Effectiveness and Side Effects of Oral Analgesics for Acute Pain in the Elderly

Pain is a common presenting complaint of patients seen in the emergency department (ED), accounting for up to 78% of visits. Inadequate pain control has been recognized by the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) as a significant problem, and regulations have targeted improving the management of persistent pain as a priority for physicians. Patients 65 years and older are particularly vulnerable to persistent pain because pain has a greater impact on function in elderly adults and because elderly adults are more likely not to receive pain medication compared to non-elderly adults. The research component of this master’s paper is a study of the effectiveness and side effects of analgesics for the management of acute pain in patients 65 years and older seen in an emergency department. Eligible patients discharged from the ED following a pain-related visit were interviewed one week post-discharge to assess levels of pain and side effects from analgesics prescribed. No significant differences in persistent pain were seen between patients prescribed opioids and those prescribed non-steroidal anti-inflammatory drugs (NSAIDs), though the trend suggests that there is a higher level of persistent pain in those prescribed opioid analgesics independent of initial pain score, race, gender and level of education. Pain may be persistent in this group because one third of patients stopped taking the prescribed opioid medication despite continued pain. Of the patients who stopped taking their opioid medications, 40% stopped secondary to adverse side effects. A systematic review of the literature was conducted with the goal of comparing opioids and NSAIDs for management of acute pain. There is a paucity of literature comparing these analgesics in the short term management of pain. There is a need for further research in analgesic use for the management of short term pain in elderly adults in order to reduce the burden of persistent pain in this important, growing, and vulnerable population.Master of Public Healt

Emotion, deliberation, and the skill model of virtuous agency

A recent skeptical challenge denies deliberation is essential to virtuous agency: what looks like genuine deliberation is just a post hoc rationalization of a decision already made by automatic mechanisms (Haidt 2001; Doris 2015). Annas’s account of virtue seems well-equipped to respond: by modeling virtue on skills, she can agree that virtuous actions are deliberation-free while insisting that their development requires significant thought. But Annas’s proposal is flawed: it over-intellectualizes deliberation’s developmental role and under-intellectualizes its significance once virtue is acquired. Doing better requires paying attention to a distinctive form of anxiety—one that functions to engage deliberation in the face of decisions that automatic mechanisms alone cannot resolve

Toward a conceptual framework of emotional relationship marketing: an examination of two UK political parties

The purpose of this paper is to review the notion of branding and evaluate its applicability to political parties. As ideological politics is in decline, branding may provide a consistent narrative where voters feel a sense of warmth and belonging. The paper aims to build an understanding of the complexity of building a political brand where a combination of image, logo, leadership, and values can all contribute to a compelling brand narrative. It investigates how competing positive and negative messages attempt to build and distort the brand identity. A critical review of bran ding, relationship marketing, and political science literature articulates the conceptual development of branding and its applicability to political parties. The success or failure of negative campaigning is due to the authenticity of a political party’s brand values — creating a coherent brand story — if there is no distance between the brand values articulated by the political party and the values their community perceives then this creates an "authentic" brand. However, if there is a gap this paper illustrates how negative campaigning can be used to build a "doppelganger brand," which undermines the credibility of the authentic political brand. The paper argues that political parties need to understand how brand stories are developed but also how they can be used to protect against negative advertising. This has implications for political marketing strategists and political parties. This paper draws together branding theory and relationship marketing and incorporates them into a framework that makes a contribution to the political marketing literature

The South, the suburbs, and the Vatican too: explaining partisan change among Catholics

This paper explains changes in partisanship among Catholics in the last quarter of the 20th Century using a theory of partisan change centered on the contexts in which Catholics lived. Catholics were part of the post-New Deal Democratic coalition, but they have become a swing demographic group. We argue that these changes in partisanship are best explained by changes in elite messages that are filtered through an individual’s social network. Those Catholics who lived or moved into the increasingly Republican suburbs and South were the Catholics who were most likely to adopt a non-Democratic partisan identity. Changes in context better explain Catholic partisanship than party abortion policy post Roe v. Wade or ideological sorting. We demonstrate evidence in support of our argument using the ANES cumulative file from 1972 through 2000

Unreflective Partisans? Policy Information and Evaluation in the Development of Partisanship

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/142526/1/pops12480.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/142526/2/pops12480-sup-0002-suppinfo2.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/142526/3/pops12480-sup-0001-suppinfo1.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/142526/4/pops12480_am.pd

When the context matters: identity, secession and the spatial dimension in Catalonia

Regional and national identities are significant determinants of people's support for secession. Most previous works, however, have implicitly assumed that national identity has a linear unconditional effect. We complement previous works by showing that the relationship between identity and support for secession changes as a function of the context in which an individual interacts, an effect particularly important among those with mixed national and regional identities. The first stage of our empirical analysis is based on a pool of 22,000 individuals in the context of Catalonia (Spain). Findings confirm that dual-identity individuals are especially affected by their immediate surroundings: the probability to vote in favour of independence among them substantially increases when the percentage of people speaking Catalan increases. On a second stage, we explore the existence of a social interaction mechanism by employing a survey that measures the preferences of people's close networks. We show that individual's interaction in like-minded networks modifies the relationship between identity and secession, with the effect being again strong among dual-identity individuals. This group is six times more likely to vote for secession when having only pro-secession close contacts, as compared to having none. These results have implications for studies on regionalism and preferences for territorial decentralization

The local roots of the participation gap: Inequality and voter turnout

It is generally accepted that the rich are more likely to participate in politics than the poor. It is also generally accepted that the probability than an individual will participate in elections is influenced by the gap between the rich and the poor. There is little agreement, however, about whether inequality across time and space increases or decreases participation. In this paper we examine the impact of inequality across space. We suggest that the impact of inequality depends crucially on whether it is defined in terms of variations between geographical units (‘segregation’) or within geographical units (‘heterogeneity’). Evidence to support this argument is drawn from multi-level British data. Heterogeneity has a mildly positive effect on participation but this effect seems to be outweighed by the negative impact of segregation. The effect of segregation, moreover, is most pronounced among the poorer sections of the population, indicating that geographical isolation among the poor ('ghettoization') leads to lower turnout among these groups

It's (Change in) the (Future) Economy, Stupid: Economic Indicators, the Media, and Public Opinion

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/111207/1/ajps12145-sup-0001-text.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/111207/2/ajps12145.pd