18 Jun

Why Two Pokies With the Same RTP Can Feel So Different

Two pokie machines with identical RTP labels but contrasting gameplay styles

Imagine two online pokies both proudly displaying a 96% return to player figure. On paper they appear equally generous, yet playing them back to back can feel like night and day. One drip-feeds steady little wins while the other plunges you into long dry spells punctuated by the occasional big hit. This apparent contradiction puzzles many players, but it has a clear explanation rooted in how games are designed beneath that single percentage. Understanding why identical RTPs produce such different experiences helps you choose games that genuinely suit your taste.

RTP Is Only Part of the Story

Return to player describes how much a game pays back over an enormous number of spins, but it says nothing about how those payouts are distributed. Two games can return the same percentage overall while delivering it in completely different patterns. One might spread its returns across many small, frequent wins, while another concentrates the same total into rare, enormous payouts. The headline figure is an average, and averages can hide wildly different underlying behaviours, which is exactly what separates these otherwise identical games.

The Crucial Role of Volatility

The single biggest reason two equal-RTP pokies feel different is volatility, also known as variance. Volatility measures how a game’s payouts are spread out over time. A low-volatility pokie pays often but in small amounts, keeping your balance relatively stable and your session calm. A high-volatility pokie withholds payouts for long stretches, then occasionally delivers a large win that makes up the difference. Both can share the same RTP while offering completely opposite emotional experiences at the screen.

Low Volatility in Practice

A low-volatility game suits players who value a long, steady session with frequent small wins to keep things ticking along. Your bankroll tends to drift down slowly rather than swinging dramatically, and big jackpots are rare or absent. This style appeals to those who play primarily for relaxed entertainment and want their money to last. The trade-off is that the excitement of a huge win is muted, since the game is designed to pay modestly but regularly rather than holding out for a spectacular result.

High Volatility in Practice

A high-volatility game is built for players who crave the thrill of chasing a major payout and can stomach long losing runs in pursuit of it. Sessions can be tense, with extended periods where nothing seems to land, followed by sudden bursts of significant value. This style demands a larger bankroll and more patience, because the gaps between wins can quickly erode a smaller balance. The reward, when it comes, is a payout far larger than anything a low-volatility game would typically offer.

Hit Frequency and Win Size

Two related concepts help explain the difference further, namely hit frequency and average win size. Hit frequency measures how often any win occurs, while average win size describes how much those wins are worth. A game with high hit frequency and small average wins feels generous and steady, while one with low hit frequency and large average wins feels feast or famine. Combine these in different ratios and you can produce countless game personalities, all while keeping the same overall return to player.

How Theme and Features Add to the Feel

Beyond the maths, presentation also shapes how a game feels even when the RTP matches. A title like the thunder empire pokies game might pace its bonus features differently from a rival, changing the emotional rhythm of play. Whether you try the thunder empire game for fun or play thunder empire for real money, its volatility and feature design create a distinct character, and exploring thunder empire pokies in demo mode lets you sense that feel firsthand. Understanding how thunder empire balances frequency and reward helps you decide if its style suits you before committing real funds.

Choosing the Right Game for You

Knowing that RTP alone cannot predict how a game will feel empowers you to look deeper before you play. Check the volatility rating, which reputable studios usually publish, and read the paytable to gauge how wins are distributed. If you want a long, easy-going session, lean toward low volatility; if you are chasing the occasional big thrill and have the budget to weather dry spells, high volatility may appeal. Matching the game to your temperament makes for a far more satisfying experience.

Playing With Realistic Expectations

Whatever volatility you prefer, the house edge remains constant and every spin stays independent of the last. A matching RTP guarantees nothing about your particular session, and neither low nor high volatility improves your long-run odds. The smartest approach is to set a budget you can afford to lose, choose a volatility that suits your mood and bankroll, and treat any winnings as a bonus rather than an expectation. If gambling ever stops feeling like fun, free and confidential help is available throughout Australia.

13 Dec

Management of Multidrug-Resistant Tuberculosis in Children: A Field Guide (Third Edition)

The Sentinel Project resource “Management of Multidrug-Resistant Tuberculosis in Children: A Field Guide, Third Edition” is now available.

This field guide is meant to serve as a tool for practitioners working with children at risk of infection or becoming sick with MDR-TB. This guide was developed by a team of experts who jointly have treated hundreds of children with MDR-TB over the last two decades in every region of the world. We hope it will be used in the field to rapidly increase the number of children receiving effective care for MDR-TB.

The guide focuses on issues relevant in clinical and programmatic practices and does not offer extensive background materials on management of MDR-TB, which can be found here. Case examples are included throughout the guide to demonstrate how the recommendations put forth in the field guide can be translated into practice. The third edition features updated information and incorporates two new anti-tubercular agents, bedaquiline and delamanid.

The third edition of the Field Guide is available in English and Spanish.

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For additional translations of the Field Guide, please send a note to 

Se**************@hm*.edu











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09 Nov

SAVE THE DATE – Pediatric DR-TB Symposia, Poster Sessions and More at the 46th Union World Conference on Lung Health

From December 2nd through 6th, 2015, TB researchers, practitioners, caregivers and advocates from around the world will be convening in Cape Town, South Africa for the 46th annual Union World Conference on Lung Health. Throughout the conference, experts in pediatric drug-resistant TB – including several Sentinel Project members and partners – will be hosting symposia, poster discussion sessions, oral abstract sessions, post-graduate courses and “Meet the Expert” sessions to discuss new developments in pediatric DR-TB.

We are excited to announce a symposium on Friday, December 4th entitled, “Research is needed to increase children’s access to drug-resistant TB care,” where several Sentinel Project members and colleagues will advocate for improvements in pediatric DR-TB research. For more information on this event, read our blog post here.

In addition to this symposium, Sentinel Project network members are conducting a post graduate course entitled “Best practices in the management of the second-line injectable drugs in children with multidrug-resistant TB,” scheduled from 09:00-16:00 on in Room MR 1.41 on Wednesday, December 2, 2015 during the conference. Click here to access the agenda for this event and see here for more information on pediatric DR-TB events.

We look forward to many productive discussions in Cape Town this December and hope to see many of you there!

For more information about the 46th annual Union World Conference on Lung Health, please visit their websitehttp://capetown.worldlunghealth.org/.

09 Dec

Dismantling the invisibility trap for children with drug-resistant tuberculosis

Tuberculosis (TB) is an airborne infectious disease that is both preventable and curable, yet it kills more than a million people every year. Children are highly vulnerable, but often invisible casualties. Drug-resistant forms of TB are on the rise globally, and children are as vulnerable as adult but less likely to be counted as cases of drug-resistant disease if they become sick. Four factors make children with drug-resistant TB ‘invisible’: first, the nature of the disease in children; second, deficiencies in existing diagnostic tools; third, overreliance on these tools; and fourth, our collective failure to deploy one effective tool for finding and treating children – contact investigation. Provisional annual targets, focused on children exposed at home to multidrug-resistant TB, to be updated every year, constitute a framework to focus attention and collective actions at the community, national and global levels. The targets tell us the number of: (i) children who require complete evaluation for TB disease and infection; (ii) children who require treatment for TB disease; and (iii) children who would benefit from preventive therapy.

Download full text here –  A targets framework: Dismantling the invisibility trap for children with drug-resistant tuberculosis

Full Citation:
Becerra MC, Swaminathan S. Dismantling the invisibility trap for children with drug-resistant tuberculosis. Journal of Public Health Policy (2014) 35, 425-454, published online 11 September 2014. doi:10.1057/jphp.2014.35

22 Oct

What’s in a number? Two recent reports on pediatric TB cases

This webinar recorded on October 09, 2014 reviews the following:

  • A 2014 report estimating global childhood TB disease incidence, including multidrug-resistant TB
  • A 2014 report estimating childhood TB infection and disease in high TB-burden countries
  • Practical implications for clinicians and other child health advocates

View a recording of the webinar here.

View a PDF version of the slides here.

21 Jun

MDR-TB weight-based dosing chart for children

This dosing chart provides recommendations for the acceptable doses of second-line TB drugs for children. This chart, available here, was developed by a team of experts in November 2013 based on published data as well as new PK data on the fluoroquinolones and aminoglycosides. The doses are based on weight bands and use tablet sizes currently available in most TB programs. Because children being treat for DR-TB often gain weight quickly, it is recommended that dose adjustments be considered on a regular basis (i.e. monthly).

For important disclaimers on the use of this dosing chart, please refer to the disclaimer section available in the Sentinel Project’s “Management of Drug-Resistant Tuberculosis in Children: A Field Guide

06 Jun

Adverse effects and adherence in children treated for MDR-TB

This webinar recorded on June 6, 2014 covers the following topics:

  • Adverse effects of the TB medications commonly used to treat MDR-TB;
  • Management of the most frequent and clinically relevant adverse effects in children with MDR-TB; and
  • Adherence challenges and strategies to support optimal treatment adherence.

View a recording of the webinar here. View a PDF version of the slides here.