text:
You are here:
Related Information
- What Is Rheumatoid Arthritis? (Fast Facts, easy-to-read)
- ¿Qué es la artritis reumatoide? (Esenciales: Hojas informativas de fácil lectura)
- What Is Rheumatoid Arthritis?
(in Chinese 繁體中文)
What Is Rheumatoid Arthritis?
- What Is Rheumatoid Arthritis?
(in Vietnamese bằng tiếng Việt)
- Juvenile Arthritis, Q&A
- Living With Arthritis: Health Information Basics for You and Your Family
- Autoimmune Diseases
(in Korean 한국어)
Other Information
Health Information
Rheumatoid Arthritis
April 2017
Handout on Health: Rheumatoid Arthritis
This publication is for people who have rheumatoid arthritis, as well as for their family members, friends, and others who want to find out more about this disease. The publication describes how rheumatoid arthritis develops, how it is diagnosed, and how it is treated, including what people can do to help manage their disease. It also highlights current research efforts supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) and other components of the U.S. Department of Health and Human Services' National Institutes of Health (NIH). If you have further questions after reading this publication, you may wish to discuss them with your doctor.
- Who has rheumatoid arthritis?
- What happens in rheumatoid arthritis?
- How does rheumatoid arthritis affect people's lives?
- What causes rheumatoid arthritis?
- How is rheumatoid arthritis diagnosed?
- How is rheumatoid arthritis treated?
- Who treats rheumatoid arthritis?
- What you can do? The importance of self-care
- What research is being conducted on rheumatoid arthritis?
- Hope for the future
- Key words
Information boxes
What is rheumatoid arthritis?
Rheumatoid arthritis (RA) is an inflammatory disease that causes pain, swelling, stiffness, and loss of function in the joints. It occurs when the immune system, which normally defends the body from invading organisms, turns its attack against the membrane lining the joints.
Rheumatoid arthritis has several features that make it different from other kinds of arthritis. (See box "Features of rheumatoid arthritis.") For example, rheumatoid arthritis generally occurs in a symmetrical pattern, meaning that if one knee or hand is involved, the other one also is. The disease often affects the wrist joints and the finger joints closest to the hand. It can also affect other parts of the body besides the joints. (See "What happens in rheumatoid arthritis?") In addition, people with rheumatoid arthritis may have fatigue, occasional fevers, and a loss of energy.
The course of rheumatoid arthritis can range from mild to severe. In most cases it is chronic, meaning it lasts a long time—often a lifetime. For many people, periods of relatively mild disease activity are punctuated by flares, or times of heightened disease activity. In others, symptoms are constant.
Features of rheumatoid arthritis
- Tender, warm, swollen joints.
- Symmetrical pattern of affected joints.
- Joint inflammation often affecting the wrist and finger joints closest to the hand.
- Joint inflammation sometimes affecting other joints, including the neck, shoulders, elbows, hips, knees, ankles, and feet.
- Fatigue, occasional fevers, a loss of energy.
- Pain and stiffness lasting for more than 30 minutes in the morning or after a long rest.
- Symptoms that last for many years.
- Variability of symptoms among people with the disease.
Who has rheumatoid arthritis?
Scientists estimate that about 1.5 million people, or about 0.6 percent of the U.S. adult population, have rheumatoid arthritis.1 Interestingly, some recent studies have suggested that although the number of new cases of rheumatoid arthritis for older people is increasing, the overall number of new cases may actually be going down.
1According to the National Arthritis Data Workgroup, the actual number of new cases of rheumatoid arthritis is lower than previous estimates because of changes in the classification for the condition, as cited in Helmick CG, Felson DT, Lawrence RC, Gabriel S, Hirsch R, Kwoh CK, Liang MH, Kremers HM, Mayes MD, Merkel PA, Pillemer SR, Reveille JD, Stone JH, for the National Arthritis Data Workgroup. Estimates of the Prevalence of Arthritis and Other Rheumatic Conditions in the United States. Part I. Arthritis Rheum 2008;58(1):15-25.
Rheumatoid arthritis occurs in all races and ethnic groups. Although the disease often begins in middle age and occurs with increased frequency in older people, older teenagers and young adults may also be diagnosed with the disease. (Children and younger teenagers may be diagnosed with juvenile idiopathic arthritis, a condition related to rheumatoid arthritis.) Like some other forms of arthritis, rheumatoid arthritis occurs much more frequently in women than in men. About two to three times as many women as men have the disease.
What happens in rheumatoid arthritis?
Rheumatoid arthritis is primarily a disease of the joints. A joint is the point where two or more bones come together. With a few exceptions (in the skull and pelvis, for example), joints are designed to allow movement between the bones and to absorb shock from movements like walking or repetitive motions. The ends of the bones are covered by a tough, elastic tissue called cartilage. The joint is surrounded by a capsule that protects and supports it (see illustration). The joint capsule is lined with a type of tissue called synovium, which produces synovial fluid, a clear substance that lubricates and nourishes the cartilage and bones inside the joint capsule.
A joint (the place where two bones meet) is surrounded by a capsule that protects and supports it. The joint capsule is lined with a type of tissue called synovium, which produces synovial fluid that lubricates and nourishes joint tissues. In rheumatoid arthritis, the synovium becomes inflamed, causing warmth, redness, swelling, and pain. As the disease progresses, the inflamed synovium invades and damages the cartilage and bone of the joint. Surrounding muscles, ligaments, and tendons become weakened. Rheumatoid arthritis also can cause more generalized bone loss that may lead to osteoporosis (fragile bones that are prone to fracture).
Like many other rheumatic diseases, rheumatoid arthritis is an autoimmune disease (auto means self), so called because a person's immune system, which normally helps protect the body from infection and disease, attacks joint tissues for unknown reasons. White blood cells, the agents of the immune system, travel to the synovium and cause inflammation (synovitis), characterized by warmth, redness, swelling, and pain – typical symptoms of rheumatoid arthritis. During the inflammation process, the normally thin synovium becomes thick and makes the joint swollen, puffy, and sometimes warm to the touch.
As rheumatoid arthritis progresses, the inflamed synovium invades and destroys the cartilage and bone within the joint. The surrounding muscles, ligaments, and tendons that support and stabilize the joint become weak and unable to work normally. These effects lead to the pain and joint damage often seen in rheumatoid arthritis. Researchers studying rheumatoid arthritis now believe that it begins to damage bones during the first year or two that a person has the disease, which is one reason why early diagnosis and treatment are so important.
Some people with rheumatoid arthritis also have symptoms in places other than their joints. Many people with rheumatoid arthritis develop anemia, or a decrease in the production of red blood cells. Other effects that occur less often include neck pain and dry eyes and mouth. Very rarely, people may have inflammation of the blood vessels (vasculitis), the lining of the lungs (pleurisy), or the sac enclosing the heart (pericarditis).
How does rheumatoid arthritis affect people's lives?
Rheumatoid arthritis affects people differently. Some people have mild or moderate forms of the disease, with periods of worsening symptoms, called flares, and periods in which they feel better, called remissions. Others have a severe form of the disease that is active most of the time, lasts for many years or a lifetime, and leads to serious joint damage and disability.
Although rheumatoid arthritis is primarily a disease of the joints, its effects are not just physical. Many people with rheumatoid arthritis also experience issues related to:
- Depression, anxiety.
- Feelings of helplessness.
- Low self-esteem.
Rheumatoid arthritis can affect virtually every area of a person's life from work life to family life. It can also interfere with the joys and responsibilities of family life and may affect the decision to have children.
Fortunately, current treatment strategies allow most people with the disease to lead active and productive lives. These strategies include pain-relieving drugs and medications that slow joint damage, a balance between rest and exercise, and patient education and support programs. In recent years, research has led to a new understanding of rheumatoid arthritis and has increased the likelihood that, in time, researchers will find even better ways to treat the disease.
What causes rheumatoid arthritis?
Scientists still do not know exactly what causes the immune system to turn against the body's own tissues in rheumatoid arthritis, but research over the last few years has begun to piece together the factors involved.
Genetic (inherited) factors: Scientists have discovered that certain genes known to play a role in the immune system are associated with a tendency to develop rheumatoid arthritis. For the genes that have been linked to rheumatoid arthritis, the frequency of the risky gene is only modestly higher in those with rheumatoid arthritis compared with healthy controls. In other words, individual genes by themselves confer only a small relative risk of disease. Some people who have these particular genes never develop the disease. These observations suggest that although a person's genetic makeup plays an important role in determining if he or she will develop rheumatoid arthritis, it is not the only factor. What is clear, however, is that more than one gene is involved in determining whether a person develops rheumatoid arthritis and how severe the disease will become.
Environmental factors: Many scientists think that something must occur to trigger the disease process in people whose genetic makeup makes them susceptible to rheumatoid arthritis. A variety of factors have been suggested, but a specific agent has not been identified.
Other factors: Some scientists also think that a variety of hormonal factors may be involved. Women are more likely to develop rheumatoid arthritis than men. The disease may improve during pregnancy and flare after pregnancy. Breastfeeding may also aggravate the disease. Contraceptive use may increase a person's likelihood of developing rheumatoid arthritis. This suggests hormones, or possibly deficiencies or changes in certain hormones, may promote the development of rheumatoid arthritis in a genetically susceptible person who has been exposed to a triggering agent from the environment.
Even though all the answers are not known, one thing is certain: rheumatoid arthritis develops as a result of an interaction of many factors. Researchers are trying to understand these factors and how they work together.
How is rheumatoid arthritis diagnosed?
Rheumatoid arthritis can be difficult to diagnose in its early stages for several reasons. First, there is no single test for the disease. In addition, symptoms differ from person to person and can be more severe in some people than in others. Also, symptoms can be similar to those of other types of arthritis and joint conditions, and it may take some time for other conditions to be ruled out. Finally, the full range of symptoms develops over time, and only a few symptoms may be present in the early stages. As a result, doctors use a variety of the following tools to diagnose the disease and to rule out other conditions:
Medical history: The doctor begins by asking the patient to describe the symptoms, and when and how the condition started, as well as how the symptoms have changed over time. The doctor will also ask about any other medical problems the patient and close family members have and about any medications the patient is taking. Accurate answers to these questions can help the doctor make a diagnosis and understand the impact the disease has on the patient's life.
Physical examination: The doctor will check the patient's reflexes and general health, including muscle strength. The doctor will also examine bothersome joints and observe the patient's ability to walk, bend, and carry out activities of daily living. The doctor will also look at the skin for a rash and listen to the chest for signs of inflammation in the lungs.
Laboratory tests: Several lab tests may be useful in confirming a diagnosis of rheumatoid arthritis. Following are some of the more common ones:
- Rheumatoid factor (RF): Rheumatoid factor is an antibody that is present eventually in the blood of most people with rheumatoid arthritis. (An antibody is a special protein made by the immune system that normally helps fight foreign substances in the body.) Not all people with rheumatoid arthritis test positive for rheumatoid factor, and some people test positive for rheumatoid factor, yet never develop the disease. Rheumatoid factor also can be positive in some other diseases; however, a positive RF in a person who has symptoms consistent with those of rheumatoid arthritis can be useful in confirming a diagnosis. Furthermore, high levels of rheumatoid factor are associated with more severe rheumatoid arthritis.
- Anti-CCP antibodies: This blood test detects antibodies to cyclic citrullinated peptide (anti-CCP). This test is positive in most people with rheumatoid arthritis and can even be positive years before rheumatoid arthritis symptoms develop. When used with the RF, this test's results are very useful in confirming a rheumatoid arthritis diagnosis.
- Others: Other common laboratory tests include a white blood cell count, a blood test for anemia, which is common in rheumatoid arthritis; the erythrocyte sedimentation rate (often called the sed rate), which measures inflammation in the body; and C-reactive protein, another common test for inflammation that is useful both in making a diagnosis and monitoring disease activity and response to anti-inflammatory therapy.
Imaging tests: X-rays are used to determine the degree of joint destruction. They are not useful in the early stages of rheumatoid arthritis before bone damage is evident; however, they may be used to rule out other causes of joint pain. They may also be used later to monitor the progression of the disease. Magnetic resonance imaging (MRI) and ultrasound may be useful in identifying the early stages of rheumatoid arthritis and can help determine the severity of the disease.
How is rheumatoid arthritis treated?
Doctors use a variety of approaches to treat rheumatoid arthritis. These are used in different combinations and at different times during the course of the disease and are chosen according to the patient's individual situation. No matter what treatment the doctor and patient choose, however, the goals are the same: to relieve pain, reduce inflammation, slow down or stop joint damage, and improve the person's sense of well-being and ability to function.
Good communication between the patient and doctor is necessary for effective treatment. Talking to the doctor can help ensure that exercise and pain management programs are provided as needed, and that drugs are prescribed appropriately. Talking to the doctor can also help people who are making decisions about surgery.
Goals of treatment
- Relieve pain.
- Reduce inflammation.
- Slow down or stop joint damage.
- Improve a person's sense of well-being and ability to function.
Current treatment approaches
- Lifestyle.
- Medications.
- Surgery.
- Routine monitoring and ongoing care.
Health behavior changes: Certain activities can help improve a person's ability to function independently and maintain a positive outlook.
- Rest and exercise: People with rheumatoid arthritis need a good balance between rest and exercise, with more rest when the disease is active and more exercise when it is not. Rest helps to reduce active joint inflammation and pain and to fight fatigue. The length of time for rest will vary from person to person, but in general, shorter rest breaks every now and then are more helpful than long times spent in bed.
Exercise is important for maintaining healthy and strong muscles, preserving joint mobility, and maintaining flexibility. Exercise can also help people sleep well, reduce pain, maintain a positive attitude, and manage weight. Exercise programs should take into account the person's physical abilities, limitations, and changing needs.
- Joint care: Some people find using a splint for a short time around a painful joint reduces pain and swelling by supporting the joint and letting it rest. Splints are used mostly on wrists and hands, but also on ankles and feet. A doctor or a physical or occupational therapist can help a person choose a splint and make sure it fits properly. Other ways to reduce stress on joints include self-help devices (for example, zipper pullers, long-handled shoe horns); devices to help with getting on and off chairs, toilet seats, and beds; and changes in the ways that a person carries out daily activities.
- Stress reduction: People with rheumatoid arthritis face emotional challenges as well as physical ones. The emotions they feel because of the disease – fear, anger, and frustration – combined with any pain and physical limitations can increase their stress level. Although there is no evidence that stress plays a role in causing rheumatoid arthritis, it can make living with the disease difficult at times. Stress also may affect the amount of pain a person feels. Several techniques can help for coping with stress. Regular rest periods can help, as can relaxation, distraction, or visualization exercises. Exercise programs, participation in support groups, and good communication with the health care team are other ways to reduce stress.
- Healthful diet: Except for several specific types of oils, there is no scientific evidence that any specific food or nutrient helps or harms people with rheumatoid arthritis. However, an overall nutritious diet with enough – but not an excess of – calories, protein, and calcium is important. Some people may need to be careful about drinking alcoholic beverages because of the medications they take for rheumatoid arthritis. Those taking methotrexate may need to avoid alcohol altogether because one of the most serious long-term side effects of methotrexate is liver damage.
- Climate: Some people notice that their arthritis gets worse when there is a sudden change in the weather. However, there is no evidence that a specific climate can prevent or reduce the effects of rheumatoid arthritis. Moving to a new place with a different climate usually does not make a long-term difference in a person's rheumatoid arthritis.
Medications: Most people who have rheumatoid arthritis take medications.2 Some medications (analgesics) are used only for pain relief; others, such as corticosteroids and nonsteroidal anti-inflammatory drugs (NSAIDs), are used to reduce inflammation.3 Still others, often called disease-modifying antirheumatic drugs (DMARDs), are used to try to slow the course of the disease. Common DMARDs include hydroxychloroquine, leflunomide, methotrexate, and sulfasalazine. Other DMARDs – called biologic response modifiers – may be used in people with more serious disease. These are genetically engineered medications that help reduce inflammation and structural damage to the joints by interrupting the cascade of events that drive inflammation. Currently, several biologic response modifiers are approved for rheumatoid arthritis, including abatacept, adalimumab, anakinra, certolizumab, etanercept, golimumab, infliximab, rituximab, and tocilizumab. Another DMARD, tofacitinib, from a new class of drugs call jak kinase (JAK) inhibitors, fights inflammation from inside the cell to reduce inflammation in people with rheumatoid arthritis.
2All medicines can have side effects. Some medicines and side effects are mentioned in this publication. Some side effects may be more severe than others. You should review the package insert that comes with your medicine and ask your health care provider or pharmacist if you have any questions about the possible side effects.
3 Warning: Side effects of NSAIDs include stomach problems; skin rashes; high blood pressure; fluid retention; and liver, kidney, and heart problems. The longer a person uses NSAIDs, the more likely he or she is to have side effects, ranging from mild to serious. Many other drugs cannot be taken when a patient is being treated with NSAIDs, because NSAIDs alter the way the body uses or eliminates these other drugs. Check with your health care provider or pharmacist before you take NSAIDs. NSAIDs should only be used at the lowest dose possible for the shortest time needed.
For many years, doctors initially prescribed aspirin or other pain-relieving drugs for rheumatoid arthritis, and they waited to prescribe more powerful drugs only if the disease worsened. In recent decades this approach to treatment has changed as studies have shown that early treatment with more powerful drugs – and the use of drug combinations instead of one medication alone – may be more effective in reducing or preventing joint damage. Someone with persistent rheumatoid arthritis symptoms should see a doctor familiar with the disease and its treatment to reduce the risk of damage.
Many of the drugs that help reduce disease in rheumatoid arthritis do so by reducing the inflammation that can cause pain and joint damage. However, in some instances, inflammation is one mechanism the body normally uses to maintain health, such as to fight infection and possibly to stop tumors from growing. The magnitude of the risk from the treatment is hard to judge because infections and cancer can occur in people with rheumatoid arthritis who are not on treatment, and probably more commonly than in healthy individuals. Nevertheless, appropriate caution and vigilance are justified.
Surgery: Several types of surgery are available to patients with severe joint damage. The primary purpose of these procedures is to reduce pain, improve the affected joint's function, and improve the patient's ability to perform daily activities. Surgery is not for everyone, however, and the decision should be made only after careful consideration by the patient and doctor. Together they should discuss the patient's overall health, the condition of the joint or tendon that will be operated on, and the reason for, as well as the risks and benefits of, the surgical procedure. Cost may be another factor.
Routine monitoring and ongoing care: Regular medical care is important to monitor the course of the disease, determine the effectiveness and any negative effects of medications, and change therapies as needed. Monitoring typically includes regular visits to the doctor. It also may include blood, urine, and other laboratory tests and x-rays.
People with rheumatoid arthritis may want to discuss preventing osteoporosis with their doctors as part of their long-term, ongoing care. Osteoporosis is a condition in which bones become weakened and fragile. Having rheumatoid arthritis increases the risk of developing osteoporosis for both men and women, particularly if a person takes corticosteroids. Such patients may want to discuss with their doctors the potential benefits of calcium and vitamin D supplements or other treatments for osteoporosis.
Alternative and complementary therapies: Special diets, vitamin supplements, and other alternative approaches have been suggested for treating rheumatoid arthritis. Research shows that some of these, for example, fish oil supplements, may help reduce arthritis inflammation. For most, however, controlled scientific studies either have not been conducted on them or have found no definite benefit to these therapies.
As with any therapy, patients should discuss the benefits and drawbacks with their doctors before beginning an alternative or new type of therapy. If the doctor feels the approach has value and will not be harmful, it can be incorporated into a person's treatment plan. However, it is important not to neglect regular health care.
Who treats rheumatoid arthritis?
Diagnosing and treating rheumatoid arthritis requires a team effort involving the patient and several types of health care professionals.
The primary doctor to treat arthritis may be an internist, a doctor who specializes in the diagnosis and medical treatment of adults, or a rheumatologist, a doctor who specializes in arthritis and other diseases of the bones, joints, and muscles.
As treatment progresses, other professionals often help. These may include the following:
- Orthopaedists: Surgeons who specialize in the treatment of, and surgery for, bone and joint diseases.
- Physical therapists: Health professionals who work with patients to improve joint function.
- Occupational therapists: Health professionals who teach ways to protect joints, minimize pain, perform activities of daily living, and conserve energy.
- Dietitians: Health professionals who teach ways to use a good diet to improve health and maintain a healthy weight.
- Nurse educators: Nurses who specialize in helping patients understand their overall condition and implement their treatment plans.
- Psychologists: Health professionals who seek to help patients cope with difficulties in the home and workplace that may result from their medical conditions.
What you can do? The importance of self-care
Although health care professionals can prescribe or recommend treatments to help patients manage their rheumatoid arthritis, the real key to living well with the disease lies with the patients themselves. Research shows that people who take part in their own care report less pain and make fewer doctor visits. They also enjoy a better quality of life.
Self-management programs teach about rheumatoid arthritis and its treatments, exercise and relaxation approaches, communication between patients and health care providers, and problem solving. Research on these programs has shown that they help people:
- Understand the disease.
- Reduce their pain while remaining active.
- Cope physically, emotionally, and mentally.
- Feel greater control over the disease and build a sense of confidence in the ability to function and lead full, active, and independent lives.
What research is being conducted on rheumatoid arthritis?
Over the last several decades, research has greatly increased our understanding of the immune system, genetics, and biology. This research is now showing results in several areas important to rheumatoid arthritis. Scientists are thinking about rheumatoid arthritis in exciting ways that were not possible years ago.
Over the past decades, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)-supported researchers have identified several genetic factors that predispose some people to develop rheumatoid arthritis, as well as factors connected to disease severity. Scientists know that more than one gene is involved in determining whether a person develops rheumatoid arthritis and how severe the disease will become.
An international research team identified dozens of new areas in the human genome associated with rheumatoid arthritis and found that many are already the targets of drugs approved for other conditions. The findings hint at new treatment approaches for the disease.
Researchers are investigating the potential connection between health, disease, and the human microbiome, which is the entire population of microorganisms that inhabit the human body. One study found that the presence of a specific type of gut bacteria correlated with rheumatoid arthritis in newly diagnosed, untreated people. The finding suggests a potential role for the bacteria in the disease.
The disease process
NIAMS intramural researchers are studying the natural history of rheumatoid arthritis in children and adults in an effort to understand how the disease progresses and impacts patient symptoms and functional status.
Investigators are also exploring whether patients with rheumatoid arthritis in remission while taking tumor necrosis factor-alpha (TNF-α) inhibitors can remain in remission after withdrawal of these medications. In addition, investigators are attempting to identify predictors of relapse in these individuals.
Scientists are continuing to understand the molecular underpinnings of rheumatoid arthritis and are working to develop tests that could help diagnose rheumatoid arthritis earlier and identify patients who would benefit most from specific treatments.
New therapies
Researchers continue to identify molecules that appear to play a role in rheumatoid arthritis and thus are potential targets for new treatments. The path between identifying the molecule and developing a drug that targets it is long and difficult. Fortunately, this path has been successfully negotiated, and new drugs have emerged that successfully reduce symptoms and damage in rheumatoid arthritis. Researchers continue to identify more candidate drugs, with hopes that these will have fewer side effects or will cure more patients.
- Tofacitinib: Tofacitinib, approved for the treatment of rheumatoid arthritis in 2012, was from a new class of drugs developed to target Janus kinases. One member of this family, JAK3, was discovered in the early 1990s by a National Institutes of Health (NIH) laboratory at the NIAMS. Subsequent studies carried out at the National Heart, Lung, and Blood Institute (NHLBI), in collaboration with the NIAMS, showed that genetic defects in JAK3 can cause severe combined immunodeficiency. This discovery led to the idea that drugs blocking Janus kinases would suppress the immune system and might be protective against the damaging inflammation of rheumatoid arthritis and certain other autoimmune diseases.
- NIH AMP Program: The NIH Accelerating Medicines Partnership (AMP) is a public-private partnership developed to transform the current model for identifying and validating the most promising biological targets for the development of new drugs and diagnostics. The NIAMS is leading the Accelerating Medicines Partnership in Rheumatoid Arthritis and Lupus (AMP RA/Lupus). The goal of this program is to integrate data from multiple genome-wide analytic approaches to generate a comprehensive understanding of the mechanisms of tissue damage in rheumatoid arthritis and lupus.
- Joint inflammation: NIAMS-funded researchers have determined that joint inflammation can continue in rheumatoid arthritis, even after clinical symptoms have eased. This finding may help doctors determine when a patient is truly in remission and can safely stop treatment.
More information on research is available from the following websites:
- National Institutes of Health (NIH) Clinical Research Trials and You was designed to help people learn more about clinical trials, why they matter, and how to participate. Visitors to the website will find information about the basics of participating in a clinical trial, first-hand stories from clinical trial volunteers, explanations from researchers, and links on how to search for a trial or enroll in a research-matching program.
- ClinicalTrials.gov offers up-to-date information for locating federally and privately supported clinical trials for a wide range of diseases and conditions.
- NIH RePORTER is an electronic tool that allows users to search a repository of both intramural and extramural NIH-funded research projects from the past 25 years and access publications (since 1985) and patents resulting from NIH funding.
- PubMed is a free service of the U.S. National Library of Medicine that lets you search millions of journal citations and abstracts in the fields of medicine, nursing, dentistry, veterinary medicine, the health care system, and preclinical sciences.
Hope for the future
Scientists are making rapid progress in understanding the complexities of rheumatoid arthritis: how and why it develops, and why some people get it and others do not, why some people get it more severely than others. Results from research are having an impact today, enabling people with rheumatoid arthritis to remain active in life, family, and work far longer than was possible 20 years ago. These advances will continue to lead to an improved quality of life for people with rheumatoid arthritis.
For more information
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Information Clearinghouse
National Institutes of Health
1 AMS Circle
Bethesda, MD 20892-3675
Phone: 301-495-4484
Toll free: 877-22-NIAMS (877-226-4267)
Fax: 301-718-6366
Email: email@example.com
Website: https://www.niams.nih.gov
If you need more information about available resources in your language or another language, please visit our website or contact the NIAMS Information Clearinghouse at email@example.com.
Other resources
National Institute of Allergy and Infectious Diseases
Website: https://www.niaid.nih.gov/Pages/default.aspx
National Center for Complementary and Integrative Health
National Institutes of Health
Website: https://nccih.nih.gov
American Academy of Orthopaedic Surgeons
Website: https://www.aaos.org (con información en español)
American College of Rheumatology
Website: https://www.rheumatology.org
Arthritis Foundation
Website: https://www.arthritis.org
Key words
Analgesics. Medications designed to relieve pain. Pure analgesics do not affect inflammation.
Anti-CCP antibodies. Antibodies to cyclic citrullinated peptide (anti-CCP). A positive test for the antibodies is useful for confirming a diagnosis of rheumatoid arthritis. In fact, tests for the antibodies can be positive years before the development of symptoms.
Autoimmune disease. A disease in which the immune system, which is designed to protect the body from foreign invaders, mistakenly sees the body's own tissues as foreign and makes autoantibodies against them, leading to tissue destruction.
Biologic response modifiers. Genetically engineered medications that help reduce inflammation and structural damage to the joints by interrupting the cascade of events that drive inflammation.
C-reactive protein. A protein produced by the body during the process of inflammation. A positive blood test for the protein indicates the presence of inflammation in the body. The test may be used in diagnosing rheumatoid arthritis and monitoring disease activity and the response of treatment.
Cartilage. A tough, elastic tissue that covers the ends of the bones where they meet to form joints. In rheumatoid arthritis, the inflamed synovium invades and destroys joint cartilage.
Corticosteroids. Powerful anti-inflammatory hormones made naturally in the body or man made for use as medicine. Corticosteroids may be taken orally to relieve the systemic inflammation of rheumatoid arthritis or injected directly into an inflamed joint to temporarily reduce inflammation and relieve pain.
Dietitian. A health professional who teaches ways to use a good diet to improve health and maintain a healthy weight.
Disease-modifying antirheumatic drugs (DMARDs). A class of medications used in the treatment of rheumatoid arthritis. DMARDs do more than ease the symptoms of rheumatoid arthritis like some other treatments. They often slow or stop the course of the disease to help prevent joint damage.
Erythrocyte sedimentation rate (sed rate). A blood test used to detect and monitor inflammation. It is measured by recording the rate at which red blood cells fall and form sediment at the bottom of a test tube.
Flare. A period of heightened disease activity. In rheumatoid arthritis, a flare may be characterized by increased fatigue; fever; and painful, swollen, and tender joints.
Hydroxychloroquine. An anti-inflammatory drug used in the treatment of rheumatoid arthritis, malaria, and lupus.
Immune system. A complex network of cells and tissues that work in concert to protect the body against invaders such as viruses and bacteria.
Joint capsule. A tough membrane sac that holds the bones and other joint parts together.
Ligaments. Tough bands of connective tissue that attach bones to each other, providing stability.
Lupus. A chronic inflammatory condition in which the immune system attacks the skin, joints, heart, lungs, blood, kidneys, and brain. Also called systemic lupus erythematosus.
Magnetic resonance imaging (MRI). Test that provides high-resolution computerized images of internal body tissues. This procedure uses a strong magnet that passes a force through the body to create these images.
Muscles. Bundles of specialized cells that contract and relax to produce movement when stimulated by nerves.
Nonsteroidal anti-inflammatory drugs (NSAIDs). A class of medications available over the counter or with a prescription that ease pain and inflammation.
Nurse educator. A nurse who specializes in helping patients understand their overall condition and implementing their treatment plans.
Occupational therapist. A health professional who teaches ways to protect joints, minimize pain, perform activities of daily living, and conserve energy.
Orthopaedist. A surgeon who specializes in the treatment of, and surgery for, bone and joint diseases. Also called orthopaedic surgeon.
Pericarditis. Inflammation of the pericardium, the thin sac-like membrane that surrounds the heart. Pericarditis can be caused by rheumatoid arthritis.
Physical therapist. A health professional who works with patients to improve joint function.
Pleurisy. Inflammation of the pleura, the linings surrounding the lungs. Pleurisy can be caused by rheumatoid arthritis.
Psychologist. A health professional who seeks to help patients cope with difficulties in the home and workplace that may result from their medical conditions.
Rheumatoid arthritis. A form of arthritis in which the immune system attacks the tissues of the joints, leading to pain, inflammation, and eventually joint damage and malformation. It causes swelling and redness in joints, and may make people feel sick, tired, and feverish. Rheumatoid arthritis may also affect skin tissue, the lungs, the eyes, or the blood vessels.
Rheumatoid factor (RF). An antibody that is present eventually in the blood of most people with rheumatoid arthritis. Not all people with rheumatoid arthritis test positive for rheumatoid factor, and some people test positive for rheumatoid factor, yet never develop the disease. Rheumatoid factor also can be positive in some other diseases.
Synovium. A thin membrane inside the joint capsule that secretes synovial fluid. In rheumatoid arthritis, the synovium is attacked by the immune system.
Synovial fluid. A fluid secreted by the synovium that lubricates the joint and keeps the cartilage smooth and healthy.
Tendons. Tough, fibrous cords that connect muscles to bones.
Ultrasound. A technique that allows doctors to view the soft tissues of the body by bouncing sound waves off the tissue and then converting the echoes into a picture called a sonogram.
Vasculitis. Inflammation of the blood vessels. Vasculitis can occur as a complication of rheumatoid arthritis.
X-ray. A procedure in which low-level radiation is passed through the body to produce a picture called a radiograph. X-rays of joints affected by rheumatoid arthritis are used to determine the degree of joint destruction.
The NIAMS gratefully acknowledges the assistance of the following individuals in the preparation and review of previous versions of this publication: John H. Klippel, M.D., Arthritis Foundation, Atlanta, GA; Amye L. Leong, Paris, France; Michael D. Lockshin, M.D., Barbara Volcker Center for Women and Rheumatic Disease, Hospital for Special Surgery, New York, NY; Kate Lorig, R.N., Dr.P.H., Stanford University, Stanford, CA; J. Lee Nelson, M.D., Fred Hutchinson Cancer Research Center, Seattle, WA; Paul G. Rochmis, M.D., Fairfax, VA; Ronald L. Wilder, M.D., Ph.D., MedImmune, Inc., Gaithersburg, MD; Stanley R. Pillemer, M.D, NIH; and Reva Lawrence, M.P.H., Paul H. Plotz, M.D., and Susana Serrate-Sztein, M.D., NIAMS/NIH. Special thanks also go to Cheryl Yarboro, R.N., B.S.P.A., NIAMS/NIH, and to the patients who reviewed this publication and provided valuable input.
The mission of the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), a part of the U.S. Department of Health and Human Services' National Institutes of Health (NIH), is to support research into the causes, treatment, and prevention of arthritis and musculoskeletal and skin diseases; the training of basic and clinical scientists to carry out this research; and the dissemination of information on research progress in these diseases. The NIAMS Information Clearinghouse is a public service sponsored by NIAMS that provides health information and information sources. Additional information can be found on the NIAMS website at www.niams.nih.gov.
For your information
This publication contains information about medications used to treat the health condition discussed here. When this publication was developed, we included the most up-to-date (accurate) information available. Occasionally, new information on medication is released.
For updates and for any questions about any medications you are taking, please contact
U.S. Food and Drug Administration
Toll free: 888-INFO-FDA (888-463-6332)
Website: https://www.fda.gov
For additional information on specific medications, visit Drugs@FDA at https://www.accessdata.fda.gov/scripts/cder/daf/. Drugs@FDA is a searchable catalog of FDA-approved drug products.
For updates and questions about statistics, please contact
Centers for Disease Control and Prevention, National Center for Health Statistics
Toll free: 800-232-4636
Website: https://www.cdc.gov/nchs
This publication is not copyrighted. Readers are encouraged to duplicate and distribute as many copies as needed.
Additional copies of this publication are available from:
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Information Clearinghouse
National Institutes of Health
1 AMS Circle
Bethesda, MD 20892-3675
Phone: 301-495-4484
Toll free: 877-22-NIAMS (877-226-4267)
Fax: 301-718-6366
Email: firstname.lastname@example.com
Website: https://www.niams.nih.gov
NIH Publication No. 17-4179


text:
Russia Today
Not enough potato harvest reports for my liking!
Iranian government-backed broadcaster Press TV has finally got its fondest wish and lost its UK broadcast licence, but its martyrdom is self-inflicted rather than the result of any government conspiracy. The channel, which had a home on the Sky Satellite platform, has been claiming to have been banned since October, saying it …
Not enough potato harvest reports for my liking!
As title...
One of the few form of racism still acceptable. I wonder why that would be?
And rednecks; you can't make fun of anyone but rednecks.
Of course, when your car breaks down, you don't want some fey-clad interior-designer-looking guy driving the tow truck ...
Thanks for including Fox News in that list!
"Fox News"
...If you take in account that the founder's original family name was 'Fuchs', pronounced the german way. "Fucks News" would be still more accurate.
Isn't Fox News a comedy channel?
BBC, CBS, NBC, NPR, etc in the list of ideologically motivated broadcasters. I'm sure it was just because The Reg only wanted to keep the story to one page, right?
Exactly what Ideology are CBS and NBC motivated by?
As for BBC and NPR, if "to educate, inform and entertain the public" is an ideology now, I think I have my new religion....
.....I think we can detect a member of the swivel-eyed and barking end of the Repubs disgruntled at El Reg including Fox News on their little list. For them Fox News isn't ideological it is simply broadcasting the truth. All other sources of news slightly more liberal than their homeboys Genghis and Attila (famous Fox News commentators :-P) are part of the Great Liberal Conspiracy.
CBS is so far left, they make the Democratic Party look Republican. And that's from scholarly research, not my opinion, BTW. MSNBC was caught actively campaigning for Obama in the last election, there's some objectivity for you. They even complained about how hard they worked for him on air! As for the Beeb, you must be joking...they've had a hard-on for anything conservative for about two solid decades now. Don't even get me started on the NPR, those guys are completely owned by the liberal left, lock, stock, and barrel.
So the conservative side gets one, just one network, and it's all: "Take up arms brothers! We musn't let dissenting opinions actually be aired!" Heaven forbid anyone actually replicate the same attack-dog reporting from the other side, or have opposing opinionated talking heads, that simply won't do!
So the liberals get the major newspapers, the conservatives get talk radio, and they're duking it out for majority shares of the TV spectrum. Has it ever occurred to you that the reason Fox has done so well is because they are the lone conservative voice on TV, whereas the liberal audience is spread across CBS, CNN, NBC, MSNBC, etc?
Consider just how balanced the nation has been over several election cycles with percentages in the 40's for both sides and independents/small segments swaying elections. Either side gets above 55% and they start calling it a "mandate", when that term used to belong to winning with 75% or more. The nation is gridlocked because neither side can earn a majority large enough to push through their agenda, and somehow one, just one network is to blame? Doesn't that just reek of partisan reporting by pretty much ALL the networks to you?
How long has Fox been around? CBS? NBC? CNN? ABC? NPR? If they were really providing an objective, independent viewpoint, would Fox have anything more than a few percentage points? The Brits are stuck with a Gov't-given independent agency where the Beeb is concerned, so they have only themselves to blame for that one, and us with NPR, for that matter... Frankly, Fox is a creation by negligence of the other networks. Had they taken care of business earlier, we'd not be having this discussion/rant...and speaking of which, I'm all ranted out, carry on.
.........post a second time and confirm just about every single point in my description of where he was likely coming from politically!
If you think CBS is left wing (or Obama for that matter) then I can only assume that you are either Hitler or Ann Rand. Or are so totally desensitised by the Tweedledee/Tweedledum nature of politics that you no longer know left from right.
"Has it ever occurred to you that the reason Fox has done so well is because they are the lone conservative voice on TV"
No. It has occurred to me that selling nonsense to gullible morons is never a bad investment, however.
"Consider just how balanced the nation has been over several election cycles with percentages in the 40's for both sides and independents/small segments swaying elections. "
Well, exactly. The difference between "left wing" and "right wing" in US politics is, to most outsiders, almost invisible.
In short, there's nothing of substance to report in US politics and one solution is to invent stuff and then scream about it. Which covers Fox News' entire editorial policy at a stroke. CNN is much the same although instead of being annoying it is simply sad and pathetic in its transparent manufacturing of fantasy news items.
It's not that the other networks are not reporting stuff, it's that they have not (quite) got to the moral nadir where they are happy to fill the air time with lies and fiction simply in order to get a reaction out of an electorate that, sub-consciously at least, know that whoever they vote for the country is run by and for big business.
Admittedly, the study is six years old, but I haven't seen much change in any of the networks to make this study out of date. Still confident of your position? Or, are you ready to admit the mainstream media are biased left of center, especially CBS? In fact, I bought the entire report and it pretty much shows Fox to be just to the right of center, with the noted exceptions, not nearly as far off center as are CBS and the other networks. Ergo, if you want more centrist news reporting, tune into Fox, again with certain exceptions.
OK, it's Saturday evening and I have other, better plans than hanging about here...
>Exactly what Ideology are CBS and NBC motivated by?
American Corporatism.
"So the conservative side gets one, just one network, and it's all"
Yeah, but Foxy News is worth at least a dozen of the other networks. See examples in the link below.
The icon is about my reaction the first time I read it. My favourite one is the one that says ""Is Afghanistan being ungrateful towards America?"
Fix found a gap in the market and filled it. Like them or not, that is the alpha and omega of it.
IIRC, didn't over 90% of the White House press corps vote for Clinton in both presidential elections, when he did not get a simple majority either time?
Oh, but there's no bias, of course.
I think you'll find the BBC are rather left of center and always have been.
Thankfully this does balance the other media outlets which aren't.
"CBS is so far left, they make the Democratic Party look Republican. And that's from scholarly research, not my opinion, BTW. MSNBC was caught actively campaigning for Obama in the last election..."
D'AHHH HA HA HA HA HA HA HA HA HA HA ...oh, damn', I've wet 'em.
Sorry, you've just set off my Teabagger Alarm. Yeah, I guess CBS and NBC are "leftist" to someone who hangs the "Marxist" tag on anyone even a crotch hair to the left of Lester Maddox. "Scholarly research"? By which researchers, and in what journals or reports? Put up or shut up.
During the recent Iraq War, CBS and NBC were among the loudest cheerleaders and most diligent suppressors of dissent, as they are during the current Afghanistan quagmire. NPR's news "reporting" has in the past decade been so pro-corporate and anti-labor that some have nicknamed them Nominally Public Radio. CNN is only different from Fox in that they do a better job of not coming off like a bunch of right-wing zanies. And far from being "leftist", MSNBC is actually tepid centrist liberal at the very best, nothing more than a Democratic Party mouthpiece... and speaking as someone who identifies as a Leftist, hearing a bunch of Teabaggers referring to the Democrats as "leftists" is, to me, simultaneously insulting and hilarious.
Recently, Fox "News" has been unable to shut up about how Newt Gingrich's serial adultery and multiple marriages would make him a "stronger President" -- totally neglecting how they ripped Bill Clinton a new one for doing precisely what Gingrich is doing: banging the staff behind his wives' backs. This only highlights the sad fact that the US "news" media have lurched so far to the right that Fox News has repeatedly been forced to break the Goofy Meter just to distinguish themselves as a right-wing media outlet.
If you turn to the right, the centre appears on your left,
On your liberal bias claims I refer you to the book "lies and the lying liars who tell them" by al Franken. Franken took on the alleged liberal bias heads on, looking at the number of pro gore and pro Clinton news reports, and anti ones. In almost all cases there were more anti than pro.
Ero, either Gore and Clinton are conservative, or it's all in your head.
I thought you could get a decent picture of the ME by letting Al Jazeera and Press cover what the other left out. Fox is just MSM on PCP, no more ideologically biased than Sky, just with added chewing the scenery and soiling itself. RT has become the refuge of independent US journalists of late.
I live in a country which embraces the freedom to disseminate information without undue government censorship.
"I live in a country which embraces the freedom to disseminate information without undue government censorship."
Which country is that?
Are you talking about Canada? At first I thought you might be referring to the US, as Americans love to talk up their constitution, but Al Jazeera is banned from broadcasting in most US states, despite offering incredibly high journalism standards (as stated by Hilary Clinton) and being broadcast in the UK without issue. And US news channels even entered into an arrangement with the government not to broadcast footage of military corpses returning home during the Iraq war. The US doesn't even make it into the top category for freedom of press.
If your statement is based upon freedom of press then it must be one of the countries with the highest rating, so it could be Canada, Norway, Sweden or Finland. It would be a lot easier if you simply included all the relevant information, rather than leaving us all to guess.
It embraced it, it extended it. Next step is...
And no, we aren't any better, or any safer from censorship here, despite $FAVOURITE_BROADCAST_NETWORK being able to air here. If I've learned anything on my travels it's that most allegedly free nations exercise a great deal of ideologically-motivated censorship and many media organisations engage in a great deal of equally-motivated self-censorship. It's just that the targets are a little different depending on each nation's culture and recent history.
I live in the UK, like the vast majority of posters on here.
A couple of years ago, that would have been commonly understood on here.
But they are Our Ideologically Motivated broadcasters, and hence Good Guys whereas PressTV is theirs and hence a Bad Guy. Simple.
Clearly the most mental "news" channel is NHK World. It somehow manages to fill 365 days of the year with absolutely nothing, but in stunning high definition. For those of you who have never seen it, I challenge you to watch for just five minutes without shouting "What the f*ck is this sh*t?" at the screen.
I really liked that channel, used to enjoy the cooking show and J-melo, hated it when they got rid of the sd channel last year, hopefully its still the same stuff otherwise im gonna be :( when i get an HD box
What do you expect?
I'm peeved that it's gone HD only.
I liked the cooking, cultural, and other factual programs, along with added world news events not covered by the likes BBC/Sky.
Unlike the BBC (and a slightly lesser extent Sky News) they do report what happing in the world even if there is no video for the morons to oggle at, and they have professional reporters rather than idiots on twitter/facebook to supply their content.
It'll mean the all-British Daily Express will be able to reclaim pole position for purveyor of weird conspiracy theories and epic idiocy masquerading as news.
One less public soapbox for that vile, despicable, poisonous slimeball surnamed Galloway. Good riddance ... for now.
And what's the dodgy interview for being fined and losing a licence ? What exactly has being said in the interview ? Where is the interview ?
Press TV interviewed a journo and broadcast clips of it without mentioning the pertinent fact that this guy was in prison at the time and threatened with execution as a spy unless he answered the questions exactly the way the authorities told him to. i.e. he was under extreme duress and Press TV didn't see fit to mention this pertinent fact while trying to disparage him.
Prove it.
Luckily much the same as the US's futile attempts at shutting down file sharing by taking out one site, Press TV is still available to be streamed to everyone on their website:
The whole thing's been done in the open. They got caught airing an interview with someone who'd been tortured (or threatened with it, or both), and was giving scripted answers, from inside a prison in Tehran.
They neglected to inform the viewers of this. That earned them a £100k fine. Which they are now refusing to pay.
They also turn out to be in breach of their license, because they're not a UK channel, but an Iranian one. Their London office isn't in charge - like they guaranteed it would be.
They could fix all of this, and keep broadcasting, but they choose not to.
Hence, no conspiracy.
I suspect their viewing figures were so pants, that it was decided that it wasn't worth keeping going. Plus they lost lots of their staff, and credibility, over their coverage of the rigged elections in Iran. Now that actually was a conspiracy...
That's not proof, that's just regurgitating what the British media have told everyone about this.
Have you seen/read the documents and all correspondence involved with your own eyes? Thought not.
Yes of course.
When faced with a simple and obvious explanation that makes perfect sense, the correct answer is the convoluted multinational conspiracy run by space gnomes.
Occam's razor is a cunning plot by the NSA to discredit Those Who Know The Truth!!!11!!
In this particular case, the ones punting the conspiracy theory are drooling theocrats who make the most ridiculous raving teapots of the tinfoil hat brigade seem eminently sensible. Why are you even bothering to attempt to breathe life into this cobblers?
See post above, with which I agree. But to give you more of an answer, I betook myself to the Press TV website, and had a good old rummage around.
They fail to make a defence, so I don't see why I have to assume they have one. So far as I can tell, they've brought the whole thing on themselves.
I've heard an interview with the guy who they broadcast, from inside a prison, but neglected to mention this (rather vital) fact. Now when I heard him interviewed, he wasn't under threat of torture. So while he would have every motive to lie (were he a real CIA agent), still he had less motive than when he gave the original 'interview'.
Also, I don't buy the Iranian government story that the CIA inspired the entire protests against the 2009 election - making it less likely he's a CIA agent... On the grounds that the CIA aren't really popular enough to get several hundred thousand people marching to the centre of Tehran, especially under the threat of beatings, possible torture or worse.
In fact, I failed to find any mention on their website of what they'd been accused of, let alone a defence against said accusations. Which strongly suggests to me, they don't have one. Otherwise, they'd make it.
So I'm going to assume wrongdoing, rather than conspiracy. Until someone provides convincing (or in fact any) evidence to the contrary. Occam's Razor.
Oh, also, I don't personally believe Ofcom could find its own arse with both hands and a map. Which leads me to doubt it's capable of taking part in an international conspiracy. Please come back if you actually have some evidence though...
You should get television the normal way, via transponders. Unfortunately Freesat and Sky use their own proprietary EPG so you need different (and very buggy) software to decode that.
If you have the chance, get a free to air receiver, get a multifeed dish and bast in the glory of foreign television. For example on 19,2° East you'll get German TV which isn't good, but has ZDF.kultur, which often airs concerts. For example they had live coverage of Glastonbury. If you can speak German you might find "Bayrisches FS" interesting. That's Bavarian television, with some programs in the local language. When they are transmitting concerts, they often are in 5.1 surround sound. "arte" is kinda like BBC four, but in German and French, so perhaps not to interesting to the British viewer.
http://www.lyngsat.com/freetv/index.html is a good introduction if you want to go channelsurfing.
No matter what you think of a channel, the decision which foreign channels you can watch should be _your_ decision, not the one of Ofcom or whatever regulator.
So it would appear that the BBC who famously refused to screen the Gaza aid appeal (for 1500 Palestinians murdered + the injured + 4000 homes and schools etc. destroyed), because they felt that the Israelis killed during the conflict (3 civilians + 10 soldiers killed, 4 those by the Israelis themselves by friendly fire) weren't getting a fair deal, is not ideologically motivated, but a paragon of virtuous fact based news that we have to pay for in Britain even if don't watch it, under threat of imprisonments (yes it's a fine, followed by jail if you don't pay the fine i.e. TV Licence), unless we stop watching all other TV as well.
Not forgetting the odd of academic study that turns up once in a while proving it's pro-Israeli bias, one even concluded that they'd convinced much of the UK populace of some rather weird ideas, including one that the Palestinians occupy Israeli lands and that they came from Afghanistan.
Funny, I object to the BBC for pretty much the opposite reason. What's going on here?
"Funny, I object to the BBC for pretty much the opposite reason. What's going on here?"
I think what's going on here must be that you're a mad Zionist. If, that is, you are seriously suggesting the BBC is biased against Israel.
I find myself watching Russia Today far more than the BBC as their news seems to cover an awful lot of things the BBC seems to be ignoring. The protests in the US were hardly mentioned on the BBC but had full coverage on RT.
I like the way RT has a different perspective on the news and makes you actually think about what is happening in the world - their reports on the banking crisis go far beyond the BBC's 'oh, they did a few things wrong, never mind, forget about it and move on'. They point out that things are still the same as ever and the banks have not changed in the slightest - not something the BBC ever mentions.
I would definitely recommend a look at RT and, as mentioned above, the Keiser Report will certainly make you look things from a different perspective which is always a good thing.
UK gov mouthpiece BBC remains on the air, as well as US govt mouthpieces NBC, CBS, ABC, PBS, CNN, MSNBC, and Fox.
Fortunately, we get Al Jazeera and Russia Today on the OTA DTV where I live (Washington DC), so we can still find out what's going on in the rest of the world -- and in our own country (which is pretty goddamn' sad when you think about it).
"Fortunately, we get Al Jazeera and Russia Today on the OTA DTV where I live (Washington DC), so we can still find out what's going on in the rest of the world -- and in our own country (which is pretty goddamn' sad when you think about it)."
Ooh, *two* international channels, now that's choice. The "land of the free" offers so much choice. Except that I bet that if you didn't live in the political capital of the country the number that are on broadcast TV would be closer to zero.
Meanwhile in Fortress Britain several (might be in the tens?) international channels, news and otherwise, successfully broadcast on satellite to millions of homes across the country without falling foul of Ofcom. Probably because they know the rules, are willing to work with Ofcom to sort it out if there are problems, and don't get fined for showing distinctly dodgy footage.
you're probably on a list at the FBI.
Don't affect me.
I use the BBC and FoxNews for my fair and balanced (TM ?) news sources.

subset: commoncrawl


text:
Eau De Reglisse Perfume
By Caron for Women
Eau De Reglisse Perfume by Caron, Introduced in 2006, it's a summer fragrance with top notes of lemon verbena and green mandarin; a heart of ginger and liquorice with a base of vanilla, patchouli, and nutmeg. All products are original, authentic name brands. We do not sell knockoffs or imitations. ... Read More
Sorry, Eau De Reglisse is not in stock
Enter your email and click "Notify Me" and we will email you as soon as it comes back in stock.
This product has 3 Out of Stock items |
3.4 oz Eau De Toilette Spray Liquorice (Tester)
Item #452395
Customers Who Bought This Item Also Bought
More Caron fragrancesfor Women: Fleur De Rocaille , Royal Bain De Caron Champagne , Aimez Moi , Miss Rocaille , My Ylang , more
for Men: Caron Pour Homme , Yatagan , Royal Bain De Caron Champagne , Caron # 3 Third Man , Yuzu Man , more
See all Caron products
Customer Comments
The prices were the best that I could find on any other fragrance sites. The service was fabulous. I was totally surprised to receive the merchandise so fast. I will definitely use FragranceX.com again for future fragrance purchases
A. Anderson (Huntington, WV)
Reviewed by 1 customer
- Clean & Fresh
- Long-Lasting
- Mood enhancing
Best Uses
- Anytime
Comments about Eau De Reglisse By Caron:
A fragrance suitable for all seasons and
any time of the day for an uplifting mood!!
Repeat purchaser.
- Gift:
- No
- Fragrance Type:
- Herbal


text:
By continuing to use this site you consent to the use of cookies on your device as described in our cookie policy unless you have disabled them. You can change your cookie settings at any time but parts of our site will not function correctly without them.
Auto enrolment and state benefits – Knowledge Direct
Old Mutual International: A winning team
Our business development support
Section Highlights
Visit the Old Mutual International Literature library
Structured products for International Portfolio Bond investors
Wealth Interactive: facts and figures at your fingertips
Section highlights
Informer – topical articles for financial advisers
Knowledge Direct – our dedicated technical financial planning resource
We are committed to helping you develop a sustainable business that's truly fit for the future.
Tax reporting requirements for FATCA and CRS
Non auto enrolement funding options
People overlook pension funding options which may be available to higher earners without breaching the auto-enrolment rules. Here we look at a pre A-Day concept applying to the new pension regime and funding.
Auto enrolment is the new government sponsored pension scheme where any qualifying individual would need to either be a member of the government sponsored NEST (The National Employment Savings Trust) or an equivalent pension scheme set up by their employer. Alternatively they could join an appropriate qualifying scheme (i.e. external non-auto enrolment scheme that meets a fixed criterion). The purpose of these schemes is to ensure that every qualifying individual has access to membership and will be saving towards their retirement in the future. The overall levels of minimum contributions are only set at a total of 8% of qualifying earnings (4% employee, 1% government tax relief and 3% employer) which come in over a series of staging dates. Information can be found on The Pension Regulator website here.
It is possible for an individual to opt out of such a scheme to run their own "non NEST" pension but they would be automatically opted back in after three years and so would need to opt out again at this point to ensure that they were not automatically set to join the scheme. This has the potential to be complex and there is a strong likelihood the people would forget these dates and deadlines.
The Collective Retirement Account is not an auto enrolment scheme nor is it a qualifying alternative scheme.
It is also worth noting that auto enrolment has an earnings threshold of £42,385 for the current year and it is only earnings below this threshold that are covered by auto enrolment and need to be funded under these rules.
Generally speaking high earners and company owners/directors will have pension funding entitlement through their contract of employment/earnings which could be well in excess of the NEST funding requirements. In these cases the employee would have the choice of either paying a larger amount into the auto enrolment scheme, or alternatively utilising something that has been historically called a top hat scheme.
All a top hat scheme refers to is a pension scheme on top of any standard pension scheme that is being offered to the general employees (i.e. top of the pile or on top of the head – so top hat). Historically speaking this was normally where an employee was a member of an occupational pension scheme where they had no control over the investment of their funds or the style of benefits that could be taken. On this basis they would have used the extra pension funding to invest into a more flexible style of contract. This used to be something like an executive pension scheme – a money purchase scheme where they have direct access to the pension fund investments they can use and maybe some option of how and in what format they take their pension benefits. An alternative to give wider investment choice would be a Small Self- Administered Scheme.
In the current post A-Day world the same scenario can be seen. Auto enrolment would be seen as the basis scheme where there are likely to be restrictions due to the charging structure and style of the scheme. The Collective Retirement Account could be seen as the top hat scheme and have significant benefits in terms of flexibility and options such as phasing, rebalancing, large investment options, flexi-access drawdown, flexible death benefits etc.
For higher earning individuals this can be seen as a very appealing opportunity to fund those pension contributions either in excess of the minimum total of 8% of the earnings threshold or just relating to higher earnings and bonuses.
Although there is nothing prohibiting the client from electing to opt out of the auto enrolled scheme every three years and fill in all the necessary paperwork to remain opted out for an additional three years, the use of the "top hat" scheme and the CRA is an efficient alternative which can run alongside the government instigated scheme with no interference until the client wishes to take benefits.
You would suggest anyone who is in a position of responsibility within the company or an owner would expect to have larger contributions made into a pension scheme than the total of 8% (4% employee, 1% HMRC and 3% employer) which is only £3,390.80.
For financial advisers only. Not to be relied on by consumers.
The information provided in this article is not intended to offer advice.
It is based on Old Mutual Wealth or Old Mutual International's interpretation of the relevant law and is correct at the date shown on the title page. While we believe this interpretation to be correct, we cannot guarantee it. We cannot accept any responsibility for any action taken or refrained from being taken as a result of the information contained in this article.
Financial Adviser Verification
The content of this site is approved for use by financial advisers only. It hasn't been approved for customers to view.
If you are NOT a financial adviser, please click here to return to Old Mutual International's homepage.


text:
Shawn Michaels won't be using his "Sweet Chin Music" move Saturday night.
Instead, he'll be on his best behavior as the WWE Hall of Famer will drive the pace car prior to the start of the NRA 500 at Texas Motor Speedway.
A three-time WWE champion and three-time Intercontinental champ, Michaels also captured a World Heavyweight Championship, European Championship and World Tag Team Championship during a 26-year career. He still appears occasionally at WWE events.
Michaels is no stranger to racing. His son, Cameron Hickenbottom, competes at Lil' Texas Motor Speedway located next to the 1.5-mile track.
The race is schedule for 7:30 p.m. ET Saturday.
MORE: NRA sponsor debate | Texas schedule | Texas winners


text:
Crew chief Jason Ratcliff worked through the weekend as his Joe Gibbs Racing team scrambled to finish building a car for testing this week at Daytona International Speedway.
As he prepared for the test, Ratcliff couldn't help but think about the potential for his No. 20 team in 2013.
After struggling through much of 2012 with young driver Joey Logano, Ratcliff now has a driver in Matt Kenseth who has 13 years of Cup experience, 24 Cup wins, eight (out of nine possible) Chase for the Sprint Cup appearances and one Cup championship.
MORE: Logano's new team | Big team changes for 2012 | Comeback candidates
That gives Ratcliff and the Gibbs team a different approach than it had with Logano, who, at 22, was still trying to learn Sprint Cup racing.
"He doesn't have to prove himself," Ratcliff said of Kenseth, the defending Daytona 500 winner. "He's bringing his credentials with him. Not that Joey wasn't, (but) it's no different than any other young guy in the sport, it just takes time."
So the time is now for Ratcliff, whose crew has a different outlook for 2013. Most of the crew is the same group that worked with Logano last year. They won one race and finished 17th points in Ratcliff's first year as a Sprint Cup crew chief.
"Do we feel like we've got an opportunity to win championships? I think so," Ratcliff said. "I think Matt has proven that he's competitive enough and experienced enough in this sport to do that regardless of what team he's with. I'd be lying if that wasn't our target."
There is pressure on Ratcliff, who won 30 races and two owners championships as a Nationwide crew chief for Gibbs, but it is different than a year ago, when he worked with a driver who had just one Cup win and had struggled in his first three years in the series. He knows that if the team doesn't perform with Kenseth, few will blame the driver.
"It doesn't really take any pressure off the race team, (but) there is no substitute for experience," Ratcliff said. "Whether it's a driver, a crew chief or a team member, any individual that makes up that team that can bring experience to the table, that's an advantage.
"So he just automatically coming in, it's going to make us a better race team because of his experience level and him knowing exactly what he needs to go fast and win races."
While Cup teams will test at Daytona Thursday through Saturday, in some ways 2013 started in late 2012 with a two-day test at Charlotte Motor Speedway.
It was the first time that Kenseth, who had spent his entire career with Roush Fenway Racing, got to test with his new JGR team.
At that test, Ratcliff expected a driver who could explain what the car was doing. But he said Kenseth's ability to dissect how the new 2013 Cup car reacted was impressive.
"He was able really to get down to the details more than I even expected, not just giving me general comments but really breaking it down what he's feeling," Ratcliff said of Kenseth, who won three races and finished seventh in the Cup standings last year. "At a test, the driver gives you his two cents and you can sit down and see if the data validates what he was saying.
"Most of the time it was. It's like having an on-board data system (with Kenseth)."
The test was an opportunity for the team to work together in a low-key environment without a lot of pressure.
"It was what we needed," Ratcliff said. "NASCAR, for us, scheduled that at the opportune time because we needed to go somewhere and just hang out for a couple of days with the team and Matt to just kind of get acclimated."
While teams will have cars ready for the test this week, the last few weeks have been a frenzy of activity because of the change to the new Gen 6 Cup car. Ratcliff said JGR wouldn't have backup cars ready for any of its three teams.
The key to the test, he said, will be seeing how the car reacts in the draft and how hot it runs in a two-car draft.
"Teams will be ready," Ratcliff said. "It's going to be the 12th hour getting there. But we're professionals and even though things are coming together at the last minute and it's going to be early in the week before we can put the final touches on it, at least it's going to allow us to get to the racetrack with a speedway package."
As for what the year might bring, Ratcliff said while the team knows it could be a championship contender, they don't necessarily talk "championship."
"Right now, we're looking at it from the perspective of which tracks do we need to work extra hard on, where do we think we're going to be strong right out of the gate and how many races can we win?" Ratcliff said. "And we'll kind of let it fall into place from there."


text:
School Raglan T-shirts are an Idakoos specialtiy! Idakoos has many things to offer. Whether you want to get a School Raglan T-shirt for a special occasion, give a School T-Shirt as a present or need to represent with a funny School Raglan Tee during Holidays or Family and Friends get-togethers, Idakoos is sure to have the right School Raglan T-shirt for you! Even if it turns out you can't find the right School Raglan Shirt with the perfect design for your mother, father or children (or friends!); Idakoos offers all of its men's women's and children's School Raglan T-shirts as Custom School T-Shirts. Personalize any School Raglan T-shirt the way you want to ensure the perfect gift.
Showing 1 - 24 of 45 Raglan T-Shirt


text:
What WSJ Canada Is Reading Thursday
By Karen Johnson
Toronto's city council Wednesday passed an unprecedented motion urging Mayor Rob Ford to step aside, a move the scandal-plagued mayor refused to make. In a new poll, 62% of Torontonians said they will not vote for Mr. Ford in 2014 "under any circumstance." Columnist Christie Blatchford, in the National Post, describes the mayor as "looking like a Kardashian wrapped inside an episode of Intervention inside a bottle of vodka."
Eighteen months after some of the world's biggest oil companies joined forces in a novel environmental-technology partnership, they have little to show for it.
Toronto architectural oddity Casa Loma might become a mixed-use complex that includes a restaurant and event rooms, as well as a museum and exhibition spaces devoted to the history of Toronto.
In a little-noticed line deep in the quarterly report it filed last week, Molson Coors warned that its core Molson brand is "at risk" of impairment.
The White House Cabinet includes 15 secretaries and eight other Cabinet-rank officers. And yet never has the job of Cabinet secretary seemed smaller, Politico's Glenn Thrush writes.


text:
Not everything that's gold glitters; sometimes it's that ancient instrument or antique silver set that shines as an investment.
The great sages knew a thing or two about investing. We may not know where the Sanhedrin stored their shekels or which mutual fund Maimonides would recommend, but the Talmud clearly spells out a strategy: diversify.
According to Nezikin (Damages, or Torts), we're supposed to divide our assets into thirds, with two portions allotted for land and business and one kept liquid. (There's even a debate over whether "land" means investing in real estate or actually burying money in the ground. Some years it's probably a toss- up.) But there are additional options beyond those three categories. Have you considered a Chippendale settee?
"There are no guarantees for anything you invest in, but antique furniture, historically, has been very steady," says Frank Levy, a fourth-generation antiques dealer. "And as far as investments go, the nice thing is it's an investment you can use and enjoy."
Levy is a partner at Bernard & S. Dean Levy, which started on New York's Lower East Side at the turn of the last century and specializes in American furniture. And although he's a New Yorker, Levy points out that early pieces from Philadelphia are "substantially more valuable" than those from his hometown — not that we're competing. He'll head here in April to show off his wares at the Philadelphia Antiques Show.
In terms of value, furniture from the 1730s up to the American Revolution — the Queen Anne and Chippendale periods — has held steadiest over the years, Levy says, which means items in decent condition from that time frame are probably your best bet if you're looking for an investment piece.
Of course, it also means they're more expensive to purchase. But prices as a whole are down right now, Levy says: "It's a really good time to buy. You could put together a good collection for a percentage of what you would have paid 10 years ago."
Also popular, though less so, are the more delicate furnishings of the Federal period (after the Revolution until around 1825). "It's very attractive stuff," Levy says, "and I think it has a chance to pick up."
Not only have these pieces been around for a while, but the practice of investing in them has, too.
"Alternative investments are a really hot area, but a really old area as well," predating stocks and bonds, says professor Chris Geczy, director of the Wealth Management Initiative at Wharton.
Geczy, who frequently advises clients on alternative investments, cites diversification as the "palpable benefit" of adding things like antiques, stamps, and rare coins to your financial portfolio, because returns over time are different from other investment classes.
"If you split your eggs across baskets, you're not going to drop them all at once," he says.
(One exception might be fine art, which appears to be correlated to stock market performance. It has "kept pace with the stock market," Geczy explains, "but the point is to do something different from the stock market.")
Illiquidity and the difficulty of valuation are the main risks of offbeat investments, Geczy says in fluent Wharton-speak. In other words, that Chippendale settee might be hard to unload quickly if you need cash in a hurry and, even if you find a buyer, you need a good amount of subject-specific knowledge to recognize whether you're getting a fair price.
Other downsides include the risk of damage to your collection and, in some cases, the issue of scarcity. Geczy uses Beanie Babies, the popular stuffed animal that was a hit with collectors in the 1990s, as an example. The manufacturer limited production, keeping the toys relatively rare — but if the company decided to make more, existing Beanie Babies would likely lose value.
That said, the "psychic benefits" — the pleasure of consumption — shouldn't be discounted. "It all comes down to the perceived benefit. Part of the pleasure is becoming an expert and knowing about what you own," Geczy says.
Fred Oster of Vintage Instruments agrees. Oster, who opened the Center City shop in 1974 and has appeared on Antiques Roadshow, sells old and antique acoustic instruments. Most of his clients are musicians who plan to put the instruments to use. "As investments, instruments are not necessarily better than anything else. But people buy them because they like them," he says.
Playing an antique violin or banjo doesn't automatically downgrade the value the way using a different kind of antique might; in fact, it's good for the sound. The exceptions are some extremely rare, historically important instruments that get top marks for maker, provenance, condition and originality. With one of those, Oster says, "you probably don't want to schlep it around and play it."
Violin values have proven the most constant over the years, with acoustic guitars coming in second, though, like with most things, it depends on the mood of the market, he says.
Either way, as with antiques or art, you still get those psychic benefits. "They provide tangible pleasure. With artwork, for example, you can put it on the wall and enjoy it," says Geczy of Wharton. "Most people don't hang stocks on the wall. You don't say, 'Come look at my beautiful mutual fund.' "
Rachel Vigoda has written for papers and publications throughout the region on a variety of topics. This article originally appeared in "Financial Health," a special section.


text:
Ira Winderman: O'Neal, James invaluable
A midseason look at where the NBA's other hardware is headed, while acknowledging that any championship parade will not be scheduled on eastern daylight time.
Most Valuable Player
Jermaine O'Neal.
Blasphemy, giving the league's top honor to someone from its lesser half? Perhaps. Yet while Indiana has built the bulk of one of the league's top records mostly against inferior Eastern competition, O'Neal stands as the game's best young two-way player, on a team that, beyond Ron Artest, hardly overwhelms with its roster.
Over the first half of the season, O'Neal has been the Tim Duncan of the East. Of course, Duncan remains the Tim Duncan of the West. But he's had his turn, so consider it along the lines of: Sure Michael Jordan should have won every year, but we recognized the value of diversity.
Others in the current top-five for consideration, from this view, are Duncan, Kevin Garnett, Baron Davis and Peja Stojakovic. Yup, no mention here for Shaq, who seems to have little interest in regular-season anything.
Seems nothing's changed
A pregame meeting between Blazers general manager John Nash and Dallas director player of personnel Donnie Nelson ended at odds, with both teams agreeing to abandon trade talks, but the Blazers' struggles continued with a 108-104 loss at the Rose Garden, their eighth loss in nine games.
Nash and Nelson met for about 20 minutes -- until pregame introductions -- before emerging with smiles, both content to move on with their seasons, which are heading in different directions.
"If it could mesh, we would have meshed by now," Nash said of the trade talks. "It seems like we have spent a lot of time talking, and we have been unable to come to a common ground."
So a deal with Dallas is dead?
"Dead is a strong word," Nash said. "I think it's safe to say there is nothing imminent."
Raptors reach out to Oakley for late-season help
The search for another big man has led the Raptors to contact an old, familiar, often-cranky veteran:
Charles Oakley.
Two team sources confirmed yesterday that the Raptors have called the cantankerous power forward to see if he'd be able or interested in helping Toronto over the final three months of the regular season.
The 39-year-old power forward has been working out on his own and hopes to land with some NBA team for a final playoff push either later this month or around the Feb. 13-15 all-star break.
The Raptors, who are now using a front-court rotation of Chris Bosh, Donyell Marshall, Lonny Baxter and, sometimes, Michael Curry, are most concerned about whether Oakley's skills have diminished to the point where he wouldn't be able to help at all.
The 6-9, 250-pound, 18-year NBA veteran always keeps himself in good shape and would lift the Raptor basketball IQ by a huge amount if he joins the team but if he can't play, it could become a distraction.
Orlando's Juwan Howard, a college teammate of Raptor Jalen Rose, is in play, according to a variety of NBA sources, and Toronto might have some interest, according to one source. However, Howard is in the first year of a six-year, $35 million (all figures U.S.) contract that would pay him $7.3 million when he's 37 years old.
The Magic, who have the worst record in the NBA at 10-30 before last night, are looking to divest high-priced players. The Raptors could offer a package of expiring contracts and Lamond Murray, who has four fewer years on his deal that Howard, and make the salaries match.
Along with Howard, other NBA big men on the market include Phoenix's Jahidi White, a huge centre who doesn't possess the kind of basketball smarts the Raptors would want, and perhaps San Antonio's Malik Rose, who has fallen out of favour with Spurs coach Gregg Popovich.
Doctor: Chance he could play
Four weeks after Alonzo Mourning had a kidney transplant, he is craving a workout.
He tells his doctor that he wants to run and lift weights. By the end of this season, perhaps he will want to play basketball, too.
For now, Mourning must continue to rest. He cannot participate in any physical activity for at least another two weeks, but his recovery has gone so smoothly that his doctor, Gerald Appel, says there is a chance that Mourning will be able to return to the NBA and rejoin the Nets.
''As well as I've known Alonzo the last three and a half years, I know that it's in the back of his mind.'' Appel said. ``So it has to be in the back of my mind, too.''
Stern's Concerns
Commissioner David Stern had some interesting thoughts on his long-held belief that the NBA should have an age minimum.
"I want to say gingerly that in my experience as commissioner age was not a factor in judgment in whether you should throw somebody through a plate-glass window (Charles Barkley), kick a photographer in the groin (Dennis Rodman) or other behavior defined as anti-social.
"Id like to marshal every argument in favor of my point of view that its a good thing that players dont come into the league at such a young age. But I also realize that the evidence is all over the lot.
Atlanta teen Dwight Howard is expected to be the third prep star to be taken with the No. 1 overall pick when the June NBA draft rolls around.
Thats not quite as alarming to Stern as it used to be. He says hes not concerned about such talents as LeBron James, Tracy McGrady and Kevin Garnett.
Instead, its the elementary school kids with unrealistic dreams that bother Stern most.
"There are going to be huge numbers of kids whose parents are already approaching me and telling me, Hes 11 years old, and he can bounce the ball extremely well, and he aint going to college because he thinks hes going to go to the NBA. And I emphasize the use of the word aint.
"Everyone knows that the chances of that young man becoming a rocket scientist are better than making the NBA.
"It just doesnt make me feel great having a system that sort of encourages kids to focus on only one thing. But Ive been a lone voice on this.
White lets game do the talking
Rodney White's future remains as uncertain as his stat line, which continues to zig and zag with the best of them.
The Nuggets' swingman may have the most deceptive scoring average on the team. His 7.4 points per game hides the fact he could be good for the 23 he scored against Boston in December or the nine combined points he scored during Denver's three-game road trip last week.
White's name hasn't surfaced publicly in trade rumblings in recent weeks, but that doesn't mean he feels any more secure about his status with the team.
"I still hear trade rumors," he said last week. "I try to just focus on game by game and let my agent focus on that. That's what I pay him for. Let's just see what happens from here."
"We haven't really pursued anything with Rodney," Vandeweghe said. "I like Rodney. I like him as a player. I like him as a person. He has worked very hard this past month, and I think he has shown a lot of improvement."
Van Exel takes time to rest
Nick Van Exel knew his painful left knee was affecting his play. He just didn't realize how much until his phone rang Wednesday night.
"I was talking to a buddy of mine," Van Exel recalled of the cross-country conversation. "(He said,) 'You got your shot blocked by Jason Williams and Earl Watson' (in the Memphis game Monday night)."
The veteran point guard thought about that for a second and drew the obvious conclusion: He needed to take some time off.
After discussing it with coach Eric Musselman at Thursday's shootaround, Van Exel placed himself on the injured list.
The team's second-leading scorer will be eligible to return to the active roster a week from today, but that seems unlikely. If nothing else, Van Exel promises to be patient this time, saying he will work on strengthening the muscles around the surgically repaired knee.
"I'm so frustrated right now, not helping the team, it's killing me," he said of a recent stretch in which he failed to hit at least half his shots in 11 consecutive games. "I don't know how long I'm going to be out."
Jamison's fine with role as sixth man
On Oct. 20 -- eight days before the season opener against the Lakers in Los Angeles -- the Mavericks picked up three-time All-Star forward Antoine Walker in a trade with Boston. Walker immediately moved into the starting lineup, and Jamison became the early season favorite for the NBA's Sixth Man of the Year Award.
At the time, Jamison embraced the deal. He said Walker's arrival not only added another weapon to a team fill with weapons, but that moving to the bench also allowed him to adopt a score-first, everything-else-second approach.
Three months later, he's still fine with it.
"I just looked at it as a situation where I get the opportunity to win a lot more," he said. "When you're on a team like this, you need certain guys to sacrifice and I didn't really think it was a problem."
Jamison said the toughest adjustment he has had to make coming off the bench has been adjusting to the flow of the game.
"When you come off the bench, the game already is at a certain tempo that you have to try and match," Jamison said. "After four and a half years as a starter, coming off the bench was definitely something new and something that I had to get comfortable with all over again.
"I'm happy, man. I can't complain at all. Things happen for a reason, and hopefully I'll be here for a while and we can get things rolling."
Loss leaves Pop peeved
After keeping his team in the locker room for more than 20 minutes following its 89-79 loss to Indiana, Gregg Popovich finally emerged with a sandwich in his left hand and fire in his belly. He said the loss was the most disappointing of the season because it was not unlike the one the Spurs suffered two nights earlier to Minnesota.
For that, he faulted nearly everyone in uniform. And himself.
"I've let the team down from a coaching standpoint in that I have not been demanding enough or made enough people responsible to compete and perform a certain way during practices and shootarounds," Popovich said. "I've been too patient, too lax, too ready to just assume things are going to get better as people spend more time here.
"That isn't good enough. That lies strictly with me. In that regard, I've let them down significantly. That will be changing immediately."
Chris Tomasson: Camby prefers Nuggets; they like him
Why would Camby opt out?
"He wants to sign a long-term deal," Kaplan said. "Marcus wants to be in one spot. He wants to know where he's going to be playing."
But would Camby be willing to take a pay cut? He doesn't sound all that enthralled with that prospect.
"I'm not looking to take one, but that's (Kaplan's) job to get it done," he said. "I have to worry about playing."
Kaplan talks about Camby signing a contract similar to the seven-
year, $68 million deal Sacramento big man Brad Miller got last summer. But Miller this season is making $7 million, which, at last look, is less than what Camby is now getting.
"It's unlikely he would take significantly less (for next season), but I could see a situation where he might make nominally less," said Kaplan, who believes Camby could be in a better overall situation if he has the security of a long-term deal.
If Camby opts out and then doesn't get a deal he likes from the Nuggets, his options could be Phoenix, the Clippers or Utah, teams that figure to be $7 million or more under the salary cap. Other teams likely wouldn't be able to offer more than the midlevel exception of $5 million.
"Wherever the price is right," Camby said. "But my first choice is to stay in Denver."
Rodman as a mentor in NBA?
Although he'll turn 43 come May and hasn't played in an NBA uniform in nearly four years, Rodman left one courtside observer convinced Friday night that he can hang with most power forwards in the league and teach the league's barely-out-of-their-teens- and-younger set more than a thing or two about how the game is supposed to be played, in the process.
"The Lakers could use him right now, especially with Karl Malone out (on the injured listed),' Sean Higgins said, smiling and shaking his head in admiration, no doubt, for what he just seen of Rodman, although the Higgins-coached Fresno team lost in the process in the Pyramid, 130-110.
"He can still rebound his butt off and frustrate opponents, especially the young guys,' Higgins said.
"And, with the nature of the game now, with so many young guys who still have so much to learn about the game is supposed to be played? Yes, he can play.'
When Higgins came into the league (in 1990, with the San Antonio Spurs), "there were so many guys in the league, 10- to 15-year veterans, who could teach you how to play,' he said.
"Now, who are those 19- or 20- year-old guys in the NBA learning from? They're 'learning' it from guys who are 21 or 22. Now, if you've been in the NBA for three or four years, you're a 'veteran."


text:
Royal Wootton Bassett Town Council is urging residents to take part in a community event that will take its Neighbourhood Plan to the next stage.
The event, which takes place on the ground floor of the Civic Centre on Saturday from 10am until 3pm, is open to everyone.
Mayor Mike Leighfield, chairman of the council's Neighbourhood Planning Steering Group, said: "This is all about the development of the town over the next 20 years and beyond, what gets built and where the infrastructure and facilities will go."
The Neighbourhood Plan is set within the boundaries of the town but will take villages and towns on its borders into consideration when plans might impact upon them.
To attend the event, email Mark Goodman at firstname.lastname@example.com or call Royal Wootton Bassett Town Council on (01793) 850222. Refreshments will be provided.
For further information visit www.wiltshirecouncil.
gov.uk or www.royalwootton bassett.gov.uk


text:
Samuel Patrick Smith's Linking Ring routine is now available on a fully searchable DVD!
The Chinese Linking Rings is one of the most talked-about effects in magic.
This video features live show performance, plus an easy-to-follow studio explanation of each move. If you've ever tried to learn the rings by reading descriptions in a book, you'll really appreciate the clear video close-ups and slow-motion effects!
You can perform this routine for kids or adults and get great reactions from any audience.
Moves explained in the routine include Simple Count, Strike Link, Tumbling Ring, Figures, Separating Rings, Proving the Rings Solid, plus proven presentation tips.
Running Time Approximately 15min
No reviews yet. Do you own this product? Write a review.