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Older adults who are African American muscle relaxant herniated disc discount voveran 50mg with mastercard, Mexican American spasms after surgery order voveran 50mg, and Asian American experience psychological problems that are often associated with discrimination by the White majority (Youdin spasms icd 9 code discount voveran 50mg with visa, 2016) muscle relaxant vs anti-inflammatory order voveran 50mg on line. Ethnic minorities are also more likely to become sick, but less likely to receive medical intervention. Older, minority women can face ageism, racism, and sexism, often referred to as triple jeopardy (Hinze, Lin, & Andersson, 2012), which can adversely affect their life in late adulthood. Poverty rates: According to Quinn and Cahill (2016), the poverty rate for older adults varies based on gender, marital status, race, and age. Women aged 65 or older were 70% more likely to be poor than men, and older women aged 80 and above have higher levels of poverty than those younger. Married couples are less likely to be poor than nonmarried men and women, and poverty is more prevalent among older racial minorities. In 2017, of those 65 years of age and older, approximately 72% of men and 48% of women lived with their spouse or partner (Administration on Aging, 2017). Between 1900 and 1990 the number of older adults living alone increased, most likely due to improvements in health and longevity during this time (see Figure 9. Since 1990 the number of older adults living alone has declined, because of older women more likely to be living with their spouse or children (Stepler, 2016c). Older women are more likely to be unmarried, living with children, with other relatives or non-relatives. Older men are more likely to be living alone than they were in 1990, although older men are more likely to reside with their spouse. The rise in divorce among those in late adulthood, along with the drop-in remarriage rate, has resulted in slightly more older men living alone today than in the past (Stepler, 2016c). According to a Pew Research Center Survey, only 33% of those living alone reported they were living comfortably, while nearly 49% of those living with others said they were living comfortably. Similarly, 12% of those living alone, but only 5% of those living with others, reported that they lacked money for basic needs (Stepler, 2016d). No, but according to the Pew Research Center, there has been an increase in the number of families living in multigenerational housing; that is three generations living Source together than in previous generations (Cohn & Passel, 2018). In 2016, a record 64 million Americans, or 20% of the population, lived in a house with at least two adult generations. However, ethnic differences are noted in the percentage of multigenerational households with Hispanic (27%), Black (26%), and Asian (29%) families living together in greater numbers than White families (16%). Consequently, the majority of older adults wish to live independently for as long as they are able. According to Erber and Szuchman (2015), the majority of those in late adulthood remain in the same location, and often in the same house, where they lived before retiring. Although some younger late adults (65-74 years) may relocate to warmer climates, once they are older (75-84 years) they often return to their home states to be closer to adult children (Stoller & Longino, 2001). Despite the previous trends, however, the recent housing crisis has kept those in late adulthood in their current suburban locations because they are unable to sell their homes (Erber & Szuchman, 2015). However, as individuals increase in age the percentage of those living in institutions, such as a nursing home, also increases. Specifically: 1% of those 65-74, 3% of those 75-84, and 10% of those 85 years and older lived in an institution in 2015. Due to the increasing number of baby boomers reaching late adulthood, the number of people who will depend on long-term care is expected to rise from 12 million in 2010 to 27 million in 2050 413 (United States Senate Commission on Long-Term Care, 2013). To meet this higher demand for services, a focus on the least restrictive care alternatives has resulted in a shift toward home and community-based care instead of placement in a nursing home (Gatz et al. Those in late adulthood need to achieve both the acceptance of their life and the inevitability of their death (Barker, 2016). This acceptance will lead to integrity, but if elders are unable to achieve this acceptance, they may experience despair. Bitterness and resentments in relationships and life events can lead one to despair at the end of life. According to Erikson (1982), successful completion of this stage leads to wisdom in late life. The current focus on aging well by keeping healthy and active, helps to promote integrity. There are many avenues for those in late adulthood to remain vital members of society, and they will be explored next. Staying Active: Many older adults want to remain active and work toward replacing opportunities lost with new ones.

Complete a search in Documentum and update an existing record or create a new record muscle relaxant ointment buy discount voveran 50 mg online. Create a "New Box" in the Record Storage Application muscle relaxant non-prescription buy voveran, which can be found at: intranapps spasms catheter cheap generic voveran uk. On the outside of the box write the box number assigned by the Record Storage Application f spasms near heart 50mg voveran with amex. Severe injuries are defined as bodily injury which involves substantial risk of death, extreme physical pain, protected and obvious disfigurement, or protracted loss or impairment of the function of a bodily member, organ, or mental faculty. Routine surgery or injury obtained through routine play or sports participation is not required to be reported. Media- incident which has drawn public media attention or become a legislative concern B. Subject Line Naming Convention the subject line of the email shall include only the following: i. If the incident does not meet the definition of a critical incident determined by the Regional Director, designee or Administrators, any follow up necessary shall be coordinated within the region. A death, near death, attempted suicide, or serious physical injury involving a child with an open service or foster care case, or a child is named in an open investigation or family assessment; 2. A death, near death, or serious physical injury of a child when child abuse or neglect is suspected; 3. The Critical Incident Review and Assessment process consists of the following parts: 1. When the Secretary has entered into a contract or memorandum of agreement or understanding the terms are binding on the entire agency. This requires communication among the various divisions, regions, contract agencies and individuals. Use of the courts to settle internal disputes diminishes, and perhaps destroys our ability to carry out our responsibility as an equal branch of government. The Family Based Assessment includes questions regarding substance use disorders to assist staff in determining the need for further screening and assessment services. Families with available insurance coverage should seek services first through the process established by that company. Addiction and Prevention Services provides funding for an array of programs across the state including these specialized services: 1. Social Detoxification for customers under the influence of drugs or alcohol or experiencing acute withdrawal. Residential and outpatient programs for pregnant women and women with dependent children. Work Program Services (job training, job search and related employment assistance) 6. Description of Penalties Penalties are utilized only when customers have clearly chosen not to cooperate and the consequences are understood. Consult the Rehabilitation Services Manual for information about eligibility and services. Coordinate the inclusion of Kansas Rehabilitation Services in the case conferences of potentially eligible youth, as needed. It is intended to provide services to a consumer in their own home and community, the least restrictive environment, at a cost savings to the Medicaid program. Home and Community Based Services include a variety of medical and non-medical services which meet the needs of those served by the waiver. For types of waivers, eligibility requirements and application information, see waiver overview chart at. These programs are intended to provide active treatment in a structured therapeutic environment for children and youth with significant functional impairments resulting from an identified mental health diagnosis, substance use diagnosis, sexual abuse disorders, and/or mental health diagnosis with co-occurring disorder. The residential treatment facility is expected to work actively with the family and other agencies to offer strengths-based, culturally competent, trauma-informed, medically appropriate treatment designed to meet the individual needs of the residents. It encourages parents and other care givers to obtain periodic well-child visits to the doctor for their children, thereby keeping immunizations up to date and treating medical conditions when they first appear. It promotes good health by identifying and treating medical, dental, developmental and emotional conditions.

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Cognitive impairment spasms heart generic voveran 50mg otc, including confusion and communication deficits spasms jaw muscles buy 50 mg voveran with mastercard, is the greatest risk factor for elder abuse muscle relaxant agents purchase line voveran, while a decline in overall health resulting in greater dependency on others is another spasms pregnant belly buy 50mg voveran with amex. Having a disability also places an elder at a higher risk for abuse (Youdin, 2016). Definitions of elder abuse typically recognize five types of abuse as shown in Table 9. Psychological and emotional abuse is considered the most common form, even though it is underreported and may go unrecognized by the elder. Continual emotional mistreatment is very damaging as it becomes internalized and results in late-life emotional problems and impairment. Financial abuse and exploitation is increasing and costs seniors nearly 3 billion dollars per year (Lichtenberg, 2016). Financial abuse is the second most common form after emotional abuse and affects approximately 5% of elders. Abuse and neglect occurring in a nursing home is estimated to be 25%-30% (Youdin, 2016). Abuse of nursing home residents is more often found in facilities that are run down and understaffed Table 9. Additionally, a family history of violence makes older women more vulnerable, especially for physical and sexual abuse (Acierno et al. Recent research indicated no differences among ethnic groups in abuse prevalence, however, cultural norms regarding what constitutes abuse differ based on ethnicity. For example, Dakin and Pearlmutter found that working class White women 422 did not consider verbal abuse as elder abuse, and higher socioeconomic status African American and White women did not consider financial abuse as a form of elder abuse (as cited in Roberto, 2016, p. Perpetrators of elder abuse are typically family members and include spouses/partners and older children (Roberto, 2016). Children who are abusive tend to be dependent on their parents for financial, housing, and emotional support. Substance use, mental illness, and chronic unemployment increase dependency on parents, which can then increase the possibility of elder abuse. Prosecuting a family member who has financially abused a parent is very difficult. The victim may be reluctant to press charges and the court dockets are often very full resulting in long waits before a case is heard. According to Tanne, family members abandoning older family members with severe disabilities in emergency rooms is a growing problem as an estimated 100,000 are dumped each year (as cited in Berk, 2007). Paid caregivers and professionals trusted to make decisions on behalf of an elder, such as guardians and lawyers, also perpetuate abuse. When elders feel they have social support and are engaged with others, they are less likely to suffer abuse. Substance Abuse and the Elderly Alcohol and drug problems, particularly prescription drug abuse, have become a serious health concern among older adults. Although people 65 years of age and older make up only 13% of the population, they account for almost 30% of all medications prescribed in the United States. Six to eleven percent of elderly hospital admissions, 14 percent of elderly emergency room admissions, and 20 percent of elderly psychiatric hospital admissions are a result of alcohol or drug problems. Older adults are hospitalized as often for alcoholic related problems as for heart attacks. Nearly 17 million prescriptions for tranquilizers are prescribed for older adults each year. Benzodiazepines, a type of tranquilizing drug, are the most commonly misused and abused prescription medications. Risk factors for psychoactive substance abuse in older adults include social isolation, which can lead to depression (Youdin, 2016). This can be caused by the death of a spouse/partner, family members and/or friends, retirement, moving, and reduced activity levels. Additionally, medical conditions, chronic pain, anxiety, and stress can all lead to the abuse of substances. Diagnosis Difficulties: Using criteria from the Diagnostic and Statistical Manual of Disorder-5th Edition (American Psychiatric Association, 2013), diagnosing older adults with a substance use disorder can be difficult (Youdin, 2016). For example, compared to adolescents and younger adults, older adults are not looking to get high, but rather become dependent by accident.

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We can then publish these as components of increasingly sophisticated digital libraries that can parse their structure and mine the machine-actionable information within them: the scholarly labor applied to each edited document becomes training data that then improves the automated results for the rest of the document in question spasms 1983 purchase online voveran, as well as the corpus of digital Latin muscle relaxant otc cvs buy 50mg voveran otc. If we understand editing as the process of enabling others to think about an object from the past spasms of the heart discount 50mg voveran fast delivery, then the editorial process applies as much to spaces skeletal muscle relaxant quizlet cheap 50 mg voveran with amex. Editors can be as much artists as scholars, for the editor who contextualizes an object directs the reader, listener or viewer to a nite set of data that align themselves into meaningful patterns. The point is not to vanishto vanish is to deceive and to imply a transparency that simply does not exist. The addition of punctuation, the use of upper case to mark proper names, specialized glossaries, the addition of name and place indices, and even translations pregure major classes of machine-actionable annotationinterpretations of morphological and syntax analyses, lexical entries, word senses, co-reference, named entities are only a subset of the features we may choose to include as new practices of editing emerge. Even when we turn to the most heavily studied classical Greek and Latin texts, a radically new world is taking shape. We have returned to an age of the editio prineps not literally the rst edition, but the rst edition in a medium so distinct from that which preceded it that it constitutes a new beginning. We see before us a great ageindeed, a heroic age, one lled with triumphs and false starts, messy, destabilized and destabilizing, and, above all, dynamic. But before exploring those consequences, we will rst outline some basic goals based upon the changing possibilities within the digital culture. The following have proven useful to me and I oer them if only to explain the decisions implicit in what I will describe later. I oer implications that I have drawn from three largely hierarchical perspectives: the humanities as a whole, the study of the Greco-Roman world, and the responsibilities of a Classical Philologist. I am not pursuing the cures to dread diseases or developing new sources of energy. To some extent, my work resembles that of the scientist or mathematician developing knowledge without immediate practical applications. But the funders of such basic research point to the long- term utility of such initially abstract activitythe basic research of today needs to be unfettered so that it can stumble upon the practical methods of tomorrow. If our goal is to support the intellectual life of humanity by making intellectual actions transparent for inspection, then the editorial process, construed as the sustained process of making primary sources intellectually accessible, rises to the fore. The most brilliant hypotheses and argumentation only assume their full value insofar as any human being can drill down behind the exposition and into the evidence. Publishing in conventional journal articles that assume specialized knowledge and that are legally restricted behind subscription gateways has much less appeal than it did when I began my life as a professional scholar a generation ago. Access has a physical dimensionwe cannot make every site and every artifact physically accessible but we can do far more with their digital counterparts. But access also has an intellectual dimensionwe need to provide people with the tools that they need to think productively about what they see. To realize physical and intellectual access, we need rights regimes that allow the digital surrogates for human cultural heritage to ow freely and instantaneously back and forth between humans and machines. In the history of intellectual life this act was as hemo s was not the rst such publication. In the 1980s, Thomas Martin, one of 24 the founders of the Perseus Project, created an Overview of Greek Culture that appeared both as a print book published by a university press and as a electronic publication that contained machine-actionable links to primary sources and to dynamic services. Christopher Blackwell was the rst to create such a publication as an independent project and to hazard his career upon the experiment. In the eld of classics, Pritchard 2008 has explored recent eorts to make more secondary scholarship available as open access. There are clear benets to working with the most up-to-date editions of Greek and Latin source materials, but if we work with primary sources that are legally entailed, whether by contract or copyright law, we bear the cost of losing open access and open content. Open access in this case designates the ability to make a source freely available and to allow anyone without restriction to examine the primary sources on which our work is based. The fact that many of these sources may not have accompanying translations in a language familiar to a particular audience is a subject to which I will return. I use open content to designate the right for third parties to modify, repurpose and redistribute derivative works from original digital editions freely. Even if we only interest ourselves to our professional colleagues with privileged access to commercial databases, we cannot conduct emerging scholarship without the ability to create derivative works. This includes not only the production of new editions but also of scholarship 25 that augments digital corpora.

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