scholarly journals Evaluation of Opioid Prescribing Habits Based on Analysis of a State Prescription Drug Monitoring Program

2019 ◽  
Vol 5 (22;5) ◽  
pp. E425-E433
Author(s):  
John C. Alexander

Background: The current opioid epidemic is perhaps the greatest public health crisis in the United States. Although multiple factors led to the rise of this epidemic, it is without question associated with the rise in opioid prescribing. Objectives: Better understanding of the opioid prescribing may provide insights into populationlevel trends contributing to this epidemic, and opportunities to decrease the magnitude of opioid overdose-related death. Therefore we assessed trends in opioid prescribing habits based on analysis of the Texas Prescription Drug Monitoring Program (PDMP) and geographic, ethnic, and incomerelated data from the US Census Bureau. Study Design: Multiple linear regression analysis of Texas PDMP and US Census Bureau data were performed to assess for correlations to opioid prescribing based on geographic, ethnic, income, and time-related variables. Setting: All controlled substances prescribed in the state of Texas from April 2015 to May 2018 were analyzed. Methods: We obtained data from the Texas PDMP for all controlled substances from April 2015 to May 2018. We performed multiple linear regression analysis of these data along with US Census Bureau data to assess for correlations based on geographic, ethnic, income, and time-related variables. We hypothesized that there would be substantial variability in opioid prescribing habits based on geographic, ethnic, and economic variables. Results: Approximately 200 million pills of controlled substances were prescribed per month over the studied time frame. Overall, high geographic variability was noted, and this strongly correlated to race and ethnicity. Opioid prescribing increased along with the proportion of white residents within a county, but a similar negative correlation was noted with increasing Hispanic population proportion. This correlation was noted throughout the study period, but up until 2017, lower income levels among higher white population had even higher correlation with increased opioid prescribing. Cumulative opioid prescriptions throughout the state fell beginning in 2017. Limitations: This analysis does not include opioids obtained illicitly or from prescriptions outside the state of Texas. The specificity of geographic data are limited to the county level due to irregular entry of zip code data by prescribing pharmacies. Conclusions: In the state of Texas over the studied time period, there was strong correlation for higher rates of opioid prescribing as white population increased despite overall decreased opioid prescribing starting in 2017. Until 2017, this correlation grew stronger as low-income white population increased. Key words: Opioid, opioid epidemic, opioid utilization

2017 ◽  
Vol 12 (1) ◽  
pp. 28-42
Author(s):  
Indra Pahala ◽  
Lisa Rachmawati ◽  
Tresno Eka Jaya

This study aimed to determine the effect of perception and motivation to Students Career Interests in Taxation of Departement of Accounting Faculty of Economics at the State University of Jakarta. This study used 75 students S1 Departement of Accounting, State University of Jakarta which is still active academic year 2010. Data used in this study is primary data and selection of samples using a convenience sampling method. The analytical tool used is multiple linear regression analysis at a significance level of 5%. The first phase of testing the validity and reliability of the statement of each variable. The second stage, performing variable regression perception and motivation towards a career in the field of taxation the interest of students. The results of testing the feasibility of the model shows that the two independent variables, namely perception and motivation affect the career interests of students in the field of taxation Accounting Department of Economics at the State University of Jakarta simultaneously.


Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Tzu-Ching Wu ◽  
Christy M Ankrom ◽  
Arvind B Bambhroliya ◽  
Shima Borzorgui ◽  
Sean I Savitz

Objective: Access to care is an important healthcare goal but access to research is also important to patients. We sought to gain an understanding of the status of stroke research among the various stroke designated hospitals in the state and to identify regions and facilities that lack access to stroke research. Methods: Texas Department of State Health Service (TDSHS) designated stroke facilities (DSF) were surveyed using a standardized questionnaire via telephone/email to confirm stroke center status, presence of a dedicated stroke coordinator, use of telestroke services, and participation in stroke research. Stroke discharge data were obtained from TDSHS and stroke volume (by ICD) were estimated for 2013 for all non-DSF. Census data were obtained from the US Census Bureau. Results: In total, 109/136 (80%) TDSHS DSF responded to the survey. Only 32/109 (29%) of the TDSHS DSF are participating in stroke research, mostly in the 4 metropolitan areas (fig 1). We identified 16 non-DSF that have 100-149 stroke discharges, and another 21 non-DSF that have ≥ 150 stroke discharges (fig 1). Over half (53%) of the DSF in the state are utilizing telestroke services. Conclusions: Most clinical stroke research conducted in Texas is in the 4 metropolitan markets. Our findings demonstrate that over 50% or ~14 million Texans reside outside of the 4 markets and therefore may lack access to stroke research. To increase access, we identified several non-DSF in the state with substantial stroke discharges (fig 1). Academic centers and non-DSF partnering through telemedicine and other relationships should be considered to expand throughout the state opportunities for participation in stroke research.


2021 ◽  
Vol 17 (1) ◽  
pp. 125
Author(s):  
Sandy Kristian Mamuaya ◽  
Joyce Jacinta Rares ◽  
Weliam Agustinus Areros

This study aims to determine the effect of leadership and work motivation on the performance of state civil servants. This research was started from July to November 2020 at the Correctional Institution Class IIA Manado. The population in this study was all State Civil Servants (ASN) in the Correctional Institution Class IIA Manado They were 100 respondents and this population was the sample in this study. Data collection techniques in this study using a questionnaire. Data analysis techniques used normality test, heteroscedasticity test, and multiple linear regression analysis. The results showed that, the first, leadership has a positive effect on the performance of the State Civil Service in Correctional Institution Class IIA Manado with a regression coefficient value of 0.034, so that the better the leadership, the better the performance of the State Civil Apparatus. Second, work motivation has a positive effect on the performance of the State Civil Apparatus in Manado Class IIA Penitentiary with a regression coefficient value of 0.742, so that the better the work motivation, the better the performance.


2017 ◽  
Vol 12 (1) ◽  
pp. 28
Author(s):  
Indra Pahala ◽  
Lisa Rachmawati ◽  
Tresno Eka Jaya

This study aimed to determine the effect of perception and motivation to Students Career Interests in Taxation of Departement of Accounting Faculty of Economics at the State University of Jakarta. This study used 75 students S1 Departement of Accounting, State University of Jakarta which is still active academic year 2010. Data used in this study is primary data and selection of samples using a convenience sampling method. The analytical tool used is multiple linear regression analysis at a significance level of 5%. The first phase of testing the validity and reliability of the statement of each variable. The second stage, performing variable regression perception and motivation towards a career in the field of taxation the interest of students. The results of testing the feasibility of the model shows that the two independent variables, namely perception and motivation affect the career interests of students in the field of taxation Accounting Department of Economics at the State University of Jakarta simultaneously.


2021 ◽  
Vol 6 (1) ◽  
pp. 94-108
Author(s):  
Dedi Suhendro ◽  
Ilham Syahputra Saragih

The purpose of this study was to determine the influence of leadership on the performance of teachers in the State-Owned High School I Tanah Jawa, Simalungun Regency. To find out the influence of organizational climate on the performance of teachers in the State-Owned High School I Tanah Jawa, Simalungun Regency. To determine the influence of job satisfaction on teacher performance in the State-Owned High School I Tanah Jawa, Simalungun Regency. To find out the influence of leadership, organizational climate, and job satisfaction on the performance of teachers in the State-Owned High School I Tanah Jawa, Simalungun Regency. The sample in this research amounted to 55 teachers. Data analysis techniques in this research used descriptive analysis and multiple linear regression analysis. The results of this research explain that the leadership variable has a positive and significant influence on teacher performance by 33.27%. Organizational climate variables have a positive and significant influence on teacher performance by 43.30%. The job satisfaction variable has a positive and significant influence on teacher performance 42.34%. The variables of leadership, organizational climate, and job satisfaction have a positive and significant influence on teacher performance by 70.00%, while the remaining 30.00% is influenced by other factors not examined.


Author(s):  
Yuliani Karlina ◽  
Asep Kurniawan ◽  
Indah Umiyati

Indonesia is a developing country that needs funds to finance its development. In order to finance all the interests of the state in realizing a better national economy, an APBN (State Revenue and Expenditure Budget) is prepared. The taxation sector is the largest sector that contributes to the State Budget. However, in the implementation of tax revenue does not match the predetermined target, one of the causes of this is due to tax evasion by taxpayers. This study aims to examine the factors that influence the intention to commit tax evasion. This research is a quantitative research with data collection techniques using a questionnaire distributed to taxpayers who are registered free workers at KPP Pratama Subang. The sample used in this study was 118 respondents using purposive sampling technique and an error rate of 5%. The analysis technique uses multiple linear regression analysis. The results showed that the coefficient of determination R2 was 0.374, which means that the dependent variable could be explained by the independent variable at 37.4% and the remaining 62.6% was explained by other variables. The results of this study conclude that partially the variable love of money, tax system, tax justice, tax discrimination, and tax sanctions has no effect on tax evasion, while the variable understanding of taxation has a negative effect on tax evasion and the variable religiosity has a negative effect on tax evasion. Simultaneously, the variable love of money, tax system, tax justice, tax discrimination, understanding of taxation, taxation sanctions and religiosity have an effect on the variable tax evasion.


2021 ◽  
Author(s):  
CHAIM MILLER ◽  
MATTHEW B. SHERMAN ◽  
ASIF M. ILYAS

Abstract Background: The opioid epidemic has hit all corners of the United States but has disproportionately affected geographical areas to varying extents over the last thirty years. Rural areas have had higher rates of opioid prescribing than urban areas. However, urban counties have higher rates of opioid overdose deaths than rural counties. This study aims to outline the trends in opioid prescribing between rural and urban counties in the state of Pennsylvania since the implementation of a statewide prescription drug monitoring program (PDMP).Methods: Data pertaining to opioid prescribing habits as listed below were obtained from the Pennsylvania Department of Health who administers the PDMP in Pennsylvania. Study data that were of interest and provided by the PDMP were: Drug name, quantity of prescriptions, average daily morphine milligram equivalents (MME), and days supplied. Urban and Rural categorizations were provided by The Center for Rural Pennsylvania, a legislative agency of the Pennsylvania General Assembly. The timeline for this study analyses began from Q1 2017 through Q1 2020. T-tests were used to compare the county informationResults: Opioid prescriptions from 2017 to 2020 decreased on average by 35% (SD= 0.13) in rural counties and 33% (SD= 0.10) in urban counties (P= 0.114). Change in average daily MME was 0.13 (SD=0.06) in the rural group and 0.14 (SD=0.03, p=0.229). Days supplied per prescription showed no significant changes between rural and urban counties with regards to; less than 3 days, 4-7 days, 8-21 days, and 31+ days. A significant decrease was seen in the 22–30-day subgroup between the rural (0.36 SD=0.08) and urban counties (0.31 SD=0.04 p=0.003).Conclusion: No significant changes were seen in the decline of opioid prescribing habits between rural and urban counties in Pennsylvania from 2017 to 2020. This compounds on similar state-specific studies showing no significant difference in the rate of decline between rural and urban counties.


2017 ◽  
Vol 12 (2) ◽  
pp. 105-121
Author(s):  
Sutaryo Sutaryo

This research is conducted to find out empirical evidence of the effect of role ambiguity, role conflict, and code of ethics compliance on the state internal auditor to state internal auditor independence in Jawa Timur. This research, which uses quantitative approach, uses data sources by taking sample of 170 state internal auditors in Jawa Timur. The collected data is then analysed by multiple linear regression analysis mehtod. The result reveals that role ambiguity and role conflict have negative effect to the state internal auditor independence, however code of ethics compliance has positive effect to the state internal auditor independence. The higher the situation of ambiguity and role conflict preceived by APIP, it will further weaken its commitment to maintain independence in duty. But not so with compliance with the code of ethics, the higher the compliance of APIP to the code of ethics, it will further increase its commitment to maintain independence in the duty.  


EDIS ◽  
2017 ◽  
Vol 2017 (6) ◽  
Author(s):  
Rebecca G. Harvey ◽  
Michael R. Rochford ◽  
Jennifer Ketterlin Eckles ◽  
Edward F. Metzger ◽  
Jennifer Nestler ◽  
...  
Keyword(s):  

Lists the objectives, activities, and accomplishments of the Everglades Invasive Reptile and Amphibian Monitoring Program over its first five years and describes some ways Floridians and visitors to the state can help with the effort.


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