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CANBERRA (Reuters) - Kevin Rudd was sworn in as Australian prime minister for the second time on Thursday, a day after toppling Julia Gillard and three months ahead of elections in which opinion polls show the ruling Labor Party faces a devastating defeat.
Rudd's return as prime minister follows three years of squabbling within the Labor leadership and as the world's 12th largest economy faces challenges stemming from a slowdown in top trade partner China.
Rudd, a Mandarin-speaking former diplomat, has highlighted the difficulties associated with "the end of China's resource boom" and said he would work to rebuild the government's strained relations with the business community.
He left open the option of changing the September 14 election date, telling parliament that prime ministers had the right to choose the date.
"There is not going to be a huge variation one way or the other," he said.
Australian business was scathing of the political instability and urged Rudd to abandon laws that strengthen trade union access to the workplace and tighten rules for temporary skilled immigration.
"Our tolerance factor with instability in the leadership of Australia's government is at breaking point, matched only by a swathe of anti-business policies which have brought business frustration to boiling point," said Peter Anderson, chief executive of the Australian Chamber of Commerce and Industry.
"The economic challenges facing Australia, especially our declining competitiveness, high cost structure and low confidence, are serious."
The favorite to win the coming elections, opposition leader Tony Abbott, has promised to scrap a carbon tax and a 30 percent tax on iron ore and coal mine profits if he wins power.
He has also promised tighter control of public spending, a speedier return to surplus budgets and stronger economic growth.
Rudd's first task will be a major cabinet reshuffle after a string of senior ministers loyal to Gillard resigned, including former deputy prime minister and treasurer Wayne Swan, Trade Minister Craig Emerson and Climate Change Minister Greg Combet.
Former Immigration Minister Chris Bowen was sworn in as Treasurer and Transport Minister Anthony Albanese was sworn in as deputy leader on Thursday.
Financial markets see few implications for the $1.5 trillion economy, which is struggling to cope with the end of a historic mining boom as commodity prices fall and a record pipeline in resource investment starts to falter.
Manufacturing has been hurt by a strong Australian dollar and other sectors of the economy are struggling to pick up the slack as the mining bonanza fades.
"While some bounce in the polls and possibly confidence is expected, the political games will be largely a sideshow to deeper issues in the Australian economy," Nomura interest rate strategist Martin Whetton said of Rudd's re-appointment.
Illustrating the challenges, almost 1,000 jobs were cut from Australian coal mines this week alone.
Voters welcomed back Rudd, always among the most popular of politicians.
"I am glad that we've now been given the opportunity to have the prime minister we voted in several years ago," said Peter Mayson, who works in the building industry in Sydney.
Rudd, who was prime minister from late 2007 until 2010, said thoughts of the good of the nation had spurred him to abandon a promise this year never to run for office again, following a failed bid to unseat Gillard.
Opinion polls had shown Gillard's minority government could lose up to 35 seats, giving the conservative opposition a massive majority in the 150-member parliament.
Gillard, his former deputy, who ousted him in 2010 and led a minority government, then fought off two attempts by Rudd to reclaim the leadership, said she was quitting politics at the next election after losing the party ballot.
"Political life is a very hard life, a very hard life indeed," Rudd said, asking fellow lawmakers to be a little "kinder and gentler" with each other.
Analysts said the dramatic leadership change should help lift Labor's standing in opinion polls, although the initial boost might not last until the elections and Labor was still likely to lose power.
"I think Kevin Rudd will probably do better than Gillard would have done," Nielsen pollster John Stirton told Australian radio on Thursday. "Where it could come unstuck is that the initial burst of support simply may not last."
Abbott has urged Rudd to call an election for early August to end the instability and to let voters decide who should be prime minister.
Additional reporting by Lincoln Feast and Maggie Lu in Sydney; Editing by Stephen Coates and Clarence Fernandez

subset: commoncrawl


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If there's one lesson all young viewers viewers should learn from watching Teen Mom, it's that parenting is incredibly challenging and probably not the sort of lifestyle you're ready for when you're still in high school.
Unless you can get a reality deal out of it, that is. Because if you can make that happen, you'll be earning the kind of salary most adults can only dream about.
Amber Portwood, the 20-year-old who got pregnant at 16, got snapped up by MTV, and was recently jailed for allegedly abusing her babydaddy, makes—are you ready for this?—$280,000 per year.
Portwood's legal troubles are the reason her salary has been made public. While shooting Teen Mom, MTV cameras recorded Portwood hitting Gary Shirley, her ex-fiancee and father of her child. She was booked on two felony counts and a misdemeanor for domestic battery on December 27, and upon being released from jail on a $5,000 bond, she appeared before a Madison County magistrate who ordered her to reveal her earnings.
Portwood stated her occupation was being a "television personality." When asked to reveal her salary, her lawyer initially objected, but was overruled. Portwood was forced to disclose that she makes $140,000 with a six-month MTV contract, for a $280,000 annual paycheck.
So many questions. Is that a typical Teen Mom salary, and if so, why do they always seem so broke? Or did Amber get a special deal for being a man-smacking trainwreck? Finally: is that money going to her kid's eventual counseling needs? Or for stilettos and more ill-advised tattoos?
The really sick thing is that as inflated as that salary sounds, it's probably nothing compared to what MTV is pulling in for Teen Mom. I can't decide if I should be disgusted that Amber is earning this kind of money, or outraged that MTV is paying her such a small percentage of their pregnant-teen-fueled profits.
Actually, I think I'm just depressed that these shows are so insanely popular.
What's your take on Amber Portwood's $280K salary?
Image via Twitter


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Optimizing system resource utilization is a key design objective for system engineers in communications, electronics, and other industries. System resources such as processors, memory, or bandwidth on a communication bus are often shared by various components in the system. To understand the utilization of a shared resource, system engineers must identify constraints on the resource, such as number of processors and memory size, and analyze the effect of input traffic or load on the shared resource.
The time-varying nature of the input traffic makes it difficult to analyze behaviors such as congestion, overload, end-to-end latencies, or packet loss. The challenge is to efficiently model the system's response to changing input traffic patterns. These systems are best modeled as event-driven or activity-based systems, since the input traffic activity places the load on the shared resource. Discrete Event Simulation is the most suitable simulation paradigm for modeling event-driven or activity-based systems.
SimEvents extends the Simulink environment for Model-Based Design into the discrete-event simulation domain. In this article, we use SimEvents to analyze resource constraints on three typical systems:
- An Ethernet communication bus
- A real-time operating system (RTOS) with prioritized task execution
- A shared memory management system
In each case, the simulation results will enable us to understand the effects of resource constraints on the system and to determine next steps.
Ethernet Communication Bus
The system in this example is a LAN consisting of three network interface cards (NICs) that share bandwidth on an Ethernet bus. We want to add another NIC and a printer to the bus—but will the bus have enough bandwidth to support them?
To answer this question, we must determine the channel utilization by evaluating the current load on the bus. As utilization increases, the end-to-end latency experienced by a packet increases in a non-linear fashion.
If the Ethernet bus is heavily utilized by the current load, it cannot support additional devices; connecting new devices will increase communication latencies and reduce throughput for all the devices.
Figure 1 shows the SimEvents model of the system. The model includes the application that sends and receives data over the Ethernet bus, a medium-access control (MAC) controller that governs each computer's use of the shared channel, and a T-junction that connects the computer to the network.
The terminator, T-junction, and cable blocks at the bottom of the model represent physical components of the bus. The blocks labeled "Cable" model the communication latency based on the cable length.
Standard Ethernet networks use a Carrier Sense Multiple Access with Collision Detection (CSMA/CD) protocol to manage use of the shared channel. Within this protocol, a collision occurs if transmissions from two computers compete for use of the channel. The colliding packets can make additional attempts to access the channel. The number of attempts and the time intervals between them are determined by a binary exponential backoff algorithm—implemented in the MAC Controller subsystem in our example. The Stateflow chart in Figure 2 shows the implementation of the binary exponential backoff algorithm.
In this setup, all applications transmit at an average rate of 100 packets per second and the packet size varies from 64 byte to 1500 bytes. Simulation of this system enables us to visualize characteristics such as the utilization of the Ethernet bus, the throughput for a particular computer, and the average latency for message transmission. Figure 3a shows the overall channel utilization, or the proportion of time that the channel is in use. We can also visualize other characteristics, such as the throughput of node B (Figure 3b).
Channel utilization is low, indicating that the bus might be able to support additional traffic. We can now incorporate the traffic from additional devices into the model and study their effect on overall channel utilization and the throughput of individual devices.
Next steps could include testing the model with different parameter sets and traffic patterns by using SimEvents with SystemTest to perform Monte Carlo analysis on the model.
Real-Time Operating System with Prioritized Task Execution
This example models the prioritized task execution in an RTOS. Tasks with different priority levels share the processor in such a system. Typical tasks include low-priority application tasks in the main loop of the RTOS and high- priority interrupt tasks that invoke interrupt service routines (ISRs). Execution of interrupt service routine delays the processing of application tasks since the application tasks wait in the task queue while the ISR is executing.
Ideally, the number of tasks waiting in the task queue should not increase and the RTOS should return to the idle task to avoid excessive processing delays. How can we verify that the RTOS satisfies this requirement?
To answer this question we must model the shared processor and its interaction with application tasks and interrupts. Specifically, the model should demonstrate priority-based task execution and preemption. Figure 4 shows the SimEvents model of such a system.
The Task Token Generators section contains subsystems that generate high-priority tokens for interrupts and low-priority tokens for application tasks. The tokens carry an attribute (TaskExecTime) that indicates the execution time for that task. The Task Token Manager section contains the task queue and the processor shared by the input tasks. The Priority-Based Task Queue sorts the current queued tasks according to priority. Interrupt task tokens entering this queue preempt the application task token being served in the processor. Upon preemption, the application task returns to the Priority Based Queue. This task resumes its processing when the interrupt service routine is complete. The dashed function-call signal lines are used to generate tasks whose execution depends on the completion of another task.
We simulate this model and generate a plot showing the number of tasks in the task queue changing over simulation time (Figure 5).
The plot indicates that the number of tasks waiting to be processed increases over time and that the task queue does not return to an empty state. It seems that the processor is not fast enough to support the high input rate of tasks.
Since we cannot control the input rate of tasks, next steps might include exploring the use of a high-speed processor to reduce the number of tasks waiting in the task queue.
Shared Memory Management
The system in this example is a communication device on a custom hardware board or a system on a chip that manages a buffer shared by the transmit buffering and receive buffering functions. Messages are dropped when the buffer is full. Low packet drop rate for the receive buffer is more important than the transmit buffer because packets can be retransmitted if they are dropped from the transmit buffer.
The quality of service (QoS) requirements limit the probability of losing received packets to 1%. How do we determine whether the design has enough memory to satisfy this requirement? To answer this question we need to model behaviors such as packet loss from the receive buffer and its relation to the size of the shared memory.
Figure 6 shows the SimEvents model of this system. The upper part of the model describes a receive buffer, where messages arrive from an I/O device such as a universal asynchronous receiver transmitter (UART). The lower part of the model describes a transmit buffer, where messages wait before transmission.
Both receive and transmit buffers model the following processes:
Generation of variable-size messages. The traffic-generation process generates messages with variable size. Each message consumes a certain space from the shared memory, depending on its size.
Regulation of the messages that cannot be stored in the buffer. When a buffer size crosses a user-defined threshold, the Message Flow Regulation subsystems begin to drop incoming messages.
Storage of messages in a buffer. The receive and transmit buffers share memory, and the receive buffer is given a preference. The memory available for transmitting messages is limited to that which is unused by the receive buffer. The Transmit Buffer and Receive Buffer subsystems both have input signals labeled "cap" that represent the capacity of each buffer.
Service of messages. The block labeled Rx Message Server models the delay in forwarding messages over the I/O bus that connects to other components. The block labeled Tx Message Server models the delay in transmitting messages.
During simulation, the Rx Message Loss Rate block displays packet loss rate for receive buffer. As Figure 6 shows, the packet loss rate at the receive buffer is 6%, which does not satisfy the QoS requirement of 1%.
To study the effect of memory size on this packet loss rate, we simulate this system with increased memory size. The following packet loss rates are observed for these simulation runs:
|Memory Size
|Rx Packet Loss Without Priority-Based QoS
These results indicate that packet loss rates decrease as memory size increases. As a system engineer, however, you might want to explore other techniques to reduce the packet loss rate, such as implementing prioritized regulation of messages (dropping low-priority messages before high-priority messages) and clearing the oldest messages from a buffer when the buffer size crosses the threshold. An advanced version of this model shows that the packet loss rate can be reduced using these techniques. The following table shows the packet loss rates with this advanced model.
|Memory Size
|Rx Packet Loss With Priority-Based QoS
|Packet Loss (Low Priority): 1.13%
Packet Loss (High Priority): 0 %
Benefits of this Approach
This article illustrates the value of discrete-event simulation using SimEvents to perform the following design tasks:
- Identify constraints on shared resources and bottlenecks in a system
- Simulate the effects of variable input traffic, such as congestion, packet loss, and increased end-to-end latencies
- Explore different design techniques and algorithms to optimize resource allocation
The real strength of this approach comes from the integration of SimEvents with MATLAB and Simulink. In addition, integration with tools such as SystemTest and Stateflow enable many other design tasks, such as Monte Carlo analysis or implementing control logic in event-driven systems for Model-Based Design.


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I was born in Djakovica. My father's family lived there for 400 years having come originally from central Serbia. My father was a miner and he worked in a chromium mine at Deva which is close to the Albanian border. My mother was from Orahovac.
When I was a child she always used to tell me,"be careful of Albanians." By that time, in the 1970s, Serbs were only 10% of the population of Djakovica, but they used to be much more.
I remember when my best friends moved to Belgrade. Almost every year, families from my neighbourhood moved there. When I was growing up my street was 90% Serbian and even officially called Serbian Street (Srpska Ulica). Now it is officially called Kosovo Liberation Army Street.
Bearing in mind what my mother told me, I was still friends with Albanians and that helped me learn Albanian well. My father spoke it wonderfully, but my mother less so because in Orahovac there were more Serbs and Albanians even talked Serbian at home.
Albanian friends used to visit me at home and I was invited to theirs too, but this was unusual. Typically people were quite friendly but generally they did not go to each other's homes.
The first time I was frightened of Albanians was just after 11 March 1981, when the major Albanian demonstrations began. I was sixteen. My Albanian teacher said we should not go to school for a few days. I asked him why we had not seen yesterday's student demonstration on television, while we could see what was happening in Lebanon or other places where there was conflict.
He told me to wait five minutes. The he came back with the head and then I was taken to see the director of all the schools in Djakovica, an Albanian. He was very aggressive. He asked me if I wanted to see how the police were beating Albanian kids and said that I was a Serbian nationalist and that he would do all he could to see that my father lost his job and that it would be best if my family left Djakovica.
I remember I was really afraid. I did not know what I had done wrong. Then I was allowed to call my uncle, who was one of the directors of a very large textile factory. They said:"He is a good man, but you are Serbian garbage." After that, my mother intervened and we went to see the Albanian mayor, who said that if we had any more problems we should come back to see him. The whole thing was a trauma for me and later, although I had the best marks, the Albanian teachers tried to give me bad grades, but they were stopped from doing so when I appealed.
After 1981 the atmosphere changed. The largest slice of power was in the hands of the Albanians. When Slobodan Milošević came to power in 1987 everything remained the same, only the power was transferred into the hands of Serbs.
There is something very specific about Djakovica. The people from the town really loathe the people from the countryside. Albanians used to say:"We would prefer to see you Serbs here than our peasants!"
I went to university in Belgrade and when I came back I was asked to be the director of the Hotel Paštrik. The only problem at the time was that I was not a member of Milošević's SPS [Socialist Party of Serbia] and I did not join. I was not politically active, but I did have to make some compromises. For example I had to organise some lunches and dinners for the SPS which the mayor told me the hotel would cover for.
In December 1993 I decided to kick out 43 police officers from Serbia and Montenegro who had been billeted in the hotel, but did not pay. They had already been there for two years. But I had 144 employees to take care of, half of them Serbs, half of them Albanians. They all warned me not to play games with the state and said:"You are crazy!" But it worked, and from January 1994 they began to pay.
Because of the police in the hotel Albanians boycotted it, but I managed to bring them back, especially since it was the best place for wedding receptions. The only thing I asked of them was not to sing Albanian nationalist songs because then the police would act and make problems for me and for them.
When the bombing started on 24 March 1999 I was on the fifth floor of the hotel but by now I was the chief of Radio Djakovica. I could see half the town burning. I went into the studio and broadcast a message to Albanians asking them to stay, saying that when all this had passed, we still had to live together again.
After that I was mobilised. I was on the border and was a witness to everything, good and bad. I was sad because of that, but happy I did not have to fight.
At the end I understood that for me and my family, life was finished in Djakovica. When I got back from the border my wife, who was with our young son and was eight months pregnant, told me 60% of the Serbs in our street had already left. Because of the trauma, she lost the baby.
I started the car and my father said,"I want to stay and protect our home." For the first time in my life I actually used violence to push him into the car. We drove to Prizren and there four Albanians jumped on the car, one in KLA uniform with a gun. My gun was between my wife's legs. I told her to cover it. Then the Albanians were distracted when they saw someone else. Luckily we then met up with a military convoy, so I knew we were safe.
For five months we ended up in Svilajnac in central Serbia. Then the Serbian government sent me back here to North Mitrovica to work for the Ministry of Information and I also worked for a television station. When [Serbian premier Zoran] Djindjić was killed in 2003 though I was fired.
Then I began to work for a Serbian news agency and from 2002 I had been working for Reuters.
In the beginning Mitrovica was an unknown place for me. Although I am a Serb I was a foreigner here but over time I have met people and have got used to it. It is better for us to live here than in Serbia proper because here I earn more money. I would like to buy a house in Zvečan, which is nearby and I think we will stay here.
Regardless of the status resolution it will be like Banja Luka [capital of the Republika Srpska in Bosnia] here.
Because I speak Albanian and important people know me [Albanian-inhabited] South Mitrovica is open to me, but it feels like another country. I only go to places or cafés where I know the owner or most of the clients.
If Albanians try to use violence here I am not scared because I know 500 Serbs, ordinary people, who will stay and fight for their families. They are already organised enough to do that. If the border with Serbia was hermetically sealed and Albanians attacked I am sure my wife would take a pistol and I will take a gun, but only to defend ourselves and our kids. Actually though I don't think violence will come.
I don't believe we can build a wall here between north and south. And you know what? I can tell you that every day there are at least 250 Albanians coming to the north and 100 Serbs going to the south to do all sorts of business. Seventy per cent of the stuff sold in shops in the north comes from wholesalers in the south but the majority of those goods come from Serbia! There are no big companies here in the north so it is cheaper to buy from Albanians who buy in bulk from Serbia.
August 2007
Tim Judah


text:
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text:
depo-subq provera (medroxyprogesterone acetate) injection, suspension
[Pharmacia and Upjohn Company]
Physician Information
Women who use depo-subQ provera 104 may lose significant bone mineral density. Bone loss is greater with increasing duration of use and may not be completely reversible.
It is unknown if use of depo-subQ provera 104 during adolescence or early adulthood, a critical period of bone accretion, will reduce peak bone mass and increase the risk for osteoporotic fracture in later life.
depo-subQ provera 104 should be used long-term (e.g., longer than 2 years) only if other methods of birth control are inadequate (see WARNINGS, section 1).
Patients should be counseled that this product does not protect against HIV infection (AIDS) and other sexually transmitted diseases.
depo-subQ provera 104 contains medroxyprogesterone acetate (MPA), a derivative of progesterone, as its active ingredient. Medroxyprogesterone acetate is active by the parenteral and oral routes of administration. It is a white to off-white, odorless crystalline powder that is stable in air and that melts between 205° and 209°C. It is freely soluble in chloroform, soluble in acetone and dioxane, sparingly soluble in alcohol and methanol, slightly soluble in ether, and insoluble in water.
The chemical name for medroxyprogesterone acetate is 17-hydroxy-6α-methylpregn-4-ene-3,20-dione 17-acetate. The structural formula is as follows:
depo-subQ provera 104 for subcutaneous (SC) injection is available in pre-filled syringes (160 mg/mL), each containing 0.65 mL (104 mg) of medroxyprogesterone acetate sterile aqueous suspension.
Each 0.65 mL contains:
|Medroxyprogesterone acetate
|104 mg
|1.040 mg
|0.098 mg
|Sodium Chloride
|5.200 mg
|Polyethylene Glycol
|18.688 mg
|Polysorbate 80
|1.950 mg
|Monobasic Sodium Phosphate ∙ H2O
|0.451 mg
|Dibasic Sodium Phosphate ∙ 12H2O
|0.382 mg
|0.975 mg
|3.250 mg
|Water for Injection
When necessary, the pH is adjusted with sodium hydroxide or hydrochloric acid, or both.
depo-subQ provera 104 (medroxyprogesterone acetate injectable suspension), when administered at 104 mg/0.65 mL to women every 3 months (12 to 14 weeks), inhibits the secretion of gonadotropins, which prevents follicular maturation and ovulation and causes endometrial thinning. These actions produce its contraceptive effect.
Supression of serum estradiol concentrations and a possible direct action of depo-subQ provera 104 on the lesions of endometriosis are likely to be responsible for the therapeutic effect on endometriosis-associated pain.
The pharmacokinetic parameters of medroxyprogesterone acetate (MPA) following a single SC injection of depo-subQ provera 104 are shown in Table 1 and Figure 1.
|Cmax = peak serum concentration; Tmax = time when Cmax is observed; C91 = serum concentration at 91 days; AUC0–91 and AUC0–∞= area under the concentration-time curve over 91 days or infinity, respectively; t½ = terminal half-life
Following a single SC injection of depo-subQ provera 104, serum MPA concentrations reach ≥ 0.2 ng/mL within 24 hours. The mean Tmax is attained approximately 1 week after injection.
In a study to assess accumulation and the achievement of steady state following multiple SC administrations, trough concentrations of MPA were determined after 6, 12, and 24 months, and in a subset of 8 subjects, bi-weekly concentrations were determined within one dosing interval in the second year of administration. The mean (SD) MPA trough concentrations were 0.67 (0.36) ng/mL (n=157), 0.79 (0.36) ng/mL (n=144), and 0.87 (0.33) ng/mL (n=106) at 6, 12 and 24 months, respectively.
depo-subQ provera 104 was administered into the anterior thigh or the abdomen to evaluate effects on the MPA concentration-time profile. MPA trough concentrations (Cmin; Day 91) were similar for the two injection locations.
Plasma protein binding of MPA averages 86%. MPA binding occurs primarily to serum albumin. No binding of MPA occurs with sex-hormone-binding globulin (SHBG).
MPA is extensively metabolized in the liver by P450 enzymes. Its metabolism primarily involves ring A and/or side-chain reduction, loss of the acetyl group, hydroxylation in the 2-, 6-, and 21-positions or a combination of these positions, resulting in more than 10 metabolites.
Residual MPA concentrations at the end of the first dosing interval (12 to 14 weeks) of depo-subQ provera 104 are generally below 0.5 ng/mL, consistent with its apparent terminal half-life of ~40 days after SC administration. Most MPA metabolites are excreted in the urine as glucuronide conjugates with only small amounts excreted as sulfates.
Following a single SC administration of doses ranging from 50 to 150 mg, the AUC and Cmin (Day 91) increased with higher doses of depo-subQ provera 104, but there was considerable overlap across dose levels. Serum MPA concentrations at Day 91 increased in a dose proportional manner but Cmax did not appear to increase proportionally with increasing dose. The AUC data were suggestive of dose linearity.
There were no significant differences in the pharmacokinetics and/or pharmacodynamics of MPA after SC administration of depo-subQ provera 104 in African-American and Caucasian women. The pharmacokinetics/pharmacodynamics of depo-subQ provera 104 were evaluated in Asian women in a separate study and also found to be similar to African-American and Caucasian women.
Although total MPA exposure was lower in obese women, no dosage adjustment of depo-subQ provera 104 is necessary based on body weight. The effect of body weight on the pharmacokinetics of MPA following a single dose was assessed in a subset of women (n = 42, body mass index [BMI] ranged from 18.2 to 46.7 kg/m2). The AUC0–91 values for MPA were 71.6, 67.9, and 46.3 ng·day/mL in women with BMI categories of ≤ 28 kg/m2, >28–38 kg/m2, and >38 kg/m2, respectively. The mean MPA Cmax was 1.74 ng/mL in women with BMI ≤ 28 kg/m2, 1.53 ng/mL in women with BMI >28–38 kg/m2, and 1.02 ng/mL in women with BMI > 38 kg/m2, respectively. The MPA trough (Cmin) concentrations had a tendency to be lower in women with BMI >38 kg/m2.
No clinical studies have evaluated the effect of hepatic disease on the disposition of depo-subQ provera 104. However, steroid hormones may be poorly metabolized in patients with severe liver dysfunction (see CONTRAINDICATIONS).
No clinical studies have evaluated the effect of renal disease on the pharmacokinetics of depo-subQ provera 104.
See PRECAUTIONS, section 9
depo-subQ provera 104 is indicated for the prevention of pregnancy in women of child bearing potential.
depo-subQ provera 104 also is indicated for management of endometriosis-associated pain.
In considering use for either indication, the loss of bone mineral density (BMD) in women of all ages and the impact on peak bone mass in adolescents should be considered, along with the decrease in BMD that occurs during pregnancy and/or lactation, in the risk/benefit assessment for women who use depo-subQ provera 104 long-term (see WARNINGS, section 1).
In three clinical studies, no pregnancies were detected among 2,042 women using depo-subQ provera 104 for up to 1 year. The Pearl Index pregnancy rate in women who were less than 36 years old at baseline, based on cycles in which they used no other contraceptive methods, was 0 pregnancies per 100 women-years of use (upper 95% confidence interval = 0.25).
Pregnancy rates for various contraceptive methods are typically reported for only the first year of use and are shown in Table 2.
|% of Women Experiencing an Unintended Pregnancy within the First Year of Use
|% of Women Continuing Use at 1 Year*
|Typical Use†
|Perfect Use‡
|Source: Hatcher et al., 1998.i
|Periodic Abstinence
|Ovulation Method
|Parous Women
|Nulliparous Women
|Parous Women
|Nulliparous Women
|Female (Reality)
|Progestin only
|Progesterone T
|Copper T 380A
|LNg 20
|Depo-Provera IM 150 mg
|Norplant and Norplant-2
|Female Sterilization
|Male Sterilization
|Emergency Contraceptive Pills: Treatment initiated within 72 hours after unprotected intercourse reduces the risk of pregnancy by at least 75%.à
Lactational Amenorrhea Method: LAM is a highly effective, temporary method of contraception.è
The efficacy of depo-subQ provera 104 in the reduction of endometriosis-associated pain in women with the signs and symptoms of endometriosis was demonstrated in two active comparator-controlled studies. Each study assessed reduction in endometriosis-associated pain over 6 months of treatment and recurrence of symptoms for 12-months post treatment. Subjects treated with depo-subQ provera 104 for 6 months received a 104 mg dose every 3 months (2 injections), while women treated with leuprolide microspheres for 6 months received a dose of 11.25 mg every 3 months (2 injections) or 3.75 mg every month (6 injections). Study 268 was conducted in the U.S. and Canada and enrolled 274 subjects (136 on depo-subQ provera 104 and 138 on leuprolide). Study 270 was conducted in South America, Europe and Asia, and enrolled 299 subjects (153 on depo-subQ provera 104 and 146 on leuprolide).
Reduction in pain was evaluated using a modified Biberoglu and Behrman scale that consisted of three patient-reported symptoms (dysmenorrhea, dyspareunia, and pelvic pain not related to menses) and two signs assessed during pelvic examination (pelvic tenderness and induration). For each category, a favorable response was defined as improvement of at least 1 unit (severity was assessed on a scale of 0 to 3) relative to baseline score (Figure 2).
Favorable Response = reduction in severity of symptom or sign of ≥ 1 point on a scale of 0 to 3, as compared to baseline
Additionally, scores from each of the five categories were combined, with the total (composite score) considered a global measurement of overall disease improvement. For subjects with baseline scores for each of the 5 categories, a mean decrease of 4 points relative to baseline was considered a clinically meaningful improvement. Across both studies, for both treatment groups, the mean changes in the composite score met the protocol-defined criterion for improvement.
In the clinical trials, treatment with depo-subQ provera 104 was limited to six months. Data on the persistence of benefit with longer treatment are not available.
Subjects recorded daily the occurrence and severity of hot flushes. Of the depo-subQ provera 104 users, 28.6% reported experiencing moderate or severe hot flushes at baseline, 36.2% at month 3, and 26.7% at month 6. Of the leuprolide users, 32.8% reported experiencing moderate or severe hot flushes at baseline, 74.2% at month 3, and 68.5% at month 6.
Use of depo-subQ provera 104 reduces serum estrogen levels and is associated with significant loss of bone mineral density (BMD) as bone metabolism accommodates to a lower estrogen level. This loss of BMD is of particular concern during adolescence and early adulthood, a critical period of bone accretion. It is unknown if use of depo-subQ provera 104 by younger women will reduce peak bone mass and increase the risk for osteoporotic fracture in later life. In both adults and adolescents, the decrease in BMD appears to be at least partially reversible after depo-subQ provera 104 is discontinued and ovarian estrogen production increases. A study to assess the reversibility of loss of BMD in adolescents is ongoing.
depo-subQ provera 104 should be used long-term (e.g., longer than 2 years) only if other methods of birth control are inadequate. BMD should be evaluated when a woman needs to use depo-subQ provera 104 long-term. In adolescents, interpretation of BMD results should take into account patient age and skeletal maturity.
Other treatments should be considered in the risk/benefit analysis for the use of depo-subQ provera 104 in women with osteoporosis risk factors. depo-subQ provera 104 can pose an additional risk in patients with risk factors for osteoporosis (e.g., metabolic bone disease, chronic alcohol and/or tobacco use, anorexia nervosa, strong family history of osteoporosis or chronic use of drugs that can reduce bone mass such as anticonvulsants or corticosteroids).
Although there are no studies addressing whether calcium and Vitamin D lessen BMD loss in women using depo-subQ provera 104, all patients should have adequate calcium and Vitamin D intake.
A study comparing changes in BMD in women using depo-subQ provera 104 with women using Depo-Provera Contraceptive Injection (Depo-Provera CI, 150 mg) showed no significant differences in BMD loss between the two groups after two years of treatment. Mean percent changes in BMD in the depo-subQ provera 104 group are listed in Table 3.
|Lumbar Spine
|Total Hip
|Femoral Neck
|Time on Treatment
|Mean % Change
|Mean % Change
|Mean % Change
|1 year
(-3.1 to -2.3)
(-2.1 to -1.3)
(-2.5 to -1.4)
|2 year
|- 4.1
(-4.6 to -3.5)
(-4.2 to -2.7)
(-4.3 to -2.6)
In another controlled clinical study, adult women using Depo-Provera CI (150 mg) for up to 5 years showed spine and hip BMD mean decreases of 5–6%, compared to no significant change in BMD in the control group. The decline in BMD was more pronounced during the first two years of use, with smaller declines in subsequent years. Mean changes in lumbar spine BMD of –2.86%, -4.11%, -4.89%, -4.93% and –5.38% after 1, 2, 3, 4 and 5 years,-respectively, were observed. Mean decreases in BMD of the total hip and femoral neck were similar.
After stopping use of Depo-Provera CI (150 mg) there was partial recovery of BMD toward baseline values during the 2-year post-therapy period. Longer duration of treatment was associated with less complete recovery during this 2-year period following the last injection. Table 4 shows the extent of recovery of BMD for women who completed 5 years of treatment.
|Lumbar Spine
|Total Hip
|Femoral Neck
|Time in Study
|Depo-Provera CI
(150 mg)*
|Depo-Provera CI
(150 mg)*
|Depo-Provera CI
(150 mg)*
|5 years
|7 years
Preliminary results from an ongoing, open-label, self-selected, non-randomized clinical study of adolescent females (12–18 years) also showed that Depo-Provera CI (150 mg) use was associated with a significant decline in BMD from baseline (Table 5). In general, adolescents increase bone density during the period of growth following menarche, as seen in the untreated cohort. However, the two cohorts were not matched at baseline for age, gynecologic age, race, BMD and other factors that influence the rate of acquisition of bone mineral density, with the result that they differed with respect to these demographic factors.
Preliminary data from the small number of adolescents participating in the 2-year post-use observation period demonstrated partial recovery of BMD.
|Duration of Treatment
Or Observation Period
|Lumbar Spine
|Total Hip
|Femoral Neck
|Depo-Provera CI
(150 mg)
|Control (Unmatched/
|Depo-Provera CI
(150 mg)
|Control (Unmatched/
|Depo-Provera CI
(150 mg)
|Control (Unmatched/
% change
% change
% change
% change
% change
% change
|Week 60
(1.2 yrs)
|Week 144
(2.8 yrs)
|Week 240
(4.6 yrs)
In two clinical studies of 573 adult women with endometriosis, the BMD effects of 6 months of depo-subQ provera 104 treatment were compared to 6 months of leuprolide treatment. Subjects were then observed, off therapy, for an additional 12 months (Table 6).
|Time of Measurement
|Lumbar Spine
|Total Hip
|depo-subQ provera 104
|depo-subQ provera 104
|Mean % change
|Mean % change
|Mean % change
|Mean % change
|EOT = End of Treatment
|Month 6 of treatment (EOT)
|6 months off treatment
|12 months off treatment
Most women using depo-subQ provera 104 experienced changes in menstrual bleeding patterns, such as amenorrhea, irregular spotting or bleeding, prolonged spotting or bleeding, and heavy bleeding. As women continued using depo-subQ provera 104, fewer experienced irregular bleeding and more experienced amenorrhea. If abnormal bleeding is persistent or severe, appropriate investigation and treatment should be instituted.
In three contraception trials, 39.0 % of women experienced amenorrhea during month six, and 56.5% experienced amenorrhea during month 12. The changes in menstrual bleeding patterns from the three contraception trials are presented in Figures 3 and 4.
N = Number of subjects in analysis for indicated month
N = Number of subjects with bleeding and/or spotting during indicated month
The changes in menstrual patterns in the two endometriosis trials are presented in Figures 5 and 6.
N = Number of subjects in analysis for indicated month
N = Number of subjects with bleeding and/or spotting during indicated month
Long-term, case-controlled surveillance of users of depot medroxyprogesterone acetate IM 150 mg (Depo-Provera CI, 150 mg) found slight or no increased overall risk of breast cancer and no overall increased risk of ovarian, liver, or cervical cancer, and a prolonged, protective effect of reducing the risk of endometrial cancer.
A pooled analysisii from two case-control studiesiii iv reported the relative risk (RR) of breast cancer for women who had ever used Depo-Provera CI (150 mg) as 1.1 (95% confidence interval [CI] 0.97 to 1.4). Overall, there was no increase in risk with increasing duration of use of Depo-Provera CI (150 mg). The RR of breast cancer for women of all ages who had initiated use of Depo-Provera CI (150 mg) within the previous 5 years was estimated to be 2.0 (95% CI 1.5 to 2.8). A component of the pooled analysisiii described above, showed an increased RR of 2.19 (95% CI 1.23 to 3.89) of breast cancer associated with use of Depo-Provera CI (150 mg) in women whose first exposure to drug was within the previous 4 years and who were under 35 years of age. However, the overall RR for ever-users of Depo-Provera CI (150 mg) was only 1.21 (95% CI 0.96 to 1.52).
[NOTE: The value of 2.19 means that women whose first exposure to drug was within the previous 4 years and who were under 35 years of age had a 2.19-fold (95% CI 1.23 to 3.89-fold) increased risk of breast cancer relative to nonusers. The National Cancer Institutev reports an average annual incidence rate for breast cancer for US women, all races, age 30 to 34 years of 26.7 per 100,000. A RR of 2.19, thus, increases the possible risk from 26.7 to 58.5 cases per 100,000 women. The attributable risk, thus, is 31.8 per 100,000 women per year.]
The relative rate of invasive squamous-cell cervical cancer in women who ever used Depo-Provera CI (150 mg) was estimated to be 1.11 (95% CI 0.96 to 1.29). No trends in risk with duration of use or times since initial or most recent exposure were observed.
Although MPA has not been causally associated with the induction of thrombotic or thromboembolic disorders, there have been rare reports of serious thrombotic events in women using Depo-Provera CI (150 mg). Any patient who develops thrombosis while undergoing therapy with depo-subQ provera 104 should discontinue treatment unless she has no other acceptable options for birth control (see CONTRAINDICATIONS).
Medication should not be re-administered pending examination if there is a sudden partial or complete loss of vision or if there is a sudden onset of proptosis, diplopia or migraine. If examination reveals papilledema or retinal vascular lesions, medication should not be re-administered.
Healthcare providers should be alert to the possibility of an ectopic pregnancy among women using depo-subQ provera 104 who become pregnant or complain of severe abdominal pain.
Serious anaphylactic reactions have been infrequently reported in women using Depo-Provera CI (150 mg). If an anaphylactic reaction occurs, appropriate emergency medical treatment should be instituted.
It is good medical practice for all women to have annual history and physical examinations, including women using depo-subQ provera 104. The physical examination, however, may be deferred until after initiation of depo-subQ provera 104 if requested by the woman and judged appropriate by the clinician. The physical examination should include special reference to blood pressure, breasts, abdomen and pelvic organs, including cervical cytology and relevant laboratory tests. In case of undiagnosed, persistent or recurrent abnormal vaginal bleeding, appropriate measures should be conducted to rule out malignancy. Women with a strong family history of breast cancer or who have breast nodules should be monitored with particular care.
Because progestational drugs may cause some degree of fluid retention, conditions that might be influenced by this condition, such as epilepsy, migraine, asthma, and cardiac or renal dysfunction, require careful observation.
Weight gain is a common occurrence in women using depo-subQ provera 104. In three large clinical trials using depo-subQ provera 104, the mean weight gain was 3.5 lb in the first year of use. In a small, two-year study comparing depo-subQ provera 104 to Depo-Provera CI (150 mg), the mean weight gain observed for women using depo-subQ provera 104 (7.5 lb) was similar to the mean weight gain for women using Depo-Provera CI, 150 mg (7.6 lb).
Although there are no data related to weight gain beyond 2 years for depo-subQ provera 104, the data on Depo-Provera CI (150 mg) may be relevant. In a clinical study, after five years, 41 women using Depo-Provera CI (150 mg) had a mean weight gain of 11.2 lb, while 114 women using non-hormonal contraception had a mean weight gain of 6.4 lb.
Return to ovulation is likely to be delayed after stopping therapy. Among 15 women who received multiple doses of depo-subQ provera 104:
However, ovulation has occurred as early as 14 weeks after a single dose of depo-subQ provera 104, and therefore it is important to follow the recommended dosing schedule.
Return to fertility also is likely to be delayed after stopping therapy. Among 28 women using depo-subQ provera 104 for contraception who stopped treatment to become pregnant, 1 became pregnant within 1 year of her last injection. A second woman became pregnant 443 days after her last injection. Seven women were lost to follow-up.
Patients with a history of treatment for clinical depression should be carefully monitored while receiving depo-subQ provera 104.
In 5 clinical studies of depo-subQ provera 104 involving 2,325 women (282 treated for up to 6 months, 1,780 treated for up to 1 year and 263 women treated for up to 2 years), 5% of women reported injection site reactions, and 1% had persistent skin changes, typically described as small areas of induration or atrophy.
Some patients receiving progestins may exhibit a decrease in glucose tolerance. Diabetic patients should be carefully observed while receiving such therapy.
If jaundice or any other liver abnormality develops in any woman receiving depo-subQ provera 104, treatment should be stopped while the cause is determined. Treatment may be resumed when liver function is acceptable and when the healthcare provider has determined that depo-subQ provera 104 did not cause the abnormality.
No drug-drug interaction studies have been conducted with depo-subQ provera 104. Aminoglutethimide administered concomitantly with depo-subQ provera 104 may significantly decrease the serum concentrations of MPA.
The pathologist should be advised of progestin therapy when relevant specimens are submitted. The physician should be informed that certain endocrine and liver function tests, and blood components may be affected by progestin therapy:
See WARNINGS, section 3 and PRECAUTIONS, section 4
Although depo-subQ provera 104 should not be used during pregnancy, there appears to be little or no increased risk of birth defects in women who have inadvertently been exposed to medroxyprogesterone acetate injections in early pregnancy. Neonates exposed to medroxyprogesterone acetate in-utero and followed to adolescence showed no evidence of any adverse effects on their health including their physical, intellectual, sexual or social development.
Although the drug is detectable in the milk of mothers receiving Depo-Provera CI (150 mg), milk composition, quality, and amount are not adversely affected. Neonates and infants exposed to medroxyprogesterone acetate from breast milk have been studied for developmental and behavioral effects through puberty, and no adverse effects have been noted.
depo-subQ provera 104 is not indicated before menarche. Use of depo-subQ provera 104 is associated with significant loss of bone mineral density (BMD). This loss of BMD is of particular concern during adolescence and early adulthood, a critical period of bone accretion. In adolescents, interpretation of BMD results should take into account patient age and skeletal maturity. It is unknown if use of depo-subQ provera 104 by younger women will reduce peak bone mass and increase the risk for osteoporotic fractures in later life. Other than concerns about loss of BMD, the safety and effectiveness are expected to be the same for postmenarchal adolescents and adult women.
depo-subQ provera 104 is intended for use in women with childbearing potential. Studies with depo-subQ provera 104 in geriatric women have not been conducted.
See PATIENT LABELING.
In five clinical studies of depo-subQ provera 104 involving 2,325 women (282 treated for up to 6 months, 1,780 treated for up to 1 year and 263 treated for up to 2 years), 9% of women discontinued treatment for adverse reactions. Among these 212 women, the most common reasons for discontinuation were:
Adverse reactions reported by 5% or more of all women in these clinical trials included:
Adverse reactions reported by 1% to <5% of all women in these clinical trials included:
General disorders: fatigue, injection site pain
Gastrointestinal disorders: abdominal distention, abdominal pain, diarrhea, nausea
Infections: bronchitis, influenza, nasopharyngitis, pharyngitis, sinusitis, upper respiratory tract infection, urinary tract infection, vaginal candidiasis, vaginitis, vaginitis bacterial
Investigations: abnormal cervix smear
Musculoskeletal, connective tissue, and bone disorders: arthralgia, back pain, limb pain
Nervous system disorders: dizziness, insomnia
Psychiatric disorders: anxiety, depression, irritability, decreased libido
Reproductive system and breast disorders: breast pain, breast tenderness, menometrorrhagia, menorrhagia, menstruation irregular, uterine hemorrhage, vaginal hemorrhage
Skin disorders: acne
Vascular disorders: hot flushes
There have been rare cases of osteoporosis including osteoporotic fractures reported postmarketing in patients taking DEPO-PROVERA Contraceptive Injection. In addition, infrequent voluntary reports of anaphylaxis and anaphylactoid reaction have been received associated with use of Depo-Provera CI (150 mg).
The following additional reactions have been reported with Depo-Provera Contraceptive Injection and may occur with use of depo-subQ provera 104:
General disorders: asthenia, axillary swelling, chills, chest pain, fever, excessive thirst
Blood and lymphatic system disorders: anemia, blood dyscrasia
Cardiac disorders: tachycardia
Gastrointestinal disorders: gastrointestinal disturbances, rectal bleeding
Hepato-biliary disorders: jaundice
Immune system disorders: allergic reaction
Infections: genitourinary infections
Investigations: decreased glucose tolerance
Musculoskeletal, connective tissue, and bone disorders: loss of bone mineral density, scleroderma
Neoplasms: breast cancer, cervical cancer
Nervous system disorders: convulsions, facial palsy, fainting, paralysis, paresthesia, somnolence
Psychiatric disorders: increased libido, nervousness
Reproductive system and breast disorders: breast lumps, galactorrhea, nipple discharge or bleeding, oligomenorrhea, prevention of lactation, prolonged anovulation, unexpected pregnancy, uterine hyperplasia, vaginal cyst
Respiratory disorders: asthma, dyspnea, hoarseness
Skin disorders: angioedema, dry skin, increased body odor, melasma, pruritus, urticaria
Vascular disorders: deep vein thrombosis, pulmonary embolus, thrombophlebitis
depo-subQ provera 104 must be given by subcutaneous injection into the anterior thigh or abdomen, once every 3 months (12 to 14 weeks). depo-subQ provera 104 is not formulated for intramuscular injection. Dosage does not need to be adjusted for body weight. The pre-filled syringe of depo-subQ provera 104 must be vigorously shaken just before use to create a uniform suspension.
Ensure that the patient is not pregnant at the time of the first injection. For women who are sexually active and having regular menses, the first injection should be given only during the first 5 days of a normal menstrual period. Women who are breast-feeding may have their first injection during or after their sixth postpartum week.
Dosing is every 12 to 14 weeks. If more than 14 weeks elapse between injections, pregnancy should be ruled out before the next injection.
When switching from other contraceptive methods, depo-subQ provera 104 should be given in a manner that ensures continuous contraceptive coverage. For example, patients switching from combined (estrogen plus progestin) contraceptives should have their first injection of depo-subQ provera 104 within 7 days after the last day of using that method (7 days after taking the last active pill, removing the patch or ring). Similarly, contraceptive coverage will be maintained in switching from Depo-Provera CI (150 mg) to depo-subQ provera 104, provided the next injection is given within the prescribed dosing period for Depo-Provera CI (150 mg).
Treatment for longer than two years is not recommended, due to the impact of long-term depo-subQ provera 104 on bone mineral density. If symptoms return after discontinuation of treatment, bone mineral density should be evaluated prior to retreatment.
Please read these instructions carefully. It is very important that the entire dose of depo-subQ provera 104 is given
Getting ready
Ensure that the medication is at room temperature. Make sure the following components are available.
depo-subQ provera 104, as with other parenteral drug products, should be inspected visually for particulate matter and discoloration prior to administration.
Step 1: Choosing & preparing the injection Area
Choose the injection area.
Preferred injection areas:
Use an alcohol pad to wipe the skin in the injection area you have chosen.
Step 2: Syringe preparation
Gently twist off the protective end cap from the needle to break the seal.
|Hold the syringe firmly by the barrel pointing upward.
|Hold the syringe barrel firmly.
|Continue to hold the syringe barrel firmly.
|While holding the syringe with the needle pointing upward,
Step 3: Injecting the dose
|Gently grasp and squeeze a large area of skin in the chosen injection area between the thumb and forefinger, pulling it away from the body.
Insert the needle at a 45 degree angle so that most of the needle is in the fatty tissue.
Inject the medication slowly until the syringe is empty.
|After the entire dose is delivered, the plunger reaches the activation arms (see diagram to right)
Some resistance might be felt when the activation arms are pushed open by the plunger rod
Remove your thumb from the plunger while the syringe is still in the tissue.
|Use a clean cotton pad to press lightly on the injection area for a few seconds.
|Following the administration of each dose, the used syringe should be discarded in a safe and proper manner.
Keep away from children.
depo-subQ provera 104 for subcutaneous use (medroxyprogesterone acetate injectable suspension 104 mg/0.65 mL) is available as a pre-filled syringe, pre-assembled with an UltraSafe Passive™ Needle Guard1 device, and packaged with a 26-gauge × 3/8 inch needle in the following presentation:
NDC 0009-4709-01 0.65 mL single-use, disposable syringe
Store at controlled room temperature 20° to 25° C (68° to 77°F) [see USP].
Rx only
October 2007
depo-subQ provera 104™
medroxyprogesterone acetate injectable suspension
104 mg/0.65 mL
WHAT IS THE MOST IMPORTANT INFORMATION I SHOULD KNOW ABOUT depo-subQ provera 104?
Use of depo-subQ provera 104 may cause you to lose calcium stored in your bones. The longer you use depo-subQ provera 104 the more calcium you are likely to lose. The calcium may not return completely once you stop using depo-subQ provera 104.
Loss of calcium may cause weak, porous bones (osteoporosis) that could increase the risk that your bones might break, especially after menopause. It is not known whether your risk of developing osteoporosis may be greater if you are a teenager when you start to use depo-subQ provera 104.
You should use depo-subQ provera 104 long-term (for example, more than 2 years) only if other methods of birth control are not right for you.
depo-subQ provera 104 does not protect you from HIV (AIDS) and other diseases spread through sex (STDs).
WHAT IS depo-subQ provera 104?
depo-subQ provera 104 is a drug for birth control. It also helps relieve pain related to endometriosis (en-do-ME-tree-OH-sis). Symptoms of endometriosis arise when cells normally inside your uterus grow outside the uterus. The cells respond to menstrual cycle hormones, and may cause painful periods, pelvic pain, and painful sex.
depo-subQ provera 104 contains a hormone called medroxyprogesterone acetate (MPA). It is given as a shot (injection) every 3 months. Three months is the same as 12 to 14 weeks.
HOW WELL DOES depo-subQ provera 104 WORK FOR PREVENTING PREGNANCY?
When you use depo-subQ provera 104 correctly, the chance of getting pregnant is very low. In studies, no women became pregnant during the year they used depo-subQ provera 104 injection.
The list below estimates the chances of getting pregnant using different types of birth control. The numbers are based on typical use. Typical use includes people who use the method correctly and people who use the method incorrectly. The list shows the number of women out of 100 women who will likely get pregnant if they use the method for one year.
|Typical chance of getting pregnant in 1 year
(No. of pregnancies in 100 women)
|Less than 1
|Female sterilization
|Male sterilization
|IUD (copper IUD and levonorgestrel IUD)
|Condom alone (male)
|Diaphragm with spermicides
|Condom alone (female)
|Periodic abstinence
|Spermicides alone
|Vaginal sponge or Cervical cap with spermicide
|20 to 40
HOW WILL I GET depo-subQ provera 104?
depo-subQ provera 104 is given as a shot just under the skin on your thigh or belly. You get it once every 3 months.
For Birth Control:
First Shot:
Your healthcare provider will want to be sure that you are not pregnant before you get your first shot. Normally, you get the shot by the 5th day from the START of your menstrual period. You get it whether or not you are still bleeding.
If you are breast-feeding, you may have your first shot as early as 6 weeks after you deliver your baby.
After the first shot:
It is very important to keep getting depo-subQ provera 104 every 3 months. If you wait more than 14 weeks between shots, you could become pregnant. Your healthcare provider must make sure you are not pregnant before you get your next shot.
When you get your shot, make an appointment for your next shot. Mark it on your calendar.
If you need a birth control method for more than two years, your healthcare provider may ask you to have a test of your bones or ask you to switch to another birth control method before continuing depo-subQ provera 104, especially if you have other risks for weak bones.
For Endometriosis:
If you have regular periods, you get depo-subQ provera 104 the same way as described above for birth control. If your periods have stopped or are not regular, your healthcare provider must test to make sure you are not pregnant before you get your first shot.
It is not recommended that you receive depo-subQ provera 104 for treatment of endometriosis for longer than two years. If your painful symptoms return after stopping treatment, your healthcare provider should ask you to have a test of your bones before restarting treatment.
DO NOT TAKE depo-subQ provera 104 IF YOU…
BEFORE TAKING depo-subQ provera 104
Your healthcare provider may do a physical examination and check your blood and urine.
Tell your healthcare provider about all your medical conditions.
Most important, tell your healthcare provider if you:
– Kidney problems
– High blood pressure
– Migraine headaches
– Asthma
– Seizures
– Diabetes, or if it runs in your family
– Depression
– Heart attack, stroke, or developed blood clots
– Bone disease
– Anorexia nervosa (an eating disorder)
– A strong family history of osteoporosis
– Drug use that can lower the amount of calcium in bones (drugs for epilepsy or steroids)
– Drinking a lot of alcohol or smoking a lot
It is important to see your healthcare provider regularly if you have any of these conditions.
Tell your healthcare provider about all the medicines you take. This includes prescription and over-the-counter medicines, vitamins, and herbal products.
WHAT ELSE SHOULD I KNOW ABOUT TAKING depo-subQ provera 104?
Other Birth Control. If you can't take birth control pills or can't use a birth control patch or ring, you may be able to use depo-subQ provera 104. Ask your healthcare provider.
Pregnancy. When you take depo-subQ provera 104 every 3 months, your chance of getting pregnant is very low. You could miss a period or have a light period and not be pregnant. If you miss 1 or 2 periods and think you might be pregnant, see your healthcare provider as soon as possible.
You should not use depo-subQ provera 104 if you are pregnant. However, depo-subQ provera 104 taken by accident during pregnancy does not seem to cause birth defects.
Pregnancy in your tubes (Ectopic Pregnancy). If you have severe pain low in your belly, tell your healthcare provider right away. Infrequently, a baby may start to grow outside the uterus, most often in the tubes.
Nursing a baby. Wait at least 6 weeks after your baby is born to start depo-subQ provera 104. You can use depo-subQ provera 104 if you are nursing.
Blood or urine tests. depo-subQ provera 104 may affect blood or urine test results. Tell your healthcare provider you are taking depo-subQ provera 104 if you are going to have blood or urine tests.
Other medicines. depo-subQ provera 104 may not work as well if you are also taking Cytadren (aminoglutethimide), a cancer medicine. You may need to use another kind of birth control.
WHAT ARE THE MOST SERIOUS RISKS OF depo-subQ provera 104?
Calcium is generally added to the bones during teenage years. The decrease of calcium in your bones is of most concern if you are a teenager or have the following risk factors:
– Bone disease
– Anorexia nervosa (an eating disorder)
– A strong family history of osteoporosis
– Drug use that can lower the amount of calcium in bones (drugs for epilepsy or steroids), or
– Drinking a lot of alcohol or smoking a lot
If you need a birth control method for more than two years, your healthcare provider may ask you to have a test of your bones or ask you to switch to another birth control method before continuing depo-subQ provera 104, especially if you have other risks for weak bones. When depo-subQ provera 104 is stopped, the calcium in your bones begins to come back. The lost calcium may not return completely once you stop using depo-subQ provera 104. Your healthcare provider may tell you to take calcium and Vitamin D as this may lessen the loss of calcium from your bones.
– Have sharp chest pain, cough blood, or suddenly have trouble breathing
– Have a sudden severe headache with vomiting, blindness or trouble talking, weakness, or
numbness in an arm or leg, or get dizzy or faint
– Have swelling or severe pain in your leg
WHAT ARE COMMON SIDE EFFECTS OF depo-subQ provera 104?
The most common side effects are:
Women using depo-subQ provera 104 for birth control or endometriosis had these less common side effects: abdominal pain, acne, breast tenderness, being irritable, depression, hot flushes, insomnia, joint pain, lack of energy, less sex drive, nausea and sleepiness.
If you feel you are having other side effects, talk with your healthcare provider.
DOES depo-subQ provera 104 CAUSE CANCER?
Plan ahead. The effect of depo-subQ provera 104 can last for a long time after you stop getting shots. Although you may be able to get pregnant quickly, it is more likely to take a year or longer after your last shot before you get pregnant.
It's best to see your healthcare provider for a pre-pregnancy check-up. Your healthcare provider may also tell you to take a vitamin called folic acid every day if you are planning to become pregnant.
GENERAL ADVICE ABOUT depo-subQ provera 104
For more information about depo-subQ provera 104, ask your healthcare provider or pharmacist. You can also visit www.depo-subQprovera104.com or call 1-866-554 DEPO (3376). A nurse can answer questions in Spanish or English 24 hours-a-day, 7 days a week.
WHAT IS IN depo-subQ provera 104?
Active ingredient: medroxyprogesterone acetate
Inactive ingredients: methylparaben, propylparaben, sodium chloride, polyethylene glycol, polysorbate 80, monobasic sodium phosphate∙H2O, dibasic sodium phosphate∙12H2O, methionine, povidone, water for shot. When necessary, the pH is adjusted with sodium hydroxide or hydrochloric acid, or both.
Rx only
|Depo-SubQ Provera (medroxyprogesterone acetate)
Data are from FDA and U.S. National Library of Medicine.


text:
Walking along Latah Creek with Maya.
Tuesday, January 31, 2012
under the bridge
Posted by Christine at 6:22 PM
No comments:
Labels: Browne's Addition, Spokane
Monday, January 30, 2012
winter nature
|The paper wasps left this behind.
|Some unknown animal left this blood.
Maya and I went for a decent walk on Sunday. Five miles? Six miles? I don't know for sure, but by the time we returned to the car, I was ready for pancakes. It was all arranged perfectly because I had pancakes waiting at home. All in all, a nice little Sunday.
Posted by Christine at 2:03 PM
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Labels: Maya and Zoey, nature treasures, Spokane
Friday, January 27, 2012
zut alors!
I felted this narwhal as part of Catherine's Christmas present. I also felted a colossal squid for Monika. Of course, I took pictures of neither squid nor narwhal, so I'm forced to rely upon the proactive photography of my sisters in order to document the little beasties. Hmm. Still waiting for some squid shots. Oddly enough. Monika. Monika...
Posted by Christine at 8:30 AM
5 comments:
Thursday, January 26, 2012
So many cables!
I finished my cable scarf that I had been working on. You can find all the details about the pattern, the yarn, and the inspiration right here. Now is the part where I will show off the finished product and you can all "oohh" and "aaahhh" over my cable talents. Genevieve will help me showcase the scarf by standing on it...
Posted by Catherine at 7:00 AM
4 comments:
Wednesday, January 25, 2012
Throw your diamonds in the sky!
I've been extra excited about glitter and sparkles lately. Those recent shiny cravings inspired this cheap, but satisfying craft project. I made some glitter diamond garlands that are good for decorating on special occasions or (in my case) every single day of the week.
First off you buy some glitter paper at the local craft store.
I picked these three different shades of sparkle at Michael's for $1.99 each. Next step, grab your fiskars.
I cut all the paper into strips about two inches in length.
Then you cut the strips into squares (I eyeballed it). From there I made the squares into diamonds.You could do any shapes. Circles, ovals, squares, diamonds, clubs, spades, hearts, etc.
I saved my scraps because the little triangles would also work well for this project.
After you have them all cut...
and separated into colors,
You sew them together! I used clear thread so that it won't show. Using clear thread is kind of a pain because it jams all the time (at least it does for me). My sewing machine had no problem drilling through these card stock diamonds, but as you may recall from my basket tutorial, my machine is a champ.
This is what it looks like on the other side. I chose to alternate my sparkle shades,but you can certainly use the same color sparkles for the whole garland. Whatevs, it's up to you.
Ta-da! I went ahead and strung them up on our dining room light fixture which, let's be honest, needed a little pizzaz.
It catches the light during the day and ever-so-slightly moves around like a little mobile.
Definitely worth it and oh-so-satisfying.
Posted by Catherine at 7:00 AM
4 comments:
Tuesday, January 24, 2012
warm and fuzzy
Posted by Christine at 8:00 AM
No comments:
Labels: felted, jewelry, necklace, projects, Valentine's Day
Monday, January 23, 2012
Look what Kara from Knitting Lemonade made!
So cool, right? Looking at it makes me absolutely giddy. Absolutely. Giddy. Visit Kara's blog for all the details.
Posted by Christine at 8:00 AM
2 comments:
Labels: embroidery, props
Snow week...
People in Washington experienced a rare event last week...snow. It was called snowpocalypse, snowmaggedon, and any other snow/disaster pun around. I documented the four days we had snow. There's still snow on the ground, but it's the gross melty, ice, slush stuff that everyone hates. I also got to try out these new chain-alternative things called auto socks. They worked wonders! All-in-all, we got close to 2 feet in 2 days. It was cray cray.
Behold, Olympia snow 2012!
(These pictures were taken at my house, or at work at the State Capitol.)
|Bigelow (neighbor)
|My car, buried.
|My car unburied with auto socks on.
|Nick's car.
|The perfect snow outfit. We also used plastic cutting boards to dig our cars out.
You see, Olympia really doesn't get snow. We didn't have shovels.
|Main road next to Puget Sound.
|This is where Peanut went in the snow. Turn out, she hates the snow.
|After she was placed in the snow, she sat on top of the toilet and warmed up like a weirdo.
We call this position "turkey" because she tucks her paws under like little wings and looks like a turkey.
Posted by Catherine at 6:00 AM
2 comments:
Labels: capitol, Glass Ave., snow, turkey
Sunday, January 22, 2012
Sunday Scents.
I am crazy for this Sugar 'n Cream scents yarn!
This soft peachy pink 100% cotton yarn smells sweet like something from childhood.
Not quite My Little Pony scented, but along the same lines.
Not quite My Little Pony scented, but along the same lines.
If you're interested, some things that do smell like My Little Ponies are:
L'oreal Colour Rich leGloss
and my all time fav conditioner, abba in the Color Protect formula
If you know any other products out there that smell of that sweet plastic goodness of our youth (My Little Ponies for us sisters; Ben says they smell like He-Man), please comment and let us know. The sisters love this scent!
Posted by Monika at 12:14 PM
3 comments:
Labels: yarn
Best Friends!
I just fell under some scrutiny by my boyfriend, Bennett, for looking at pictures of my dog on my laptop, while (to his dismay) she was sitting right next to me. So what? I can't get enough of her right now. Notice I said right now, I would like to say that I definitely can get enough of her sometimes.
This post is going to get me tons of eye rolls but I don't care.
I also have some great pictures of Lucca too. These are my favorite pictures of little Luc. Ben took these one afternoon as he followed her around the yard. He could have easily helped her and fixed her dumb ears, but just like any good documentarian he refused to interfere.
This post is going to get me tons of eye rolls but I don't care.
|Her Ladyship Olive
|Best Friends!
|She may look cute...
|But don't be fooled.
|She can be a pill just like Catherine's bad kitten.
|I like pictures where you can only see her dumb little eyes.
|And I also like it when she looks posh.
I also have some great pictures of Lucca too. These are my favorite pictures of little Luc. Ben took these one afternoon as he followed her around the yard. He could have easily helped her and fixed her dumb ears, but just like any good documentarian he refused to interfere.
|Lucca trying to climb Olive.
Posted by Monika at 8:00 AM
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Labels: best friends, lucca, Olive
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First of all, it is important to realize that all tree building methods assume that the alignment is correct; errors in the alignment can lead to a very misleading tree. Once the alignment is optimal, there are many different methods to create phylogenies. Roughly, the methods can be divided into distance-based and character-based methods. Character-based methods use the individual substitutions among the sequences to determine the most likely ancestral relationships, while distance-based methods first calculate the overall distance between the all pairs of sequences, and then calculate a tree based on those distances. Maximum parsimony (MP) and maximum likelihood (ML) are the most important character-based methods. In most comparative studies, ML seems to be the method that yields the best trees (Leitner, 1996).
The most important drawback of ML is that it is very computationally intensive; it is almost unusable with more than a few dozen sequences. MP is much faster than ML, but still slow compared to most distance-based methods. Both these programs calculate large numbers of trees and compare them by either the likelihood or the parsimony score. There are programs available which speed up the process considerably, such as FastDNAml (Olsen, 1994) but for large numbers of sequences the computational burden is still a major hurdle.
The distance-based methods are generally much faster than the character-based ones. In this group, Neighbor Joining (NJ) is by far the most popular method. It is very fast and generally quite good, although there are conditions under which it systematically produces a wrong tree (bias). NJ is not the only biased method: in fact, under the right conditions (mostly when evolutionary rates are different for different sites, which is frequently the case for HIV) any method is biased, i.e. systematically produces the wrong tree (Kuhner & Felsenstein, 1994). The importance of the bias for the everyday tree is a matter of fierce debate.
Weighbor ("weighted Neighbor-Joining") is a method by Bruno, Socci, and Halpern which gives less weight to the longer distances in the distance matrix. The resulting trees are less sensitive to specific biases than NJ and MP, and negative branch lengths are avoided. The method is much faster than ML and usually faster than MP, but much slower than NJ.
To some extent the choice between methods can be based on the purpose of the tree. For subtyping sequences, an NJ tree based on a matrix of genetic distances is generally good enough. It is not vital that the tree is correct in every branch, only that the sequence of interest is clustered with the right subtype. Almost any method will solve this problem correctly. However, when more detailed information on the evolutionary relationships is important, for instance in forensic analyses, or when studying rates of evolution or trying to resolve key relationships (for example, short domains and potential recombination), more realistic models of evolution and unbiased tree reconstruction methods should be used.
The simplest way to calculate a distance between two sequences is to count the number of differences. This measure is often called the Hamming distance. It reflects the difference between sequences, but ignores their evolutionary relationship. The most intuitive way to show how this can be misleading is to think of superimposed or reversed mutations: a nucleotide in a sequence, say an A, gets mutated and becomes a G. This results in a difference of 1. Many replication rounds later the same site gets mutated again. If it becomes an A, the difference now goes down, even though the genetic distance (the number of mutational events) has gone up. If it then becomes a T or a C, the number of differences doesn't change, but the evolutionary distance should increase, because there have now been two evolutionary events.
The oldest attempt to adjust the number of differences between two sequences for the chances of a parallel or back mutation was designed by Jukes and Cantor (1969). They proposed the corrective formula D=-3/4ln(1-(4p/3)). The relation between the percent difference and the genetic distance according to the Jukes/Cantor formula is shown in Figure 1. The figure illustrates two things. First, the effect of the correction increases with the difference between the sequences, and is negligible with very homologous sequences. Second, the effect of saturation can be seen: beyond a certain number of differences (~75%), it becomes impossible to tell what the true genetic distance is.
Figure 1. The percent difference vs. genetic distance according to the Jukes/Cantor formula.
Since this formula was first proposed in 1969, many different models have been proposed to accurately estimate the underlying evolutionary distance from the observed number of differences between the sequences, taking into account new knowledge about the behavior of DNA, such as different transition/transversion rates, different base frequencies, and non-uniform substitution rates between sites. Not all of these sophisticated methods are easily available (Dnadist, for example, only offers Jukes-Cantor, Kimura 2-parameter, Jin-Nei, and the F84 model Phylip uses for its maximum likelihood trees; Mega also offers Tamura and Tamura-Nei and a set of Gamma distribution-based distances).
A relatively new development is the use of models that incorporate variable evolutionary rates across sites. This is an important extension of the existing models, especially for HIV, which is well-known to show dramatically different evolutionary rates (e.g. under the influence of immune escape) over the length of the genome. Gary Olsen has a program called DNArates which can estimate the rates of evolution in different sites, given an initial tree. The number of categories for the rates can be specified by the user. Using the DNArates program can quite dramatically increase the quality of the resulting trees. The program is unpublished, but can be obtained from Gary Olsen's website and from the UIBIO archive.
Many simulations show that the importance of using a realistic substitution model for estimating the genetic distance depends very much on the divergence of the sequences. If the expected number of substitutions per site is small (below 0.2), the resulting tree will not change much when different substitution models are used. If the sequences are highly diverged, however, and especially when the number of substitutions per site rises above 1, the differences become marked, the the choice of the substitution model is very important.
Probably the most widely used program suite is Felsenstein's PHYLIP. It offers a large array of methods, including ML, MP and NJ. The choice of genetic distance is fairly limited, and learning to use the programs requires some time investment, but their versatility makes them very popular. Most allow input of user trees, jumbling (randomizing input orders), and outgroup designation.
MEGA is a nifty little program for DOS/Windows. It offers NJ and MP (although in a quirky implementation) and the sophisticated Tamura-Nei genetic distance estimation. MEGA is able to build trees on the basis of silent or non-silent mutations only, and has a fast bootstrapping option built in. It is available for minimal cost from the authors. Downsides are that the program is fairly unstable and has memory problems with large sets of sequences, and the printing of the trees often gives problems.
PHYLOWIN is a UNIX/Linux based program with a very nice graphical user interface. It does ML, MP and NJ, allows selection of sequences (rows) and position (columns) and bootstrapping. It allows the user to define subsets of sequences and positions and save them. It is available free of charge for academic users.
FastDNAml computes fast(er) ML trees. It is not very easy to use, but is often the only option if one wants to calculate ML trees for more than 20 sequences. It uses input file or command line parameters to specify the trees. The C source code for the program and an executable for Powermac are available by FastDNAml FTP site.
PAUP* is a very versatile program that does maximum likelihood treebuilding in addition to parsimony, and allows incorporation of variable rates per site. It is presently distributed as a beta version, and costs around $100. The Mac version is entirely menu-driven, but the user interface is very clumsy. There are no user interfaces for the Windows and Unix versions.
Links to these and dozens of other phylogenetic programs can be found at Joe Felsenstein's Phylogeny Programs site.
Our Treemaker interface is just that: it interfaces between the user and the phylogenetic programs Dnadist, Neighbor, and Drawtree/Drawgram
from Joe Felsenstein's PHYLIP suite. The interface can only be used to make
Neighbor-Joining trees, which may not be optimal for all circumstances, but usually form a good starting point for more sophisticated
analysis; and as mentioned above, if the inferences made from the tree need not be very exact, for example for subtyping a small
region or for a quick contamination check, this tree can suffice. Please note that the interface does not do bootstrapping.
The interface takes a sequence alignment in several formats, allows the adjustment of a few parameters (transition/transversion ratio, outgroup, and the shape of the tree). It uses the F84 genetic distance estimate (i.e. the option called 'ML' in Dnadist).
REMEDY: If you want to include bootstrap values in a tree created with PHYLIP, the simplest method is to simply paste the
values into the non-bootstrapped tree with valid branchlengths. The better way is to use the tree you get from the Consense
program as input for another run of the tree-building program to have the branch lengths estimated for that particular tree.
This also solves the (infrequent) problem where the topology of the consensus tree doesn't exactly match the one of the original tree.
The misaligned/hypermutated sequence is shown in red.
a. Visually check the alignment of your sequences. There are many alignment editors available that make it very easy to do this. We gives links to sites where you can download sequence editing software on our External Tools page.
b. Check your sequence for hypermutation. Hypermutation, a relatively common phenomenon in HIV, means a very high incidence of G -> A mutations, usually resulting in a non-viable sequence. We have created an interface on our site that was designed to detect hypermutation: HYPERMUT.
REMEDY: If you suspect your sequence may be a recombinant, there are a multitude of ways to look at this more closely. On this
website we maintain RIP, which produces an alignment and an easy-to-read plot that shows the similarity of your sequence
to a set of reference sequences over the entire length of the sequence. If there are major changes in what the most similar sequence
is over the length of your sequence, this suggests recombination.
This assumption is not realistic for HIV, and it is very uncommon for other organisms. The most commonly used method that produces these trees is UPGMA; the Kitsch (which explicitly assumes a molecular clock) program from the PHYLIP suite also results in this type of tree.
REMEDY: Use a different tree reconstruction method. Neighbor-joining, Maximum Parsimony and Maximum Likelihood all produce trees that do not assume a strict molecular clock.
NOTE: When using PAUP*, the default method for printing a tree is a 'rectangular cladogram' which will make the tree look like this. Setting the drawing style to 'phylogram' remedies this.
If none of these errors describe your situation, but you still think your tree is off, there are a few things you can do.
By far the most popular test for trees is the bootstrap. Contrary to what many people think, this is not a test of how accurate your tree is; it only gives information about the stability of the tree topology (the branching order), and it helps assess whether the sequence data is adequate to validate the topology. The bootstrap randomly resamples columns from your alignment, so that some positions will not be used and others will be used more than once, and builds a new tree from this dataset. This is done as many times as you specify. The bootstrap value is a count or percentage of how often each branch was present in exactly the same topology in all the resampled trees, so it gives an impression of how much the tree topology could change if, for example, you'd reconstruct it using a different gene. There are many rules of thumb about how to interpret the bootstrap. It is known to be a conservative measure, so a bootstrap of 95% gives more than 95% confidence in that branch. The number of 70% is often cited as a cut-off for a 'reliable' branch (see Hillis & Bull, 1993).


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Regards from the new and first FutureNet Cafe in Wroclaw in Poland!
What a fantastic week. We met our new Marketing team here in Poland. Soon you will see the Videos for our 900sqm FutureNet Restaurant in Warszawa as well as report from our first FutureNet Café in Wroclaw, Poland.
We have signed the cooperation with champions league level marketing professionals which will produce for us videos in the best quality.
First one you will see next week. Than they will produce for FutureNet Flyers, Magazins, Sponsor Tools and a complete Sponsor System.
We had meeting in regards to MACAU 2018. Let me tell you, history will be written by this event. This week Roman and I are signing a contract that changes everything for FutureNet. So sit tight in next two weeks we will have two amazing news for you. Plus in Macau we will present something, what never has been seen in whole marketing world.
Regards From First FN Cafe In Poland
Regards from the new and first FutureNet Cafe in Wroclaw in Poland!


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Select a City
Aiea, HI
Best Parks and Camping around Aiea, HI
Add an Organization
Ahukini State Recreational Pier
3101-3147 Ahukini Rd
Lihue, HI
Ahukini Pier is situated at mouth of the Hanamaulu Stream. It consists of a cement pier with a wooden walkway located where the stream meets the Pa...
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Ahupua'a O Kahana State Park
52-222 Kamehameha Hwy
Kaaawa, HI
Ahupuaʻa ʻO Kahana State Park is located on the windward side of O'ahu, between Kane'ohe and Laʻie, and 26 miles from Honolulu. Kaha...
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Aiea Bay State Recreation Area
Kamehameha Hwy
Aiea, HI
Along the banks of Pearl Harbor's East Loch, the park offers picnicking opportunities and views of Pearl Harbor and the Arizona Memorial. The...
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Aiea Top Searches
Car Dealers
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Diamond Head State Monument
Diamond Head Road at 18th Ave.
Honolulu, HI
The unique profile of Diamond Head (LÄ"'ahi) sits prominently near the eastern edge of Waikiki's coastline. Hawaii's most recogni...
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Ha'ena State Park
Kuhio Highway
Kapaa, HI
Haʻena State Park, which is about an hour drive from Lihue, boasts of beautiful beaches, hiking trails and 4,000 year old caves.The combination of...
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Hapuna Beach State Recreation Area
Old Puako road
Waimea, HI
Landscaped beach park with swimming during calm seas, bodysurfing during periods of shore breaks, sunbathing and other beach-related activities, pi...
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He'eia State Park
46-465 Kamehameha Hwy
Kaneohe, HI
Heʻeia State Park is a coastal site with picnicking and good views of Kaneʻohe Bay and Heʻeia Fishpond. Community programs are available as well...
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Iao Valley State Monument
'Iao Valley Rd, Hwy 32
Wailuku, HI
A paved 0.6 mile walk provides a scenic viewpoint of Kuka'emoku (ʻIao Needle), an erosional feature which abruptly rises 1200 feet from the ...
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Iolani Palace State Monument
364 S King St
Honolulu, HI
'Iolani Palace, the official residence of Hawaii's monarchy, is a marvel of opulence, innovation and political intrigue that tells of a...
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Ka'ena Point State Park
81-780 Farrington Hwy
Kapolei, HI
Relatively remote wild coastline with picnicking opportunities and shore fishing. Large sandy beach at Keawa'ula Bay with board surfing and b...
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Kailua Beach Park
526 Kawailoa Road
Kailua, HI
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Kaiwi State Scenic Shoreline
8751-9057 Kalanianaole Hwy
Honolulu, HI
A 1-mile hike (one-way) along a paved roadway leads to a lookout atop a headland above the historic Makapuʻu lighthouse (the lighthouse itself is ...
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Kalaupapa National Historical Park
P.O.Box 2222
Kalaupapa, HI
Kalaupapa National Historical Park was established on December 22, 1980. Now more than thirty years old, the park is dedicated to preserving the me...
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Kaloko-Honokohau National Historical Park
73-4786 Kanalani Street, No. 14
Kailua Kona, HI
Kaloko-Honokohau National Historical Park offers you the chance to enjoy the culture and natural history of Hawai'i. There are many activities to b...
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Kalopa State Recreation Area
End of Kalopa Road
Honokaa, HI
Lodging, picnicking and easy family nature hike (0.7-mile loop trail) in a native 'ohi'a forest at a 2000-foot elevation. Trail passes ...
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Kaumahina State Wayside
Hana Highway
Haiku, HI
Forested rest stop with exotic plants. Picnicking and scenic viewpoint of northeast Maui coastline. No drinking water. (7.8 acres)
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Keaiwa Heiau State Recreation Area
Aiea Heights Drive
Aiea, HI
Keaiwa Heiau State Recreation Area is a 384-acre park located approximately 12 miles from Waikiki. Keaïwa Heiau is located at the park entry. ...
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Kealakekua Bay State Historical Park
Pu'uhonoa Rd at Mamalahoa Hwy
Kealakekua, HI
Site of the first extensive contact between Hawaiians and Westerners with the arrival of Captain Cook in 1779. Viewing of Hikiau Heiau, a tradition...
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Kekaha Kai (Kona Coast) State Park
Hwy 19
Kailua Kona, HI
Mahai'ula section has a sandy beach and dune offering opportunities for swimming and beach-related activities. A picnic area with tables is a...
Read More »
Kohala Historical Sites State Monument
Upolu Point Road
Hawi, HI
Viewing of Mo'okini Heiau and Kamehameha I Birthsite. A National Historic Landmark, Mo'okini is one of the most famous luakini heiau (s...
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Known for its adjustable signature straps, the Air Jordan VIII debuted in 1993 and was adorned with a fuzzy "carpet" logo on the tongue. They also hav...e a leather upper, neoprene inner bootie, torsion plate, color splash accents above the midsole, and a rubber outsole. Micheal Jordan laced up this Tinker Hatfield-designed model during his quest to clench a third NBA ring with the Chicago Bulls. Read More
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The Passback Program is a joint effort between the Colorado Rapids, the U.S. Soccer Foundation, Soccer Dreams Without Borders, and Major League Soccer to assist in meeting the soccer needs of all communities.
Since its inception, the Rapids have held collections for soccer gear that has been collected and distributed to underserved schools, clubs, and organizations throughout the country and abroad. Equipment collected by Passback has also been distributed to countries as far away as Africa and the ultimate goal is to collect and distribute a million items of soccer gear in the U.S.A.
New and gently-used soccer equipment is collected prior to designated Rapids games each season. Colorado Youth Soccer Clubs are encouraged to donate a complete set of their team uniforms when buying new uniforms.
Unfortunately, due to the high volume of requests for equipment the Rapids receive each season, thwe are unable to accept indicidual requests.
The Next 2011 Passback Program Event:
- Saturday, May 28 prior to the Rapids vs. Sporting Kansas City game from 5:45-7:15pm outside gates B and G. Every family that donates new or slightly used soccer equipment will receive a voucher good for a Buy One, Get One Free ticket to the Rapids vs. Philadelphia Union game on June 4.
For more information, please contact the Rapids Fan Development Dept. at (303) 727-3517.