Postoperative Disposal of Unused Opioids: A Systematic Review

2021 ◽  
pp. 155633162110013
Author(s):  
Joseph D. Lamplot ◽  
Ajay Premkumar ◽  
Evan W. James ◽  
Cort D. Lawton ◽  
Andrew D. Pearle
Keyword(s):  
Systematic Review ◽  
Large Scale ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Relevant Information ◽  
The United States ◽  
Screening Strategy ◽  
Inclusion Criteria ◽  
Health Crisis ◽  
Postoperative Setting

Introduction: Opioid misuse and overprescription have contributed to a national public health crisis in the United States. Postoperatively, patients are often left with unused opioids, which pose a risk for diversion if not appropriately disposed of. Patients are infrequently provided instructions on safe disposal methods of surplus opioids. Purpose: We sought to determine the current rates of disposal of unused opioids and the reported disposal mechanisms for unused opioids that were prescribed for acute postoperative pain control. Methods: A systematic review was performed of the PubMed, Cochrane, and Embase databases for relevant articles from their earliest entries through October 2, 2019. We used the search terms “opioid” or “narcotic” and “disposal” and “surgery.” Studies were considered for inclusion if they reported the rate of disposal of unused opioids following surgery. A screening strategy was used to identify relevant articles using Covidence. For studies meeting inclusion criteria, relevant information was extracted. Results: Sixteen studies met inclusion criteria. We found that surplus opioid disposal rates varied widely, from 4.9% to 87.0%. Among studies with no intervention (opioid disposal education or drug disposal kit/bag), rates of opioid disposal ranged from 4.9% to 46.5%. While 7 studies used opioid disposal education as an intervention, only 3 showed a significant increase in surplus opioid disposal compared with standard care. All 3 studies that used an opioid disposal kit or bag as an intervention demonstrated significant increases in opioid disposal. Conclusions: Baseline rates of surplus opioid disposal are relatively low in the postoperative setting. Our findings suggest that opioid disposal kits significantly increase rates of surplus opioid disposal postoperatively. Further research, including a large-scale cost-benefit analysis, will be necessary prior to recommending widespread implementation of drug disposal kits or bags.

The Industrial Safety Professionals: A Comparative Analysis from World War I until the 1980S

1992 ◽  
Vol 22 (4) ◽  
pp. 705-727 ◽  
Author(s):  
Tom Dwyer
Keyword(s):  
World War I ◽  
Social Relations ◽  
New Technologies ◽  
Cost Benefit Analysis ◽  
Traditional Approach ◽  
Cost Benefit ◽  
The United States ◽  
Industrial Safety ◽  
Industrial Society ◽  
Industrial Medicine

The birth of industrial society produced demand for the services of professionals specialized in matters related to industrial safety. Three professions—safety engineering, industrial medicine, and ergonomics—are examined. These professions are observed to either submit to single sets of demands, to integrate contradictory demands, or to experience scission. Until the late 1960s their growth appears to have been relatively peaceful and uncontroversial. From this period onward, controversy breaks out over questions related to industrial safety, and professions and government administrations grow. Increasingly, the traditional approach of safety professionals is called into question, and they adopt new orientations. These changes are mapped through the examination of data drawn principally from the United States, France, Great Britain, and to a lesser extent Brazil. The traditional standards approach competes with cost-benefit analysis and with systemic safety for influence; in addition, an emergent approach that analyzes accident causes in terms of social relations of work is detected. From Bhopal to Chernobyl, new technologies subject civilian populations to risks of catastrophic accidents, and the action of safety professionals comes under the spotlight. The analysis constructed permits new understandings of the past and the future of these professions.

Inflation Inequality: Measurement, Causes, and Policy Implications

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Xavier Jaravel
Keyword(s):  
United States ◽  
Income Distribution ◽  
Interest Rates ◽  
Optimal Taxation ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
The United States ◽  
Policy Implications ◽  
Annual Review ◽  
Publication Date

Does inflation vary across the income distribution? This article reviews the growing literature on inflation inequality, describing recent advances and opportunities for further research in four areas. First, new price index theory facilitates the study of inflation inequality. Second, new data show that inflation rates decline with household income in the United States. Accurate measurement requires granular price and expenditure data because of aggregation bias. Third, new evidence quantifies the impacts of innovation and trade on inflation inequality. Contrary to common wisdom, empirical estimates show that the direction of innovation is a significant driver of inflation inequality in the United States, whereas trade has similar price effects across the income distribution. Fourth, inflation inequality and non-homotheticities have important policy implications. They transform cost-benefit analysis, optimal taxation, the effectiveness of stabilization policies, and our understanding of secular macroeconomic trends—including structural change, the decline in the labor share and interest rates, and labor market polarization. Expected final online publication date for the Annual Review of Economics, Volume 13 is August 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

The Impact of Race/Ethnicity on the Outcomes of Burn Patients: A Systematic Review of the Literature

2021 ◽  
Author(s):  
Jasmine Peters ◽  
Mariel S Bello ◽  
Leigh Spera ◽  
T Justin Gillenwater ◽  
Haig A Yenikomshian
Keyword(s):  
Systematic Review ◽  
Native American ◽  
The United States ◽  
Current Status ◽  
Surgical Trauma ◽  
Insurance Status ◽  
Inclusion Criteria ◽  
Burn Care ◽  
Race Ethnicity ◽  
The Impact

Abstract Racial and ethnic disparities are endemic to the United States and are only beginning to attract the attention of researchers. With an increasingly diverse population, focused and tailored medicine to provide more equitable care is needed. For surgical trauma populations, this topic is a small but expanding field and still rarely mentioned in burn medicine. Disparities in prevention, treatment, and recovery outcomes between different racial and ethnic minorities who are burned are rarely discussed. The purpose of this study is to determine the current status of identified disparities of care in the burn population literature and areas of future research. A systematic review was conducted of literature utilizing PubMed for articles published between 2000-2020. Searches were used to identify articles that crossed the burn term (burn patient OR burn recovery OR burn survivor OR burn care) and a race/ethnicity and insurance status-related term (race/ethnicity OR African-American OR Black OR Asian OR Hispanic OR Latino OR Native American OR Indigenous OR Mixed race OR 2 or more races OR socioeconomic status OR insurance status). Inclusion criteria were English studies in the US that discussed disparities in burn injury outcomes or risk factors associated with race/ethnicity. 1,169 papers were populated, 55 were reviewed, and 36 articles met inclusion criteria. Most studies showed minorities had poorer inpatient and outpatient outcomes. While this is a concerning trend, there is a paucity of literature in this field and more research is needed to create culturally-tailored medical care and address the needs of disadvantaged burn survivors.

scholarly journals GATECloud.net: a platform for large-scale, open-source text processing on the cloud

2013 ◽  
Vol 371 (1983) ◽  
pp. 20120071 ◽  
Author(s):  
Valentin Tablan ◽  
Ian Roberts ◽  
Hamish Cunningham ◽  
Kalina Bontcheva
Keyword(s):  
Cloud Computing ◽  
Language Processing ◽  
Large Scale ◽  
Virtual Machines ◽  
Cost Benefit Analysis ◽  
Text Processing ◽  
Cost Benefit ◽  
Data Intensive ◽  
On Demand ◽  
Usage Evaluation

Cloud computing is increasingly being regarded as a key enabler of the ‘democratization of science’, because on-demand, highly scalable cloud computing facilities enable researchers anywhere to carry out data-intensive experiments. In the context of natural language processing (NLP), algorithms tend to be complex, which makes their parallelization and deployment on cloud platforms a non-trivial task. This study presents a new, unique, cloud-based platform for large-scale NLP research—GATECloud. net. It enables researchers to carry out data-intensive NLP experiments by harnessing the vast, on-demand compute power of the Amazon cloud. Important infrastructural issues are dealt with by the platform, completely transparently for the researcher: load balancing, efficient data upload and storage, deployment on the virtual machines, security and fault tolerance. We also include a cost–benefit analysis and usage evaluation.

scholarly journals The New Control of Territory and Urban Planning: the Eminent Domain in the US

2018 ◽  
Vol 6 (4) ◽  
pp. 38
Author(s):  
Sonia Paone
Keyword(s):  
Private Property ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
The United States ◽  
Eminent Domain ◽  
Public Utility ◽  
Transfer Property ◽  
The Us ◽  
Us Supreme Court ◽  
The City

The article analyses the transformations of the use of eminent domain in the United States in the context of urban redevelopment programs. In the past the private property has been expropriated for public use only. Recently it is possible to forcibly transfer property, from a private subject to private developers, on the basis of a cost-benefit analysis that demonstrates that the new use is more efficient than the previous one. This profound change has been possible thanks to a progressive modification of the concept of public use. Traditionally, public use coincided with the construction of infrastructures and public utility, such as highways and railroads. Over the time, it has come to include other aims: firstly, projects of urban renewal and economic development carried forth by private developers. Essentially, it has resulted in the use of expropriation to assemble lands which are then granted to subjects who intervene in the reconfiguration of the city for private purposes. Starting from some important examples of urban development, the main phases of this process are reconstructed, also taking into account the most important decisions of the US Supreme Court that contributed to the change of doctrine, invalidating the postulate of public use as justification for expropriation.

scholarly journals College Students’ Well-being during the COVID-19 Pandemic: A Systematic Review of the Literature

2021 ◽  
Vol 4 (4) ◽  
pp. p1
Author(s):  
Michaela Q. Iglesia ◽  
Ming-Tsan Lu
Keyword(s):  
United States ◽  
College Students ◽  
Systematic Review ◽  
Large Scale ◽  
Psychological Impact ◽  
Well Being ◽  
The United States ◽  
Socioeconomic Impacts ◽  
Health Lifestyle ◽  
Gender Minorities

Studies have shown increased levels of distress during the coronavirus disease-19 (COVID-19) pandemic, and college students are becoming more recognized as a vulnerable population. This narrative systematic review aims to synthesize the current understanding of mental health, lifestyle, and socioeconomic impacts that the pandemic had on college students in the United States. A search was conducted on PubMed, PsycInfo, and Web of Science. A total of 34 observational studies were included which examined aspects of college students’ health and experiences during the COVID-19 pandemic in the United States. A great deal of students was shown to experience a moderate level of stress and subsyndromal depression and anxiety in the early months of the COVID-19 pandemic. Several risk and protective factors have been characterized. Students experienced various academic, financial, and housing disruptions. Studies have highlighted the need for institutional support to reduce the adverse psychological impact of the pandemic. There is a need for further large-scale research to assess the scope of COVID-19-related biopsychosocial impact, especially in vulnerable populations such as racial/ethnic and sexual/gender minorities.

scholarly journals Managing Leadership in the Indo-Pacific: The United States’ South Asia Strategy Revisited

2017 ◽  
Vol 03 (04) ◽  
pp. 463-480
Author(s):  
Xiaoping Yang
Keyword(s):  
United States ◽  
South Asia ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Balance Of Power ◽  
The United States ◽  
Leadership Role ◽  
Conditional Cooperation ◽  
United States South ◽  
Strategic Objective

The United States’ South Asia strategy has been based on the calculation of its overall national security priorities. In practice, when U.S. priorities are at odds with those of other regional powers, Washington tends to adopt a “no-expectations” psychological approach toward its regional partners to avoid disappointment, a technical “de-hyphenation strategy” to improve policy efficiency, and practical cost-benefit analysis to evaluate the effectiveness of its South Asia strategy. However, Washington often has to come to terms with the realities on the ground with regard to its leadership role in South Asia. For the time being, Washington has articulated its strategic objective in South Asia, that is, a regional balance of power in favor of the United States vis-a-vis its perceived competitor, China. Therefore, it has conducted conditional cooperation with Pakistan and Afghanistan on land, and committed support for India on security issues in the Indian Ocean, so as to hedge against China’s growing presence in South Asia. The enhancement of U.S.-India defense and security cooperation has fueled China’s suspicion of India’s intention to join the U.S.-led coalition against it. By the logic of balance of power, the United States will continue to regard India as a strategic counterweight to China, which is likely to increase the possibility of strategic tensions and conflicts between China and India that may finally entangle the United States.

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