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Prevalence of alcohol and other psychoactive substances in drivers in general traffic Part I: General results generic digoxin 0.25mg online. Introduction In the questionnaire digoxin 0.25 mg with mastercard, we ask about different traffic situations and your reactions to them order 0.25mg digoxin with visa. Socio-demographic information (1) Q1) Are you a… male - female Q2a) In which year were you born? Start with your most frequent mode first generic digoxin 0.25mg otc, followed by your second most frequent discount digoxin 0.25 mg with visa, and so on. Items: only items marked in Q5a are displayed Q6) Did you drive a car yourself in the past 6 months? Items: only items marked in Q5a are displayed Road safety in general Q9) How concerned are you about each of the following issues? Binary variable: concerned (1-2) - not concerned (3-4) Items: rate of crime – pollution - road accidents - standard of health care - traffic congestion – unemployment Acceptability of unsafe traffic behaviour Q10) Where you live, how acceptable would most other people say it is for a driver to….? Binary variable: acceptable (4-5) – unacceptable (1-3) Items (random)  drive 20 km per hour over the speed limit on a freeway / motorway  drive 20 km per hour over the speed limit on a residential street  drive 20 km per hour over the speed limit in an urban area  drive 20 km per hour over the speed limit in a school zone  talk on a hand-held mobile phone while driving  type text messages or e-mails while driving  check or update social media (example: Facebook, twitter, etc. You can indicate your answer on a scale from 1 to 5, where 1 is “unacceptable” and 5 is “acceptable”. Binary variable: acceptable (4-5) – unacceptable (1-3) Items (random): idem Q10 Support for road safety policy measures Q12) Do you support each of the following measures? Answering options: yes – no – don’t know/no response Items (fixed order): each time for: speeding – alcohol – drugs – seat belt  The traffic rules should be more strict  The traffic rules are not being checked sufficiently  The penalties are too severe Self-declared behaviour Q14) In the past 12 months, as a road user, how often did you…? You can indicate your answer on a scale from 1 to 5, where 1 is “never” and 5 is “(almost) always”. You can indicate your answer on a scale from 1 to 5, where 1 is “disagree” and 5 is “agree”. Binary variable: agree (4-5) – disagree (1-3) Items (random)  Driving under the influence of alcohol seriously increases the risk of an accident  Most of my acquaintances / friends think driving under the influence of alcohol is unacceptable  If you drive under the influence of alcohol, it is difficult to react appropriately in a dangerous situation  Driving under the influence of drugs seriously increases the risk of an accident  Most of my acquaintances / friends think driving under the influence of drugs is unacceptable  I know how many drugs I can take and still be safe to drive  Driving fast is risking your own life, and the lives of others  I have to drive fast, otherwise I have the impression of losing time  Driving faster than the speed limit makes it harder to react appropriately in a dangerous situation  Most of my acquaintances / friends feel one should respect the speed limits  Speed limits are usually set at acceptable levels  By increasing speed by 10 km/h, you have a higher risk of being involved in an accident  It is not necessary to wear a seat belt in the back seat of the car  I always ask my passengers to wear their seat belt  The instructions for using the child restraints are unclear  It is dangerous if children travelling with you do not wear a seat belt or use appropriate restraint  For short trips, it is not really necessary to use the appropriate child restraint  My attention to the traffic decreases when talking on a hands free mobile phone while driving  My attention to the traffic decreases when talking on a hand-held mobile phone while driving  Almost all car drivers occasionally talk on a hand-held mobile phone while driving  People talking on a hand-held mobile phone while driving have a higher risk of getting involved in an accident  When I feel sleepy, I should not drive a car  Even if I feel sleepy while driving a car, I will continue to drive  If I feel sleepy while driving, then the risk of being in an accident increases Subjective safety and risk perception Q17) How (un)safe do you feel when using the following transport modes in [country]? You can indicate your answer on a scale from 0 to 10, where 0 is “very unsafe” and 10 is “very safe”. Items (random): only items marked in Q5a are displayed Q18) In your opinion, how many road traffic accidents are caused by each of the following factors? In other words, how many accidents out of 100 were caused by the following factors. Always answer using a figure between 0 and 100 (+ option: don’t know) The total sum of all the factors can be more than 100. Items (random):  aggressive drivers  distracted drivers (drivers who are busy with something else, e. Answering options: increased – no change – decreased Items (random): idem Q19 Involvement in road crashes Q21a) In the past three months have you been involved in a road traffic accident as a … (if no accident: answering option: ‘none of these’) Items (multiple responses possible; only items indicated in Q5a are displayed): Extra sub-items for  motorcycling: motorcyclist (50-125 cc) – motorcyclist (>125 cc)  public transport: on the train – on the subway – on a tram – on the bus Q21b) Please indicate the severity of the accident: Answering options (multiple responses possible per transport mode (i. Items (multiple responses possible): violating the speed limits – driving under the influence of alcohol – driving under the influence of drugs (other than medication) – not wearing a seat belt – transporting children in the car without securing them correctly (child’s car seat, seat belt, etc. Items (multiple responses possible): idem Q23b Q24) In the past 12 months, how many times were you checked by the police for alcohol while driving a car (i. Binary variable: at least once - never Q25) In the past 12 months, how many times have you been checked by the police for the use of drugs/medication while driving? Binary variable: at least once - never Socio-demographic information (2) Q26) What is the highest qualification or educational certificate you obtained? Items: None – Primary education – Secondary education – Bachelor’s degree or similar – Master’s degree or higher – No answer 6 Q27) What is the postal code of the municipality in which you live? They also address the training and registered in the profession in relation to a matter of roles of dispensary assistants. These guidelines are developed to provide guidance to registered pharmacists or those seeking to become Guidelines registered pharmacists. They apply to all pharmacists In dispensing a prescription, a pharmacist has to exercise registered in the following categories: an independent judgment to ensure the medicine is safe • general and appropriate for the patient, as well as that it conforms to the prescriber’s requirements. In addition to complying with these guidelines, pharmacists are encouraged to maintain an awareness of 2 Dispensing multiple repeat the standards published by the profession, and relevant prescriptions at one time to their area of practice and category of registration.

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The time dummy coefficients 0.25 mg digoxin free shipping, δt discount 0.25 mg digoxin, capture the average value of the other influences for each time period discount 0.25 mg digoxin with amex, and are estimates of the aggregate constant-quality price level (rather than price relative) for the good at time t purchase 0.25 mg digoxin mastercard. Empirical results 16 To date digoxin 0.25 mg free shipping, there are only five studies that have used hedonic techniques to construct price indexes for drugs: Suslow (ulcers), Berndt, Cockburn and Griliches (depression), Cockburn and Annis (arthritis), and Lucarelli and Nicholson (colorectal cancer). All of these studies show that price indexes that control for differences in attributes across drugs and over time show substantially slower price growth than average prices. The kind of drug attributes that they used included features such as the efficacy of the drug (like healing or survival rates), ease of administration (number of daily doses needed for treatment), as well as the unwanted presence of side effects and interactions with other medications. An advantage of this regression approach over matched-model price indexes is that it can accommodate attributes that change over time, something that matched-model indexes cannot. For example, Cockburn and Anis (1998) include variables to reflect new information on old drugs from clinical trials—that is, what is known about drugs changes over time and that can be incorporated in the hedonic regression. Empirically, hedonic techniques applied to drugs have failed to find an overwhelming connection between the attributes and price. This result has also been reported in demand studies where the coefficient on price tends to be insignificant (Cockburn and Anis 1998 and Lucarelli and Nicholson 2009). Some have noted that this might be a reflection that patients and doctors are not very sensitive to price. Surveys cited in Suslow (1992) suggest that patients ranked affordability fourth in importance in the list of factors they look for in anti-ulcer medications, behind “Be safe,” “Make you feel better quickly,” and “Be convenient to take. This is consistent with the observation that prices can be fairly non- responsive to relatively large changes in markets, including drugs coming off patent and the subsequent entry of generics. This issue was studied by Silver and Heravi (2002) and Aizcorbe, Corrado and Doms (2003). For the new good, the hedonic regression imputes a price relative as the difference between the quality-adjusted price for the new product at time 1 ( lnPn,1 − ΣkβkC n,k,1 ) and 18 the average quality-adjusted price for all observed products in the prior period ( Σ i ( ln Pi,0 − Σk βkC k,i,0) / N0 ). It differs, however, in that the hedonic explicitly estimates quality differences based on the hedonic coefficients. Some think that this is because the hedonic is better at capturing changes in quality than standard price indexes (Triplett, 2006). One way to calculate the quality change implied by price indexes is using the identity: dln(average price) = ln(price index) + dln(quality change). There are choices to make about what to use as the average price and those choices could yield different measures for implied quality. For a geomean price index, for example, if one measures the change in the average price as the change in geometric means of the logged price levels for prices of all goods sold in each period, then, the implied change in quality has a clean interpretation as the difference between the (logged) price of the new goods and the average (logged) price of all goods sold that period (Aizcorbe 2006). For other index formulas, the implied quality term does not have a tidy interpretation. Nonetheless, as a first cut, we do the calculations using differences in a geomean of the (logged) price levels to get a rough gauge of how much quality growth is implied by the different indexes. However, the drug-specific fixed effects will control for any of those attributes that are fixed over the life of the drug. The last column of the table shows growth rates for a price index generated using an unweighted geometric mean formula. However, the similarity only holds when the geomean index is chained, thereby including new goods quickly. For example, standard price indexes for Intel’s microprocessors implied quality growth of over 20 percent per quarter over the 1990s (Aizcorbe 2006). Similarly, Bils and Klenow (2001) estimate that average quality of over 60 categories of durable goods grew 3-3/4 percent per year over the 1980-96 period. Compared with these rates of quality growth, the estimates for quality growth for drugs seem small and suggest that the methods discussed above do not adequately measure the value of new pharmaceutical innovations. This probably reflects, in part, the inability of prices to provide a good gauge of patients’ valuations. To the extent that the average quality of drugs improves over time, price indexes generated using standard methods are perhaps best viewed as upper bounds to an unobserved price index that takes these quality improvements into account. Measuring quality directly Health economists view the output of medical services as the incremental improvements to health status that result from treatment. For heart attacks, several different types of treatments are given at the same time (e.

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Dockets and other court records shall be maintained and court proceedings undertaken so that the names and identities of the parties to actions brought pursuant to this section will not be disclosed to the public purchase digoxin 0.25mg without a prescription. If the court fails to issue its ruling at the conclusion of the hearing purchase 0.25mg digoxin fast delivery, the petition is deemed to have been granted and the consent requirement is waived generic digoxin 0.25 mg line. A minor shall file her notice of appeal within five (5) days effective digoxin 0.25mg, excluding weekends and holidays trusted 0.25mg digoxin, after her petition was denied by the district court. The appellate court shall hold the hearing within forty- eight (48) hours, excluding weekends and holidays, after the notice of appeal is filed and shall issue its ruling at the conclusion of the hearing. If the appellate court fails to issue its ruling at the conclusion of the hearing, the petition is deemed to have been granted and the consent requirement is waived. Filing fees are not required of the pregnant minor at either the district court or the appellate level. The consent of the parent, parents, or legal guardian of such minor shall not be necessary to authorize hospital, medical and surgical care related to such disease and such parent, parents, or legal guardian shall not be liable for payment for any care rendered pursuant to this section. The consent to the performance of a medical or surgical procedure by a physician licensed to practice medicine and surgery executed by a married 47 person who is a minor, by a parent who is a minor, by a pregnant woman who is a minor, or by any person 18 years of age or older, is not voidable because of such minority, and, for such purpose, a married person who is a minor, a parent who is a minor, a pregnant woman who is a minor, or any person 18 years of age or older, is deemed to have the same legal capacity to act and has the same powers and obligations as has a person of legal age. Any parent, including a parent who is a minor, may consent to the performance upon his or her child of a medical or surgical procedure by a physician licensed to practice medicine and surgery or a dental procedure by a licensed dentist. The consent of a parent who is a minor shall not be voidable because of such minority, but, for such purpose, a parent who is a minor shall be deemed to have the same legal capacity to act and shall have the same powers and obligations as has a person of legal age. The minor may consent to such counseling, diagnosis or treatment as if the minor had reached his or her age of majority. Such consent shall not be voidable, nor subject to later disaffirmance, because of minority. Notwithstanding any other provision of law, a minor 12 years of age or older who may have come into contact with any sexually transmitted disease, or may be determined to be an addict, an alcoholic or an intoxicated person, as defined in the Alcoholism and Other Drug Abuse and Dependency Act, or who may have a family member who abuses drugs or alcohol, may give consent 48 to the furnishing of medical care or counseling related to the diagnosis or treatment of the disease. Each incident of sexually transmitted disease shall be reported to the State Department of Public Health or the local board of health in accordance with regulations adopted under statute or ordinance. The consent of the minor shall be valid and binding as if the minor had achieved his or her majority. The consent shall not be voidable nor subject to later disaffirmance because of minority. Reasonable effort shall be extended to assist the minor in accepting the involvement of his or her family in the care and treatment being given. Such medical care or services shall be provided by or under the supervision of a physician licensed to practice medicine and surgery or osteopathic medicine and surgery, a physician assistant, or an advanced registered nurse practitioner. The consent of another person, including but not limited to the consent of a spouse, parent, custodian, or guardian, shall not be necessary. The licensed physician who will perform the abortion shall provide notification in person or by mailing the notification by restricted certified mail to a parent of the pregnant minor at the usual place of abode of the parent. If the pregnant minor objects to the notification of a parent prior to the performance of an abortion on the pregnant minor, the pregnant minor may petition the court to authorize waiver of the notification requirement pursuant to this section in accordance with the following procedures: a. The court may appoint a guardian ad litem for the pregnant minor and the court shall appoint a guardian ad litem for the pregnant minor if the pregnant minor is not accompanied by a responsible adult or if the pregnant minor has not viewed the video as provided pursuant to section 135L. In appointing a guardian ad litem for the pregnant minor, the court shall consider a person licensed to practice psychology pursuant to chapter 154B, a licensed social worker pursuant to chapter 154C, a licensed marital and family therapist pursuant to chapter 154D, or a licensed mental health counselor pursuant to chapter 154D to serve in the capacity of guardian ad litem. The court proceedings shall be conducted in a manner which protects the confidentiality of the pregnant minor and notwithstanding section 232. Notwithstanding any law or rule to the contrary, the court proceedings under this section shall be given precedence over other pending matters to ensure that the court reaches a decision expeditiously. Upon petition and following an appropriate hearing, the court shall waive the notification requirements if the court determines either of the following: (1) That the pregnant minor is mature and capable of providing informed consent for the performance of an abortion. The court shall issue specific factual findings and legal conclusions, in writing, to support the decision. An expedited, confidential appeal shall be available to a pregnant minor for whom the court denies a petition for waiver of notification. Access to the appellate courts for the purpose of an appeal under this section shall be provided to a pregnant minor twenty-four hours a day, seven days a week. A pregnant minor who chooses to utilize the waiver of notification procedures under this section shall not be required to pay a fee at any level of the proceedings. Fees charged and court costs taxed in connection with a proceeding under this section are waived. If the court denies the petition for waiver of notification and if the decision is not appealed or all appeals are exhausted, the court shall advise the pregnant minor that, upon the request of the pregnant minor, the court will appoint a licensed marital and family therapist to assist the pregnant minor in addressing any intrafamilial problems.

Tables listing dissolution rate of individual sample under each testing condition cheap digoxin 0.25mg free shipping, average dissoluions and standard deviations of each lot cheap 0.25mg digoxin otc. Figures comparing average dissolution curves of each lot under each testing condition ii generic digoxin 0.25mg on line. Comparison of reference and test products Tables listing dissolved % of individual sample under each testing condition proven 0.25mg digoxin, the average dissoluions and standard deviations of test and reference products order 0.25 mg digoxin mastercard. Figures comparing average dissolution curves of test and reference products under each testing condition. Subjects: Age, sex, body weight and other data obtained by laboratory tests are described. Individual gastric acidity should be reported if necessary or otherwise available. Drug administration 15 Duration of fasting, co-administered water volume, and time of food ingestion after drug administration are described. In the case of postprandial administration, menu, content of meal (protein, fat, carbohydrate, calories and others), and time from food ingestion to drug administration are described. The correlation coefficient for determining kel should be reported together with time points used. Figures comparing individual drug concentration-time profiles of the two products drawn on a linear/linear scale. Figures comparing average drug level-time profiles of the two products drawn on a linear/linear scale. Analysis of pharmacokinetic parameters If deconvolution is used, the program, algorithm, pharmacokinetic models and fitting information should be listed. Others Information on dropouts (data, reasons), monitoring records of health status of subjects. Among the three lots, the one which shows intermediate dissolution should be selected as the reference product. When the average dissolution of any of the lots does not reach 85%, the test solution providing the fastest dissolution should be used. If a reference product cannot be appropriately selected for the drug product by dissolution testing as described above, the reference product should be the innovator product lot that shows intermediate characteristics when either a dissolution (release) test appropriate for the characteristics of the drug product or a substitute physicochemical test is performed. The test generic product must not differ markedly from the innovator product in size, shape, specific gravity or release mechanism. The dissolution behaviour of the test product must be similar to that of the reference product. Test Method Bioequivalence studies should be performed by single dose studies in both the fasted and fed states. In the case of postprandial administration, a high fat diet of 900 kcal or more containing 35% lipid content should be used. The meal should be eaten within 20 min, and drugs administered within 10 min thereafter. When a high incidence of severe adverse events is indicated after dosing in the fasting state, the fasting dose studies can be replaced with postprandial dose studies with the low fat meal employed in the study for oral immediate release products and enteric-coated products. Other testing conditions should follow those of oral immediate release products and enteric-coated products. Assessment of bioequivalence 1) Bioequivalence range, parameters, data transformation and statistical analysis These are the same as those of oral immediate release products and enteric-coated products. The assessment of reference parameters follows that of oral immediate release products and enteric-coated products. Pharmacodynamic and clinical studies If bioequivalence studies cannot be performed, pharmacodynamic or clinical studies should be carried out to evaluate therapeutic equivalence according to the studies for oral immediate release products and enteric-coated products. The test can be stopped at the time when the average dissolution of reference product reaches 85%. Apparatus: Paddle apparatus, rotating basket and disintegration testing apparatus can be selected, the reason for which should be stated. Volume of test solution, Temperature and Test solutions should follow the description of oral immediate release products and enteric-coated products. When the average dissolution of the reference product does not reach 80 % within 24 hr in any of test fluids, the test solution where the dissolution is the fastest should be selected. Acceptance criteria for similarity and equivalence of dissolution profiles If the results meet one of the following criteria shown in 1) under all testing conditions, the dissolution profile of the test product is judged to be similar to that of the reference product. If the average dissolution of the reference product reaches 80% within the testing time point specified in at least one test condition, and the results meet one of the following criteria shown in 2) under all testing conditions, the dissolution profile of the test product is judged to be equivalent to that of the reference product.

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