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Such social safeguards are important for guarding against elite capture and social exclusion spasms and spasticity cheap flavoxate 200 mg fast delivery. The role of the community development committee is to muscle relaxant 563 pliva flavoxate 200 mg with visa manage all processes at the community level from participatory appraisal to spasms spanish order 200 mg flavoxate with amex program implementation, including money management, resource mobilization, contracting, financial control, M&E, auditing and reporting, upward and downward accountability, and delegation of execution responsibility for specific community projects to subcommittees. Final approval of plans at the local and community levels and of projects or sets of projects can be a function of one of several entities, including the development committee itself, an elected council, or-for large local projects-a higher-level authority such as the ministry of local development, a social fund, or other program or project unit. Disbursement orders are then given by the respective chief financial officer or treasurer, with checks signed by the person or persons designated in the operational manual or financial regulations. Still another option is for small projects to be approved at the subdistrict level and for larger ones to be approved at the district level. In addition, M&E should be made the responsibility of the communities and the subdistrict committees, preferably via participatory M&E. Regular reports in easily understandable form and expressed in local languages are needed to disseminate information on program progress and financial information. Community radio can be used to communicate key messages to all stakeholders, convene meetings in an area where mail and telephones are weak, and serve as a conduit for two-way information. Where they do not exist, community radio systems can be set up at low cost with community contributions and district sponsorship. Stakeholders and communities can stay informed and connected through emerging Internet technologies. A wide array of cost-effective Web-based conferencing tools, such as Skype or video-over-Internet protocol, could be supported by donors in the technology sector. Further decentralization to a subdistrict development committee is almost always needed to manage initiatives, and such committees often already exist. In addition, they will not have the time or capacity to document fully all of the steps, processes, tools, logistics, and training materials that will be developed and then summarized in comprehensive operational and training manuals. Nor can councilors and other local stakeholders be expected to fulfill these tasks. It will usually be necessary to hire a team of consultants to provide support for and document the pilot phase of scaling up and to produce all of the outputs that are expected from it. Such a team (or teams, if several districts are involved) can help to solve problems at the level of the district, the subdistricts, and the communities and to assist the stakeholders in making the many decisions that have to be made during the pilot phase of scaling up. A major responsibility of the local team is to document all decisions and prepare the outputs, reports, tools, and operational manuals. The local program development support team will usually consist of consultants with the required facilitation, program design, training, documentation, and writing skills. They need to support the leadership of local stakeholders in program design, to translate what is going on in the field and in the councils into tools, operational manuals, and training manuals, and to translate, produce, and distribute them. Consultants will need to be residents of the district for the duration of the pilot phase. Specialists for M&E and for Impact Evaluation A sound M&E system has four broad components: participatory M&E by communities, local governments, and users for implementation monitoring; financial and accounting systems for financial monitoring; a management information system for progress monitoring; and independent monitoring. Pushing for standardization can also help to consolidate information at the local, national, and donor levels. Implementing these improvements in M&E will require a small task force that would provide support to ministries and agencies and help to strengthen national capacity. In order to be close to operations, this task force should consist of a network of monitoring and evaluation specialists spread out horizontally in the various sectors and vertically across the administrative levels and out to the communities. Managers at all levels need to know, starting with the community development committee. Therefore, simple metrics, understood by all in the community, are to be chosen, preferably by the community itself as part of participatory M&E with at least one measurable indicator, one metric, that points to outcomes in a meaningful way (see box 5. An example comes from Uganda: the number of families eating beer bananas-a clear leading indicator of food shortage-can be counted even by children because the discarded peels are visible.
Heavily rural states have also seen greater increases in opioid-related mortality and injury than non-rural areas (National Rural Health Association muscle relaxant triazolam flavoxate 200mg overnight delivery, 2017) spasms esophagus problems cheapest flavoxate. Factors driving the rural opioid crisis also differ from those driving opioid use in urban areas spasms thoracic spine discount 200 mg flavoxate fast delivery. Strong social and kinship network connections may facilitate diversion and distribution, while economic stressors may make people more vulnerable to drug use (Keyes et al. Health care workforce shortages have left between 60 and 80 percent of rural counties without a single psychiatrist and around 40 percent of rural counties without any buprenorphine-waivered physicians (Corso and Townley, 2016; Larson et al. This shortage contributes to the lack of treatment capacity in rural areas (Zur et al. Treating homeless opioid dependent patients with buprenorphine in an office-based setting. Gender and prescription opioids: Findings from the National Survey on Drug Use and Health. Characteristics and correlates of men and women with prescription opioid dependence. Ethnic differences in psychosocial factors in methadone maintenance: Hmong versus non-Hmong. Sex differences in substance use, health, and social functioning among opioid users receiving methadone treatment: A multicenter cohort study. Directly observed antiretroviral therapy improves adherence and viral load in drug users attending methadone maintenance clinics: A randomized controlled trial. Hepatitis C virus testing and treatment among persons receiving buprenorphine in an office-based program for opioid use disorders. Medication-assisted treatment for youth with opioid use disorder: Current dilemmas and remaining questions. Exploring opioid use disorder, its impact, and treatment among individuals experiencing homelessness as part of a family. Co-morbidity and utilization of medical services by pain patients receiving opioid medications: Data from an insurance claims database. The changing face of heroin use in the united states: A retrospective analysis of the past 50 years. Medication-assisted treatment of opioid use disorder: Review of the evidence and future directions. Intervention, treatment, and prevention strategies to address opioid use disorders in rural areas. Buprenorphine treatment outcomes among opioid-dependent cocaine users and non-users. Chronic pain opioid-maintained patients receive less analgesic opioid prescriptions. Impact of chronic pain on treatment prognosis for patients with opioid use disorder: A systematic review and meta-analysis. Epidemiology of pain among outpatients in methadone maintenance treatment programs. Sex-dependent influences of morphine and its metabolites on pain sensitivity in the rat. Patient characteristics associated with buprenorphine/naloxone treatment outcome for prescription opioid dependence: Results from a multisite study. Dissociation between sex differences in the immunological, behavioral, and physiological effects of kappa- and delta-opioids in fischer rats. Medication-assisted treatment for adolescents in specialty treatment for opioid use disorder. Drug treatment outcomes among hiv-infected opioid-dependent patients receiving buprenorphine/naloxone. Comorbidity of antisocial personality and mood disorders among psychoactive substance-dependent treatment clients. Gender differences in methadone dose patterns and length of treatment in outpatient methadone maintenance treatment programs. Understanding and treating opioid use disorders in lesbian, gay, bisexual, transgender, and queer populations. Interactions between methadone and medications used to treat hiv infection: A review.
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That is not to spasms below left rib cage purchase flavoxate online now suggest you have not thought hard about your subject before spasms toddler cheap flavoxate master card, but we expect you will have developed your ideas more fully through the course readings spasms below middle rib cage 200mg flavoxate visa, personal reflection, and seminar discussions. On the first page of your essay include the title of your essay, your name, seminar number, course name, and the word count (the cover page does not count against your word count). Timeline the important milestones for the Leadership Concepts Essay are as follows: Explanation of Essay Requirement. Your Leadership Concepts Professor will discuss the purpose, timeline, grading and objectives of the essay during the first few weeks of the Leadership Concepts course. Provide your essay topic and general ideas in writing to your Leadership Concepts professor no later than Leadership Concepts session-8 (8 December 2016). Your proposal should incorporate a short paragraph outlining the key ideas you intend to explore in your essay. Each student should meet with their Leadership Concepts professor to discuss your essay topic and explain your basic approach to exploring the material and arguments you intend to make in it. This meeting will be scheduled at a mutually agreeable date/time during the period 5 to 16 December 2016. Each student will provide a nearly final draft of their essay to two assigned seminar classmates no later than Tuesday, 31 January 2017. Peer reviewers will provide written feedback using the peer review evaluation form (see example below) and be prepared to discuss those comments with the essay author prior to the due date for the essay. Students are left to arrange a mutually agreeable date, time, and place to accomplish their peer review process, but should do so by Friday, 3 February 2017. All Leadership Concepts essays are due to your professor no later than 1630 on Tuesday, 7 February 2017. Grading Criteria Your Leadership Concepts Professor will grade the essays in accordance with Naval War College guidelines with particular attention to: Clarity. The essay addresses all of the important dimensions of the subject and identifies likely objections your positions or conclusions. Check and recheck to ensure your essay is free of spelling and grammatical errors. Has the author remained consistent with the purpose of the essay during the discussion and conclusion Does the author omit any glaring issues or points that would seem to bear on the subject chosen Is the essay written with proper grammar, word usage, spelling, sentence, and paragraph structure Your preparation and participation has enriched the educational experience of you and your classmates. We are continually striving to improve the professional education that we provide for our students. I therefore would request your attention and focus one additional time on this important End of Course Survey. Your frank and considered views are essential in order to assist us in assessing whether, where, and how modifications could be made to improve the course. Additionally, as teachers we want to know where we are effective individually and where we could improve. Your input will be treated completely anonymously and survey results will not be shared with individual faculty members until after all students have received final course grades. In order to ensure anonymity, you will need a password to access the online survey. Thank you for taking the time to help us assess the curriculum and instruction of this course. Written Assignments: Comments: 231 5. Please respond to the following statements regarding each member of your teaching: a) Leadership Concepts: Please select the name of your Leadership Professor from the drop down menu. This professor was effective at linking sub-course concepts with the unifying "levels of analysis" course framework.
Some repeat offenders deserve their return visit spasms headache buy genuine flavoxate on-line, but many are almost forced into a life outside the law by circumstances resulting from their first arrest spasms perineum discount 200 mg flavoxate mastercard, conviction and sentence muscle relaxer 93 generic flavoxate 200 mg without prescription. There was a time when one "paid" his or her "debt to society" and could move on, but technology, the type of jobs now available, and the institutional safeguards put in place by many businesses and their insurers has made that more difficult. Prison splits families, produces negative role models, and reduces family incomes. Incarceration can cost more than $100,000 per year, more than an Ivy League education. Once a prisoner is released, successfully reentering society requires a fresh perspective and whatever retooling and retraining we can assess and provide. Jails and prisons are here to stay and truly dangerous lawbreakers deserve long sentences. But this should not obscure the fact that much can and should be done to improve the system. If there was ever a system that required a comprehensive overhaul, it is our criminal justice system. Kleiman Professor of Public Policy University of California, Los Angeles* 10 "We need to swap prison for effective supervision. Prisoners should be released after serving some portion of their time behind bars. They should then spend the rest of their sentence outside bars, gradually earning their way toward freedom: a process of `graduated reentry. Our prison system is built on the false notion that the only way to punish someone and control his behavior is by locking him up. It often does not get better when it ends: Of the people released from prison today, about 60 percent will be back behind bars within three years. The transition from prison to the "free world" can be very tough, both for the offender and for the neighborhood he returns A *This piece is co-authored with Angela Hawken and Ross Halperin. In the month after getting out, a person released from prison has about a dozen times the mortality rate of comparable people in the same neighborhood, with the leading causes of death among former inmates being drug overdose, heart attacks, murder, and suicide. Typically that person came into prison with poor impulse control, weak if any attachment to legal employment, and few marketable skills. But he has not learned anything about how to manage himself in freedom, because he has not had any recent freedom. And he has not learned to provide for himself, because he has been fed, clothed, and housed at public expense. Now let him out with $40 in his pocket, sketchy if any identification documents, and not enrolled for basic income support, housing, or health insurance. Even if he has family or friends who can tide him over the immediate transition, his chances of finding legitimate work in a hurry are slim. If he is not working, he has much free time to get into trouble, and no legal way of supporting himself. They should then spend the rest of their sentence outside bars, gradually earning their way toward freedom: a process of "graduated reentry. To get back to our historical level of incarceration, we would need to reduce the prisoner headcount by 80 percent. For the transition from prison to life outside to be successful, it needs to be more gradual. If someone needed to be locked up yesterday, he should not be completely at liberty today. And he should not be asked to go from utter dependency to total self-sufficiency in one flying Kleiman 57 leap. Spend some of the money that would otherwise have financed a prison cell to rent a small, sparsely-furnished efficiency apartment. In some ways, that apartment is still a cell, and the offender is still a prisoner. But he does not need guards, and does not have to worry about prison gangs or assault.
To be sure muscle relaxant valerian buy flavoxate 200 mg online, deterrence is more than nuclear weapons but during the Cold War muscle relaxant 750 mg order flavoxate 200 mg fast delivery, they were almost inseparable spasms under right rib cage buy generic flavoxate on-line. In the years following the Cold War, analysts gave far less thought to deterrence and nuclear weapons but over the past several years, that has changed. Many studies are examining the utility and application of Cold War deterrence concepts and are raising important questions about whether these ideas are appropriate for 21st century security challenges such as terrorism and cyber security among others. Comprehend the challenges and limitations associated with deterrence and compellence. Schelling lays out the basic concepts for using threats in achieving state goals and makes important distinctions between the use of force and threats to support diplomacy. He also examines the differences between deterrence and compellence, two different aspects of coercive strategy. He maintains that, since the Cold War ended, the United States has continued to rely on deterrence in places it should not have. In addition, Betts laments deterrence was once central to United States security policy, yet in recent years has "almost vanished from the vocabulary of strategic debate. John Klein raises two fundamental questions regarding nuclear weapons and security: what is the purpose of nuclear weapons and how many must the United States have He provides an overview of Obama Administration thinking on the role of nuclear weapons as outlined in the 2010 Nuclear Posture Review that argues for nuclear weapons to play a reduced role in American security planning. After summarizing the arguments made by proponents of Global Zero, Klein argues that setting a minimum number of nuclear weapons is the wrong approach; maintaining an arsenal based on minimum numbers is arbitrary and might tempt an adversary to challenge deterrence. What is your answer to the questions regarding the role and number of nuclear weapons for United States defense planning Given the scope of this effort, some assessments have projected the total cost to be close to $1 trillion over the next thirty years. Adam Mount reviews the proposed changes and questions whether the United States can afford this. How would you prioritize the various elements of modernizing American strategic forces Economic activity must provide a basic quality of life for citizens, while simultaneously providing sufficient resources to support those functions for which the state is responsible. History provides numerous examples of how states and other political entities have managed the economic behavior of individuals and groups, and there is no global consensus on which system is best. Political economy refers to the processes by which market activity is structured and regulated by the political unit. An idealized pure free market optimizes the values of efficiency and individual liberty (to dispose of property as the individual prefers), but can also create instability and inequality. Comparative political economy looks at how different states approach the issues of production and distribution of resources, and how the decisions those states make affect their security and relations with the rest of the world. Objectives Assess alternative economic system theories and relate economic success to national security. Analyze the economic characteristics of a few different models and the advantages and disadvantages of each. Assess the relationship between successful states, failed states and economic systems. The reputation of (neo) liberal, laissez-faire free-market capitalism has suffered of late, largely as a result of the 2008 U. This reignited a perennial discussion regarding whether there is one "best" economic system for the world, and if so, which one it is. This question is particularly important for the developing world, as many states have an opportunity to choose what kind of system they will build. The United States has long been the champion of neoliberal free-market economics, and has shaped global institutions to promote that approach, but there are alternatives. Another narrative urges developing countries to adopt democratic principles and practices in order to support modern economic growth and development. One major difference in economic systems is how they choose to respond to economic downturns or crises. Two major strands of economic thought call for opposite strategies, and this can create serious tension when countries are trying to coordinate their responses (as the countries of the European Union must, or as the major world economies tried to do following the 2008 crash). Focus In the previous session we explored the debates on how states choose to organize their economies, both in theory and looking at practical examples and problems seen today. At the simplest theoretical level, we consider why and how countries interact with each other in the first place.
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