An inevitable wave of prescription drug monitoring programs in the context of prescription opioids: pros, cons and tensions

BACKGROUND: In an effort to control non-medical use and/or medical abuse of prescription drugs, particularly prescription opioids, electronic prescription drug monitoring programs (PDMP) have been introduced in North-American countries, Australia and some parts of Europe. Paradoxically, there are simultaneous pressures to increase opioid prescribing for the benefit of individual patients and to reduce it for the sake of public health, and this pressure warrants a delicate balance of appropriate therapeutic uses of these drugs with the risk of developing dependence. This article discusses pros and cons of PDMP in reducing diversion of prescription opioids, without hampering access to those medications for those with genuine needs, and highlights tensions around PDMP implementation. DISCUSSION: PDMPs may help alleviate diversion, over-prescription and fraudulent prescribing/dispensing; prompt drug treatment referrals; avoid awkward drug urine test; and inform spatial changes in prescribing practices and help designing tailored interventions. Fear of legal retribution, privacy and data security, potential confusion about addiction and pseudo-addiction, and potential undue pressure of detecting misuse/diversion - are the major problems. There are tensions about unintended consequence of excessive regulatory enforcements, corresponding collateral damages particularly about inadequate prescribing for patients with genuine needs, and mandatory consultation requirements of PDMP. SUMMARY: In this era of information technology PDMP is likely to flourish and remain with us for a long time. A clear standard of practice against which physicians' care will be judged may expedite the utilisation of PDMP. In addition, adequate training on addiction and pain management along with public awareness, point-of-supply data entry from pharmacy, point-of-care real-time access to data, increasing access to addiction treatment and appropriate regulatory enforcement preferably through healthcare administration, together, may help remove barriers to PDMP use

Inequality and economic growth in Bangladesh- a diversified evidence on Kuznets pattern 'U' hypothesis

The study of inequality and economic growth to the developing countries are now a days a comprehensive issue since growth stimulate the standard of living to the poor people and accordingly reduce income inequality.The improvement of inequality and growth may reduce the social movement to the government and may keep the economic and social integrity amongst the different ethnic groups by efficient resource allocation and income redistribution in Bangladesh. The objective of this research is to assess the long term relationship between inequality and growth in Bangladesh with a methodology of Kuznets pattern inverted U hypothesis first introduced by Simon Kuznets since 1955. The popular concept of Kuznets hypothesis suggests that as economic growth occurs,income inequality first increase and then decline after a certain turning point. The study of Kuznets hypothesis is popular to the international economic environment rather than domestic, especially to the developing countries where the per capita GDP is below the level of world average. This study found the evidence that the presumption of Kuznets hypothesis has satisfy in the economy of Bangladesh in national level. In low income countries, structural adjustment is necessary to satisfy the Kuznets hypothesis.Kuznets Hypothesis, Inequality, Growth

Power in global agriculture: economics, politics, and natural resources

Recent events, such as the 2008 food price crisis, have focussed global attention on the agriculture and food sectors. In particular, many countries have become increasingly concerned with the issue of ensuring the security of their food supply and one key element of this is who has power within the food supply chain. Through examining three dimensions of power – Economic, Political, and Natural Resources – this paper explores where power currently lies in world agriculture and how this might change in the future. Whilst recognising that power is a somewhat abstract concept, through a process of deriving potential indicators, a picture of the distribution of power is drawn. These indicators were also used to develop a simple 'global power index'. The power index indicates that the US and the EU dominate world agriculture in terms of economics and politics, but are potentially vulnerable in terms of their possession of natural resources. On the other hand, the emerging economies have lower political and corporate power, but seem better placed in terms of natural resources. The paper concludes by discussing the implications of these findings for the main food producing regions

Using a Goal-Driven Approach in the Investigation of a Questioned Contract

Part 3: FORENSIC TECHNIQUESInternational audienceThis paper presents a systematic process for describing digital forensic investigations. It focuses on forensic goals and anti-forensic obstacles and their operationalization in terms of human and software actions. The paper also demonstrates how the process can be used to capture the various forensic and anti-forensic aspects of a real-world case involving document forgery

Estimation of Rain Attenuation at EHF bands for Earth-to-Satellite Links in Bangladesh

Due to heavy congestion in lower frequency bands, engineers are looking for new frequency bands to support new services that require higher data rates, which in turn needs broader bandwidths. To meet this requirement, extremely high frequency (EHF), particularly Q (36 to 46 GHz) and V (46 to 56 GHz) bands, is the best viable solution because of its complete availability. The most serious challenge the EHF band poses is the attenuation caused by rain. This paper investigates the effect of the rain on Q and V bands' performances in Bangladeshi climatic conditions. The rain attenuations of the two bands are predicted for the four main regions of Bangladesh using ITU rain attenuation model. The measured rain statistics is used for this prediction. It is observed that the attenuation due to rain in the Q/V band reaches up to 150 dB which is much higher than that of the currently used Ka band. The variability of the rain attenuation is also investigated over different sessions of Bangladesh. The attenuation varies from 40 dB to 170 dB depending on the months. Finally, the amount of rain fade required to compensate the high rain attenuation is also predicted for different elevation angles.Comment: Int'l Conf. on Electrical, Computer and Communication Engineering (IEEE sponsored), Cox's Bazar, Bangladesh, February 2017, pp. 589-59