攪拌ミル内ビーズ運動のシミュレーションへの粒子要素法の応用と最適粉砕条件

学術(環

The changing landscape of opioid prescribing: long-acting and extended-release opioid class-wide Risk Evaluation and Mitigation Strategy

Prescriptions for opioid analgesics to manage moderate-to-severe chronic noncancer pain have increased markedly over the last decade, as have postmarketing reports of adverse events associated with opioids. As an unintentional consequence of greater prescription opioid utilization, there has been the parallel increase in misuse, abuse, and overdose, which are serious risks associated with all opioid analgesics. In response to these concerns, the Food and Drug Administration announced the requirement for a class-wide Risk Evaluation and Mitigation Strategy (REMS) for long-acting and extended-release (ER) opioid analgesics in April 2011. An understanding of the details of this REMS will be of particular importance to primary care providers. The class-wide REMS is focused on educating health care providers and patients on appropriate prescribing and safe use of ER opioids. Support from primary care will be necessary for the success of this REMS, as these clinicians are the predominant providers of care and the main prescribers of opioid analgesics for patients with chronic pain. Although currently voluntary, future policy will likely dictate that providers undergo mandatory training to continue prescribing medications within this class. This article outlines the elements of the class-wide REMS for ER opioids and clarifies the impact on primary care providers with regard to training, patient education, and clinical practice

Le Statut Communautaire de la Polynésie Française

From the point of view of France, French Polynesia is an integral part of the French Republic but it does have a certain degree of political autonomy.  From the point of view of European Community law, French Polynesia has a special status under the Part 4 of the EC Treaty.  That Part confers on French Polynesia the benefit of a special relationship with the European Union.  In addition French law considers that those living overseas are all French citizens and therefore have under the EC Treaty the status of European citizen.  In this paper the author considers the nature of the association of the French territories to the European Union that is provided in the Treaty and notes that it is not radically different from that provided in the Cotonou Agreement.  Working from that point the article investigates whether the provisions of Part 4 alone apply to the overseas territories and seeks to identify the true range of the application of community law to the overseas territories