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Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.
Drug abuse persists as one of the most costly and contentious problems on the nation's agenda. Pathways of Addiction meets the need for a clear and thoughtful national research agenda that will yield the greatest benefit from today's limited resources. The committee makes its recommendations within the public health framework and incorporates diverse fields of inquiry and a range of policy positions. It examines both the demand and supply aspects of drug abuse. Pathways of Addiction offers a fact-filled, highly readable examination of drug abuse issues in the United States, describing findings and outlining research needs in the areas of behavioral and neurobiological foundations of drug abuse. The book covers the epidemiology and etiology of drug abuse and discusses several of its most troubling health and social consequences, including HIV, violence, and harm to children. Pathways of Addiction looks at the efficacy of different prevention interventions and the many advances that have been made in treatment research in the past 20 years. The book also examines drug treatment in the criminal justice setting and the effectiveness of drug treatment under managed care. The committee advocates systematic study of the laws by which the nation attempts to control drug use and identifies the research questions most germane to public policy. Pathways of Addiction provides a strategic outline for wise investment of the nation's research resources in drug abuse. This comprehensive and accessible volume will have widespread relevanceâ€"to policymakers, researchers, research administrators, foundation decisionmakers, healthcare professionals, faculty and students, and concerned individuals.
Research centering on blood flow in the heart continues to hold an important position, especially since a better understanding of the subject may help reduce the incidence of coronary arterial disease and heart attacks. This book summarizes recent advances in the field; it is the product of fruitful cooperation among international scientists who met in Japan in May, 1990 to discuss the regulation of coronary blood flow.
The primary purpose of this report is to provide information and to describe techniques that will help utilities and others determine the impacts of reduced demand on water utilities. The remainder of the report is organized as follows: Chapter 2, "Methods and Materials", describes the case-study format and the methodology used to collect the data; Chapter 3, "General Concepts," provides an overview of the significant economic and financial analysis concepts used to categorize and analyze the data; Chapter 4, "Profiles of Participating Agencies," describes the participating agencies, including general profiles of each; Chapter 5, "Operating Cost Impacts," details the analytical framework and results for short-term operating costs; Chapter 6, "Revenue Impacts," illustrates how water utility revenues and rates are affected by reduced demand and potential reactions to rate adjustments; Chapter 7, "Long-Term Capital Savings," describes potential savings from capital deferrals or avoidance resulting from demand reduction; Chapter 8, "External Impacts," provides an overview of the impacts that may occur outside of water utilities as the demand for water decreases; Chapter 9, "Conclusions," looks at all the impacts and how the results of this study can be used by utilities.
The Model Rules of Professional Conduct provides an up-to-date resource for information on legal ethics. Federal, state and local courts in all jurisdictions look to the Rules for guidance in solving lawyer malpractice cases, disciplinary actions, disqualification issues, sanctions questions and much more. In this volume, black-letter Rules of Professional Conduct are followed by numbered Comments that explain each Rule's purpose and provide suggestions for its practical application. The Rules will help you identify proper conduct in a variety of given situations, review those instances where discretionary action is possible, and define the nature of the relationship between you and your clients, colleagues and the courts.
Despite efforts to reduce drug consumption in the United States over the past 35 years, drugs are just as cheap and available as they have ever been. Cocaine, heroin, and methamphetamines continue to cause great harm in the country, particularly in minority communities in the major cities. Marijuana use remains a part of adolescent development for about half of the country's young people, although there is controversy about the extent of its harm. Given the persistence of drug demand in the face of lengthy and expensive efforts to control the markets, the National Institute of Justice asked the National Research Council to undertake a study of current research on the demand for drugs in order to help better focus national efforts to reduce that demand. This study complements the 2003 book, Informing America's Policy on Illegal Drugs by giving more attention to the sources of demand and assessing the potential of demand-side interventions to make a substantial difference to the nation's drug problems. Understanding the Demand for Illegal Drugs therefore focuses tightly on demand models in the field of economics and evaluates the data needs for advancing this relatively undeveloped area of investigation.
New technologies are revolutionising the way manufacturing and supply chain management are implemented. These changes are delivering manufacturing firms the competitive advantage of a highly flexible and responsive supply chain and manufacturing system to ensure that they meet the high expectations of their customers, who, in today's economy, demand absolutely the best service, price, delivery time and product quality.To make e-manufacturing and supply chain technologies effective, integration is needed between various, often disparate systems. To understand why this is such an issue, one needs to understand what the different systems or system components do, their objectives, their specific focus areas and how they interact with other systems. It is also required to understand how these systems evolved to their current state, as the concepts used during the early development of systems and technology tend to remain in place throughout the life-cycle of the systems/technology. This book explores various standards, concepts and techniques used over the years to model systems and hierarchies in order to understand where they fit into the organization and supply chain. It looks at the specific system components and the ways in which they can be designed and graphically depicted for easy understanding by both information technology (IT) and non-IT personnel.Without a good implementation philosophy, very few systems add any real benefit to an organization, and for this reason the ways in which systems are implemented and installation projects managed are also explored and recommendations are made as to possible methods that have proven successful in the past. The human factor and how that impacts on system success are also addressed, as is the motivation for system investment and subsequent benefit measurement processes.Finally, the vendor/user supply/demand within the e-manufacturing domain is explored and a method is put forward that enables the reduction of vendor bias during the vendor selection process.The objective of this book is to provide the reader with a good understanding regarding the four critical factors (business/physical processes, systems supporting the processes, company personnel and company/personal performance measures) that influence the success of any e-manufacturing implementation, and the synchronization required between these factors.· Discover how to implement the flexible and responsive supply chain and manufacturing execution systems required for competitive and customer-focused manufacturing· Build a working knowledge of the latest plant automation, manufacturing execution systems (MES) and supply chain management (SCM) design techniques· Gain a fuller understanding of the four critical factors (business and physical processes, systems supporting the processes, company personnel, performance measurement) that influence the success of any e-manufacturing implementation, and how to evaluate and optimize all four factors
This volume addresses the interface of two major national problems: the epidemic of HIV-AIDS and the widespread use of illegal injection drugs. Should communities have the option of giving drug users sterile needles or bleach for cleaning needs in order to reduce the spread of HIV? Does needle distribution worsen the drug problem, as opponents of such programs argue? Do they reduce the spread of other serious diseases, such as hepatitis? Do they result in more used needles being carelessly discarded in the community? The panel takes a critical look at the available data on needle exchange and bleach distribution programs, reaches conclusions about their efficacy, and offers concrete recommendations for public policy to reduce the spread of HIV/AIDS. The book includes current knowledge about the epidemiologies of HIV/AIDS and injection drug use; characteristics of needle exchange and bleach distribution programs and views on those programs from diverse community groups; and a discussion of laws designed to control possession of needles, their impact on needle sharing among injection drug users, and their implications for needle exchange programs.
Evidence-Based Practice (EBP) has over the last decade made an increasing mark in several fields, notably health and medicine, education and social welfare. In recent years it has begun to make its mark in criminal justice. As engagement with EBP has spread, it has begun to evolve from what might be regarded as a somewhat narrow doctrine and orthodoxy to something more complex and various. Often criminological research has been at odds with the assumptions, conventions and methodologies associated with first generation EBP. In that context EBP poses a challenge to the research community and existing evidence base and is, accordingly, hotly controversial. This book is a welcome and timely contribution to current debates on evidence-based practice in policing. With a sharp conceptual focus, the chapters provide a critical examination of the recent history of EBP in academic, policy and practitioner communities, evaluate key dimensions of its application to policing, challenge established understandings and pave the way for a much needed change in how research 'evidence' is perceived, generated, transferred, implemented and evaluated.