Daniel Lee Gilstrap, MD

• Assistant Professor of Medicine

https://medicine.duke.edu/faculty/daniel-lee-gilstrap-md

Stomach 6 Registry Data Collection Variables See chapter for more details on these variables antibiotic classes 200mg suprax visa. Small Intestine: Adenocarcinoma 1 Terms of Use the cancer staging form is a specific document in the patient record; it is not a substitute for documentation of history virus repair order suprax with mastercard, physical examination virus and bacteria buy cheap suprax, and staging evaluation antibiotic 850mg suprax 200mg low cost, or for documenting treatment plans or follow-up antibiotic resistance acne purchase discount suprax on line. Small Intestine: Other Histologies 1 Terms of Use the cancer staging form is a specific document in the patient record; it is not a substitute for documentation of history commonly used antibiotics for sinus infection generic suprax 200 mg with visa, physical examination, and staging evaluation, or for documenting treatment plans or follow-up. Appendix Carcinoma 1 Terms of Use the cancer staging form is a specific document in the patient record; it is not a substitute for documentation of history, physical examination, and staging evaluation, or for documenting treatment plans or follow-up. Acellular mucin or mucinous epithelium that extends into the subserosa or serosa should be classified as T3 or T4a, respectively. T1 Tumor invades the submucosa (through the muscularis mucosa but not into the muscularis propria) T2 Tumor invades the muscularis propria T3 Tumor invades through the muscularis propria into the subserosa or the mesoappendix T4 Tumor invades the visceral peritoneum, including the acellular mucin or mucinous epithelium involving the serosa of the appendix or mesoappendix, and/or directly invades adjacent organs or structures T4a Tumor invades through the visceral peritoneum, including the acellular mucin or mucinous epithelium involving the serosa of the appendix or serosa of the mesoappendix T4b Tumor directly invades or adheres to adjacent organs or structures  T Suffix Definition (m) Select if synchronous primary tumors are found in single organ. Colon and Rectum 1 Terms of Use the cancer staging form is a specific document in the patient record; it is not a substitute for documentation of history, physical examination, and staging evaluation, or for documenting treatment plans or follow-up. Colon and Rectum 6 Registry Data Collection Variables See chapter for more details on these variables. Anus 1 Terms of Use the cancer staging form is a specific document in the patient record; it is not a substitute for documentation of history, physical examination, and staging evaluation, or for documenting treatment plans or follow-up. However, if all time points are recorded on a single form, the staging basis for each element should be identified clearly. Anal cancer (A–C), perianal cancer (D), and skin cancer (E) as visualized with gentle traction placed on the buttocks. Liver 1 Terms of Use the cancer staging form is a specific document in the patient record; it is not a substitute for documentation of history, physical examination, and staging evaluation, or for documenting treatment plans or follow-up. The liver is divided into two hemilivers and eight segments according to the portal venous ramification pattern. Intrahepatic Bile Duct 1 Terms of Use the cancer staging form is a specific document in the patient record; it is not a substitute for documentation of history, physical examination, and staging evaluation, or for documenting treatment plans or follow-up. Intrahepatic Bile Duct 6 Registry Data Collection Variables See chapter for more details on these variables. Liver diagram differentiating intrahepatic bile ducts from extrahepatic bile ducts and mass-forming growth pattern (A) from periductal infiltrating growth pattern (B), with associated intrahepatic biliary dilatation. Differential lymphatic drainage patterns for left and right liver intrahepatic cholangiocarcinomas. Right liver tumors drain to right portal (A) and then portocaval (C) nodal basins, while left liver tumors drain to left gastric and celiac (B) nodal basins. Gallbladder 1 Terms of Use the cancer staging form is a specific document in the patient record; it is not a substitute for documentation of history, physical examination, and staging evaluation, or for documenting treatment plans or follow-up. Perihilar Bile Ducts 1 Terms of Use the cancer staging form is a specific document in the patient record; it is not a substitute for documentation of history, physical examination, and staging evaluation, or for documenting treatment plans or follow-up. Distal Bile Duct 1 Terms of Use the cancer staging form is a specific document in the patient record; it is not a substitute for documentation of history, physical examination, and staging evaluation, or for documenting treatment plans or follow-up. Diagram highlighting the location of tumors to be staged as distal bile duct tumors. These tumors have an epicenter located between the confluence of the cystic duct and common hepatic duct and the ampulla of Vater (highlighted) (Modified from the College of American Pathologists). Ampulla of Vater 1 Terms of Use the cancer staging form is a specific document in the patient record; it is not a substitute for documentation of history, physical examination, and staging evaluation, or for documenting treatment plans or follow-up. Exocrine Pancreas 1 Terms of Use the cancer staging form is a specific document in the patient record; it is not a substitute for documentation of history, physical examination, and staging evaluation, or for documenting treatment plans or follow-up. This includes high-grade pancreatic intraepithelial neoplasia (PanIn-3), intraductal papillary mucinous neoplasm with high-grade dysplasia, intraductal tubulopapillary neoplasm with high-grade dysplasia, and mucinous cystic neoplasm with high-grade dysplasia. Tumors of the head of the pancreas are those arising to the right of the superior mesenteric-portal vein confluence. Tumors of the body of the pancreas are those arising between the left border of the superior mesenteric vein and the left border of the aorta. Tumors of the tail of the pancreas are those arising between the left border of the aorta and the hilum of the spleen. Neuroendocrine Tumors of the Stomach 1 Terms of Use the cancer staging form is a specific document in the patient record; it is not a substitute for documentation of history, physical examination, and staging evaluation, or for documenting treatment plans or follow-up. In cases of disparity between Ki-67 proliferative index and mitotic count, the result that indicates a higher-grade tumor should be selected as the final grade. Neuroendocrine Tumors of the Duodenum and Ampulla of Vater 1 Terms of Use the cancer staging form is a specific document in the patient record; it is not a substitute for documentation of history, physical examination, and staging evaluation, or for documenting treatment plans or follow-up. Maximum depth of invasion (microscopic tumor extension):  Small intestine (including duodenum):  cannot be assessed  no evidence of primary tumor  lamina  propriasubmucosa  muscularis propria  subserosal tissue without involvement of visceral peritoneum  penetrates serosa (visceral peritoneum)  directly invades adjacent structures  penetrates visceral peritoneum and adjacent structures  Ampulla of Vater:  cannot be assessed  no evidence of primary tumor  tumor limited to ampulla of Vater or sphincter of Oddi  tumor invades duodenal submucosa  tumor invades duodenal muscularis propria  tumor invades pancreas  tumor invades peripancreatic soft tissues  tumor invades common bile duct  directly invades adjacent structures 3. Lymph node status (including number of nodes assessed and number of positive nodes): 5. Margin status:  Positive (+)  Negative (−) this form continues on the next page. Location in duodenum:  first portion  second portion  third portion  fourth portion  ampulla of Vater 14. Anatomic sites used in the staging of tumors of the duodenum and ampulla of Vater. Neuroendocrine Tumors of the Jejunum and Ileum 1 Terms of Use the cancer staging form is a specific document in the patient record; it is not a substitute for documentation of history, physical examination, and staging evaluation, or for documenting treatment plans or follow-up. In cases of disparity between Ki-67 proliferative index and mitotic count, the result indicating a higher-grade tumor should be selected as the final grade. See chapter 30 for more information about staging neuroendocrine tumors of the duodenum. Neuroendocrine Tumors of the Appendix 1 Terms of Use the cancer staging form is a specific document in the patient record; it is not a substitute for documentation of history, physical examination, and staging evaluation, or for documenting treatment plans or follow-up. In cases of disparity between Ki-67 (proliferative index) and mitotic count, the result indicating a higher-grade tumor should be selected as the final grade. Neuroendocrine Tumors of the Colon and Rectum 1 Terms of Use the cancer staging form is a specific document in the patient record; it is not a substitute for documentation of history, physical examination, and staging evaluation, or for documenting treatment plans or follow-up. Neuroendocrine Tumors of the Pancreas 1 Terms of Use the cancer staging form is a specific document in the patient record; it is not a substitute for documentation of history, physical examination, and staging evaluation, or for documenting treatment plans or follow-up. Note: Multiple tumors should be designated as such (the largest tumor should be used to assign T category). Presence of invasion into adjacent organs/structures:  Yes  No If yes, which ones (pick all that apply):  Stomach  Duodenum  Spleen  Colon  Other: If yes, were multiple adjacent organs involved? Lymph node status (including number of lymph nodes assessed and number of positive nodes): 6. Location in pancreas:  head  tail  body  junction body/tail  junction body/head  unknown 15. Type of surgery:  enucleation  distal pancreatectomy with splenectomy  distal pancreatectomy without splenectomy  central pancreatectomy  pancreaticoduodenectomy (Whipple procedure)  unknown  other 16. Thymus 1 Terms of Use the cancer staging form is a specific document in the patient record; it is not a substitute for documentation of history, physical examination, and staging evaluation, or for documenting treatment plans or follow-up. T1, level 1 structures: thymus, anterior mediastinal fat, mediastinal pleura; T2, level 2 structures: pericardium; T3, level 3 structures: lung, brachiocephalic vein, superior vena cava, phrenic nerve, chest wall, hilar pulmonary vessels; T4, level 4 structures: aorta (ascending, arch, or descending), arch vessels, intrapericardial pulmonary artery, myocardium, trachea, esophagus. Lung 1 Terms of Use the cancer staging form is a specific document in the patient record; it is not a substitute for documentation of history, physical examination, and staging evaluation, or for documenting treatment plans or follow-up. A superficial, spreading tumor of any size whose invasive component is limited to the bronchial wall and may extend proximal to the main bronchus also is classified as T1a, but these tumors are uncommon. In a few patients, however, multiple microscopic examinations of pleural (pericardial) fluid are negative for tumor, and the fluid is nonbloody and not an exudate. If these elements and clinical judgment dictate that the effusion is not related to the tumor, the effusion should be excluded as a staging descriptor. Lung 6 Registry Data Collection Variables See chapter for more details on these variables. For data collection, all T, N, and M descriptors and at least the prognostic factors considered essential and additional in Additional Factors Recommended for Clinical Care should be collected. Malignant Pleural Mesothelioma 1 Terms of Use the cancer staging form is a specific document in the patient record; it is not a substitute for documentation of history, physical examination, and staging evaluation, or for documenting treatment plans or follow-up. Tumor involving all the ipsilateral pleural surfaces (parietal, mediastinal, diaphragmatic, and visceral pleura) with at least one of the following features. Surgical resection with curative intent:  pleurectomy/decortications  extended pleurectomy/decortications  extrapleural pneumonectomy 7. For patients undergoing multimodality therapy, use of chemotherapy and/or radiotherapy: this form continues on the next page. Bone the Definitions of Primary Tumor (T) differ among cancers arising in the Appendicular Skeleton, Trunk, Skull and Facial Bones, the Spine, and the Pelvis. Bone: Appendicular Skeleton, Trunk, Skull and Facial Bones 1 Terms of Use the cancer staging form is a specific document in the patient record; it is not a substitute for documentation of history, physical examination, and staging evaluation, or for documenting treatment plans or follow-up. Percentage of necrosis after neoadjuvant systemic therapy, from pathology report: 4. Bone: Spine 1 Terms of Use the cancer staging form is a specific document in the patient record; it is not a substitute for documentation of history, physical examination, and staging evaluation, or for documenting treatment plans or follow-up. Bone: Pelvis 1 Terms of Use the cancer staging form is a specific document in the patient record; it is not a substitute for documentation of history, physical examination, and staging evaluation, or for documenting treatment plans or follow-up. Number of resected pulmonary metastases, from pathology report: this form continues on the next page. Soft Tissue Sarcoma of the Head and Neck 1 Terms of Use the cancer staging form is a specific document in the patient record; it is not a substitute for documentation of history, physical examination, and staging evaluation, or for documenting treatment plans or follow-up. Soft Tissue Sarcoma of the Head and Neck 6 Registry Data Collection Variables See chapter for more details on these variables. Necrosis Definition  Score 0 No necrosis 1 <50% tumor necrosis 2 ≥50% tumor necrosis this form continues on the next page. Soft Tissue Sarcoma of the Trunk and Extremities 1 Terms of Use the cancer staging form is a specific document in the patient record; it is not a substitute for documentation of history, physical examination, and staging evaluation, or for documenting treatment plans or follow-up. Soft Tissue Sarcoma of the Trunk and Extremities 5 Prognostic Factors Required for Stage Grouping 5. Each parameter is scored as follows: differentiation (1–3), mitotic activity (1–3), and necrosis (0–2). Soft Tissue Sarcoma of the Trunk and Extremities 7 Registry Data Collection Variables See chapter for more details on these variables. Soft Tissue Sarcoma of the Abdomen and Thoracic Visceral Organs 1 Terms of Use the cancer staging form is a specific document in the patient record; it is not a substitute for documentation of history, physical examination, and staging evaluation, or for documenting treatment plans or follow-up. Any of the M categories (cM0, cM1, or pM1) may be used with pathological stage grouping. Soft Tissue Sarcoma of the Abdomen and Thoracic Visceral Organs 6 Registry Data Collection Variables See chapter for more details on these variables. The staging form may be used to document cancer stage at different points in the patient’s care and during the course of therapy, including before therapy begins, after surgery and completion of all staging evaluations, or at the time of recurrence. Tumor site:  esophagus  stomach  duodenum  jejunum/ileum  rectum  extraintestinal 3. Soft Tissue Sarcoma of the Retroperitoneum 1 Terms of Use the cancer staging form is a specific document in the patient record; it is not a substitute for documentation of history, physical examination, and staging evaluation, or for documenting treatment plans or follow-up. Soft Tissue Sarcoma of the Retroperitoneum 5 Prognostic Factors Required for Stage Grouping 5. Soft Tissue Sarcoma of the Retroperitoneum 7 Registry Data Collection Variables See chapter for more details on these variables. Soft Tissue Sarcoma – Unusual Histologies and Sites 1 Terms of Use the cancer staging form is a specific document in the patient record; it is not a substitute for documentation of history, physical examination, and staging evaluation, or for documenting treatment plans or follow-up. Merkel Cell Carcinoma 1 Terms of Use the cancer staging form is a specific document in the patient record; it is not a substitute for documentation of history, physical examination, and staging evaluation, or for documenting treatment plans or follow-up. Merkel Cell Carcinoma 6 Registry Data Collection Variables See chapter for more details on these variables. Largest tumor diameter (in millimeters):  measured clinically  measured histologically 2. Tumor nest size in regional lymph node(s) (greatest dimension of largest aggregate in millimeters): 14. Eyelid tumor involving the upper or lower eyelid, or both:  upper eyelid  lower eyelid  both 16. Eyelid tumor involving the eyelid margin, defined as the juncture of eyelid skin and tarsal plate at the lash line:  yes  no If present, is the eyelid margin involvement full thickness? Melanoma of the Skin 1 Terms of Use the cancer staging form is a specific document in the patient record; it is not a substitute for documentation of history, physical examination, and staging evaluation, or for documenting treatment plans or follow-up. N0 No regional metastases detected No N1 One tumor-involved node or in-transit, satellite, and/or microsatellite One tumor-involved node or in-transit, metastases with no tumor-involved nodes satellite, and/or microsatellite metastases with no tumor-involved nodes N1a One clinically occult. By convention, clinical staging should be used after biopsy of the primary melanoma, with clinical assessment for regional and distant metastases. Note that pathological assessment of the primary melanoma is used for both clinical and pathological classification. Diagnostic biopsies to evaluate possible regional and/or distant metastasis also are included. Melanoma of the Skin 6 Registry Data Collection Variables See chapter for more details on these variables. Microsatellites (pathologically detected satellites, not clinically apparent) (yes/no) 5. Microscopic confirmation of tumor metastasis in any regional lymph node that was clinically or radiologically detected (yes/no) 13. Number of lymph nodes examined from completion or therapeutic lymph node dissection (whole number) 20. Number of lymph nodes involved with tumor from completion or therapeutic lymph node dissection (whole number) 21. Tumor thickness is measured from the top of the granular layer of the epidermis (or, if the surface overlying the entire dermal component is ulcerated, from the base of the ulcer) to the deepest invasive cell across the broad base of the tumor.

Syndromes

• Reactions to medicines
• Bleeding or spotting after 1 year or more of no bleeding after menopause
• Technetium scan
• You or your child develops complications or severe symptoms after getting an HPV vaccine
• Cold or clammy skin
• Meningitis
• Determine how well your heart is pumping
• Stiff neck
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Feel they have lots of responsibilities and pressures—from Acknowledging girls’ pressures and sharing how stress can home antibiotic no alcohol buy suprax with a mastercard, school bacteria in mouth buy 200 mg suprax with mastercard, peers lafee virus buy suprax 100mg free shipping, work antibiotics rash toddler cheap suprax, and so on treatment for early uti safe suprax 100 mg. Are continuing to navigate their increasing independence Trusting girls to plan and make key decisions bacteria characteristics suprax 100 mg with visa, allowing and expectations from adults—at school and at home. Can see the complexity of situations and controversial Inviting girls to develop stories as a group, and then issues—they understand that problems often have no clear individually create endings that they later discuss and solution and that varying points of view may each have share. Have strong problem-solving and critical-thinking skills, and Girls are more than able to go beyond community service can adapt logical thinking to real-life situations. Spend more time with peers than with their families and are Girls will enjoy teaming up in small or large groups for art very concerned about friends and relationships with others projects, performances, and written activities. Alter the makeup of groups with each activity so that girls interact with those they might not usually pair up with. Encouraging girls to express their individuality in their dress, creative expression, and thinking. Feel they have lots of responsibilities and pressures—from Acknowledging girls’ pressures and sharing how stress can home, school, peers, work, etc. Help girls release stress through creative expression, movement, and more traditional stress-reduction techniques. Are continuing to navigate their increasing independence Trusting girls to plan and make key decisions, allowing and expectations from adults—at school and at home—and them to experience what’s known as “fun failure. Girl Scout research shows that girls are looking for an emotionally safe environment, where confidentiality is respected and they can express themselves without fear. The environment you create is as important—maybe more—than the activities girls do; it’s the key to developing the sort of group that girls want to be part of. The following sections share some tips on creating a warm, safe environment for girls. Girl Scouting is for the enjoyment and benefit of the girls, so meetings are built around girls’ ideas. When you put the girls first, you’re helping develop a team relationship, making space for the development of leadership skills, and allowing girls to benefit from the guidance, mentoring, and coaching of caring adults. The three Girl Scout processes (girl-led, learning by doing, and cooperative learning) are integral to the girl-adult partnership. Take time to read about the processes and think about how to incorporate them into your group’s experiences. They can survive a poor meeting place or an activity that flops, but they cannot endure being ignored or rejected. They look for fairness in the ways responsibilities are shared, in handling of disagreements, and in responses to performance and accomplishment. When possible, consult girls as to what they think is fair before decisions are made. Try to see that the responsibilities, as well as the chances for feeling important, are equally divided. Help girls explore and decide for themselves the fair ways of solving problems, carrying out activities, and responding to behavior and accomplishments. Girl Scouts of Greater Los Angeles strives to provide resources to volunteers working with girls with developmental disabilities, learning disabilities, physical disabilities, or multiple disabilities. Conflicts and disagreements are an inevitable part of life, and when handled constructively can actually enhance communication and relationships. At the very least, Girl Scouts are expected to practice self-control and diplomacy so that conflicts do not erupt into regrettable incidents. When a conflict arises between girls or a girl and a volunteer, get those involved to sit down together and talk calmly and in a nonjudgmental manner. Whatever you do, do not share your complaint with others—this causes the situation to escalate. They like having someone they can talk to about important things, including things that might not seem important to adults. Speak your mind openly when you are happy or concerned about something, and encourage girls to do this, too. Leave the door open for girls to seek advice, share ideas and feelings, and propose plans or improvements. Help girls see how open communication can result in action, discovery, better understanding of self and others, and a more comfortable climate for fun and accomplishment. When communicating with girls, consider the following tips: ➢ Listen: Listening to girls, as opposed to telling them what to think, feel, or do (no “you should”) is the first step in helping them take ownership of their program. But whatever option is chosen, girls at every grade level also want guidance and parameters. It signifies that you can listen and accept how she is feeling about the situation. I’ll listen,” “I know you’re mad—talking it out helps,” and “I can handle it—say whatever you want to . Since its founding in 2000, the Girl Scout Research Institute has become an internationally recognized center for research and public policy information on the development and well-being of girls. We provide the youth development field with definitive research reviews that consolidate existing studies. And, by most measures, we are now the leading source of original research on the issues that girls face and the social trends that affect their lives. To get girls outdoors more regularly, Girl Scouts need adult volunteers who encourage and promote outdoor experiences. Communicating to volunteers and parents that casual outdoor experiences are effective ways of giving girls opportunities to build competencies and try new things may be the key to opening the gateway for all Girl Scouts to participate in the outdoors on a more regular basis. Any age group may have questions about racial and ethnic differences, disabilities, size/weight, climate change/global warming, and death or dying. According to Feeling Safe: What Girls Say, a 2003 Girl Scout Research Institute study, girls are looking for groups that allow connection and a sense of close friendship. They want volunteers who are teen savvy and can help them with issues they face, such as bullying, peer pressure, dating, athletic and academic performance, and more. Some of these issues may be considered “sensitive” by parents, and they may have opinions or input about how, and whether, Girl Scouts should cover these topics with their daughters. Girl Scouts welcomes and serves girls and families from a wide spectrum of faiths and cultures. We feel our role is to help girls develop self-confidence and good decision-making skills that will help them make wise choices in all areas of their lives. We believe parents and caregivers, along with schools and faith communities, are the primary sources of information on these topics. Parents/caregivers make all decisions regarding their girl’s participation in Girl Scout program that may be of a sensitive nature. As a volunteer leader, you must get written parental permission for any locally-planned program offering that could be considered sensitive. Included on the permission form should be the topic of the activity, any specific content that might create controversy, and any action steps the girls will take when the activity is complete. Be sure to have a form for each girl, and keep the forms on hand in case a problem arises. What to do if you have concerns: Volunteers are not mandated reporters, but if a child is in immediate danger, call 911 or the local police. There may be times when you worry about the health and well-being of girls in your group. Alcohol, drugs, sex, bullying, abuse, depression, and eating disorders are some of the issues girls may encounter. You are on the frontlines of girls’ lives, and you are in a unique position to identify a situation in which a girl may need help. If you believe a girl is at risk of hurting herself or others, your role is to promptly bring that information to her parent/caregiver or support specialist so she can get the expert assistance she needs. And you almost always have the same goal, which is to make Girl Scouting an enriching experience for their girls. The office also supports Girl Scout councils at the state and local levels, as they build capacity to be the voice for girls. These advocacy efforts help demonstrate to lawmakers that Girl Scouts is a resource and an authority on issues affecting girls. Perhaps the most important tip for communicating with parents/caregivers is for you to use “I” statements instead of “you” statements. Here are some examples of “you” statements: ➢ “Your daughter just isn’t responsible. Here are some written guidelines on have no idea of how to follow through or take leadership how to prepare for our camping trip. Your project ideas you’d like to group better, develop and lead can fit well in our plans. Girl Scouting is for all girls, and by Denise really doesn’t belong in this group,” teaching your daughter to be sensitive to others’ feelings you help teach the whole group sensitivity. If you could take a few moments from your busy schedule to let me know what you value about what we’re doing, I’d appreciate it. Each girl—without regard to socioeconomic status, race, physical or cognitive ability, ethnicity, primary language, sexual orientation, or religion—is an equal and valued member of the group, and groups reflect the diversity of the community. Inclusion is about belonging, about all girls being offered the same opportunities, about respect and dignity, and about honoring the uniqueness of and differences among us all. You’re accepting and inclusive when you: ➢ Welcome every girl and focus on building community. The Hispanic population is the largest-growing in the United States, which is why Girls Scouts has translated many of its publications into Spanish. Over time, Girl Scouts will continue to identify members’ needs and produce resources to support those needs, including translating publications into additional languages and formats. Girl Scouts welcomes those who’s learning or physical disabilities may limit their activities but not their hopes and achievements. The Girl Scout Leadership Experience is flexible enough that most girls and adults of any ability can participate. Historically, disabilities have been looked at from a deficit viewpoint with a focus on how people with disabilities could be fixed. Today, the focus is on a person’s abilities—on what she can do rather than on what she cannot. Girl Scouts can increase socialization skills that help them to interact with others appropriately. It can help build gross and fine motor skills, and it can increase tolerance to different textures, noises, and lights. It can be beneficial for typical girls as well as they can learn to accept differences and develop patience. They can learn how to understand others and move past first impressions and get to know someone as an individual. Please respect the privacy of the medical diagnosis of the child unless the parent has given permission to discuss/inform others. Prior to sharing any information about the girl’s needs or diagnoses, it is critical to attain the parent’s written permission. Initially, communicating with the parents is important to discuss any necessary accommodations the girl may require. In some cases, it will be advisable to ask the parent to be present for the meetings initially. The gradual process can involve the parent being in the back of the room, then the room next door, and then in their car. If necessary, please develop a plan with the girl’s parents about how to support her. When talking to a girl with a disability, please speak directly to her, not through a parent/caregiver and treat her as you would any other girl in the troop to the extent it is possible. It may be helpful to email the parents ahead of time to let them know what will be taking place at the meeting. In addition, note that people-first language puts the person before the disability. When speaking to a girl who is deaf and using an interpreter, speak to the girl, not the interpreter. If you have girls with mobility challenges, please call or check the website of the location prior to any meeting/event to make sure they can accommodate any needs your girls might have. When speaking for more than a few minutes to a girl who uses a wheelchair, place yourself at her eye level. It’s okay to offer assistance to a girl with a disability but wait until your offer is accepted before you begin to help. When greeting a girl with a visual impairment, always identify yourself and others. If you have girls with food intolerances/allergies, please make sure there is an option they can select. Girls with intellectual disabilities can be registered as closely as possible to their chronological ages. Young women with intellectual disabilities may choose to retain their girl membership through their 21st year, and then move into an adult membership category. If a child is recognized by the family and school/community as a girl, and lives culturally as a girl, the Girl Scouts can serve her in a setting that is both emotionally and physically safe. External experts have shared that troops will be most successful if they invite the family of the transgender girl to work with them as a team to ensure that she has a safe and supported experience as a Girl Scout. Girls with cognitive disabilities can be registered as closely as possible to their chronological ages.

Region Number of Hours to Make Number of Hours to Make One High-Quality Care One Low-Quality Car North 30 20 South 60 30 1 treatment for uti in hospital cheap suprax 100 mg line. There are 1 million hours of labor available for making cars in the North bacteria resistant to antibiotics generic 200mg suprax visa, and another 1 million hours of labor available for making cars in the South best antibiotic for sinus infection or bronchitis cheap suprax 100mg mastercard. In a no-trade world virus titer discount suprax 100 mg otc, let’s assume that two-thirds of the auto industry labor in each region is used to make high-quality cars and one-third is used to make low-quality cars antibiotics for dogs eye cheap suprax 200 mg otc. If each region completely specializes in the type of car in which it holds the comparative advantage infection gone septic order genuine suprax, what will be the global output of low-quality cars? The Japanese people currently pay about four times the world price for rice because of trade barriers. Who is more likely to make a greater effort lobbying for or against a reduction in trade barriers? The supply curve for rice in Japan slopes upward, just like any normal supply curve. If Japan eliminated its trade barriers to rice, what would happen to the number of workers employed in the rice-producing industry in Japan: Would it rise or fall? However, you are very unlikely to ever encounter bumper stickers that say things like “Out of money yet? Sugar farmers in Florida who use unusually large amounts of fertilizer to produce their crops do so because their land isn’t all that great for sugar production. If we translate this into the language of the supply curve, where would these sugar farmers be on the supply curve? The supply of goods is purchased by the buyers that place the highest value on the goods. Which condition or conditions cease to hold in the case of a tariff on imported goods? If the United States were to eliminate a tariff on, say, Mexican shirts thereby lowering its cost, which product might be purchased more by Americans? Some people argue for protectionism by pointing out that other countries with whom we trade engage in “unfair trade practices,” and that we should retaliate with our own protectionist measures. One such policy is the policy of some countries to subsidize exporting industries. The annoyance of your neighbor because she doesn’t like your achingly conventional music a. The crime that is more likely to occur to your neighbor once a criminal sees a “Protected by alarm” sticker on your window. The extra safety your neighbor might experience because criminals tend to stay away from neighborhoods that have a lot of burglar alarms a. A happy movie might make people smile more, which improves the lives of people who don’t see the movie. A new fashion trend for tight-fitting clothing might hurt the body image of people who think they won’t look good in the new trendy clothing. Let’s consider the market for one cultural good that unrealistically raises expectations about the opposite sex: the romance novel. In romance novels, men are dangerous yet safe, wealthy yet never at work, they ride high-speed motorcycles yet never get in terrible accidents, they look fantastic even though they never waste endless hours at the gym, and so on. Subsidizing books including male protagonists who are overweight and seriously flawed. For the following six questions, determine whether there is an external benefit or cost and estimate its size. Finally, decide between a tax or a subsidy as a simple way to compensate for the externality. Economists have found that increasing the proportion of girls in primary and secondary school leads to significant improvement in students’ cognitive outcomes (Victor Lavy and Analia Schlosser. One key channel seems to be that on average boys create more trouble in class, which makes it harder for everyone to learn. However, fruits provide an external benefit to the beekeepers because their honeybees need fruits. Which external benefit is larger: honeybees’ external benefit to fruit farmers and fruits’ external benefit to beekeepers? Given what you’ve learned about externalities, should human-caused global warming be completely stopped? No A government is deciding between command and control solutions versus tax and subsidy solutions to solve an externality problem. Suppose that whales are threatened with extinction because a large number of people like to eat whale meat. Governments are torn between banning all whaling except for certain religious ceremonies, and heavily taxing all whale meat. Assume there are only a few countries in the world who consume whale meat, and that they have fairly efficient governments. LoJack is an example of a vehicle tracking system designed to help police recover stolen vehicles. Steve Levitt found evidence that Lojack and other vehicle tracking devices create a positive externality of decreasing all car thefts because car thieves do not know which cars have Lojack installed, making them more hesitant to break into any car. As long as no one is around to experience the unpleasant odor, what type of externality is produced? Suppose that the family clearly possesses the right to a pleasant-smelling environment. For the following four questions, in which cases will the Coase theorem’s assumptions likely to be true? The ugly shrub, of course, imposes an external cost on him and on his property value. My neighbors all would love for me to get that broken-down Willies Jeep off my front lawn. And would it be too much for me to paint the house and fill up that 6-foot deep ditch in the front yard? A coal-fired electricity plant dumps its leftover hot water into the nearby lake, killing the naturally occurring fish. A coal-fired electricity plant dumps its leftover hot water into the nearby river, killing the naturally occurring fish downstream. In theory, one reason why tradable pollution allowances are preferable to pollution regulation is because they: a. If the permits were not tradeable, how would this affect the efficiency of the program? A government is torn between selling annual pollution allowances and setting an annual pollution tax. Unlike in the messy real world, this government is quite certain that it can achieve the same price and quantity either way. Maxicon is opening a new coal-fired power plant, but the government wants to keep pollution down using tradable pollution permits. If a corrupt government just grants Maxicon all of the pollution permits in the entire nation (even though there are many energy companies), what do we predict will happen to pollution production? Maxicon will pollute much more than it would have if it were not given all of the permits. Pollution permits will not be traded because Maxicon has no incentive to trade with other firms. The firms polluting will likely be those with the highest costs of reducing pollution. On January 27, 2011, the price of Ford Motor Company stock hit an almost 10-year high at $18. Suppose instead that on January 27, 2011, you wanted to sell your 10,000 shares of Ford stock but you reduced your asking price to $18. Which characteristic below best describes the demand curve that you as an individual seller of Ford stock face? The economic definition of profit differs from the accounting definition of profit in that the economic definition includes a. Sometimes those costs are explicit—like when Alex borrowed the money from the bank—and sometimes those costs are implicit— like when Tyler had to forgo the interest he could have earned had he left his funds in a savings account. If an economist and accountant calculated Alex and Tyler’s costs, for whom would they have identical numbers and for whom would the numbers differ? In the aforementioned disagreement on cost of one of the activities, which profession would calculate a larger cost? A competitive firm maximizes profit by choosing a level of output where the world price is equal to the firm’s a. True or False: When a competitive firm maximizes profit, profits are always greater than 0. Over the last few years, such wines sold for 7 euros per bottle; but with a global recession, the price has fallen to 5 euros per bottle. Given the information below, let’s find out which of these three winemakers (if any) should shut down temporarily until times get better. To keep things simple, let’s assume that each winemaker has calculated the optimal quantity to produce if they decide to stay in business; your job is simply to figure out if she should produce that amount or just shut down. Winemaker Fixed Costs Variable Costs Recession Revenues Paulette $50,000 $80,000 $120,000 Camille $100,000 $40,000 $70,000 Hortense $200,000 $250,000 $200,000 7. Fill in the blank: Even if profit is negative, if revenues are variable costs, then it’s best to stay open in the short run. You’ve been hired as a management consultant to WaffleCo, a maker of generic-brand frozen waffles. They’re each trying to figure out if they should produce a little more output or a little bit less in order to maximize their profits. The firms all have typical marginal cost curves: They rise as the firm produces more. Your staff did all the hard work for you of figuring out the price of the firm’s output is $4 per box and the marginal cost of producing one more unit of output is $2 per box at its current level of output. However, they forgot to collect data on how much the firm is actually producing at the moment. In your final report, you need to decide if the firm should produce more, less, or stay at the current output level. Given the cost function for Simon, a housepainter in a competitive local market, below, answer the questions that follow. What is the minimum price per room at which Simon would be earning positive economic profit? In the ancient Western world, incense was one of the first commodities transported long distances. It grew only in the south of the Arabian Peninsula (modern-day Yemen, known then as Arabia Felix) and was transported by camel to Alexandria and the Mediterranean civilizations, notably the Roman Republic. As the republic expanded into a richer and larger empire, the demand for incense grew and planters in Arabia added a second and then a third annual crop (though this incense was not as high of a quality). Cultivation also crossed to the Horn of Africa (modern-day Oman) even though such fields were farther away from Rome. The fact that additional annual crops were of lower quality indicates that this industry has a. In the competitive children’s pajama industry, a new government safety regulation raises the average cost of children’s pajamas by $2 per pair. If this is a constant cost industry, then in the long run, what exactly happens to the price of children’s pajamas? If this is an increasing cost industry instead, will the long-run price of pajamas rise by more than $2 or less? As Ngoy started hiring more Cambodian refugees to work in his donut shop, this made it more likely that a. At this point in the story, what sort of cost industry (constant, increasing, or decreasing) would you consider doughnut shops owned by Cambodians to be? Fast forward 40 years: What kind of cost structure are Californian doughnut shops probably in now? In American homes, carpets are much less popular than they were in the 1960s and 1970s, when “wall-to-wall 85 carpeting” was fashionable in homes. Suppose that carpeting became even less popular than it is today: What would this fall in demand probably do to the price of carpet in the long run? No change to carpet prices 86 Competition and the Invisible Hand Video name: Minimization of Total Industry Costs of Production ​ 1. Suppose there are two industries: a high-profit industry, Industry H, and a low-profit industry, Industry L. If the two industries have similar costs, then what must be true about prices in the two industries? Assuming that prices in the two industries were identical, if labor and capital are moved from Industry L to Industry H, are more units of output lost in Industry L or gained in Industry H? Suppose that two industries, the pizza industry and the calzone industry, are equally risky, but rates of return on capital investments are 5% in the pizza industry and 8% in the calzone industry. We’ve claimed that the efficient way to spread out work across firms in the same industry is to set the marginal cost of production to be the same across firms. Consider a competitive market for rolled steel (measured by the ton) with just two firms: SmallCo and BigCo. If we wanted to be more realistic, we could say there were 100 firms like SmallCo and 100 firms like BigCo, but that would just make the math harder without generating any insight. What would the price have to be in this competitive market for these two firms to produce a total of 11 tons of steel?

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The names of the following counties are ofen misspelled and/or confused: Allegany in Maryland and New York Brooke in West Virginia Alleghany in North Carolina and Virginia Brooks in Georgia and Texas Allegheny in Pennsylvania Bulloch in Georgia Andrew in Missouri Bullock in Alabama Andrews in Texas Burnet in Texas Aransas in Texas Burnett in Wisconsin Arkansas in Arkansas Cheboygan in Michigan Barber in Kansas Sheboygan in Wisconsin Barbour in Alabama and West Virginia Clarke in Alabama antibiotic 7244 93 generic suprax 100mg, Georgia, Iowa, Brevard in Florida Mississippi, and Virginia Broward in Florida Clark in all other States Geologic Terms and Geographic Divisions 375 Cofee in Alabama, Georgia, and Manatee in Florida Tennessee Manistee in Michigan Cofey in Kansas Merced in California Coal in Oklahoma Mercer in all other States Cole in Missouri Morton in Kansas Coles in Illinois Norton in Kansas Cook in Illinois and Minnesota Muscogee in Georgia Cooke in Texas Muskogee in Oklahoma Davidson in North Carolina and Park in Colorado and Montana Tennessee Parke in Indiana Davie in North Carolina Pottawatomie in Kansas and Daviess in Indiana, Kentucky, Oklahoma and Missouri Pottawattamie in Iowa Davis in Iowa and Utah Prince George in Virginia Davison in South Dakota Prince George’s in Maryland DeKalb all one word Sanders in Montana Dickenson in Virginia Saunders in Nebraska Dickinson in Iowa, Kansas, and Smyth in Virginia Michigan Smith in all other States Dickson in Tennessee Staford in Virginia Forrest in Mississippi Straford in New Hampshire Forest in all other States Stanley in South Dakota Glascock in Georgia Stanly in North Carolina Glasscock in Texas Stark in Illinois, North Dakota, Green in Kentucky and Wisconsin and Ohio Greene in all other States Starke in Indiana Harford in Maryland Stephens in Georgia, Oklahoma, Hartford in Connecticut and Texas Huntingdon in Pennsylvania Stevens in Kansas, Minnesota, Huntington in Indiana and Washington Johnston in North Carolina and Storey in Nevada Oklahoma Story in Iowa Johnson in all other States Terrell in Georgia and Texas Kanabec in Minnesota Tyrrell in North Carolina Kennebec in Maine Tooele in Utah Kearney in Nebraska Toole in Montana Kearny in Kansas Vermillion in Indiana Kenedy in Texas Vermilion in all other States Linn in Iowa, Kansas, Missouri, Woods in Oklahoma and Oregon Wood in all other States Lynn in Texas Wyandot in Ohio Loudon in Tennessee Wyandotte in Kansas Loudoun in Virginia 19. Congressional Record Code of laws of the United States and rules for publication of the Congressional Record Title 44, Section 901. It shall provide for the publication of an index of the Congressional Record semimonthly during and at the close of sessions of Congress. The same general style should be followed in the permanent (bound) Record as is used in the daily Record. It is important to be familiar with the exceptions and the forms peculiar to the Record. Element identifer codes are programmatically inserted, and galley output is accomplished without manual intervention. However, Record style will be followed, as stated in the following rules: Daily and permanent Record texts are set in 8-point type on a 9-point body. An F-dash will be used preceding 8-point cap lines in the proceedings of the Senate and House. All extracts are set 7 point unless otherwise ordered by the Joint Committee on Printing. 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A resolution adopted by the our national opportunity to recon House of Representatives of the State of sider Roe v. Rhode Island expressing its opposition to Roe against Wade and its companion federal proposals to authorize increases case, Doe v. Madam Speaker, I followed as submitted for acronyms, symbols, now yield 5 minutes to the gentleman or abbreviations. On the question of ordering the yeas So (two-thirds not having voted in fa and nays there were 18 ayes and 88 vor thereof) the motion was rejected. The vote was taken by electronic the question was taken; and on a di device, and there were—ayes 228, vision [demanded by Mr. Adams Matsui Takano Members will record their presence Bonamici McCollum Van Hollen by electronic device. The following the assistant legislative clerk Senators are necessarily absent: proceeded to call the roll, and the fol the Senator from Minnesota (Mr. President, I move Further, if present and voting, that the Sergeant at Arms be in the Senator from Minnesota (Ms. On this Booker Klobuchar Sanders question the yeas and nays have been Boxer Landrieu Schatz Brown Leahy Schumer ordered, and the clerk will call the Cantwell Levin Shaheen roll. Cardin Manchin Stabenow the Assistant legislative clerk Carper Markey Tester called the roll. Speaker, I voted, the Clerk announced the following but, being paired with the gentlelady pairs: from Minnesota, Mrs. Speaker, I have a pair Until further notice: with the gentleman from New York, Mr. Few of those who learned the (By Benjamin Civiletti, Dick Thornburgh details of the program have criticized its and William Webster) necessity. This bill is now such surveillance without court orders to being considered by the Senate Judiciary defend the country. The lines of A pall-like silence fell upon the patrons of the poem should align on the left, those that the game. Congressional Record 391 But Flynn preceded Casey, as did also Close by the sturdy batsman the ball Jimmy Blake, unheeded sped— And the former was a hoodoo and the latter “That ain’t my style,” said Casey. And when the dust had lifted, and the men With a smile of Christian charity great saw what had occurred, Casey’s visage shone; There was Jimmy safe at second and Flynn He stilled the rising tumult; he bade the a-hugging third. There was ease in Casey’s manner as he They saw his face grow stern and cold, they stepped into his place; saw his muscles strain, There was pride in Casey’s bearing and a And they knew that Casey wouldn’t let smile lit Casey’s face. And when, responding to the cheers, he the sneer is gone from Casey’s lip, his lightly doffed his hat, teeth are clenched in hate; No stranger in the crowd could doubt ’twas He pounds with cruel violence his bat upon Casey at the bat. Ten thousand eyes were on him as he And now the pitcher holds the ball, and rubbed his hands with dirt; now he lets it go, Five thousand tongues applauded when he And now the air is shattered by the force of wiped them on his shirt. We have had a very thorough dered otherwise by the Joint Committee on review of what we’re doing. The beginning of the 7-point extract must Ap pro priations Subcommittee on start with a true paragraph; 8-point type fol Defense: lowing is always a paragraph. Help the chair as Acting President pro them in their debates to distinguish tempore. President, I ask unanimous consent that the order for the quorum call be rescinded. An act to extend the pediatric To the Senate of the United States: priority review voucher program. Novotny, one of its reading from terrorist attacks, and under clerks, announced that the House has mines core U. Novotny, one of its reading unanimous consent, and referred as clerks, announced that the House indicated: has passed the following bill, with an H. An act to amend the Internal Revenue Code of 1986 to exempt from the [Note the insertion of S. Would it not be neces “by further authorization of Congress sary to change the resolving clause and”, so as to make the paragraph also? The next amendment was, on the bill was ordered to be engrossed page 34, in line 9, under the head for a third reading, read the third time, and passed. President, I have the words “of class 1”, to strike out just had an opportunity to exam “twenty-seven” and insert “twenty”; ine this joint resolution. The sert “two”; and in line 18, to strike out Secretary will state the amendment “$124,940” and insert “$102,590”, so as offered by the Senator from Arizona. Speaker, I appreci cordance with the order previously ate the constructive approach you and the entered, that the Senate stand in other leaders took at the end of last year to pass a budget and make tax cuts perma recess until the hour of 10:30 a. All these things the following scheme for subheads is to be still matter to hardworking families; they followed: are still the right thing to do; and I will not [Heads indicating service, or branch or let up until they get done. Conroy, offered the follow ing prayer: ing prayer: Merciful God, we give You thanks We give You thanks, O God, for giv for giving us another day. Insofar as this spirit mon good that will lead to ways of of alienation has descended upon this equity and peace. House, help each Member to overcome May all that is done this day be for unnecessary divisions that ham Your greater honor and glory. Give the Members lis called to order by the Speaker pro tening hearts, ready and willing to tempore (Mr.

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