Non-Steroidal Anti-Inflammatory Drug and Antacid Co-Prescription in Taiwan: Analysis of National Insurance Claims

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Non-Steroidal Anti-Inflammatory Drug and Antacid Co-Prescription in Taiwan: Analysis of National Insurance Claims"

Transcription

1 Chi nese Med i cal Jour nal (Taipei) 2002;65: Orig i nal Non-Steroidal Anti-Inflammatory Drug and Antacid Co-Prescription in Taiwan: Analysis of National Insurance Claims Tzeng-Ji Chen Jui-Yao Liu Shinn-Jang Hwang De part ment of Fam ily Med i cine, Tai pei Vet erans Gen eral Hos pi tal; and Na tional Yang-Ming Uni ver sity School of Med i cine, Tai pei, Tai wan, R.O.C. Key Words ant ac ids; anti-inflammatory agents, non-steroidal; drug ther apy, com bi na tion; na tional health pro grams; pharmacoepidemiology Background. Antacids were usually co-prescribed with non-steroidal anti-inflammatory drugs (NSAIDs), al though no broad ev i dences were available as to the effects of antacids in preventing NSAID-associated gastropathy. We per formed a sur vey of na tional in sur ance claims for out - pa tient ser vices in Tai wan to de ter mine the ex tent of this co-therapy na - tionwide. Methods. The Na tional Health In sur ance Re search Da ta base sup plied the sam pling datasets for anal y sis. They rep re sented 0.2% of the en tire claims for out pa tient med i cal ser vices in Co-prescribing was as sessed as NSAIDs and ant ac ids on the same pre scrip tion. The se lec tion and group - ing of NSAIDs followed the guidelines of the Anatomical Therapeutic Chem i cal (ATC) Classification System rec om mended by the World Health Or ga ni za tion. Only the oral drugs pre scribed on reg u lar vis its were taken into ac count. Results. In to tally 425,442 pre scrip tions with 1,825,604 items of drugs, non-aspirin NSAIDs were pres ent in 108,818 (25.6%) pre scrip tions and ant ac ids in 235,252 (55.3%) pre scrip tions re spec tively. Fur ther more, ant - ac ids were pres ent in 71.3% of pre scrip tions that con tained NSAIDs and in 49.8% of pre scrip tions that did not con tain NSAIDs (p < 0.001). Sig nif - i cant as so ci a tion of NSAIDs and ant ac ids ex isted in dif fer ent spe cial ties of prescribing physicians, but the co-prescription rate (ant ac ids in NSAIDs pre scrip tions) var ied from the high est of 92.8% in the neu ro sur - gery to the low est of 49.8% in the pe di at rics. Sig nif i cant as so ci a tion of NSAIDs and ant ac ids also ex isted at dif fer ent lev els of health care fa cil i - ties, where the co-prescription rates were 80.9% at med i cal cen ters, 83.5% at re gional hos pi tals, 87.4% at lo cal hos pi tals, and 66.6% at pri mary care units. The sub group of oxicams was more fre quently co-prescribed with ant ac ids than other sub groups (odds ra tio = 1.51, p = 0.001). Conclusions. Con com i tant pre scrip tion of oral non-aspirin NSAIDs and ant ac ids was in deed a pop u lar prac tice in Tai wan. Be side their ef fects in al le vi at ing the NSAID-associated dys pep sia, the role of ant ac ids in pre - vent ing NSAID-associated pep tic ul cers or in mask ing the warn ing symp - toms of these ul cers de mands fur ther eval u a tion. [Chin Med J (Tai pei) 2002;65: ] Re ceived: January 3, Ac cepted: October 22, Cor re spon dence to: Tzeng-Ji Chen, MD, De part ment of Fam ily Med i cine, Tai pei Vet erans Gen eral Hos pi tal, 201, Sec. 2, Shih-Pai Road, Tai pei 112, Tai wan. Fax: ;

2 De cem ber 2002 NSAID and Ant acid Co-Prescription 589 The ad verse ef fects of non-steroidal antiinflammatory drugs (NSAIDs), es pe cially in the up per gas tro in tes ti nal tract, al ways con cern both phy - si cians and pa tients. The choice of drugs to pre vent such events re mains con tro ver sial. In a pre vi ous ob - ser va tional study con ducted at the out pa tient poly - clinic of a med i cal cen ter in Tai wan, it was found that ant ac ids were con com i tantly pre scribed in 87.3% of pre scrip tions with NSAIDs. 1 A sim i lar phe nom e non has been also ob served in Sin ga pore. 2 No large-scale ran dom ized con trolled trial has been ever per formed to in ves ti gate the ef fi cacy of ant ac ids for pro phy laxis of NSAID-associated gastropathy. A pro spec tive study even found that asymp tom atic pa tients tak ing ant ac ids with NSAIDs had a higher risk of se ri ous gas tro in tes ti - nal com pli ca tions than those tak ing NSAIDs only. 3 The stud ies on con com i tant pre scrip tion of NSAIDs and ant ac ids are rare be cause ant ac ids are nor mally ap proved as non pre scrip tion (over-thecounter) drugs and not re im bursed by most thirdpayer in sur ance in west ern coun tries. Thanks to the lib eral pol icy of Tai wan s Na tional Health In sur ance in re im burs ing ant ac ids, it turns pos si ble to ac cess the data. In the cur rent study, we per formed a sur vey of na tional in sur ance claims for out pa tient ser vices in Tai wan to de ter mine how the co-prescription of NSAIDs and ant ac ids pre vails across the coun try. The dif fer ences among spe cial ties of pre scrib ing phy si - cians, sta tus of health care fa cil i ties and sub groups of NSAIDs would be also an a lyzed. Methods The Na tional Health In sur ance (NHI) in Tai wan was im ple mented in 1995 to cover nearly all cit i zens of the coun try. The pay ment to health care fa cil i ties oc - curs monthly on the ba sis of claims. The claims data in the out pa tient area are visit-based and in clude a visit file and an or der file among oth ers. While one re cord of the visit file reg is ters the sum mary data of each en coun - ter be side the fa cil ity and pa tient iden ti fi ca tion, the or - der file lists the cor re spond ing or der items (in clud ing lab o ra tory tests and drug pre scrip tions) of ev ery visit. A spe cific se rial num ber for each visit al lows the link - age of the visit and or der files. Since 1999, the Bu reau of NHI has re leased all the claims data to the pub lic for the pur pose of ac a demic re search. The iden ti fi ca tion data of pa tients and fa cil i ties are scram bled to at tain an - o nym ity and thus pro tect pri vacy. In the first year the Na tional Health Re search In sti tutes was in charge of the huge da ta base in size of terabytes un der the pro ject of Na tional Health In sur ance Re search Da ta base (NHIRD) ( and of fered doz ens of ex tracted datasets for each year be gin ning from In the cur rent study, we used the files of the year 1999 (S_CD19990 and S_OO19990 of NHIRD) for the anal y sis. These two files were ex tracted from the en tire da ta base of out pa tient claims (ex clud ing ser - vices of the den tal and tra di tional Chi nese med i cine) with the sys tem atic sam pling method. Ac cord ing to the NHIRD, the size of the sub set from each month is de ter mined by the ra tio of the amount of data in each month to that of the en tire year. Then the sys tem atic sam pling is per formed for each month to ran domly choose a rep re sen ta tive sub set. This sam pling da ta - base is ob tained by com bin ing the sub sets from 12 months. The sam pling da ta base of S_CD19990 was con structed at first then the rel a tive ob ser va tions in S_OO19990 were drawn out ac cord ingly. The sam - pling da ta base of S_CD19990 was 0.2% to the orig i - nal da ta base. We also ob tained a com plete da ta base of ap proved drugs in Tai wan from the web site of the Bu - reau of NHI ( (ac cessed 25 May 2001). Each drug of dif fer ent brand, strength and form was of fi cially as signed a unique code that was used in the claims file. An other file about ba sic data of health care fa cil i ties (HOSB1999 of NHIRD) pro - vides the sta tus of ac cred i ta tion: med i cal cen ter, re - gional hos pi tal, lo cal hos pi tal, and pri mary care unit. The visit file of S_CD19990 con tained 539,661 re - cords and the order file of S_OO19990 con tained 2,803,110 re cords. Our study in cluded only the reg u lar vis its with phy si cian con sul ta tion and ex cluded emer - gen cies, out pa tient op er a tions, di al y sis, home care, pre - ven tive ser vices, and so forth. Among the reg u lar vis its we fur ther dif fer en ti ated into vis its with or der of ei ther lab o ra tory test(s) or drug(s), vis its with pre scrip tion of drug(s), and vis its with pre scrip tion of drug(s) for oral

3 590 Tzeng-Ji Chen, et al. Chi nese Med i cal Jour nal (Tai pei) Vol. 65 No. 12 Table 1. The summary of S_CD19990 and S_OO19990 datasets (0.2% sampling) Claim Regular visit Visit withorder Visitwith drug Visitwith PO drug Record count 539, , , , ,442 Patient count a 524, , , , ,496 Male 234, , , , ,164 Female 287, , , , ,432 Unknown 2,482 2,279 2,209 2,090 1,909 Patient s average age 37.0 (SD b 24.4) 36.8 (SD 24.5) 36.9 (SD 24.5) 36.8 (SD 24.7) 36.4 (SD 24.7) Total count (items) of order 2,803,110 2,640,236 2,640,236 Total count (items) of drug 2,126,397 2,064,552 2,064,552 2,064,552 Total count (items) of PO drug 1,868,337 1,825,604 1,825,604 1,825,604 1,825,604 a Slight discrepancy because some patients had more than one record sampled but different values were given in the field of patient s sex. PO = per os; SD = standard deviation. Table 2. The relationship of NSAID and antacid prescriptions Number of prescriptions With NSAIDs Without NSAIDs Total With antacids 77,605 (71.3%) 157,647 (49.8%) 235,252 Without antacids 31,213 (28.7%) 158,977 (50.2%) 190,190 Total 108,818 (100.0%) 316,624 (100.0%) 425,442 p < by chi-square test. in take (PO) in a hi er ar chi cal way. Ta ble 1 shows the sum mary of our data source. Sub se quent anal y sis in our study fo cused only on the drugs for oral in take. Ad di tionally, the Bu reau of NHI of fered a list of An a tom i cal Ther a peu tic Chem i cal (ATC) codes for each drug. This ATC clas si fi ca tion sys tem was rec om - mended by the World Health Or ga ni za tion for drug uti - li za tion stud ies 4 and has been in ter na tion ally used. The struc ture of ATC code has five lev els to divide the drugs into dif fer ent groups and sub groups. Two groups of drugs in which our study has in ter est are M01A (anti-inflammatory and anti-rheumatic prod ucts, non-steroids) and A02A (ant ac ids, drugs for treat ment of pep tic ul cer and flat u lence). NSAIDs have 7 chem i - cal sub groups of the 4th level: butylpyrazolidines (M01AA), ace tic acid derivatives and related sub - stances (M01AB), oxicams (M01AC), propionic acid de riv a tives (M01AE), fenamates (M01AG), coxibs (M01AH), and others (M01AX). Because salicylic acid and de riv a tives (N02BA) were usu ally pre scribed in low dos age for the pre ven tive pur pose of cardio- and cerebrovascular dis eases in Tai wan, our study did not in clude them in the anal y sis. The da ta base soft ware of Microsoft SQL Server 2000 was used for data link age and pro cess ing. The as so ci a tion of NSAID and ant acid pre scrip tions was tested by chi-square test. Co-prescribing was as sessed as NSAID(s) and ant acid(s) on the same pre scrip tion. Be side the over all anal y sis of the files, we con ducted sim i lar anal y ses strat i fied by spe cialty of phy si cian, ac cred i ta tion sta tus of health care fa cil ity and chem i - cal sub group of NSAID. A p-value of less than 0.05 (two-tail test) was con sid ered as sig nif i cant sta tis ti - cally. Results Among the 425,442 vis its with pre scrip tion of drug(s) for oral in take, non-aspirin NSAIDs and ant - ac ids were pres ent in 25.6% (108,818) and 55.3% (235,252) of pre scrip tions re spec tively. Ant acids were pres ent in 71.3% of pre scrip tions that con tained NSAIDs and in 49.8% of pre scrip tions that did not con tain NSAIDs (p < 0.001) (Ta ble 2). Sig nif i cant association of ant ac ids pre scrip tion

4 De cem ber 2002 NSAID and Ant acid Co-Prescription 591 Table 3. The relationship of NSAID and antacid prescriptions, stratified by selected specialties with more than 1000 sampling records Specialty Number of prescriptions Frequency of antacids in prescriptions with NSAIDs Frequency of antacids in prescriptions without NSAIDs p value a Practitioners 111, % (20621/30873) 51.8% (41662/80388) < Internal Medicine 65, % (10633/13755) 58.1% (30214/52032) < Otorhinolaryngology 55, % (10736/16235) 52.9% (20701/39152) < Family Medicine 48, % (8399/12513) 52.2% (18998/36396) < Pediatrics 39, % (3411/6848) 30.2% (9926/32884) < Gynecology 22, % (4409/5759) 46.6% (7858/16859) < Dermatology 12, % (839/1346) 42.2% (4802/11370) < Surgery 12, % (4302/5008) 66.1% (5086/7695) < Orthopedics 10, % (7563/8360) 67.0% (1455/2172) < Neurology 6, % (1609/1889) 51.6% (2399/4650) < Cardiology 6, % (160/236) 39.3% (2340/5955) < Gastroenterology 5, % (174/220) 61.6% (3338/5419) < Psychiatry 4, % (130/187) 21.0% (883/4201) < Urology 4, % (517/604) 52.2% (1790/3430) < Ophthalmology 3, % (586/833) 41.4% (1119/2701) < Endocrinology 3, % (105/168) 31.1% (962/3091) < Rehabilitation 2, % (1378/1632) 45.1% (433/961) < Chest Medicine 2, % (171/212) 60.0% (1258/2097) < Nephrology 1, % (155/200) 36.9% (522/1416) < Neurosurgery 1, % (606/653) 61.5% (539/877) < Rheumatology 1, % (698/782) 54.1% (366/676) < a chi-square test. Table 4. The relationship of NSAID and antacid prescriptions, stratified by accreditation status of health care facilities Kind of facility Number of prescriptions Frequency of antacids in prescriptions with NSAIDs Frequency of antacids in prescriptions without NSAIDs p value a Medical centers 29, % (3638/4498) 37.8% (9396/24855) < Regional hospitals 33, % (4927/5904) 44.0% (12063/27439) < Local hospitals 59, % (14761/16880) 57.7% (24691/42783) < Primary care units 303, % (54279/81536) 50.3% (111497/221547) < a chi-square test. with NSAIDs ex isted in nearly all spe cial ties. Ta ble 3 lists only the data of those spe cial ties with more than 1,000 sam pling vis its. The co-prescription rate dif fered among spe cial ties (Chi-square test, p < 0.001) and var - ied from the high est of 92.8% in the neu ro sur gery to the lowest of 49.8% in the pe di at rics. Although some subspecialties (e.g. gastroenterology, car di ol ogy, chest med i cine and nephrology) of in ter nal med i cine pre - scribed NSAIDs less fre quently, their co-prescription rate of NSAIDs with ant ac ids re mained high. The association of ant ac ids pre scrip tion with NSAIDs also ex isted in dif fer ent lev els of health care fa cil i ties (Ta ble 4) and the co-prescription rate dif fered among lev els of health care fa cil i ties (Chi-square test, p < 0.001). Nev er the less, the pri mary care units had a lower co-prescription rate of 66.6% than hospitals (odds ra tio = 0.338, p < 0.001). The co-prescription rates with ant ac ids in ma jor sub groups of NSAIDs are listed in Ta ble 5. The sub - group of oxicams (M01AC), which in cluded piroxicam, tenoxicam, droxicam, lornoxicam and meloxicam, was more fre quently co-prescribed with ant ac ids than

5 592 Tzeng-Ji Chen, et al. Chi nese Med i cal Jour nal (Tai pei) Vol. 65 No. 12 Table 5. The relationship of different subgroups of NSAID prescriptions with antacids Subgroup of NSAID Number of prescriptions With antacids Without antacids M01AA: butylpyrazolidines (59.4%) 13 (40.6%) M01AB: acetic acid derivatives 44,555 32,571 (73.1%) 11,984 (26.9%) M01AC: oxicams 5,477 4,346 (79.4%) 1,131 (20.6%) M01AE: propionic acid derivatives 33,455 22,907 (68.5%) 10,548 (31.5%) M01AG: fenamates 26,788 19,020 (71.0%) 7,768 (29.0%) M01AH: coxibs 0 M01AX: others 4,964 3,445 (69.4%) 1,519 (30.6%) other sub groups (odds ra tio = 1.51, p = 0.001). In 1999, the sub group of coxibs (M01AH) was not yet avail able to the NHI in sured. The dis crep ancy be - tween the sum of pre scrip tions with dif fer ent groups of NSAIDs in Ta ble 5 and the to tal count of pre scrip - tions with NSAIDs in Ta ble 2 was caused by the fact that 8000 pre scrip tions con tained mul ti ple (> = 2) NSAIDs. Discussion Our study re-confirmed the fact that con com i tant pre scrip tion of oral non-aspirin NSAIDs and ant ac ids was a pop u lar prac tice in Tai wan. In our study, co-prescribing was as sessed as NSAIDs and ant ac ids on the same pre scrip tion. Be cause the datasets arose from visit-based sam pling, the lon gi tu di nal data of in - di vid ual pa tients were not avail able. We thus could not iden tify the sit u a tion in which a pa tient re ceived NSAIDs and ant ac ids from sep a rate pre scrip tions. If the pa tient re ally took all drugs pre scribed, the con - com i tant use of NSAIDs and ant ac ids would be more prev a lent than that cal cu lated in our study. Our study showed that pri mary care units had a lower co-prescription rate of NSAIDs and ant ac ids than hos pi tals, which might be at trib uted to case mix at dif fer ent lev els of health care fa cil i ties. The out pa - tient de part ments of hos pi tals in Tai wan are open to all the in sured with out any re fer ral lim i ta tion. The NHI has a fee-for-service pay ment in the ma jor ity of cases. The trend was then to ward that the hos pi tals saw more chronic pa tients and the pri mary care units pre scribed more with short du ra tion. Be sides, the pri - mary care units with dis pens ing rights are al lowed to charge the daily drug fee as a lump sum for the pre - scrip tions with up to three days sup ply. This reg u la - tion on pri mary care units im plic itly puts con straints on polypharmacy and helps avoid un nec es sary drug pre scrip tions. On the other hand, the pe di at ric pa tients were less likely to be chronic and thus had the low est co-prescription rate among all spe cial ties. In the lit er a ture, ant ac ids were sel dom pro posed for pre ven tion of NSAID-related gas tro in tes ti nal prob lems. The re search in ter ests fo cused on H 2 -re cep - tor an tag o nists (e.g. ranitidine), pros ta glan din analogs (e.g. misoprostol), and pro ton pump in hib i tors (e.g. omeprazole) in stead. 5-7 In Tai wan, the NHI re im - bursed these ul cer-healing drugs with strict lim i ta - tions. Ex cept for some small groups of high-risk pa - tients, ul cer-healing drugs could be pre scribed only if the di ag no sis of pep tic ul cer or re flux esophagitis is proved by a re cent en dos copy, ra di og ra phy or sur gery. Sim i lar re stric tions were also pres ent in other coun - tries. 8 Al though such re stric tions might lead to more ant ac ids pre scrip tion, they could hardly ex plain the ex tremely high co-prescription rate of NSAIDs with ant ac ids in Tai wan. The rea son for the ex treme frac tion of ant ac ids in the pre scrip tions with NSAIDs might come from both the phy si cian s and pa tient s sides. The phy si cians feared for side ef fects of NSAIDs and the pa tients had con cerns about in tol er ance to NSAIDs and other chem i cal drugs. The ex act cause de manded qual i ta - tive in ves ti ga tions. Sim i larly, it re mained un known whether ant ac ids were pre scribed to treat a pre ex ist ing gas tro in tes ti nal dis ease rather than to pre vent the po - ten tial NSAID-related gas tro in tes ti nal prob lems. Al - though up to three di ag nos tic codes of ICD-9-CM (In - ter na tional Clas si fi ca tion of Dis eases, 9th Re vi sion,

6 De cem ber 2002 NSAID and Ant acid Co-Prescription 593 Clin i cal Mod i fi ca tion) were pro vided in each NHI claims re cord, we did not in tend to use them for a judg ment about the pur pose of treat ment. The claims di ag no ses in the in sur ance sys tem usu ally serve for the re im burse ment only and are not ver i fied, es pe - cially in the out pa tient area. Be sides, there is no spe - cific code for the gastropathy caused by NSAIDs. It is in con clu sive whether the in sur ance pol icy should limit the co-therapy of NSAIDs with ant ac ids. The acid ity does play a role in NSAID dam age to the gas tric mu cosa through al ter ing the gas tric ab sorp tion of NSAIDs and in ter fer ing in the sec ond ary acid in - jury. 9 Be sides, ant ac ids can al le vi ate the more fre - quent NSAID-associated dys pep sia that dif fers from NSAID-associated ul cer in pathophysiological mech - anism. 10 Al though ant ac ids might not ef fec tively pre - vent ul cers in chronic NSAID us ers, they could lessen the in tol er ance in most pa tients who just oc ca sion ally take NSAIDs. On the con trary, the phy si cian should ex er cise cau tion in high-risk pa tients and adopt more po tent ul cer-healing drugs for pro phy laxis. Al though rou tine pre scrib ing of ant ac ids to gether with NSAIDs might not be a uni ver sal phe nom e non, 11 our study had yet an other par tic u lar mean ing. No phar ma ceu ti cal firms would take in ter est in sup port - ing stud ies re lated to ant ac ids, which have not so many fi nan cial ben e fits. The seem ingly ir ra tio nal or con tro ver sial pre scrib ing pro vides ex cel lent ma te ri als for nat u ral ob ser va tion or sur veil lance. If the di men - sion of co-prescription is sig nif i cant, fol low-up stud - ies can con tinue. Of course, due cau tion should also be needed in such ret ro spec tive ob ser va tional stud - ies. 12 Finally, the meth ods and tech niques we used to an a lyze the large amount of data could be ex tended to any pos si ble com bined pre scrip tion of drugs. In the era of elec tronic pre scrib ing, our ap proach might con - trib ute to the field of pharmacoepidemiology. Acknowledgements This study is based in part on data from the Na - tional Health In sur ance Re search Da ta base pro vided by the Bu reau of Na tional Health In sur ance, De part - ment of Health and man aged by Na tional Health Re - search In sti tutes in Tai wan. The in ter pre ta tion and con clu sions con tained herein do not rep re sent those of Bu reau of Na tional Health In sur ance, De part ment of Health or Na tional Health Re search In sti tutes. References 1. Liu JY, Chen TJ, Hwang SJ. Con com i tant pre scrip tion of non-steroidal anti-inflammatory drugs and ant ac ids in the out pa tient set ting of a med i cal cen ter in Tai wan: a pre scrip - tion da ta base study. Eur J Clin Pharmacol 2001;57: See Y, Ng SC, Tho KS, Teo SK. Are ant ac ids nec es sary as rou tine prescriptives with non-steroidal anti-inflammatory drugs? Ann Acad Med Sin ga pore 1998;27: Singh G, Ramey DR, Morfeld D, Shi H, Hatoum HT, Fries JF. Gas tro in tes ti nal tract com pli ca tions of nonsteroidal anti-inflammatory drug treat ment in rheu ma toid ar thri tis: a pro spec tive ob ser va tional co hort study. Arch In tern Med 1996;156: Guide lines for ATC Clas si fi ca tion and DDD As sign ment. 3 rd edi tion. Oslo: WHO Col lab o rating Cen tre for Drug Sta tis tics Meth od ol ogy, Ehsanullah RS, Page MC, Tildesley G, Wood JR. Pre ven tion of gastroduodenal dam age in duced by non-steroidal antiinflammatory drugs: con trolled trial of ranitidine. BMJ 1988;297: Gra ham DY, Agrawal NM, Roth SH. Pre ven tion of NSAID-induced gas tric ul cer with misoprostol: multicentre, dou ble-blind, pla cebo-controlled trial. Lancet 1988;2: Yeomans ND, Tulassay Z, Juhasz L, Racz I, Howard JM, van Rensburg CJ, et al. A com par i son of omeprazole with ranitidine for ul cers as so ci ated with nonsteroidal antiinflammatory drugs. N Engl J Med 1998;338: West brook JI, Duggan AE, McIntosh JH. Pre scrip tions for antiulcer drugs in Aus tra lia: vol ume, trends, and costs. BMJ 2001;323: Yeomans ND. Ap proaches to heal ing and pro phy laxis of nonsteroidal anti-inflammatory drug-associated ul cers. Am J Med 2001;110(1A):24-8S. 10. Jones J, Raud J. Nonsteroidal anti-inflammatory drug-associated dys pep sia: ba sic mech a nisms and fu ture re search. Am J Med 2001;110(1A):14-8S. 11. Clinard F, Bardou M, Sgro C, Lefevre N, Ra phael F, Paille F, et al. Non-steroidal anti-inflammatory and cytoprotective drug co-prescription in gen eral prac tice: a gen eral prac ti tio - ner-based sur vey in France. Eur J Clin Pharmacol 2001; 57: McMahon AD. Ob ser va tion and ex per i ment with the ef fi - cacy of drugs: a warn ing ex am ple from a co hort of nonsteroidal anti-inflammatory and ul cer-healing drug us ers. Am J Epidemiol 2001;154:

LSNJ...justice for all

LSNJ...justice for all a g l Educa t Le H LSNJ io...justice for all n s a n d b o ok Copyright 2010 Legal Services of New Jersey All rights reserved. No part of this handbook may be reproduced without permission. For further

More information

Child Abuse and Ne glect

Child Abuse and Ne glect Child Abuse and Ne glect A guide for par ents in volved in child abuse or ne glect cases in New Jersey 2015 Le gal Ser vices of New Jer sey Le gal Ser vices of New Jer sey makes this pub li ca tion avail

More information

Appendix D: Guidelines for Collaborative Study Procedures To Validate Characteristics of a Method of Anal y sis

Appendix D: Guidelines for Collaborative Study Procedures To Validate Characteristics of a Method of Anal y sis Appendix D: Guidelines for Collaborative Study Procedures To Validate Characteristics of a Method of Anal y sis {Note: These guide lines in cor po rate sym bols, ter mi nology, and rec om men da tions

More information

TUITION, FEES AND OTHER FINANCIAL INFORMATION General Information

TUITION, FEES AND OTHER FINANCIAL INFORMATION General Information TUITION, FEES AND OTHER FINANCIAL INFORMATION General Information The ex penses for each se mes ter will vary ac cord ing to the per sonal needs of the stu dent and the course of study pur sued. The tu

More information

Real Life Online Seminars. HEART of Accounting. The. John W. Day, MBA. A 4-hour course for non-accountants!

Real Life Online Seminars. HEART of Accounting. The. John W. Day, MBA. A 4-hour course for non-accountants! Real Life Online Seminars The HEART of Accounting TM A 4-hour course for non-accountants! John W. Day, MBA Real Life Online Sem i nars Pres ents The HEART of Account ing A 4-Hour Step-By-Step Course That

More information

Mass Me dia Ex po sure among Ur ban Youth in Ne pal

Mass Me dia Ex po sure among Ur ban Youth in Ne pal Articles Mass Me dia Ex po sure among Ur ban Youth in Ne pal Mass me dia in ter ven tions need to re duce the wide gaps in re pro duc tive health knowl edge that ex ist be tween sin gle and mar ried and

More information

Restoration Certificate No. 201501

Restoration Certificate No. 201501 Restoration Certificate No. 201501 19th Century Alabaster Clock adorned with Cupid, French 8-day Japy Movement with Hourly and Half-Hourly Strike, Alabaster and Gilt Dial Issued by Dr N Bjergstrom, All

More information

ASCENT TM Integrated Shipment Management

ASCENT TM Integrated Shipment Management ASCENT TM Integrated Shipment Management Software Solutions Production mail Shipping systems Copier systems Facsimile systems Mailing systems Management services Financial services Consulting Supplies

More information

SM 3300 - Interface modules

SM 3300 - Interface modules Vissersdijk 4 4301 ND Zierikzee The Netherlands Tel. +31 111 413656 Fax. +31 111 416919 www.deltapowersupplies.com DELTA ELEKTRONIKA B.V. SM 3300 - Interface modules Mod els Description INT MOD M/S Master/Slave

More information

Up dated 12/7/1999. General Ledger User s Guide

Up dated 12/7/1999. General Ledger User s Guide Up dated 12/7/1999 General Ledger User s Guide : 1999 Print ing Copy right 1994 Boy Scouts of Amer ica Irving, Texas No. 80-173 Contents: Contents Con tents......................... 1 In tro duc tion.......................

More information

lert AMarket solutions to public policy problems

lert AMarket solutions to public policy problems Fraser lert AMarket solutions to public policy problems April 21 The Canadian Consumer Tax Index, 21 Main Conclusions The Canadian Consumer Tax Index tracks the total tax bill of the average Canadian family

More information

ES 150 - Series 150 W DC POWER SUP PLIES

ES 150 - Series 150 W DC POWER SUP PLIES Vissersdijk 4 4301 ND Zierikzee The Netherlands Tel. +31 111 413656 Fax. +31 111 416919 www.deltapowersupplies.com DELTA ELEKTRONIKA B.V. ES 150 - Series 150 W DC POWER SUP PLIES Mod els Volt age range

More information

TUITION, FEES AND OTHER FINANCIAL INFORMATION General Information

TUITION, FEES AND OTHER FINANCIAL INFORMATION General Information TUITION, FEES AND OTHER FINANCIAL INFORMATION General Information The ex penses for each se mes ter will vary ac cord ing to the per sonal needs of the stu dent and the course of study pur sued. The tu

More information

SM 3300 - Series 3300 W DC POWER SUP PLIES

SM 3300 - Series 3300 W DC POWER SUP PLIES Vissersdijk 4 4301 ND Zierikzee The Netherlands Tel. +31 111 413656 Fax. +31 111 416919 www.deltapowersupplies.com DELTA ELEKTRONIKA B.V. SM 3300 Series 3300 W DC POWER SUP PLIES One or Three phase input

More information

ES150 - se ries. 150 watts DC POWER SUP PLIES. ES V 0-10 A ES V 0-5 A ES V 0-2 A ES V ma

ES150 - se ries. 150 watts DC POWER SUP PLIES. ES V 0-10 A ES V 0-5 A ES V 0-2 A ES V ma P.O. BOX 27 4300 AA ZIERIKZEE NETHERLANDS TEL. +31 111 413656 FAX +31 111 416919 www.deltapowersupplies.com ES150 - se ries 150 watts DC POWER SUP PLIES ES 015-10 0-15 V 0-10 A ES 030-5 0-30 V 0-5 A ES

More information

ARE CONSTITUTIONS LEGITIMATE?* Andrei MARMOR

ARE CONSTITUTIONS LEGITIMATE?* Andrei MARMOR PROBLEMA Anua rio de Fi lo so fía y Teo ría del De re cho 1 ARE CONSTITUTIONS LEGITIMATE?* Andrei MARMOR Re su men: Aun que la idea del cons ti tu cio na lis mo ha sido ex ten sa men te di fun di da y

More information

3 Class A-surface. 3.1 Introduction. Copyright by Richard Haslauer

3 Class A-surface. 3.1 Introduction. Copyright by Richard Haslauer 3.1 Introduction The ger man term Strak (in Eng lish: Class A-sur face) has its or i gins in the ship build ing where com pli cated free form sur faces were de scribed with ver ti cal, lon gi tu - di nal

More information

Lens Equation Purpose

Lens Equation Purpose Lens Equation Purpose To verify the lens equation for both a converging lens and a diverging lens. To investigate optical systems. To find the focal lengths of a converging lens and a diverging lens. Background

More information

Appendix E: Laboratory Quality Assurance

Appendix E: Laboratory Quality Assurance Appendix E: Laboratory Quality Assurance Joanna Lynch, Chapter Editor Cornell University For over a cen tury, AOAC IN TER NA TIONAL has pro vided the meth ods of anal y sis re quired for the mea sure ment

More information

1.- L a m e j o r o p c ió n e s c l o na r e l d i s co ( s e e x p li c a r á d es p u é s ).

1.- L a m e j o r o p c ió n e s c l o na r e l d i s co ( s e e x p li c a r á d es p u é s ). PROCEDIMIENTO DE RECUPERACION Y COPIAS DE SEGURIDAD DEL CORTAFUEGOS LINUX P ar a p od e r re c u p e ra r nu e s t r o c o rt a f u e go s an t e un d es a s t r e ( r ot u r a d e l di s c o o d e l a

More information

TROU BLE SHOOTING VIKING ALARM VALVES

TROU BLE SHOOTING VIKING ALARM VALVES TROU BLE SHOOTING VIKING ALARM VALVES 1 TROUBLESHOOTING THE VIKING MODEL E, F, AND G ALARM VALVES What are the symp toms of the sys tem? 1) Are alarms ring ing in ter mit tently? a) It is prob a bly the

More information

A WEB-BASED DECISION SUPPORT SYSTEM FOR DIVORCE LAWYERS

A WEB-BASED DECISION SUPPORT SYSTEM FOR DIVORCE LAWYERS A WEB-BASED DECISION SUPPORT SYSTEM FOR DIVORCE LAWYERS Li lian EDWARDS John KINGSTON SUMMARY: I. In tro duc tion. II. Back ground. III. Fi nan - cial Pro vi sion on Di vorce. IV. Tech nol ogy and Law.

More information

SCIENCE EDUCATION IN ROMANIA THROUGH HANDS-ON ACTIVITIES

SCIENCE EDUCATION IN ROMANIA THROUGH HANDS-ON ACTIVITIES SCIENCE EDUCATION IN ROMANIA THROUGH HANDS-ON ACTIVITIES D. Sporea and Adelina Sporea National In sti tute for La sers, Plasma and Ra di a tion Phys ics, Bu cha rest, Ro ma nia, sporea@ifin.nipne.ro or

More information

SM Se ries 3000 W DC POWER SUP PLIES

SM Se ries 3000 W DC POWER SUP PLIES Vissersdijk 4 4301 ND Zierikzee The Netherlands Tel. +31 111 413656 Fax. +31 111 416919 www.deltapowersupplies.com DELTA ELEKTRONIKA B.V. SM 3000 - Se ries 3000 W DC POWER SUP PLIES Mod els Volt age range

More information

Debt Management Handbook

Debt Management Handbook Debt Management Handbook > ready > set > succeed Commonwealth of Pennsylvania Edward G. Rendell, Governor www.state.pa.us Department of Community & Economic Development Dennis Yablonsky, Secretary newpa.com

More information

IRS-8B. In stal la tion and Pro gram ming Man ual. Soft ware Ver. 1.03 Man ual N 18322 Rev. -

IRS-8B. In stal la tion and Pro gram ming Man ual. Soft ware Ver. 1.03 Man ual N 18322 Rev. - IRS-8B In stal la tion and Pro gram ming Man ual Soft ware Ver. 1.03 Man ual N 18322 Rev. - The in for ma tion in this man ual re places any pre vi ously pub lished in for ma tion. Sicep re serves the

More information

Aper son who can not see or hear or who

Aper son who can not see or hear or who DB LINK The National Information Clearinghouse on Children Who Are Deaf-Blind Helen Kel ler Na tional Cen ter Perkins School for the Blind Teach ing Re search Talk ing the Lan guage of the Hands to the

More information

MULTILINK 8 IN PUTS 8 OUTPUTS INTERFACE/PERIPHERAL ML-8

MULTILINK 8 IN PUTS 8 OUTPUTS INTERFACE/PERIPHERAL ML-8 MULTILINK 8 IN PUTS 8 OUTPUTS INTERFACE/PERIPHERAL ML-8 In stal la tion and user man ual Soft ware Ver. 1.02 Man ual N 18926 Rev. A The information in this manual replaces any previously published information.

More information

Density in Urban Development

Density in Urban Development Density in Urban Development Claudio Acioly Jr. and Forbes Davidson The au thors are with the In sti tute for Housing and Ur ban De vel op ment Studies (IHS), The Neth er lands, and are in volved with

More information

THIS BUL LE TIN IS FAA AP PROVED FOR EN GI NEER ING DE SIGN SUB JECT: IN SPEC TION OF FUSELAGE TUBULAR STRUC TURE

THIS BUL LE TIN IS FAA AP PROVED FOR EN GI NEER ING DE SIGN SUB JECT: IN SPEC TION OF FUSELAGE TUBULAR STRUC TURE SERV ICE BUL LE TIN NUM BER M20-208B DATE: 8-18-89 THIS BUL LE TIN IS FAA AP PROVED FOR EN GI NEER ING DE SIGN SUB JECT: IN SPEC TION OF FUSELAGE TUBULAR STRUC TURE MOD ELS AF FECTED:Part A only All M20

More information

Tax Benefits of Ownership. Sample. Chapter 1 Outline

Tax Benefits of Ownership. Sample. Chapter 1 Outline Chapter 1 Home loan interest deductions This chapter reviews the home loan interest deduction for reporting the tax consequences of financing first and second homes. Chapter 1 Outline Two residences, two

More information

Solar Heat Worldwide

Solar Heat Worldwide Solar Heat Worldwide Markets and Contribution to the Energy Supply 2006 E D I T I O N 2 0 0 9 Werner Weiss Irene Bergmann Roman Stelzer AEE INTEC AEE - Institute for Sustainable Technologies A-8200 Gleisdorf,

More information

PT-100. Use and pro gram ming man ual. Soft ware Ver. 1.0.4d IST-PT-100.20108 Rev. -

PT-100. Use and pro gram ming man ual. Soft ware Ver. 1.0.4d IST-PT-100.20108 Rev. - PT-100 Use and pro gram ming man ual Soft ware Ver. 1.0.4d IST-PT-100.20108 Rev. - The information in this manual replaces any previously published information. Sicep reserves the right to modify prices

More information

G ri d m on i tori n g w i th N A G I O S (*) (*) Work in collaboration with P. Lo Re, G. S av a and G. T ortone WP3-I CHEP 2000, N F N 10.02.2000 M e e t i n g, N a p l e s, 29.1 1.20 0 2 R o b e r 1

More information

B y R us se ll E ri c Wr ig ht, DV M. M as te r of S ci en ce I n V et er in ar y Me di ca l Sc ie nc es. A pp ro ve d:

B y R us se ll E ri c Wr ig ht, DV M. M as te r of S ci en ce I n V et er in ar y Me di ca l Sc ie nc es. A pp ro ve d: E ff ec ts o f El ec tr ic al ly -S ti mu la te d Si lv er -C oa te d Im pl an ts a nd B ac te ri al C on ta mi na ti on i n a Ca ni ne R ad iu s Fr ac tu re G ap M od el B y R us se ll E ri c Wr ig ht,

More information

CHAPTER 10 MEANS OF EGRESS. User Note: See Pref ace page iv ( mar ginal mark ings ) for Chap ter 10 reor ga ni za tion in for ma tion.

CHAPTER 10 MEANS OF EGRESS. User Note: See Pref ace page iv ( mar ginal mark ings ) for Chap ter 10 reor ga ni za tion in for ma tion. CHAPTER 10 MEANS OF EGRESS User Note: See Pref ace page iv ( mar ginal mark ings ) for Chap ter 10 reor ga ni za tion in for ma tion. SECTION 1001 ADMINISTRATION 1001.1 Gen eral. Build ings or por tions

More information

SPECIAL CONSTRUCTION

SPECIAL CONSTRUCTION CHAPTER 31 SPECIAL CONSTRUCTION SECTION 3101 GENERAL 3101.1 Scope. The provisions of this chap ter shall gov ern spe - cial build ing con struc tion in clud ing mem brane struc tures, tem - po rary struc

More information

Problema: Anuario de Filosofía y Teoría del Derecho ISSN: 2007-4387 problema.unam@gmail.com. Universidad Nacional Autónoma de México.

Problema: Anuario de Filosofía y Teoría del Derecho ISSN: 2007-4387 problema.unam@gmail.com. Universidad Nacional Autónoma de México. Problema: Anuario de Filosofía y Teoría del Derecho ISSN: 2007-4387 problema.unam@gmail.com Universidad Nacional Autónoma de México México CÁCERES, Enrique COGNITION, EPISTEMOLOGY, AND REASONING ABOUT

More information

DETERMINATION OF POINT-GROUP SYMMETRY VIA TEM EXPERIMENTS

DETERMINATION OF POINT-GROUP SYMMETRY VIA TEM EXPERIMENTS 80 Materials Structure, vol. 0, number 2 (2003) DETERMINATION OF POINT-GROUP SYMMETRY VIA TEM EXPERIMENTS Mária Èaplovièová, Pavel Fejdi 2, Jozef Krištín Cen tral lab o ra tory of elec tron-op tic meth

More information

Public Accounts. For the Fiscal Year Ended March 31, 2004. Ministry of Finance Office of the Comptroller General

Public Accounts. For the Fiscal Year Ended March 31, 2004. Ministry of Finance Office of the Comptroller General Public Accounts Ministry of Finance Office of the Comptroller General For the Fiscal Year Ended March 31, 2004 2003 / 2004 Ministry of Finance Office of the Comptroller General National Library of Canada

More information

SM 6000 - Se ries 6000 W DC POWER SUP PLIES DELTA ELEKTRONIKA B.V. Mod els Volt age range Cur rent range. Three phase input

SM 6000 - Se ries 6000 W DC POWER SUP PLIES DELTA ELEKTRONIKA B.V. Mod els Volt age range Cur rent range. Three phase input Vissersdijk 4 4301 ND Zierikzee The Netherlands Tel. +31 111 413656 Fax. +31 111 416919 www.deltapowersupplies.com DELTA ELEKTRONIKA B.V. SM 6000 - Se ries 6000 W DC POWER SUP PLIES Three phase input Mod

More information

Prediction of In-Hospital Mortality in Patients with Myocardial Infarction Using APACHE II System

Prediction of In-Hospital Mortality in Patients with Myocardial Infarction Using APACHE II System Chi nese Med i cal Jour nal (Taipei) 2001;64:501-506 Orig i nal Prediction of In-Hospital Mortality in Patients with Myocardial Infarction Using APACHE II System Hung-Ting Chiang Shoa-Lin Lin Hsiang-Chin

More information

TEXAS A&M UNIVERSITY AT GALVESTON 2013-2014 CATALOG NO. 136

TEXAS A&M UNIVERSITY AT GALVESTON 2013-2014 CATALOG NO. 136 TEXAS A&M UNIVERSITY AT GALVESTON 2013-2014 CATALOG NO. 136 Purpose of Catalog The pur pose of this cat a log is to pro vide in for ma tion about the ac a demic pro grams of Texas A&M Uni ver sity at Galveston

More information

TRUST DEED INVESTMENTS WHAT YOU SHOULD KNOW!! SERVING CALIFORNIANS SINCE 1917 DEPARTMENT OF REAL ESTATE

TRUST DEED INVESTMENTS WHAT YOU SHOULD KNOW!! SERVING CALIFORNIANS SINCE 1917 DEPARTMENT OF REAL ESTATE TRUST DEED INVESTMENTS WHAT YOU SHOULD KNOW!! SERVING CALIFORNIANS SINCE 1917 DEPARTMENT OF REAL ESTATE TRUST DEED INVESTMENTS WHAT YOU SHOULD KNOW!! ARNOLD SCHWARZENEGGER Governor State of California

More information

UN-436. In stal la tion and Pro gram ming Man ual. Soft ware Ver. 1.2.0 Man ual n 19969 Rev. A

UN-436. In stal la tion and Pro gram ming Man ual. Soft ware Ver. 1.2.0 Man ual n 19969 Rev. A UN-436 In stal la tion and Pro gram ming Man ual Soft ware Ver. 1.2.0 Man ual n 19969 Rev. A The information in this manual replaces any previously published information. Sicep reserves the right to modify

More information

SPECIFIC APPLIANCES, FIREPLACES AND SOLID FUEL-BURNING EQUIPMENT

SPECIFIC APPLIANCES, FIREPLACES AND SOLID FUEL-BURNING EQUIPMENT CHAPTER 9 SPECIFIC APPLIANCES, FIREPLACES AND SOLID FUEL-BURNING EQUIPMENT SECTION 901 GENERAL 901.1 Scope. This chap ter shall gov ern the ap proval, de sign, in stal la tion, con struc tion, main te

More information

i n g S e c u r it y 3 1B# ; u r w e b a p p li c a tio n s f r o m ha c ke r s w ith t his å ] í d : L : g u id e Scanned by CamScanner

i n g S e c u r it y 3 1B# ; u r w e b a p p li c a tio n s f r o m ha c ke r s w ith t his å ] í d : L : g u id e Scanned by CamScanner í d : r ' " B o m m 1 E x p e r i e n c e L : i i n g S e c u r it y. 1-1B# ; u r w e b a p p li c a tio n s f r o m ha c ke r s w ith t his g u id e å ] - ew i c h P e t e r M u la e n PACKT ' TAÞ$Æo

More information

SM 800 - Se ries 800 W DC POWER SUP PLY

SM 800 - Se ries 800 W DC POWER SUP PLY Vissersdijk 4 4301 ND Zierikzee The Netherlands Tel. +31 111 413656 Fax. +31 111 416919 www.deltapowersupplies.com DELTA ELEKTRONIKA B.V. SM 800 Se ries 800 W DC POWER SUP PLY Mod els Volt age range Cur

More information

Data Center end users for 40G/100G and market dy nami c s for 40G/100G on S M F Adam Carter Ci s c o 1 W Now that 40GbE is part of the IEEE 802.3ba there will be a wid er array of applic ation s that will

More information

Handoff Between a Wireless Local Area Network (WLAN) and a Wide Area Network (UMTS)

Handoff Between a Wireless Local Area Network (WLAN) and a Wide Area Network (UMTS) RIIT Vol.X. Num.2. 2009 167-184, ISSN1405-7743 FI-UNAM (artículo arbitrado) Handoff Between a Wireless Local Area Network (WLAN) and a Wide Area Network (UMTS) Traspaso entre una red inalámbrica de área

More information

Nursing. Nursing. 2010-2011 Undergraduate Bulletin

Nursing. Nursing. 2010-2011 Undergraduate Bulletin Nursing Nursing College of Allied Health & Nursing School of Nursing 360 Wissink Hall 507-389-6022 Web site: http://ahn.mnsu.edu/nursing/ Chair: Marcia Stevens Sue Ellen Bell, Annette Benson, Donna Brauer,

More information

Put the human back in Human Resources.

Put the human back in Human Resources. Put the human back in Human Resources A Co m p l et e Hu m a n Ca p i t a l Ma n a g em en t So l u t i o n t h a t em p o w er s HR p r o f essi o n a l s t o m eet t h ei r co r p o r a t e o b j ect

More information

Pharma Ingredients & Services. Kolliphor EL. Macrogolglycerol Ricinoleate Ph. Eur., Poly oxyl 35 Cas tor Oil USP. Technical Information

Pharma Ingredients & Services. Kolliphor EL. Macrogolglycerol Ricinoleate Ph. Eur., Poly oxyl 35 Cas tor Oil USP. Technical Information Technical Information March 2012 Supersedes issue dated December 2011 03_111139e-02/Page 1 of 6 WF-No. 118483 Kolliphor EL Macrogolglycerol Ricinoleate Ph. Eur., Poly oxyl 35 Cas tor Oil USP = Trademark

More information

SM 1500 - Series 1500 Watts DC POWER SUP PLIES

SM 1500 - Series 1500 Watts DC POWER SUP PLIES Vissersdijk 4 4301 ND Zierikzee The Netherlands Tel. +31 111 413656 Fax. +31 111 416919 www.deltapowersupplies.com DELTA ELEKTRONIKA B.V. SM 1500 Series 1500 Watts DC POWER SUP PLIES Mod els Volt age range

More information

MOTORI ELETTRICI TRIFASE SERIE MS MOTORI ELETTRICI MONOFASE SERIE MY

MOTORI ELETTRICI TRIFASE SERIE MS MOTORI ELETTRICI MONOFASE SERIE MY RI RI OORI RICI OO RI Y Caratteristiche tecniche / echnical characteristics I mo to ri ran stec no se rie e Y sono chiu si e do ta ti di ven to la di raf fred da men to. and Y se ries ran stec no mo tors

More information

Polish public opinion on the Eu ro pe an Union and the Con sti tu tio nal Tre a ty

Polish public opinion on the Eu ro pe an Union and the Con sti tu tio nal Tre a ty INSTYTUT SPRAW PUBLICZNYCH THE INSTITUTE OF PUBLIC AFFAIRS Polish public opinion on the Eu ro pe an Union and the Con sti tu tio nal Tre a ty Su r vey Re port Warsaw, May 2006 In tro du c tion The pe riod

More information

Methodological Naturalism Under Attack

Methodological Naturalism Under Attack Methodological Naturalism Under Attack Mi chael Ruse De part ment of Phi los o phy Florida State Uni ver sity Tal la has see, FL 32306-1500 USA E-mail: mruse@mailer.fsu.edu Abstract Meth od olog i cal

More information

T e s t e xp re s s i o n B o d y o f i f E xi t F i g u re 1 - F l o w c h art o f th e i f s tate m M u l ti S tate m s i n th e i f B o d y : L ik

T e s t e xp re s s i o n B o d y o f i f E xi t F i g u re 1 - F l o w c h art o f th e i f s tate m M u l ti S tate m s i n th e i f B o d y : L ik MQL4 COURSE By Coders guru w w w. f orex -t sd. c om -6- Loops & Decisions Part 2 ---------------------------- We l c o m e t o t h e s ix t h l e s s o n in m y c o u r s e a b o u t M Q L 4. I h o pe

More information

IRS-CB. In stal la tion and Pro gram ming Man ual. Soft ware Ver. 1.0.6 Man ual n 18942 Rev. A

IRS-CB. In stal la tion and Pro gram ming Man ual. Soft ware Ver. 1.0.6 Man ual n 18942 Rev. A In stal la tion and Pro gram ming Man ual Soft ware Ver. 1.0.6 Man ual n 18942 Rev. A The in for ma tion in this man ual re places any pre vi ously pub lished in for ma tion. Sicep re serves the right

More information

Warsaw School of Economics (SGH)

Warsaw School of Economics (SGH) www.sgh.waw.pl Fo un ded in 1906, the War saw Scho ol of Eco no mics (Szko ła Głów na Han dlo wa w War - sza wie, SGH) is the ol dest pu blic uni ver si ty of eco no mics and business in Po land. Education.

More information

Editorial: SIRCC-ing to the Future... / 3. Supervising new CYC staff... / 5 Jack Phelan

Editorial: SIRCC-ing to the Future... / 3. Supervising new CYC staff... / 5 Jack Phelan Contents Editorial: SIRCC-ing to the Future....................... / 3 Supervising new CYC staff.......................... / 5 Jack Phelan Relationships and Relational Practice...................... /

More information

SCO TT G LEA SO N D EM O Z G EB R E-

SCO TT G LEA SO N D EM O Z G EB R E- SCO TT G LEA SO N D EM O Z G EB R E- EG Z IA B H ER e d it o r s N ) LICA TIO N S A N D M ETH O D S t DVD N CLUDED C o n t e n Ls Pr e fa c e x v G l o b a l N a v i g a t i o n Sa t e llit e S y s t e

More information

RE MOTE AC CESS TO ATOMTEX 1125A IN STRU MENT

RE MOTE AC CESS TO ATOMTEX 1125A IN STRU MENT Nu clear Tech nol ogy & Ra di a tion Pro tec tion: Year 2013, Vol. 28, No. 1, pp. 97-101 97 RE MOTE AC CESS TO ATOMTEX 1125A IN STRU MENT by Vlade UROŠEVI] Faculty of Technical Science, University of Kragujevac,

More information

UNEMPLOYMENT DURATION IN THE PORTUGUESE LABOUR MARKET*

UNEMPLOYMENT DURATION IN THE PORTUGUESE LABOUR MARKET* Articles Win ter 2008 UNEMPLOYMENT DURATION IN THE PORTUGUESE LABOUR MARKET* Pedro Portugal** O sa ber sem inteireza é uã roda de vento D. Fran cisco de Por tu gal, 1º Conde de Vimioso 1. INTRODUCTION

More information

Convergencia. Revista de Ciencias Sociales ISSN: 1405-1435 revistaconvergencia@yahoo.com.mx Universidad Autónoma del Estado de México México

Convergencia. Revista de Ciencias Sociales ISSN: 1405-1435 revistaconvergencia@yahoo.com.mx Universidad Autónoma del Estado de México México Convergencia. Revista de Ciencias Sociales ISSN: 1405-1435 revistaconvergencia@yahoo.com.mx Universidad Autónoma del Estado de México México Law, John Traduction / Trahison: Notes on ANT Convergencia.

More information

Auto Insurance Market Quality Index, 2010: Comparison of North American Auto Insurance Markets

Auto Insurance Market Quality Index, 2010: Comparison of North American Auto Insurance Markets December 2010 Market solutions to public policy problems Auto Insurance Market Quality Index, 2010: Comparison of North American Auto Insurance Markets By Brett J. Skinner and Mark Rovere Main Conclusions

More information

THE SCHOOL OF NURSING

THE SCHOOL OF NURSING THE SCHOOL OF NURSING Master of Science in Nursing Mission Statement To provide masters nursing education that builds on the baccalaureate undergraduate foun da tion. To prepare the graduate for advanced

More information

Modbus Plus Adapter. EIG Model MP1, a Modbus Plus adapter for DMMS 300+ and Futura+ Monitors. User Manual and Reference Guide Version 1.

Modbus Plus Adapter. EIG Model MP1, a Modbus Plus adapter for DMMS 300+ and Futura+ Monitors. User Manual and Reference Guide Version 1. Modbus Plus Adapter EIG Model MP1, a Modbus Plus adapter for DMMS 300+ and Futura+ Monitors User Manual and Reference Guide Version 1.6 Modbus Plus Adapter User Manual and Reference Guide Version 1.6

More information

A NUMERICAL STUDY OF FLOW AND TEMPERATURE FIELDS IN CIRCULAR TUBE HEAT EXCHANGER WITH ELLIPTIC VORTEX GENERATORS

A NUMERICAL STUDY OF FLOW AND TEMPERATURE FIELDS IN CIRCULAR TUBE HEAT EXCHANGER WITH ELLIPTIC VORTEX GENERATORS THERMAL SCIENCE: Vol. 1 (008), No., pp. 19-136 19 A NUMERICAL STUDY OF FLOW AND TEMPERATURE FIELDS IN CIRCULAR TUBE HEAT EXCHANGER WITH ELLIPTIC VORTEX GENERATORS by Ehsan MOHSENI-LANGURI, Mofid GORJI-BANDPY,

More information

THE CULTURAL ACTIVITIES CLUSTER IN PORTUGAL Trends and perspectives

THE CULTURAL ACTIVITIES CLUSTER IN PORTUGAL Trends and perspectives THE CULTURAL ACTIVITIES CLUSTER IN PORTUGAL Trends and perspectives Pedro Costa Abstract The aim of this article is to evaluate briefly the importance of cultural activities in the Portuguese economy,

More information

What are the mark ers of a good qual ity life? How can we con trib ute to the qual ity of a studen t s life

What are the mark ers of a good qual ity life? How can we con trib ute to the qual ity of a studen t s life Volume 2, Issue 3 Spring 1995 Heidi s Inclusion in Junior High: Transition and Educational Planning for a Student with Deaf-Blindness Susan W. Edelman Jean Knutson Daniel Osborn Michael F. Giangreco University

More information

TECHNICAL DATA. NOTES: For use with Trim Chart on page 27 b. (open fold-out)

TECHNICAL DATA. NOTES: For use with Trim Chart on page 27 b. (open fold-out) De cem ber 6, 1999 Trim 27 a MODEL J-1 ALARM CHECK VALVE VERTICAL TRIM Maximum 250 PSI WWP This Trim Chart is for use with the following Viking Trim Sets Valve Size Standard* Trim P/N Foam System** Trim

More information

EXTENDING SOCIAL SECURITY TO ALL. Changing the development policy paradigm: Investing in a social security floor for all

EXTENDING SOCIAL SECURITY TO ALL. Changing the development policy paradigm: Investing in a social security floor for all EXTENDING SOCIAL SECURITY TO ALL Changing the development policy paradigm: Investing in a social security floor for all Michael Cichon and Krzysztof Hagemejer Social Security Department, International

More information

OBSOLETE AIRCRAFT HANGAR FIRE PROTECTION APPLICATION DESIGN DATA. March 1, Foam 430a

OBSOLETE AIRCRAFT HANGAR FIRE PROTECTION APPLICATION DESIGN DATA. March 1, Foam 430a APPLICATION Foam 430a FIRE PROTECTION Form No. 062793 Re places pages 950a-h dated Feb ru ary 28, 1994 and 940i-k dated Au gust 26, 1994. Re vised page num ber. Foam 430b March 1, 2001 GENERAL A fixed

More information

Using USPS Confirmation Services with Digital Mailing Systems

Using USPS Confirmation Services with Digital Mailing Systems Using USPS Confirmation Services with Digital Mailing Systems DM100i, DM125, DM225, DM200L, DM300c, DM400c, DM450c, DM475, DP100i, DP200L, DP300C, DP400C, DP450C, DP475 Reference Manual SV61156 Rev. F

More information

Vocal solo part. Carl Philipp Emanuel BACH MAGNIFICAT

Vocal solo part. Carl Philipp Emanuel BACH MAGNIFICAT Vocal solo art Carl Phili Emanuel BACH MAGNIFICAT Vocal solo art Allegro 1. Magniicat TACET Carl Phili Emanuel BACH (1714-1788) 2. Quia resexit Sorano Andante 5 9 12 2 C.Ph.E.Bach. Magniicat Vocal solo

More information

First A S E M R e c to rs C o n f e re n c e : A sia E u ro p e H ig h e r E d u c a tio n L e a d e rsh ip D ia l o g u e Fre ie U n iv e rsitä t, B e rl in O c to b e r 2 7-2 9 2 0 0 8 G p A G e e a

More information

CalVet originates approximately 2,000 loans annually, ranging from 1,000 to 4,000 in any one year.

CalVet originates approximately 2,000 loans annually, ranging from 1,000 to 4,000 in any one year. Chapter 41 CalVet loan contracts This chapter discusses the CalVet loan program administered by the California Department of Veterans Affairs and documented by a hybridized lien without mortgage law protection.

More information

DOCTORAL PROGRAMS FOR CURRICULUM PRACTfT ONERS: BEFORE AND SINCE 1969

DOCTORAL PROGRAMS FOR CURRICULUM PRACTfT ONERS: BEFORE AND SINCE 1969 DOCTORAL PROGRAMS FOR CURRICULUM PRACTfT ONERS: BEFORE AND SINCE n IN RECENT years there has been a growing interest in the nature of doctoral programs designed to prepare curriculum specialists to work

More information

word List Direct Instruction for Decoding, Spelling, and Understanding Multisyllabic Words Grades 4 12 RTI Megawords 7

word List Direct Instruction for Decoding, Spelling, and Understanding Multisyllabic Words Grades 4 12 RTI Megawords 7 word List Direct Instruction for Decoding, Spelling, and Understanding Multisyllabic Words Grades 4 12 RTI Megawords 7 tel 800.225.5750 epsbooks.com fax 888.440.2665 WORD LIST 34 Unaccented i = /ә / or

More information

Nikon Capture 4 CMS The Color Management Tab (Windows) Change Display Profi le Advanced Add

Nikon Capture 4 CMS The Color Management Tab (Windows) Change Display Profi le Advanced Add Nikon Capture 4 CMS The Color Management Tab (Windows) The Color Management tab is where you spec i fy the color management profi les used for displaying im ag es on your monitor, ed it ing and saving

More information

The Personal Cost and Affordability of Auto Insurance in Canada

The Personal Cost and Affordability of Auto Insurance in Canada Studies in Financial Policy October 2011 The Personal Cost and Affordability of Auto Insurance in Canada 2011 Edition by Neil Mohindra and M. Emrul Hasan Key Conclusions Auto insurance premium costs in

More information

MINNESOTA OFFICE OF THE LEGISLATIVE AUDITOR State Building Maintenance

MINNESOTA OFFICE OF THE LEGISLATIVE AUDITOR State Building Maintenance MINNESOTA OFFICE OF THE LEGISLATIVE AUDITOR State Building Maintenance SUMMARY P reservation of buildings owned by the State of Minnesota has become a topic of increasing concern within both the legislative

More information

PERFORMANCE EVALUATION OF TUBE-IN-TUBE HEAT EXCHANGERS WITH HEAT TRANSFER ENHANCEMENT IN THE ANNULUS

PERFORMANCE EVALUATION OF TUBE-IN-TUBE HEAT EXCHANGERS WITH HEAT TRANSFER ENHANCEMENT IN THE ANNULUS PEFOMANCE EVALUATION OF TUBE-IN-TUBE HEAT EXCHANGE WITH HEAT TANFE ENHANCEMENT IN THE ANNULU by Ventsislav D. ZIMPAOV, Plamen J. PENCHEV, and Joshua P. MEYE Original scientiic paper UDC: 66.045.1:519.876.5

More information

Be cause ther a peu tic ef fi cacy across an ti de pres sants (ADs)

Be cause ther a peu tic ef fi cacy across an ti de pres sants (ADs) Orig i nal Re search Antidepressant Side Effects in Depression Patients Treated in A Naturalistic Setting: A Study of Bupropion, Moclobemide, Paroxetine, Sertraline, and Venlafaxine JD Vanderkooy, BSc

More information

Lease vs. Purchase. Guidelines for Lease vs. Purchase of Information Technologies. Department of Information Resources.

Lease vs. Purchase. Guidelines for Lease vs. Purchase of Information Technologies. Department of Information Resources. Lease vs. Purchase Guidelines for Lease vs. Purchase of Information Technologies Department of Information Resources Austin, Texas May 1998 Acknowledgements Lisa Lewis, Dell Computer Corporation Denise

More information

CHANGES IN GROUND WA TER STOR AGE, KAMIENNA DRAIN AGE BA SIN, SOUTH EAST ERN PO LAND

CHANGES IN GROUND WA TER STOR AGE, KAMIENNA DRAIN AGE BA SIN, SOUTH EAST ERN PO LAND Annales Societatis Geologorum Poloniae (2013), vol. 83: 149 159. CHANGES IN GROUND WA TER STOR AGE, KAMIENNA DRAIN AGE BA SIN, SOUTH EAST ERN PO LAND Jan PRA AK Pol ish Geo log i cal In sti tute Na tional

More information

«С e n tra l- A s ia n E le c tric - P o w e r C o rp o ra tio n», JS C

«С e n tra l- A s ia n E le c tric - P o w e r C o rp o ra tio n», JS C J o in t - s t o c k c o m p C E N T R A L - A S IA N E L E C T R IC P O W a n y E R C O R P O R A T IO N I n t e r n a l A u d i t P O L IC Y o f J o in t - S t o c k C o m p a n y C E N T R A L - A S

More information

Festivalization: the boom in events

Festivalization: the boom in events Festivalization: the boom in events Participation, identification, and transformation as the core parameters of a new industry, with cities competing to become the FestiValley competence center How the

More information

Barriers to College Success

Barriers to College Success putting ideas to work Barriers to College Success America s high school students have higher educational aspirations than ever before, yet these aspirations are being undermined by disconnected educational

More information

H. R. 2536. To provide access to medication-assisted therapy, and for other purposes. IN THE HOUSE OF REPRESENTATIVES

H. R. 2536. To provide access to medication-assisted therapy, and for other purposes. IN THE HOUSE OF REPRESENTATIVES I TH CONGRESS ST SESSION H. R. To provide access to medication-assisted therapy, and for other purposes. IN THE HOUSE OF REPRESENTATIVES MAY, 0 Mr. HIGGINS (for himself, Mr. HANNA, Mr. TONKO, and Mr. KATKO)

More information

Online resources. The National Juvenile Court Data Archive www.ojjdp.gov/ojstatbb/njcda

Online resources. The National Juvenile Court Data Archive www.ojjdp.gov/ojstatbb/njcda Online resources The National Juvenile Court Data Archive www.ojjdp.gov/ojstatbb/njcda The annual Juvenile Court Statistics report series is one of many products supported by the National Juvenile Court

More information

WARNING: Read all instructions in this manual and component manufacturer supplied information before using your RV.

WARNING: Read all instructions in this manual and component manufacturer supplied information before using your RV. Model Year 2008 Camping Trailer Owner s Manual www.jayco.com : Read all instructions in this manual and component manufacturer supplied information before using your RV. This manual has been provided by

More information

Pro ceed ings of the 2000 Gen eral Con fer ence of The United Meth od ist Church

Pro ceed ings of the 2000 Gen eral Con fer ence of The United Meth od ist Church Daily Edition Vol. 4 No. 5 1911 Pro ceed ings of the 2000 Gen eral Con fer ence of The United Meth od ist Church Thurs day Morning May 4, 2000 (Con tinued from page 1858) OLSEN (con tin ued): Ful filling

More information

Zebra. Programming for Page Mode Printing. Programer's Guide. Part #980352-001 Rev.E

Zebra. Programming for Page Mode Printing. Programer's Guide. Part #980352-001 Rev.E Zebra Programming for Page Mode Printing Programer's Guide Part #980352-001 Rev.E FOREWORD This man ual pro vides pro gram ming in for ma tion for print ers fea tur ing Ze bra s EPL2 Pro - gramming and

More information

Online resources. OJJDP s Statistical Briefing Book. National Juvenile Court Data Archive. National Center for Juvenile Justice ncjj.

Online resources. OJJDP s Statistical Briefing Book. National Juvenile Court Data Archive. National Center for Juvenile Justice ncjj. Online resources National Center for Juvenile Justice ncjj.org NCJJ s Web site describes its research activities, services, and publications, featuring links to project-supported sites and data resources

More information

THE NEW SET-UP IN THE BEL GRADE LOW-LEVEL AND COS MIC-RAY LAB O RA TORY

THE NEW SET-UP IN THE BEL GRADE LOW-LEVEL AND COS MIC-RAY LAB O RA TORY Nu clear Tech nol ogy & Ra di a tion Pro tec tion: Year 2011, Vol. 26, No. 3, pp.181-192 181 THE NEW SET-UP IN THE BEL GRADE LOW-LEVEL AND COS MIC-RAY LAB O RA TORY by Aleksandar DRAGI] 1*, Vladi mir I.

More information

Using USPS Confirmation Services with Digital Mailing Systems

Using USPS Confirmation Services with Digital Mailing Systems Using USPS Confirmation Services with Digital Mailing Systems Models: DM100i, DM125, DM225, DM200L, DM300c, DM400c, DM450c, DP100i, DP200L, DP300C, DP400C, DP450C Reference Manual SV61156 Rev. E January

More information

w ith In fla m m a to r y B o w e l D ise a se. G a s tro in te s tin a l C lin ic, 2-8 -2, K a s h iw a z a, A g e o C ity, S a ita m a 3 6 2 -

w ith In fla m m a to r y B o w e l D ise a se. G a s tro in te s tin a l C lin ic, 2-8 -2, K a s h iw a z a, A g e o C ity, S a ita m a 3 6 2 - E ffic a c y o f S e le c tiv e M y e lo id L in e a g e L e u c o c y te D e p le tio n in P y o d e r m a G a n g re n o su m a n d P so r ia sis A sso c ia te d w ith In fla m m a to r y B o w e l D

More information

Au ton o mous Sur gi cal Ro bot ics Us ing 3-D Ul tra sound Guid ance: Fea si bil ity Study

Au ton o mous Sur gi cal Ro bot ics Us ing 3-D Ul tra sound Guid ance: Fea si bil ity Study ULTRASONIC IMAGING 29, 213-219 (2007) Au ton o mous Sur gi cal Ro bot ics Us ing 3-D Ul tra sound Guid ance: Fea si bil ity Study JOHN WHITMAN, MATTHEW P. FRONHEISER, NIKOLAS M. IVANCEVICH AND STEPHEN

More information