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Addiction Medicine: A Talk With Dr. Jarid Pachter

first_imgFamily medicine specialist Jarid Pachter led a lecture on Addiction Medicine at the Cutchogue New Suffolk Free Library on June 20, sponsored by Eastern Long Island Hospital. Attendees were given a NARCAN kit with instructions on its use. Dr. Pachter has been practicing in Southold for more than a dozen years.What is NARCAN?NARCAN is not a treatment for drug-use disorder. NARCAN is a treatment that brings someone back from the brink of death from an opioid overdose. The way this medication works is that you put it in a person’s nose and it removes the opiate from the parts of the brain that are controlling their breathing so they’re not in respiratory arrest anymore.It’s my feeling that everyone should be given a NARCAN kit.Is it effective for all opioid-related overdoses?The problem with NARCAN is that most heroin nowadays has fentanyl in it, so it takes more than one dose of NARCAN to revive that person because the fentanyl is so powerful.Why is fentanyl put into heroin?Drug dealers from multiple countries are competing with each other for business and fentanyl is not just a more potent drug, it’s also a hell of a lot cheaper, which means people can produce more of it and make more money off of it.Where do substance-abuse disorders stem from?Substances have been around for thousands of years. When something has been around for that long, it actually has the ability to change your genetic make-up. There’s always a family history. The story is always the same with patients who I see in detox. There’s always a family history of that person — and not necessarily using substances. It could be gambling; it could be a sex addiction; it could be a body-building obsession or body dysmorphia, but there is mostly always a family history of addiction.What is a common road toward heroin use?Let’s pretend you got Vicodin because you got your wisdom tooth removed and that first time you took the Vicodin you loved it. It was amazing. The dentist was so nice he gave you 60 of them, which happens all the time. I don’t mean to pick on dentists, but they’re notorious for this. I can’t attest that much has changed with that since the prevalence of opiate use.So he gives you the 60 pills and says you should take them in three or four weeks, but you went through them in three or four days, so you start going toward the doctor to get more pills, which aren’t going to make you feel the same way as the first one, but you start buying, crushing, and sniffing pills, which are expensive, and eventually you’ll run out of money and turn to heroin. Everyone says, ‘Oh, I’ll never do heroin.’ Yeah, you will. It’s inevitable, so you start sniffing heroin and injecting heroin, but you’ll never again feel the same way as you did that first time. What happens is, over time, dopamine isn’t getting released anymore and all the morphine or heroin or oxycodone is doing is keeping you from having withdrawal or not being sick, then you have to keep using in order to not be [email protected] Sharelast_img read more

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Sovereign Wealth Fund: A proposed framework for Guyana’s Petroleum Sector – (Part 1)

first_imgGuyana is just two years away from the commencement of commercial oil production in 2020. Hence, in the coming weeks, this column will be dedicating a series of articles on a proposed framework for a Sovereign Wealth Fund (SWF) for the extractive sector. The Government of Guyana (GoG) has assured that a SWF will be in place well in advance of the production of oil in 2020. However, this should not be treated lightly given the slothful pace at which things are being done sometimes, if not at all time – for it will call for a lot of work on the part of the Government to establish.Over the last two years or so (2016/2017), there has been much public discussions and/or debates on the model of the SWF that Guyana should adopt. As a contribution to the discussions, this newspaper carried a beautiful piece in one of its Editorials on June 22, 2017, with the caption – “Guyana’s Sovereign Wealth Fund”. The editorial highlighted that the Opposition Leader suggested that Guyana should adopt the Norway model instead of Trinidad and Tobago’s. Indeed, the Norway model is among one of the bests in the world as compared to Trinidad and Tobago.But surprisingly, in the last press release on the subject of a SWF sometime in December 2017, the Finance Minister implied that the Government has crafted a preliminary legislation by looking closely at Uganda’s legislation, and which has been reviewed by the Inter-American Development Bank (IDB), International Monetary Fund (IMF), the Commonwealth, United States and the United Kingdom.Despite it has been (hopefully & truthfully) submitted for review by these international institutions, according to the Minister; this column is not convinced and/or impressed with this development – chiefly the mirroring of Uganda’s model. The Finance Minister sought to justify this approach by stating that Uganda is at a similar stage of development of its petroleum sector to that where Guyana is currently or will be (I stand corrected). This justification (if its indeed true) is in itself an unjustifiable and unfathomable justification, simply because – if Uganda is at the same stage as Guyana, then they are still at the trial and error phase and it is thus logically a weak framework, or certainly not the best.One may naturally have the proclivity to wonder, why such a harsh assertion as stated above. Uganda is an oil producing country in East Africa, but the problem with Uganda is that it is known to be one of the most corrupt countries in the world. In fact, this is not just an universal perception, it is a factual ideology supported by an 11-page report which was published on the “Overview of corruption and anti-corruption in Uganda,” by Transparency International (www.transparency.org).Also, recently there was a video on YouTube – which went viral on the Internet – showing a huge ‘brawl’ in Uganda’s Parliament. The video was circulated just around the same time on social media, when our own Parliament went into a moment of chaos, paralleling the exact drama in Uganda’s Parliament; but the only differences were, (1) the Police did not intervene in Uganda’s Parliament and, (2) the politicians were seen, literally and physically assaulting one another.For a developing country like Guyana, the least you want to do is to adopt a weak framework, susceptible to corrupt tendencies by politicians. The wisest and brilliant thing to do is to adopt one of those frameworks that were proven to be successful and yield the best results for the country and its people, by the much more advanced economies.Norway, on the other hand, is one of the most peaceful and clean countries and it ranks among the least corrupt countries in the world (http://www.business-anti-corruption.com/country-profiles/norway), noting that according to the 2016 Corruptions Perception Index reported by the Transparency International, Norway is the 6th least corrupt nation out of 175 countries. In further citing the report, “Corruption Rank in Norway averaged 8.09 from 1995 – 2016, reaching an all-time high of 14 in 2008 and a record low of five in 2013. In the same report, Uganda was ranked 151 least corrupt out of 175, ranking on average 112 from 1996-2016, reaching an all-time high of 151 in 2016 and a record low of 43 in 1996 – while Guyana was ranked 108 least corrupt out of 175 nations, averaging 123.58 from 2005 – 2016, reaching an all-time high of 136 in 2013 and a record-low of 108 in 2016.In closing for today, should we not try to emulate a country like Norway that has done remarkably well in these key areas? Why do we want to emulate a globally perceived corrupt country that is even worse off in that regard than our own country? What does this tell you about where we are heading and the kind of framework that the Administration wishes to set up?*The Author is the holder of a MSc. Degree in Business Management, with concentration in Global Finance, Financial Markets, Institutions & Banking from a UK university of international standing.last_img read more

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APOEL Nicosia 0-3 Tottenham: Harry Kane the hat-trick hero

first_img1 Harry Kane delivered a Champions League masterclass by hitting a hat-trick and leading Tottenham to a 3-0 demolition of Apoel Nicosia.There are few superlatives left to describe Kane’s relentless goalscoring form but the striker broke new ground in Cyprus with his first treble in Europe’s premier competition.A cool first-half finish set Spurs on their way before two in five minutes after the interval rounded off another stellar night for Kane, who trundled off to a standing ovation with 15 minutes left.His ninth club hat-trick also puts Tottenham in a commanding position to qualify from Group H after Borussia Dortmund’s loss at home to Real Madrid leaves the German side six points adrift.Mauricio Pochettino’s men head to the Santiago Bernabeu next month and they will hope to have a stronger representation too, given they arrived here with seven key players missing.With Kane in this sort of mood, they will believe anything is possible, the 23-year-old’s record in 2017 now showing 34 goals in 30 Spurs appearances.He is only the seventh English player to score a Champions League hat-trick after Andy Cole, Mike Newell, Michael Owen, Wayne Rooney, Alan Shearer and Danny Welbeck.There were fears Tottenham might struggle with Christian Eriksen and Mousa Dembele joining Erik Lamela, Danny Rose, Victor Wanyama on the sidelines, along with the suspended Jan Vertonghen and Dele Alli.Pochettino’s solution was to push Ben Davies into the back three, where he has often played for Wales, while Serge Aurier and Kieran Trippier took position out on the flanks and Harry Winks was handed his second start of the season in midfield.Winks was excellent and his dynamic display will offer Pochettino encouragement should Dembele’s niggling foot injury continue to limit the Belgian’s playing time.Apoel’s own talented playmaker Roland Sallai was deemed fit enough to start and there was also a place for holding midfielder Nuno Morais, once bought by Jose Mourinho for Chelsea.The Cypriot side boast a surprisingly strong record at home, having previously lost only one of their last 11 European matches in front of their own fans, and they rattled the crossbar after 18 minutes when Igor de Camargo took advantage of an Aurier slip.Tottenham lost their way as the half wore on and Apoel twice could have taken the lead, Carlao heading wide from a corner before Hugo Lloris kicked straight into Sallai and was relieved to see the ball cannon clear of his own post.The hosts would soon rue their missed chances. One pass from Toby Alderweireld in the 39th minute split their defence open and Kane, played onside by Praxitelis Vouros on the far side, confidently slid home the finish.Son Heung-min and Sallai both had sights at goal early in the second period and when Apoel got in down the left again, this time through the excellent Stathis Aloneftis, Pochettino decided Aurier’s night was up. The Ivorian came off for Fernando Llorente and the visitors reverted to four in defence.Just as Apoel looked to be gaining momentum again, Spurs, and Kane, delivered two goals in the 62nd and 67th minutes to crush any hopes of a comeback.First, Moussa Sissoko provided an excellent cut-back from the right for Kane to plant in the corner and then the striker turned playmaker too, sending a bending pass wide to Trippier before ghosting into the box and heading in the resulting cross.Apoel’s belief was now extinguished and all that was left was for 20-year-old Anthony Georgiou, a Cypriot youth international, to make his debut off the bench late on. By then Kane was resting up for Huddersfield on Saturday. Harry Kane claims the match ball last_img read more

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Low lending rate, forex ‘will shield SA’

first_img11 August 2011 A low lending rate and the Reserve Bank’s stockpiling of more than US$50-billion in foreign currency will help shield South Africa from some of the turmoil experienced by global markets following the US credit rating downgrade, says the Bank’s deputy chief economist. However, the market turmoil of the past few days would impact “fairly heavily” on consumer and business confidence, Johan van den Heever told the National Assembly’s finance committee in Cape Town on Wednesday. He was briefing the committee on the release of the Reserve Bank’s 2011 Annual Economic Report, which highlights South Africa’s poor export performance and slow recovery of lending by banks.Not good news for investment “It is quite clear that people will under the circumstances be more reluctant to enter into bold ventures, big capital expenditure, really heavily-geared undertakings, and so that it is not good news for short-term growth and longer-term investment,” Van den Heever said. But he believed that despite this, South Africa would continue to grow – on the back of a consumer spending upswing combined with low interest rates, a strong financial system and relatively good fiscal conditions. One positive to come out of the market chaos and resultant high level of uncertainty, he added, was an increase in the gold price, which would benefit the economy.Bank lending still low Turning to the Reserve Bank’s annual economic report, the Reserve Bank’s head of financial analysis and public finance, Vukani Mamba, said that despite South Africa’s interest rates being at their lowest in 30 years, lending by the country’s banks had not picked up substantially since the global financial crisis of 2008-09. He said recovery of credit advances had been slower than that following South Africa’s previous recessions in 1974, 1982 and 1990. The report revealed that advance of credit had, by February 2011, increased by just 5% from the level it stood at in May 2009, just months before the economy began recovering in September 2009. Mamba attributed this to the poor recovery of the country’s productive sectors, the high number of job losses (reducing the number of those who qualified for credit) and high levels of indebtedness of consumers. Banks had also incurred high impairment rates, which had seen them pulling back on lending. The report said the level of impaired advances, which grew to 6.1% in December 2009, had levelled off last year and stood at 5.8% in April this year. Despite this, South Africa’s percentage of non-performing loans remained “relatively high” when compared with other emerging-market countries. At just under 6% in the fourth quarter of 2010, the level of non-performing loans was lower than Russia (at over 9%), but higher than Brazil and Chile (3%) and India (just below 3%). However, Mamba believed the prudence of the country’s banks had been instrumental in protecting the economy, considering that the global financial crisis had been triggered by US banks lending to highly indebted individuals.Poor export performance Another area of concern highlighted by the Reserve Bank’s report is South Africa’s poor export performance. Van den Heever pointed out that the country’s exports had not kept track with those of its fellow BRICS countries and advanced economies, which had rebounded at a far faster rate following the end of the recession. He attributed the poor performance of exports to “quite a long list” of problems and not just to the strength of the rand. These included infrastructure bottlenecks, lack of electricity capacity and the falling quality of some of the country’s minerals, including the grade of gold mined. South Africa’s productivity was also a challenge, particularly when compared with a country like China, Van den Heever said. Added to this, many of South Africa’s export destinations were in the developing world – Europe, Japan and the US – where the recession had cut the deepest. He warned that if South Africa’s exports continued their lacklustre performance, the fiscus would be reduced. However, he said South Africa had built up its foreign currency reserves from $8-billion in 2002 to about $50-billion currently, which would allow the country to pay for imports if it exports continued to underperform. Source: BuaNewslast_img read more

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South African artist to honour ‘lost men’ of WW1

first_img15 November 2013A work by South African artist Paul Emmanuel has been included in France’s official state commemoration of the centenary of the First World War next year.Emmanuel’s The Lost Men France was selected by a multidisciplinary committee of World War One experts from France and elsewhere.The programme, which was launched in Paris on 7 November, begins next year and will run for four years, Nkosingiphile Khumalo, account executive at Art Source South Africa, said in a statement last week. Art Source SA are managing The Lost Men project.Emmanuel’s work will be shown near the Thiepval Memorial to the Missing of the Somme in the region of Picardie, northern France from July to October next year. The banners will be reinstalled during 2016 and 2018.The Thiepval Memorial is a major war memorial to the more than 72 000 missing British and South African men who died on the Somme battlefields 1915 and 1918 and who have no known grave.As a member of the Commonwealth, South Africa joined Britain in its fight against the German Empire, Khumalo says. Many South African soldiers, who would have been wearing British uniforms, died in the Verdun/Normandy/Delville Wood areas during 1916.The Battle of Verdun is known as the single worst land battle ever fought; it had the most casualties ever recorded in any war in human history.The Lost Men France engages with the 45-metre-high Thiepval monument and “visitors will encounter the ephemeral, temporary installation while walking down an adjacent farm road within view of and accessible from the Thiepval Memorial grounds”.“An anti-monument, it does not glorify war but asks questions about masculinity and vulnerability,” Emmanuel writes on his website. “It questions the exclusion of certain people in traditional memorials – in particular black South African servicemen.”‘Left to the wind’The work will comprise a 600m stretch of “large, fragile, semi-transparent silk banners” which, unlike the Thiepval Memorial, will “depict the names of black and white South African servicemen and will include the names of soldiers from the other Allied Forces as well as those of German soldiers who died in battlefields all over the Western Front”, says Emmanuel. It will “be a non-partisan artwork and makes no political statements”.The names were photographed after being pressed into the artist’s body, without reference to rank, nationality or ethnicity. These banners will be hung in the landscape and “left to the wind”.In his speech at the projects’ launch last week, French President Francois Hollande invited the public to this and other sites of remembrance by saying, “tracer des chemins de memoire”, or “trace the paths of memory”.Emmanuel researched First World War battles during his extended stay in France in 2012 while on a four-month residency supported by Institut Français.In his artist’s statement, Emmanuel writes: “I am, as many are, affected by these terrible historic battles. A war has lasting psychological effects that are passed from generation to generation; we lose humanity, gentleness and vulnerability, feeling, empathy and sensitivity.“We lose dignity, treasured relationships, potentiality, hope and the future. We become defined by ideologies that can confine and define our world-view. As the Thiepval Memorial bears witness to the memory of thousands of lost servicemen, so The Lost Men France will also bear witness. It is a non-partisan artwork that aims to stimulate contemplation about all of this.”The Lost Men France is supported by La Mission du Centennaire de la Premiere Guerre Mondiale, Institut Français Paris and Johannesburg, and the National Arts Council of South Africa.Source: SAinfo reporter and ArtSource South Africalast_img read more

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