Publications 1995

Diagnostic Criteria for Alcohol Abuse and Dependence. Diagnosis is the process of identifying and labeling specific conditions such as alcohol abuse or dependence 1. Diagnostic criteria for alcohol abuse and dependence reflect the consensus of researchers as to precisely which patterns of behavior or physiological characteristics constitute symptoms of these conditions 1. Diagnostic criteria allow clinicians to plan treatment and monitor treatment progress; make communication possible between clinicians and researchers; enable public health planners to ensure the availability of treatment facilities; help health care insurers to decide whether treatment will be reimbursed; and allow patients access to medical insurance coverage Diagnostic criteria for alcohol abuse and dependence have evolved over time.

As new data become available, researchers revise the criteria to improve their reliability, validity, and precision 4,5. Evolution of Diagnostic Criteria. At least 39 diagnostic systems had been identified before 2.

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In Jlinek first published what is considered a groundbreaking theory of subtypes of what was, untiltermed alcoholism 2,8. Jellinek associated these subtypes with different degrees of physical, psychological, social, and occupational impairment 2,9. Alcoholism was categorized in both editions as a subset of personality disorders, homosexuality, and neuroses 2, In response to perceived deficiencies in DSM-I and DSM-II, the Feighner criteria were developed in the 's to establish a research base for the diagnostic criteria of alcoholism 5, These criteria were the first to be based on research rather than on subjective judgment and clinical experience alone 5.

Though designed for use in clinical practice, they were primarily developed to stimulate continued research for the development of even more useful diagnostic criteria 5. Several years later, Edwards and Gross focused solely on alcohol dependence 8.

They considered essential elements of dependence to be a narrowing of the drinking repertoire, drink-seeking behavior, tolerance, withdrawal, drinking to relieve or avoid withdrawal symptoms, subjective awareness of the compulsion to drink, and a return to drinking after a period of abstinence 8.

The evolution of diagnostic criteria for behavioral disorders involving alcohol reached a turning point in with the publication of the Diagnostic and Statistical Manual of Mental Disorders, Third Edition In DSM-III, for the first time, the term "alcoholism" was dropped in favor of two distinct categories labeled "alcohol abuse" and "alcohol dependence" 1,2,12, In a further break from the past, DSM-III included alcohol abus e and dependence in the category "substance use disorders" rather than as subsets of personality disorders 1,2, For example, the DSM-III-R described dependence as including both physiological symptoms, such as tolerance and withdrawal, and behavioral symptoms, such as impaired control over drinking In DSM-III-R, abuse became a residual category for diagnosing those who never met the criteria for dependence, but who drank despite alcohol-related physical, social, psychological, or occupational problems, or who drank in dangerous situations, such as in conjunction with driving According to Babor, this conceptualization allowed the clinician to classify meaningful aspects of a patient's behavior even when that behavior was not clearly associated with dependence January 26, The views contained in the report do not necessarily represent those of the Administration, as this document has not been subjected to the A Executive Branch review process.

Dear Mr. Under its Congressional mandate, the National Council on Disability is charged with the responsibility to gather information on the implementation, effectiveness, and impact of the Americans with Disabilities Act. This report measures progress to date in the implementation of this landmark civil rights legislation from the perspectives of people with disabilities, private sector representatives, local, State, and Federal government officials, and national experts in the field of disability policy.

Overall, impressive progress has occurred in the implementation of the Americans with Disabilities Act. However, given the many areas where compliance has not yet been achieved and in recognition of the relatively brief time in which the law has been in effect, it is clear that further efforts are necessary in order to increase public awareness of the Act, provide education and clarification regarding the provisions of the Act to covered entities, and provide resources necessary to both encourage voluntary compliance and to ensure effective enforcement.

publications 1995

Today, as we observe -- and celebrate -- further progress in the full implementation of the Americans with Disabilities Act, I would once again pledge our unwavering commitment to ensuring that equality of opportunity, full participation, independent living, and economic self-sufficiency become realities in the lives of Americans with disabilities. Under your leadership I remain confident that we can continue to build an America where all citizens have equal access to the American dream.

Marca Bristo Chairperson. Marca Bristo, Chairperson John A. Gannon, Vice Chairperson Linda W. Allison Ellis B. Bodron Larry Brown, Jr. Flack Robert S. Raether Shirley W. Ryan Anne C. Seggerman Michael B.

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Unhjem Kate Pew Wolters. This report was prepared under contract by Edward P. The National Council on Disability wishes to thank the many government officials who participated in its meetings on the Americans with Disabilities Act ADA and provided data regarding their efforts to implement the ADA.

Most of all, the Council wishes to thank the many consumers, advocates, and representatives of both public and private sector agencies who shared their experiences, suggestions and valuable time with us in order to assist us in our ongoing efforts to assesss the implementation, effectiveness, and impact of the Americans with Disabilities Act. Finally, the Council wishes to express its appreciation to the staff, and Edward P. Burke whose hard work made this report possible.

The first recommendation made in this report was as follows:. Congress should enact a comprehensive law requiring equal opportunity for individuals with disabilities, with broad coverage and setting clear, consistent, and enforceable standards prohibiting discrimination on the basis of handicap. Since the passage of the Americans with Disabilities Act, the National Council on Disability has been charged with gathering information regarding the implementation, effectiveness, and impact of the Americans with Disabilities Act ADA.

Since the publication of this report, the Council has continued its ADA-related monitoring activities. The present report summarizes the findings and recommendations emanating from these two events and is intended to provide the Administration, the Congress, and the public with an updated assessment of the ADA's effectiveness. Over the course of the next year, the Council intends to continue its ADA monitoring activities in order to assist the Nation in creating a society in which every citizen has equal access to the American Dream.

Together we've begun to shift disability in America away from exclusion, towards inclusion; away from dependence, towards independence; away from paternalism, towards empowerment And we have made a commitment -- a real commitment -- to enforce the Americans with Disabilities Act, until all citizens with disabilities receive equal treatment under the law, whether in the workplace, or school, in government or in the courts. House of Representatives on a vote of The next day, it passed the Senate on a vote of Shortly thereafter, on July 26,the Act was signed by President George Bush on the South Lawn of the White House in front of over 3, disability advocates, the largest bill-signing ceremony that had ever taken place at the White House.

Clearly, the ADA was passed in an atmosphere of great support from the Congress, the Administration, and the community at large. It's been the work of a true coalition.Alcohol and Tolerance. Alcohol consumption interferes with many bodily functions and affects behavior.

The Americans with Disabilities Act: Ensuring Equal Access to the American Dream

However, after chronic alcohol consumption, the drinker often develops tolerance to at least some of alcohol's effects. Tolerance means that after continued drinking, consumption of a constant amount of alcohol produces a lesser effect or increasing amounts of alcohol are necessary to produce the same effect 1.

Despite this uncomplicated definition, scientists distinguish between several types of tolerance that are produced by different mechanisms.

Tolerance to alcohol's effects influences drinking behavior and drinking consequences in several ways. This Alcohol Alert describes how tolerance may encourage alcohol consumption, contributing to alcohol dependence and organ damage; affect the performance of tasks, such as driving, while under the influence of alcohol; contribute to the ineffectiveness or toxicity of other drugs and medications; and may contribute to the risk for alcoholism.

Functional Tolerance. Humans and animals develop tolerance when their brain functions adapt to compensate for the disruption caused by alcohol in both their behavior and their bodily functions. This adaptation is called functional tolerance 2. Chronic heavy drinkers display functional tolerance when they show few obvious signs of intoxication even at high blood alcohol concentrations BAC'swhich in others would be incapacitating or even fatal 3.

Because the drinker does not experience significant behavioral impairment as a result of drinking, tolerance may facilitate the consumption of increasing amounts of alcohol. This can result in physical dependence and alcohol-related organ damage. However, functional tolerance does not develop at the same rate for all alcohol effects Consequently, a person may be able to perform some tasks after consuming alcohol while being impaired in performing others.

In one study, young men developed tolerance more quickly when conducting a task requiring mental functions, such as taking a test, than when conducting a task requiring eye-hand coordination 4such as driving a car.

publications 1995

Development of tolerance to different alcohol effects at different rates also can influence how much a person drinks. Rapid development of tolerance to unpleasant, but not to pleasurable, alcohol effects could promote increased alcohol consumption 7.

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Different types of functional tolerance and the factors influencing their development are described below. During repeated exposure to low levels of alcohol, environmental cues and processes related to memory and learning can facilitate tolerance development; during exposure to high levels of alcohol, tolerance may develop independently of environmental influences.

Acute tolerance. Although tolerance to most alcohol effects develops over time and over several drinking sessions, it also has been observed within a single drinking session. This phenomenon is called acute tolerance 2. It means that alcohol-induced impairment is greater when measured soon after beginning alcohol consumption than when measured later in the drinking session, even if the BAC is the same at both times Acute tolerance does not develop to all effects of alcohol but does develop to the feeling of intoxication experienced after alcohol consumption 4.

This may prompt the drinker to consume more alcohol, which in turn can impair performance or bodily functions that do not develop acute tolerance. Environment-dependent tolerance.

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The development of tolerance to alcohol's eff ects over several drinking sessions is accelerated if alcohol is always administered in the same environment or is accompanied by the same cues. This effect has been called environment-dependent tolerance.

Rats that regularly received alcohol in one room and a placebo in a different room demonstrated tolerance to the sedative and temperature-lowering effects of alcohol only in the alcohol-specific environment Similar results were found when an alcohol-induced increase in heart rate was studied in humans When the study subjects always received alcohol in the same room, their heart rate increased to a lesser extent after drinking in that room than in a new environment.

Environment-dependent tolerance develops even in "social" drinkers in response to alcohol-associated cues. In a study analyzing alcohol's effects on the performance of an eye-hand coordination task, a group of men classified as social drinkers received alcohol either in an office or in a room resembling a bar.

Most subjects performed the task better i. This suggests that for many people, a bar contains cues that are associated with alcohol consumption and promote environment-dependent tolerance. Learned tolerance. The development of tolerance also can be accelerated by practicing a task while under the influence of alcohol.The guidance presented in this document is intended for digital health intervention designers, developers, implementers, researchers and funders.

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The Pharmacovigilance team in WHO aims to assure the safety of medicines and vaccines by ensuring reliable and timely exchange of information on safety The Hinari Access to Research for Health programme is a partnership with major publishers to provide free or very low-cost online access to biomedical and health literature journals to local, not-for-profit institutions in developing countries.

It benefits health workers and researchers, and in turn, contributes to improving global health. The Global Index Medicus provides universal access to biomedical and public health literature produced by and within low-middle income countries. Read More. Buy WHO publications Send an email to : bookorders who. Journals of the World Health Organization. Bulletin of the World Health Organization. WHO Regional publications.

African Region. South-East Asia Region. European Region. Eastern Mediterranean Region. Western Pacific Region. Hinari Research for Health. Visit Hinari. Library and Information Networks for Knowledge.

Access to GIM. Historical research: Researchers who wish to use the Historical Collection should make an appointment by contacting the Archives at WHO. Archives at WHO - Practical information Distinction between library collections, archives and current records.Having a branded tracking page brings your brand to the next level. It was easy to set up and so far I've had no issues with it, pretty cool app.

AfterShip is such an easy plugin to our store and allows for a professional seamless process for our customers to return.

publications 1995

Excellent service to help boost the fluidity of the Shopify workflow and automation. Support is highly responsive. This app is amazing. I use it every day on multiple different websites to track orders all around the globe. Great app, lets you and your customers easily track your shipments!. Working like a charm and it's even free to a certa. This app is worth every cent.

Running an apparel business, if I didn't have a rock solid returns system for wrong sizing. Even for a non native English speaker like myself Super Great appworks very well. Very easy to navigate and use. Will continue to use in the futureand recommend an. Yes I would use this app again and again. Recommend for any new store and advanced. Really does gave you your shipment updates in less than 1. Added this app to my site, gave the customers.

It's really easy to use and makes my store look very professional. Great App, easy to setup and use, definitely a must have for any Shopify store.

publications 1995

The visitors to my onli. I love this app. As a store owner who runs all operations on her own, this has taken so much work off of my plate. Awesome App definitely a must have if you're serious about your Shopify business. Easy to use and has just made my life a million times easier.Sacramento heads into the game with records of 7-17 straight up (SU) and 10-11-3 against the spread (ATS). Meanwhile, New Orleans owns records of 13-12 SU and 14-11 ATS. Vegas tends to place the total low when the Pelicans are involved, as 56.

Both teams have had a player take their game to the next level over their last five games. This is the second game of the season between these two teams.

In the first, Cousins scored a game-high 41 points and the Pelicans beat the Kings 114-106, covering as 1-point underdogs.

He also recorded 23 rebounds and six assists. The game finished with a total of 220 points, which was 16 points above the projected point total of 204 points.

New Orleans had a much better offensive rebounding percentage (25. New Orleans ranks second in assists per game (26. The Pelicans rank 12th in three pointers attempted per game (30. Sacramento ranks third in points off turnovers allowed per game (15. The Kings rank 10th in steals per game (8. New Orleans ranks second in points in the paint per game (51. The Kings rank 12th in fast break points allowed per game (10. New Orleans averages 12.

Sacramento ranks 15th in second chance points allowed per game (12. During their last five games, the Pelicans have scored an average of 114. Tags New Orleans Pelicans Sacramento KingsThe Creighton Bluejays (6-2) matchup against the Nebraska Cornhuskers (7-3) at CenturyLink Center Omaha on Saturday night. The Oklahoma State Cowboys (7-1) welcome the No. ET on Friday, December 8 on NBC Sacramento Kings vs. At home, New Orleans is 6-6 ATS with 7 overs and 5 unders.

Sacramento is 3-2 when they allow below 100 points, while New Orleans is 4-0. When scoring over 100 points, the Kings are 4-4 and the Pelicans are 11-7.

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New Orleans ranks 14th in rebounds per game (44. The Kings rank fifth in blocks allowed per game (4. Bettings Trends: In their last five games, Sacramento is 3-1-1 ATS with 4 overs and 1 under.With Instagram analytics, you can obtain a ton of valuable data and information to understand how your brand is performing on Instagram and how you can improve your results.

In this guide, we will be covering several topics under Instagram analytics. To make it more digestible, this guide is divided into four chapters. Feel free to skip to the chapter that interests you the most.

Chapter 1: 28 Instagram metrics and insights to measure and improve your performanceChapter 2: Instagram insights and 10 other free Instagram analytics toolsChapter 3: How we track our Instagram performance at BufferChapter 4: How to act on your Instagram insightsJump to any section of this post Instagram provides a wide range of metrics and insights for you to measure your performance, understand your audience, and improve the results of your Instagram marketing.

Instagram Insights) or other Instagram analytics tools. Most metrics available can be considered as level-one metrics data in its most basic form (e. We will go through level-two metrics calculated metrics (e. Follower count: The number of people following your Instagram account.

Impressions: The total number of times all of your posts have been seen. Reach: The number of unique accounts that saw any of your posts. Profile views: The number of times your profile was viewed. Website clicks: The number of taps on the website link in your profile bio.

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Posts: The number of Instagram posts you have published. Mentions: The number of Instagram posts mentioning your Instagram handle. Branded hashtags: The number of Instagram posts with your branded hashtags. Gender: The gender distribution of your followers (men or women).

Top locations: The top five cities and countries where your followers are. Impressions: The total number of times a post has been seen. Likes: The number of unique accounts that liked a post. Saved: The number of unique accounts that saved a post.

Engagement: The number of unique accounts that liked, saved, or commented on a post. Impressions: The number of times a particular photo or video has been seen in your story. Reach: The number of unique accounts that saw a particular photo or video in your story. Replies: The number of replies to a particular photo or video in your story. People insights: The list of accounts that have seen a particular photo or video in your story.

Tip: You can check out their accounts by simply clicking on their handle in the list. Viewers: The number of accounts that saw any part of your Instagram live video.


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