Adolescent Substance Abuse

Adolescent drug abusers have unique needs stemming from underdeveloped or immature neurocognitive and psychosocial stages. Research demonstrates that the brain undergoes a prolonged process of development and refinement, from birth to early adulthood, during which a developmental shift occurs where actions change from impulsive to more reasoned and reflective. In fact, the brain areas most closely associated with aspects of behaviors like decision making, judgment, planning and self control, undergo a period of rapid development during adolescence. Adolescent drug abuse is often associated with other mental health problems including attention deficit hyperactivity disorder, oppositional defiant disorder and conduct problems and depressive and anxiety disorders. The developmental period of adolescence makes the teen susceptible to physical and or sexual abuse and academic difficulties. Adolescents are especially sensitive to social cues. Peer groups and families are highly influential during this time. Therefore, treatments that facilitate positive parental involvement, integrate other systems in which the adolescent participates, such as school and athletics and recognize the importance of social peer relationships are very effective. Successful substance abuse treatment relies on access to comprehensive assessment, treatment, case management and support services that are developmentally, culturally and gender appropriate.

Executive Health

Executive Health Practitioner Associations are coming together to customize health programs for groups of executives and independent businesses with an objective of reducing the lost productivity time. At the core of many Executive Healthcare packages is an Executive Physical. In many instances, the doctor will travel to company facilities in order to perform a basic physical for all executive members. In others, as in the case of Elite IPA (Independent Practitioner Association), the office visit is an option, but executives are given the benefit of in-depth diagnostic treatment, which allows for an even more in-depth analysis of their health than what is typical. This level of the physical exam, given at a time that is convenient for the executive, is to have a positive impact on the bottom line. The average wait to see a physician is 68 minutes. There is no wait with the IPA Health associates for executives. IPA works around the schedule. Nor does IPA rush the visit. The visit is complete only when all of the concerns and questions answered. For those who prefer to communicate in writing, IPA is only an e-mail away. IPA physicians travel with hand-held e-mail devices for quick responses. Furthermore, IPA does not rush the visit. The visit is complete only when all of the concerns and questions are answered. Of course, there are times when one just wants to speak directly with the doctor on the telephone. One of the first things given to a new IPA patient is the doctor’s personal cell phone number. Wherever business or pleasure takes you, IPA is just a phone call away. Turn to IPA’s Executive Health for a complete executive physical that looks at health from all angles. True health and wellness is only achieved when there is a good understanding of the family history and personal medical history. IPA offers the latest in both non-invasive and blood-based cardiovascular screening testing. For early cancer detection, there may be reason to consider modern scanning approaches, including the PET technology. The integration of state-of-the-art cancer detection approach is a major feature of the program, as is ready access to leading specialists for preventive consultations.

Shuffling

Shuffling is a procedure used to randomize a deck of playing cards to provide an element of chance in card games. Shuffling is often followed by a cut, to help ensure that the shuffler has not manipulated the outcome. A common shuffling technique is called the riffle or dovetail shuffle, in which half of the deck is held in each hand with the thumbs inward, then cards are released by the thumbs so that they fall to the table interleaved. Many also lift the cards up after a riffle, forming what is called a bridge which puts the cards back into place. This can also be done by placing the halves flat on the table with their rear corners touching, then lifting the back edges with the thumbs while pushing the halves together. While this method is more difficult, it is often used in casinos because it minimizes the risk of exposing cards during the shuffle. There are two types of perfect riffle shuffles: if the top card moves to be 2nd from the top then it is an in shuffle, otherwise it is known as an out shuffle which preserves both the top and bottom cards.

Riffle shuffling does, however, carry a risk of damaging cards from excessive bending. Casinos often replace their playing cards to prevent cheating from players that detect deformations in the cards. However, collectible card game cards are considerably less replaceable than playing cards, and CCG cards can be damaged from riffle shuffling, even when protected with card sleeves.

Because standard shuffling techniques are seen as weak, and in order to avoid inside jobs where employees collaborate with gamblers by performing inadequate shuffles, many casinos employ automatic shuffling machines. They also save time that would otherwise be spent shuffling, allowing several more hands per hour to be played and increasing the profitability of the table. These machines are also used to lessen repetitive motion stress injuries to a dealer. Note that the shuffling machines have to be carefully designed, as they can generate biased shuffles otherwise: the most recent shuffling machines are computer-controlled, though they have not yet fully been integrated into gaming.

Pan

Pan is short for Panguingue

Playing Pan

Panguingue is a rummy-type game played with eight standard 52-card decks with the 8's, 9's, and 10's removed, for a total of 320 cards. No jokers are used. Cards in each suit rank king (high), queen, jack, seven, six, etc. with aces being low. The cards are dealt counterclockwise

Players strive to meld eleven cards in valid sets of three or more cards. There are two kinds of melds: a rope which must be string of cards of matching suits, squares consisting of the ranks 2, 3, 4, 5, 6, 7, Jack or Queen. Squares must be either all cards of different suits or all the same suit. Squares consisting of Kings or Aces qualify regardless of suit. There are no betting rounds in the game.

Each player is dealt 10 cards to meld into sets and sequences with certain cards having special values. Each player, in turn, draws either a card from the top of the remaining deck or from the top of an adjacent discard pile. This sequence of play continues until one player goes out with a total meld of eleven cards, including the card(s) just drawn. Melds (or spread) must be at least three cards, and it may be as many as eleven. The melds are classified as ropes and squares. The rope is any three cards in sequence of the same suit. A square is a set of three cards in the same rank and of different suits or of the same suit. All 3s, 5s and 7s are valle cards (cards of value). Cards of other rank are non-valle. Any three aces or any three kings form a set, regardless of the suit.