text:
|Acute and Maintenance Tocolysis
|Medical Policy
Prescription Drugs
|Original Policy Date
|Last Review Status/Date
Reviewed with Literature search/10:2014
|Return to Medical Policy Index
Our medical policies are designed for informational purposes only and are not an authorization, or an explanation of benefits, or a contract. Receipt of benefits is subject to satisfaction of all terms and conditions of the coverage. Medical technology is constantly changing, and we reserve the right to review and update our policies periodically.
General indications for tocolysis, or the suppression of preterm labor, include continued regular uterine contractions associated with cervical changes in a pregnant woman at less than 37 weeks' gestation. Successful delay of preterm delivery allows further fetal development and precludes potential complications of preterm delivery, especially neonatal respiratory distress syndrome (RDS). Even short-term delay of delivery is thought to be beneficial in that it allows treatment of the patient with corticosteroids, which has proved beneficial in ameliorating the effects of neonatal RDS. In some cases, a short delay in delivery may also allow transport of the pregnant woman to a medical center better equipped to handle premature delivery and neonatal intensive care.
A variety of agents have been used for tocolysis. The only FDA-approved tocolytic drug is ritodrine, a beta-sympathomimetic. Ritodrine is no longer available in the U.S., and thus only off-label medications are available. Terbutaline sulfate, FDA-approved for several non-tocolytic indications, is also a beta-sympathomimetic. Terbutaline is available as an oral or intravenous medication and, more recently, has been administered by continuous subcutaneous infusion via a portable pump for maintenance tocolysis. Other tocolytic drugs include calcium channel blockers (e.g., nifedipine), magnesium sulfate, oxytocin receptor antagonists (e.g., atosiban), prostaglandin inhibitors (e.g., indomethacin), and nitrates (e.g., nitroglycerin).
Tocolytic agents have potential risks as well as potential benefits. A 2012 guideline issued by the American College of Obstetricians and Gynecologists (ACOG) summarized the potential adverse effects of common classes of tocolytic agents (1):
Calcium Channel Blockers
- Maternal side effects: Dizziness, flushing, and hypotension; suppression of heart rate, contractility, and left ventricular systolic pressure when used with magnesium sulfate; and elevation of hepatic transaminases
- Fetal or newborn adverse effects: No known adverse effects
Non-steroidal Anti-inflammatory Drugs (NSAIDs)
- Maternal side effects: Nausea, esophageal reflux, gastritis, and emesis; platelet dysfunction is rarely of clinical significance in patients without underlying bleeding disorder
- Fetal or newborn adverse effects: In utero constriction of ductus arteriosus*, oligohydramnios*, necrotizing enterocolitis in preterm newborns, and patent ductus arteriosus in newborn†
*Greatest risk associated with use for longer than 48 hours
†Data are conflicting regarding this association
Beta-adrenergic Receptor Agonists
- Maternal side effects: Tachycardia, hypotension, tremor, palpitations, shortness of breath, chest discomfort, pulmonary edema, hypokalemia, and hyperglycemia
- Fetal or newborn adverse effects: Fetal tachycardia
Magnesium Sulfate
- Maternal side effects: Causes flushing, diaphoresis, nausea, loss of deep tendon reflexes, respiratory depression, and cardiac arrest; suppresses heart rate, contractility and left ventricular systolic pressure when used with calcium channel blockers; and produces neuromuscular blockade when used with calcium channel blockers.
- Fetal or newborn adverse effects: Neonatal depression. (The use of magnesium sulfate in doses and duration for fetal neuroprotection alone does not appear to be associated with an increased risk of neonatal depression when correlated with cord blood magnesium levels.)
Regulatory Status
Ritodrine was approved by the U.S. Food and Drug Administration (FDA) for use as a tocolytic agent. Ritodrine was voluntarily withdrawn from the U.S. market in 1998.
Terbutaline is FDA approved for the prevention and treatment of bronchospasm in patients with asthma and reversible bronchospasm associated with bronchitis and emphysema. Like other tocolytic agents, its use in tocolysis is off-label. In response to a citizen petition in June, 2008, the FDA reviewed safety data on terbutaline sulfate. They issued a safety announcement on February 17, 2011. (2) Based on animal studies, the FDA reclassified terbutaline from pregnancy risk category B to pregnancy risk category C. In addition, the FDA required a boxed warning stating that injectable terbutaline should not be used for prevention or prolonged (beyond 2-3 days) treatment of preterm labor, and oral terbutaline should not be used for acute or maintenance tocolysis. The labeling change is based on a review of postmarketing safety reports submitted to the FDA's Adverse Event Reporting System (AERS) of maternal death and serious maternal cardiovascular events associated with use of terbutaline.
Acute tocolytic therapy with calcium channel blockers, magnesium sulfate, prostaglandin inhibitors, and parenteral terbutaline may be considered medically necessary for the induction of tocolysis in patients with preterm (<37 weeks' gestational age) labor.
Maintenance (beyond 48-72 hours) tocolytic therapy with any medication is considered investigational.
Policy Guidelines
Patient selection criteria for induction of tocolysis include regular uterine contractions associated with cervical changes. Induction of tocolysis typically requires hospitalization to monitor for incipient delivery.
Benefit Application
BlueCard/National Account Issues
Continuous infusion of terbutaline for maintenance therapy via a subcutaneous pump (HCPCS code E0781) may be offered as part of the management protocols of high-risk pregnancies offered by carve-out networks, such as Matria. However, as noted above, this therapy is considered investigational.
An initial literature search was performed in 1997. The policy was updated regularly with a literature review using MEDLINE. Most recently, the literature was reviewed through September 2, 2014. Following is a summary of the literature to date:
Acute tocolysis
Studies have focused on the ability of tocolytic agents to prevent preterm delivery and thereby reduce associated maternal and neonatal risks. A comprehensive meta-analysis of randomized controlled trials (RCTs) on acute tocolysis was published by Haas et al. in 2009. (3) Haas and colleagues included 58 studies that directly compared different tocolytic medications or compared 1 medication to placebo or usual care. Studies were included if they compared 2 drugs in the same class but excluded if they included 2 doses of the same medication. Participants were women who were diagnosed with preterm labor or had threatened preterm labor. The analysis was limited to studies with fetuses of mean gestational ages between 28 and 32 weeks' gestation. Multiple gestation was not an exclusion criterion, but if trials stratified on this variable, only data on singleton pregnancies were used. Data were extracted for each outcome and combined by drug class to calculate a weighted mean and standard error for proportions of successful events; proportions were weighted based on the number of participants in each study. Primary efficacy and safety outcomes are as follows in Tables 1 and 2:
Table 1. Effect of tocolytics on delaying birth (weighted % of women experiencing outcome)
48-hour delay
7-day delay
After 37 weeks
No. Studies
No. Studies
No. Studies
53 (45-61)
39 (28-49)
36 (20-52)
75 (65-85)
65 (59-71)
46 (36-56)
Calcium channel blockers
76 (57-95)
62 (56-69)
47 (32-62)
Magnesium sulfate
89 (85-93)
61 (39-84)
42 (31-53)
Oxytocin receptor antag.
86 (80-91)
78 (68-88)
No data
Prostaglandin inhibitors
93 (90-95)
76 (67-85)
43 (6-79)
CI=confidence interval
Table 2. Adverse maternal and neonatal effects associated with tocolytics (weighted % of women/neonates experiencing outcome)
Maternal adverse effects
Neonates with RDS
Neonatal death
No. Studies
No. Studies
No. Studies
21 (17-26)
14 (9-18)
13 (8-18)
14 (9-18)
Calcium channel blockers
1 (0-3)
19 (4-33)
1 (0-3)
Magnesium sulfate
3 (1-6)
16 (11-20)
3 (1-6)
Oxytocin receptor antag.
2 (0-5)
14 (8-21)
2 (0-5)
Prostaglandin inhibitors
0 (0-2)
2 (0-4)
0 (0-2)
Maternal adverse effects are those that required discontinuation of the medication
CI: confidence interval; RDS, respiratory distress syndrome
All tocolytic agents were significantly better than placebo/control at delaying delivery for 48 hours and delaying delivery for 7 days. None were significantly better than placebo/control at delaying delivery until after 37 weeks' gestation. The rate of discontinuation due to adverse effects was significantly higher for
betamimetics compared with placebo/control but not for any of the other categories of medication.
As part of their review, the investigators also conducted a decision analysis to determine the optimal medication based on the balance of benefits and risks. The decision analysis model found that prostaglandin inhibitors might be the superior agent up to 32 weeks of gestation due to a high effectiveness at delaying delivery by at least 7 days and a low rate of adverse effects. Calcium channel blockers were the superior agent for delaying delivery until 37 weeks. Compared with other tocolytics, calcium channel blockers reduced the incidence of birth within 7 days of treatment (relative risk [RR], 0.76; 95% confidence interval [CI], 0.60 to 0.97) and before 34 weeks of gestation (RR=0.83; 95% CI, 0.69 to 0.99).
In an additional study published in 2012, Haas et al conducted a network meta-analysis in which direct and indirect evidence on relative impacts of tocolytics on health outcomes were pooled simultaneously.(4) Consequently, the analysis was not limited to the comparisons in head-to-head trials that the research
team had addressed in 2009. The investigators identified a total of 95 RCTs; 25 contained a placebo arm, 60 included betamimetics, 29 included magnesium sulfate, 29 included calcium channel blockers, 18 included prostaglandin inhibitors, 13 included oxytocin receptor blockers, 4 included nitrates, and 5
included "other" drugs. The authors assumed that all drugs in the same class had a similar effect.
Fifty-five studies were included in the network analysis for the primary efficacy outcome, delivery delayed by 48 hours. All active classes were found to be superior to placebo. The analysis also suggested that prostaglandin inhibitors had a greater beneficial effect than any other active class of medication, and
calcium channel blockers and magnesium sulfate had a greater beneficial effect than oxytocin receptor blockers, nitrates and betamimetics. Prostaglandin inhibitors had an 83% probability of being the "best" class of active medications. The probability of being ranked among the 3 most efficacious classes was
96% for prostaglandin inhibitors, 63% for magnesium sulfate, 57% for calcium channel blockers, 33% for betamimetics, 24% for nitrates, and 14% for oxytocin receptor blockers.
Forty trials were included in the network analysis for the outcome neonatal mortality. There was no clear evidence for any class of medication being superior to placebo. Calcium channel blockers were found to be the "best" class, but the probability of this was only 41%, which reflects the considerable uncertainty in the estimate. Prostaglandin inhibitors had a 28% chance of being the "best" class, which was the second highest probability of any class. Similarly, calcium channel blockers was the "best" class for reducing neonatal respiratory distress syndrome (RDS), but the probability of being the best was only 47%. Fiftyeight trials were included in the network analysis for the outcome all-cause maternal side effects. Other than placebo, prostaglandin inhibitors had a 79% chance of being the drug class with the fewest maternal side effects. This was followed by oxytocin receptor blockers, which had a 70% probability of the class with the lowest rate of maternal side effects. Calcium channel blockers had a 15% chance of being included in the top 3 drug classes for the fewest maternal side effects. Overall, prostaglandin inhibitors and calcium channel blockers had the highest probability of being the best classes of medication based
on all 4 outcome measures: delivery delayed by 48 hours, neonatal mortality, neonatal RDS and maternal side effects.
There are also meta-analyses on acute tocolysis, focusing on a single tocolytic class or agent. In 2011, Conde-Agudelo et al reviewed trials on nifedipine, a calcium channel blocker.(5) The investigators identified 26 randomized trials with a total of 2179 women comparing nifedipine with placebo, no treatment, or a different tocolytic agent. Twenty-three of the trials evaluated acute tocolysis and 3 evaluated maintenance tocolysis (maintenance tocolysis is discussed later in the Rationale section). Findings were mixed. Pooled analyses of trials comparing nifedipine and beta-agonists found significantly lower rates of delivery within 7 days of treatment (10 trials; RR=0.82; 95% CI, 0.70 to 0.97) and preterm birth before 34 weeks' gestation (5 trials; RR=77; 95% CI, 0.66 to 0.91) but no significant difference in the rate of preterm delivery within 48 hours of treatment (13 trials, RR: 0.84, 95% CI, 0.68 to 1.05) or preterm delivery before 37 weeks' gestation (9 trials; RR=0.97; 95% CI, 0.87 to 1.08). There were no significant differences in any of the preterm delivery variables when nifedipine was compared with magnesium sulfate, but the number of trials and total sample sizes were small, making it difficult to draw conclusions about comparative efficacy.
Several Cochrane reviews on a single type of tocolytic agent are available and are described briefly next:
A 2014 review identified 38 trials evaluating calcium channel blockers for tocolysis, with a total of 3550 women.(6) The calcium channel blocker was nifedipine in 35 trials and nicardipine in the other 3. Thirty-five trials used other tocolytic agents as the comparison intervention (19 used betamimetics), 1 compared doses of nifedipine and the remaining 2 compared calcium channel blockers with placebo or no intervention. Only 1 trial was double-blinded. The authors evaluated several primary and secondary outcomes and conducted pooled analyses when sufficient data were available. Findings were mixed
among primary outcomes, but several favored calcium channel blockers over betamimetics. There was a significantly lower rate of "very preterm birth" before 34 weeks of gestation with calcium channel blockers compared with betamimetics (6 trials; RR=0.78; 95% CI, 0.66 to 0.93) and a significantly lower rate of
maternal adverse effects (15 trials; RR=0.36; 95% CI, 0.24 to 0.53). The incidence of birth less than 48 hours after trial entry and the rate of perinatal mortality did not differ significantly between calcium channel blockers and other tocolytic agents. Among secondary outcome measures, there was a significantly lower rate of preterm birth before completion of 37 weeks of gestation with calcium channel blockers compared with betamimetics (13 trials; RR=0.89; 95% CI, 0.80 to 0.98), and there were too few studies to compare with other tocolytic agents The authors noted that the quality of studies eg, lack of blinding and limited placebo controls, limited the ability for firm conclusions to be drawn about the efficacy of calcium channel blockers compared with other tocolytic agents.
A Cochrane review, updated in 2014, identified 14 trials on oxytocin inhibitors, with a total of 2485 women.(7) The control intervention was placebo in 4 trials, betamimetics in 8 trials and a calcium channel blocker in 2 studies. Pooled analyses did not demonstrate the superiority of oxytocin receptor antagonists
over betamimetics or placebo in terms of reduction in preterm birth or adverse neonatal outcomes. (Note: Oxytocin inhibitors are not approved by FDA for use in the United States.)
Another 2014 Cochrane review identified 37 trials with a total of 3571 women.(8) Comparison interventions included other tocolytic drugs, predominantly betamimetics, nitroglycerine, human chorionic gonadotropin, saline, and dextrose. No placebo-controlled trials were identified. Pooled analyses found no statistically significant differences between magnesium sulfate and comparison interventions for outcomes including birth less than 48 hours after trial entry, serious infant adverse events, and preterm birth before 37 weeks of gestation.
A 2005 Cochrane review by King et al included 13 trials on cyclo-oxygenase (COX) inhibitors, with a total of 713 women; indomethacin was used in 10 of the trials.(9) Only 1 trial compared COX inhibitors with placebo. Pooled analysis of studies comparing COX inhibitors with other tocolytics found a significant
reduction in the incidence of birth before 37 weeks of gestation (RR=0.53; 54 women). The authors noted that numbers were small, and thus estimates were imprecise and not definitive.
In addition to these reviews on single agents, in 2014 Vogel et al published a Cochrane review on combinations of tocolytic agents for preventing preterm labor.(10) The investigators searched for RCTs comparing any combination of tocolytic agents with any other treatment (including other combinations,
single tocolytic agents, no intervention, or placebo). Eleven trials evaluating 7 different comparisons met the review's inclusion criteria; 2 of these did not report relevant outcome data. Thus, few studies with small combined sample sizes were available for analysis, and the authors were not able to pool data or
draw conclusions about the safety and efficacy of any combination of tocolytics versus any comparison intervention.
Section Summary
Multiple RCTs and meta-analyses have found tocolytics to be effective at decreasing rates of preterm birth in women with preterm labor, eg, delaying delivery for 7 days and/or decreasing rates of delivery before 34 or 37 weeks of gestation. The optimal first-line medication is not certain. A 2012 network metaanalyses suggests that prostaglandin inhibitors and calcium channel blockers may have greater efficacy and fewer adverse effects than other classes of medication. However, there was considerable uncertainty in the estimates of which class of medication was the "best" for each of the outcomes. Cochrane reviews of various tocolytic agents have not found that any agent is clearly superior to any other agent.
Maintenance of Tocolysis
Several meta-analyses of the published literature have been published. The 2011 Conde-Agudelo et al meta-analysis, described earlier,(5) included 3 studies evaluating the calcium channel blocker nifedipine for maintenance tocolysis. A pooled analysis of these 3 trials (total N=215) did not find a significant difference in the rate of preterm birth before 37 weeks of gestation with nifedipine compared with placebo or no treatment (RR=0.87; 97% CI, 0.69 to 1.08). There were insufficient data to conduct pooled analyses on other pregnancy outcome variables.
In 2009, a Health Technology Assessment from the U.K. addressed a wider range of maintenance tocolytic agents.(11) However, for the outcomes prevention of preterm birth before 34 weeks' or 37 weeks of gestation, there were only a sufficient number of trials to conduct pooled analyses for 2 comparisons.
Neither of the analyses found a statistically significant benefit of tocolysis. In a pooled analysis of magnesium maintenance therapy to other tocolytic agents, the combined RR was 0.98 (95% CI, 0.56 to 1.72). In addition, a pooled analysis of 4 trials (total N=384) did not find a significant benefit of oral
betamimetics compared with placebo or no treatment for preventing preterm birth before 37 weeks' gestation. The combined relative risk was 1.08 (95% CI, 0.88 to 1.22).
Several Cochrane reviews have addressed specific agents used for maintenance therapy and are described briefly next.
A 2014 Cochrane review of maintenance therapy with oxytocin antagonists identified only 1 trial.(12) This trial, published in 2000 by Valenzuela et al, did not find that atoisiban reduced the rate of preterm birth after threatened preterm birth compared with placebo.(13)
Another 2014 Cochrane review identified 6 RCTs on maintenance therapy with calcium channel blockers.(14) Nifedipine was used in all trials and a total of 794 women were included. The comparison intervention was placebo in 3 trials and no treatment in the other 3 trials. Pooled analyses did not find that
calcium channel blockers significantly reduced the rate of preterm birth before 37 weeks (5 trials; RR=0.97; 95% CI, 0.87 to 1.09) or 34 weeks (3 trials; RR=1.07; 95% CI, 0.88 to 1.30). A pooled analysis of 2 trials did not find significant differences between calcium channel blockers and controls for the outcome birth within 48 hours of treatment. There were insufficient data to draw conclusions about other outcomes.
In 2012, Dodd et al published a Cochrane review on oral betamimetics for maintenance tocolysis after threatened preterm labor.(15) The authors identified 13 RCTs; some of these had more than 2 arms. There were 10 comparisons of a betamimetic and placebo or no treatment, 1 comparison of a betamimetic and indomethacin, 1 comparison between 2 different betamimetics and 3 comparisons between a betamimetic and magnesium. Data could not be pooled for all outcomes due to a shortage of studies on a particular comparison. In a pooled analysis of 6 studies, there was not a statistically significant difference in the rate of preterm birth before 37 weeks in patients receiving a maintenance betamimetic versus placebo or no treatment (RR=1.11; 95% CI, 0.91 to 1.35). In other pooled analysis of findings from studies comparing maintenance betamimetics with placebo or no treatment, there were not statistically significant differences between groups in birthweight (7 studies; mean difference, 4.13; 95% CI, -91.89 to 100.16), risk of perinatal mortality (6 studies; RR=2.41; 95% CI, 0.86 to 6.74) and risk of RDS in the infant (6 studies; RR=1.10; 95% CI, 0.61 to 1.98).
A 2010 review by Han et al evaluated magnesium maintenance therapy and did not find a statistically significant effect of magnesium maintenance therapy on prevention of preterm birth before 37 weeks of gestation.(16) A meta-analysis of 2 studies (total N=99) that compared magnesium therapy with placebo or no treatment found a combined risk ratio of 1.05 (99% CI, 0.80 to 1.40). Two studies (total N=100) were also available for a meta-analysis of studies comparing magnesium therapy with an alternative treatment. In this analysis, the combined RR was 0.99 (95% CI, 0.57 to 1.72).
Section Summary
There are fewer RCTs on maintenance tocolysis compared with acute tocolysis. RCTs and metaanalyses on maintenance tocolysis have generally found that tocolytic agents do not significantly improve health outcomes. Moreover, there are insufficient data from placebo-controlled trials.
Risks Associated With terbutaline
An FDA-conducted search of its Adverse Event Reporting System (AERS) identified reports of 16 maternal deaths associated with terbutaline between 1976 and 2009.(2) FDA documents stated that in 3 cases, it was specified that terbutaline was administered by a subcutaneous pump, and in 9 cases oral
terbutaline was used instead of or in addition to injectable or subcutaneous terbutaline. (Presumably, in the remaining cases, the mode of administration was not reported.) Moreover, between 1998 and July 2009, 12 cases of serious maternal cardiovascular events associated with terbutaline were submitted to
AERS; in 3 cases, use of subcutaneous terbutaline was specified and in 5 cases, it was reported that oral terbutaline was used alone or in addition to subcutaneous terbutaline.
A 2011 commentary examined the human and animal evidence on risks of autism spectrum disorders associated with terbutaline.(17) The authors concluded that the literature does not support the hypothesis that β²-adrenergic agonists including terbutaline are associated with autism spectrum disorders in the
Clinical Input Received From Physician Specialty Societies and Academic Medical Centers
In response to requests, input was received through 2 physician specialty societies and 4 academic medical centers while this policy was under review in 2012. While the various physician specialty societies and academic medical centers may collaborate with and make recommendations during this
process, through the provision of appropriate reviewers, input received does not represent an endorsement or position statement by the physician specialty societies or academic medical centers, unless otherwise noted. There was consensus that acute tocolysis may be considered medically necessary for the induction of tocolysis in patients with preterm labor and near-consensus that preterm should be defined as "<37 weeks" gestational age. There was mixed input on the investigational policy statement on maintenance tocolysis (beyond 48-72 hours).
Summary of Evidence
There is sufficient evidence that the commonly used tocolytic agents presented here are effective at inducing tocolysis in patients with preterm labor or threatened preterm labor. Thus, these agents are considered medically necessary for the acute prevention of preterm delivery. There are data suggesting
that oral terbutaline is associated with more adverse events than parenteral terbutaline for acute tocolysis. Each medication has a different risk/benefit profile, and there is no clear first-line tocolytic agent. There are fewer studies on medications to maintain tocolysis. The available evidence does not suggest that maintenance tocolysis improves health outcomes, and therefore maintenance tocolysis is considered investigational.
Practice Guidelines and Position Statements
- American College of Obstetricians and Gynecologists
The American College of Obstetricians and Gynecologists' Management of preterm labor practice bulletin (2012)(1) contains the following recommendations based on "good and consistent" scientific evidence:
- "A single course of corticosteroids is recommended for pregnant women between 24 weeks of gestation and 34 weeks of gestation who are at risk of preterm delivery within 7 days.
- Accumulated available evidence suggests that magnesium sulfate reduces the severity and risk of cerebral palsy in surviving infants if administered when birth is anticipated before 32 weeks of gestation. Hospitals that elect to use magnesium sulfate for fetal neuroprotection should develop uniform and specific guidelines for their departments regarding inclusion criteria, treatment regimens, concurrent tocolysis, and monitoring in accordance with one of the larger trials.
- The evidence supports the use of first-line tocolytic treatment with beta-adrenergic agonist therapy, calcium channel blockers, or non-steroidal anti-inflammatory drugs (NSAIDs) for shortterm prolongation of pregnancy (up to 48 hours) to allow for the administration of antenatal steroids.
- Maintenance therapy with tocolytics is ineffective for preventing preterm birth and improving neonatal outcomes and is not recommended for this purpose.
- Antibiotics should not be used to prolong gestation or improve neonatal outcomes in women with pre-term labor and intact membranes."
Royal College of Obstetricians and Gynecologists
The Royal College of Obstetricians and Gynecologists evidence-based guideline (updated in February 2011)(18) on use of tocolysis for women in preterm labor included the following conclusions relevant to this policy:
- There is no clear evidence that tocolytic drugs improve outcome and therefore it is reasonable not to use them. However, tocolysis should be considered if the few days gained would be put to good use, such as completing a course of corticosteroids or in utero transfer.
- Nifedipine and atosiban have comparable effectiveness in delaying birth for up to seven days.
- Compared with beta-agonists, nifedipine is associated with improvement in neonatal outcome, although there are no long-term data.
- Beta-agonists have a high frequency of adverse effects. Nifedipine, atosiban and the COX inhibitors have fewer types of adverse effects, and they occur less frequently than for betaagonists but how they compare with each other is unclear.
- There is insufficient evidence for any firm conclusions about whether or not tocolysis leads to benefit in preterm labor in multiple pregnancy.
- There is insufficient evidence for any firm conclusion about whether or not maintenance tocolytic therapy following threatened preterm labor is worthwhile. Thus, maintenance therapy is not recommended.
U.S. Preventive Services Task Force Recommendations
No relevant recommendations were found.
Medicare National Coverage
There is no national coverage determination (NCD). In the absence of an NCD, coverage decisions are left to the discretion of local Medicare carriers.
- American College of Obstetricians and Gynecologists (ACOG) . Management of Preterm Labor. 2012.
- FDA drug safety communication: New warnings against use of terbutaline to treat preterm labor.; February 17, 2011.
- Haas DM, Imperiale TF, Kirkpatrick PR et al . Tocolytic therapy: a meta-analysis and decision analysis. Obstet Gynecol. 2009;113(3):585-94.
- Haas DM, Caldwell DM, Kirkpatrick P et al . Tocolytic therapy for preterm delivery: systematic review and network meta-analysis. BMJ. 2012;345:e6226.
- Conde-Agudelo A, Romero R, Kusanovic JP . Nifedipine in the management of preterm labor: a systematic review and metaanalysis. Am J Obstet Gynecol. 2011;204(2):134 e1-20.
- Flenady V, Wojcieszek AM, Papatsonis DN, et al. Calcium channel blockers for inhibiting preterm labour and birth. Cochrane Database Syst Rev. 2014;6:CD002255. PMID 24901312
- Flenady V, Reinebrant HE, Liley HG, et al. Oxytocin receptor antagonists for inhibiting preterm labour. Cochrane Database Syst Rev. 2014;6:CD004452. PMID 24903678
- Crowther CA, Brown J, McKinlay CJ, et al. Magnesium sulphate for preventing preterm birth in threatened preterm labour. Cochrane Database Syst Rev. 2014;8:CD001060. PMID 25126773
- King J, Flenady V, Cole S, et al. Cyclo-oxygenase (COX) inhibitors for treating preterm labour. Cochrane Database Syst Rev. 2005(2):CD001992. PMID 15846626
- Vogel JP, Nardin JM, Dowswell T, et al. Combination of tocolytic agents for inhibiting preterm labour. Cochrane Database Syst Rev. 2014;7:CD006169. PMID 25010869
- Honest H, Forbes CA, Duree KH, et al. Screening to prevent spontaneous preterm birth: systematic reviews of accuracy and effectiveness literature with economic modelling. Health Technol Assess. Sep 2009;13(43):1-627. PMID 19796569
- Papatsonis DN, Flenady V, Liley HG. Maintenance therapy with oxytocin antagonists for inhibiting preterm birth after threatened preterm labour. Cochrane Database Syst Rev. 2013;10:CD005938. PMID 24122673
- Valenzuela GJ, Sanchez-Ramos L, Romero R, et al. Maintenance treatment of preterm labor with the oxytocin antagonist atosiban. The Atosiban PTL-098 Study Group. Am J Obstet Gynecol. May 2000;182(5):1184-1190. PMID 10819856
- Naik Gaunekar N, Raman P, Bain E, et al. Maintenance therapy with calcium channel blockers for preventing preterm birth after threatened preterm labour. Cochrane Database Syst Rev. 2013;10:CD004071. PMID 24173691
- Dodd JM, Crowther CA, Middleton P. Oral betamimetics for maintenance therapy after threatened preterm labour. Cochrane Database Syst Rev. 2012;12:CD003927. PMID 23235600
- Han S, Crowther CA, Moore V. Magnesium maintenance therapy for preventing preterm birth after threatened preterm labour. Cochrane Database Syst Rev. 2010(7):CD000940. PMID 20614423
- Rodier P, Miller RK, Brent RL. Does treatment of premature labor with terbutaline increase the risk of autism spectrum disorders? Am J Obstet Gynecol. Feb 2011;204(2):91-94. PMID 21284962
- Royal College of Obstetricians and Gynecologists Green-top Guideline 1b. Tocolysis for women in preterm labor. February 2011; http://www.rcog.org.uk/womens-health/clinical-guidance/tocolytic-drugs-women-preterm-labourgreen-top-1b. Accessed August, 2014.
Therapeutic, prophylactic or diagnostic injection (specify substance or drug); subcutaneous or intramuscular
Intravenous push, single or initial substance/drug
ICD-9 Procedure
Injection or infusion of other therapeutic or prophylactic substance
ICD-9 Diagnosis
644.00 - 644.03
Early or threatened labor
Injection, terbutaline sulfate, up to 1 mg
|Injection, magnesium sulfate, per 500mg
Home infusion therapy, tocolytic infusion therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem
|ICD-10-CM (effective 10/1/15)
|False labor code range (includes threatened labor)
|Preterm labor without delivery code range
|ICD-10-PCS (effective 10/1/15)
|ICD-10-PCS codes are only used for inpatient services.
There is no specific ICD-10-PCS code for this procedure.
Type of Service
Place of Service
Terbutaline Tocolysis
Tocolysis, Terbutaline
Policy History
Add to Prescription Drug section
New policy
Replace policy
Policy updated; title changed to include tocolytics other than terbutaline; policy statement unchanged
Replace policy
Literature review update; policy regarding intravenous and subcutaneous terbutaline unchanged. Policy retitled to focus on intravenous or subcutaneous terbutaline therapy; policy no longer addresses oral terbutaline
Replace policy
Policy updated with literature review; no change in policy statement
Replace policy – coding update only
CPT codes updated
Replace policy
Policy updated with literature review for the period of October 2004 through January 2006; no change in policy statement. Reference #7 added.
Replace policy
|Policy updated with literature review up to July 2007; no change in policy statement. Reference number 8 added.
|Policy Archived
|Policy updated with literature review through October 2009; new reference numbers 1-5 and 9-10 added. Policy broadened, and policy title changed, to include additional agents in addition to terbutatline. Use in acute tocolysis may be considered medically necessary, use as maintenance is considered investigational. Policy remains archived
|Replace policy
|returned to active status- Policy updated with literature review through October 2010; no change in policy statement. Reference numbers 2, 7 and 8 added; other references re-numbered or removed.
|Replace policy
|Policy updated with literature review through February 2011. Policy statement on acute tocolysis changed to state that parenteral terbutaline, rather than all betaminetics, may be considered medically necessary. Time frame (beyond 48-72 hours) added to maintenance tocolysis policy statement and mention of specific medications was removed. Reference numbers 3, 5, 9-10, 14-15 added; other references renumbered/removed.
|Replace policy
|Policy updated with literature review through July 2012. Clinical input added. Reference numbers 4 and 11 added; other references renumbered/removed.
|Replace policy
|Policy updated with literature review through July 12, 2013. Reference numbers 1, 3, 11 and 12 added; other references renumbered/removed. No change to policy statements.
|Replace policy
|Policy updated with literature review through September 2, 2014 References 6-8, 10, 12, and 14. No change to policy statements.


text:
Minor Research Project Half Year B
ECJS881 is rated by StudentVIP members:
rate me!
0 StudentVIP members in ECJS881
0 textbooks listed
0 tutors available
2 tutor searches
0 subject ratings
What do you rate ECJS881?
Add ECJS881 to your subjects
You can add ECJS881 to your StudentVIP account to find textbooks, tutors and more.Join StudentVIP
Reviews and tips for ECJS881
0 reviews
Where are classes for ECJS881?
Easy, get a great map app for Macquarie, including locations for classes in ECJS881.Get Lost On Campus
0 notes available for ECJS881
Upload & earn:Sell your notes
Tutors for ECJS881
0 tutors available for tutoring ECJS881Become a tutor for ECJS881
2 tutor searches for ECJS881!
Encourage students to become a tutor. Add a no-obligation tutor request. We'll notify you when a new tutor registers.

subset: commoncrawl


text:
* Gerhard Tonn <firstname.lastname@example.com> [030615 17:06]: > >Arnd, seems to have all (of most of) the core libraries ported. > >I was looking at the dependencies of sbuild.. and was considering moving > >to perl, bind9 (for libdns), or exim. > > > >Since we don't need these to be 64bit... maybe it's time to start using > >sbuild. > > > >Any thoughts? > > > > I am still maintaining a list of patches for the most important packages > to support lib64 locations at http://people.debian.org/~gt/lib64. I am > also working on perl5.8. I am doing the work mainly for s390x, but if > you are interested to use my dpkg and debhelper patches, you could reuse > the patches as well. I belive Arnd has taken care of all of these packages for amd64... and I belive with the help of your patches, so thank you for the work. > My main goal is to get all these changes accepted by the package > maintainers. I will submit bug reports as soon as the dpkg and debhelper > patches have been accepted. We would all like this. B. -- WebSig: http://www.jukie.net/~bart/sig/
Description: PGP signature


text:
Included with your purchase:
- Lifetime Warranty
- 30 Day Return Policy
Certified Appraisal
Diamond Certificate
Free FedEx 2 Day Domestic Shipping
Luxury Gift Box
Basic Information
|Stock number:
|Metal Type:
|14k White Gold
|Metal Weight:
|6.5 Grams
|8.7mm at its Largest Point
|Appraisal Value:
|Setting type:
|Channel & Prong
Diamond Information
|Diamond Carat:
|1.40ct Total, .85ct Solitaire, .55ct Surrounding
|Diamond Clarity:
|SI-1 Solitaire, VS-2 - SI-1 Surrounding
|Diamond Color:
|Blue Solitaire, F Surrounding
|Diamond Cut:
|Excellent Solitaire, Very Good Surrounding
|Diamond Shape:
|Round Solitaire, Round Surrounding
Product Details
This item is a new certified 1.40ct diamond ring and matching band set in 14k white gold. A solitaire .85ct blue round diamond is set in the center of the ring. Surrounding down the sides of the ring and on the band are round channel set diamonds. Excellent quality VS-2 - SI-1 clarity and F color sparkling diamonds are set in the rings. All of the diamonds are 100% natural, and the blue diamond is a natural diamond that was color enhanced to achieve its fancy blue color. It's accompanied by a full independent gemological laboratory UGL diamond certificate and separate Front Jewelers store appraisal. Both state its characteristics and appraisal value of $5,995. This fantastic ring is 100% risk-free because of our 30-day return policy, and due to our customer satisfaction guarantee. If you have any questions please contact us at 1-877-376-1940 Monday through Friday 10am - 5pm eastern time.
Setting Information
Channel Setting
Diamonds are set girdle to girdle in a groove. This groove is made of precious metal and is secured by hammering down its walls.
Recently purchased engagement rings
See what our customers most recently purchased and loved!Read More
Diamond Education
What everyone shopping for a diamond should know.Read More


text:
About Missys Cakes and Cookies
I specialize in custom cakes, cupcakes and cookies - always made individually for your event. I work with every customer... Read MoreRead More to create a unique and delicious cake (or cookies!) for any celebration. There's nothing 'boxed' about our sweets!
Whether you're celebrating a wedding, anniversary, graduation, birthday... ANY occasion! I am sure I can create a one-of-a-kind tasty treat for you and your friends and/or family.
We deliver to the following areas, and if you ask, may be willing to travel further! North Port, Venice, Nokomis, Osprey, Sarasota, Siesta Key, St. Armands, and Longboat Key.


text:
It looks like you're using an Ad Blocker.
Please white-list or disable AboveTopSecret.com in your ad-blocking tool.
Thank you.
Some features of ATS will be disabled while you continue to use an ad-blocker.
Originally posted by Sinny
reply to post by Manhater
Arr, that's the first bit of personal history I've seen "Manhater" disclose
Originally posted by Flyzoid
And furthermore, if this is not just about money and about other things maybe in my control or maybe out of my control and she feels that the grass is greener on the other side then I will let her go.


text:
Got a company? Looking for cash? UNYTECH has a venture capitalist for you. Maybe.
The 2007 SmartStart & UNYTECH Venture Forum is officially open. The event offers a chance for the owners of young companies, especially those created in a university setting, to meet with V.C.'s and other potential investors.
Entrepreneurs who want to present their business plans at the event can register at www.smartstartvf.com.


text:
i think hes lieingVisitor's Question from a 16-20 year old Female
so i meet this guy nd we had a very serious thing for 4 months we were always talking like bf nd gf jus not officail but everyone knew bout us nd hes 2 years oldder then me then i had to go to a fam vaction for 5 weeks nd i talked to him bout wutd happend to us nd he sed yur the girl im serious bout nd nothings gonna happend ima msg yu everyday nd he did for the first 2-3 weeks then he slowly stopped then wen i came bak he texted me sayin yur bak nd why didnt yu tell me nd told me he really liked me hbut lost his feeling nd he noes id never take him bak but the truth is i would i love him ... nd its been 4 months nd im still not over him so we started talking again nd it was like b4 we talked all day morning nd night.. jus less flirtin nd stuff but i could tell we both cared for each otherr then one day i texted him nd he never replied so i text the next morning nd we talked then i got a msg sayin delete this bbm its not him nemore i was a lil chocked cuz i can get angry fast nd make assumptions but he tolld me his fones stolen so i believed it nd his bbm pics nd status are being updated like if it was him nd how he do it.so my frien called from a unknown nummber nd a guy piked up she couldnt tell if it was him but im thinking if his fone was stolen wouldnt he put up a fb status nd who ever stole i would delete me off bbm nd change the bbm name also not pik up the calls ...i think hes liein but my friends keep sayin somethings fishy but he has no reason to lie to yu idk wut to do next ,wuts goin on im jus a mess...
RomanceClass.com Advice
It does sound fishy; your friends are right. I'd stop texting or Facebooking this guy and put him out of your mind. You don't want someone who doesn't want you.
-- from Jill
One of Your Friendly Advisors at RomanceClass.com
|Follow @RomanceClass
Speak Your Mind - Share your Thoughts on this Question!
All Advice in the category - I Want my Ex Back
Browse our Answer Database- Browse Answers by Question Category
- Browse Answers by Age Group
- Browse Answers by Date of Response
Please read through the advice on this site before you Submit your Own Question! We have thousands of pages of valuable advice that can immediately help you with your situation.


text:
Halliburton Company (NYSE: HAL) shares were up almost 2% ahead of the company's operational update. The stock was halted for this update and the stock is now in the red, but it is driving peers and ETFs lower.
Here is what the company released: The company has experienced increased costs for guar gum, an agricultural commodity used as a blending additive to its fluids utilized in hydraulic fracturing. The price has inflated more rapidly than previously expected due to concerns over the potential for shortages for the commodity later in 2012. The higher costs have impacted its second quarter North America margins more than anticipated and it sees North America margins being impacted about 300 basis points higher than its previous guidance of 200 to 250 basis points for a total impact of 500-550 basis points lower than first quarter levels.
Ouch! Keep in mind that this is a sector-wide issue most likely. The key is this "concerns over the potential for shortages for the commodity later in 2012" in the update. That will transfer to peers and competitors most likely. Is it possible that Halliburton is the only one experiencing tight supplies? Unlikely.
Market Vectors Oil Services ETF (AMEX: OIH) is still up 1.45% at $35.22 but this was up as high as $35.83 earlier. Baker Hughes Incorporated (NYSE: BHI) is now down 0.1% at $41.03 after having been up and as high as $42.26 earlier. Schlumberger Limited (NYSE: SLB) is up 2% at $63.49 after having been as high as $64.75 earlier today.
Maybe this should not be a total surprise if you read this obscure article in Reuters out of Mumbai, India from the end of May.


text:
- Errore
Description studio tuning download
FileName: studio tuning download
Language: ENGLISH
04/03/2015 02:59:50
Website | All Programs
Total downloads::
Windows XP/Vista/7/8 (32-Bit/64-Bit)
Download URLs
Related software:
04/03/2015 02:59:50
Studio quality audio recording software. Record, edit, overdub your audio tracks; apply effects, process audio live input and mix; burn audio CDs or create mp3 filesUpgrades to Auto-Tune 8 Vocal Studio Native. To Upgrade, you will need the Registration Code from your current product. (If you can't find it, we can probably help.For more than 100 years Hallmark has designed greeting cards for life's special moments. Hallmark Card Studio Deluxe extends this tradition, making it easy to …Learn more about Avanquest and its wide range of software. We offer software for PC tune-up, website creation, education, small business, bookkeeping and more!DAZ Studio free download, 100% safe and virus free download from Softonic. DAZ Studio free download, download DAZ Studio 4.0 for free3/1/2010 This post, the second in a series of articles on Visual Studio 2010's use of WPF, covers tips and techniques for optimizing performance of WPF ...Download. Download the latest versions of all of our products, product demos, product manuals and more.Introducing TunerStudio, Easier EFI tuning using the most advanced tuning application available.Free FL Studio Download,FL Studio 11.0.4 is It is one of the world's most popular and exciting music production systems.FMJ-Software: Awave Studio - Awave Audio - Chromatia Tuner - Image Eye - Any Image - StarStrider - CleanDisk - ACDR. Awave Studio is the no 1 audio and …
studio tuning download
Most downloaded this week:
project gotham racing 2 cheats hints
harbor after school program
rescue fanny packs
insert pdf to html
how to create a psychedelic poster
big fish edgar allan poe
recipe oat cracker
see no evi
basic drum books
hooked on crochet
super anti spyware professional keygen
White Witch - Illusion mp3
zombie paris simo is_safe:1
pacala se intoarce
movie collector 9
strike back season 04
professional sound and music san diego
wildgames polar golfer
pumpkin patch sarver pa
times best games
technology drivers for today's information system
how to tell if eyes dilate
how to read itunesdb file
kingdom amalur crack


text:
i try to test the performance for our api which has a request-limiter (100requets in 100sec).You can avoid this with a custom header. The value for this header is generate by a java class.
With jruby i can use "require" and "import" too use the class.
How can i do this for JMeter?
Check Solution


text:
Remember JBS Swift?
Check this out:
After watching the video, officials at Pleasanton, Calif.-based Safeway said they had stopped purchases from its supplier, JBS Swift, which distributes pork from the Iowa company, until an investigation into the conditions shown on the video can be completed.
"Safeway does not tolerate animal abuse of any kind and finds the images and animal handling practices contained in the Mercy for Animals video to be extremely disturbing and in violation of our animal welfare policies," spokeswoman Teena Massingill said in a statement.
Kroger spokesman Keith Dailey said his company also had asked JBS Swift to investigate the conditions shown in the video. Until that investigation is completed, Kroger has told JBS Swift to stop supplying the chain with pork from the Iowa operation.
Here's the sickening video mentioned above:
Makes you wonder about what goes on in Butchertown.


text:
On "Throwback Thursday", Hugh Hefner posted a picture that threw some followers of the Playboy founder for a loop. According to Hefner, the photo featured was of him and his then girlfriend during their first holiday together. She's very blonde and very pretty, but she looks different in the old picture.
Many are puzzled to the point of wondering if Hugh got his blondes crossed. Well in actuality, there are a few simple explanations as to why his wife looks so different five years later.
First, there's the possibility of plastic surgery. Perhaps this young woman decided that she wanted to change aspects of her physical person. Some may disagree with the decision, but it's her body, her life, and her choice. If she looks different due to surgery, the outcome may be startling, but it shouldn't be controversial. It would definitely be a testament to what money can buy. With the right amount of cash and a really good surgeon, it's possible to look completely different.
Second is something that continues to mystify men and those women who don't really know how to use it to full effect: Makeup.
Check out these images of porn actresses with and without their make-up. It's the same story for women all over the world: A lot of time and a lot of makeup will can you look completely different. It's just a matter of knowing how to use techniques to full effect to undergo both dramatic and temporary changes.
Lastly, there's the difference in facial expression and camera angles. One image has Mrs. Hefner full on facing camera and smiling. The other features a sultry sideways glance at an angle. In the age of the "selfie", netizens should know that we look different depending on the camera angle and lighting. You can get dozens of looks without make-up or plastic surgery: Just point the camera a different way and face a window.
What's the explanation behind why Crystal Hefner looks different? Who knows. At the end of the day...does it really matter?


text:
Cherry Coke. (But a very big on the vanilla soap!)Originally Posted by JDHeninger
Gingerale or Mt. Dew?
Cherry Coke. (But a very big on the vanilla soap!)Originally Posted by JDHeninger
Gingerale or Mt. Dew?
Originally Posted by JDHeninger
Incidently, it's still your turn, motor muth.
I used to have a g/f that loved the dew.... looks and tastes like antifreeze to me...Originally Posted by Wayner
(don't ask how I know that)
Coke or diet coke?
fight fight fight.....Originally Posted by JDHeninger
oh, i guess that dismisses the passive front of mine...
calmness or delusion?
Diet Coke - I drink Diet Coke like everyone else drinks water (or anything else) - besides if you drink the diet coke, which has no calories, it will reverse the effect of any calories in the food you are stuffing into your mouth. Ask any fat person about dat.Originally Posted by senrik
I like to delude myself into thinking I'm calm. I guess that's calmness.Originally Posted by senrik
paranoia or narcisism?
Paranoia. I feel badly for paranoids (or is it paranoics?); narcisists are just annoying. Plus, you can play more tricks on paranoid folks.Originally Posted by JDHeninger
Greek Mythology or Roman Mythology?
Was that directed at me? Is this all just one big trick? Where are the cameras? Quit following me. I know you're there. Oh, what was I saying?Originally Posted by Wayner
There is a difference between Greek and Roman? Hmmm. You got me on that one. I only know about urban mythology.
matches or disposable lighters?
Yep, there's a different. For example, I think the Greek God of War was Ares, Roman God of War was Mars. The Greeks hadOriginally Posted by JDHeninger
Aphrodite, the Romans Venus. (And I sound like such a geek right now.)
Disposable lighters.
Crayon: flesh or peach?
Wayner? You, too, have been spending too much time with Sen.Originally Posted by Wayner
flesh crayon. some of my favorite things are flesh colored.
blue-green or red-orange crayons?


text:
Wednesday, July 16, 2008
Search our Database for Opinions and News Items
Iowa bar solicits aid for flood-stricken lawyers
The Iowa State Bar Association estimates that as many as 250 attorneys in the Cedar Rapids area have experienced a loss of some degree, with 30-50 having lost everything, and that another dozen in the Iowa City-Coralville area have been displaced due to recent flooding. The federal courthouse and county courthouse also sit on the river in Cedar Rapids, and damage to those buildings is being assessed. In response to the disaster, the bar association has established a fund to help affected lawyers pay clean up and file restoration costs. Those wanting to help can learn more on the foundation's web site:
Click on the category of your choice to view summaries of today's opinions from that court, or other body. A link at the end of each case summary will let you download the full opinion in PDF format. To search all opinions in the TBALink database or to obtain a text version of each opinion, go to our
page. If you have forgotten your password or need to obtain a password, you can look it up on TBALink at
the TBA's Membership Central
00 - TN Supreme Court
00 - TN Worker's Comp Appeals
00 - TN Supreme Court - Rules
00 - TN Court of Appeals
07 - TN Court of Criminal Appeals
00 - TN Attorney General Opinions
00 - Judicial Ethics Opinions
00 - Formal Ethics Opinions - BPR
You can obtain full-text versions of the opinions two ways. We recommend that you download the Opinions to your computer and then open them from there.
1) Click the URL
at end of each Opinion paragraph below. This should give you the option to download the original document. If not, you may need to right-click on the URL to get the option to save the file to your computer.
2) Do a key word search in the
Search Link
area of TBALink. This option will allow you to view and save a plain-text version of the opinion.
STATE OF TENNESSEE v. TONY LYNN ALLEN
Court: TCCA
David Neal Brady, District Public Defender, and H. Marshall Judd, Assistant Public Defender, for the appellant, Tony Lynn Allen.
Robert E. Cooper, Jr., Attorney General and Reporter; Benjamin A. Ball, Assistant Attorney General; Anthony J. Craighead, Interim District Attorney General; and Marty S. Savage, Assistant District Attorney General, for the appellee, State of Tennessee.
Judge: TIPTON
The defendant, Tony Lynn Allen, pled guilty to violation of a habitual motor vehicle offender (HMVO) order, a class E felony, see T.C.A. section 55-10-616, and received a two-year sentence, suspended after sixty days in jail. He reserved a certified question on appeal regarding whether the trial court erred in not setting aside the 1984 order declaring him a habitual motor vehicle offender and not dismissing the charge for violation of the HMVO order. We affirm the judgment of the trial court.
STATE OF TENNESSEE v. GEORGE GARNER, JR.
Court: TCCA
John G. Mitchell, III, Murfreesboro, Tennessee, for the appellant, George Garner, Jr.
Robert E. Cooper, Jr., Attorney General and Reporter; Elizabeth B. Marney, Assistant Attorney General; William C. Whitesell, Jr., District Attorney General; and Jennings H. Jones, Assistant District Attorney General, for the appellee, State of Tennessee.
Judge: WITT
The defendant, George Garner, Jr., appeals his Rutherford County Criminal Court conviction of one count of attempted second degree murder. In this appeal, he contends that the evidence was insufficient and that his sentence is excessive. We affirm the judgment of the trial court.
STATE OF TENNESSEE v. JAMES GLADDEN, JR.
Court: TCCA
Michael J. Collins, Shelbyville, Tennessee, for the Appellant, James Gladden, Jr.
Robert E. Cooper, Jr., Attorney General and Reporter; Michael E. Moore, Solicitor General; David H. Findley, Assistant Attorney General; Charles F. Crawford, Jr., District Attorney General; Weakley E. Barnard, Assistant District Attorney General, for the Appellee, State of Tennessee.
Judge: WEDEMEYER
The Defendant pled guilty to two counts of theft of property valued at more than $1000 but less than $10,000 in case number 17588 and two counts of theft of property valued at more than $1000 but less than $10,000 and one count of aggravated criminal trespassing in case number 17589. The trial court merged the two theft counts in case number 17588 and merged the two theft counts in case number 17589, and it imposed an effective sentence of four years of incarceration. On appeal, he claims the trial court ordered an excessive sentence and one contrary to the law. After a thorough review of the record and the applicable law, we affirm the trial court's judgments.
STATE OF TENNESSEE v. JOHNNY S. HUDGINS
Court: TCCA
Robert D. Massey (at trial) and Kyle E. Dodd (on appeal), Pulaski, Tennessee, for the Appellant, Johnny S. Hudgins.
Robert E. Cooper, Jr., Attorney General and Reporter; Michael E. Moore, Solicitor General; Jennifer L. Bledsoe, Assistant Attorney General; Mike Bottoms, District Attorney General; J. Douglas Dicus, Assistant District Attorney General, for the Appellee, State of Tennessee.
Judge: WEDEMEYER
A Wayne County jury found the Defendant, Johnny S. Hudgins, guilty of two counts of rape of a child, and the trial court sentenced him to an effective sentence of twenty-five years in prison. On appeal, the Defendant claims: (1) the trial court erred by admitting the Defendant's pre-arrest statement; (2) the trial court erred in letting a witness testify about statements made by the victim; and (3) the State presented insufficient evidence to support his convictions. After a thorough review of the record and the applicable law, we affirm the judgments of the trial court.
STATE OF TENNESSEE v. MICHAEL TODD KIRKUP
Court: TCCA
Emma Rae Tennent (on appeal) and J. Michael Engle (at trial), Nashville, Tennessee, for the Appellant, Michael Todd Kirkup.
Robert E. Cooper, Jr., Attorney General and Reporter; Michael E. Moore, Solicitor General; Deshea Dulany, Assistant Attorney General; Victor S. Johnson, III, District Attorney General; Bret Gunn, Assistant District Attorney General, for the Appellee, State of Tennessee.
Judge: WEDEMEYER
A Davidson County jury convicted the Defendant, Michael Todd Kirkup, of one count of theft of property over $1000, one count of possession of drug paraphernalia, and one count of second offense driving on a revoked license. The trial court sentenced the Defendant to an effective sentence of six years in prison. On appeal, the Defendant contends that: (1) the trial court erred when it allowed the State to impeach his credibility with his prior convictions for theft and fraudulent use of a credit card; (2) there is insufficient evidence to support his convictions; and (3) the trial court erred when it enhanced his sentence. Finding no error, we affirm the judgments of the trial court.
STATE OF TENNESSEE v. PERRY A. MARCH
Court: TCCA
C. Edward Fowlkes and Michael J. Flanagan, Nashville, Tennessee, for the appellant, Perry A. March.
Robert E. Cooper, Jr., Attorney General and Reporter; Mark A. Fulks, Assistant Attorney General; Victor S. Johnson, III, District Attorney General; and Amy Eisenbeck and Benjamin Winters, Assistant District Attorneys General, for the appellee, State of Tennessee.
Judge: WITT
The defendant, Perry A. March, appeals his jury-imposed, Davidson County Criminal Court theft conviction and his five-year sentence. In his appeal, the defendant claims that the convicting evidence was insufficient because of a variance between the indictment and the proof, that the trial court erred in denying his objection to the use of pattern jury instructions for theft, and that the court erred in enhancing his sentence. Claiming that the trial court did not enter an order to address the defendant's timely motion for new trial, the State seeks dismissal of the appeal. We reject the State's claim for dismissal, and because the proof supported the claim of theft, we affirm the conviction; however, we modify the sentence to three years.
TIPTON Concurring
STATE OF TENNESSEE v. KATIE ANN WALSH
Court: TCCA
Stephen M. Wallace, District Public Defender, and Joseph F. Harrison, Assistant Public Defender, for the appellant, Katie Ann Walsh.
Robert E. Cooper, Jr., Attorney General and Reporter; Renee W. Turner, Assistant Attorney General; H. Greeley Wells, Jr., District Attorney General; and James Franklin Goodwin, Jr., Assistant District Attorney General, for the appellee, State of Tennessee.
Judge: TIPTON
The defendant, Katie Ann Walsh, pled guilty in the Sullivan County Criminal Court to violation of a habitual traffic offender order, reckless endangerment, and felony failure to appear, all Class E felonies. The Sullivan County Criminal Court sentenced her to concurrent one-year sentences as a Range I offender for the habitual traffic offender violation and reckless endangerment and fined her $250.00 on each offense. The court sentenced her to one year as a Range I offender for the failure to appear, with a $250.00 fine, to be served consecutively to the other sentences. The defendant appeals, contending that the trial court erred in interpreting and applying applicable law in denying her any form of alternative sentencing. We affirm the judgments of the trial court.
Legal News
Disciplinary Actions
TBA Member Services
Legal News
Key Ford witness won't have to testify
U.S. District Judge Todd Campbell ruled today that a witness, seen as crucial to John Ford's corruption defense, does not have to testify on behalf of the ex-state senator. Doral Dental co-founder Craig Kasten repeatedly invoked his Fifth Amendment right against self-incrimination during testimony, after which Ford's defense asked Campbell to grant Kasten immunity from prosecution. Campbell denied the request and released Kasten from his subpoena.
Read the latest developments in the case in the News Sentinel
In related news, a second witness today declined to answer questions on the stand, while a third witness is expected to invoke the Fifth Amendment when he is called.
The Tennessean reports
Dispute continues in Blount County courts
Blount County Circuit Court Judge Mike Meares has declared two portions of the local court rules to be "void and of no effect." The action is the latest in a months-long dispute over caseloads and dispositions that has pitted Meares against members of the legal community. Meares' order alleges that the portions in question -- which lay out the presiding judge's authority to oversee administration of cases -- were not published for comment as required. The order also directs the court clerk to report back on Friday as to what steps have been taken to improve the court's statistical reporting of criminal case dispositions.
Read more in the News Sentinel
Meares to Young: Respond or step down
The order issued by Judge Mike Meares also contains an ultimatum for Presiding Judge W. Dale Young. While Meares prefaces his findings with the statement that the court has not found, and does not imply misconduct by any individual, he calls on Young to abandon office if he can not or will not explain (1) alleged misstatements in the two provisions and (2) how the provisions came to be added to the rules.
The Daily Times has the story
Nashville sheriff lobbies for immigration court
Davidson County Sheriff Daron Hall plans to travel to Washington D.C. to advocate for a federal immigration court in Nashville. He will meet with legislators to make the case that Middle Tennessee needs its own immigration court (the closest court now is in Memphis). He cites statistics that show Middle Tennessee is the nation's fourth largest area for processing criminals who are illegal immigrants.
Read about his uphill battle from News Channel 5
Appeals court takes two years off March sentence
The Tennessee Court of Criminal Appeals ruled yesterday that convicted murderer Perry March was improperly given a two-year sentencing enhancement for misappropriating funds from his father-in-law's law firm. Under the appeals court's decision, the state must now release March in January 2060 and make parole available in 2038. The Nashville Post reported the news.
Download the appeals court opinion
Read Judge Tipton's concurring opinion
Virtual law firm promises more flexibility, less stress
Craig Johnson, the Silicon Valley lawyer-entrepreneur who brought us the Venture Law Group, is onto his next big thing: a virtual law firm. Johnson and 14 other lawyers unveiled the new firm, called Virtual Law Partners, with the idea of giving lawyers more work-life balance and the opportunity to work from home, save on overhead, charge clients less and keep more of what they earn. But the best news for some will be the firm's decision not to have billable hour requirements.
Read more about the venture on Law.com
Survey to measure perceptions of judicial fairness
Lawyers, witnesses, police officers and other court participants in nine states are being asked about the fairness of court proceedings. The "Tell it to the Judge" survey is being conducted by the American Judges Association in cooperation with the National Center for State Courts. The survey poses questions about whether the judge listened to all sides and whether the parties were treated with respect. The survey will be conducted in Arizona, California, Kansas, Michigan, Missouri, Ohio, Oregon, Nevada and Texas, according to the American Judges Association.
Disciplinary Actions
Additional attorneys suspended
Out-of-state lawyers who have not paid their annual fee to the Board of Professional Responsibility were suspended on June 30. This is the second group of lawyers to be suspended for non-payment this year in a new process announced by the board.
View a list of all attorneys suspended to date
Three lawyers reinstated
Alvin Quincey Malone of Memphis, Charles Steven Moore of Nashville and William P. Van Wyke of Port Monmouth, N.J., have been reinstated to the practice of law in Tennessee after paying their annual BPR fee and required fines.
View a list of all attorneys suspended to date
Florida lawyer reinstated
Chris D. Birkel of Gainesville was reinstated to the practice of law in Tennessee on July 14 after complying with requirements for continuing legal education. He had been suspended in 2003 for CLE non-compliance.
TBA Member Services
Program offers savings on auto insurance
See how being a member of the TBA could help you save 8 percent on car insurance. GEICO offers 24-hour sales, service and claims. Call GEICO at (800) 368-2734
or get an online rate quote
Discontinue your TBA Today subscription? ... Surely not!
But if you must, visit the TBALink web site at:
Questions, comments:
Email us at
About this publication:
Today's News is a compilation of digests of news reports of interest to Tennessee lawyers compiled by TBA staff, links to digested press releases, and occasional stories about the TBA and other activities written by the TBA staff or members. Statements or opinions herein are those of the authors and do not necessarily reflect those of the Tennessee Bar Association, its officers, board or staff.
© Copyright 2008 Tennessee Bar Association


text:
Model :
Hardware Version :
Firmware Version :
I've received the Archer VR600 yesterday and installed it.
However, when tried to setup the MAC filtering I noticed that... its not there...
I looked everywhere, under advanced>Wireless, Security, Firewall but nothing.
I looked in the manuals and seems it should be there, at least in V1, but I have V2 firmware (the blue flavor).
If I do factory reset - will it reset to V1 or V2?
I'm quite concerned here since this is a basic logic that was there in other tp-link models even in this one.
Any idea?


text: Merger Arbitrage & Shareholder Wealth Effects of M&A Transactions Chapter 12 Part 1 Distribution of Takeover Premiums 1993 ~ 2000 (U.S.) Number of transactions 285 298 217 210 130 129 111 71 69 37 -10 0 10 20 30 40 50 60 70 80 28 90 28 18 12 7 100 110 120 More [%] Source: Securities Data Company Target Shareholder Wealth Effects • Target takeover premiums average 30% + – 3 day announcement window – Target shares gain 16% – With longer window Target shares gain 24% – Why is announcement effect less than takeover premium? • This is real money – average annual stock return for the typical NYSE, Amex and Nasdaq listed firms was 12%! – Given a Target's median equity value of $230 million – The Target share gain of 16% translates into $37 million for Target shareholders, who are the clear winners! • Variations – Target shareholders also gain more in cash deals than in stock deals, even controlling for deal size – Target shareholders gain much less in MOEs (Merger of Equals). Why? Target Shareholder Wealth Effects in Cancelled Deals • Target stock prices react strongly to deal cancellation announcements • Target stock price immediately drops (on average), but remains above its pre-takeover bid announcement price level. • If initial bidder does not make another bid and no other bidder materializes, then over next 6 months Target stock price continues to fall toward its pretakeover bid announcement price. • Interpretation: once the market concludes that no subsequent takeover bid is likely, the Target stock price falls to its pre-bid level Target Stock Returns Near Announcements Fig. 2. Cumulative average abnormal returns to target firms' stocks from trading day –126 to +253 relative to the first bid in the period 1975 – 91. Market model parameters are used to calculate abnormal returns. The full sample of 1,815 offers for NYSE- and AMEX-listed target firms is broken into 1401 successful and 414 unsuccessful offers. Buyer Shareholder Wealth Effects • Not as positive as for target – Three day merger announcement return is -.7% for successful Bidder shares – Longer window return is –3.8% for Bidder shares – Neither return is statistically significant, but it is still disturbing that Acquirers do not seem to benefit from the merger – (Maybe it's just a statistical artifact) • Acquiring shareholders appear to subsidize mergers, while Target shareholders capture more than the entire gains for the transaction! • But Acquirer wealth effects are not the same across M&A deals Stock versus Cash Financed M&A • Average Announcement Effects for Bidder Stocks Vary with the Merger Currency Choice – Cash deals have insignificantly positive Bidder announcement returns of +.4% – Stock deals have significantly negative Bidder announcement returns of -1.5% – So Bidder shareholder wealth effect is negative only in stock mergers – Yet Target shareholders gain more in cash deals! Why? • What is special about stock financed acquisitions? Stock versus Cash Financed M&A • Stock financed deals represent a combo: an acquisition + a stock offer by the Buyer • Studies of seasoned equity offerings (vs. IPO) find average announcement returns of -3.0% • So why don't stock acquisitions have a -3.0% announcement return? • Backing out the announcement return from the deal announcement effect (previous slide) would leave a positive 1.5% acquisition announcement effect (difference between expected 3% loss and reported 1.5% loss ) • So revisiting the cash/share difference -• if the stock offer effect is taken out, Buyer shareholders gain more wealth in stock deals than cash deals ( which have 0.4% announcement effect)! • But Target shareholders gain more wealth in cash deals ( +1.5% ) • Why? Premiums rise with hostility & less favorable tax treatment Risk Arbitrage Basics • After an M&A deal announcement, arbitrageurs are primary buyers of Target stock. – Risk arbitrageurs buy Target shares within minutes of an M&A announcement, pushing up a Target's stock price, moving it toward a Bidder's offer price. – (In bad old days, arbs would be tipped as to M&A announcement, so they could "warehouse" – Yet, a Target's stock price is almost always below a Bidder's offer price. Why? – A risk arbitrageur's motivation is short-term profits from buying Target stock at a price typically below a bidder's offer price ("deal spread"), and then holding it until deal completion or possibly selling it sooner. Risk arbitrage 2 • Deal Break Insurance – Target shareholders often prefer to sell immediately and capture most of the takeover premium, rather than wait until deal completion to capture the entire takeover premium. Why? – Arbitrageurs accept deal break risk by buying Target stock, thereby supplying deal break insurance to risk averse Target shareholders. • How does it change dynamic? • Arbs do not want to hold stock for long given their large risk exposure. • Arbs have high costs of capital, so they need to liquidate their positions quickly. • Arbs also prefer to be paid in cash to reduce their costs of closing their positions. Deal Spread on Compaq-HP Merger Deal spread is difference between sale price and offer price Risk Arbitrage Basics: Cash Deals • Risk arbitrage is profitable when: (1) a positive deal spread and (2) deal is completed. • Deal spread = Bidder's offer – Target stock's market price • Arbitrageurs bear deal-break risk: After a deal cancellation, Target shares will drop with the reduction in probability of an expected takeover premium. • If the price falls below an arb's purchase price, then they take large losses. • Risk Arbitrageur's Decision Rule: –Buy Target stock if deal spread exceeds the sum of the arbitrage costs: (1) Transaction costs of buying Target stock and later selling it or tendering it. (2) Cost of hedging a Target stock's market risk and idiosyncratic risk (3) Risk premium for bearing deal break risk (expected loss on deal cancellation). Risk Arbitrage Basics: Cash Deals • Arbs calculate an expected return from the deal spread and their estimate of the probability of a deal break (cancellation). – Arb's Expected Rate of Return = Target's Expected Purchase Price (w. Deal) x Probability of Deal Completion + Target Stock's Expected Price (w. Deal Break) x Probability of Deal Break – Target Stock's Current Price / Target Stock's Current Price Math phobes -Don't worry about this • Key Economic Variables: (1) Probabilities of a deal break and a deal completion (2) Expected Target purchase price with deal completion (3) Expected Target share price with a deal break • Arb's Risk Exposure: Deal break risk, market risk, industry risk, firm specific risk. They can all cause the post-deal break Target stock's price to fall! • Arbs Decision Rule: expand or contract Target stockholdings by comparing their expected rate of return to Treasury bill interest rate + deal risk premium. Hedging Market Risk in Cash Deals • After a deal break, Target shares will – (1) drop due to a reduction in probability of an expected takeover premium and – (2) could drop further if overall stock market has fallen. • Risk arbs try to limit their loses by hedging a Target stock's market risk & idiosyncratic risk – Arbs can hedge away the market risk in a Target stock by buying "at-the-money" put options on a stock market index. – A put option gives a buyer a right, but not an obligation, to sell an underlying risky asset (stock index) at the option strike price. An at-the-money option is where the strike price equals the underlying risky asset's current market value. – By exercising the option to sell the stock index when it falls, an arb is paid the difference between the strike price (set equal to stock index's earlier higher value), and stock index's lower current value. • In a deal break, a put option on a market index protects the arb against a loss in Target stock value due to a general market downturn or meltdown. – What other losses are still there? from loss of expected takeover premium or from industry risk or firm specific risk Risk Arbitrage in Stock Deal (Fixed Exchange Rate): Effects on Target & Buyer Stock Prices • Target stock price rises immediately after an M&A announcement and Bidder's stock price tends to fall • Target stock price tracks Buyer stock price (high correlation) if: – It is a fixed exchange rate stock financed deal – The deal is likely to succeed – Any collar or walk away clause is far away from being triggered • Buyer stock price falls on M&A announcement if: – It is a fixed exchange rate stock financed deal – The deal is likely to succeed – Deal size relative to Buyer's equity capitalization is large Share prices of JP Morgan & Chase 200 180 Stock Price ($) 160 140 120 CMB JPM 100 80 60 40 20 0 15-Jul-00 4-Aug-00 24-Aug-00 13-Sep-00 3-Oct-00 23-Oct-00 Ratio of share pices of JP Morgan & Chase 0.5 0.45 0.4 CMB/ JPM 0.35 0.3 0.25 0.2 0.15 0.1 0.05 0 15-Jul-00 4-Aug-00 24-Aug-00 13-Sep-00 3-Oct-00 23-Oct-00 M&A Arbitrage: Hedging in Fixed Exchange Rate Stock Deals • Within minutes of an M&A deal announcement, arbs act: – Buy Target stock, pushing up its price – Short sell Bidder stock, putting downward pressure on its price. – Short sale of B stock hedges some of the risk of holding Target stock (why?) • Short selling a stock – What does it mean? – You borrow stock from a shareholder and immediately sell at current market price. – You also commit to return the stock at a future date by buying the stock in the market at its future unknown price A poem about short selling . . . He who sells what isn't his'n Must buy it back or goes to prison. Daniel Drew (1797-1879) Legal and Economic Bounds on the Search for Information • Information is the principal raw material in the arbitrage business • It can be useful for purchasing stock in takeover targets prior to merger announcement (which can be insider trading) or merger arbitrage--purchase of acquirer/target stock after deal announcement. • A legal boundary as much as economic. "The most valuable valuable commodity commodity II know know of of isis The most information, wouldn't you agree?" information. Wouldn't you agree? How Law Shapes the Information Market • Positive Stimulus e.g. Mandatory disclosure – when must you disclose to the public you are doing a merger? • Negative Stimulus e.g. Antifraud liability – Can you trade (without disclosing) ahead of the market on merger knowledge? Mandatory Disclosure • Disclosure to protect investors; triggered by: – Issuance of securities (Securities Act of 1933); – Solicitation of Proxies (Securities Exchange Act of 1934- Section 14(a)) – Making a Tender Offer (Section 14(d)) – Going Private (Rule 13e-3) – Periodic Reporting (Annual-10K, Quarterly-10Q; 8K) • So, at what point in the acquisitions process will each trigger require disclosure? Mandatory disclosure • Disclosure required by the Securities Act of 1933 when securities are issued. – Applies to acquisitions in which stock is used as currency. – disclosure does not occur until issuance is to occur which will be after public announcement of the deal. • Section 14(a) of the 1934 Act requires extensive disclosure when proxies are solicited. – Applies to deals requiring a shareholder vote – mergers on the target side and some mergers on the acquirer side, but not tender offers. – not be required until after the deal has been negotiated by the boards and publicly announced Mandatory disclosure • The Williams Act amendments to the Securities Exchange Act – adds disclosure if offer asking target shareholders to sell as opposed to vote – E.g. the bidder's financing • via Section 13(d) disclosure required even before a transaction is announced – "early warning" section requires disclosure when a person's ownership exceeds 5% even if no pending tender offer and applies to groups – Tender offer regulation includes some substantive regulation – e.g. requiring best price and – requiring an offer be open for 20 business days – goes beyond the usual disclosure focus of the federal securities laws Periodic Disclosures • 10‐K and 10‐Q disclosures required under the federal disclosure laws – Calendar is the trip wire – if the filing date happens to occur in the midst of negotiations, there can be tough questions about whether information about the deal needs to be disclosed, – particularly under the broad Regulation S‐K, the common disclosure base for the various SEC disclosure requirements – Shortly after the Basic case the SEC issued a release giving planners more room to keep pending merger talks under wraps State disclosure & Stock exchange rules • Whatever disclosure is required by state law will occur after the deal has been negotiated by the board and announced when the board is asking for some shareholder action • Stock exchange listing requirements sometimes require disclosure even where federal and state law does not, as, for example, in the Basic case below. Negative Disclosure Obligations- Antifraud • Rule 10b-5– Can't lie or speak half-truths – "unlawful…(b) to make any untrue statement of a material fact or to omit to state a material fact necessary to make the statements made…not misleading; (c) to engage in…a fraud or deceit" • Dilemma for the planners of a merger– Basic v. Levinson, 485 U.S. 224 (1988): – Takeover target in extended talks with acquirer received calls from the press and inquiry from NYSE – Company's response: "Management is unaware of any present or pending company development that would result in the abnormal heavy trading activity [of] the last few days." • = Liability to all who sold for too little in the run up to merger announcement Management's Choices in a Basic setting • Tell the whole story – And then what happens? • Dissemble (i.e., lie) • No comment! – FN 17 No comment is functional equivalent of silence; – "silence absent a duty to disclose is not misleading under Rule 10b-5" – And then what happens? Another option . . . Keep it secret • Prevent press inquiry or stock exchange call from occurring • structure transaction to minimize possibility that information will get out • This regularly practiced by takeover lawyers and clients • Negotiations kept within a small group of participants on need to know basis for as long as possible • When group in the know starts to broaden, the pace to completion begins to accelerate • common that deals are often hurried to be completed over the weekend when markets are closed so as to be done by the time that markets reopen • E.g. timeline in the HCA case in next chapter


text:
What does LFON mean in Airport Codes?
This page is about the meanings of the acronym/abbreviation/shorthand LFON in the Regional field in general and in the Airport Codes terminology in particular.
Dreux-Vernouillet, S-France
Find a translation for LFON in other languages:
Select another language:
Discuss this LFON abbreviation with the community:
Use the citation below to add this abbreviation to your bibliography:
"LFON." Abbreviations.com. STANDS4 LLC, 2018. Web. 20 Mar. 2018. <https://www.abbreviations.com/term/1376609>.


text:
If you want to inform users about your own K-Meleon Extension Page or if you want to discuss an extension or extension page, please, use an existing thread or open Your own new thread on the Extensions dedicated forum.
Please, give the owner of the respective Extension Page a chance to post there first so that he can control the post about their own page, so that he can later edit it.
When You are a user that knows a page that has not been mentioned here for a while, You can also post it on the Extensions dedicated forum. But please understand that admins may remove Your post as duplicate, when the owner of the page later posts here.
Responsible for K-Meleon Extension Pages and extensions are their respective owners.
NO WARRANTY OF ANY KIND. Use on your own risk.
After this is said: Thanks to all K-Meleon contributors.
For now, two websites have a lot of extensions for K-Meleon and offers an extension manager:
K-Meleon Extension Setup (KMES): On the K-Meleon Extension Setup pages you can find a description of this extension setup system and more interesting for the users, a lot of extensions (some Mozilla extensions, for example) adapted for K-Meleon.
K-Meleon Extensions Central: http://kmext.sourceforge.net is the place where you will find many of the popular mozilla xpi extensions modified to work with K-Meleon as well as many other non-xul extensions written especially for K-Meleon.


text:
Safer water, better health
Costs, benefits and sustainability of interventions to protect and promote health
The first-ever report depicting country-by-country estimates of the burden of disease due to water, sanitation and hygiene highlights how much disease could be prevented through increased access to safe water and better hygiene.
This comprehensive overview provides the epidemiological evidence and economic arguments for fully integrating water, sanitation and hygiene in countries' disease reduction strategies -- a pre-requisite to achieving the Millennium Development Goals. It also provides the basis for preventive action by all relevant sectors managing critical water resources and services in support of public health efforts.
Lack of safe water, sanitation and hygiene remains one of the world's most urgent health issues.


text:
Q&A with Sun's Jonathan Schwartz
by Steve Anglin
Related link: http://www.theopenenterprise.com/story/TOE20021025S0001
Here's a Q&A with Sun's software group executive vice president Jonathan Schwartz. In it, he talks about the relationship with Java and LAMP, as well as open source and its impact on Sun's server strategy.
What do you think of his views?


text:
What are some movies that have made you cry?
For me it would have to Latter days and Beautiful thing.
Something about Gay Romance films makes me cry, Its always the part were they come out, or they both say they love each other.
Im crying now
What are some movies that have made you cry?
For me it would have to Latter days and Beautiful thing.
Something about Gay Romance films makes me cry, Its always the part were they come out, or they both say they love each other.
Im crying now
Last edited by Fuzzzie; 2010-12-09 at 04:04 AM.
Gilbert Grape. I cannot see that movie without crying. I even have a hard time thinking about that movie, it reachers me in a way no other film does.
My best friend is numbers
you cry to when u watch gay romance films and ur colour is black....i think someone didnt do their questionare truthfully..
Friday the 13th (remake) because those tits were stupendous.
Donnie Darko. While not straight out crying it always waters my eyes when I see the ending where we see all the characters again (don't want to spoil too much here) and Gary Jules' cover of "Mad World" just fits perfectly.
....Untamed Heart..
Great First Film Date, Make sure she hasn't watched it first though..
And Ink which as a very clever low budge Film, Not Really a Weepy film, just one part when he is battling his conscience, Well worth finding this film..
Moon, when he was talking to his daughter
also, in the same movie when the GERTY robot had a sad smiley face
Last edited by sagan-man; 2010-09-28 at 12:59 AM.
Shallow Hal. Late in the movie when Hal goes to the hospital to find Rosemary and sees Cade--
Need Roll - 1 for [Bright Pink Imbued Mageweave Banana-Hammock] by Ayirasi
Toy story 3
At first sight
Karate kid the new one was actually good, the scene when Will Smiths son was getting jumped and Jakie Chan comes and saves the day!
Idk if you guys watch house md but the episode "Wilson's heart" was a tear maker.
sad moments
Last edited by ShamanWiz; 2010-10-04 at 05:27 AM.
Requiem for a Dream...
...actually, I cry a lot at movies, but that one was particularly bad.
I've only ever shed a tear while I watched Seven Pounds.
I'm not trying to be all buff and manly but I rarely cry, though I'll get emotionally touched by some movies.
But I really did shed a tear or two when I watched Seven Pounds the first time.
I hath no shame though, because my girlfriend were crying rivers next to me.
Originally Posted by Ghostcrawler
i know it's not a movie, but from scrubs when Laverne dies just as carla says her final good bye
Ladder 49 at the end when he radios in for them to evacuate and leave him in the burning building to die.
I didnt cry in this one, but: When Hector dies in Troy, and is dragged around the city.
Gladiator, end scene.
Braveheart, getting tortured.
I dont really cry in movies, but these are all emotionally strong imo.
I cried at the end of Saving Private Ryan, when the flashback was over, and he was saluting in front of the grave.
Originally Posted by Respen


text:
Procuring a specialist co-op with skill on site improvement can be either great or awful for an online business. The consequences of their endeavors can impel a site to the highest point of web index results, or it can reverse discharge. The result relies on upon the capacities of the group of web advertisers. It has been demonstrated that site proprietors can profit by capable administrations gave by advisors and organizations that offer flow and honest to goodness site design improvement rehearse. By performing promoting capacities, they can influence key changes on movement, transformations, and deals. Customarily, website streamlining is related with catchphrase inquire about, yet there is a whole other world to this practice. Get more info on SEO agency Seattle.
An informed site proprietor will realize that it is best to contract administrations identified with web showcasing at the beginning. The best time to enlist an office is amid the stage site advancement. A site that is neighborly to web indexes from the base up will have a superior possibility of drawing in consideration towards it and far from the opposition. In any case, it is not very late to enhance a site that is as of now up and running for a long time. With the assistance of a capable specialist organization, the components of the site that should be enhanced can be distinguished.
Advanced showcasing office assumes a significant part in our life. It has turned out to be difficult to do any sort of business without the assistance of the advanced promoting. The advanced advertising organizations attempt their level best to illustrate any business in the web. Today the vast majority of the general population of enlightened nations know how to work PC and web and they look anything on web and the advanced promoting office attempt to convey everything to the peruses or watchers. The photo of the web advertise has experienced intense change lately. The rankings can likewise change notwithstanding when there are no calculation changes, basically in light of the way that the greater part of alternate sites too are attempting to advance themselves and remain on top.
This is the reason, never simply rely on upon the web indexes for all your web movement. Attempt alternate intends to get activity as well, and do guarantee that your Internet promoting administration is putting forth you a total bundle that incorporates them. Aside from SEO, the bundle may incorporate PPC or running a Pay Per Click crusade, member advancements, article showcasing, composing public statements, blog promoting, gathering postings, flag commercials and others. Attempt to enhance the movement sources as much as you can to guarantee long haul achievement. Click here SEO agency Seattle for more details.
The most effective method to Select Your Internet Marketing Service -There are a ton of specialist co-ops out there and it is basic that you pick one deliberately. As said some time recently, initially ask them what exercises are incorporated into the administrations advertised. Likewise do guarantee that the organization is focusing on your principle watchwords when they are promoting your site. There are many organizations that objective the optional or the long tail watchwords on the grounds that the essential catchphrases are just excessively focused. Never succumb to this. The truth of the matter is, auxiliary and long tail catchphrases will never truly give you that much movement.


text:
Welcome to WebmasterWorld Guest from 126.96.36.199
Forum Moderators: phranque
It is not 1 week older but i m afriad not even a single robot has crawled my site till now.
So anyone can tell me how can i get my site crawled or can able to give names of sites to whom i can link my site to crawl.
Thank You
Rahul Doshi
or Yahoo! Search here:
or MSN Search here:
To rank well, you need to build a high quality, info-packed site. Brett's 12 months to success in Google [webmasterworld.com] is a little dated, but still very relevant.


text:
Claw and Fang. Issue 0.
Record details
- ISBN: 9781620984178 (electronic bk.)
- ISBN: 1620984172 (electronic bk.)
- Physical Description: 1 online resource
- Publisher: [United States] : Stormfront Publishing : 2015.
Content descriptions
|Restrictions on Access Note:
| Digital content provided by hoopla.
|Summary, etc.:
| Banished from Earth over three thousand years ago by a powerful young Celtic King, the demon named Noro has had time to plot his revenge. Summoned back from the dark abyss of nothingness, Noro is unleashed by those who wish to use him for their own gain. A young video gamer born with the heart and soul of an ancient warrior, Justin, escapes the monotony of his daily life by spending every waking hour living in an online fantasy world. Forced by fate, Justin must now confront real life to save us all.This special edition has never before seen images and character designs from the series.
|System Details Note:
| Mode of access: World Wide Web.
Search for related items by subject
|Electronic books.
Graphic novels.
Comic books, strips, etc.


text:
Sign in | Check Order Status | Sign Up For Our E-Mail List
0 Items | $0.00
View Cart
Seiko ladies stainless steel watch with gold-tone finish. Square champagne-colored dial with gold-tone hands and hour markers. 12 and 6 o'clock marked by scripted numbers. Jeweler's clasp on bracelet. Quartz technology. Water resistant to 30 meters.
More details about this
See a better price somewhere? Just email us to speak with our trained Seiko specialists. There's no better place to buy a Seiko watch, guaranteed.
This stainless steel watch is gold-tone finish and has a shimmering champagne-colored square dial. Gold-tone hour and minute hands and hour markers complete this classic monochromatic look. The 12 and 6 o'clock hours are marked by beautifully scripted gold-tone numbers. Black second hand. This is a slim, feminine watch.
The bracelet on this watch has a jeweler's clasp. Hardlex crystal. Water resistant to 30 meters. Approximate battery life of 2 years.
Case width: 16mm
A few important details:
BillyTheTree.com. Family-owned since 2004.
Back to top of page
2617 Jewell Rd
Belleair Bluffs
Be the first to hear all about the latest news, promotions and offers from Billy The Tree.com