Process to develop a State Model Law to reduce prescription drug trafficking while protecting pain management

This paper will discuss the intersection of pill mills and the under-treatment of pain, while addressing the unintended consequence that cracking down on pill mills actually has on medical professionals' treatment of legitimate pain in clinical settings. Moreover, the impact each issue has on the spectrum of related policy, regulatory issues and legislation will be analyzed while addressing the national impact on medical care. Lastly, this paper will outline a process to develop a State Model Law on this subject. This process will include suggestions for the future and how we can move forward to adequately address public safety needs and how we can attempt to mitigate the unintended impact prescription drug trafficking has had on a patient's right to appropriate pain management. This balance is achievable and this paper will address ways we can find this elusive balancing point through the development of a State Model Law. ^

ECONOMIC ANALYSIS OF THE DEMAND FOR PRESCRIPTION MEDICINE IN THE UNITED STATES

The purpose of this study was to understand the role of principle economic, sociodemographic and health status factors in determining the likelihood and volume of prescription drug use. Econometric demand regression models were developed for this purpose. Ten explanatory variables were examined: family income, coinsurance rate, age, sex, race, household head education level, size of family, health status, number of medical visits, and type of provider seen during medical visits. The economic factors (family income and coinsurance) were given special emphasis in this study.^ The National Medical Care Utilization and Expenditure Survey (NMCUES) was the data source. The sample represented the civilian, noninstitutionalized residents of the United States in 1980. The sample method used in the survey was a stratified four-stage, area probability design. The sample was comprised of 6,600 households (17,123 individuals). The weighted sample provided the population estimates used in the analysis. Five repeated interviews were conducted with each household. The household survey provided detailed information on the United States health status, pattern of health care utilization, charges for services received, and methods of payments for 1980.^ The study provided evidence that economic factors influenced the use of prescription drugs, but the use was not highly responsive to family income and coinsurance for the levels examined. The elasticities for family income ranged from -.0002 to -.013 and coinsurance ranged from -.174 to -.108. Income has a greater influence on the likelihood of prescription drug use, and coinsurance rates had an impact on the amount spent on prescription drugs. The coinsurance effect was not examined for the likelihood of drug use due to limitations in the measurement of coinsurance. Health status appeared to overwhelm any effects which may be attributed to family income or coinsurance. The likelihood of prescription drug use was highly dependent on visits to medical providers. The volume of prescription drug use was highly dependent on the health status, age, and whether or not the individual saw a general practitioner. ^

THE RELATIONSHIP OF PRESCRIPTION RECEIPT AND EXPECTATION OF SICK-ROLE LEGITIMATION BY AMBULATORY VETERANS

This study explored the relationship of attitudes, needs, and health services utilization patterns of elderly veterans who were identified and categorized by their expectation for and receipt of sick-role legitimation. Three prescription types (new, change, renewal) were defined as the operational variables. A population of 676 ambulatory, chronically ill (average age 60 years) veterans were sent a questionnaire (74% response rate). In addition, retrospective medical and prescription record review was performed for a 45% sample of respondents. The results were analyzed using discriminant function and regression analysis. Fewer than 20% of the veterans responding expected to receive more prescriptions than were presently prescribed, whereas over 80% expected refill authorizations. Distinct attitudinal, need, and utilization patterns were identified. ^

A practice-based culminating experience: Writing a HRSA grant application with Texas Organ Sharing Alliance for public education efforts to increase solid organ donation

In November 2010, nearly 110,000 people in the United States were waiting for organs for transplantation. Despite the fact that the organ donor registration rate has doubled in the last year, Texas has the lowest registration rate in the nation. Due to the need for improved registration rates in Texas, this practice-based culminating experience was to write an application for federal funding for the central Texas organ procurement organization, Texas Organ Sharing Alliance. The culminating experience has two levels of significance for public health – (1) to engage in an activity to promote organ donation registration, and (2) to provide professional experience in grant writing. ^ The process began with a literature review. The review was to identify successful intervention activities in motivating organ donation registration that could be used in intervention design for the grant application. Conclusions derived from the literature review included (1) the need to specifically encourage family discussions, (2) religious and community leaders can be leveraged to facilitate organ donation conversations in families, (3) communication content must be culturally sensitive and (4) ethnic disparities in transplantation must be acknowledged and discussed.^ Post the literature review; the experience followed a five step process of developing the grant application. The steps included securing permission to proceed, assembling a project team, creation of a project plan and timeline, writing each element of the grant application including the design of proposed intervention activities, and completion of the federal grant application. ^ After the grant application was written, an evaluation of the grant writing process was conducted. Opportunities for improvement were identified. The first opportunity was the need for better timeline management to allow for review of the application by an independent party, iterative development of the budget proposal, and development of collaborative partnerships. Another improvement opportunity was the management of conflict regarding the design of the intervention that stemmed from marketing versus evidence-based approaches. The most important improvement opportunity was the need to develop a more exhaustive evaluation plan.^ Eight supplementary files are attached to appendices: Feasibility Discussion in Appendix 1, Grant Guidance and Workshop Notes in Appendix 2, Presentation to Texas Organ Sharing Alliance in Appendix 3, Team Recruitment Presentation in Appendix 5, Grant Project Narrative in Appendix 7, Federal Application Form in Appendix 8, and Budget Workbook with Budget Narrative in Appendix 9.^

Microbe Hunters Revisited – Paul de Kruif and the Beginning of Popular Science Writing

Paul de Kruif is credited with being one of the first popular science writers for the general public. He received his Ph.D. from the University of Michigan in 1916 and worked at the Rockefeller Institute under Simon Flexner. After being fired in 1922 for publishing a scathing article on medical research, de Kruif caught the attention of Sinclair Lewis, who used his scientific background to write his Pulitzer Prize winning novel, Arrowsmith. In 1926, de Kruif published Microbe Hunters which recounted the exploits and discoveries of 14 renowned microbiologists from von Leeuwenhoek to Pasteur, Ross, Paul Ehrlich and Walter Reed. Microbe Hunters became a best seller, was translated into 18 languages, and formed the basis of two Hollywood movies, "Yellow Jack" and "The Magic Bullet." Generations of young readers were captivated by the vivid protrayal of these men and their discoveries.

Self, writing and feminine transactions in Virginia Woolf's Orlando and Clarice Lispector’s The stream of life

Este artículo realiza un acercamiento a Orlando, de Virginia Woolf, y a Agua viva, de Clarice Lispector, como obras que logran escribir la multiplicidad, la fluidez y la contingencia del ser. Jugando con las convenciones de la biografía y la autobiografía respectivamente, estas obras encuentran los medios para presentar un sujeto multidimensional y para mostrar, en particular, cómo la dimensión relacional, forjada por un orden simbólico patriarcal, ha hecho de la mujer el “otro" del hombre; un “otro" que debe ser dominado. Se exploran en este artículo los conceptos de “economía masculina" y “economía femenina" teorizados por Hélène Cixous y se propone al lenguaje poético como un medio capaz de eludir los dictados del falocentrismo. Lo poético, que no puede ser nunca agotado por uno o varios sistemas de significación, brinda la posibilidad de ir más allá de las categorizaciones y de explorar la multiplicidad. Tanto Orlando como Agua viva muestran las estrategias y las esperanzas de personajes y escritoras que ven en el lenguaje poético, en la “escritura femenina" como la entiende Cixous, el potencial de desarticular la “economía masculina" y abrir un nuevo espacio para sujetos diversos, múltiples y complejos.

Fabrication of luminescent nanostructures by electron-beam direct writing of PMMA resist

We report on the conversion of non-luminescent conventional poly(methylmethacrylate) (PMMA)-based electron-beam resists into luminescent materials when used as negative-tone resists, that is, when exposed to high electron irradiation doses. Raman spectroscopy reveals the chemical transformation induced by electron irradiation which is responsible for the observed luminescence in the visible (blue) region. The emission intensity from exposed PMMA-based patterns can be controlled by the electron irradiation dose employed to create them.

Microfabrication processes for microfluidic devices on a single laser Workstation: direct writing lithography on SU-8, laser ablation on polymers and mask manufacturing

We demonstrate the capability of a laser micromachining workstation for cost-effective manufacturing of a variety of microfluidic devices, including SU-8 microchannels on silicon wafers and 3D complex structures made on polyimide Kapton® or poly carbonate (PC). The workstation combines a KrF excimer laser at 248 nm and a Nd3+:YVO4 DPSS with a frequency tripled at 355 nm with a lens magnification 10X, both lasers working at a pulsed regime with nanoseconds (ns) pulse duration. Workstation also includes a high-resolution motorized XYZ-tilt axis (~ 1 um / axis) and a Through The Lens (TTL) imaging system for a high accurate positioning over a 120 x 120 mm working area. We have surveyed different fabrication techniques: direct writing lithography,mask manufacturing for contact lithography and polymer laser ablation for complex 3D devices, achieving width channels down to 13μ m on 50μ m SU-8 thickness using direct writing lithography, and width channels of 40 μm for polyimide on SiO2 plate. Finally, we have tested the use of some devices for capillary chips measuring the flow speed for liquids with different viscosities. As a result, we have characterized the presence of liquid in the channel by interferometric microscopy.

Teaching writing through reading: a text-centred approach

Se comparan y contrastan las destrezas requeridas para la comprensión lectora con aquellas que se necesitan para la producción de escritos correctos, en inglés, coherentes y bien cohesionados. Se comentan las actividades didácticas relacionadas con ello.The aim of this article is to establish the relevance of teaching reading and writing skills to students at Madrid Polytechnic University, and to show the relationship and interdependence of these activities in EAP courses. The skills involved in reading and writing processes for academic purposes for L2 students are compared and commented on from a rhetorical point of view. Learning tasks based on text-type analysis are recommended as adequate activities to build schemata for writing and represent a synthesis of the teaching objectives proposed for reading and writing English courses.

Writers Write! University Creative - Writing Workshop with Author

Admission: LU Students, Faculty and Staff interested in reserving a seat to participate must sign up by November 1, 2015 here: http://goo.gl/forms/WDqM7RXlic

HERSTORIES Library Short Creative Writing Course

Course Title: HERSTORIES – Women Writers of Missouri Course Instructor: kYmberly Keeton, M.L.S. Course Focus: Introduce students and community members to women writers in the state of Missouri. Dates for Course: March 22nd, April 12th, April 26th, and May 3rd Meeting Times: 11:00 AM -12:30 PM Course Info: All materials are provided by the library. Course Website: www.herstories365.wordpress.com