He walked up the steps.
He was happy—another job well done. Within moments, he would be with his ten year old son and his lovely wife.
He knew he was not like any other dad or husband. A life of sitting behind a desk was not for him.
Ever since he was a kid, he knew his calling —-to be an artist. But not a painter or a musician—-those had been done to death.You go to an art gallery. You see a painting. You move on. Listen to a tune. Move it from your mind for another. Too ephemeral. He wanted his art to leave a lasting effect—once you would be touched by his "brush", there would be no going back.
And what, he reasoned, could leave more irreversible impact than personally drawing the line between life and death?
His art was murder– and vocation.
And today he was coming back from a "hit"—oh how he hated that word. He much preferred the word "execution". A "hit" implied a hodge-podge job whose success depended on fortune—hit or miss.
However when he did his job, there was nothing left to chance. Every execution was meticulously planned, all emergencies accounted for. Even the person executed suffered the minimum pain possible—a clean bullet through his heart. Nothing messy, nothing unaesthetic.
It was because of the perfection he brought to his work that he never had a police record. As far as the law was concerned, he just did notexist.
But he did. And there is nothing a true artist hates more than anonymity. So he signed each of his masterpieces by leaving a picture of Michelangelo on the dead body—-a calling card to tell the world that the master was here. He always carried a Michelangelo picture card in his jacket pocket because Michelangelo was his talisman. He was Michelangelo.
He knocked on his door. Today had been his sixth execution. A darkroom, a sleeping mafia boss, one muffled shot and then silent death.The streets however will not be silent. Soon they shall burn as the vendetta wars begin. He would be out of it though, reading his son a bed time story.
His only regret was that he could never tell his family what he did for a living. The ones he loved most would never know how great he was.
The door opened and his son ran into his arms shouting "Daddy"…………His wife was behind him smiling.
Yes he thought. His son is at that age when they begin playing pranks. The age of innocence——–he wondered when that passed him by.
Clasped in the child's small hands was a signed family group photo that he had printed out as a card to fit into his wallet. He had printed out two of them—one of which was being held by his son.
The second family group photo lay drenched in the blood of a 60 year-old mafia don.
The master had made a mistake.
Good story with a great twist in the tail. Why not post it on the soc.culture.indian newsgroup? I found this funny story there, narrated by a gorilla!
To be honest, this wasn't a good story. The characters weren't interesting, the twist was predictable. It does not, of course, mean that you shouldn't continue writing fiction.
Maybe you should try a humorous short story- that would be fun.
kya ulta sidha idea phenk raha hai?
I like all your posts. But honestly, this was the worst. The story is predictable and stereotype. The biggest let down was, "His art was murder — and vocation". I wanted to stop reading at that point itself, but for the sake of loyalty and my immense respect for you (thanks to previous posts) I continued reading. Just one suggestion – whatever you do, please! don't lose originality!!
Interesting story, though not necessarily the best you can write; the twist was good, though there is a small problem there.
Now here is a plot change in the story: The boy merely writes " To daddy, love Laxmivenkataraghavan" on the back. The murderer panics. He thinks, "They will know that the murderer has a son named Laxmivenkataraghavan" and tie the murder to him. So he goes back to the scene of the murder. No one is there yet. He quickly grabs the card. There is nothing on the back. He reaches into his pocket and finds the other card – the one with his son's message. And then the police arrive.
Still, a little contrived and cliched.
I got an ice cream from a guy named Laxmi last night. I figured his name had to be longer.
Nice story dude, but you have written much better posts earlier!
Great story Arnab. I definitely think you should write more of fiction stories.
@Ramesh,Malik,Joy For Ever, Anon: Thank you for the rare words of appreciation visavis this post.
@Anirudh: It's slightly difficult to make characters within 500–600 words. Anyhow.
@Dandy: Abhe Dandy, mera naam Bongi nahin hain.
@Kandarp: Okay…well it's original in that its not stolen from anywhere.
@Supremus: Well I disagree. Someone who is so used to murder, if he is going to make a mistake, it will be at the very end–doing something that has become a conditioned reflex to him. The same reason why 70% of all accidents involving us happen within 2 miles of where we live– because close to home, we tend to relax and put our minds on autopilot.
@Devdutt: No need to duck for cover—I take criticism well. Or so I think.
Seemed like you were forcing yourself to write. You are a far better writer than this short story. This one seemed too influenced.
That's true. One can't really develop a character in 500-600 words. But this fellow didn't affect me in any way. And as I said, the twist wasn't interesting either.
Can you give me premission to publish it on my blog..i can put back link to it?
I have simmilar interesting stuff on it so would help me alot!!
I am new to your blog. Actually, found it just a week ago… probably wasn't looking hard enough… whatever! However, in the past one week, I must have read about 4 months worth of your work and trust me (never trust people who use that phrase!)… I have a pretty busy life and if I read 4 months worth of your work in 7… or so, days it speaks something about your writing style… I normally have an attention span of a 4 year old… my wife will vouch for that.
Now, having said that, it is my opinion… not that it counts… not that it should count… but blogs are just that – "aaa bayl mujhe maar"! (btw, I have learnt putting three dots after fractional sentences from my teenaged niece, it is the electronic equivalent of using "like" after every third word)… oh yeah, I almost forgot… my opinion… right… you should refrain from writing such cheesy stories!!! Yeah, 3 exclamation marks! Anybody can write such stories. You are not in that league man! Your writing style (no matter if people tell you you are one- dimensional or pro-bong or whatever pseudo-intellectual sounding defamations are in style these days) outside of fiction is unique and intelligent. When you write about your own experience or opinions, you are so original, sharp witted and eloquent that either the audience is completely at awe (like yours truly) or they make a complete fool of themselves (like that Akash fella in Nov last year… no! what am I saying? He made a fool of himself without any help… I was actually surprised that so many of your otherwise sane readers like "yourfan" and "shabbir" actually bothered to respond to his incoherent blabberfest 3-4 times in that one post about "One down, a million to go", and that too at great length… I have started having doubts about their intellect… I apologize, I am just trying to be deliberately mean, I guess! But no offense guys! It is just an effort to try to pull you out of a future conversation with a hopeless character like Akash).
Arnab, please do not go into that fiction lane, again. It is not for everybody, you know? You have a lot to offer in the realistic space. That's where you have the expertise. Leave the fictions alone to the experts in that field. But then that is my opinion and I could be wrong.
I just can not believe I used the Dennis Miller line!!! I hate that guy!!!
@Vurdlak: Sure go ahead. You actually liked it? Or is your site kind of like the "worst of" ?
@Debashish: Thank you for your words of appreciation and criticism. However I had one question. Did you form your opinion about my capacity to write fiction based on only this post? Or did you for instance read my 55-word story or -1-900 HOTTIES? However the larger point is that if indeed I don't write decent fiction, then does that mean I should not write it or write it even more so that I "improve". There are always 2 ways of looking at a thing: don't you agree?
First of all, it is Debasish not Debashish. I am very touchy about that :-). I take great pleasure in throwing my now stale punchline at the uninitiateds who ask me 'how come you spell it as "sish" when you pronounce it as "shish"'. My response to them is 'how do you spell "sugar"?'. After all this time, though I still cannot resist my pathological flair for repetition, I wince every time I say it.
Also, I hope you are not confusing me with the other guest of your blog who goes by the "h" version of the name. I am sure you are intelligent enough to detect that but wanted to clarify anyways just in case it was overlooked. I don't think the extra "h" guy will want to be associated with any comments I ever make.
In my school back in India, here was this guy who aspired to be a professional cricketer. He bowled medium pace and had a, what we thought, pretty good arsenal… in-swing, out-swing, off-cutter, leg-cutter… the works. When finally he found a bowling coach, his coach wanted him to drop the in-swing since he was mediocre in that and asked him to concentrate on the rest. Not that it is a great success story because the boy vanished in thin air. Nonetheless, my criticism was based on similar thought process. Also, I will not be truthful if I do not mention that my criticism stemmed from a rather selfish objective as well. I like your "other" pieces more, would like to be fed more of them and would hate to see you churning out stuff that I do not care for as much.
Yes, I read your 55 word story and my reaction was "ummm, okay! Let me see what else he's got." And no, I have not read 1-900-hotties.
Sorry for wrongly spelling your name. Dont worry I shall not vanish…not yet. The 1900 Hotties is on the sidebar as a featured folly.
GreatBong, I quite enjoyed the piece; ignore the hatin' in the comments above.
I'd reckon the ppl who did not like this are the same ppl who hate Quentin Tarantino.
A bit of flourish here, a homage there, a tinge of hyperbole: some of these subtleties zoom over the head of many ppl like the flourish of a Hatori Hanzo sword.
I am also new to your blog.And I'm very happy to read your novel,honestly to say.
But I also want to say that this one is much too simple.and the scenerio is quite predictable.It's just like some other fictions I've read before.It need to be improved to be more unique.
hehe,it's just my personal opinions.But hope you can accept it quite pleasely.
I don't know it's lack of words or what, but it lacked typical punch of greatbong.
GB really i thought i have read all of ur posts and then i was randomly searching "Interviews with Greatbong" and it threw this post….I quite liked it….and as usual comment space is the best …..


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Your Hometown
About Us ›
Middlesex University Dubai is the first overseas campus of the internationally renowned Middlesex University in London.
Middlesex University's quality credentials are outstanding. Middlesex University is audited by the UK's Quality Assurance Agency (QAA) for Higher Education and the Dubai campus is an integral part of this audit process. Our Dubai campus is subject to the same rigorous quality assurance procedures that have earned Middlesex University the highest possible endorsement from the QAA.
Middlesex University Dubai is also licensed by the Dubai government's Knowledge and Human Development Authority (KHDA). Furthermore, the University Quality Assurance International Board at KHDA reviews all programmes on offer in Dubai to ensure that the quality of programmes taught in Dubai are equivalent to those at the home campus in London.
Academic programmes in Dubai have the same validation and monitoring system as in London, with the same examinations taken simultaneously in both cities. The Honours undergraduate and Masters degrees awarded to Dubai campus students are therefore identical to those achieved by students at the London campuses, and students can usually transfer between campuses if they wish to do so.
Whether in London or Dubai, Middlesex University students are prepared for a significant role in the global economy.
Institutional Audit by the UK's Quality Assurance Agency (QAA) for Higher Education
(www.qaa.ac.uk)
Middlesex University has had the quality and standards of its provision confirmed by the Quality Assurance Agency for Higher Education (QAA) in the UK. The QAA reviews UK universities to provide public information about the maintenance of academic standards and its audit processes are respected globally for their robustness. QAA's Higher Education Reviews are carried out by experts from other universities and colleges. Every review team includes a student reviewer, because QAA believes that students should be partners in the quality assurance of their education.Most recently, a team of QAA reviewers visited Middlesex University in October 2015 and judged that its academic standards, the quality and enhancement of its student learning opportunities, and the quality of information about its learning opportunities all meet UK expectations.
You can read the full report here: http://www.qaa.ac.uk/reviews-and-reports/provider?UKPRN=10004351
The previous Middlesex University review report published in 2009 identified as 'good practice' the meticulous attention given to the establishment, development and integration of the University's Dubai campus. The panel praised Middlesex Dubai for the meticulous methods and detailed attention to quality matters, and perhaps more importantly for assuring learning opportunities in Dubai are comparable to those available to students in London.
In 2014, QAA conducted a Review of Transnational Education (TNE) in the UAE which resulted in a positive report for Middlesex University Dubai. The pastoral and academic support provided to students was a particular strength noted in the review. The review found that "students have a range of opportunities for engaging with employers during their studies with employability embedded within the curriculum and extracurricular activities provided". The report also offered an acknowledgement of 'a growing research culture' on campus. A range of students from across the university participated in this review and their contribution was instrumental in offering the QAA an insight into the strengths of our campus. The full report is provided at: http://www.qaa.ac.uk/en/ReviewsAndReports/Pages/TNE-Review-UAE-2014.aspx.
The Times Higher Education quoted that according to the Review of UK Transnational Education in United Arab Emirates, published on 4 June, "Only two providers, [including] … Middlesex, are readily recognisable as branch campuses [offering] the range of facilities a student would expect of a campus in the UK". (Times Higher Education, 12 June 2014)
The QAA is an independent body that provides an integrated quality assurance service for UK higher education institutions. The Agency promotes public confidence that quality of provision and standards of awards in higher education are being safeguarded and enhanced. The Agency's reviews cover public and private higher education in universities and colleges, including arrangements for collaboration with overseas partners; and by assessing the quality and standards of teaching and learning at subject level. These activities result in reports that are available to the public, as printed publications and on their website. For more information see: www.qaa.ac.uk.
Dubai Government's Knowledge and Human Development Authority
(www.khda.gov.ae)
Middlesex University Dubai is licensed by the Government of Dubai's Knowledge and Human Development Authority (KHDA). Established in 2006 by royal decree, the KHDA is responsible for licensure and quality assurance across the entire education and human development continuum covering schools and higher education institutions in the Emirate of Dubai.
In addition to annual licensure, all programmes at Middlesex University Dubai are reviewed by the KHDA's University Quality Assurance International Board or UQAIB, which is a Board of influential academics and quality assurance experts from all over the world that has been assigned the responsibility for setting standards across international higher education on offer in the Emirate. Reviews conducted by UQAIB essentially require that the University demonstrates that the quality of programmes taught in Dubai are equivalent to those at the home campus in London. For more information see: http://www.khda.gov.ae/en/directory/universities-search-results/university?id=774
Middlesex MBA Tops Forbes Middle East MBA Programme Ranking in Dubai
Forbes Middle East Magazine in their March 2012 issue has ranked the Middlesex MBA as the number one MBA in Dubai. The top ranking is an affirmation of the unique attributes of the Middlesex MBA which are :
UK Degree with a comprehensive business management syllabus.
A multi-cultural cohort that work in a range of industries and businesses
Outstanding full time faculty with industry experience based in Dubai
A range of specializations : Business Excellence, Finance, International Business, Marketing, and Operations & Logistics
Invited faculty from the top international businesses
Four Applied Learning Experiences and Four Executive Skills Development activities – away from the classroom.
International experience with a well-established international field trip to Paris or Milan or Shanghai.
A range of practical assessments for each module spread out over the term
A project-based MBA that can be taken further in setting up a business or has consultancy applications.
QAA checks how UK universities and colleges maintain the standard of their higher education provision. Click here to read Middlesex University's latest review report. The QAA diamond logo and 'QAA' are registered trademarks of the Quality Assurance Agency for Higher Education.

redpajama_set_name: RedPajamaCommonCrawl


You will feel sweet. You will feel on-trend. You will feel PRETTY! The stretch in these perfectly pink bottoms is unparalleled offering you comfort and style. This soft color is the best summer neutral and can be worn with so much! Enjoy and effortless wardrobe and add this to your cart!


It's not okay, if you missed this "Summer of Scotty EP" by CzechRoyalty. But we're here for you.
It's not okay, if you missed the "Summer of Scotty EP" by CzechRoyalty. But we're here for you. These tracks are for pulling up to the house party late AF because you're already lit.
J.R. Donato - "Trap Never Closed"


Photography - Trial and Error way: Video Recording With A DSLR- Is it worth it?
This is a million dollar question: Why should I use my SLR for HD Video? If you search online, you will come across conflicting opinions and misleading reviews. You will get confused in the end. On this page I am going to tell you in a few minutes what you really need to know about video recording with various types of cameras and camcorders and I will also provide you some tips on how to take professional looking HD videos with a DSLR.
When it comes to video recording, you really have 4 options: Use your smartphone, use a compact point and shoot camera, use a camcorder or use a digital SLR. Let us look at pros and cons for each one of them.
The biggest benefit with using a smartphone like an iPhone or an Android phone is the convenience and ease of use. You have your iPhone or Android phone all the time. Take your smartphone out of your pocket and press a button or two and you are in business. Now if you are watching your iPhone videos on your iPhone, I am sure you will be happy with the recording. If the light is good, your smartphone camera will do a good job. Plus, the screen on most smartphones is so bright and optimized, your videos will look nicer on that tiny 4 inch screen. If you download to your PC or upload it on Youtube, probably you will not be that happy with the quality. Also try using your smartphone in dull light and you can get frustrated. In dull or low light, most smartphone are almost unusable for video recording.
In short, in good daylight or for situations where we really don't need to have very high quality videos, your smartphone is an excellent and very handy tool to capture videos.
How does a camera compare to a smartphone with regards to video quality? Not much difference as such. In low light, you camera may do a bit better than a smartphone though. Most smartphones don't have any zoom but most cameras have. So a camera can help you zoom in and take close up videos. However there are two important things. Try to avoid zooming in or out while you are recording. This can add some noise in your recording plus focusing issues can ruin your video. Also, if you zoom in too much, the shake can become too obvious so a tripod is recommended to avoid any shake.
Smartphones and compact cameras have tiny lenses. This is an advantage as well as a limitation when it comes video recording. The limitation is that they are too small so they can't take much light in. Hence in low or dull light, they are not able to take sharp videos. Now the advantage is that they keep everything in focus so you really don't have to worry much about focusing while you are recording with your iPhone. They will always come out well. On the other end, if you compare your videos with professionally taken videos, you will notice that smartphone videos are flat and boring. You can't get any background blur or can have subject stand out in the videos.
Let us not forget that many times we want to capture precious moments or some events in our videos. This is mostly for personal use or for sharing with friends and families. Content here is more critical and if think your camera is doing a good job, you are all set IMO.
Videos with HD Camcorders or pocket cams like Sony Bloggie or FlipHD.
We don't see many video camcorders these days after iPhone and other smartphones started offering video recording. As they are dedicated video recorders, they do a bit better job but their quality is not much different. Everything always in focus. Flat videos.
Now you can buy expensive Canon, JVS or Sony HD camcorders for videos. They offer stunning 30-50x zoom with very useful shake reduction. Naturally, their videos will be better than videos taken with any smartphone or any compact digital camera. The drawback is they are bulky and not much convenient. You don't get much improvement in quality too unless you are spending $4000 upwards. With most consumer camcorders, you really can't keep certain things in focus and other things blurred. Unless if you have noticed, most HD camcorder videos are plain and boring. If you are fine with this, they can be a good choice for you. You can find some good ones around $200-$500 range.
For most of people, a smartphone or a compact camera is enough for capturing videos. However if you like to capture long videos or if you are a person who prefers video recording to photo shooting, a dedicated camcorder is a good choice.
Compared to a phone or a P&S camera, a DSLR will do a better job at recording videos in most situations. As they have bigger sensors and lenses, they are able to capture light quickly and can offer some capabilities for selective focusing too. With selective focusing, you have to be careful about focusing capabilities of your camera and also your skills. If it is not focused properly, your videos can sometimes be worse than an iPhone video!
Most older DSLRs and many new ones too don't auto focus during video recording. SLR cameras normally use phase-detection for focusing during photos but this can't be used for videos (because of the mirror which needs to be flipped for focusing). Now some DSLRs offer contrast based focusing in video which is not that accurate but it does work. You can bypass this limitation with a mirror-less camera like Panasonic G or GF series which can auto focus.
What makes a movie or documentary video recording better than our video recording? It is mainly the background blurring. I mean selective focusing where only subject is in focus to grab all of your attention. There is no other distraction in the frame. With SLR, this is possible because of large sensors and bigger (I mean wide aperture) lenses. However most kit lenses have f number 3.5 or higher. They really don't open much so it is difficult to be able to get selective focusing. So if you want to take HD as well as HQ (High Quality) videos, you will need some fast lenses. These are the lenses with F1.8 or F1.4. With such lenses, you can really see the advantages offered by DSLRs for video recording. Now this advantage comes with one responsibility. Focusing becomes very very critical. This is the reason many professional photographers use manual focusing. Many serious Canon users use Canon full frame cameras with some wide aperture, fast lenses.Search for Super Takumar F1.4 videos with Canon on the Internet and you will know how good job DSLRs can do when it comes to video recording.
Why use Manual focus while shooting video?
Now as DSLRs offer us nice focusing and background blurring, there comes one problem. Many people get annoyed when they hear that camera does not AF during video. However you shouldn't want your camera to auto focus because you want to decide where to focus. In a scene with say 3 people, you want to focus on the person who is speaking but the AF in the camera may decide to focus on the quiet person instead!! This will be a disaster. AF is fine with video recording with compact cameras or camcorders because they keep most of the scene in focus! With SLR, you can get a movie like effect with very selective focusing. Most movies or documentaries are shot with Manual focusing.
Many of professionals specifically use Manual lenses with manual focus and one favorite is Super Takumar 50mm F1.4 lens.
Here are some benefits of using manual focusing during video recording with DSLRs.
Motors of auto-focus lenses create some hissing sound during focusing which can create bad audio in your recording.
The Autofocus may not work in low light and the focusing motor may keep trying ruining your recording. Also there are times when AF doesn't focus correctly.
Auto focus as name mentions auto-focuses so if you want to have only person A in focus out of a group of 5 people, you really can't do it on the fly. If want to focus only specific area while shooting video, you can't do it unless you manually focus for it.
Also, most auto focus lenses don't let you change aperture on the fly to control depth of field. Old lenses like, Super Takumar, let you control focus, aperture very smoothly.
I am not an expert but here is one video I recorded in low indoor light with Panasonic GF3 and a Super Takumar lens. I am still learning manual focus so please bear with me. However I am sure this group of 6 year old kids running/traveling with the ball will not fail to entertain you. If you are short on budget but want to take nice videos, you can buy a Pentax K-01 body for around $300. Buy a Super Takumar M42 lens for around $100 with an adapter for Pentax. Once you get hold of the manual focusing, you will be amazed how beautiful videos you can take with a DSLR compared to compact cameras or most consumer SLRs with kit lens. Even with those HD camcorders.


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6 Simply Amazing Museum Interiors
These high-design museums invite visitors to get lost within their walls. For more inspiration, check out our Institutions board on Pinterest.
1. Hongkun Museum of Fine Arts by PeNDa
The Hongkun Museum of Fine Arts by PeNDA is defined by an intricate system of arches and counter-arches, references to the mountains and valleys in the museum's landscape paintings and the ancient caves on which stories about people, events, and traditions were once painted. While the forward-thinking museum is intended to be an anchor for an arts district that is expected to develop in the neighborhood, it maintains some sense of convention. While complex curves encircle the entry, staircases, and cloakroom, the art hangs in standard, rectilinear exhibition spaces.
2. International Wine & Spirits Museum by Shanghai Godolphin
In their design for the International Wine & Spirits Museum in Shanghai, China, the architects at Shanghai Godolphin embraced the history of a vaulted, 32,000-square-foot venue. No significant structural changes were made to the 1930's-era bunker, which was initially built to hold military equipment and cultural treasures. The museum now boasts a botanical garden, tasting bar, VIP cellar, and more. The concrete structure is softened by a sculptural swoosh made with crates that once contained bottles of Château Malmaison.
3. "Van Cleef & Arpels: The Art and Science of Gems" Exhibition at the ArtScience Museum by Jouin Manku
Visitors at the ArtScience Museum in Singapore can admire 450 historic pieces and 250 mineral specimens from France's Muséum National d'Histoire Naturelle in a transformative exhibition designed by Patrick Jouin and Sanjit Manku of Jouin Manku. Spread over nine galleries, the exhibition features cascading lengths of cotton lit to create an impression of traveling through space.
4. Museum of Tomorrow by Santiago Calatrava
Every two years, the Olympics brings unprecedented global exposure to its host city. This attention inspires architectural innovations, one example of which is Rio de Janeiro's new Museum of Tomorrow by Santiago Calatrava. Featuring massive pergola-like cantilevers, adjustable solar panels, and science-oriented exhibits, the museum will help revitalize its neighborhood, Porto Maravilha.
5. The Centre d'Art Diane-Dufresne by ACDF Architecture
Named after singer, actress, and painter Diane Dufresne, the Centre d'Art Diane-Dufresne has diverse aspirations. The streamlined glass and steel structure holds a 15,000-square-foot gallery and performance space, both floored in diamond-polished concrete. The museum is part of a master plan to activate an underutilized park in Repentigny, thereby transforming the Montreal suburb into a cultural destination.
6. The Michal and Renata Hornstein Pavilion for Peace at the Montreal Museum of Fine Arts by Atelier TAG and Jodoin Lamarre Pratte Architects
Part of the Montreal Museum of Fine Arts, the 4,958-square-foot Pavilion for Peace in Montreal is home to the museum's international art collection. The building's transparent facade, shielded only by a veil of aluminum rods, forges a connection with the outside world. The wood-clad lobby features an "event-stair" centerpiece, which functions as a hub for social activity.
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Retail Industry Plans to Hire More Workers; Department of Labor in Close Watch
Posted on February 3, 2012 by
More sales is the secret to creating more jobs and that's been certified by specialty retailers. According to reports, more merchants and specialty retailers are planning to add jobs this year as new stores are opened and operations are expanded. This positive response somehow eases previous concerns regarding an April 6 report that showed a decline in retail employment covering the periods of February to March.
The unexpected increase in retail employment could be attributed to an increase in retail sales. According to the Commerce Department, sales of goods ranging from electronics to furniture and clothing rose to about 0.8 percent as of last month alone. Meanwhile, the International Council of Shopping Centers reported an increase of 4.1 percent in receipts alone.
Joseph LaVorgna, chief US economist at the Deutsche Bank Securities Inc. says that the strength of retail spending in the first quarter of this year is a strong indication of more retail hiring. He adds that although there are concerns in other sectors of businesses, the retail industry is experiencing a momentum in hiring and spending.
But the momentum LaVorgna is referring to has been slow and uneven. In fact, last month's drop in retail sales was recorded to be the lowest since October 2009. This resulted in merchants only regaining a third of the total jobs lost in 2008 and 2009.
However, retailers have been steadily adding 35,000 employees every month for the last six months. This is a strong improvement to the pre-recession average of employment of 55,000 employees per month in 2006 and 2007. The figure is also a good measure of the true state of the market health.
What is the significance of this increase in the overall progress of the economy?
These numbers are essential because retailers employ one in every four Americans. Meanwhile, retail sales account to about 50% of consumer spending based on the 2011 data from the Commerce Department.
If the retail spending remains high, investors will become interested in boosting their shares too. For instance, a retail company is recorded to have gained approximately 17% this year alone.
Statistics also indicate that large stores have become more efficient in managing their workforce by scheduling staff especially during peak shopping hours. On the other hand, Internet-based sales expanded faster than those in physical stores, with a growth rate of 9.3% as of March compared to a 6.5% growth in traditional merchants' customer based facilities.
In order to attract more consumers, large retail stores have decided to restructure to somehow cope with the changing shopper demands. Meanwhile, other stores are aggressively expanding by establishing more chains and hiring more employees, following a good sales report from the previous months. Hence, as business is growing more rapidly than before, it would also indicate a closer monitoring by the Department of Labor for possible employer violations.
But economists warn not to get everyone's hopes high because the sales during the first-quarter alone are not enough to indicate a hiring boom. There are other factors that could have contributed to the sales from last month and these may include the higher gasoline prices, expansion in low-employment sectors as well as deep-discount chains.
For more news and articles on labor, employment and related topics, go to www.johnfoxassociates.com
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Raw materials of the mineral origin are used in an extensive variety of industrial sectors: energy, metallurgy, chemical technology, mining sector, and a far more.
Modern society is strongly dependent on mineral raw materials. Continued economic growth, industries' expansion and growth as well as rising population lead to the increase in the demand for mineral feedstock. However, deposits of mineral raw materials are limited, so efficient use and conservation of mineral resources have turned into burning issues. Companies constantly search for the most rational and effective ways of feedstock exploitation.
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RAND Health Quarterly
>Article 8
Preventing, Identifying, and Treating Prescription Drug Misuse Among Active-Duty Service Members
by Rosalie Liccardo Pacula, Sarah B. Hunter, Allison J. Ober, Karen Chan Osilla, Raffaele Vardavas, Janice C. Blanchard, David DeVries, Emmanuel Fulgence Drabo, Kristin J. Leuschner, Warren Stewart, Jennifer Walters
RAND Health Quarterly, 2017; 7(1):8
Prescription drug misuse (PDM) is of critical concern for the military because of its potential impact on military readiness, the health and well-being of military personnel, and associated health care costs. The purpose of this study is to summarize insights gleaned from a series of activities that the RAND Corporation undertook for the Deputy Assistant Secretary of Defense for Readiness to address this important health and military readiness issue. The authors completed a review of U.S. Department of Defense policies and a comprehensive literature review of clinical guidelines and the empirical literature on the prevention and treatment of PDM and conducted individual face-to-face interviews with 66 health and behavioral health care providers at nine medical treatment facilities across three regions within the contiguous United States to identify best practices in the prevention, identification, and treatment of PDM and the extent to which those practices are known and followed. The study also presents the framework of an analytic tool that, once informed by data available to the military but not available to the authors, can assist the military in predicting future trends in PDM based on current demographics of active-duty service members and rates of injury and prescribing of prescription drugs. The findings from this work led the authors to formulate a set of key insights that they believe might improve the rapid identification and treatment of service members dealing with PDM, thereby improving future force readiness.
For more information, see RAND RR-1345-OSD at https://www.rand.org/pubs/research_reports/RR1345.html
Mental Health and Illness,
Military Health and Health Care,
Pain Management,
Prescription Drug Abuse,
Analyses of medical and pharmacy claims and drug-screening data from fiscal year 2010 show that nearly one-third of active-duty service members (ADSMs) have received at least one prescription for an opioid, central nervous–system depressant, or stimulant, and well over one-quarter (26.4 percent) receive at least one prescription opioid during this period (Jeffery, May, et al., 2014). The U.S. Department of Defense (DoD) defines prescription drug misuse (PDM) as either medication misuse caused by using it too frequently or in higher doses than prescribed or medication use without a prescription (Bray, Pemberton, Hourani, et al., 2009). PDM is an increasingly common problem in both civilian and military populations. Anonymous surveys of active-duty military personnel suggest an increase of PDM (Bray, Pemberton, Lane, et al., 2010). This parallels the recent trend of PDM seen in the civilian population, in which there is growing concern among policymakers, the Centers for Disease Control and Prevention, and other stakeholders about nonmedical initiation and use of pain relievers (Substance Abuse and Mental Health Services Administration [SAMHSA], 2011).
The misuse of prescribed substances is of special concern for the military because of its potential impact on military readiness, the health and well-being of military personnel, and associated health care costs. However, addressing this problem poses special challenges in the detection and prevention of misuse because of the important clinical indications for which these drugs might be prescribed. Effective strategies are needed to reduce the risk of PDM and ensure safe use.
To help DoD address these issues, the RAND National Defense Research Institute conducted three related efforts that could provide useful information for assisting the military in preventing, identifying, and treating PDM: a review of guidelines and empirical literature for the prevention, identification, and treatment of PDM in clinical settings (both military and civilian) to help identify best practices; the development of an analytic tool that can be used to predict trends and changes in PDM among ADSMs today and into the future; and interviews with civilian and military providers at military installations. This study includes information gleaned from each of these three major activities and summarizes common themes from across them. Of course, as is true with any study, to some degree the limitations of the approaches taken, which we describe in detail in each of the chapters, shape the findings and insights, which should be viewed within the contexts of the strengths and limitations of the study.
Evidence-Based Practices for Preventing, Identifying, and Treating Prescription Drug Misuse
We reviewed all publicly available DoD policies and clinical guidelines and examined the empirical literature to identify practices for preventing, identifying, and treating PDM. We were specifically interested in identifying evidence-based practices for PDM (rather than substance abuse more broadly) and understanding whether they have been tested and were being used in military settings. Our project officer defined prescription drugs of interest based on DoD interest (see Table 1) and included opioids (i.e., morphine, codeine, hydrocodone, oxycodone, methadone, fentanyl, and meperidine), stimulants (i.e., methylphenidate and a combination of dextroamphetamine and amphetamine), benzodiazepines, and barbiturates.
Table 1. Prescription Drugs of Interest for Our Study
Common Brand Names
Opioids Morphine Duramorph, DepoDur, Astramorph, Infumorph
Hydrocodone Zohydro Extended Release, Hysingla Extended Release
Oxycodone Oxycontin, Roxicodone, Oxecta
Methadone Methadose, Diskets, Dolophine
Fentanyl Duragesic, Abstral, Subsys, Ionsys, Sublimaze
Meperidine Demerol
Stimulants Methylphenidate Ritalin, Daytrana, Concerta, Methylin, Aptensio
Dextroamphetamine with amphetamine Adderall
U.S. Department of Defense Directives Provide Little Guidance on Preventing and Managing Prescription Drug Misuse
The 20 DoD directives we reviewed provide little guidance specifically pertaining to the management of prescription drug use and misuse within the military. Instead, many focus on defining PDM and the consequences following identification, such as the process for adjudicating urine tests. Some directives included so-called limited-use policies that were inconsistently presented alongside zero tolerance guidelines. The majority of the clinical guidelines reviewed (both military-specific and others) focus on prescription opioids, with little guidance on the management of misuse of other classes of prescription drugs. Current DoD clinical recommendations for prescription opioid misuse appear to be similar to non-DoD clinical guidelines. Most guidelines note the lack of strong research evidence for many of the current care recommendations that address the prevention of misuse of prescription opioids.
All guidelines, both military and civilian, support an initial assessment to evaluate risk of PDM at the time a provider is considering prescribing the opioid. Guidelines provide consistent support for conducting a comprehensive assessment of a patient's medical history, including history of substance abuse and comorbid psychiatric and medical history, before initiating therapy (Cantrill et al., 2012; Chou, Fanciullo, et al., 2009; Manchikanti et al., 2012a, 2012b; Thorson et al., 2013). However, there is little supporting evidence concerning the effectiveness of approaches, such as screening exams, to predict patient characteristics for misuse. Many guidelines recommend written management plans and urine drug screens when there is a high risk of PDM despite limited evidence of these tools' effectiveness (Cantrill et al., 2012; Chou, Fanciullo, et al., 2009; Manchikanti et al., 2012a, 2012b; Thorson et al., 2013).
The current DoD guidelines regarding substance use discuss general approaches to treatment and are generally not focused on specific management of PDM (Management of Substance Use Disorders Work Group, 2009). The problem of opioid abuse is particularly challenging, given the need to balance the benefits of pain management and the risk of addiction (Prescription Drug Abuse Subcommittee, 2013). There is also a paucity of studies addressing the specific problem of prescription opioid abuse in the broader literature, and few empirical studies specifically address the prevention or treatment of PDM.
In 2009, then–U.S. Army Surgeon General LTG Eric B. Schoomaker led a multidisciplinary task force to address pain management issues in the military (Office of the Army Surgeon General, 2010). This task force stressed the importance of deemphasizing opioid therapy for the management of chronic pain and having providers focus more on problems of prescription opioid abuse. However, as this systematic review shows, more evidence is needed to help guide proper implementation of task-force recommendations with respect to alternatives to writing prescriptions.
Given the complexities of managing patients suffering with chronic, as well as acute, pain; the tremendous potential for these patients in particular to misuse prescription drugs, as well as other substances (McLellan and Turner, 2010; Nuckols et al., 2014); and the fact that providers typically lack general knowledge or training on how to deal with these patients, it would seem that, alongside remedial training of existing health care providers, immediate training of all new military health care providers would be useful. In particular, this training would allow the military the opportunity to promote and adopt a single standardized assessment tool for identifying a variety of substances that might be misused (e.g., prescription opioid, alcohol, benzodiazepines); train providers on how to use the tool and what to do when someone is identified as being at risk; provide clear directives on the military's position regarding pharmacotherapy's role in treating opioid misuse (or alcohol dependence); and provide clarity on policies, protocols, and clinical guidelines to follow for these particularly difficult and unique cases.
Analytic Tool to Predict Trends and Changes in Prescription Drug Misuse Among Active-Duty Service Members
To know when to intervene with those experiencing PDM problems, one must first know where these people might be identified. To assist the military in its effort to better understand the extent to which PDM stems from medically indicated use (i.e., misuse that stems from a having a prescription for a highly addictive prescription) and nonmedical use (i.e., misuse of a prescription drug that was not prescribed to that person), we developed an analytic tool that, once populated with data that the military owns, can serve as a valuable means for understanding the dynamics of the current PDM problem. In addition to identifying for policymakers the share of PDM that emerges from medically indicated use versus nonmedical use and how these will change over time, the analytic tool can be used to identify nodes in the model at which prevention and treatment resources might more effectively be concentrated so as to more efficiently and effectively tackle the problem. Prevention and treatment dollars are limited, so understanding the key factors (nodes, in our model) that drive higher rates of misuse will also tell decisionmakers where limited resources might be focused so as to more efficiently reduce the problem.
In addition to providing military officials with a better understanding of the incidence and prevalence of PDM beyond what can be determined from regular drug testing and occasional survey data, the analytic tool can be used to forecast how the incidence and prevalence of PDM will change in the future if current practices stay the course. For example, the analytic tool can be used to project how PDM might grow among those with medical indications vis-à-vis growth in the non–medical use population. Alternatively, the analytic tool could be used to project how current trajectories might change with a change in any of the tool's underlying assumptions, such as the rate of heavy use among the medically indicated, escalation rates from light to heavy use, the rate at which people enter treatment, and the relative effectiveness of different treatments. Using the tool in this manner is commonly referred to as predictive forecasting. Alternatively, the analytic tool could be restructured to accommodate different classes of prescription drugs individually (e.g., narcotics only, stimulants only) and then could be used to describe patterns of use and trends for particular prescription drug trajectories.
Like the value of any epidemiological model of health behavior, the value of the tool we propose here will depend on the reliability of estimates obtained for the various assumptions that make up the model that underlies it. Our scan of the data fields contained in TRICARE (the military health care system that includes insurance claims), the DoD Health Related Behaviors Survey and drug-testing data suggest that sufficient data exist to develop empirically driven assumptions for the model variables needed. Standard techniques for checking reliability and validity of the model would be necessary, but, assuming that the model is shown to be both externally valid and reliable, the tool proposed here could provide military health leaders with guidance on how to target limited prevention and treatment dollars toward the key factors that appear to drive higher rates of misuse.
Qualitative Interviews
Finally, we conducted semistructured interviews with military personnel to better understand perceptions of the nature and extent of PDM among ADSMs; current practices and policies to prevent, identify, and treat PDM; and barriers to effective management of PDM. To collect information from personnel with relevant experience, we developed a strategic sampling of military bases with medical treatment facilities (MTFs) in regions of the conterminous United States where selective prescription drugs, particularly opiates and benzodiazepines, were frequently administered in 2010, according to evidence in the TRICARE pharmacy claim data. TRICARE is a health care insurance program of the U.S. Military Health System (MHS) (formerly known as the Civilian Health and Medical Program for the Uniformed Services) that covers care not available through U.S. military medical service or public health service facilities. Our goal was to include bases from each of the service branches, although our ability to reach base commanders and obtain necessary approvals for the interviews within the time frame allotted for the study greatly influenced the list of final bases we included in our sample. Our final sample included 66 health providers at nine MTFs across the services.
In general, providers reported that PDM is a problem among ADSMs and that PDM most commonly occurs among those who, at one time, had medically indicated use. Although diversion of prescription drugs for nonmedical purposes occurs, most providers we interviewed do not think the prevalence of this type of misuse is high. The providers we interviewed perceive that PDM occurs because of a combination of factors, including the high prevalence of pain among ADSMs; psychological vulnerability to addiction; and provider problems, such as overprescribing and lack of training and expertise in recognizing PDM and in treating people who have chronic pain.
Although the providers we interviewed had some knowledge of clinical practice guidelines for chronic pain, as well as DoD directives around substance abuse and PDM, practices and adherence tend to vary by provider and MTF in those we accessed, with providers noting the need for more-consistent guidelines and greater adherence. For example, most of the MTFs reported using so-called sole-provider agreements, which are agreements between health care providers and patients that limit patients to a single prescribing physician for all medications (i.e., a sole-provider agreement) and might have other requirements regarding refills, frequency of medical appointments, and consequences of misuse (a high-risk medication agreement). However, even clinics within the same MTFs have different patient criteria for utilizing agreements, the terms of the agreements, and the names of the agreements. Additionally, despite policies that state otherwise, providers perceive that typically a zero tolerance policy around PDM parallels the policy for illicit-drug use. However, they also reported that decisions around PDM are made on a case-by-case basis. This discrepancy seems to lead to uncertainty about how to handle PDM. The providers with whom we spoke mentioned that they would like to see more-consistent guidelines, more-consistent monitoring of and adherence to clinical practice guidelines, and more guidance around administrative outcomes for ADSMs with PDM.
Evidence-based practices, such as standardized assessments for potential misuse and behavioral and pharmacological treatments, are not typically implemented in primary care or emergency room settings, according to our sample. Some pain specialists employ screening procedures, and there have been some efforts to bring screening to primary care and family practice settings, but with little success. Although providers acknowledge that there is very little time to conduct assessments, as well as a lack of understanding about what to do if a patient with pain is susceptible to PDM (according to an assessment), they see the value of having a more standardized tool for assessing the potential for PDM. Use of medication-assisted treatment for PDM was not mentioned. However, when prompted, some providers noted that medication-assisted treatment might present a challenge for providers: To prescribe Suboxone (a medication for opioid dependence containing buprenorphine and naloxone) to treat addiction, a provider must have a special U.S. Drug Enforcement Administration license. Providers with whom we spoke also lack understanding about their role in treating opioid dependence pharmacologically within the MTF. Naltrexone, both injectable and oral, is a viable option for treating some opioid-dependent patients (SAMHSA, 2015), but the providers with whom we spoke are not familiar with the medication, not comfortable providing medication for opioid dependence, or not aware of the regulations around doing so.
The greatest challenge in managing PDM facing the providers with whom we spoke is the lack of a clear definition of PDM, therefore leading to challenges in appropriately preventing, identifying, and treating PDM. Also, a lack of clarity around the policies, protocols, and guidelines across MTFs and bases leads to inconsistent practices. Providers offered a variety of recommendations for addressing these challenges, including expanding resources for preventing, identifying, and treating PDM by embedding case managers and clinical pharmacists into clinics; having pain specialists at each clinic; offering patient-centered practices, such as complementary approaches to medication; improving patient education around prescriptions, including the provision of self-management tools; clarifying and supporting adherence to guidelines and policies; improving electronic systems to enhance tracking of all prescriptions; and increasing provider training and interdisciplinary support and coordination of care.
Additionally, the substance abuse treatment providers with whom we spoke reported that there might be a lack of capacity to treat PDM on base as opposed to at a nonmilitary treatment center. Some providers said that MTF substance abuse treatment programs typically treat only alcohol problems, while others reported also treating PDM but not having specific tools for doing so. Some providers reported using educational treatment models and others reported including members with PDM into treatment groups with other illicit-drug users. The substance abuse providers with whom we spoke would like to see more-tailored educational and treatment protocols for ADSMs with PDM.
Key Insights from This Work and Strategies for Going Forward
Determining what should be done about PDM is a complex task. As indicated in our systematic literature review, few available evidence-based solutions focus specifically on the prevention, identification, or treatment of PDM in the military or civilian practice. Moreover, the DoD regulations are complex, emphasizing a general zero tolerance approach to drugs with little mention of addressing prescription drug use and misuse. Furthermore, the providers we interviewed made many recommendations with limited knowledge of the significant barriers to implementing the change suggested (e.g., distributing standardized guidelines on identification and treatment of PDM requires existence of effective evidence-based models). However, given the information gleaned from our literature review and interviews with selected providers, we can offer the following insights for consideration and potential paths forward.
Implement and Parameterize the Compartmental Model Developed in This Study to Enable a Clear Assessment of the Extent to Which the Current Prescription Drug Misuse Problem Within the Military Stems from Abuse Following Legitimate Medical Need or Simple Inappropriate Use
Military leadership can use the model, once parameterized and tested, to track the evolution of the PDM problem over time (based on trends in key characteristics driving the problem over time) and identify the extent to which particular policy approaches (e.g., harsh penalties targeting misusers, or broader implementation of step-down therapies and pain management techniques for patients suffering from severe injuries causing pain) might be effective at addressing the unique PDM problem that the military faces.
Dedicate Resources to Providing Remedial Training and Support to All Military Health Care Providers in the Identification and Treatment of Substance Abuse in Patients
Our findings provide justification for clinical training of all new and existing medical personnel on identifying and treating addictions (i.e., a comprehensive course providing information on identifying early signs of all addictive behaviors, not just those most problematic today). In doing so, the military can address the current PDM problem and educate its providers on how to identify future potential health problems, such as problems with benzodiazepines, alcohol, or even e-cigarettes. However, the military needs to do more than just provide training. In particular, it needs to make sure that the training that is provided is indeed scientifically supported and effective. It must make sure that the training is easy for providers to access and use, even when time is limited with patients. Remedial courses with military health care providers before they are assigned to their posts is one way to engage providers early on and educate them on preferred practices, such as the use of a single standardized, evidence-based screening tool for identification of substance misuse across the MHS and what to do if someone screens positive using that tool.
The military needs to go further than just providing training to providers, however, for the training to be truly effective. The military needs to be aware of and address for providers the system- and patient-level barriers that make providing linked care so difficult. It could remove patient barriers through the broad-scale implementation of a modified limited-use policy, such as the Army's Confidential Alcohol Treatment and Education Program (CATEP), but applied to PDM. Health system barriers might be overcome through electronic connectivity between providers, brief case-management strategies, and supportive care activities to better connect care received in the medical and specialty treatment settings (Cucciare and Timko, 2015; Molfenter et al., 2012; Rapp et al., 2008). These are just a couple of strategies currently being adopted within the civilian health care system in light of mandates associated with the Patient Protection and Affordable Care Act (Pub. L. 111–148, 2010) to better integrate behavioral and medical health care for people suffering from substance use disorders (Humphreys and Frank, 2014; Ghitza and Tai, 2014).
Facilitate Interdisciplinary Provider Coordination in Approaches to Identifying and Treating Prescription Drug Misuse, as Well as the Transition to Integrated Care
Although effective coordination of care through electronic medical records might be years away, changes in civilian and military health care systems that include care coordination through patient-centered medical homes (PCMHs) provide a natural opportunity for expanded prevention, identification, and treatment of PDM. Several models of PCMHs are currently being evaluated within the military sector (Nathan, 2013). In MTFs that have already begun to make these changes, providers reported greater collaboration between providers since the institution of PCMHs through the use of embedded case managers and behavioral health therapists to facilitate chart reviews and communication about and management of ADSMs with PDM and at risk for PDM. Given that service integration is relatively new, it is important to continue to monitor these efforts to help inform how to best design these systems for the future.
For Those Suffering with Chronic Pain, Expand the Availability of and Access to Pain Management and Patient-Centered Practices Within the Military Health System
It was clear from our discussion with providers that pain management and patient-centered, complementary services are not readily available or accessible to those suffering from chronic pain. Providers believe that these practices can support treatment for patients with chronic pain, but there are few within the MHS who provide these services and, where they are available, waiting lists can be long. Treatment outside of the MHS is also possible, but coverage for that care might be limited, and the tracking of these alternative treatments is often difficult.
Given the unique challenges of managing PDM patients suffering from either acute or chronic pain, as well as the lack of general medical training on how to treat these patients, the military could benefit from the development of some remedial training for all new military health care providers on this topic as well. This training, which could commence before the medical and paramedical personnel are first assigned to their posts, would provide the military the opportunity to educate its medical providers on how to use a single standardized assessment tool for identifying pain patients who are at risk of substance abuse (e.g., PDM or alcohol) and what to do when ADSMs are identified as at risk from these assessments. Remedial training for existing medical personnel encountering these types of patients should also be encouraged. Clear directives could be provided to all medical and paramedical personnel on the policies, protocols, and clinical guidelines that the military believes are the most effective to follow for these patients, as well as provide clear directives to providers regarding the role of pharmacotherapies for treating opioid (or even alcohol) misuse.
Encourage the Use of State Prescription Drug Monitoring Programs
Existing state prescription drug monitoring programs (PDMPs) are infrequently used and fraught with barriers for those providing medical services within the military. Enhanced policies and procedures to direct military providers to PDMPs to check for purchases made outside the TRICARE system would help reduce risk of overprescribing and overcome some, although not all, of the barriers. Potential challenges to this approach include making sure that someone at each military medical facility or clinic has access to the state's PDMP (different states have different rules regarding who is allowed to access their PDMPs). Potential policy changes might be needed to fully realize the benefit, such as allowing military health providers access to state PDMPs or requiring prescriptions purchased through TRICARE to be included in state PDMPs. However, these policy changes are likely to happen far more expeditiously than the adoption of a military-wide PDMP that also has access to state PDMPs, which is likely to be the only way for any PDMP to reduce prescription drug abuse among active service members and their dependents, but considerably more costly to build and implement.
Determine Whether Military Substance Abuse Programs Should Provide Unique, Prescription Drug Misuse–Focused Treatment for Service Members Who Develop Dependence on Prescription Medications
The military should explore the potential use of pharmacological maintenance, tapering, and anticraving medications for opiate dependence (e.g., buprenorphine/naloxone or oral, injectable, or extended-release naltrexone). These treatments have been shown to be potentially effective for opioid-dependent populations (SAMHSA, 2015). Although there are administrative and practical complexities to providing some of these pharmacological treatments for substance dependence to ADSMs, adoption of these forms of treatment could facilitate and expedite recovery and reintegration of service members into active duty. Other evidence-based behavioral therapies tailored for people misusing prescription drugs, including those suffering from opioid misuse and chronic pain, also exist (e.g., Rawson, Shoptaw, et al., 1995; Rawson, Marinelli-Casey, et al., 2004).
If the number of ADSMs who experience PDM is expected to grow in the future, which the full implementation of our proposed analytic tool could reveal, then attention to building and sustaining the internal treatment capacity for PDM will definitely be needed. Although it is expensive to seek broader-scale adoption of any of the treatment approaches described in the previous paragraph, the cost-effectiveness of doing so would dramatically decrease if the size of the hidden population is substantially larger than the relatively small number of ADSMs who seek or receive treatment within the military today. Thus, use of a forecasting tool, such as the one we describe in this study, could be very helpful for evaluating the desirability of pursuing the development of any particular approach broad scale at military treatment centers.
Consider Adoption, Implementation, and Improved Dissemination of a U.S. Department of Defense–Wide Limited-Use Policy
DoD policies toward substance abuse are quite complex but generally emphasize a zero tolerance approach to controlled substance use, including the nonmedical use of a prescription drug. However, some of the services have adopted what is commonly referred to as limited-use policies, in which people who misuse prescription drugs can, under very specific conditions, self-refer to treatment and avoid harsh disciplinary actions or administrative separation. These programs are modeled on the successful Army CATEP, which was implemented with the explicit purpose of encouraging ADSMs to self-refer to treatment for alcohol problems before a reportable event occurs. Limited-use policies exist today in the Army (Army Regulation 600-85, 2012 [Headquarters, Department of the Army, 2012], p. 25, § 4-2) and Navy (Chief of Naval Operations Instruction 5350.4D, 2009 [Director, Personal Readiness and Community Support Branch, 2009], enc. 2, § e, p. 12) for those suffering from PDM, although they vary in terms of allowable behaviors and remain quite complex to fully interpret in light of the harsh zero tolerance language that surrounds them. Very few military medical providers with whom we spoke made any mention of the ability to self-refer to treatment, even though these policies exist, and those who did retained their belief that the risk of administrative separation from the military was a strong deterrent. Thus, either (1) broad awareness of these policies has not been achieved or (2) they do not represent a true change in the previous culture or perception of PDM as an illegal behavior worthy of separation from the military. Our reading of these policies suggests that expanding PDM limited-use policies to more service branches might be possible, making PDM function more like alcohol use does in CATEP. However, legal experts more familiar with the specific nuances of these policies and legal precedent within each of the service branches would need to be consulted before such a conclusion could be definitively made.
Of course, the insights from this study need to be considered in light of the study's limitations. In particular, there was limited evidence of effective strategies at the time in which we conducted our systematic review of the literature, but substantial attention given to the problem of PDM in the civilian sector in the past year might have generated some new evidence. Additional limitations of our study include the use of a limited sample of military medical providers and MTFs and missing data to inform the mathematical model. Before considering action on any of the study's key insights, it might be wise to conduct a more comprehensive survey of military health providers to obtain a more representative perspective of providers' barriers, challenges, and recommendations of providers, one that can consider differences that are likely to exist across regions, military facilities, and provider types.
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This research was sponsored by the Deputy Assistant Secretary of Defense for Readiness and conducted within the Forces and Resources Policy Center of the RAND National Defense Research Institute, a federally funded research and development center sponsored by the Office of the Secretary of Defense, the Joint Staff, the Unified Combatant Commands, the Navy, the Marine Corps, the defense agencies, and the defense Intelligence Community.
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Do you remember as kids when TGIF had a completely different meaning then it does now?
It meant that later in the evening Boy Meets World, Fresh Prince, and Sabrina would be on tv!
Now, it means the work week is done! Yay!
What I am getting to is TGIF!
Today I am linking up with Alison from Long Distance Loving for Friday's Fancies.
Awww...TGIF takes me back. And SNICK on Saturday nights...loving the peach get-up.
The kid in me really misses TGIF!
I totally agree...those are my two favorite items on the board as well! Have a great weekend!
TGIF meant Full House..Family Matters..Step by Step...Boy Meets World.. Ahhh! The good ol' days!
Oh yeah, I forgot about Step by Step, what great shows!
Fresh Prince of Bel Air...yes, please!! I can sing the entire theme song!! Love the FF round up...those shorts, top and scarf are definitely me!! Happy weekend!
haha When I read your comment I started singing the theme song.
I love that scarf and the sunglasses!
They really were such great shows!
I miss those days! Oh, to be a kid again!
Hello! I found your blog via the GFC Blog Hop and I've been reading back through your posts. I'm loving everything you listed here + the color palette. Also, speaking of TGIF, do you remember SNick?
Thanks so much! Oh, I completely forgot about snick!
i love that scarf - and i love that you included the melon- yum!
I can't ever get enough melon!


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Home Housing Henderson to consider embracing developers' worst nightmare
Henderson to consider embracing developers' worst nightmare
April Corbin Girnus
Single-family housing is the standard in Southern Nevada. (Image by Wallula from Pixabay)
"Anything except inclusionary zoning. Do not bring that up."
That was the immediate response one developer had for a Henderson City Council member after hearing the city would be updating its strategic housing plan.
Yet, despite the hemming and hawing from developers dead set against anyone even muttering those two words, the City of Henderson is currently working with national consultants to determine what inclusionary zoning policies might work for the growing suburb of more than 300,000 people. According to a city spokesperson, staff has requested proposals from two consulting companies and will be selecting one to delve into more specific research on the topic. City staff plans on updating city council members on the progress "in the next couple of weeks."
A meeting last month with city council members, developers and homebuilders provides some insight into what the debate might look like.
Inclusionary zoning is the tag given to municipal public policies that encourage or mandate that housing developments be affordable to people making low or moderate incomes. They vary from mandatory ("10 percent of your development must be priced below market rate") to voluntary ("we'll give you a tax break if 10 percent of your development is below market rate"), from inflexible ("your development will not be approved unless you do this") to flexible ("we'll take a fee instead and use it to fund our own affordable housing projects.").
Tyler Bump of EcoNorthwest, one of the firms consulting the city of Henderson, told the group of elected officials and developers that many people have a misconception that inclusionary zoning is one specific policy.
"Policies are different all over the country," he said.
Bump added that both flexible and inflexible zoning policies have proven to be successful, and that success depends on market specifics.
Michael Massie of Jamboree Housing Corporation, a nonprofit affordable housing developer based in California, echoed that. He said the nonprofit has built affordable housing developments both in cities that have inclusionary zoning policies and cities that don't.
"Does inclusionary zoning work? It absolutely does. Is there a cost? Yes. Is it possible to do it without inclusionary zoning? Yes, but with a big giant 'but' after it."
Massie compared two California cities — Irvine and Anaheim. He said the former adopted inclusionary zoning policies with the support of "a sophisticated staff and an enlightened elected council." The latter has not embraced inclusionary zoning but has used "every other resource" available, including buying land, hiring a large staff of their own and putting "real money, general fund money" into projects.
"Without that level of commitment, it's hard to get affordable housing done in any meaningful way," he said.
Anaheim was compelled to tackle the issue of affordable housing due to the growing number of low-wage workers at Disney's various resorts.
In Nevada, housing costs have outpaced wage growth by leaps and bounds, creating and widening what analysts call "the missing middle." Households that fall into the missing middle earn between $35,000 and $60,000 in annual income, therefore they do not qualify for public housing subsidies, but they also cannot afford available housing.
When it comes to housing, affordability is typically defined as spending 30 percent or less of your annual income. According to Applied Analysis, 30 percent of Henderson households are housing cost burdened. If current trends hold steady that number is expected to grow. The number reflects employed workers, renters, home owners and people across age demographics.
The median closing price of new homes sold in Henderson: $405,916.
Inclusionary zoning policies have been adopted across the country as a way to combat the issue of affordable housing.
Opposition from builders and developers is well documented nationally and in Nevada. During the 2019 Legislative Session, builders and developers spoke out against a seemingly simple bill whose only purpose was to clarify that local municipalities already have the legal authority to implement affordable housing policies such as inclusionary zoning or rent control. That bill unceremoniously died.
But several Henderson City Council members last month had a clear message to builders and developers: Inclusionary zoning is on the table here, so offer your constructive input.
"We have to figure out a way to solve this issue (of affordable housing)," said Councilman Dan Shaw. "How many affordable housing units did we build in Henderson last year? I don't know if we did any."
Councilman John Marz directed his thoughts directly to the developers and builders: "This is something we want you at the table for, because if you're not then you're going to be the victims. Because somebody has to do something."
Shaw said he has kids and grandkids making $50,000 — around the median annual income in Southern Nevada — and that they cannot afford market rate rents.
Later, one developer argued that affordable housing isn't as big of a problem as many make it out to be, and that the market rate for a one-bedroom apartment is within the generally accepted range of being 30 percent of annual median income in Southern Nevada. But the councilmembers pushed back.
"It is a problem now," said Marz. "Your example gives people no options. If I make $55,000 I have to have a one bedroom. I have no choice based off what you said."
David Paull of Nevada HAND, a nonprofit affordable housing provider, noted that starting teachers within Clark County School District don't make that amount per year.
"Teachers have to live outside the city," he said.
Representatives from builders and developers noted their support for other strategies mentioned in the current draft of the strategic plan. Those ideas include establishing an affordable housing trust seeded with revenue from short-term rental fees, exploring employer-assisted housing programs, encouraging nonprofits to rehabilitate existing multi-family properties into affordable housing, expanding the use of federal community development block grant money, and encouraging the use of "alternative construction methods that may allow for naturally occurring affordable housing due to lower construction/fabrication costs."
"We are at the table," said Amanda Moss of the Southern Nevada Home Builders Association. "We are here now. We want to be part of the solution but (inclusionary zoning) gives us a lot of heartburn."
The developers and builders argued that inclusionary zoning is better suited for more urban areas with higher density overall. In Henderson, single-family residences are the standard, comprising 75 percent of all housing units. That is a higher percentage than in Clark County as a whole, where 62 percent of housing units are single-family residences. The developers noted that new apartment complexes, which are more likely to help affordability than standalone homes, face an uphill battle when getting approved because existing residents fight them tooth and nail over fear they will negatively impact their property value.
Moss argued that while inclusionary zoning may lead to the creation of some below-market-rate units, it does so at the expense of private developers and leads to the price of market-rate units rising, which in turn just prices out other people who are also looking for housing: "For every $1,000 increase, you price out 18,000 people. You price out 18,000 for 440 (affordable housing) units."
She and others argued the city would be better off promoting voluntary incentive programs and fixing other housing-related issues, such as those related to density, land availability and infrastructure to support new developments. Several developers said or suggested they believe the city has an overall supply issue that isn't being properly addressed.
The council members acknowledged those concerns but seemed to hold steady on their belief that inclusionary zoning needs to be explored as an option.
"Every homebuilder has come (to us) and cried about density," said Marz to the developers and builders. "We have lowered the density. Much to my dismay. I've fought it for five years. You want 300-square-foot lots and you still charge $350,000."
April Corbin Girnus is an award-winning journalist with a decade of media experience. She has been a beat writer at Las Vegas Sun, a staff writer at LEO Weekly, web editor of Las Vegas Weekly and a blogger documenting North American bike share systems' efforts to increase ridership in underserved communities. An occasional adjunct journalism professor, April steadfastly rejects the notion that journalism is a worthless major. Amid the Great Recession, she earned a B.A. in journalism from the University of Nevada Las Vegas, where she served as editor-in-chief of the student newspaper. She later earned an M.A. in media studies and a graduate certificate in media management from The New School for Public Engagement. April currently serves on the board of the Society of Professional Journalists Las Vegas pro chapter. A stickler about municipal boundary lines, April enjoys teaching people about unincorporated Clark County. She grew up in Sunrise Manor and currently resides in Paradise with her husband, two children and three mutts.
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