Abuse of prescription of narcotics in primary care and its prevention Dissertation - 1

Abuse of prescription of narcotics in primary care and its prevention - Dissertation Example The prescription of opioids to assist the patients with malignant cancers has proven to be beneficial, but the increasing misuse and abuse of these medications by patients suffering from non-chronic pain has served to overshadow the benefits of opioids, despite the wide variety of medications available to treat non-cancer associated pain (Potter et al, 2001). While theoretically, the constant prescription of opioids is necessary and effective only in the treatment of malignant cancer-related, significantly more serious pain (Becker et al, 2011), health practitioners seem to have favored the prescription of these drugs in cases of all chronic pain (Potter et al, 2011). The supposition is therefore that this more widespread prescription has led to NUPM and PUPD. But it is not only the increase in prescription of opioids that can explain the ballooning of the incidence of NUPM. It seems that the failure of health professionals to monitor their patients’ use of drugs may also be a significant factor arguing for restraint, and even the cessation of the practice of widely prescribing opioids (Liebschutz et al, 2010). What are the conditions, consequently, that should accompany the distribution if opioids to patients? Is the only available, effective option to ban these medications outright, or would it be possible to formulate and implement policies that would effectively prevent abuse and misuse of these narcotics? A. Trends in the prescription of narcotics The findings of studies suggested that the varied barriers to the use of opioids must be addressed before any mandates or guidelines regulating the prescription of opioids can be implemented. Primary caregivers are more likely to be frustrated by the barriers, than by conforming to sets of guidelines. Therefore the prescription of opioids for the treatment of chronic pain in older patients is widespread. Spitz et al. (2011) found that the majority of the participants in their quantitative study were prescr ibing opioids to older patients, but only as a second or subsequent line of treatment. This initial reluctance may be due to the possibility of causing harm; the subjective nature of pain; deficient education regarding the effectiveness and consequences of using opioids; and the stigma attached to opioid use. Family members and the patients themselves were reluctant to try opioid treatment due to concerns regarding possible opioid abuse or misuse. In the findings of other studies, it was clear that significant attention had been given to the probability of substance abuse in patients prescribed opioids on a regular and ongoing basis. The clinical significance of the association between opioid use and common mental disorders is often overlooked. The evident lacunae resulting from the overemphasis on substance abuse, and the underemphasized incidence of mental disorders must be addressed. The prevalence of high-risk patients, in the prescription of opioid treatments, is a vital consid eration. Patients on opioid treatment were found to be two to three times more likely to seek mental health assistance by Sullivan et al. (2006) despite their not reporting a higher requirement for substance abuse treatment. In this cross-sectional study, it was found that continued use of opioids in participants, over the period 1988-2001, posed an increased risk for common mental disorders. This study illustrates the link between common mental disorders, as well as substance abuse, with the continuous use of prescribed opioids based on evidence from a large prospective population based data study. Furthermore, a lack of confidence among physicians relating to the prescription of narcotics can be discerned. Nonetheless, urine toxicology screening was rarely carried out either

Multi line regression Statistics Project Example | Topics and Well Written Essays - 1250 words

Multi line regression - Statistics Project Example atly depends on statistics in order to determine how well a country is doing in terms of trading with the relevant partners and in enhancing economic growth. In this task, the chosen dependent variable was the United States of America exports, the dependent variables selected are; oil prices, USA car prices and technological product prices. It is assumed that the selected independent variables have a direct relationship with the dependent variable. For instance, car prices will determine if the exports of the same will be higher, especially when compared to prices of cars from other countries such as Japan. In order to understand how the independent variables impact on the dependent variable, multiple regression analysis is usually utilized. Regression is a statistical analysis that is used to evaluate the association or relationship between continuous dependent and continuous independent variable (Chatterjee & Simonoff, 2013). Usually the regression analysis helps establish a number of issues such as if a relationship exists between variables, the strength of the association, the structure or form of the relationship, as well as help in predicting the values of the dependent variable and controlling for other dependent variables. This makes regression superior to correlation analysis. Ideally, regression coefficients depict the mean, variance or change variables under investigation variable for one unit of change in the predictor variable while holding other predictor variables constant in the same model. With regards to coefficients above, it is evident that when oil prices and technical product prices are held constant, the amount of exports will increase by 6.94, when car prices, and technical product prices are held constant, then exports will increase by 4.27 and lastly, when car prices and oil prices are held constant, exports will reduce by -0.52. R-square value stood at 0.9472. Coefficient of determination adjusted for the degree of freedom denoted as

The Paris Peace Conference Research Paper Essay Example for Free

The Paris Peace Conference Research Paper Essay The Paris Peace Conference is only one of many conferences throughout the world. This conference was led by not only by just a United States President, but by my blood lines. President Woodrow Wilson is my great, great, great grandfather. He had chosen to lead the delegation of the Peace Conference with Paris after World War I. Woodrow Wilson was also the first President to visit Europe in their term as president of the United States of America. This Paris Peace Conference had been known as another name, the Treaty of Versailles. This Treaty (Paris Peace Conference) was basically written to finish off, and declare the ending of World War I. This was held not just within Paris, but many countries had been involved, such as Germany, Russia, France, Great Britain, Italy, and the United States. These countries were all given the task of following the treaty to end this â€Å"war of all wars†. Although many people in having the basic knowledge of this Treaty, do not realize that this entire war ending Conference takes an entire Process. This process consists of Economists, Geographers, Ethicists, Military Experts, and of course the Ambassadors. Each person or group of people had their own set of tasks to accomplish during this Conference. The Economists were in charge of all the costs, and payments that may be due. Then the Geographers helped to determine boundaries over each country; this was to be placed in the Treaty. Next the Ethicists, to basically figure out how this war was even started in the first place; then the military experts were in charge of the power given to most people; this included the restrictions and certain regulations. Then the last groups of people are the Ambassadors, they usually hold the speeches and speak their own countries testimonies. This Paris Peace Conference was not just a sudden agreement either; there was an agreement leading up to the Peace Conference. This was called the Armistice. This was an agreement signed on November eleventh in 1918. This agreed to everyone holding a Peace conference discussing Post-war world. The Paris Peace Conference was held on the 12th of January in 1919. The ending of this Conference was dated to the 20th of January in 1920. There were countries that had their disagreements towards this Treaty, for example Great Britain wanted power over the Seas, but they were not the only ones, also they wanted control over Germany.

Urban Structure in Modern Society

Urban Structure in Modern Society How Should a Modern, Globalized Society Adapt Its Urban Structure? A Comparison of Four Texts Globalization, much like the Industrial Revolution that propelled Europe and North America to the forefront of the global economic stage, has forced the redevelopment and organization of urban hubs. Some, like Moulaert and Waley, support government-led initiatives addressing the problem of the economic disparities among social classes caused by the redefinition of labor markets. Others, including Logan and Swanstrom, argue against centrally-planned economies and markets, positing that cities should not work outside the boundaries of their national context. Scholars like Haila, on the other hand, present a married political ideology combining the two, arguing that while differences in cities may exist, real estate and private investment is the common link binding all â€Å"global cities.† With globalization overtaking the norms of familiar market economies, contemporary urban hubs face â€Å"persistent high levels of unemployment, shortage of job opportunities, homelessness, deteriorating housing and living conditions, widening income gaps, [and] social violence†; these problems have become â€Å"an integral part of the new urban context, regardless of prevailing dynamics of economic growth or decline†[1]. Consequently, Moulaert and his contemporaries suggest government-mandated interventions are necessary, including the coerced transformation of labor markets. According to Moulaert, â€Å"the transformation of employment is, doubtless, the key axis of urban socio-economic restructuring and the primary factor shaping increasing inequality and social fragmentation in cities†[2]. Logan and Swanstrom concur, but question the extent to which the government ought to be able to intervene in the restructuring of society. They question â€Å"what form th ese interventions should take,† as reform in the East â€Å"is a synonym for raising prices, reducing some types of consumption, and accepting structural unemployment†; the Communist-type failure of urban restructuring (and central planning) is therefore representative of a â€Å"political and economic event,† avoidable through the careful, monitored endorsement of free market economies[3]. Waley, like Moulaert and his contemporaries, supports a degree of government intervention in urban restructuring and cites the Japanese post-war example. Waley suggests Japan’s success in urban restructuring can be attributed to â€Å"reorganizing urban space in pursuit of economic growth,† which entailed national â€Å"relaxation of zoning, disposal of public land, and measures advantageous to private landowners† vis-à  -vis the strategies outlined by Haila which will be examined later[4]. The government, Waley argues, is the greatest facilitator of econ omic growth through its power to enact policies; contrary to the Communist model, however, Waley’s proposition is one of incentive to the private sector. Logan and Swanstrom directly oppose governmental intervention supported by Moulaert and (to a degree) Waley, specifying that policy cures and the measure of urban restructuring in an ailing economy are better prescribed at the national level; the two stress that â€Å"cities cannot be abstracted from their national context†[5]. Logan and Swanstrom’s position endorse Waley’s admonitions to â€Å"avoid the dangers of a simplistic cultural-determinist response† to the necessity of urban restructuring[6]. On the other hand, Moulaert concedes the fallibility of his model, surmising that government intervention can be detrimental to a point as federal programs are a de facto means of increasing â€Å"the concentration of deprivation in particular urban areas and neighborhoods,† reproducing â€Å"the formation of â€Å"excluded communities, reproduced by the very initiatives that purportedly aim at eradicating them†[7]. Haila echoes the power of pu blic perception, claiming that the aforementioned factor drives the model of private real estate-powered economies. Pointing out the paradigm shift of Japanese investment in Los Angeles from the 1980s to the 1990s, Haila notes that urban development can be catalyzed or snuffed by a change in public perception; after all, â€Å"in the 1980s, Los Angeles was a city favored by Japanese investors,† but the 1992 race riots â€Å"changed this situation, as a property market where an asset can be demolished in one night is not a good market†[8]. While Haila does not prescribe uniformity in the application of economic and urban restructuring, she endorses the facet that all cities which aim to restructure themselves into â€Å"global cities† have real estate in common, echoing Waley’s sentiments regarding Japanese investment in Los Angeles. Private land ownership lends to the environment necessary for economic rehabilitation per globalization. Cities therein affe ct cities; the price falls and gains from one city inevitably affect another[9]. While Logan and Swanstrom support the contention that restructuring carries significant social and political institutions in its wake[10], their views are most applicable to the current global economy due to their calls for uniformity and consistence on a national level. Tied to Haila’s theory of inter-dependent cities, Logan and Swanstrom’s model prevents the cannibalization of intra-national markets. Moreover, Logan and Swanstrom advocate a laissez-faire attitude within the confines of a national agenda, therein tempering the so-called â€Å"free market.† Moulaert’s supposition that global restructuring entails urban development projects, his advocacy for government intervention, finds fault along the lines of market restriction. The workings of bureaucracy prevent the intervention of the individuals Haila perceives as vital to the growth of an economy through land ownership. Though they can be tempered by applicant law and a statute, truncating the invo lvement of the private sector limits growth and future adaptations to a globalizing world economy where punctuality can mean the difference between prosperity and recession. Waley may concede restructured Tokyo’s disparity between the living conditions of the poor and the profit expansions of business corporations, but in his assertions he glosses over the state’s possible use of higher tax revenues to revive the lower classes, thus leaving the question of self-propagating poverty and economic stagnation unanswered[11]. Perhaps most important to note is the necessity of policy fluidity in the degree of laissez-faire economics and governmental intervention. While all four works prescribed a degree of flexibility, none presented the simple fact that globalization, as a new world market and concept, cannot be approached using a template or a macroeconomic stencil of some sort. Adaptation in the urban sector, like all forms of adaptation, cannot be expected to work within the stricture of obstinate thought. BIBLIOGRAPHY Haila, A. (1997) â€Å"The Neglected Builder of Global Cities.† In: Cities in Transformation Transformation in Cities: Social and Symbolic Change of Urban Space, pp. 51 64. London: Ashgate P. Logan, John R and Todd Swanstrom. (1990) â€Å"Urban Restructuring: A Critical View.† In: Beyond the City Limits: Urban Policy and Economic restructuring in Comparative Perspective, pp. 3-24. New York: Temple U P. Moulaert, Frank et al. (2003) â€Å"Urban Restructuring, Social-Political Polarization and New Urban Policies.† In: The Globalized City: Economic Restructuring and Social Polarization in European Cities, pp. 29-45. Oxford: Oxford U P. Waley, P. (2000) â€Å"Tokyo: Patterns of Familiarity and Partitions of Difference.† In: Globalizing Cities: A New Spatial Order?, pp. 127-157. New York: Blackwell Publishers. Footnotes [1] Moulaert et al 2003, p. 30 [2] Moulaert et al 2003, p. 31 [3] Logan and Swanstrom 1990, p. 4 [4] Waley 2000, p.139 [5] Logan and Swanstrom 1990, p. 6 [6] Waley 2000, p. 128 [7] Moulaert et al 2003, p. 32 [8] Haila 1997, p. 56 [9] Haila 1997, p. 52 [10] Logan and Swanstrom 1990, p. 12 [11] Waley 200, p. 141

The Sarbane-Oxley Act (SOA) Essay -- Corporate Governance

INTRODUCTION "The Public Company Accounting Reform and Investor Protection Act" was signed into law by President Bush on July 30, 2002. The law is now known as The Sarbane-Oxley Act (SOA). The SOA has eleven titles within the act and numerous sections, pertaining to ethics, accounting, financial reporting, responsibilities of officers, whistleblower protection, and increased criminal penalties built upon prior securities laws. SOA is the most comprehensive securities legislation written since the 1940s. In the early part of the twentieth century companies did not have the sophistication and abilities of the modern company in regard to information technology, number of accountants, advisors and analysts. This legislation is a big step toward keeping U.S. law up to date with modern business practices. The Sarbane-Oxley Act was necessary to protect the U.S. economy and restore investor confidence after the many years of dishonest business practices by ENRON, WORLDCOM, TYCO and other companies. The practitioners of shady accounting and greed brought about a collapse in stock prices, shook investor confidence and hurt the credibility of all publicly traded companies. A mass "bail-out" by large stockholders ensued; however the average small investor held on, hoping that the stock would stabilize and believing the reassurances of companies, that claimed they were financially well-off when they were actually worth less than what they owed. In the end, investors and lower-rung employees of these companies were devastated financially. The underhandedness and greed of these corporate officers had the potential to hurl the U.S. economy out of control. The small investors, who are registered voters demanded action. This paper will review the sections of The Sarbane-Oxley Act, highlight their broad implications and discuss compliance. Compliance will cost all publicly traded companies a great deal of money. ?Deloitte's Point of View? will be used to illustrate that compliance, when embraced properly and approached positively can bring rewards for companies in the long term. SECTIONS The sections that follow are a simplification of the Sarbane-Oxley legislation. There are many niches that will require attorneys, accountants and advisors. Keep in mind all prior SEC (securities exchange commission) legislation such as (The Securities Act of 1933, Securiti... ...s Point of View, Sarbanes-Oxley Compliance. (Online). 8 Pages. Retrieved January 16, 2003 from: http://www.deloitte.com/dtt/section_node/0%2C2332%2Csid%25253D5601%2C00.html PriceWaterhouseCoopers. (2003). Key Elements of Antifraud Programs and Controls, A White Paper. 29 Pages (Online). Retrieved January 16, 2003 from: http://www.pwcglobal.com/Extweb/NewCoAtWork.nsf/docid/D0D7F79003C6D64485256CF30074D66C Securities and Exchange Commission. (2002). Proposed Rule: Certification of Disclosure in Companies? Quarterly and Annual Reports. 6 Pages (Online). Retrieved January 17, 2003 from: http://www.sec.gov/rules/proposed/34-46300.htm Securities and Exchange Commission. (2003). The Laws That Govern the Securities Industry. 5 Pages, (Online). Retrieved January 17, 2003 from: http://www.sec.gov/about/laws.shtml#secact1933 Securities and Exchange Commission. (2003). Summary of SEC Actions. 3 Pages, (Online). Retrieved January 17, 2003 from: www.sec.gov/news/press/2003-89a.htm Worthen B. (2003, December 1). A Funny Thing Happened on the Way to Compliance. CIO Magazine, Retrieved January 15, 2003 from: http://www.cio.com/archive/120103/oxley.html

Free Essays - The Depiction of Black Men in Alice Walkers Color Purple :: Color Purple Essays

Depiction of Black Men in The Color Purple Several critics claim Alice Walker's depiction of men is too harsh and too one-dimensional, but based on what I have read in The Color Purple, I cannot agree. Celie is a woman who has been negatively affected by men her whole life. Whether it was her stepfather throughout her childhood or her husband, Mr. _____, during her 20s, men made her life miserable. The harsh depiction of men is accurate based on the way Celie's stepfather and Mr. _____ treated her. Celie's stepfather mistreated her in such a way that an accurate depiction was made. When Celie's mother became ill and unable to satisfy her husband, he told Celie to fulfill her mother's job. When Celie cried because of the pain, her stepfather said, "you better shut up and git used to it"(3). To assure himself that no one would find out about his secret he told Celie "you better not never tell nobody but God it'd kill your mammy"(1) and told Mr._____ "she tell lies"(9). As a result, when Celie's mother passed away, she felt that she killed her mother, when in fact her mother was terminally ill. After two pregnancies, Celie was unable to produce anymore children because her father injured her reproductive system. The children Celie had, her stepfather took them away from her, while in her heart she yearned to find them even years later. Celie's stepfather degraded her and always wanted to keep her self-esteem low by constantly telling her "she is a bad influence on my o ther girls...she ugly don't even look like she kin to Nettie...she aint smart either"(9). After Celie got married, the way men treated her did not change too much. Celie got beaten in the same manor Mr. _____ beat the children, but only because she was his wife. Mr. _____'s children not wanting a new mother created a bad situation between them and Celie. The oldest boy threw a rock at Celie's head that burst open her head, the girls cry, scream, and curse and all Mr. _____ said was to not do it. Mr. _____ only married Celie to have someone to cook, clean, work, take care of the children and sleep with.

History Of The Paraprofessional Education Essay

There has been a long history of statute law and alterations in educational doctrine that have influenced both the functions and the makings of paraprofessionals. † ( â€Å" Unit 7 Reading † . neodymium. parity. 1 ) The paraprofessional function is dramatically critical presents because of these alterations and influences. Today, the life of a paraprofessional is filled with extended undertakings and duties that stretch far beyond the boundaries of clerical work ; paraprofessionals in my sentiment are one of the most indispensable gateways, if you would, to the academic success of particular needs pupils and to those that seek farther direction. However, since this was non ever the instance for paraprofessionals, a brief history of the paraprofessional function and attach toing Torahs of each epoch of paraprofessional history is included in the undermentioned paragraphs. Read on. There are a figure of past events and associated Torahs that have impacted the function of the paraprofessional. To get down with, in the 1950 ‘s equal rights for kids ‘s instruction was good needed but non present. This academic inequality was based on racial segregation and a deficit in accredited instructors. Brown v. Board of Education of Topeka ( 1954 ) challenged the Acts of the Apostless of academic racial bias in a tribunal of jurisprudence that resulted in a opinion for academic equality for all pupils. ( â€Å" Unit 7 Game Study Guide † . neodymium. parity. 3 ) As for the remainder of the accredited instructors, paraprofessionals were recruited for excess aid. Revolution peers change no affair what the circumstance. In the 1960 ‘s a radical motion in societal services, wellness attention, instruction, and employment brought away the alteration in rightful standing of many. Womans and the detested, the disableds and the hapless insisted upon the same rights as the remainder of world and the wealthy. These demands resulted in the undermentioned Torahs and plans: Civil Rights Act of 1964, Head Start ( 1965 ) – a plan for kids in the earliest phases of development that I am so grateful for, it offers a battalion of support for runing from faculty members to wellness and health for kids who are like me when I was a kid ( you know, a small less fortunate ) . In the same epoch, The Elementary and Secondary Education Act of 1965 passed and urged parents to acquire involved with the school and academic life of their kid or kids ; Title I plans established through this Act â€Å" aˆÂ ¦ increased instructional support of basic acco mplishments to deprived pupils. † ( â€Å" Unit 7 Game Study Guide † . neodymium. parity. 4 ) Still in that same clip frame, yet another jurisprudence was passed-Immigration and National Act Amendments of 1965-and alleviated certain judicial admissions on policies for in-migration. This Act caused an augmented demand for paraprofessionals in the schoolroom because of an addition in pupils with linguistic communication and/or cultural barriers. A bilingual or multilingual paraprofessional was an ideal campaigner in conformity to this Act. Today, people with disablements are protected from favoritism because of the civil rights jurisprudence passed in the 1970 ‘s. Section 504 of the Vocational Rehabilitation Act of 1973 appointed equal chance rights for the mentally and physically disabled against favoritism in every facet including the educational facet of society. ( Charmatz. Penn. neodymium. parity. 1 ) In sight of this new right, more paraprofessionals were needed. A twelvemonth subsequently, the Equal Educational Opportunities Act extended its range out to pupils with linguistic communication and/or cultural barriers to acquisition, doing it compulsory for schools to help these pupils ; therefore ensuing in the farther demand of expertness of paraprofessionals. The Education for All Handicapped Children Act or Public Law 94-142 ( 1975 ) besides required extra support of pupils with disablements, bit by bit increasing the demand for paraprofessionals thenceforth. ( â€Å" Unit 7 Game Study Guide † . ne odymium. parity. 5 ) A call for reformation of the needed criterions and teacher answerability arose after a series of educational studies by a figure of governmental bureaus in the 1980 ‘s. These studies were directed toward the quality of instruction and the overall answerability of instructors for the expected criterions of their Plutos, and their instructional abilities. Simultaneously, instructors, the local school communities, and parents were encouraged to collaborate to find pupil larning abilities and failings, wellness and physical challenges in order to find which larning plans are the best to integrate in the school ‘s course of study. The National Resource Center for Paraprofessionals and the Council of Exceptional Children besides supported structured course of study and criterions for paraprofessionals and their supervisors. ( â€Å" Unit 7 Game Study Guide † . neodymium. parity. 6 ) The Immigration Act of 1990 besides contributed to the addition in paraprofessionals, particularly those that were culturally diverse. The Americans with Disabilities Act mandated adjustments for pupils and workers with disablements. Persons with Disabilities Education Act, a reauthorization of the Education of all Handicapped Children Act ( reauthorized twelvemonth 1997 ) . Actual acknowledgment of the paraprofessional function, developing specifications and appropriate supervising specifications of the paraprofessional function were identified, clarified, and mandated. ( â€Å" Unit 7 Game Study Guide † . neodymium. parity. 7 ) In the twelvemonth 2001, the ill-famed No Child Left Behind Act ( once known as the Elementary and Secondary Education Act ) focused a batch on the countries of instruction that will assist increase the academic standing of pupils with and without disablements, every bit good as for the economically advantaged and disadvantaged, and for the behaviorally, mentally, and physically challenged. In 2004, the Persons with Disabilities Education Act was one time once more reauthorized, this clip as the Education of all Handicapped Children Act ( reauthorized twelvemonth 1997 ) made important alterations in the Individual Education Plans ( IEPs ) for kids with particular demands and larning disablements. These alterations once more, resulted in the increased demand for paraprofessionals. ( â€Å" Unit 7 Game Study Guide † . neodymium. parity. 8 ) Nowadays, as a consequence of all the history of the paraprofessional, paraprofessionals I able and required to further help all pupils that need excess aid. Undertakings that a paraprofessional can anticipate to carry through are transporting out remedial lessons, helping pupils with disablements in transitional plans, of class copying documents and rating documents, they can anticipate to assist maintain up with schoolroom visual aspect and help the oversing instructor in lesson planning excessively, they can besides anticipate to work in a figure of topographic points like in traditional schoolroom scenes, in remedial acquisition categories, and transitional categories, they can anticipate to chaperone kids on field trips along with many other undertakings and duties. All in all, the significance, day-to-day undertakings, and duties of the paraprofessional function have changed enormously, as a consequence of a long history of alterations and reforms to the Torahs and plans in edu cational history.