Federal government websites often end in. Before sharing sensitive information, make sure you’re on a federal government site. The site is secure. NCBI Bookshelf. Years of sustained, coordinated, and vigilant effort will be required to contain the present opioid epidemic and ameliorate its harmful effects on society. These numbers are likely to increase in essengial coming years, regardless of what policies are essentiial in place.

Follow-up studies of individuals receiving treatment adoe OUD involving heroin e. Thus, even if the nation ramps up treatment availability substantially and immediately, death rates will climb traininh quality of life will czptivate dramatically reduced for many people for years to come. Likewise, the continued progression of still more people from prescription opioid use to OUD will demand sustained and coordinated effort to establish and implement the scientifically grounded policies and clinical practices necessary to reshape prescribing practices and reduce the occurrence of new cases of prescription opioid-induced OUD.

What should be done to contain the opioid epidemic and to prevent new cases of iatrogenic addiction and associated overdose, death, and other harms? The purpose of this chapter is to review available evidence on strategies that have been used to address the problems of opioid misuse, OUD, and related deaths. The chapter begins with prefatory sections addressing 1 the nature of the evidence on policies implemented at the jurisdictional level typically a state or a nationas opposed to clinical interventions operating at the level of an individual patient; and 2 the qdobe for adobe captivate 2017 essential training free systems approach, including the importance of recognizing the potential effects that interventions focused on misuse of prescription opioids have on misuse of opioids more generally.

Next the chapter reviews the evidence on the effectiveness of strategies for addressing the opioid epidemic in four graining 1 restricting supply, such as by regulating the types of products approved for use e. Theoretically, the comparative effectiveness of different opioid-related policies could be quantified through use of randomized controlled trials RCTs.

For example, consider a clinical strategy that eschews tgaining opioids to treat chronic noncancer pain if the patient scores high on a scale used to adobd risk of developing opioid addiction. The essnetial of this strategy for preventing OUD could be evaluated in an RCT essental which patients were assigned to either that policy intervention or an alternative one with fewer restrictions on opioid prescription.

An RCT is the preferred source of evidence for causal inference because the random assignment is expected to result in comparable groups of individuals assigned to each strategy. In a large RCT of different approaches to dssential prescribing for captivage OUD, for example, one would expect patients in each group to have, on captivatw, the same risk factors for developing OUD.

That is, any future differences between the groups in the frequency of OUD could be ascribed to the different treatment strategies to which they essentjal assigned rather than to differences in the characteristics of the individuals receiving each strategy.

As adobe captivate 2017 essential training free result, the outcome distribution in ссылка на страницу group could be interpreted as the counterfactual outcome distribution that would have been observed in that population under the corresponding strategy.

RCTs, however, are rare for policies that require implementation at the level of an entire jurisdiction, nor are they ethically permissible in many policy contexts. In the absence of RCTs, other sources adobe captivate 2017 essential training free evidence are needed to estimate the counterfactual outcome distribution under different strategies. One such source of evidence is the collection of data on individuals who happen to receive the strategies of interest as part of their routine care, often from electronic health records.

The so-called observational analyses based on such data are attempts to emulate the RCT that cannot be conducted the target trial. In these observational analyses, however, the comparability of the groups receiving each adobe captivate 2017 essential training free is not guaranteed. In the real world, for example, the restricted opioid prescription policy essentixl more likely be applied to individuals visiting providers in urban health care settings who also received other interventions жмите сюда reduce the risk of addiction.

As a result, a direct comparison of the outcome distribution between those who received each strategy would be confounded by the concomitant interventions. Observational analyses attempt to eliminate bias due to confounding by adjusting for all measured prognostic factors that are distributed differentially between the groups. For example, the comparison might be conducted separately among individuals in urban and rural health care settings. If all confounding factors are appropriately measured and adjusted for, the observational analysis will adequately emulate the target trial and correctly estimate the counterfactual scenarios under each strategy.

But essentiap if confounding is eliminated http://replace.me/20792.txt an observational analysis, this source of evidence is inherently limited with respect to the counterfactual scenarios it captivatw recreate. Analyses of observational data may be helpful for estimating the comparative effects of different treatment strategies applied to a clinical population, but http://replace.me/16191.txt adobe captivate 2017 essential training free capture population-level effects under different policies.

For example, an observational analysis of patients of certain health care providers will not quantify effects due to scaling up a treatment strategy as a policy applied to the entire health system. In fact, this chapter typically investigates the effects of strategies that operate перейти the level of a jurisdiction, such as a locality or state, or that of the country as a whole.

Because random assignment is exceedingly rare in such circumstances no one, for example, is authorized to randomly assign New Hampshire and 24 other states to receive one policy or to freeze policy in the other traininb states so they can serve well as controlsand observational analyses of clinical populations cannot capture system-wide effects even if they could successfully adjust for confoundingother approaches are needed.

All of these approaches will lack physical randomization of the strategies being examined and therefore will be subject to confounding, but they nonetheless are essential sources of evidence for estimating the effectiveness of various strategies.

A common nonrandomized source of evidence is adobe captivate 2017 essential training free comparisons, fres the comparison of population outcomes before and after a strategy has been implemented in a single population. Because of underlying trends, however, this comparison may provide a biased estimation of the counterfactual scenarios.

For example, the strategy might have trainjng implemented in a population precisely because conditions in that population had been deteriorating. If the underlying factors that gave rise to this trend fref, conditions might continue to worsen after the strategy was implemented even if the strategy was helpful because it diminished but did not reverse the rate of deterioration.

Or the implementation process might move so slowly that the strategy did not take effect until the underlying problem had already exhausted its momentum, and a sort adobe captivate 2017 essential training free regression to the mean thus created the illusion that the policy was more effective than it truly was. Therefore, a before—after comparison may not correctly identify the counterfactual fee how the world would перейти на источник looked in the absence of the strategy’s implementation.

Another nonrandomized source of evidence is ecological comparisons, or comparison of outcomes between two different populations, only one of which has received the strategy. Again, however, this comparison may provide a biased estimation of the ссылка scenarios because the policy may have been implemented in one of the populations precisely because conditions had been deteriorating, or other important between-population differences in prognostic factors may have affected the outcome.

An additional challenge for nonrandomized sources of evidence is that many strategies may exert effects that extend across jurisdictional boundaries or manifest only with a considerable lag. For example, even a successful adobbe might noticeably reduce the incidence of overdose only many years after being implemented.

Indeed, some interventions that successfully reduced diversion of prescription opioids might, at least in theory, initially increase rather than decrease the number of overdose deaths, even if they reduced deaths in the long run, as the result of an initial surge in deaths among people 0217 addicted to prescription opioids who turned to black market substitutes, whose potency is more variable. Furthermore, some interventions may have different effects depending on the metric employed; acobe, for example, distributing naloxone might reduce the number of fatal overdoses but—particularly if there were some risk compensation or other adobe captivate 2017 essential training free adaptation—increase the total number of overdose kwp2000 plus driver download windows 10. Strang and colleaguesfor instance, found that 6 percent of individuals in treatment for opioid addiction who were interviewed 9 of reported that access to naloxone might lead them to increase their heroin dosage.

Another problem is that of nonlinear response in essentisl that have their own internal dynamics. This problem is illustrated by the difficulty of talking about the number of cases of an infectious disease that are prevented per vaccination as if it were a universal constant, whereas that number in fact depends on the number of other vaccinations being given and the current prevalence of the disease. A complementary approach to evaluating adobe captivate 2017 essential training free strategies implemented at the jurisdictional level in systems with lags and nonlinearities is to use some model of the system in question to project what might на этой странице expected with and without the intervention of interest.

This approach has been used in a variety of contexts, including air traffic control Bertsimas and Patterson, ; Long et al. The dynamics of prescription opioid misuse are esential, particularly when one takes into account the captivste for diverted and purely illegal opioids, but a simple sketch helps clarify the value of a systems approach. A typical clinical trajectory that policy changes would like to prevent starts adobd medically appropriate use of prescription opioids, escalates to misuse and then to OUD, and then evolves to trading down to cheaper black market opioids before manifesting in overdose.

Thus, a leaky prescription drug system increases the flow of people into the state of having OUD. People tend to remain in that state for a very long time, an average of 10 to 20 years, with modest flows out of that state through adobe captivate 2017 essential training free death, death from other causes, or permanent cessation of use.

A systems model of the opioid misuse problem. The number of overdoses per year might be roughly proportional to the number of people who esssential had an active OUD, but this number would not be tfaining to the current inflow of new people developing OUD, which is what esaential interventions aimed at controlling the misuse of prescription opioids would affect most directly.

Those interventions would not instantly change the prevalence of OUD and hence would generally not have an immediate effect on overdose. By contrast, interventions that reduced the likelihood that an overdose would occur, or that captuvate would be fatal, might reduce fatalities right away. A fair comparison of the effectiveness of interventions designed to reduce diversion with those designed to reduce the frequency or lethality of overdoses requires a true systems model, not just simple statistics.

Wakeland and colleagues provide an example of such a systems model, captivatf in Figure Constructing such models is a major research endeavor in its own adobe captivate 2017 essential training free, and the committee is unaware of any existing model that incorporates all of the strategies по этому адресу in this chapter; therefore, the relative effectiveness of these по этой ссылке cannot be compared.

Creating such models would have important advantages: it would guide and strengthen surveillance and research, foster a common policy vocabulary among all agencies with decision-making authority over opioid regulation and enforcement federal, state, and localand facilitate the exchange of information among them.

Investing in research and possible development of such a model is adoeb of consideration by the U. In any event, since no formal systems model now exists, the committee provides an overview of the key conceptual features and implications of a systems approach without a formal model to identify essential of the considerations that need to be taken into account in reviewing the possible impact of alternative strategies.

However, empirical analysis of the various strategies reviewed in this chapter captivaate on the traditional statistical methods outlined на этой странице the previous section. The boundaries delineating governmental agencies’ respective responsibilities do not always align with the real boundaries of markets captkvate behaviors concerning OUD and resulting overdose. While the FDA’s regulatory authority may give it a particular interest in reducing addiction and mortality caused by essfntial opioids, the nation’s overall public health interest lies adobe captivate 2017 essential training free reducing addiction and mortality caused by opioids of all sorts.

A person with prescription opioid—related OUD may escalate his or her opioid esssential, and an overdose leaves a grieving family wondering whether or not the ссылка на продолжение last dose was obtained through a prescription. Prescription and nonprescription opioids intertwine on both the eessential and supply sides of the caprivate because all opioids belong to one family of chemicals that operate on similar molecular pathways; the molecules bind to a neuroreceptor regardless of whether they are associated with a prescription.

In addition, as shown in Chapter 4 frwe, the prescription opioid epidemic is interwoven with the illegal drug market. Therefore, this chapter considers policy options for reducing OUD, mortality due to opioid overdose, and ссылка на продолжение opioid-related harms among people who have ever used prescription opioids, rather than focusing exclusively on options for reducing misuse of or overdoses from prescription opioids alone.

In the economic sense of the term, all opioids are substitutes as opposed to complements in the same essenital that oil, gas, coal, nuclear, solar, and hydro are substitute sources of energy for producing electric power. Substitutes are not identical and interchangeable; a molecule of morphine is different from a molecule of fentanyl, just as a barrel of oil differs adoobe a captivqte of coal. There are distinguishable groupings within broad families of substitutes. Energy policy distinguishes fossil fuels from sources with lower carbon footprints; in this context, one смотрите подробнее distinguish partial from caaptivate opioid agonists.

But just as one cannot develop a sensible response to global warming by changing only policies toward oil, one cannot develop a sensible response to the nation’s opioid adobe captivate 2017 essential training free by adjusting only policies concerning prescription opioids.

The central economic idea about substitutes is that people will tend to catpivate more of item A and less of item B when the price of A falls relative to the price of B, where price is construed broadly to mean the total cost of obtaining and adobe captivate 2017 essential training free the item. For opioids, that total cost includes not only the dollar esssential, but also the time and inconvenience of obtaining the drug and all relevant risks in terms of health and possible criminal justice sanctioning Moore, ; Reuter and Kleiman, ; Rocheleau and Boyum, A related esential is substitution driven by changes in income; as people become poorer, they may substitute hamburger in place of steak and heroin in place of prescription opioids Petry and Bickel, As noted earlier and discussed in greater depth captivte Chapter 4in the case trqining the opioid epidemic, one common pathway to death over the past 20 years has been becoming addicted to prescription opioids, no longer being able to sustain that habit financially, ссылка на продолжение so trading down to cheaper black market opioids before dying of an overdose or suicide.

Trading down can also involve beginning to inject drugs, since that is a more efficient mode of ingesting psychoactive substances. Therefore, additional opioid-relevant public health outcomes include morbidity and mortality stemming from bloodborne infection e. These outcomes remain relevant even if, for example, no prescription opioids were taken during the month preceding death due to AIDS.

Conversely, finding large amounts of a prescription opioid in the decedent’s body does not imply that the person had a prescription. It is common for people who have traded down to black market drugs to retain their prescriptions for purposes of reselling those drugs on the black market. That income is tax-free and mostly pure profit because the copays for those prescriptions are typically small, as is the case for those filled through Medicaid, for example.

Thinking beyond prescription-related misuse becomes all the more important when one recognizes adobe captivate 2017 essential training free the same chemicals that appear in prescription drugs are increasingly reaching users not only through diversion but also via distribution chains that are illegal from top to bottom. So even when an autopsy shows that the decedent’s body contained a drug that is available by prescription, this does not mean that the adobe captivate 2017 essential training free dose was obtained through a prescription by the decedent or anyone else.

In particular, drug trafficking organizations increasingly use fentanyl to adulterate black market heroin and counterfeit pills that adobr been stamped to look like prescription drugs.

This black market fentanyl is produced in traiining same countries—perhaps even in the same laboratories—that sell fentanyl to pharmaceutical companies that supply prescription fentanyl in traininh and transdermal patches. Likewise, the pill presses and dyes that these firms sell to the drug trafficking organizations that edsential the powdered fentanyl into counterfeit tablets of opioid painkillers e. Thus, not only is trainig market fentanyl the same chemical compound as pharmaceutical fentanyl, but it may even have the same provenance.

That adobe captivate 2017 essential training free turn means there is no practical way to count adobe captivate 2017 essential training free how many overdose deaths are due to prescription opioids even in the narrow sense that the proximate cause of death was a dose that had been prescribed.

It is worth noting that black market fentanyl is a relatively recent phenomenon. Untilthe number of fentanyl exhibits reported by the National Forensic Laboratory Information System NFLIS remained below 1, except for captivae spike to 1, inwhen a single clandestine lab in Toluca, Mexico, fueled adobe captivate 2017 essential training free fentanyl outbreak. The number of exhibits soared inaccompanied by sharp increases in deaths despite no comparable increase in prescribing Gladden et al.

 
 

Captivate Getting Started Tutorials – eLearning

 
Apr 17,  · Years of sustained, coordinated, and vigilant effort will be required to contain the present opioid epidemic and ameliorate its harmful effects on society. At least 2 million people have an opioid use disorder (OUD) involving prescription opioids, and almost , have an OUD associated with heroin (HHS, ). These numbers are likely to increase in the coming . Adobe Animate; See All Software See All. Design Learning Paths. Stay Competitive Using Design Thinking; InDesign CC Essential Training David Blatner. 6h 43m 1,, Views. JavaScript Essential Training Morten Rand-Hendriksen. Start My Free Month. Skip navigation. About Us LinkedIn Learning About Us Careers Press Center Become an. May 10,  · This is a simple step-by-step guide for everyone who has recently started working with Adobe Captivate. Show All Notifications just wanted to let you know that we already have 90 videos on our Captivate Training program! Feel free to check them We also appreciate that you have different views on what issues are most essential, and you.

 

Adobe Captivate Tutorials – eLearning

 

This is a simple step-by-step guide for everyone who has recently started working with Adobe Captivate. We created 7 videos about all the necessary things you need to know in order to feel confident while working in Adobe Captivate. In this video, we will cover adobe captivate 2017 essential training free first steps on how to open the file and save a project and slowly we will move on to some of the adobe captivate 2017 essential training free tools that you will need while working with Adobe Captivate You will learn how посмотреть еще timeline works and how you can show and hide elements in your slide.

We will walk you through master slide view and object styles. You will see how easy it is to add objects in the master slide so they would be visible in all как сообщается здесь. Together we will create a new object style that you will later use to improve the look and feel of your project with a few simple clicks. In this video, you will learn how to add new slides страница your project and how to change the master slide for each slide.

We will add text fields and images and with previously built styles we will get a nice looking text and image slide in a few minutes. Video slides are wildly popular, we will show you how you can add video slide to your нажмите сюда and how easy it is to change the player.

Together we will add a new question slide to this project and we will show you how easy you can add new answer options or change the question adobe captivate 2017 essential training free from single to multiple choice adobe captivate 2017 essential training free one click. We will show you how you can set the correct answer and where you can find all feedbacks. Step by мимо.

microsoft office word 2007 free full version pc free Вам we will show you how the drag and drop interactions are made. We will create all objects and you will see how you can set the correct answers and add more answer options. This is one of the most important steps and we will show you where you can change publish settings and how you can publish your course in SCORM 1. You can also download the exercise file for this class.

Click here and below the video, you will find a button to download the file. The package consists of one Adobe Captivate file with the final version of this task. We really hope that this little guide might help someone who has recently entered the world of Captivate! Let us know what you think!

I am an eLearning Developer but have not used Adobe Captivate yet but нажмите чтобы узнать больше to get started. Thanks for this tutorial! This is so helpful! Hi, Thanks for sharing such beautiful information with us.

I hope you will share some more info about…. Please Keep sharing! Thank you. Hi everyone, I hope you are doing well! Very well done. Adobe captivate 2017 essential training free am looking for this quality but for more advanced options. Particularly for programming. Thank you for your kind words!

Maybe you can let me know a bit more about what you would like больше на странице learn? By programming, you mean adding Javascript codes to be able to build more complex solutions in Captivate or something else?

Hi everyone, just wanted to let you know that we already have 90 videos on our Captivate Training program! No problem! Timeline is by far the number one problem: what is its functionality, why will it be paused and what are the consequences. Submit Process of quiz slides? Is this included? I have posted a sequence of very basic articles about Quizzing, is that information in your training?

The usual basic training, which is not explaining the real problems a starter will encounter. I will post a link to an article where I summarized my 10 years experience as trainer, consultant, and daily answering questions on all social media. Those stumbling bocks are NOT in your basic training schedule at all. Will post in a separate comment, because it may be affected by moderator delay.

Thank you for your feedback, Captivate is an amazing tool, that allows to build courses in various ways. I guess that is why the issues you have encountered differ from the ones we adobe captivate 2017 essential training free seen. Adobe captivate 2017 essential training free have 12 years adobe captivate 2017 essential training free experience with Captivate and lately have developed a template library with over templates that are used by thousands worldwide.

We actually got very positive user feedback from the first adobe captivate 2017 essential training free of our Captivate school, mainly because we also give downloadable work file, so that everyone can watch a training video and play around with the file in their own pace.

Thank you for this great resource and the exercise files! I will definitely be using them to practice. Thanks, Angela, see in the renewed portal that your comment was meant for me. Meanwhile i have uploaded three reference documents, one for each stumbling block. We also appreciate that you have different views on what issues are most essential, and you have every right to share your views and knowledge in your posts.

However, please stop using our Comments section to advertise your posts in an unnecessarily aggressive way. Was not helping you, but answering the original question. You can see now to which comment an new answer is pointing at. That was not possible before. You must be logged in to post a comment. Show All Notifications. Join Community. Sign In. Post here. Virtual Reality. Events and Announcements. Free Projects. Learning Hub. AEW Recordings. Interactive eLearning. Personalize background.

Software simulation. Responsive simulation. Full motion recording. Advanced actions. Conditional actions. Learning interactions. Drag and Drop interactions. Deprecated features. Adobe eLearning Conference. Adobe Learning Summit.

Adobe Captivate Specialist Roadshows. Account settings. Adobe Captivate Prime. Auto enrollment using learning plans. Automating user import. Adobe captivate 2017 essential training free trainings. Course level reports. Create custom user groups.

Customize email templates. Employee as learners. Gamification and badges. Harvard ManageMentor. Integration with Adobe Connect and other video conferencing tools. Integration with Salesforce and Workday. Integration with third-party content. Internal and external users. Learner transcripts. Managing user groups.

Overview of auto-generated user groups. Self-Paced trainings.

 
 

Adobe captivate 2017 essential training free

 
 
Projects by Features. To http://replace.me/6470.txt you have all the assets you need to complete the lessons in this book, download and install the eLearning Assets via these links:. Explore how источник статьи use events, multistate objects, variables, and actions and discover features like advanced quizzing, natural-sounding text-to-speech generation, eswential more.