One Toke Over the Line: The Proliferation of State Medical Marijuana Laws

[Excerpt] “Marijuana has been used for medicinal purposes for at least five thousand years. In fact, it was used medicinally in the United States up until the twentieth century when antidrug zealots managed to prohibit it. Prohibition was the status quo until 1996 when California became the first state to adopt a law allowing medicinal marijuana use. Since then, thirteen additional states, along with the District of Columbia, have enacted similar laws. More states are now lining up with their own laws, which are in various stages of adoption. In addition, the Supreme Court has impacted the issue, both with decisions made as well as those not made. The state of the law is rapidly evolving, and this article addresses its history, recent changes, and future. Part II examines the past, from the third millennium B.C. to the 1990s. Part III examines the present, including California’s trailblazing law and its imitators. Part IV examines case law and court challenges to medical marijuana laws, as well as currently pending medical marijuana laws. Part V looks to the future to determine the likely legality and impact of medical marijuana laws.

Decomposing the declining volatility of long-term inflation expectations

The level and volatility of survey-based measures of long-term inflation expectations have come down dramatically over the past several decades. To capture these changes in inflation dynamics, we embed both short- and long-term expectations into a medium-scale VAR with stochastic volatility. The model documents a marked decline in the volatility of expectations, but also reveals a shift in the factors driving their movement. Throughout the 1980s and early 1990s, the majority of the variance in long-term expectations were driven by 'own' shocks. Beginning in the mid-1990s, however, the factors explaining the variance of long-term expectations began shifting amidst an overall decline in volatility. At the end of the sample in 2008, innovations to measures of inflation and output account for the majority of the remaining low-level of volatility in long-term expectations. We document a shift in monetary policy towards more systematic behavior that precedes the shift in the factors driving long-term expectations.

An empirical assessment of the relationships among inflation and short- and long-term expectations

This paper uses a detailed literature review and an empirical analysis of three models to assess the links among inflation and survey measures of long- and short-term expectations. In the first approach, we jointly estimate a model of inflation, survey expectations and monetary policy, where each is a function of a common time-varying inflation trend. In the estimates, long-term expectations track closely the unobserved trend that is an important factor in inflation dynamics, implying that changes in long-run expectations can lead to persistent movements in inflation. In the second approach, we estimate a time-varying parameter VAR with stochastic volatility. This model relaxes the cross-equation and constant parameter restrictions from the first model. Impulse response analysis shows a relatively stable relationship between inflation and survey measures of inflation, although with some modest changes consistent with improved anchoring of long-term expectations. Finally, we rely on a conventional VAR framework incorporating several macroeconomic variables, including both short- and long-term measures of expected inflation. In these estimates, shocks to either measure of expectations lead to a rise in the other measure and some limited pass-through to inflation. Shocks to inflation cause both short- and long-term expectations to rise. Other factors such as monetary policy, economic activity, and food price inflation also affect expectations and inflation.

An Educational Intervention for Hospice and Palliative Care Nurses

The provision of high quality nursing care to the dying has become a significant concern in the United States (Kruse, Melhado, Convertine & Stecher, 2008). The goal of palliative care is to provide care that allows for optimal quality of life for patients and their families (Betcher, 20 10; Mcllfatrick, Mawhinney, & Gilmour, 2010). The recognition of valuable and underutilized zed end-of-life nursing skills may provide guidance for the development of interventions to improve nurses\u27 roles in caring for dying patients and their family members (Reinke et al., 2010). The American Association of the Colleges of Nursing (AACN. 2002) has established a list of fifteen core competencies essential in the provision of high quality nursing care to patients and their families during the end-of-life transition period. This project describes an educational intervention focused on nurses working in hospice and palliative care. The educational intervention was delivered in a lecture sty le format utilizing handouts and discussions to augment understanding. The goal of this project was to enhance the level of perceived competency. in nurses caring for patients in the end-of-life care setting, which generally includes hospice and palliative care. The theoretical foundation for this project was based on Therese The Careful Nursing Model. The link between this project and this model\u27s theory lies in the understanding that the given areas of care should not be a part of w hat nurses do, but should actually be hemmed by their caring both in action and in belief. This study was a pre-test, posttest quasi-experimental design as randomization was not possible mainly due to the small sample size. Subjects then participated in an educational session composed of Iecture with discussion and handouts based on the TNEEL curriculum designed by the Cancer Pain and Symptom Management Nursing Research Group (20 11) to facilitate learners in meeting the AACN competencies recommended to provide quality care for hospice patients. Finally. subjects completed the Post Intervention Assessment: Perceptions on End-of-Life Care Questionnaire immediately after the fin al education session and again 30 days post education intervention. The overall questionnaire responses were analyzed for each item. Each item score was then totaled. averaged, and compared to determine ne mean differences for each stage of the questionnaire and statistical significance. Though improvement in mean scores was noted between the first and second administration of the questionnaire, the improvement was not statistically significant (p \u3e .623). There is a statistically significant improvement in mean scores between the second and third administration of the questionnaire (p = .00 I). When the combined mean scores for the five lowest scoring items (used to design the educational intervention) on the questionnaire were compared, no statistically significant differences were noted between the first and second, first and third or second and third questionnaire administrations. While this study demonstrated limited efficacy in hospice nurse education using the TNEEL program, further research is needed to help identify methodologies for effectively educating nurses to achieve higher self-reported skills in the identified core competencies

What Factors Affect General Aviation Pilot Adoption of Electronic Flight Bags?

Why do some pilots choose to use electronic flight bags (EFBs) in their flight operations, yet others continue to rely on traditional avionics and paper charts? Does the use of EFBs differ by age, gender, or flight experience? EFBs, now a common tool in aviation, can display navigational charts, weather, and traffic information, and automate calculation of critical fuel and aircraft performance data. Research that uses EFBs as interactive nodes to exchange data with the System-Wide Information Management (SWIM) network is underway. Understanding what factors may explain differences in pilot adoption and use of EFB technology could shape regulations governing EFB development and design, and could influence how EFBs are integrated into flight operations. Insights into whether EFB adoption differs by demographic factors like age, gender, or flight experience could illuminate whether some adoption factors are more important to different groups of pilots. Such knowledge could impact development of training strategies that address diverse pilot views on EFB use, or inform product sales and marketing strategies. An overview of an ongoing research project using leading theories of technology acceptance will be presented, with a focus on how technology acceptance research could contribute to our understanding of EFB usage trends. Factors to be considered include pilot expectations of the utility of EFBs, how difficult they are to use, available support, social influences, price value, habit, and the pleasure derived from using EFBs

Lead Activation of a Developmentally Regulated Calcium Channel in Rat Hippocampal Nerve Terminals

Low level lead (Pb2+) exposure may produce lasting deficits in learning and memory by altering calcium (Ca2+) dependent processes. Isolated presynaptic nerve terminals from rat hippocampus were loaded with the intracellular (Ca2+) indicator Fura-2. The changes in cytoplasmic free calcium ([Ca2+]i) were measured by stopped-flow fluorescence spectroscopy following depolarization with elevated potassium on a millisecond time scale (Lentzner et al., 1992). Depolarization promoted a rapid increase in Ca2+i which occured in two kinetically distinguishable phases: a fast component, representing the activity of rapidly inactivating Ca2+ channels (τ ~ 60 msec), and a slow component, which is comprised of slowly inactivating Ca2+ channels (τ ~ 1sec) and Na+/Ca2+ exchange operating in the reverse mode. Low concentrations of Pb2+ (0.1-0.5 μΜ ) blocked competitively both the rapidly and slowly inactivating channels. At higher concentrations (≥1μΜ) , Pb2+ permeated the rapidly inactivating channels. Pb2+ permeation was accompanied by a subsequent rise in intracellular Ca2+ even in the absence of extracellular Ca2+. The rise in Ca2+ was reduced by thapsigargin, suggesting Pb2+ activates the release of Ca2+ from intracellular stores, possibly an IP3 sensitive store. The Ca2+ release was greatest in younger animals and gradually declined during postnatal development

Mechanism-based strategies for the management of autoimmunity and immune dysregulation in primary immunodeficiencies

A broad spectrum of autoimmunity is now well described in patients with primary immunodeficiencies (PIDs). Management of autoimmune disease in the background of PID is particularly challenging given the seemingly discordant goals of immune support and immune suppression. Our growing ability to define the molecular underpinnings of immune dysregulation has facilitated novel targeted therapeutics. This review focuses on mechanism-based treatment strategies for the most common autoimmune and inflammatory complications of PID including autoimmune cytopenias, rheumatologic disease, and gastrointestinal disease. We aim to provide guidance regarding the rational use of these agents in the complex PID patient population