boards clearly detail what took place and the status of restorations. Fantastic!
Spruce Tree House was our first stop on a recent trip to Mesa Verde National Park. It is located in the Chapin Mesa area of the park and shares a parking lot with the Chapin Mesa Archeological Museum and the Spruce Tree Terrace restaurant.
Due to rockslides you aren't able to tour the site but can view it from an...
I could write a separate review on each of the major sites inside the park for Cliff Palace, Balcony House, Spruce Tree House, Long House, The Research Center, Chapin Mesa Museum, Step House and others but I am not. I am going to make this easy on myself and hopefully give you a broad over view of the park in...
Yet another amazing architectural landmark in Mesa Verde NP.
We did not go down to these houses, but instead admired from across the valley. Easily accessible viewpoint- absolutely worth enjoying the views.
Our tour guide was great at explaining all the history surrounding these former dwelling places. Due to rock slides you are no longer allowed entrance. There is a great view just outside the Museum. If you zoom in with your camera you can get a great picture.
Just amazing how they lived and gathered enough food and water.
They call this the "spruce tree house" because it was originally visited by shinnying down what was thought to be a spruce tree. The tree is long gone but the name stayed. You can view this "house" from a lookout across a canyon. Interesting structures.
Access to Spruce Tree House is restricted due to rock slide potential. There is a nice lookout just out back of the Museum and a friendly and knowledgeable ranger is stationed there to answer any questions.


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Film of an Irish stream shot by visual artist Johnnie Lawson has been viewed over 6 million times and its effects are so impressive that it's being incorporated into medical research.
The video, of the River Bonet flowing under a bridge and over rooks in dappled sunlight, shaded by trees, isn't what typically ends up getting thousands of shares across the social web. But since it was uploaded almost two years ago it has become hugely popular with people around the world looking to relieve tension and get a good night's sleep.
So much so that it and a number of Lawson's other videos, are now being used in clinical trials at a number of London hospitals aimed at reducing post-traumatic stress for intensive care patents.
Speaking to the BBC, Dr Dorothy Wade, a health psychologist who works in the intensive care unit at University College Hospital, London, said: "As part of the therapy, nurses give patients tablet computers with different relaxation materials on them."


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Aumentadora latest regeneration and muscle mass formula
The complete, instant food for your muscles with scientifically proven assets
35 Professional Volumass — \"the\" almost compulsory supplement for all the people who do physical activity. Volumass 35 It is our most successful product until today and 35 Professional Volumass It is his new latest version. The training is nothing if not you can regenerate you on it and if you you do not provide the adequate support of nutrients to develop muscle and power. For this task, regardless of your specific goals and training phase, there is a universally ideal proportion of carbohydrates, proteins, amino acids and other nutrients used. 35 Professional Volumass It has been designed to provide these nutrients in a perfectly balanced manner. 35 Professional Volumass It contains the best whey protein: whey concentrate occurs through ultra and Microfiltered, addition of purified enzyme. It is rich in protein, lactalbumin, lactoglobulin, lactoferrin and immunoglobulin fractions. Isolated whey is the protein more clean and with the highest biological value that is prepared through Microfiltered by cross flow CFM.
Volumass 35 Professional provides quickly absorbed carbohydrate for glycogen stores become rapidly recharged and the rest of the nutrients will also be used in an appropriate manner (\"insulin pump\"), but also the new Palatinose ? design of timed absorption and very low carbohydrate index of sugar \/ insulin is also included in the formula, which provides lasting energy and prevents the fall of sugar in the blood.
Creatine that is in the product is the best asset free of calories. It is responsible for providing energy for muscle contractions and increase muscle volume, which is a (constructive) anabolic signal for the body. In the Volumass 35 Professional formula creatine component has been changed for the better product, the popular creatine matrix multi vector ATTACK!
In terms of the critical amino acids, in Volumass 35 Professional there are more than 10,000 mg BCAA and 8,000 mg of glutamine per dose, the latter comes from the matrix G-BOMB super glutamine, which already itself is also a successful product. This matrix provides more stable and better utilization of biological glutaminas.
35 Professional Volumass It is reinforced with taurine, taurine ethyl ester and phosphates, in addition all doses provides 50% of the recommended amount of vitamins. The formula is free of aspartame.
Directions: Mix a dose of Volumass 35 Professional with 500 ml of water or milk skimmed. For best results consume it within 30 minutes after your workout or apply as food during the day.
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1997 Oldsmobile Achieva Repair and Maintenance Costs
A guide to repairs, service, and maintenance costs for your 1997 Oldsmobile Achieva
Never overpay. Check prices with our estimator
Verified by mechanics, reported by drivers like you
Ask a mechanic in our community
Our experts translate recalls into plain English
1997 Oldsmobile Achieva ProblemsPower Window Not Working Due to Window Motor
A door window may move slowly or stop in mid travel due to a failing power window motor. The affected window may start working again after the motor cools off. Replacing the faulty window motor will commonly correct this concern.
A coolant leak may develop from the water pump. This can result in an engine overheating condition. A leaking water pump will require replacement.
The automatic transmission shifter may fail causing the ignition key to become stuck in the ignition lock cylinder.
1997 Oldsmobile Achieva QuestionsTHE NEW FAN BELT i PUT ON KEEPS COMMING OFF AS SOON AS I CRANK IT UP (1 answer)
Read a lot of posts about pass lock problems and mine does the same thing. Starts for a second then stops. But I have no dash lights. If I put the key on and wait for the dash lights to illuminate most times it will start. Then runs very rough until I can get on the road. This happened twice...


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Join us for the best in family camping in a beautiful wooded setting. Rental cottage available. A well-stocked store and snack bar help make family camping here GREAT! A swimming pool, a spring-fed lake(Rice Lake), fishing, rowboat & canoe rental, mini-golf, shuffleboard, horsehoses, playground, game room rec hall, lots of weekend planned activities make it FUN!
May 1-Oct 15
Take exit 160 off of Interstate I-90. Turn North on Hwy 73. Turn East on Hwy 106. Turn North on Hillside Road.
Articles: Hickory Hills Campground


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Don't Talk to Me, I'm PCSing T-Shirt
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Style: Men's Basic T-Shirt
Comfortable, casual and loose fitting, our heavyweight t-shirt will easily become a closet staple. Made from 100% cotton, it wears well on anyone. We've double-needle stitched the bottom and sleeve hems for extra durability.
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- Model is 6'1" and is wearing a medium
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Don't Talk to Me, I'm PCSing T-Shirt
Hate them or love them, most Military Moms will have to deal with a Permanent Change of Station (PCS) at one time or another. This t-shirt has a tongue-in-cheek message that is sure to amuse even the most experienced Military Mom!
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Sri Lanka Road Trip
Take a road trip to explore the wonders of Sri Lanka, including Tsunami Honganji Vihara, sea turtles, Yala National Park, elephants and Royal Rock Temple.
Northeast: Vermont"When I lived in Vermont, hundreds would come and ride the scenic train every fall." – Michele F. 960 1280
Northeast: New Hampshire"White Mountains in New Hampshire – Kencamagus Highway is gorgeous!" – Stephanie C. 960 1280
South: Tennessee"Gatlinburg is absolutely beautiful! Can't beat the Smoky Mountains in the fall!!" – Amanda M. 960 1280
Midwest: Indiana"Indiana near the beautiful covered bridges". – L. Morrison 960 1280
West: Washington
"Seattle, Washington" – Sarah K.
You don't have to go far to see Autumnal hues, picnic and play in fallen leaves at Woodland Park (just south of the zoo) or stroll along nearby Bellevue Botanical Garden's Lost Meadow loop.960 1280
Mid-Atlantic: North Carolina"Blue Ridge Mountains in Western North Carolina." – David R. 960 1280
Mid-Atlantic: Virginia"Charlottesville, Virginia (or better yet, at a nearby vineyard)." – Brian P. 960 1280
Mid-Atlantic: Pennsylvania
"Bucks County, Pennsylvania!" – Jeff H.
Embark on a tour of Bucks County's charming covered bridges (there are 12 in all) or getting a bird's-eye view of the countryside with the U.S. Hot Air Balloon team!960 1280


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WATCH: Eco Healing Retreat to the Big Island
Ready for a sunny escape? Then come with us on this episode, where we soak up…Read More
Ready for a sunny escape? Then come with us on this episode, where we soak up…Read More
On this episode, we visit the jewel of California's Central Coast: the quaint and quirky beach…Read More
Unplug from your daily routine on this episode, and rediscover what's essential with a visit to…Read More
On this adventure, we spent one magical night in Rome's bohemian Monti neighborhood. After some fun…Read More
Finding Your Zen at Tassajara On this episode of Conscious Living, we visit the nation's oldest…Read More
What happens when a government asks a graffiti crew to give a small town a facelift?…Read More
There's nothing like a getaway to Tahoe – the sunshine, fresh air, mountains and the lake…Read More
A night of karaoke will make you happier than a new sound system, according to science….Read More
By Loukas Billas Nothing beats boredom and a sedentary lifestyle better than going on a vacation….Read More
By Mary Bemis I was wading through icy-cold water — willingly — and it felt great….Read More


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Get your Buy One Get One Free Crush 20 oz. printable coupon (value up to $1.49).
Thanks, Give Me Neither!
Be sure to check out the rest of the printable coupons or search the In-Store only Christmas Price Guarantee!
You can read about how to save on ink while printing these fabulous coupons in my previous post "Tips for Printing Internet Coupons."


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Hi guys,
I'm trying to remedy this comfort issue with my new pair of M50. At first they really hurt the top of my head after 5 minutes, just the weight of it pressing down on the very top (of my soft and probably misshapen noggin). Truth be told, there's not much padding between the metal bar and your head, and the weight of the headphones push down a good amount.
I bent the headband slightly to a more acute angled curve so that the pressure falls on two points on the top of my head instead, but it still weighs on my soft baby head after about 15 minutes now. The headphones clamp fine but they're not enough to keep the band from pressing to the point of pain.
So I saw this thread http://www.head-fi.org/forum/thread/257522/dt770-headband-cushion-on-denon-d5000 and was wondering if there's a mod I can add to cushion the pad more. I actually added a thin foam pad used to fit bike helmets onto the inner face of the band using rubberbands so I know this would work, but it's not aesthetically pleasing. If I could get some assurance that the linked pad would fit, or something like it, I would buy it.


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Hotfrog Philippines provides information regarding Mooon Cafe in Iloilo City Iloilo. Mooon Cafe is located at Iloilo City Iloilo 5000 and provides Food And Dining services. Contact them on (033) 509 5530.
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Upcoming PC games
What are the best upcoming PC games and the new PC games to keep an eye on this year and next? Hope, anticipation, agony and elation - it's the endless cycle of emotions we gamers go through during the annual PC release schedule. Year in, year out, games - via Steam and otherwise - are produced in such varying degrees of quality that no announcement is destined for certain success. Masterpieces are released alongside utter disasters, franchises are born while others dwindle and occasionally - so very occasionally - a game actually lives up to our expectations.
You'll find more of the best new PC games of the year in our round-up of 2016's top releases.
And there's plenty on the horizon to feel positive about. From franchise heavyweights to inventive indies, the sheer range of exciting titles due for release in the not too distant future is enough to spread a smile across the face of even the most cynical of gamers. Well, almost.
Upcoming PC games Q1 2017
Torment: Tides of Numenera
Another old-school RPG looking to get you all warm and fuzzy with nostalgia. A spiritual successor to Planescape: Torment, this classic isometric roleplayer will carry on the heavy themes of its inspiration, but transfer the action to the setting of Numenera (an already established pen-and-paper RPG world). Expect a heavily story-led, dialogue-rich campaign exploring the darkest corners of existence and mortality, a solid helping of wit, and tactical combat rife with opportunity.
Torment: Tides of Numenera release date: February 28, 2017
Ghost Recon Wildlands
Ghost Recon has sometimes struggled to find its place along Ubisoft's spectrum of stealth-action games - jostling for space with Rainbow Six and Assassin's Creed - but it's now decided to be Far Cry crossed with GTA, and that turns out to be a really attractive idea. Shoot narcos every which way you like.
Tom Clancy's Ghost Recon: Wildlands release date: March 7, 2017
Star Trek: Bridge Crew
Star Trek: Bridge Crew was perhaps the most pleasant surprise at E3 2016 - a VR recreation of a USS vessel you can occupy with a bunch of goggle-wearing mates. Together, you'll endeavour to keep the thing in one piece, playing your given role as captain or engineer to ready the ship for warp or raise shields for battle.
Behind it all are Ubisoft's Red Storm, the multiplayer specialists who birthed Rainbow Six.
Star Trek: Bridge Crew release date: March 14, 2017
Styx: Shards of Darkness
That another Styx game even exists is quite surprising - not because the original was particularly poor, more a reasonable medium, but just that the budget and sales it attracted don't normally lend themselves to follow-ups. Publishers Focus Home do live a little more on the wild side though, and thus we get to spend a little more time with the goblin fellow. It looks pretty fun, too.
Styx: Shards of Darkness release date: March 14, 2017
Mass Effect: Andromeda
You might have heard of this one, small series with a lot of room to grow, hasn't had an edition in a while, yeah? Haha, yes, the joke is obviously you've heard of Mass Effect: Andromeda because it's bloody Mass Effect: Andromeda. Hype's leaking out of the ears for this one, and as we near release, the details are starting to come thick and fast too. If you're interested, here's what we know about characters and romance. If you can't wait until general release, you can subscribe to Origin access for a ten-hour trial on March 16.
Mass Effect: Andromeda release date: March 21 (NA) and March 23 (Europe)
Strafe is like if Nu-Doom and Quake made a baby together and it grew up listening to The Pixies. It's extremely 90s, fast-paced and has had the oddest marketing campaign of all time. Seriously. They've gone a bit dark and there have clearly been delays in getting the game out given it was announced way back in early 2015. Hopefully it lives up to it come release.
Strafe release date: March 28
Outcast: Second Contact
Long awaited remake of a cult-classic, Outcast: Second Contact is one of several games hitting next year (not all on our platform, sadly) that many never thought they would see. Despite failing a Kickstarter several years ago, funding was acquired and the game is being made - Matt even got to see it at Gamescom.
Outcast: Second Contact release date: March 2017
Tokyo 42
The technicolour hybrid of Hitman and Syndicate, Tokyo 42 immediately made an impressive impact on debut, looking just a bit different from absolutely everything else. Published by indie experts Mode 7 of Frozen Synapse and Endzone, it's developed by just a two-person team at SMAC teams. Hopefully it can live up to its beauty, and you can read more about how it works in Jordan's Tokyo 42 preview.
Tokyo 42 release date: Early 2017
Outlast 2
Sequel to the surprisingly excellent 2014 horror game, Outlast 2 keeps the journalist but trades in the asylum hospital for a desert, a field and loads of tall grass. Mix in an unhealthy dose of religious overtones, burning crosses and the usual brand of maximum over-violence and you hopefully have as good a game as its predecessor. A 2016 demo (around Halloween, natch) wetted appetites well despite the delay.
Outlast 2 release date: Q1 2017
Upcoming PC games Q2 2017
Sniper: Ghost Warrior 3
With a name that sounds like an amalgam of Sniper Elite and Ghost Recon, Sniper: Ghost Warrior 3 is... well, somewhere between Sniper Elite and Ghost Recon. This is a tactical FPS, set in an open-world for the first time in the series, that finds a retired US marine hunting a target through Georgia (Eastern Europe, not the Deep South).
While previous Sniper: Ghost Warrior games suffered for smaller budgets, this one is said to be a proper triple-A production.
Sniper: Ghost Warrior 3 release date: April 4, 2017
To hell with ultra realistic settings, brutal melee takedowns and all things trendy in gaming, give us vibrant colours, some endearing animal protagonists, and loads of floaty jumping any day of the week. Yooka-Laylee, a crowdfunded throwback to the 3D platformers of the '90s, is offering up something a little lighter for gamers to sink their teeth into - just as you'd expect given that it's being made by ex-Banjo-Kazooie devs.
Yooka-Laylee release date: April 11, 2017
Looking awfully System Shock, Prey is nothing like its basic FPS predecessor and bares a lot more resemblance to Dishonored In Space than anything else. Makes sense coming from Arkane, and it's shaping up as one of the more exciting games of 2017. They haven't quite gone whole-hog on the promotion yet, so expect to know much more before release.
Prey release date: May 5, 2017
The Surge
The next attempt at the Dark-Souls-but game-making strategy, The Surge puts the rock-hard difficulty, exploration focused and combat-heavy gameplay into space. Set in the far, far future after robots have made most manual labour pointless, large exoskeletons are the only way anyone can get anything done - upsteps the hero ready to beat some bad guys brainless with his.
The Surge release date: May 2017
Much-delayed and previously PS4-only exploration puzzler Rime is now actually coming to PC. That, of course, is if you agree it's a puzzle game, which we didn't in our preview, but did find it to be rather magical all the same. It certainly looks the part.
Rime release date: May 2017
Tekken 7
Fighting games come on PC these days (hooray), and Tekken 7 is no exception. Akuma joins the cast of Street Fighter's largest competitor this go round, adding fireballs and spinning kicks to the laser beam eyes and … spinning kicks. It's been out in Japanese arcades for quite a while now, meaning the PC and console home release is actually the Fated Retribution version - prettier, better and more balanced.
Tekken 7 release date: June 2, 2017
Dirt 4
The latest in the series that grew from the venerable Colin McRae Rally badge, Dirt's focus on rally driving offers racing fans something a bit different. Developers Codemasters have been doing this a very long time now, and with a brand new track generator to add to all the off-roading fun, Dirt 4 looks set to be the most full-featured yet.
Dirt 4 release date: June 9, 2017
The most intriguing art style in development, Cuphead bases its looks on early 1900s cartoon animation and its play on a co-op version of Mega Man. How that all combines is the question, and its taken its time getting here - hopefully it can live up to its own design.
Cuphead release date: Q2 2017
The next game from the Gone Home folks is silent, creepy and explorative, as is tradition, but also in space. Excellent. Fullbright haven't exactly shouted out the plot details, as you might expect, but you're aboard a space station and something's not quite right. Originally slated for a 2016 launch, it got delayed to refactor various parts of the game to something better and should now be out soon.
Tacoma release date: Spring 2017
Upcoming PC Games Q3 2017
We Happy Few
Already in Early Access and making quite a stormer of it, We Happy Few aims to mix Bioshock and survival games into, presumably, some sort of world-devouring omni-game. Set in an alternate universe where drugs are all that keep the British population in check, it's horror, humour, survival and story all wrapped into one.
Upcoming PC Games Q4 2017
Shenmue 3
Well, it's happening. A massively successful Kickstarter, some amount of Sony money and an almost bottomless pile of hype. It's estimated for the end of 2017, but we'd be surprised if it doesn't slip into the year after - or even further. Some, however, will wait however long they need to.
Shenmue 3 release date: December 2017
Crackdown 3
How do you make explosions even more explosions? You get the cloud to compute them. That's the plan for Crackdown 3, the seven-years-late sequel to one of the Xbox's most popular games. Destructible environments in a sandbox city are the set-up, but beyond that we haven't seen much more since the reveal in 2015.
Crackdown 3 release date: Q4 2017
Upcoming PC games TBC 2017
Nier: Automata
We're living in a new age, where JRPGs are just as at home on PC as they are every other gaming box. Get used to it and start reaping the benefits. Automata is a follow-up to the well-remembered, Square-published Nier, and stars androids with names like 2B and 9S in a world ravaged by a proxy war between machines.
This one is coming courtesy of PlatinumGames, so you know Automata's combat will be particularly special. The action game is scheduled for a February 23 release on console in Japan, March 7 in NA, but Square Enix are tight-lipped on the PC release. Hopefully it follows soon after.
Nier: Automata release date: TBC 2017
Dawn of War III
For seven years the forge worlds lay silent - or so we thought. Turns out Relic have fired them up again for Dawn of War III, producing huge numbers of units to match the original game's bigger battles, as well as ginormous walkers designed to swallow a sizeable portion of your screen. Expect Eldar, Orks and Space Marines to converge on the mysterious world of Acheron, where they've found - what else? - a terrible weapon.
Dawn of War III release date: TBC 2017
Divinity: Original Sin II
2014's Divinity: Original Sin was one of best classic RPGs made in recent years, with plenty of charm, depth and challenge to spare. Larian Studios' follow up promises the same respect for player choices, new origin stories, a revamped crafting system and addictive competitive party elements. And we can attest to all of this following our Original Sin II hands-on.
Divinity: Original Sin II release date: TBC 2017
Kingdom Come: Deliverance
Ever wondered what Skyrim without magic and cat people would look like? Wonder no more, because Warhorse Studios are in the process of making a medieval RPG set in 1403. The game promises to have historically accurate armour, weapons and combat techniques, and is intended to allow the player to become whoever they want - rogue, warrior or bard. Even more so when Kingdom Come mods get going.
Kingdom Come: Deliverance release date: TBC 2017
Frozen Synapse 2
After distilling the merits of their simultaneously turn-based tactical shooter in the purist sports strategy of Frozen Cortex, Mode 7 Games have returned to the Synapse series with a view to expand. They'll retain the waypoint system that evokes early Rainbow Six, but move the action outside those familiar office complexes in favour of "open world tactics". However that manifests itself, it'll be a huge departure from the taut, two-player maps of the original Frozen Synapse.
Frozen Synapse 2 release date: TBC 2017
Star Citizen
Without a doubt the most wildly ambitious game in a long time, Star Citizen aims to be the ultimate space exploration experience. Taking to the skies in one of numerous ridiculously detailed craft, you will be able to engage in military service, become a reputable trader of goods, live the life of a smuggler, or become a universe-famous race pilot. If it ever gets finished, of course. Squadron 42, the single-player component, is supposed to be out this year. But also last year.
Star Citizen release date: TBC 2017
After a well-received reveal at The Game Awards 2016, Dauntless will doubtless (ha!) enter a period of hibernation while the brains behind it put the F2P Monster Hunter-esque together. We're hoping to hear some more from them very soon, so stay tuned to PCGamesN - which we know you're doing anyway, you lovely lot.
Dauntless release date: TBC 2017.
Xenonauts 2
XCOM's indie cousin takes a lot from the original games, not so much the smaller squad sizes of the modern day efforts. Xenonauts 2 was announced with a splash page and little else in 2016, and has had work done on it quietly ever since. There's been a couple of alpha playtests for combat and graphics, but beyond that not a lot of proper announcements. Expect more, soon.
Xenonauts 2 release date: TBC 2017
The first game for feels-central developer Dontnod to release after Life is Strange is, obviously, about consuming the flesh of the living for sustenance. Vampyr casts you as a recently-vampirised doctor in 1918, just as Spanish Flu is really starting to mess Europe up. London is the setting, dark is the tone and surviving is the plan, while trying not to destroy all sense of civilization in Britain's capital. Good luck.
Vampyr release date: TBC 2017
Mount & Blade 2: Bannerlord
The long-awaited followup to the crowd favourite Mount & Blade, the sequel is promising to be bigger and better in pretty much every way. They've focused on two areas so far in reveals: humongous siege battles and making the game moddable. With the latter they're going as far as possible, giving modders as much power as possible to make their game even better.
Mount & Blade 2 release date: TBC 2017
Dead Island 2
This, apparently, still exists and making "fantastic progress" at take-over developers Sumo according to a recent issue of industry magazine MCV. Exactly how much resemblance it will have with the weird californian sunpocalypse we saw on display during the original announcement, but it's still tentatively scheduled for 2017.
Dead Island 2 release date: TBC 2017
Quake Champions
Quake Champions takes some surprising steps away from its roots, while claiming to be as grounded as possible. It's still going to feature the lightning gun, railgun and rocket launcher that made Quake 3 one of the world's first global eSports. But it's also adding character selection, special abilities and, possibly, a free to play monetization model. We've got a list of all the announced and rumoured Quake Champions characters if you're after it, and we'll hopefully know more during 2017.
Quake Champions release date: TBC 2017
Star Wars: Battlefront 2
Not to be confused with Star Wars: Battlefront II, Battlefront 2 will be the sequel to DICE's attempt at space lasers and heroes. It's definitely happening, will almost certainly accompany the release of Episode 8, but otherwise who knows. EA drew a lot of flak for the lack of single-player the first time round, which would be lovely. Expect to see more at E3.
Star Wars: Battlefront 2 release date: TBC 2017
Metal Gear Survive
Konami are doing another full Metal Gear game, without Hideo Kojima. Fan reactions are as to be expected, but at least it's suitably silly - rock zombies, time travel, alternate dimensions, portals through space, time and structure. It's co-op in nature and likely won't bear much resemblance to what's come before.
Metal Gear Survive release date: TBC 2017
More than a little odd, Absolver is about punching - simple enough so far - but to a degree almost no game ever is. You can customise your fighting style, your combos, the way your character moves, all in the hope of creating a build an opponent can't defeat in 1v1 online combat. It made a splash on first announcement during E3 and looks like it could be an early contender for indie smash hit of the year.
Absolver release date: TBC 2017
State of Decay 2
The definition of a cult indie hit, State of Decay was a lot of great ideas, well implemented and not locked in early access for a thousand years. It did well too, managing to garner quite the gaggle of fans that appreciated a group zombie survival where things actually worked. The sequel wants to do all that, better, and could be one of the semi-surprise hits of the year if it nails it.
State of Decay 2 release date: TBC 2017
Cliff Bleszinski's hat thrown into the hero shooter ring, Lawbreakers bares a bit more similarity to classic shooters than Overwatch, Battleborn and the like. No cartoony art style, though still something of a sense of humour, and lots of rocket jumps along with the wall-running. It's running a lot of beta tests currently, and will probably make it out fairly early in 2017.
Lawbreakers release date: TBC 2017
Battletech is back(letech), meaning we get to watch giant mechs beat each other up all over again. Created by notable Kickstarter success story Harebrained Schemes, of Shadowrun fame, it's progressing at speed with regular updates and should be out in 2017.
Battletech release date: TBC 2017
Originally debuting a couple of years back, Eitr went into deep hiding after very positive responses to demo builds to finish up the pixelated, isometric Dark Souls. It still looks lovely, and publishers Devolver Digital have confirmed that it's coming out in 2017.
Eitr release date: TBC 2017
Worlds Adrift
Operating somewhat as a tech demo for new MMO tech, Worlds Adrift is about sky pirates and a massive, persistant world. It calls itself a "first in a new generation" of multiplayer games and it's certainly pretty enough to sell the premise. If it works, it could be The Next Big Thing - we'll get to play it in 2017.
Worlds Adrift release date: TBC 2017
What Remains of Edith Finch
First person puzzle-venturing, the titular Edith Finch tries to discover why everyone else is dead via exploring her house. It's part spooky, part interesting and all very Gone Home, at least from initial impressions. Hopefully it fills those extra-large shoes well.
What Remains of Edith Finch release date: TBC 2017
The very definition of cult classic, Pathologic is one of the oddest games ever released, not least because of a dodgy translation from native Russian. After a very successful Kickstarter, a full remake is in development which hit early-alpha in late 2016 - we even played a bit of it. It will almost certainly be an event, bad or good.
Pathologic release date: TBC 2017
Hellblade: Senua's Sacrifice
An independent effort by DmC developers Ninja Theory, Hellblade: Senua's Sacrifice follows Celtic warrior Senua on a journey into the savage viking heartlands in search of her lover. It looks and sounds gorgeous so far, and sees its protagonist wrestle with weighty themes such as trauma and psychosis. Unfortunately, development hasn't gone smoothly, and it's been delayed from 2016 into a vague 2017 release window.
Hellblade: Senua's Sacrifice release date: TBC 2017
Mirage: Arcane Warfare
Mirage: Arcane Warfare is the follow-up to Chivalry: Medieval Warfare, which boasts some of the deepest melee combat you've ever seen. Using every mouse button and even its drag speed, several different attacks were possible, as were parries and feints. Each weapon had varying stats for reach, speed and damage, further complicating things.
To this intricate mix, Mirage promises to bring synergistic magical powers and a rather lovely pastel colour scheme, which you'll spoil by disembowelling your enemies all over the map. A likely rival to For Honor for deep multiplayer brawling, expect Mirage's beta test and then a full launch later this year.
Mirage: Arcane Warfare release date: TBC 2017
South Park: The Fractured But Whole
Obsidian opened a wildly successful series of RPGs with South Park: The Stick of Truth, but it continues on without them. Ubi are tackling this one internally, sensibly sticking to the map left behind by some of the most respected role-playing designers in the world. No bad news here - except for that which saw The Fractured But Whole delayed into 2017.
South Park: The Fractured But Whole release date: TBC 2017
Black Mesa
With the full mod released after what felt like a century of development, many assumed that was the end of legendary project Black Mesa, bringing the original Half-Life up to code in the latest version of the source engine. Not so. Never having added Xen to their version of the game, the devs set up Black Mesa as a full Early Access project, selling at a budget and starting to build a whole new ending to their favourite game. Now it's nearly done.
Black Mesa release date: TBC 2017
Full Metal Furies
A brawler with attitude, pixel graphics and unholy-large weapons, Full Metal Furies is what's coming next from the folks behind Rogue Legacy. It looks beautiful, is very fast and seems to involve no small amount of killing large monsters with larger weapons. Good stuff.
Full Metal Furies release date: TBC 2017
Into the Breach
The FTL folks are back, and if that's not enough to get you excited... well, for one thing, there might be something wrong with you. That aside, it's an isometric turn-based strategy game where you must save the Earth from various kaiju-sized threats by commanding humongous robots. It looks extremely rad.
Into the Breach release date: TBC
Unreal Tournament
Joining its erstwhile brother in fragging as a likely 2017 release, Unreal Tournament is taking a different tack - its been in open development since its earliest stages. As in, since they were still developing weapon models, deciding on movement mechanics, the very groundwork of the game. It's going to be free and supported by cosmetic microtransactions. They're still calling it pre-alpha so who knows when it will be out.
Unreal Tournament release date: TBC
Werewolf: The Apocalypse
Other than this definitely happening, we don't know a whole lot and won't under the Focus Home event at the start of February when it's due to be properly revealed. You'll play a Werewolf and you will probably tear stuff up at a high rate. It's to be the first WOD game since Vampire: The Masquerade - Bloodlines, so heavy weight is on it to be proper good.
Werewolf: The Apocalypse release date: TBC
Necromunda: Underhive Wars
Try not to cheer too loud: those folks behind Mordheim are making the 40k equivelent, Necromunda, and there really isn't any excuse for it not to be great. Again, not a lot to know before Focus Home's event in early February, which will doubtless bring trailer and gameplay details aplenty.
Necromunda: Underhive Wars release date: TBC
Sunless Skies
Equally dark sequel to the rather good Sunless Sea, Failbetter are back on Kickstarter and doing exceptionally well. Fully funded within four hours, Skies will almost certainly be a total pleasure to fans of the studio. Plenty of information over on the Kickstarter as they continue to gather cash.
Sunless Skies release date: May 2018
Pillars of Eternity 2
Pillars 2 is on the way, that's about all we know. Obsidian have been working on it since at least early 2016 according to interviews, but they've kept quiet about exactly how it's changing. We do know it will be in an entirely different section of the world, featuring all-new characters and a different plot. More to follow in early 2017, we'd guess.
Pillars of Eternity 2 release date: Q1 2018
Revived by SimBin after a messy cancellation in the bad old days, GTR 3 is in production by the new SimBin and should be in a playable state by mid-2017. They're aiming a little later for a full release, but it's an exciting time to be a fan of crossing tarmac quickly.
GTR 3 release date: 2018
Barkley 2
Fully titled 'The Magical Realms of Tír na nÓg: Escape from Necron 7 - Revenge of Cuchulainn: The Official Game of the Movie - Chapter 2 of the Hoopz Barkley SaGa', Barkley 2 is the sequel to one of the oddest fangames to ever exited, Charles Barkley's Shut Up and Jam: Gaiden. It was Kickstarted in December 2012 and has been in some form of development ever since. If it will ever come out is up for debate, but it's worth keeping track of for "what?" points alone.
Barkley 2 release date: TBC
Capybara's latest has been delayed more times than the end of the world. Below was originally meant to come out as early as 2014, with an announcement at E3 2013. That was now four years ago, and after a delay in August 2016 it never revealed itself again. Capy did say they were deliberately going dark until it was done, but who knows when it may resurface. We hope it does.
Below release date: TBC
Drift Stage
Like neon fever dream made flesh, Drift Stage has been hanging around the internet in constant development for a couple of years. They're running a non-Steam early access plan through their website, but $60,000 on Kickstarter back in 2015 hasn't lead to a release date any time soon.
Drift Stage release date: TBC
Galaxy in Turmoil
A good, or at least reasonable, end to one of the many fan-game turned cease-and-desist stories. Galaxy in Turmoil used to be a fan-made Star Wars Battlefront successor until EA and Disney gave it the "er, actually." Instead of taking their space-ball and going home, Frontwire Studios decided to keep it up and have got as far as space walks now.
Galaxy in Turmoil release date: TBC
Death Stranding
Nobody knows what's going on with Death Stranding, probably not even Hideo Kojima. We're not even sure it's coming to PC as well as its Sony-funded home, but it is mad as a box of frogs and that just makes us want to tell you about it. The Mads Mikkelsen trailer reinforced this after the initial reveal, and honestly we can't wait for more. Doesn't even matter if it never comes out.
Death Stranding realease date: TBC
System Shock 3
The other side of the System Shock development split, System Shock 3 is likely a long, long way off. We know Warren Spector is involved and … that's about it. Otherside Entertainment are doing the actual production, with Spector now there as studio director - we're expecting to hear more from them through 2017.
System Shock 3 release date: TBC
Cyberpunk 2077
The next game from those guys who made The Witcher - you might have heard of it. They announced it far, far too early with a teaser trailer and we've heard nothing official since. They're even a little sick of answering questions about it, it seems, but did get funding for some special city tech recently. Supposedly, it'll be out before 2019, but who knows.
Cyberpunk 2077 release date: 2077?
These are the upcoming PC games that have got us most excited. Any games on the horizon that have you seriously considering a pre-order? Let us know in the comments.


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You've just found the home of the British quizzing community! Here you'll find lots of people who are fanatical about quizzes, lots of great trivia questions and lots of useful information to help you get on TV and to improve your general knowledge.
We're very excited about our new site. Some great sections will be opening over the coming months. There will be a quiz training school and online quiz events too. For now though, the forum is open for discussion about all things quiz - from TV shows to the World Quizzing Championships and everything in between.
So come and join us. You might learn something new!
The Quizzing Order Of Merit was designed to recognise the achievements of quizzers at our sanctioned quiz events.LEARN MORE
Saturday 4th March 2017 will see us in St Crispin's Social Club, Duston once again for what has for many years now been the most eagerly awaited and best attended Grand Prix event of the calendar. There will also be a satellite event in Edinburgh: http://quizzing.co.uk/forum/viewtopic.php?f=6&t=627)LEARN MORE
The 2017 European Quizzing Championships will now be hosted by the city of Zagreb in Croatia over the weekend of 10-12 November. Initial details HERE, bookings to be open in the coming weeks, including details of discounted accommodation rates and specially arranged (complementary) trips hosted by the local tourist board.
The scores are up! It looks like 168 people took part! Congratulations to Kevin Ashman on his victory. The top five were Kevin Ashman, Didier Bruyere, Pat Gibson, Anne Hegerty and Ian Bayley.
Huge congratulations to Didier Bruyere who has stormed today's QUEST event (the British Open) with a score of 140.4 - 30.4 in Lifestyle! Didier has an EIGHT point lead over the second-placed player, Kevin Ashman.
Continuous Quiz: High Brow
OK, I'll jump in with a quick one..
Continuous Quiz: High Brow
C S Lewis and Aldous Huxley, I believe
Continuous Quiz: High Brow
Over to you Ken.
Continuous Quiz: High Brow
Thanks Pete.
Continuous Quiz: High Brow
Charles Dickens?
Continuous Quiz: High Brow
Dickens is indeed the person.
Continuous Quiz: High Brow
A clue - the crash was in Kent (though not Rochester), in a more southerly, semi-rural location.
Continuous Quiz: High Brow
As a gesture of goodwill, the answer is Staplehurst for the train crash. A significant event - but not significant enough ...
Continuous Quiz: News
When this was in the news, Dustin Lance Black was named as Tom Daley's partner.
Continuous Quiz: Sport
I think both of the last 2 answers are correct!
Copyright 2012 Quizzing Interactive Ltd. All Rights Reserved.


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- Release Date: 11/18/2003
Best Buy is dedicated to always offering the best value to our customers. We will match the price, at the time of purchase, on a Price Match Guarantee product if you find the same item at a lower price at a Designated Major Online Retailer or at a local retail competitor's store.Here's how:
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Special Features
- Interactive menus
- Chapter seletions
- Digitally mastered
- Optional Spanish subtitles
Noted record producer and musician Glen Ballard (who has collaborated with Alanis Morissette, Dave Matthews Band, No Doubt, and Aerosmith) wrote this drama which offers an insider's look at the long, hard road to the top of the music business. Kennedy (Jimmy Tuckett) is the frontman of a struggling rock & roll band who have come to Los Angeles in hopes of making it big. Kennedy's brother, King (Brad Hunt), is the band's manager, but while the group works hard, they have little to show for it, and King seems to alienate more industry bigwigs than he's won over. The members of the band are also having a hard time keeping body and soul together; they not only have to work day jobs to support themselves, but to pay clubowners, who often charge musicians for the "privilege" of playing a well-known venue. Mondo (Rodney Eastman), the drummer, brings even more problems into the picture when he starts dealing hard drugs to earn money. Finally, the band attracts the attention of a powerful and well-known record producer, but there's a catch -- he's only interested in Kennedy, and wants him to ditch the rest of his band. Clubland also stars Lori Petty, Heather Stephens, and Scot James; the film also features cameo appearances from Steven Tyler of Aerosmith and Terence Trent D'Arby. ~ Mark Deming, Rovi
Cast & Crew
- Rodney Eastman - Mondo
- Jimmy Tuckett - Kennedy
- Brad Hunt - King
- Lori Petty
- Heather Stephens