Education and implementation of the clinical opiate withdrawal scale (COWS) in the acute care setting for care providers.

The opioid epidemic is a growing crisis, the US consumes a majority of the worlds opioid supply. There are an estimated 100,000,000 opioid dependent persons and according to the National Institute of Health (NIH) over 7 million of those individuals also have an overlapping mental illness which further complicates treatment for this population. In the inpatient setting there is a great need to assess the opioid dependent patient and identify withdrawal signs and symptoms. There are many challenges especially within the ICU when recognizing these patients. Patients can require mechanical ventilation and intravenous sedation and pain medication which consist of opioids. This can have grave consequences on the health of these patients as well as the ability of the healthcare provider to provide appropriate, adequate and affordable care. Recognizing the need for an accurate and targeted tool for the healthcare provider has become vital in the management of these very complex individuals. The clinical opiate withdrawal scale (COWS) assessment tool which has been previously recognized as a reliable tool of opiate withdraw was introduced to the staff of various ICUs. Staff were surveyed both before and after the introduction of this tool and analysis was performed to assess both understanding of the tool as well as comfort level utilizing the tool

Early Stages of Prairie Restoration on a 1.5 Hectare Field in Faulkner County, Arkansas

A plot of land on the University of Central Arkansas campus has been permanently designated as a Nature Reserve which is to remain much as it is with woods and open, grassy fields for class use and other educational purposes. The 1.5 hectare open field is a particularly good site for prairie restoration, since the area has not been under cultivation in recent time. Andropogon gerardi, A. scoparius, Sorghastrum avenaceum, Panicum virgatum, Liatris pycnostachya, Eryngium yuccifolium, Rudbeckia hirta, and Helianthus sp. are examples of plants naturally occurring here with some frequency. A number of other plants typical of prairie remnants in Arkansas occur but some are in smaller numbers. Vegetation monitoring has included compilation of a species list and frequency of species sampled during the fall of 1981 as well as gathering of quantitative data on the percent cover. Restoration has included elimination of some encroaching woody species and burning as well as a program involving seed collection, sowing and transplant operations

Get It Right: 5 Shifts Philanthropy Must Make Toward An Equitable Region

Northern California harbors some of the most extreme economic inequality in the nation. In 2016, Open Impact's report "The Giving Code: Silicon Valley Nonprofits and Philanthropy" highlighted a mismatch between the region's astounding wealth and resourcing of community-based organizations which struggled to meet the most basic needs of lower income folks: safe and stable shelter, sufficient nutritious food, livable wage jobs, and a good education.Now five years later, while there are some breakthroughs and bright spots, the philanthropy gap has only grown. To chart a course toward a more caring, connected, and equitable region powered by the philanthropy sector, the David and Lucile Packard Foundation supported a unique partnership between Northern California Grantmakers and Open Impact to identify the shifts that decision-makers — including philanthropy board members, trustees, and executives, as well as individual donors — must make. These shifts in practice enable Northern California donors and institutions to align their resources and propel changes that close racialized wealth gaps and establish conditions for regional vibrancy and communal well-being.The report recommends practices such as: centering equity rather than your experience, emphasizing systems rather than symptoms, choosing collective over individual action, leveraging capital to the scale of the issue, and updating outdated grantmaking processes. By embracing and applying these practices, leaders in philanthropy can be an even more effective partners in building a region where everyone flourishes