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Medicine and law in the treatment of drug addiction
I. Introduction
II. Nature, extent in U.S.A., and treatment of narcotic drug addiction
III. Areas of medical-legal impact in treatment of narcotic drug addiction
IV. Addiction and Crime
V. Learning more about narcotic addiction
VI. Community action in treating narcotic drug addiction
VII. Conclusion
Author: James V. Lowry, Earle V. Simrell
Pages: 9 to 16
Creation Date: 1963/01/01
Medicine and law in the treatment of drug addiction 1M.D. James V. Lowry Assistant Surgeon General, Chief, Bureau of Medical Services, U.S. Public Health Service.
LL.B. Earle V. Simrell Special Assistant to the Chief, Bureau of Medical Services, USPHS.
I. Introduction
In the United States there has been a long-standing double attack by legal and medical agencies on the problem of narcotic drug addiction. In many ways this has been a partnership, with the legal agencies preventing the spread of addiction by decreasing the available supplies, and the medical agencies treating addicted persons. The efforts of each have achieved a partial success.
Narcotic drug addiction has been a problem in the United States for a hundred years. Administration of morphine by the use of the then newly developed hypodermic syringe was a blessing to the painfully wounded of our Civil War, but it also resulted in the spread of addiction. Fifty years later, the Federal Government enacted legal controls on the distribution of narcotic drugs. In 1935 the U.S. Public Health Service opened its first hospital for the treatment of addicted federal prisoners.
Since then the activities of the Public Health Service have broadened greatly. A second hospital was established in 1938. Research began when the hospitals were opened and has been very productive. Research and demonstration projects are supported by grants to non governmental agencies. The states are assisted in meeting the health problems of addiction by grants for mental health services and for hospital construction and by technical assistance.
A physician is primarily concerned with the prevention and treatment of disease and the rehabilitation of those who become afflicted. He is not an expert in law or law enforcement, just as lawyers and law enforcement officers are not experts in the nature of disease and the methods of prevention and treatment. Because narcotic drug addiction and the illicit traffic in narcotic drugs are so closely interrelated, there is a strain on our ability to contribute what we can to common objectives without confusing our professional roles.1
1 Presented at the First Inter-American Conference on Legal Medicine and Forensic Science, University of Puerto Rico, Friday, 30 November 1962.
Justice Cardozo once addressed the New York Academy of Medicine under the title, "What medicine can do for law" (1). This expresses one aspect of the present subject; another is what law can do for medicine. As applied to narcotic drug addiction, my presentation is an exploration of certain areas of impact between law and medicine to consider how medicine can assist the law, and how the law can assist medicine, in the treatment of addiction.
II. Nature, extent in U.S.A., and treatment of narcotic drug addiction
Narcotic drug addiction is a state of physical and mental dependence on an opiate drug or a synthetic drug with opiate-like qualities. The essential characteristic is the physical and mental dependence which the addict describes as being "hooked ". He is subject to a psychological compulsion beyond his power of self-control, and physically has undergone changes in the central nervous system and the endocrine system which will produce withdrawal symptoms if he discontinues the use of narcotic drugs. Narcotic drug addiction has this characteristic in common with addiction to alcohol and barbiturates. It distinguishes true addiction from the use or abuse of these drugs and from episodes of intoxication with these or other drugs.
Introduction to the use of narcotic drugs is usually by association with an addict who shares his drugs and equipment. The initiate finds that drugs relieve anxiety, fear and frustration and provide an orgiastic-like pleasure and escape into a world of unreality. The body develops tolerance to the drugs so that a steadily increasing dosage is required to obtain the same effects. Ultimately the addict may find this demand impossible to satisfy, and still he cannot stop. What started as a voluntary experiment in pleasure, or relief from unpleasantness, becomes a compulsive drive to maintain what the addict considers his "normal" condition of euphoria.
Withdrawal symptoms are produced whenever the addict stops, or significantly reduces, his use of narcotic drugs. These symptoms include restlessness, profuse perspiration, muscle jerking, abdominal cramps, vomiting, diarrhoea, insomnia, increased blood pressure and temperature, and sometimes collapse and death. The severity of withdrawal symptoms varies with the degree of addiction; they represent an acute physiological illness and not the discomfort of giving up a bad habit.
Most of our statistics on addiction in the U.S. come from law enforcement sources. The U.S. Bureau of Narcotics lists about 47,000 persons known to have been addicted in the last five years (2). We know too little about the epidemiology of drug addiction, but we do know that drug addiction in the U.S. is concentrated mainly in a few urban areas that have a great many other social problems. Addiction is primarily a disease of young male adults between 21 and 30 years of age. Ethnic groupings suggest the importance of social and environmental rather than racial factors. Before World War II the rate of addiction among the U.S. Negro population was low. In 1961 the proportion of Negro addicts was reported to be over half, mainly in northern cities. Chinese addicts, once a principal group and the original importers of smoking-opium into the U.S., are now almost non-existent in the U.S., although plentiful in the Far East.
Addiction is usually associated with underlying mental, emotional, or personality disorders. Patients can become addicted from medical use of narcotics but this is unusual. Addiction usually develops in individuals who are made susceptible by anxieties, emotional disturbances, and feelings of inadequacy or personality disorders.
The two phases of treatment are ( a) treatment of physical dependence, and ( b) physical, psychiatric and social rehabilitation. The treatment of physical dependence usually precedes rehabilitation. Two British physicians recently reported on the treatment of a small series of addicts who were stabilized on drugs before being admitted to "private nursing homes" for treatment of physical dependence. Rehabilitation procedures were initiated before withdrawal and reinstituted afterwards. Of 51 patients treated, 32 obtained good results (3).
Effective treatment of physical dependence on narcotic drugs is not too difficult. Treatment of the psychological dependence and underlying mental disorders is both difficult and complex. In the PHS hospitals, treatment of physical dependence is by substitution of a synthetic narcotic, methadone, for whatever narcotic has been used and reduction of the dosage of methadone over a period of time. Patients are interviewed by members of the vocational, social service, and psychiatric staffs, and a programme of further treatment and rehabilitation is formulated. The programme varies from patient to patient but includes hospitalization for at least four months to complete the recovery from physical dependence and to initiate a pattern of living without drugs. Psychotherapy is included where it seems likely to be beneficial; group psychotherapy seems to be more suitable than individual psychotherapy for patients with personality disorders. Vocational training is provided, both for its value in learning to work with other people in constructive relationships and in order to prepare the patient for employment at the end of his hospitalization. Recreational activities are designed to develop interests other than narcotic drugs as a source of pleasure and social relationships. Religious services, group discussions,and individual counselling are available and play an important part in the lives of many patients. Patients who are prisoners or on probation are required to stay until the programme of hospital treatment is completed. Some who demonstrate their unsuitability for treatment are transferred. About two-thirds of the voluntary patients leave the hospital against medical advice before treatment is completed. We know that completion of the hospital treatment is not completion of rehabilitation for the patient. That can only occur when the patient has left the hospital and established himself in a community as a member of society able to live without narcotics (4).
The PHS method of treating narcotic drug addiction is not the only method. An interesting recent development is the "Synanon" project. As reported, this organization, founded some four or five years ago, houses about 100 narcotic-drug addicts and ex-addicts in a building in Santa Monica, California, and relies on voluntary treatment and group therapy. Addicts apply and are told the rules of the organization, including an absolute ban on narcotics. The sanction is not compulsion but expulsion. If admitted, the addict goes through "cold turkey" withdrawal with the help of sympathetic companionship of members, who have been through it. He becomes part of what the founder describes as "a more or less autocratic family structure ". He is told what to do, but he is free to earn his own status in the family. Members are their own and each other's therapists. Each becomes involved in and identified with the group, establishes his own role in the group, and develops constructive relationships in work and recreation with others. After a year or so, members are expected to get a job outside but continue to live at Synanon; still later they move out of the building, living and working in town but continuing to visit Synanon and take part in group sessions. It is too soon to measure long-term results, but Synanon is an interesting experiment (5).
III. Areas of medical-legal impact in treatment of narcotic drug addiction
Some reports give the impression that medical and law enforcement organizations are engaged in a jurisdictional struggle over narcotic drug addicts-the physicians seeking to treat them, and the law enforcement agencies seeking to put them in prison and keep them there. This is a distortion of the truth. Most physicians prefer to avoid treating addicts, and law enforcement agencies face a serious problem in the absence of an alternative to jailing addicts. We need to consider how physicians could do their part more effectively, and how addicts and incipient addicts could be removed from the illicit drug market by more effective and constructive methods than jail.
A recent and authoritative statement on the treatment of addicted patients was issued by the American Medical Association and the National Research Council in May 1962 and endorsed by the U.S. Bureau of Narcotics as consistent with federal law (6). It states:
"The successful and humane withdrawal of individuals addicted to narcotics in the United States necessitates constant control, under conditions affording a drug-free environment, and always requires close medical supervision.
"The successful treatment of narcotic addicts in the United States requires extensive post-withdrawal rehabilitation and other therapeutic services.
"The maintenance of stable dosage levels in individuals addicted to narcotics is generally inadequate and medically unsound and ambulatory clinic plans for the withdrawal of narcotics from addicts are likewise generally inadequate and medically unsound."
This statement requires some explanation. "Drug-free environment" means free of drugs that are not prescribed by the physician.
In the U.S.A., the current generally accepted course of treatment is in a hospital, with carefully controlled and gradually reduced administration of narcotic drugs until withdrawal is completed and rehabilitation advanced to a point where the patient has a fair chance of pursuing it outside the hospital; then to provide community health and social services that will strengthen the patient against re-addiction brought about by causes similar to those which contributed to his previous addiction. Unfortunately, the physician may find this course unavailable.
There may be no hospital available for the addict. New York City, for example, after efforts to open its hospitals to addicts during the past few years, is reported to have 400 beds (7) available for addicts with more than 20,000 known addicts (almost one-half of all addicts in the U.S.) and nearly 3,000 new addicts in the last year (8). In the U.S., jails are open to addicts, but hospitals commonly are not. The present availability of hospital treatment for addiction had been compared with that for mental illness a century ago. The physician who wants to hospitalize an addict-patient faces this situation. There should be more hospitals willing and able to provide adequate treatment for addiction. But what is the physician to do in the meantime?
A leading text, The Law of Medical Practice, by Professors Shartel & Plant of the University of Michigan, states, "About the only safe courses open to him are to refuse to deal with the addict or to see that he is hospitalized in order to cure his drug habit (9)." And the Council on Mental Health of the American Medical Association says in its 1957 Report on Narcotic Addiction, "A physician who furnishes an addict with a small quantity of narcotics to tide him over until he reaches an institution, or who gives an addict narcotics so he can arrange his affairs prior to entering a hospital for treatment is in danger of being charged with a violation of the law, despite the fact that he may be acting in what he regards as the best interest of the patient (10)." Whether these statements correctly reflect the law is not the primary question from the physician's point of view. Only the clearest sort of assurance, communicated to physicians through their professional groups and public health agencies as well as by sources of legal information, can be expected to bring physicians generally into the treatment of drug addiction on a more effective basis than refusing to deal with the addict unless he is hospitalized. This has nothing to do with a physician who misuses his practice to become a drug pedlar. When a doctor sold 4,000 narcotics orders in 11 months to anyone paying 50 cents each, the U.S. Supreme Court said, "to call such an order... a physician's prescription would be so plain a perversion of meaning that no discussion of the subject is required." (11)
Physicians fully support the basic standard of our federal narcotics laws that narcotics be used only in good faith in the course of professional treatment. The medical community in the U.S. has stated views quite consistent with the legal interpretations of the Federal Bureau of Narcotics (12). In addition to the joint statements of May 1962 by the American Medical Association and the National Research Council, a more detailed statement is that of the American Medical Association, published in its Journal in 1952 (13). This states the following basic position:
"In general, the physician will be acting in accordance with the consensus of medical opinion with regard to addiction and will be complying with the letter and spirit of the regulations if he follows two principles:
Ambulatory treatment of addiction should not be attempted as institutional treatment is always required;
Narcotic drugs should never be given to an addict for self-administration,"
It is the principle that" ambulatory treatment of addiction should not be attempted as institutional treatment is always required" that, combined with the lack of available institutional facilities, presents a doctor's dilemma in how to treat an addict patient.
Addicts may refuse hospitalization because they are not really seeking treatment of their addiction but only a source of drugs. In other cases the motivation may be genuine but circumstances may be a serious deterrent. Addicts who have been able to keep their addiction secret and maintain themselves in the community may reasonably fear that extended hospitalization will interrupt their employment and normal associations for too long a period. The choice between hospitalization or continuation of addiction is for them and their physicians a harsh dilemma.
There are many addicts who have a genuine motivation to seek treatment but not enough to overcome the compulsion of the addiction. These addicts are too sick to accept the necessary treatment. If facilities are available they can be involuntarily hospitalized in some states. If hospital facilities are not available, the prevailing practice in the U.S. is to abandon treatment. Some physicians would support efforts to maintain such addicts with medically administered narcotic drugs while trying every means to strengthen them to the point where they are willing and able to accept withdrawal.
In addition to the compelling facts of the unavailability of hospital facilities for addicts and the resistance of addicts due to the nature of addiction, there is need for some flexibility in the norm of hospitalization. The history of medicine, as of all science, included many beliefs that became dogmas and were accepted as scientific. Medicine has been credited by some with being more alert than law to this danger. It was a great jurist, Justice Holmes, who said, "An ideal system of law should draw its postulates and its legislative justification from science. As it is now, we rely upon tradition, or vague sentiment, or the fact that we never thought of any other way of doing things, as our warrant for rules which we enforce with as much confidence as if they embodied revealed wisdom (14)." If medicine is less open to this charge, it is because of the scientific discipline of continual testing of current beliefs and practices by research and experimentation. Neither medicine nor law should make hospitalization for the treatment of drug addiction a dogma unchecked by controlled research on other methods of treatment.
The trend of modern psychiatry is strongly in favour of voluntary treatment of patients with mental disorders. The nature of a disorder may make involuntary treatment necessary in some situations. Then medicine must look to the law for reinforcement. Medicine must also look to the law to provide social supports that help, and to control social stresses that hinder treatment.
In narcotic drug addiction there are three critical problems of this general nature. One problem is the addicts who are unwilling to undergo treatment. For these, one course of action is civil commitment, but the immediate question then is commitment to what. A committee of the U.S. Senate in 1956 reported: "A startling number of those states which have legislated against drug addiction and prescribed mandatory treatment have failed to provide even the minimum facilities required for treating addicts (15)." We need provisions for civil commitment for addiction as for other mental disorders, but we should not delude ourselves into thinking that commitment to purely custodial institutions means treatment. Unless hospitals are available for actual treatment of addicts, civil commitment laws are useless legal instruments, or devices for imprisonment under another name rather than for treatment and rehabilitation of the addict.
Provisions for civil commitment also need safeguards for continuing evaluation, improvement, and new methods of treatment. At the recent White House Conference on Narcotics, a knowledgeable and devoted community leader in the field of narcotic addiction, the Rev. Norman Eddy, said, "We of the New York Council on Narcotics Addiction are fearful that one approach may pre-empt the field. Specifically, we oppose the civil commitment and parole programme, except on an experimental basis (16)." These views on civil commitment are reconcilable and should be reconciled in any civil commitment programme. Experiments such as Synanon, for example, should not be thwarted by compulsory civil commitment to hospitals.
Some addicts who want treatment are too unstable to continue it long enough to be effective. Some addicts want treatment of their addiction, others want to reduce their drug requirement and get a fresh start on the insidious process of drug tolerance and physical dependence. They gain admission to a hospital, get some benefit of medical care and then leave prematurely. Some who enter with the best intentions are subject to acute anxiety and panic reactions during the withdrawal period or later over-optimism. Dr. Nyswander of New York City, a physician noted for her espousal of new ways of treatment for addicts, has written: "At some point in the treatment it is inevitable that the patient will become frightened by his own decision to go off drugs. At this juncture the physician will have to be extremely patient, retracing and reaffirming the thinking that went into the patient's original resolution. However, the addict's fright will often become so pronounced that no amount of reassurance will reduce it. This is the time to provide custodial care." Also she says: "The simple fact is that the finest medical treatment can be totally invalidated if the basic and ever present custodial needs of the patient are neglected (17)." But at any hospital treating addicts as voluntary patients, the convalescing addict may walk out - against medical advice. About one-third of the voluntary patients at the Lexington PHS hospital leave within two weeks.
Two ways of getting at this problem seem worthy of consideration. One is exemplified by New York State's statutory provision for civil commitment on voluntary application by the addict himself, so that it is his decision to seek hospitalization but his decision is reinforced by legal authority as well as medical advice when he has to fight his addiction through the crises of recovery. The New York State Legislative Committee on Narcotic Study points out that this provision dates from 1909 (18). Another way would be to maintain the voluntary character of admission but to provide for detention during periods of crisis during treatment. It would be intended to help the addict through his panic, as an alcoholic might be restrained through an attack of delirium tremens or any patient during a transient mental disorder.
Addicts commonly relapse after hospital treatment, but it is an over-simplification to relate this exclusively to the addict or the inadequacy of treatment. If a treated susceptible individual is re-exposed to an environment conducive to relapse he can be expected to relapse whether his disease is narcotic addiction or tuberculosis. An environment where drugs are easily, available assures relapse of treated addicts. Continued care is necessary to prevent re-addiction, even after the best of hospital treatment and effort on the part of the patient. Unfortunately only a little has been accomplished or even attempted in this phase of treatment of addiction. Repetitive hospitalization and jail sentences are common. Systematic preventive measures by competent health and other social agencies to maintain the ex-addict's rehabilitation in the community are scarce. California and New York have started programmes of post -hospital care. The Public Health Service has conducted a demonstration in New York City in order to assist local agencies to extend their services to former drug addicts, and to learn more of the patterns of relapse and adjustment. There are some heroic non-governmental efforts on a small scale, limited by insufficient financial support. The East Harlem Protestant Parish, under the leadership of the Rev. Norman Eddy, has had a programme ranging from the prevention of addiction to helping theex-addict get a job, psychotherapy, legal aid, religious support, and friendly social relationships that accept the ex-addict as an individual and sustain him in living without drugs.
Narcotics Anonymous, a society of ex-addicts similar to Alcoholics Anonymous, founded in 1948, has struggled against community suspicion and lack of resources to give some ex-addicts the support of mutual understanding and active personal interest in each one's fight to live without drugs.
One of the most encouraging projects in rehabilitating addicts and preventing re-addiction is that of the New York State Division of Parole. In the initial phase of this project, parole officers supervised 346 parolees who had been addicts. With 30 or fewer men for each probation officer, there was more personal attention, counselling and aid in employment, education, and supervision of leisure activities. The results over a three-year period showed that more than 40% of the parolees did not relapse to drugs. The costs of this project were estimated at $ 250 per year per parolee compared with a cost of custody in a correctional institution of over $ 1,900 (19).
These are all hopeful moves towards restoring ex-addicts to a normal life in the community but we need much more of both study and action. The ex-addict's problem is nothing less than the reconstruction of his life. He needs a home, a job, counsel that will build his self-respect and self-confidence. He needs associations that will take the place of those centred on the drug habit, and medical care to maintain his physical health, to ameliorate the underlying emotional and personality problems that make him susceptible. He needs help in crises when nothing seems as important as the relief that drugs can give him.
The ex-addict faces these problems with the added handicap of his identity as an addict, and probably as an ex-convict. If other elements of the community reject him on this account his former associates in the drug habit can usually be counted on to receive him and the police will do their job of enforcing the law as it is written. The treadmill continues, but the readdiction problem is not solved.
Two points in this connexion deserve special emphasis: the importance of continuity in treating addiction all the way from its incipiency to full rehabilitation; and the alternative between abandonment after a first or second or third relapse and successful rehabilitation even after multiple relapses.
When the first preventive measures fail and the drug user becomes an addict, it is time to look to his post-hospital rehabilitation as well as to the immediate need of hospital treatment. Before he leaves the hospital there should be assurance of what he is going to do for himself and what others are going to do to help him. Such devices as "half-way houses" deserve at least more trial than they have had. As the addict tries to establish himself in a life without drugs, any ordinary difficulty- lack of a job, family problems, simple loneliness- may send him back to drugs. His defences need to be continuous.
Any relapse to the use of drugs is serious but whether it becomes re-addiction or only a temporary set-back may depend on how it is treated. If it is taken as proof of the hopelessness of the case, the drug-user can be expected to give up too. If it is taken as a temporary set-back calling for treatment rather than punishment or abandonment, it may be no more than that. It is a mistake to over-estimate the significance of relapse. Relapse, even to the point of re-addiction, calls for treatment directed to the causes and prevention of further relapses. Underlying emotional and personality disorders are likely to bring about re-addiction unless the predisposing factors in the individual or his environment or both are corrected. This does not mean "Once an addict, always an addict." There are recoveries even after numerous relapses. The man who founded Narcotics Anonymous, for example, was hospitalized eight times before he made a complete recovery. The experience of relapse may be a preliminary to successful rehabilitation, because it provides the addict with recognition of the realities of himself and his disease.
Measures to prevent relapse may have to include an element of authority, whether the ex-addict is discharged from a hospital or paroled from a penal institution. Civil commitment laws should require post-hospital treatment and supervision. Venereal disease was controlled by making treatment mandatory. The authority of such "an autocratic family structure" as Synanon may serve the purpose. Whatever the particular means, the personality traits of dependency and immaturity characteristic of most addicts seem to demand, and be responsive to, this element of authority, provided it is a friendly, supportive authority rather than a hostile, threatening one.
IV. Addiction and Crime
What a narcotic drug addict, or anyone else, does is a matter of conduct subject to the prohibitions of the law; but addiction is a disease, a mental and physical disorder with which the addict is afflicted, not something he does. Addiction usually results from his conduct, but the disease is as distinct from his conduct as syphilis and paresis are distinct from the intercourse that preceded them. Our federal laws impose penalties on illegal conduct in relation to narcotic drugs, but there is no federal law that makes addiction a crime. Some state laws have done so, but the U.S. Supreme Court in June 1962 held it to be unconstitutional to make it a criminal offence to" be addicted to the use of narcotics ". In the words of the court:
"It is unlikely that any state at this moment in history would attempt to make it a criminal offence for a person to be mentally ill, or a leper, or to be afflicted with a venereal disease. A state might determine that the general health and welfare required that the victims of these and other human afflictions be dealt with by compulsory treatment, involving quarantine, confinement, or sequestration. But, in the light of contemporary human knowledge, a law which made a criminal offence of such a disease would doubtless be universally thought to be an infliction of cruel and unusual punishment in violation of the Eighth and Fourteenth Amendments.
"We cannot but consider the statute before us as of the same category (20)."
It would be convenient if physicians and legal authorities could separate their interests at that point and each concern himself solely with his special interest. But the addict is still one person even though his addiction is clearly a disease and what he does to maintain it is usually a crime, under both federal and state laws. As a consumer of illicit narcotics, the addict is an essential part of the illicit traffic, which our laws and our law enforcers are devoted to eliminating. The addict is a consumer of illicit narcotics, and hence a criminal, by force of his addiction. He may have started as a voluntary experimenter in the use of drugs but when he is addicted the compulsion to use drugs is ever present and overwhelming. Punishment does not cure him, or the fear of punishment deter him. He can be locked up, at great cost to himself and society, but to rehabilitate him as a useful member of society requires treatment of his addiction and its underlying causes. Strict laws and strict enforcement against illicit narcotics are also indispensable for the prevention of addiction or relapse of the treated patient. Our mutual concern, therefore, is to design our laws and their administration to get at the causes of addiction and minimize the disease, the illicit traffic, and crimes that addicts commit to pay for narcotics.
Considering the characteristics of addiction, and its underlying causes, how well are our penal laws adapted to controlling it ? Mr. Kuh, Assistant to the District Attorney of the County of New York, has said, "In combating heroin addiction in our largest cities, law enforcement has failed dismally (21)." This is a respected lawyer's judgement. Fortunately, since Mr. Kuh published this comment in 1961, there have been some improvements.
From a medical point of view, the following are some features of our federal or state laws in the U.S. that would seem to call for further consideration in terms of effectiveness:
Legal procedures, such as release of narcotic drug addicts on bail, which are appropriate to criminal prosecution but do not provide for the person's immediate need for treatment of his addiction;
Jail sentences that add to the addict's circle of criminal contacts and his own degradation and handicap him rather than help him in any attempt at rehabilitation;
Prison sentences, without parole, that destroy the individual's motivation to rehabilitate himself, crowd the prisons, and preclude post-institutional supervision;
Restrictions on judicial discretion that prevent intelligent consideration of individual cases.
Developing sound policy in these areas of over-lapping medical and legal interests is a task for all those concerned and not for any one professional group. Physicians are not equipped and have no ambition to write penal laws but they may be able to help. When Justice Cardozo gave his ideas of "What medicine can do for law ", he spoke particularly of the law of crime (1).
Some alternatives are already available for more effective handling of addicts who violate the law in order to maintain their addiction. Some alternatives depend on a policy decision. Some may require new programmes with facilities and staff to make them effective. Parole requires competent staff and community co-operation, but it releases custodial staff and overcrowded facilities. Its benefits can be made available by changing the laws that exclude its use and following through with such projects as New York's. Other restrictions on judicial discretion in sentencing are likewise matters of legislation and not dependent on construction of facilities or new programmes.
Treatment as an alternative to criminal prosecution does depend on facilities and staff to provide the treatment. This may require new facilities, but more could be done with existing facilities if they were opened to addicts. Jails and prisons also require facilities and staff. If the purpose is to take addicts out of the illicit narcotic drug market and rehabilitate them, the choice between prosecution and treatment is a question of effectiveness. One thing that can be said for our penal laws is that they have been used to coerce many addicts into seeking treatment. If this is sound it should be recognized as public policy and accomplished directly and openly. More of our health resources - hospitals, physicians, social agencies - should be enlisted to deal with the problem
V. Learning more about narcotic addiction
Much excellent research has been done and is being done in the laboratory and hospital, but relatively little in the community. We do not have the data, or established methods for acquiring the data, that are needed about drug addiction as it exists in the community.
Public health knowledge in general rests on systematic reporting by attending physicians, and other sources of original information, to state or local public health agencies. The use of such reports by the public health agencies provides correlated, meaningful data and a basis for necessary public health action. In the field of narcotic addiction there is no systematic method of developing health information as a basis for health measures. In some states a start has been made and a more complete programme could be developed in the light of their pioneering and the general development of public health methods. In addition to the work that law enforcement agencies do in reporting data for law enforcement purposes, it is clear that health agencies have a distinct and additional job of health intelligence to perform. The difference between an offence against the narcotics laws and addiction as a medical condition underlies the important difference between health data and enforcement data. The responsibility of health agencies should be established on as clear a basis as that of enforcement agencies.
There are some obstacles to gathering necessary health data regarding narcotic addiction. In some states physicians are required by law to report any drug addict whom they attend. If such reports are made only to health authorities and used exclusively for health purposes, not for prosecution, it may be possible to encourage addicts to seek treatment. Fear of disclosure to enforcement authorities keeps the addict away from legitimate treatment. The confidentiality of the addict's disclosure of his condition to a physician, except as required for health purposes, would be a small concession to the need for more professional knowledge of addiction.
VI. Community action in treating narcotic drug addiction
There is increasing conviction among those concerned with the prevention and treatment of mental disorders in general that community health services are the most effective method. The tradition of isolating mentally disordered patients in institutions removed from the community is changing even though it is far from being wholly replaced in practice. As expressed by the New York State Legislative Committee, "Narcotics addiction represents perhaps the one major mental health disease entity which is now completely ignored by community mental health resources (22)." The community approach is as valid for narcotic drug addiction as for other mental disorders. It would deal with the problem where the problem exists, and with the factors that contribute to the problem, in the individual's family, his school and work experience and his associations. It would utilize the variety of community agencies that are necessary. It would provide continuity in understanding and helping the susceptible individual, whether in preventing addiction, in treating it, or in preventing relapses.
As the World Health Organization's Study Group on Treatment and Care of Addicts has said, "It is in the community that the final phase of adjustment and adaptation should occur (23)." We seem to be learning that the intermediate stages may also best be dealt with in the community. Clearly, we have a long way to go, but the direction seems to be towards community services with appropriate state and federal assistance.
VII. Conclusion
Proposals have been made for acquiring "definitive information" regarding all aspects of narcotic drug addiction and accomplishing a "sweeping reform" of our present laws and procedures. Such proposals are apt to be illusory. What we can do, both realistically and constructively, is ( a) to approach the problem in an attitude of seeking to make the best use of what knowledge we have while we develop through research and experiment more knowledge and more effective methods; ( b) to review whatever in our present laws or practices may be a handicap in our efforts to prevent and treat addiction and rehabilitate addicts as useful members of society; and ( c) to develop through collaboration such programmes as seem likely to move in the right direction. This means less emphasis on simple formulas for getting rid of the problem - whether by getting rid of the addicts by placing them all in institutions or by accepting their addiction as a way of life and making drugs easily available. It means combining experience and thought as in this Conference on Legal Medicine, and more translation of the product of this interprofessional exchange into the thinking of our policy-making bodies, including the citizens of our local communities who will accept or reject any proposed solution and determine how effective it will be in practice
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Bureau of Narcotics: "Active Narcotic Addicts reported in the U.S. as of Dec. 31, 1961 ".003
FRANKAU & STANWELL: "The treatment of drug addiction ", The Lancet, 24 Dec, 1960, p. 1377.004
LOWRY, J. V.: "Hospital treatment of the narcotic addict", Federal Probation, Dec. 1956.005
YABLONSKY, L.: "The anticriminal society: Synanon", Federal Probation, Sept. 1962; "S.S. Hang Tough ", Time Magazine, 7 Apr. 1961; Senator Thos. J. Dodd, "A Study in Heroism ", statement in U.S. Senate, 6 Sept. 1962.006
Press releases, 14 May 1962.007
KUH, R. H.: "The narcotics offender and the criminal law", Inter-American Conference on Legal Medicine. XXV.008
Bureau of Narcotics: "Active narcotic addicts reported in the U.S. as of Dec. 31, 1961 ".009
SHARTEL & PLANT: The Law of Medical Practice, 1959, p. 320.010
Council on Mental Health, A.M.A.: "Report on narcotic addiction ", p. 51, reprinted from Journal of the A.M.A., 14 Dec. 1957.011
Webb v. U.S., 249 U.S. 96 (1919).012
Bureau of Narcotics: "Prescribing and dispensing of narcotics under Harrison narcotic law", pamphlet No. 56, rev. Sept. 1960.013
Journal of Amer. Med. Assn., vol. 149, 25 July 1952, p. 1220.014
HOLMES, O. W., Jr.: "Learning and science ", in Collected Legal Papers (1920), p. 138.015
U.S. Senate, Committee on the Judiciary, Subcommittee on Improvements in the Federal Criminal Code: "Laws controlling illicit narcotics traffic ", document No. 120, 84th Cong., 2d Sess., 1956, p. 45.016
EDDY, Rev. Norman: Mimeographed release at White House Conference on Narcotics and Drug Abuse, 27-28 Sept. 1962. (Proceedings being prepared for publication.)017
NYSWANDER, Marie: The Drug Addict as a Patient (1956), pp. 113-114.018
State of N.Y,: Report of Joint Legislative Committee on Narcotic Study, 1959, p. 36.019
DISKIND, M. H.: "New horizons in treatment of narcotic addiction ", Federal Probation, Dec. 1960.020
Robinson v. Calif., 82 Supreme Court Reporter 1417 (25 June 1962).021
KUH, Richard H.: "A prosecutor's thoughts concerning addiction ", Journal of Criminal Law, Criminology and Police Science, vol. 52 (Sept.-Oct. 1961), p. 321.022
State of N.Y.: Report of Joint Legislative Committee on Narcotic Study, 1959, p. 60.023
WHO Technical Report Series No. 131 (1957), p. 11.


text:
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See also: Cancer, Oncology Nurses, Nursing on Twitter, http://www.nursingdiscussions.com/cancer
Leah Korkis, BSN, RN, Healthy Now and Later:"Healthy Now and Later is a free resource for caregivers and those 55+. There they will find information on common
health topics, health promotion recipes for special diets, and a nation-wide database of local services and financial aid.
For further information or clarification, visitors may also "Ask A Nurse"."
Shannon Garrett, BS, RN, CHLC, Shannon Garrett Wellness, @AutoimmuneRN, Tennessee Nurse Entrepreneurs, Health Coaches:"I provide holistic health, wellness, nutrition, and lifestyle coaching for women who struggle with the many complexities of living with autoimmune or other chronic health issues. I have a 12 week program I work them through to help them reach their goals and I provide a NANDA wellness care plan for them. I personally have three autoimmune issues and know what these women go through. Medication nor diet are stand-alone treatments. Lifestyle issues are an integral part of healing and I help them work through challenges."
Daniel P. Gracie, DNP, RN-BC, Nursing Informatics Institute, South Carolina Nurse Entrepreneurs:"The Nursing Informatics Institute is a provider of healthcare and nursing informatics. We offer courses on-site in topics such as project management, basics of nursing informatics, and nursing informatics review courses. Additionally we offer online study questions and are working on some books and online learning opportunities for the future."
Renee Thompson, DNP, RN, RT Connections, LLC, @RTConnections:"At RTConnections, I educate, connect and inspire current and future nurses. I started this company because I really believe that patients deserve to be cared for by competent, compassionate nurses and that nurses deserve to believe they make a difference. To make that happen I offer keynote presentations that help nurses take ownership of their practice; seminars and workshops to improve clinical and professional practice; and consulting to help organizations create nurturing and supportive work environments for employees and the patients they serve. My area of expertise is in professional development, nurse-to-nurse bullying, communication/collaboration, team building and academic service partnerships."
Med-Legal Healthcare Consultants, Inc (MLHCC):"Med-Legal Healthcare Consultants, Inc (MLHCC) is a team of Registered Nurses and other healthcare providers who provide a variety of services. These include Case Management, Legal Nurse Consulting, Geriatric Care Management, Life Care Planning and Nurse Coaching. We attend Defense Medical Exams(DME) and offer educational training and speaking services."
Nancy Banfield Johnson, MSN, RN, ANP, Nurse Mentor Nancy, @NurseMentorNanc:"On my blog and in my presentations, I give strategies to bedside nurses gain confidence, respect and prevent burnout. I published my first book 10/2012, "Catching Critical Changes, Six Essential Steps for Effective Nursing Assessment."
Patricia Ann Bemis, RN CEN LHRM, President & CEO, National Nurses in Business Association:"Love your work? Hate your job? Want more independence? Want more respect? Want more money? Join the NNBA and learn how to be self-employed or start a full or part-time business and love your job! Get more independence, respect, and money! I like to share information with other healthcare professionals. I am president of the National Nurses in Business Association, president of the Space Coast Emergency Nurse Association. I work as a online manager, course author and instructor with the University of Florida Professional Development Unit. Click here for Job Options in Nursing Utilizing Your Current Skills and Degrees!"
Facebook: https://facebook.com/patriciabemis
Linkedin: http://www.linkedin.com/in/patriciabemis
Blog: http://forensicsciencefornurses.com
Crown Legal Nurse Consulting, LLC, Erica Leach RN, CLNC:"Welcome To Crown Legal Nurse Consulting. Once your firm recieves our expert litigation support services, it will not be difficult to understand why we have been considered the attorneys best kept secret. Behind the scenes we will assist your practice with uncovering crucial case-winning facts which will increase your overall bottom line, save you time and money. Finding one vital piece of pertinent information during our analysis and investigation will strengthen your bargaining power during settlement negotiations. High powered legal firms have discovered the value of adding certified legal nurse consultants to their litigation team as behind the scenes experts. The winning combination of your legal expertise and the CLNC's healthcare knowledge enhances even the most authoritative and commanding courtroom presence."
Online Journal of Nursing Informatics:"The Online Journal of Nursing Informatics (OJNI) is a free, international, professional, refereed publication that focuses on nursing informatics in all practice settings. OJNI is committed to addressing the theoretical and practical aspects of nursing informatics as it relates to the art of nursing. CINAHL indexes the journal.
We are proud that our readership spans 49 countries!
The Journal was initiated in 1996 making OJNI the longest running journal dedicated to Nursing Informatics. "
Trisha Coady RN BScN MN(c), CoursePark.com:"We provide approved nursing continuing education in various clinical specialties such as cardiology, critical care, emergency, community health, etc. As well, we offer a leadership and regulatory catalog that can be consumed by either individual nurse professionals or healthcare organizations. Promoting community engagement, lifelong learning, and the Nursing profession. Together, we learn more."
Vanessa Wyche Graham, GrapeVine Innovations:"GrapeVine Innovations is the vision of ministry bestowed upon Vanessa Wyche Graham in 2004. The purpose of the ministry is to care for individuals throughout the lifespan in a holistic manner -- whether it be through pastoral care & counseling, training & education, or community outreach services. Having an extensive nursing background in the care of families, and a history of providing counseling to many individuals in the community, Vanessa has attained the certifications and experience necessary to provide a wide range of services to the community, while also creating employment opportunities for those who demonstrate an appropriate fit in the organization itself."
Beth Boynton, RN, MS Consulting Services:"Beth Boynton, RN, MS, Nurse Consultant & Author of award-winning book, "Confident Voices: The Nurses' Guide to Improving Communication & Creating Positive Workplaces". Speaker, trainer, coach, and writer specializing in teaching nurses positive communication and collaboration skills, emotional intelligence, group dynamics & leadership.
E-mail Address: firstname.lastname@example.com
Blogs: http://www.confidentvoices.com
Social Media Twitter: https://twitter.com/#!/BethBoynton
Linkedin: Beth Boynton, RN, MS
Facebook: http://www.facebook.com/profile.php?id=1458311533&ref=tn_tnmn
Homepage Address:
Patricia Iyer MSN RN LNCC, Patricia Iyer Associates, Med League Support Services, Inc.:"Patricia Iyer Associates provides legal nurse consultants with the critical information they need to succeed in their roles.
Med League Support Services, Inc. assists attorneys with the medical issues of their cases. We specialize in medical malpractice and personal injury cases, and supply expert witnesses and medical analysis in the form of timelines, chronologies and medical summaries."
Social Media (Twitter, Linkedin, Facebook, etc)
Connect with me
Michael Pergrem (AKA CoachPerg), LPN, Coach Perg – The Nurses Coach, Ohio Coaching Nurse Entrepreneurs:"Please describe in detail your business/services youprovide: I am a Life Transformation Coach for nurses. I help nurses avoid/recover from burnout and guide nurses desiring to make a career change to discovering their passions/calling/purpose and the means to get to the destination those discoveries determine for them."
Blogs: http://CoachPerg.com/blog
Social Media (Twitter, Linkedin, Facebook, etc)
Facebook.com: https://www.facebook.com/CoachPerg
Twitter @CoachPerg: https://twitter.com/#!/coachperg
LinkedIn: http://www.linkedin.com/pub/coach-perg/41/767/622,
Google Plus: https://plus.google.com/106217815179233967116/posts
Homepage Address: http://CoachPerg.com
Academy of Medical-Surgical Nurses (AMSN):"The Academy of Medical-Surgical Nurses (AMSN) is the only national professional nursing specialty organization dedicated to adult health/medical-surgical nurses. Its mission is to enhance the knowledge, skills, and professionalism of medical-surgical nurses in all practice settings through certification, education, nurturing relationships, and the promotion of quality nursing care and wellness."
Categories: Facebook Nurses, Medical Surgical Nurses, Nursing Associations Twtter Nurses
Campnursejobs.com:"Campnursejobs.com is a camp nurse job board and nurse recruitment resource designed to introduce nurses to camp employers in order to facilitate the hiring process for both sides.
For nurses, we strive to find the widest variety of camp nurse jobs by partnering with leading camps across the nation. Nurses can place their resumes online through our system and have interested employers contact them, and/or contact employers directly. There is never a charge to job seekers for our service.
For employers, we offer an affordable alternative to reach nurses interested in camping througha terrific niche job board, customized recruitment solutions and attractive advertising opportunities. For camp employers with nursing jobs to fill, we are the best recruiting resource available."
Shahina Lakhani, RN, MSN, ThroughLifeAndDeath.com, @ShahinaLakhani, Georgia Nurse Entrepreneurs:"Personal empowerment coaching for people going through major life change and serious illness. Support and coaching for caregivers and terminally ill. Personal empowerment/self help book: The forbidden love. Speaker on Personal empowerment, issues in nursing, hospice and palliative care and how to provide holistic care for the sick and the dying. Working on books on End of life care."
Facebook: https://www.facebook.com/ShahinaLakhaniBiz
http://www.ThroughLifeAnd Death.com
Tina Lanciault, RN, SmallBusinessNurse.com, Delaware Nurse Entrepreneurs, @tinalancio:"I provide nursing career advice and business ideas through my writing on both of my sites for new nursing grads and nurses wanting to make a change especially those nurses who are burnout and want to leave the bedside. There are options such as nurse entrepreneurship, Holistic nursing and Nursing Informatics, available to all nurses including LPN/LVNs. Lots of nursing resources, tips on finding a job or creating your own job plus many other tips and information just for nurses."
Social Media (Twitter, Linkedin, Facebook, etc)
Lori 'Minky' Radcliffe, RN, BS, CFNC, CFPC, Founder of Certified Fitness Nurse™ Academy, @loriminkyrad:"At CertifiedFitnessNurseCoach.com we are not personal trainers who happen to be nurses. We show nurses how to stay in the health care industry and promote exercise within a 'not-so-healthy' pre-diabetic population;and NOT try to be a nurse in the fitness 'percieved healthy' industry. Just as waist reduction is 20% exercise and 80% diet; Certified Fitness Nurse™ Coaches are 20% fitness and 80% nursing in our practice. We teach a physical-environmental-financial-social-emotional model... like a nursing assessment.
We offer a 23-hour certification course for nurses who are fitness enthusiasts, who want to help pre-diabetics, with a specifically designed program for them, that will improve their health and reduce their waists in a sustainable manner. This is done through a 12-week group coaching course
via the computer, video and telephone. We also teach you how to get started with only a few clients working part-time, from home and making full time money in a scalable business model. The physician and other health care professionals are actually where we get our clients and we utilize a fitness nursing assessment to determine the right minimum effective dose (M.E.D.) of diet, exercise and supplementation, the right client and the right time, which are the 3 Rights of a Certified Fitness Nurse™ Coach."
Homepage Address: http://www.CertifiedFitnessNurseCoach.com
Crunchy Nurse @Crunchynurse:"Former pediatric nurse, now full time mama. Homeschooling, special needs, aspergers, celiac disease, GFCF, holistic, Christian, supporter of the Constitution."
Twitter Nurses, http://www.nursingdiscussions.com/twitter/
WoundRounds, Benefits For Wound Care Nurses:"As a wound care nurse, gathering data is a time consuming process. Entering data multiple times, filling out paper forms and searching for past notes to complete required documentation is inefficient and prone to error.
WoundRounds eliminates the need for hand written charting and redundant documentation.
Team collaboration for patient care is enhanced.
Patient information is electronically captured at the bedside and uploaded over the internet to secure servers. Information is immediately available over the Internet—whenever and where ever it is needed."
Gwenn Dalton, RN, CEO/Educator, Pro Hospice Solutions, LLC, Texas Nurse Entrepreneurs, Hospice Educators:"Pro Hospice Solutions, LLC understands that care is more than tending to the physical end of life; it is a way of caring for the patient, their family, and
support group. Through our community outreach programs, mentorship programs, and continuing education workshops, we empower those care givers and end of life professionals with the ability to advance quality of life and to accept the gift of providing a compassionate end of life for their patient or loved one. Above all, Pro Hospice Solutions, LLC is dedicated to providing training and support for those Hospice Heroes and Healthcare Warriors who continue to fight for end of life rights!
Anna Morrison, BA, BSN, RN, CLNC, The EntrepreneNurse Group, LLC, Florida Nurse-Entrepreneurs:"Speaker, Keynotes, Seminars, Nursing Career Coach & Strategist, Blogger, Author, Soon to be Radio Show Host"
E-mail Address: firstname.lastname@example.com
Social Media Accounts:
Joni Watson @joniwatson Austin, Texas:"Nonprofit Director, RN, OCN, wife, mom, Christ lover, shoe junkie, reader, blogger, and oh, so much more."
Gwenn Dalton, RN, Pro Hospice Solutions, LLC:"Pro Hospice Solutions, LLC understands that care is more than tending to the physical end of life; it is a way of caring for the patient, their family, and support group. Through our community outreach programs, continuing nursing education and continuing education workshops, we empower those care givers and end of life professionals with the ability to advance quality of life and to accept the gift of providing a compassionate end of life for their patient or loved one."
Continuing Education,http://www.nursefriendly.com/ceu/
Sharon Gauthier RN/MSN-iRNPA, Patient Advocate for You, LLC:"Our services coordinate care, educate patients and families, collaborate with your healthcare team and support your needs with a personal seasoned RN patient advocate. We do not provide hands on care and don't replace home
care agencies. We are adjunct to your support system while expanding your resources to stay well. Relieving your stress is our expertise. We are your voice helping you navigate through the system. We tell your story and make sure someone listens. We are a well respected addition to your present healthcare team by your side throughout the system you are in, evaluating, collaborating, educating and supporting you and your family."
Lynette Damir, RN, CEO and Creative Director, SwaddleDesigns
Lynette Damir, RN, CEO and Creative Director, founded SwaddleDesigns in 2002. The inspiration for SwaddleDesigns was sparked when Lynette visited families with new babies in their homes and she noticed they struggled with swaddling for two reasons. First, the blanket they were using was too small or too thick, and second, they could not remember how to make a good secure swaddle. The parents consistently asked her to share the secret of the hospital nurses - how to swaddle."
ARN Consulting:"ARN Consulting is dedicated to empowering attorneys by providing competent, comprehensive, and cost-effective evidence-based opinions of medical records. Medical knowledge is the key to successful litigation for plaintiff or defense, and we are determined to unlock discovery of relevant issues and provide expert testimony to protect consumers and providers."
100 Best Twitter Feeds for Nurses, UltrasoundTechnicianSchools.org:"While many consider nursing to be a rewarding profession, it can also be a stressful one. For many nurses, having a community of support can create a positive way to release some of the stress involved in their day-to-day experiences. Twitter provides an excellent opportunity for nurses around the world to connect in this way. From feeds discussing nursing as a career to the best LPN to RN programs, this collection of Twitter feeds promise a wealth of information and fun for nurses everywhere."
Dermatology Nursing:"Dermatology Nursing, the official journal
of the Dermatology Nurses' Association (DNA),
is nursing's #1 skin care resource. The journal
publishes state-of-the-art, peer-reviewed
articles on all aspects of skin and wound
care. Dermatology Nursing provides its readers
with the multifaceted information they need
to provide clinically excellent patient care
and to enhance their patient care practice."
@Lainey315 Michigan:"R.N.,currently working with long term ventilator dependent patients."
factnurse @factnurse Kansas The Sunflower State:"RN, Sister, Aunt, Daughter, Love to travel, NFL, College football, sports in general, Politics - wish democrats and republicans were nicer to each other.
@seejanenurse Lost in your limbic system.:"Oh! A medication dispenser!"
Sharon Gauthier RN/MSN-iRNPA, Patient Advocate for You, LLC:"Our services coordinate care, educate patients and families, collaborate with your healthcare team and support your needs with a personal seasoned RN patient advocate. We do not provide hands on care and don't replace home
care agencies. We are adjunct to your support system while expanding your resources to stay well. Relieving your stress is our expertise. We are your voice helping you navigate through the system. We tell your story and make sure someone listens. We are a well respected addition to your present healthcare team by your side throughout the system you are in, evaluating, collaborating, educating and supporting you and your family."
Amber Keinath, Registered Nurse and Health Coach:"Amber is a Registered Nurse and Health Coach who is very passionate about educating and inspiring women to be healthy for life. She started her nursing career working in the medical, postpartum & newborn, and pediatric specialties in both inpatient and outpatient settings. Amber continued her education by completing her Master's Degree in Nursing with an emphasis in Wellness Promotion and becoming certified as a Health Coach.
From Hospital Nurse to Health Coach: During Amber's nursing career, she began to question her ability to help people in the hospital. She witnessed many people get discharged from the hospital with more medications only to wind up readmitted a few days later. People were not getting healthier despite all the care provided. She felt there was a better way to help these people."
Alana Ngo
@alana_ngo Massachusetts, USA:"I'm currently working as a nurse. Praying that it's God's will for me to be accepted in a Nurse Practitioner program. God bless to everyone around the world."
Alicia Sable Hunt, Founder & President of Sable's Foods, @SablesFoods Connecticut:""As a Registered Nurse, it is my role to collaborate with the healthcare team to educate the patient and provide them with the skills they need to travel the cancer journey. After years of working with cancer patients, I decided to develop a handcrafted bar focusing on their nutritional, taste and texture needs. I am proud to offer my bars to the cancer population as part of a nutritionally balanced diet."
– Sable, RN and Founder"
Rosita Rodriguez
@RoRod101 United States:"Healthcare Professional (Registered Nurse, Nurse Practitioner, Educator, & Doctor of Nursing Practice)."
All Things Nurses
@AllThingsNurses Nashville, TN:"The voice of AllThingsNurses.com, the online hub community to empower nurses. Amplifying conversation, online articles, blogs, and resources."
Helen Elliott
@epnurse1994 ÜT:"Clinical RN-OU Medical Center Cardiac Electrophysiology Lab"
@jm_healy Charlotte NC:"Nursing, Owned a Retail store, Technology, NeuroSci, Fast machines, Parenting, Forensics, Finding my moxy, SteelerFan, born and bread."
Mary Verrilli
@mv Seattle:"mother of three, and sometimes more, RN, Health care advocate, case manager and health literacy interpreter."
Dan Weberg
@NurseDan Phoenix, AZ:"ER Nurse, masters degree in healthcare innovation, PhD student health innovation, Own innovation business, changing the world."
@AllMyNurseJobs Nationwide USA:"The Registered Nurse and Nurse Practitioner Job Board dedicated exclusively to Professionals with the desire to succeed."
Andrew Lopez, RN @nursefriendly New Jersey Registered Nurse, we review and approve healthcare websites on our site. Follow/Search us for Diabetes, Cancer, Cardiac, Respiratory, Drug Resources and more. http://www.nursefriendly.com/social/ ******************************************************
American Academy of Nursing:"The Academy serves the public and the nursing profession by advancing health policy and practice through the generation, synthesis, and dissemination of nursing knowledge. Every day across America, the Academy and its members create and execute knowledge-driven and policy-related initiatives to drive reform of America's health care system.
AAN's 1,500 members - known as Fellows - are nursing's most accomplished leaders in education, management, practice and research. They have been recognized for their extraordinary nursing careers and are among the nation's most highly-educated citizens; more than 80 percent hold doctoral degrees, and the rest have completed masters programs. Sixty-four percent of the Fellowship work in academic settings, 30 percent work in service and practice settings, and about 3 percent work in state and federal government agencies."
Name Christine Anne,
Location St. Louis, MO:"Bio Christine Anne is a nurse practitioner and educator focusing on STRESS SOLUTIONS for life and business by using natural
Rita Batchley
@thenursesnurse:"The Nurses Nurse is the pen name for Rita Batchley, an RN, and healthcare activist who wants you to be aware of the healthcare injustices that are occurring everyday, and the real-life role registered nurses play to save you from disaster. After reading her novel, Labor Pains, you will understand the truth behind insurance companies and what you can do about it.
People trust that RNs care. For the seventh year in a row, the Gallop poll ranked nurses highest as the most trusted profession. Now,with the advent of healthcare reform, nurses will have even greater challenges seeing that patients get the kind of treatment they need, as well as protection from serious harm. Remember: A doctor will admit you to the hospital but it's the nurse who will make sure you get to go home."
TheresaBrown, @TheresaBrown Pittsburgh:"I'm an oncology nurse who writes about nursing. Read my book: Critical Care: A New Nurse Faces Death, Life, and Everything in Between (June 2010, HarperStudio)
Ashleigh Pugh-Clarke
@Ashleigh_RN Toronto, ON:"MN, BScN, RN, CON(C)- Oncology Nurse Educator/ Technology Coordinator in Toronto. Lover of life & lifelong learning. My tweets are my own."
The Best Defense Is a Good Documentation Offense, Corexcel.com:"After completion of The Best Defense Is A Good Documentation Offense, the participant will be able to:
Categories: Charting, Documentation, Nurses Notes, Continuing Education, Delaware Businesses, Delaware Nursing Resources, Facebook, LinkedIn, Twitter
DebErupts, Name Deborah, RN, JD:"Bio 30 year career in Nursing and Law. Activist in HCR. Artist. Writer. Mom caring for daughter w/recent C5 spinal cord injury. Believe!"
Andra DeCarlo, RN, Summit Medical Litigation Consulting, Inc.:"Andra DeCarlo, owner of Summit Medical Litigation Consulting and her team of nurses provide Legal Nurse Consulting for both defense and plaintiff attorneys looking for a clear explanation of what actually happened with the client. Is there a case? Is there a defense? We specialize in looking outside-the-box to help find the key to the case. Nursing home neglegance, PI, Medical Malpractice and more."
Amanda Dieterich, RN, The Cruise Academy:"Amanda is a Registered Nurse with a passion for cruising who also runs a small cruise agency with her husband, Bob.
When New Jersey & Pennsylvania announced the newly instituted requirements for 30 continuing education hours to be earned every two years, I thought, Why Not a cruise seminar?
We're now in our fifth year of continuing education cruises for nurses. We hope to offer more seminars every year. We are currently doing 2 seminars yearly, and will expand to more by 2011.
When you call The Cruise Academy, you'll be greeted by Bob or Amanda."
Emergiblog.com, The Life & Times of an ER Nurse:"My name is Kim McAllister, and I'm a registered nurse in the San Francisco Bay area. I graduated in 1978 with my ADN and have been a nurse for 32 years.; I graduated in 1978 with my ADN. My experience is predominately Emergency and Critical Care, but I also worked in Psychiatry and did pediatric telephone triage. I made the decision to be a nurse back in 1966 at the age of nine."
California Nurses, http://www.nursefriendly.com/california/
Laresa Enderes Cline, RN
Jennifer A. Grisso, RN BSN LNC, GrissoMedLegal:"Experienced RN with recent experience in most areas including: Telemetry, Cardiac, CCU, Stepdown, MedSurg, ER, ICU, Ambulatory, Telephonic Triage, Telephonic Disease Management. We bridge the legal and medical world. We are involved in any type of litigation that involves injury or illness, to save you time and money on the medical record, research, chronology. Also we help you prepare for depositions, mediation, or trial, all at a lower cost than other medical professionals."
Wendie A. Howland RN-BC MN CRRN CCM CNLCP LNCP-C:"Wendie A. Howland RN-BC MN CRRN CCM CNLCP LNCP-C brings decades of great experience to your cases. She is a graduate of Boston University, Boston MA (Bachelor of Science, Nursing), and the University of Washington, Seattle WA (Master in Nursing, Physiological/Critical Care, thesis program, award for research).
Following a full career in critical care at world-class medical centers (Stanford University Hospital, University of Washington) she embarked on more than a decade's experience in catastrophic case management and life care planning for catastrophic and high-expense chronic conditions. She has done files for primary and reinsurance carriers in worker's compensation and liability, working with both defense and plaintiffs. Expertise in research, clarity in writing, meticulous detail, and organization are the hallmarks of her work, as evidenced by her satisfied customers in many markets."
Tina Lanciault (Owner, Smallbusinessnurse.com):"A nurse here who is also a blogger, Affiliate marketer and Author of the smallbusinessnurse.com."
Donna Maheady, Ed.D., ARNP, ExceptionalNurse.com:"A resource network for nurses and nursing students with disabilities. We provide links to disability related organizations, mentors, employment opportunities, financial aid, continuing education, books, equipment, legal issues, research, related articles as well as support and career counseling.
Marybeth Mills, RN, Time for Nurses:"Time for Nurses is here to help spark a public conversation about improving the work-life balance of nurses nationwide. The site is run by OnCall Scheduling Solutions of Westborough, Mass., and we encourage contributions by nurses and medical professionals about how to improve scheduling and make life better for nurses everywhere.
OnCall Scheduling provides an advanced, affordable, easy-to-use Web 2.0 service to help nurses manage their work lives better and to help hospitals reduce the unnecessary costs of hiring last-minute temp workers. See the For nurses or For administrators pages for descriptions of how OnCall benefits nurses and hospitals while reducing costs.
Categories: Massachusetts Nurses, Nursing Agencies, Staffing Resources. Nursing Entrepreneurs, Nurse-Owned Businesses, Twitter Nurses
Katie Morales, RN, C, LNC, BSN, DisceRNment, LLC:"Why Choose DisceRNment, LLC? As we enter our fifth year serving Georgia's legal community, DisceRNment, LLC thanks you for helping us grow into your Southeast legal nurse consulting choice. DisceRNment, LLC saves attorneys time, money, and effort."
Category: Georgia Legal Nurse Consultants, Georgia Nurse Entrepreneurs, Georgia Nurses
Mosby's Nursing:"Bio Mosby's Nursing Suite is an online resource that gives everyone in your organization the confidence they need to consistently provide optimal patient care."
Twitter Nurses, http://www.nursingdiscussions.com/twitter/
NursePractitionerBusinessOwner.com, Barbara Phillips, NP:"The NPBO is a private, members-only, resource website that gives you direct, searchable access to a wealth of information about exploring, starting, or growing your own practice or business. As a member, you'll receive 365 days of uninterrupted, 24-hour access to the Member-Only Area of our site."
Follow on:
Nurse Practitioners
@NurseTogether Here and There:"A daily dose..er, TWEET of nurse empowerment. encouragement. enjoyment.",br>
PaddedCell (Australian, Psychiatric Nurse):"Let's just say I have an avid interest in the treatment of insanity"
Psychiatric Nurses, Psych, http://www.nursefriendly.com/psych/
Twitter Nurses, http://www.nursingdiscussions.com/twitter/
Pediatric Nursing @PedNursing Pitman, NJ:"Pediatric Nursing is a clinically based journal focusing on the needs of professional nurses in pediatric practice, research, administration, and education."
Categories: New Jersey Nursing, Nurses on Twitter, Pediatric Nursing
Safety Institute
@SafetyInstitute Charlotte NC:"Valuable online resource for healthcare-related information and tools that enhance patient, worker, and environmental safety."
Larry Snyder, BA, RN, DBA, RN.ORG, SA, Nursing Continuing Education Providers:"Larry Snyder, RN is the Founder and President of RN.ORG®, SA. As a licensed healthcare professional with over 15 years of experience in nursing as well as a computer authority with in-excess of 20 years of experience, he is knowledgeable with the integration of healthcare and computers and sees a strong need for licensed professionals to maintain their license in an easy, convenient, comfortable no stress environment. Larry has worked in various aspects of nursing in many states in both large and small hospitals and has the experience and background to make healthcare and nursing education friendly. Larry also functioned as a consulant at large corporations in various aspects of IT management including CBS Sports, Sportsline.com, Sports.com, Universal Studios, Nickelodeon, Viacom, Flexsys and Monsanto. Larry also has served as an expert witness on several high profile cases throughout the United States sharing his valuable input as an experienced Emergency Room nurse."
Categories: Emergency Department Nursing, Nursing Continuing Education, Nursing Education http://www.nursefriendly.com/educators">Nursing Educators, http://www.nursefriendly.com/informatics">Nursing/Healthcare Informatics
Stephborgmann, Twitter.com:"Bio I'm a RN and also a beachbody coach. Check me out at www.beachbodycoach.com/SBORGMANN"
Lisa Ann Stern:"Personalized Home Health Care and Geriatric Care Management for Seniors in Palm Beach County, Florida. At Stern Nursing Services (SNS), my goal is to help clients achieve the best quality of life possible. I understand that one solution does not fit every situation so I take the time to actively listen and learn about each client's needs and preferences. This enables me to tailor a care program that maximizes the client's independence and dignity."
Time for Nurses, Marybeth Mills, RN:"Time for Nurses is here to help spark a public conversation about improving the work-life balance of nurses nationwide. The site is run by OnCall Scheduling Solutions of Westborough, Mass., and we encourage contributions by nurses and medical professionals about how to improve scheduling and make life better for nurses everywhere.
OnCall Scheduling provides an advanced, affordable, easy-to-use Web 2.0 service to help nurses manage their work lives better and to help hospitals reduce the unnecessary costs of hiring last-minute temp workers. See the For nurses or For administrators pages for descriptions of how OnCall benefits nurses and hospitals while reducing costs.
Categories: Massachusetts Nurses, Nursing Agencies, Staffing Resources. Nursing Entrepreneurs, Nurse-Owned Businesses, Twitter Nurses
Joni Watson @joniwatson Austin, Texas:"Nonprofit Director, RN, OCN, wife, mom, Christ lover, shoe junkie, reader, blogger, and oh, so much more."
Karen Webb, @g00nergirl Cambridgeshire (UK):"married geordie mother, loves nursing and policy and advocates for the underdog. Tweets personally"
Teri Yarbrough, RN
Doctors On Twitter
Cynthia Bailey
Nursing Jobs, (Nurse, Medical Recruiters) on Twitter:
Health Medical Jobs: Bio Health care and medical jobs.
See also:
Patch Adams
@realpatchadams Arlington, VA:"Patch Adams is best known for his work as a medical doctor and a clown, and he is also a social activist who has devoted 40 years to changing health care.
Kevin Bernstein, MMS
@mdstudent31 Quakertown, PA:"4th Year Medical Student, Primary Care Advocate, Future Navy Family Physician, CrossFit, Runner, Drummer, Co-Founder: Future of Family Medicine Blog"
Jonathan, MS, NCC
@DrJonathan almost Chicago, IL:"4th yr med student,future FM resident,med media enthusiast,Host of DrJonathanLIVE!,National Certified Counselor,Brickman pianist,vocalist,actor,Notary Public."
Dave deBronkart
@ePatientDave Boston based:"International patient engagement advocate, speaker, author of Laugh Sing & Eat Like a Pig, blogger
Howard Luks
@hjluks NY:"Orthopedist navigating the intersection of Social Media and Healthcare. http://www.howardluksmd.com/disclaimer"
AgingInfoUSA:"Sue Salach-Cutler has worked in the geriatric healthcare field for close to 20 years and is the Author of "Along Comes Grandpa", a caregiving resource guide, and the novel "If I Walked in Her Shoes" (http://www.AlongComesGrandpa.com). As a National Speaker, Sue utilizes her personal and professional experiences to educate and empower professionals on the work/life affects of caregiving. ;As CEO of AgingInfoUSA she partners with companies to evaluate the cost of employee caregiving on their bottom line and implement cost effective solutions. Sue was the 2010 recipient of the YWCA Marguerite Henry Leadership Award for Communications/Technology and the Influential Women in Business Award from the Business Ledger and NAWBO. AgingInfoUSA received the 2010 Excellence in Business Award from the Business Ledger and was nominated for the Chicago Innovation Award."
Categories: Care Givers, Facebook/, Geriatric Resources, Geriatric Nurses, LinkedIn, Long Term Care (LTC), Twitter, Youtube
Christopher Bond, International Listening Association:"@cdbond St. Joseph, MO:"Professor of PR, Health Comm & Nonverbal Behavior; President @IntListening @CARPP; Health & #SM Researcher; International Listening Association
Cancer Care Ontario
@CancerCare_ON Ontario:"CCO is the provincial agency responsible for continually improving cancer services, and the Ontario government's cancer advisor."
Dave deBronkart
@ePatientDave Boston based:"International patient engagement advocate, speaker, author of Laugh Sing & Eat Like a Pig, blogger
@doctorfunnybone doctorfunnybone
Kansas PCMH
@KansasPCMH Wichita, KS:"Kansas Patient Centered Medical Home Initiative. Leading Health 3.0 ... people, process, practice. [Opinions are my own.]"
Lorraine Yarde, @RxDrugSAFE:"What is the price of a child's life? Provide a safe environment for your kids - lock up your medications today with Rx DrugSAFE
Twitter.com-Lawyers and Legal Professionals
MartinFletcherLocums:"Martin, Fletcher Locums™ offers a unique staffing experience for both the physician seeking locum tenens opportunities and the client who is in need of the talent and skills of a locum tenens physician. Our two-pronged recruitment approach allows our team to focus on physician needs and client needs independently.
As a member of the National Association of Locum Tenens Organizations and National Association of Physician Recruiters, you know you are working with a credible and trusted staffing partner. We offer full service support from paperwork completion to in-house licensing, credentialing and travel assistance."
@ONThealth Ontario, Canada:"The official Twitter account of the Ontario Ministry of Health and Long Term Care. News, tips, facts and information about health care in Ontario."
Beth Clarkson
@DoctorClarkson NYC:"Pre-Med student. Fibromyalgia and Asthma patient. Dedicating this twitter to the things I learn, think about, do and experience on the road to becoming a Doctor"
Paul de Roos, MD:"Bio Neurology, Parkinsonsummerschool.com, Healthcare 3.0, Innovation, Training, Education, TED, TEDx, Projects, activism & social entrepreneurship, Music, Tenor Sax."
Gregg Masters
@2healthguru San Diego
Architect | Curator | Consultant.:"Web presence design, affinity community curation & digital conversation catalyst. Co-founder & partner XanateMedia.com."
PreOp_com Education
@PatientEduTv Boston, Ma:"This is an information resource designed to help you understand the nature of a medical condition and the surgical procedure most commonly used to treat it."
See also:
New York Twitter Nurses, Nursing on Twitter, http://www.nursingdiscussions.com/ny
Code Status, End of Life Wishes:
End to Farms (Organized Wisdom Protests):
Healthcare Reform:
Nursing Students:
Organized Wisdom, Twitter Search Results:
Six easy ways to reward your twitter followers:
Wendy Alpine, @alpinepr Marietta, GA:"Atlanta PR Guru. Hiker. Yoga Enthusiast. Long Island native. PR Blogger."
This Page is Part of The Nursefriendly National Nursing A To Z & Consumer Health Directories
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Other products and companies referred to herein are trademarks or registered trademarks of their respective companies or mark holders, and are not owned or affiliated with Nursefriendly, Inc. or any of it's affiliated companies.

subset: commoncrawl


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Australia Day Working Bee / Sewing Day / Pot-Luck Lunch & BBQ Dinner.
Wednesday, 26th January, 2011. 10am.
A " Clean Up" of the Hall and garden first ( trimming the trees, getting up on the roof to clean the gutters again, that sort of fun stuff - See Dimi"tree" )– A little of your time in service to the Barony is all that we ask - the more hands the quicker we finish and we can then move onto our crafting activities!
A Sewing day & evening – bring your latest items to complete!
Your new veil and or headwear – for men and women for March Baronial Competition
If you need assistance with your documentations for the competition please bring it in and discuss with our Laurels and long-term members. Assistance with clothing that you are making for the first time!
The Italian garments started last year - there is still at least 6 people still keen to finish and we are still keen to help you to do so. BYO items to sew or craft and machine etc- remember we do have a sewing machine in the Hall.
A pot luck lunch (bring a plate to feed 6) for those that are there, and
A $4 BBQ dinner, using the lunch left overs as well.
Please let Josseline know if you will be lunching with us and / or dinner so we can make sure we have enough. Also let me know what you are bringing for the potluck lunch please so we don't double up…
Looking forward to another fun and creative year ahead.


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I am thinking of getting butt implants placed within the gluteus muscle, and choosing round shaped implants. how likely would it be for these implants to shift? if they do shift, are incisions made in the same place to position them correctly or could I have another scar someplace else?
Doctor Answers 2
Buttock Implants "shifting"?
Allow me to share with you some information that you may not hear elsewhere. There are only two proven safe and relatively effective methods for Buttock Augmentation: 1) Autologous Fat Transfer (using your own fat, transferring from one area of the body to the other) and 2) Buttock Implants (semi-solid silicone rubber implants that cannot rupture &/or leak). Both are very good options so what it comes down to, like any surgery, is proper patient selection. Indeed because at least 50+ % of the fat transferred will melt away within a year, most patients are not good candidates because they lack an adequate amount of fat to harvest. Thus buttock implants become a very good, safe, and long term reliable option for most patients seeking buttock augmentation (at least in my practice). I prefer to insert the implants through a single 2 ½ inch long incision over the tailbone (concealed within the crevice between the buttock cheeks). The implant should always be placed under or within the gluteus maximus muscle. In this position, the implant is less palpable, less visible, and does not sag or shift/migrate over time unlike implants placed on top of the muscle. Therefore it is extremely important to seek consultation with a board certified plastic surgeon who specializes in this procedure. Best of luck...RAS
Butt implants
Dear Cape cod person, You stated few thing that I would hope will change for you after reading this comment. I use oval round implants because the butt anatomy is elongated and not round. The butt muscles start from the posterior iliac crest, consequently , a youthful and attractive butt is full on top, projecting in the center and has smooth shape laterally. The best location of the pocket for the implants is sub-fascial and not intra-muscular or sub-muscular. This plane allows for larger implants , has less pain and less complications. To prevent the implants shift , my implants have suture tabs that allows me to attach the implans to the fascia and prevent shift and seromas. I also apply a binder for 1 month to help prevent these problems and protect the incision. Consult with a board certified plastic surgeon who has lots of experience with implants surgery. Check the before and after to make sure that you like the result. Best of luck, Dr Widder
Learn more: http://widderplasticsurgery.com
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.


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Reflecting on the Johannesburg Summit of the Forum on China-Africa Cooperation (FOCAC): Where to from here?
The following policy brief seeks to draw linkages between China's second Africa policy paper and the declarations of the Johannesburg summit. It asks what the FOCAC summit managed to achieve before asking what the way forward is in terms of China-Africa relations.
Energy Dialogues in Africa? Is the Grand Ethiopian Renaissance Dam Transforming Ethiopia's Regional Role?
Major hydro power projects, such as the Grand Ethiopian Renaissance Dam (GERD) in Ethiopia, invite enquiry into the potential to increase the generation, transmission and distribution of power, how best to finance these infrastructures and how to balance them with the call for a sustainable development approach.
When refugees cannot return home: A conflict conundrum in Africa's Great Lakes region
The large number of refugees and internally displaced persons (IDPs) in the Great Lakes region poses immense challenges to peace-building processes within the countries affected, as well as in that entire conflict system. An influx of refugees impacts peace and security, citizenship considerations, as well as cross-border and ethnic conflicts.
Social Protection: Targeting the Most Vulnerable Children The Case Study of Tanzania
This research reported on the targeting approaches used in social protection interventions for the livelihood of the most vulnerable children. It was revealed in the findings that the majority of the interventions targeted orphans living in poor households, children living on the streets, labourers, and those living with very old caretakers.
Tax Revenue Effects of Sectoral Growth and Public Expenditure in Uganda
The authors of this paper assess the tax revenue performance in Sub Saharan Africa and propose policies to support the development of linkages between agricultural and industrial sectors while emphasizing the need to unlock the potentially large contributions of the informal sector with a view of widening the tax base.
Improving the Relevance of University Training to Labour Market Demands in Africa
Universities in Africa have a crucial role to play in addressing emerging socio-economic challenges facing Africa. However, efforts to establish universities as dominant knowledge and innovation hubs for the productive sector is being hampered by a number of critical factors.
How do Gender Approaches Contribute to Climate Compatible Development? Lessons from Kenya
What socioeconomic, political and cultural factors constrain or favour gender-sensitive approaches in the context of climate compatible development, and the ability of men and women to tackle climate-related risks in urban contexts? This report outlines lessons from a Kenyan case study.
As South Africa's Local Elections Approach Public Confidence Underpins System in Turmoil
South Africa's upcoming fourth democratic local government elections will be a test for many groups: the long-ruling but troubled African National Congress (ANC), opposition parties and the Independent Electoral Commission (IEC) caught between court orders and logistical realities.
Who will "tear down" the Wall of Hostility between Ethiopia and Eritrea?
The most recent kidnapping events of Ethiopian citizens by Eritrean forces, and an Ethiopian military containment as a reprisal to its action, reflect foreign policy actions of the two countries in recent years. A political compromise is necessary to make sustainable peace between the two nations possible and to normalize their relations.
Post-1994 South Africa: Better than Apartheid, but few Gains in Socioeconomic Conditions
Since South Africa's transition from apartheid to democracy in 1994, the government's development plans have focused on redressing racial inequalities in socioeconomic outcomes.


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Law of Disability Discrimination Handbook: Statutes and Regulatory Guidance, The
A companion book, The Law of Disability Discrimination Handbook: Statutes and Regulatory Guidance, includes reference material relevant to interpreting federal law prohibiting discrimination on the basis of disability. The Law of Disability Discrimination Handbook includes the statutory language of each of the five Titles of the ADA as amended. In addition, with respect to Titles I, II, and III, the authors of this book have included the regulations, interpretive guidance, and technical assistance manual promulgated by the EEOC and the United States DOJ. The Handbook also includes reference material relevant to interpreting Section 504 of the Rehabilitation Act of 1973 and the Fair Housing Act Amendments of 1998, as well as excerpts from the Civil Rights Act of 1991. Further, the Handbook contains the text of the IDEA and the EEOC Compliance Manual on Employee Benefits.
Book Details
- Physical Description: 178 pages
- Edition Info: Paperback; 2011-08-01
Buying This Book
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- Product Description
- Product Features
- Technical Specification
- Customer Reviews
- Questions and Answers
Product Features
- Touch Pad
Located on the top of the controller, the TouchPad offers gamers completely new ways to play and interact with games.
- Light bar
Four color LEDs offer a simpler way to easily identify players and quickly see useful game information, like when a character is low on health or has taken major damage.
- SHARE button
Share triumphs and accomplishments by streaming live gameplay to Ustream or uploading recorded videos to Facebook.
- Built-in mono speaker and headset jack
Enjoy high-fidelity sound effects of games from both the TV and also from the controller. Chat with friends playing online with the bundled headset.
- New shape
Improved ergonomics means it's more comfortable to hold, while improved analog sticks and buttons mean more precise control.
- Enhanced vibration
Multiple vibration motors give games a greater degree of expression and heighten the sense of immersion for players.
Technical Specification
|Product Description
|Sony Dual Shock 4 - game pad - wireless - Bluetooth
|Product Type
|Game pad
|Connectivity Technology
|Wireless - Bluetooth
|Dual analogue sticks, PS button, directional buttons, action buttons, triggers, dual point touch pad, Options button, Share button
|6 axis, built-in speaker, headset port, vibration, capacitive touch pad, 4-colour LED Light Bar, Click Mechanism, Extension Port
|Glacier White
|Designed For
|Sony PlayStation 4
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Original URL: http://www.theregister.co.uk/2009/10/28/ddd_acer_3d_laptop/
Hands on with Acer's 3D laptop
Polarising specs at the ready...
Posted in Personal Tech, 28th October 2009 10:23 GMT
First Look Acer will enter the record books today by releasing the world's first 3D-capable laptop. So Register Hardware caught-up with the firm behind the technology – Dynamic Digital Depth – to discover how 3D content will look on Acer's machine.
The 15.6in Acer Aspire 5738DZG 3D laptop has a screen that is coated with a thin 3D film. You wear polarising glasses rather than active shutter or red and green anaglyph glasses.
Can't see the video? Download Flash Player from Adobe.com
DDD's TriDef software, which can be used with any GPU, facilitates playback of both 2D and 3D content, company President Chris Yewdall told Register Hardware.
Our initial response to the on-screen 3D display was good and - despite it only being capable of a 720p resolution – the content was clear, crisp and vibrant.
The depth of the 3D image displayed depends heavily on the screen's tilt angle. Angle the screen too far forward or too far back and you'll probably only see a blurred 2D image – as you do when you take the glasses off altogether.
While the laptop is supplied with a stylish and light pair of polarising glasses, Yewdall claimed that opticians aren't too far away from offering to make up prescription 3D glasses. In the short-term, though, DDD can also supply a pair of clip-on polarising specs.
Converting 2D into 3D is as simple as right click with TriDef
Acer's 5738DG won't display everything in 3D, so you can forget browsing through Windows 7's icons in 3D or jazzing up Excel with 3D spreadsheets. TriDef is largely limited to media content.
TriDef enables almost any 2D content to be transformed into 3D, Yewdall explained, as he took us through a slideshow of 2D photos converted into 3D. He also showed us a selection of movies and games that TriDef converted into 3D.
For the user, this conversion process is as simple as right-clicking on say, a JPEG, and selecting "Play with TriDef Media Player".
The difference in 3D quality between a film and JPEG or videogame was negligible, in our opinion.
However, a '3D adjustment bar' inside TriDef enables to tweak the depth of the displayed 3D content.
With such an apparently simple 3D system, why hasn't DDD signed deals with Sony, LG, Panasonic, et al to create other 3D laptops?
Acer ships the 3D laptop with polarising specs, but clip-on filters are also available
Yewdall claimed that DDD is "in talks with several of them for 3D laptops", adding that the first 3D laptop that hasn't got Acer branding will probably arrive in early 2010.
Acer's 3D laptop will undoubtedly be cheaper than, say, a 50in 3D TV. But for those times when you need a slightly larger viewing area, the machine's HDMI port enables 3D images to be displayed on an ordinary HD TV.
But in order to make this happen users must first select TriDef's 'anaglyph output mode', which Yewdall claimed "doesn't hold a candle" to the normal polarised 3D that the combined Acer display and TriDef software usually offer.
It's worth noting that Acer's laptop will work with 3D-ready TVs, and Yewdall stressed that TriDef's output resolution can be bumped up from 1366 x 768 to 1930 x 1080 in such cases.
TriDef allows you to adjust the 3D depth
To capitalise on the increasing popularity surrounding 3D films and hardware, DDD has also developed a dedicated online portal – Yabazam – where 3D PC customers can download specially made 3D content, including Imax movies and blockbusters.
The Acer Aspire 5738DZG 3D laptop is on sale now for around £600 ($982/€662). ®