Sunday, February 16, 2020

Abuse of prescription of narcotics in primary care Dissertation

Abuse of prescription of narcotics in primary care - Dissertation Example Chronic non cancer pain in primary care and use of opioids (Nicholson & Pasik, 2007).  In the USA estimates suggest that 50 million people suffer from chronic non cancer pain, with 41% dissatisfied with the outcomes of their pain treatment. The frequent site at which these patients seek health care is from primary care. In the primary care environment prevalence of chronic non cancer pain ranges from 5% to 33% (Nicholson & Pasik, 2007).3) Extent of opioid misuse in primary care and causes (Von Korff et al, 2011).   True estimates of the extent to which prescription opioids are misused among primary care patients are not available, but the limited evidence from surveys conducted suggest that the prevalence of prescription opioid misuse in primary care could range from 4% to 26% (Von Korff et al, 2011)4) Primary care givers need to have adequate knowledge on preventing opioid misuse Salloum, 2010).   Though the true prevalence of prescription opioid misuse remains elusive the ind ications of high abuse of prescription opioids raises the relevance of prevention practices at the point of misuse (Ruiz & Strain, 2010).B.  Establish a working definition of prescription opioid abuse and identification of the characteristics of prescription opioid abuse    1)   According to Friedman et al p, 454, NUPM in a wide perspective may be taken to mean â€Å"the use of a scheduled prescription medication without the prescribing clinician’s knowledge† (Friedman et al, 2009).2) Characteristics of abuse of prescription narcotics (Liebschutz et al, 2010)... ry care patients diagnosed with chronic pain and prescribed opioids shows that the characteristics for PDUD in such patients include cigarette smoking, high severity of pain, personal and family history of substance abuse, post-traumatic stress disorder, and experience of a jail sentence (Liebschutz et al, 2010). 3) Caregiver knowledge and attitudes in the prescribing of narcotics for non cancer chronic pain (Srivatsava, 2007). Evidence coming from surveys conducted on care givers points to knowledge deficits in care givers and attitudinal issues acting as barriers to efficient management of pain. Quite often fear of addiction and misuse of prescribed narcotics is the basis of unsatisfactory management of pain (Srivatsava, 2007). 4) Patient perspective on prescribing of narcotics for non cancer chronic pain (Srivatsava, 2007). From the perspective of patients it is the care providers in the form of medical and nursing professionals that are knowledgeable on issues pertaining to emplo ying narcotics in the treatment of pain, and they expect that these professionals provide them with the appropriate information on narcotics in the treatment of non cancer chronic pain, to make it a useful part in their treatment (Srivatsava, 2007). II Theoretical Considerations (Not done as no guidelines received and not mandatory for the annotated outline) III Review of Literature A literature review matrix has been generated for effectively developing the literature review. 15 peer reviewed primary research articles relevant to the topic of the dissertation were selected. The inclusion criterion was that these articles were published on or later than 2006. The rationale behind such an inclusion criteria was to make the literature deliver the currently relevant body of knowledge on the

Monday, February 3, 2020

A Schematic Analysis of Medical Coronation Rituals Research Paper

A Schematic Analysis of Medical Coronation Rituals - Research Paper Example Schematic analysis of medieval coronation rituals indicates how powerful these factors are and how aware medical rulers were of the effects they could have. Ritual and symbolic communication have very specific characteristics (Luger, 2003). â€Å"When individual factors of communication are reduced and constitutive conditions changed or distorted, certain consequences for communication ensue...The ritualized element in speech is characterized by restricted individuality, as well as by being the consequence of a specific over-conventionalization† (Lager, 2003). Coronation rituals are a form of ritualistic communication that in a sense brings this to its height: While superficially an individual is gaining tremendous power, in actual fact an institution is being filled. One of the ways that medieval rulers brought to mind schema that would confer legitimacy and power was the connection to Old Testament rulers in imagery (Hedeman, 1991). â€Å"Ceremony and art dealing more speci fically with the king also associated biblical with French kingship. One of the most important ceremonies to do this was the French coronation, versions of which were drafted around 1230 and again around 1250† (Hedeman, 1991, 10).... Men like Moses and Abraham were leaders of men, wise and capable. These schema would bring to mind in the subjects of the Capetians images and feelings of power, wisdom, charisma and strength. â€Å"The changed subject matter and new narrative style in these cycles invested religious history with a "new prescriptive force" to become an example for royal behavior† (Hedeman, 1991, 10). Coronation rituals thus used Old Testament elements. One conclusion that is utterly clear is that the kings had no limit to their audacity. â€Å"After Louis's canonization in 1297, hagiographic programs, frequently presented within a dynastic framework, became more common at court. The presence of a royal saint allowed subsequent rulers such as Philip III or Philip the Fair to glorify the royal house by promoting the cult of their saintly forebear† (Hedeman, 1991, 10). Prior to the beatification of Louis IX, it would be impossible to imagine using New Testament imagery: This would place th e kings on the level of the saints or the Apostles and would be tantamount to blasphemy. But after a canonization, it was possible to use the imagery of the New Testament and of sainthood to give the dynasty an even more blessed touch. But it is not just religious legitimacy and imagery that is deployed. â€Å"Increasingly, courtly commissions emphasized the continuous succession of the three races of French kings, a succession whose length and holiness, confirmed by the sainthood of Louis IX, were the subject of the Grandes Chroniques de France† (Hedeman, 1991, 10). Schema for coronations are not just ways of establishing the power, wisdom and strength of the ruler to the people, but also the ongoing vitality and legitimacy of the institution of the kinghood itself.