Eleanor L. Ormsby, MD, MPH

• Chief Resident, Diagnostic Imaging
• UC Davis Medical Center
• Sacramento, California

Terefore I can control Nations Educational symptoms 0f diabetes cheap careprost 3 ml mastercard, Scientifc medications during labor generic careprost 3 ml, and achieve gender equality symptoms umbilical hernia generic careprost 3ml without a prescription, and ensure the world symptoms ectopic pregnancy purchase 3 ml careprost with mastercard. Accessed October strengthening of respect for human rights and 74 See full report at medications before surgery buy 3 ml careprost with mastercard. Parents have a prior right to choose the kind of Documents/Intl-literacy-day/literacy-infographic-2013 70 Ibid medications going generic in 2016 buy cheap careprost 3 ml line. She is the youngest Tere is also evidence that the will go on to infuence and positively recipient of the Nobel Peace Prize importance of educating females develop their villages, cities, and and is a human rights activist is gaining momentum in many nations. One of these Pakhtunkhwa province of northwest Development found that the gender organizations is the Unreasonable Pakistan, a place where the local gap has closed in almost all countries Group, which together with the Taliban had sometimes banned in primary education and that it Nike Foundation launched a females from attending school. An example that young females complete twelve it reported that more than thirty of one of these organizations is years of safe, quality education so fve million females do not attend ZanaAfrica, an organization set up they can achieve their potential school in developing countries. Malala Yousafzai, nations and are working to provide this organization as a movement in the founder of this organization, school uniforms for students, free 2008 in partnership with the Novo was shot in the head by the Taliban meals, and books in order to ofset Foundation and the United Nations in 2012 for speaking out in favor of the direct and indirect costs for Foundation at the World Economic female education. It is also fundamental child marriage, raped or unjustly does not permit me to go into to self-awareness, self-identity, and imprisoned; and create awareness further detail. Studies show that against sexually transmitted diseases for there to be gender parity and an educated female has the power to and provide care for those females equality, laws and policies should infuence change in her life, family, who fall victim of unwanted not just be made with the hope and community. Instead, year of education gives a female a ten social workers in the communities, people need to infuence and change to twenty percent chance of earning attempt to get school authorities to cultural perceptions from the ground more income in her lifetime. Changing attitudes and cultures reduces mother and infant mortality escape sex trafcking. With education, females is doing great work in providing through the use of gender-neutral become a key component to ending educational opportunities for policies, media, and education. It involves infuencing the issue of religious interpretation females, and Nicholas Kristof and the younger generation of males or misinterpretation, which tends Sheryl WuDunn, who both continue and females who are the future to be a problem in predominately to speak up against injustices against leaders, fathers, mothers, brothers, Muslim societies. If they are convinced poses a threat to female education I wrote this paper, because I, too, that education is critical, they will in developing nations because when want to be part of the change that fght to get their children or siblings females are married of at a young I wish to see in the world. It is my educated, or at least recognize the age, it often means withdrawal from hope that this thesis is the frst step importance of educating females as school for the rest of their lives. If a a challenge to female education in males and females in developing society fails to invest in females, it is places such as Nepal, because these nations. Tere Conclusion education of females in developing are also various political challenges The necessity and importance of nations as listed above as well as to to female education from war to investing in the education of females change the perception of males in patriarchal traditions. Education is essential 95 Kristof and Wudunn, Half the Sky, 56 because many international 96 Ibid. Tese entities community in the Northern have created laws and treaties that Nigeria. Comparative Education 17, work to provide access to better Encyclopedia of Transnational no. Children and Youth Unit & Poverty Reduction and Economic Management Erkin, Mariam. Empowering women and girls menstruation-can-mean-days-in Ibadan: Ibadan University Press. This article is written in the then a vital perspective is silenced, limiting form of a literary criticism, within the subfeld the expansive possibilities of a text. Jane Bennett, an alternative perspective in which water, author of Vibrant Matter: A Political Ecology fowers, clothing, and soil act as integral of Things, was the frst to coin this term, players, displaying an infuential Thing applying Thing-Power to literature, politics, Power. By endowing objects dissertation Tool-Being: Heidegger and the with Thing-Power, their value increases. She distributes a the inability to adequately grieve historical relationship with objects. The ability to gift the inability to lament and her devout Ontology raises these objects to the intangible is truly optimistic, but wish for this to be acknowledged. This acknowledging this relationship, we can move away theory coaxes readers to rethink from the use, abuse, and disuse of objects, slowing the the roles objects play in their everyday lives. In literature there pollution of our world and progressively preserving our is an evident transference of power most essential object: Earth. By acknowledging this has deteriorated; nonhuman entities only separated by the theatrical relationship, we can move away step in as messengers, mending the timeframe of a single scene. The purpose of the interpretation: a mistake brought importance of environment in the fowers is further clarifed, and on by a compromised state of mind play. This interpretation would to decompose into a nonhuman opens up the ongoing debate about still bestow Ting-Power upon the entity. For are intrinsically involved the spring of water from within here lies the point: if I drown myself in the balance of life and himself. First Clown begins occurred and one party retreated as far as he could go before resorting to force. But, the ability to induce death upon human burial, when she willfully seeks defendant, though saved from execution, still had to entities. By exploring on which object possessed the While First Clown originally did not the process by which the human higher Ting-Power at the time of mean to divest agency upon water, body decomposes, Hamlet bestows her demise. Similar to the Grave Diggerstransformed Caesar fghts against alongside their human counterparts. Utilizing lens, traditional interpretations are well-known political fgures, like uprooted to reveal their untapped, As thus: Alexander died, Alexander the Great and Julius interwoven potential restlessly Alexander was buried, Alexander Caesar, Hamlet seeks to speak of the waiting beneath. Vibrant Matter: A why of that loam whereto he was status, that are maintained among Political Ecology of Tings. Imperious Caesar, eventual equality of all humans dead and turned to clay, might based on mortality and thereby Bevington, David. Forensic By: Simone Longe anthropologists conduct various analyses, including skeletal trauma An essential aspect of conducting a forensic anthropological analysis, forensic taphonomy, and analysis is estimating the sex of an unknown individual. Research to note that forensic anthropologists only work with human remains that continues to show that the os coxa (pelvis) is the best indicator of are of both modern and of forensic sex due to the morphological differences between males and females signifcance (Tersigni-Tarrant and (Phenice, 1969; Buikstra and Ubelaker, 1994; Blanchard, 2010; White Shirley, 2013). Forensic Although forensic anthropologists anthropologists are often presented with incomplete skeletons, which perform many roles of skeletal require other bones beside the pelvis to be relied upon to estimate the analysis, perhaps their most important is conducting biological sex of a person. According to Spradley and Jantz (2011), metric analysis of the A biological profle consists of the postcranial skeleton for estimating sex provides more accurate results basic demographic information of a than both metric and nonmetric traits of the skull. Further, some person: the sex, age, ancestry, stature, postcranial elements prove more accurate than others. Recognizing certain aspects of these unidentifed highest scoring estimators for sex. The conducting a biological profle is sample used for Spradley and Jantz was taken from the Forensic estimating the sex, or whether they were biologically male or female. Sexual dimorphism factors such as genetics and hormone anthropologists frequently encounter is generally defned as the shape levels can also afect the level of incomplete skeletons with a missing, and size diferences between males sexual dimorphism among an fragmented, or damaged pelvis. Because of the genus Homo were vastly to compare two intrinsically diferent skeletons retrieved from forensic more sexually dimorphic than samples: the Texas State University investigations have the possibility of modern humans, modern humans Donated Skeletal Collection and being incomplete, other bones must still display a signifcant level of the collection used in the Spradley be relied upon to estimate the sex of diferences in size and shape between and Jantz study. Spradley in all populations males appeared such as homicide, which usually and Jantz used only positively to have larger coxae than females involve younger, more suspicious identifed American black and white (Betti, 2014).

The relatively late development of synaptic connections in the 242 hippocampus may be the reason that children have poor declarative memory in their early years medicine cabinets recessed purchase careprost canada. Synapses are modified not only when we encounter new information treatment lymphoma cheap 3 ml careprost with amex, but also later schedule 8 medications list cheap careprost online american express, as memories are reprocessed medications by mail buy careprost 3 ml low price. This process is known as reconsolidation symptoms 7 days after iui buy cheap careprost on line, in which a stable (consolidated) memory is re-strengthened kapous treatment buy careprost online now. Changes can even happen offline when we are not actively thinking about the information, as memories are also strengthened during sleep (see chapter 7). These changes in synapses and neurons participate not only in the learning of facts in school, but in all changes in the developing the brain. Students often wait until the last minute, then make up for lost time in a marathon study session. This strategy flies in the face of one of the most reliable results in research on learning: the power of spaced study. The brain retains many kinds of information longer if there is time to process the learned information between training sessions. Two study sessions with time between them can result in twice as much learning as a single study session of the same total length. Spaced training works with students of all ages and ability levels, across a variety of topics and teaching procedures. In general, the longer the gap between study sessions (up to a year in some cases), the longer people will remember the material. One possible reason why this approach works is that breaks allow time for newly acquired information to be consolidated (see main text). Memories are not written just once, but reinforced either during recall or even offline, for instance during sleep. Because memories are reconsolidated when they are recalled, tests actually improve learning (and slow down subsequent forgetting) by compelling the student to actively recall the course material. You can take advantage of this fact by quizzing your child at home during study time to improve her performance at school and by teaching your child to test herself as a study strategy. Children who see ten similar examples in a row learn considerably less than children who see ten different examples. This strategy works across domains, affecting the way we learn sports, art history, math, or any other subject. But young children can recall things that happened earlier, suggesting that information is stored but gets lost on the way to adult life. One possibility is that the 245 brain is incapable of transferring memories into long-term storage in the neocortex. Recent evidence suggests that an alternative cause is instability of the initial memory. As we described in chapter 1, infants can learn to form associations, as evidenced by their ability to learn to kick when their foot is attached by a ribbon to a mobile. When they get older, they outgrow this game, so that researchers have to come up with something more complex, such as pressing a lever to cause a miniature train to go around a track. After that remembering grows steadily, until at eighteen months, children can remember simple associations for three months. At eighteen months, they can make a more complex movement, like dressing a teddy bear, after a delay of four weeks. Four reminders spread over six months lead babies to remember the task for a full year. As memories fade, reminders that are similar but a little bit off can distort the original memory, as also happens in adulthood. Children who think a test measures their innate competence do not try as hard or perform as well as those who think that effort is the major determinant of success or failure. In contrast, children who believe that hard work can improve their cognitive abilities often welcome difficult tasks and bounce back from failure, feeling that they have learned from the experience. For this reason, emphasizing the importance of intelligence to children may paradoxically reduce their chances of success. Accordingly, interventions to change studentsviews of intelligence can improve academic performance. In one longitudinal study, math test scores were static over two years in students who entered seventh grade believing that intelligence is fixed, while scores improved over time in their peers who believed that intelligence is influenced by experience. The researchers then went to a different school and offered seventh graders an eight-week class (half an hour per week) on brain function and study skills. Later, the first group scored significantly higher on math tests than the second group, though the two groups had performed similarly before starting the class. Though telling a child that he is smart or artistic or athletic may seem like a good way to make him feel good about himself (see box, Myth: Praise builds self-esteem, which protects against many problems, in chapter 29), it also teaches him to view those characteristics as fixed traits. On the other hand, praising your child for effort or improvement, or for choosing a particular way to respond to a problem, communicates that his behavior and choices are what matter to you. Since he can control his behavior but not his traits, that message is more empowering. This argument is ongoing partly because the development of intelligence has political implications for disadvantaged groups and partly because the issue is genuinely complicated. You may find the next section easier to follow if you first go back and read the box in chapter 10 (Practical tip: Outdoor play may reduce the risk of nearsightedness) to remind yourself of how a trait can be highly heritable and strongly affected by the environment at the same time. Intelligence can be subdivided into knowledge (crystallized intelligence) and reasoning skills (fluid intelligence). Higher-intelligence brains process information more efficiently, reacting more quickly to stimuli and requiring less activity to solve problems than less intelligent brains. People with high intelligence are resistant to distraction: they are less likely to lose their place when they return to a task after temporarily turning their attention to something else. It grows quickly until middle childhood and then more slowly until it reaches a plateau in mid-adolescence. After that, it declines very slowly through adult life, and then more quickly in old age. Still, parents (and teachers, and everyone else) should keep in mind that intelligence accounts for a bit less than half of the variation among individuals on most cognitive tests. The remainder of the test variance is attributable to 250 mood, motivation, specific cognitive strengths and weaknesses, and experience with the particular test and with testing in general. Finally, life success depends not only on ability, but also on opportunity and effort. Twin and adoption studies demonstrate conclusively that genes strongly influence individual differences in intelligence. This change occurs partly because as children grow older, they become more able to choose environments that suit their personal characteristics. In particular, intelligent children tend to place themselves in intellectually stimulating circumstances if they can, which improves their cognitive development. It is important to note that this interplay of genes with environment is far weaker under conditions of deprivation (see chapter 30). If the environment is sufficiently impoverished, there is little or no correlation between genetic inheritance and intelligence. This probably happens because such environments offer children few opportunities to develop their genetic potential. There are many uncertainties involved in measuring (or perhaps defining) intelligence early in life, before it has fully developed. This measure is not very reliable, as it predicts only 17 percent 251 of the variability in later intelligence and often produces different results when researchers retest the same child over time. Cognitive testing in babies and young children can distinguish mental retardation from normal intelligence, but cannot distinguish moderate differences in normal intelligence. Curiously, although researchers have identified about 300 genes associated with mental retardation, not a single specific gene has been definitively linked to normal variations in intelligence. For comparison, forty genes are known so far that contribute to height, but they explain a total of only 5 percent of variation among individuals; more than likely, many more height genes remain to be identified. This correlation becomes stronger with age, and both measures are influenced by similar genes. In a longitudinal study of children, the pattern of developmental changes in cortical thickness predicted intelligence more strongly than did the adult configuration at age twenty (see chapter 9). Dendritic branching in neurons has also been correlated with intelligence in a few studies. Reasoning requires the transfer of information between brain regions, and so brain connectivity is important. Among the major bottlenecks are certain long-distance connections within the brain; intelligence is correlated with making these connections easily and effectively. One study found that links from a region of prefrontal cortex to the anterior cingulate and parietal cortex were stronger in more intelligent children and adolescents. In adulthood, a network of frontal and parietal cortex regions seems to be most important for intelligence. In patients with brain damage, lesions in the left frontal and parietal cortex impair working memory, a key component of intelligence that allows you to remember things like where you are in a multi-step task. Damage to the left inferior frontal cortex impairs verbal comprehension, and right parietal damage impairs perceptual organization. An area called the rostrolateral prefrontal cortex seems to be activated specifically during tasks that require participants to integrate multiple mental representations, as you do when plotting your next move in a game of chess. A handful of imaging studies suggest that children may use their brains differently from adults during abstract reasoning. Compared to adults, children ages six to thirteen recruit the rostrolateral prefrontal cortex for easier tasks. The role of the environment in the development of intelligence is also substantial, but it has proven more difficult to define. Heritability estimates are somewhat misleading 253 in this regard because their calculation assumes that the effects of genes and environment are independent of each other. As we discussed in chapter 2, that assumption is rarely reliable, and it seems unlikely to be correct in this case. This statistic suggests that environmental disadvantages limit the development of intelligence in poor children, leaving their full genetic potential unrealized. These findings and others suggest that improving the environment may increase the apparent contribution of genetics to individual differences. The same improvement was seen when these eighteen-year-olds were compared with their own fathers. It might be tempting to say that this younger generation had evolved to be more intelligent than their parents, but evolution takes much longer than a few decades. Flynn points out that modern times have increasingly rewarded complex and abstract reasoning, and that this has been happening for over a 254 century.

Nurse Cramer was a good-hearted medicine x topol 2015 buy cheap careprost 3 ml on-line, sentimental creature who rejoiced unselfishly at news of weddings medicine 93832 cheap careprost 3 ml with amex, engagements treatment of tuberculosis careprost 3 ml overnight delivery, births and anniversaries even though she was unacquainted with any of the people involved symptoms 4 weeks 3 days pregnant generic careprost 3 ml on line. Nurse Cramer was still standing directly in front of him so that he could not pass symptoms nervous breakdown purchase cheapest careprost. Yossarian drew back his fist to punch her in the jaw just as his leg buckled and he began to fall bad medicine order careprost 3ml without prescription. Next morning while she was standing bent over smoothing the sheets at the foot of his bed, he slipped his hand stealthily into the narrow space between her knees and, all at once, brought it up swiftly under her dress as far as it would go. She backed away too far, and Dunbar, who had watched from the beginning, sprang forward on his bed without warning and flung both arms around her bosom from behind. Nurse Duckett let out another scream and twisted away, fleeing far enough from Dunbar for Yossarian to lunge forward and grab her by the snatch again. Nurse Duckett bounced out across the aisle once more like a ping-pong ball with legs. Dunbar missed completely and sailed by her over the bed to the floor, landing on his skull with a soggy, crunching thud that knocked him cold. He woke up on the floor with a bleeding nose and exactly the same distressful head symptoms he had been feigning all along. Nurse Duckett was in tears, and Yossarian was consoling her apologetically as he sat beside her on the edge of a bed. The commanding colonel was wroth and shouting at Yossarian that he would not permit his patients to take indecent liberties with his nurses. Hungry Joe had nightmares because he had finished sixty missions and was waiting again to go home, but he was unwilling to share any when he came to the hospital to visit. They want everyone to serve overseas at least once, even administrative personnel. He whirled back to Yossarian and, before he could speak, sneezed thunderously six times, staggering sideways on rubbery legs in the intervals and raising his elbows ineffectively to fend each seizure off. Yossarian was enraged when the ambulance returned him to the squadron, and he went limping for justice to Doc Daneeka, who glared at him glumly with misery and disdain. He whistled upward four times into his drooping yellow mustache and spurted away into the hills on the dented old green motorcycle he had purchased secondhand months before. Yossarian waited until the last faint bark of the motor had died away in the distance. The escape hatches in the front and rear sections flew open while the sea was still foaming white and green around the plane, and the men scrambled out as speedily as they could in their flaccid orange Mae West life jackets that failed to inflate and dangled limp and useless around their necks and waists. The plane went down about three seconds after we left it and we were out there all alone, and right after that we began unscrewing the caps on our Mae Wests to see what the hell had gone wrong and found those goddam notes from Milo telling us that what was good for him was good enough for the rest of us. Jesus, did we curse him, all except that buddy of yours, Orr, who just kept grinning as though for all he cared what was good for Milo might be good enough for the rest of us. He kept slapping his hands on his legs every few seconds as though he had the shakes and saying, "All right now, all right," and giggling like a crazy little freak, then saying, "All right now, all right," again, and giggling like a crazy little freak some more. Watching him was all that kept us from going to pieces altogether during the first few minutes, what with each wave washing over us into the raft or dumping a few of us back into the water so that we had to climb back in again before the next wave came along and washed us right back out. First he found a box of chocolate bars and he passed those around so we sat there eating salty chocolate bars while the waves kept knocking us out of the raft into the water. The next thing he finds is a fishing line and dried bait, and his face lights up as though the Air-Sea Rescue launch had just sped up to save us before we died of exposure or before the Germans sent a boat out from Spezia to take us prisoner or machine-gun us. In no time at all, Orr had that fishing line out into the water, trolling away as happy as a lark. After that he found a small magnetic compass and a big waterproof map, and he spread the map open on his knees and set the compass on top of it. He would certainly have preferred Sweden, where the level of intelligence was high and where he could swim nude with beautiful girls with low, demurring voices and sire whole happy, undisciplined tribes of illegitimate Yossarians that the state would assist through parturition and launch into life without stigma; but Sweden was out of reach, too far away, and Yossarian waited for the piece of flak that would knock out one engine over the Italian Alps and provide him with the excuse for heading for Switzerland. Dobbs and Hungry Joe were out of the question, and so was Orr, who was tinkering with the valve of the stove again when Yossarian limped despondently back into the tent after Dobbs had turned him down. The stove Orr was manufacturing out of an inverted metal drum stood in the middle of the smooth cement floor he had constructed. Yossarian tried paying no attention to him and limped wearily to his cot and sat down with a labored, drawn-out grunt. Orr studied Yossarian over his shoulder, his moist lips drawn back around convex rows of large buck teeth. Reaching sideways, he dug a bottle of warm beer out of his foot locker, and he handed it to Yossarian after prying off the cap. Orr snickered with a slight, mucid sibilance and turned back to his work, squatting. Who would protect a warm-hearted, simple-minded gnome like Orr from rowdies and cliques and from expert athletes like Appleby who had flies in their eyes and would walk right over him with swaggering conceit and self-assurance every chance they got Orr was a happy and unsuspecting simpleton with a thick mass of wavy polychromatic hair parted down the center. Orr was an eccentric midget, a freakish, likable dwarf with a smutty mind and a thousand valuable skills that would keep him in a low income group all his life. He could use a soldering iron and hammer two boards together so that the wood did not split and the nails did not bend. He had built a good deal more in the tent while Yossarian was away in the hospital. He had filed or chiseled a perfect channel in the cement so that the slender gasoline line was flush with the floor as it ran to the stove from the tank he had built outside on an elevated platform. He had constructed andirons for the fireplace out of excess bomb parts and had filled them with stout silver logs, and he had framed with stained wood the photographs of girls with big breasts he had torn out of cheesecake magazines and hung over the mantelpiece. He could dig holes, and he had a real gift for bringing water for them both in cans and canteens from the tanks near the mess hall. He could engross himself in an inconsequential task for hours without growing restless or bored, as oblivious to fatigue as the stump of a tree, and almost as taciturn. He had an uncanny knowledge of wildlife and was not afraid of dogs or cats or beetles or moths, or of foods like scrod or tripe. Yossarian sighed drearily and began brooding about the rumored mission to Bologna. The valve Orr was dismantling was about the size of a thumb and contained thirty seven separate parts, excluding the casing, many of them so minute that Orr was required to pinch them tightly between the tips of his fingernails as he placed them carefully on the floor in orderly, catalogued rows, never quickening his movements or slowing them down, never tiring, never pausing in his relentless, methodical, monotonous procedure unless it was to leer at Yossarian with maniacal mischief. He turned away, shutting his eyes, but that was even worse, for now he had only the sounds, the tiny maddening, indefatigable, distinct clicks and rustles of hands and weightless parts. Yossarian clenched his fists and looked at the long bone handled hunting knife hanging in a holster over the cot of the dead man in the tent. The idea of murdering Orr was so ridiculous that he began to consider it seriously with queer whimsy and fascination. Just the daintiest stick there would kill him and solve so many serious, agonizing problems for them both. You know, that fat bald one in Sicily with the turban who kept sweating all over us all night long He was late getting out of the plane and ended up alone in a raft that began drifting away from the men in the other raft and was out of sight by the time the Air-Sea Rescue launch came plowing up through the wind and splattering raindrops to take them aboard. The stove worked perfectly, with a strong, robust blaze that could be raised or lowered by turning the tap Orr had finally finished repairing. Yossarian cooked a can of hot soup to have ready for Orr and ate it all himself as the time passed. Each time he caught himself worrying he made himself remember that Orr could do everything and broke into silent laughter at the picture of Orr in the raft as Sergeant Knight had described him, bent forward with a busy, preoccupied smile over the map and compass in his lap, stuffing one soaking-wet chocolate bar after another into his grinning, tittering mouth as he paddled away dutifully through the lightning, thunder and rain with the bright-blue useless toy oar, the fishing line with dried bait trailing out behind him. If fish could be caught with that silly fishing line, Orr would catch them, and if it was codfish he was after, then Orr would catch a codfish, even though no codfish had ever been caught in those waters before. Every time a car door slammed, he broke into a hopeful smile and turned expectantly toward the entrance, listening for footsteps. General Peckem welcomed Colonel Scheisskopf with effusive charm and said he was delighted to have him. An additional colonel on his staff meant that he could now begin agitating for two additional majors, four additional captains, sixteen additional lieutenants and untold quantities of additional enlisted men, typewriters, desks, filing cabinets, automobiles and other substantial equipment and supplies that would contribute to the prestige of his position and increase his striking power in the war he had declared against General Dreedle. He now had two full colonels; General Dreedle had only five, and four of those were combat commanders. With almost no intriguing at all, General Peckem had executed a maneuver that would eventually double his strength. The future looked wonderful, and General Peckem contemplated his bright new colonel enchantedly with an effulgent smile. Peckem was, as he always remarked when he was about to criticize the work of some close associate publicly, a realist. He had silver-gray hair, slightly myopic eyes and thin, overhanging, sensual lips. It was not true that he wrote *memorandums* praising himself and recommending that his authority be *enhanced* to include all combat operations; he wrote *memoranda*. And the prose in the *memoranda* of other officers was always *turgid, stilted*, or *ambiguous*. Regulations were *stringent*, and his data never *was* obtained from a reliable source, but always *were* obtained. Things were often *incumbent* upon him, and he frequently acted with *greatest reluctance*. It never escaped his memory that neither black nor white was a color, and he never used *verbal* when he meant *oral*. He could quote glibly from Plato, Nietzsche, Montaigne, Theodore Roosevelt, the Marquis de Sade and Warren G. He beamed urbanely as he began orienting Colonel Scheisskopf to his new surroundings. He had just opened with one of his most trusted paradoxes, and he was positively alarmed that not the slightest flicker of acknowledgment had moved across that impervious face, which began to remind him suddenly, in hue and texture, of an unused soap eraser. Perhaps Colonel Scheisskopf was tired, General Peckem granted to himself charitably; he had come a long way, and everything was unfamiliar. He mentioned often that if the people who worked for him met him halfway, he would meet them more than halfway, with the result, as he always added with an astute chuckle, that there was never any meeting of the minds at all. And it was indeed an objective Peckem who gazed at Colonel Scheisskopf encouragingly and resumed his indoctrination with an attitude of magnanimous forgiveness. Somewhere down near the lowest level of this co-ordinated organization I run are people who do get the work done when it reaches them, and everything manages to run along smoothly without too much effort on my part. On the other hand, it is important that we let people know we do a great deal of it. While none of the work we do is very important, it is important that we do a great deal of it. Reinforcements like yourself keep arriving, and we have more than enough time to plan our entire strategy carefully. Colonel Scheisskopf, squinting, moved very close to the map, and for the first time since he entered the room a light of comprehension shed a dim glow over his stolid face. General Dreedle commands four bomb groups that we simply must capture in order to continue our offensive. Conquering General Dreedle will give us the aircraft and vital bases we need to carry our operations into other areas. General Peckem liked listening to himself talk, like most of all listening to himself talk about himself. When he accuses me of seeking to undermine him, I merely answer that my only purpose in calling attention to his errors is to strengthen our war effort by eliminating inefficiency. He began to wonder with genuine concern just what sort of shithead the Pentagon had foisted on him. It will make Colonel Cargill jealous, and I learned from Wintergreen this morning that General Dreedle will be off in Sardinia. The purpose of the mission is to knock the whole village sliding down the side of the mountain and create a roadblock that the Germans will have to clear. These two armored divisions will be coming down from Austria into Italy along this road. The village is built on such a steep incline that all the rubble from the houses and other buildings you destroy will certainly tumble right down and pile upon the road. I get a big kick out of the way the men come charging over to me after the mission and call me dirty names. Nobody is more distressed about those lousy wops up in the hills than Colonel Cathcart and myself. He knew he cut a fine figure there on the platform with his open shirt collar, his cigarette holder, and his close-cropped, gray-tipped curly black hair. Another colonel in the area meant another rival, another enemy, another person who hated him. A horrifying thought occurred to Colonel Cathcart: Suppose Colonel Scheisskopf had already bribed all the men in the room to begin moaning, as they had done at the first Avignon mission. Colonel Cathcart was seized with such fright that he almost beckoned to Colonel Korn. He had proved himself brilliantly under pressure, and he concluded the briefing with an inspiring peroration that every instinct told him was a masterful exhibition of eloquent tact and subtlety. Go on out there and bomb for me, for your country, for God, and for that great American, General P. The fall in the hospital had either shown him the light or scrambled his brains; it was impossible to say which. He snarled belligerently at superior officers, even at Major Danby, and was crude and surly and profane even in front of the chaplain, who was afraid of Dunbar now and seemed to be wasting away also. A brash assistant brought the chaplain a stolen Zippo cigarette lighter as a gift and informed him condescendingly that Wintergreen was too deeply involved with wartime activities to concern himself with matters so trivial as the number of missions men had to fly. The chaplain worried about Dunbar and brooded more over Yossarian now that Orr was gone. To the chaplain, who lived by himself in a spacious tent whose pointy top sealed him in gloomy solitude each night like the cap of a tomb, it seemed incredible that Yossarian really preferred living alone and wanted no roommates.

The many books and articles by these parents confrm the view that discrimi natory attitudes make raising a disabled child much more difcult than the actual logistics of care medicine pill identification discount 3 ml careprost mastercard. The attitudes that disabled people are frightening or inhuman result from lack of meaningful in teraction with disabled people medicine 665 discount 3 ml careprost with amex. But among people with little exposure to disabled people medications by class purchase 3ml careprost visa, it is common to think that this is a romanticization or rationalization of someone stuck with the burden of a damaged child symptoms night sweats discount 3ml careprost visa. Many who resist selective abortion insist that there is something deeply valuable and profoundly human (though difcult to articulate in the sound bites of contemporary thought) in meeting and loving a child or adult with a severe disability 4 medications at walmart order careprost. Tus treatment quadriceps pain generic careprost 3 ml free shipping, contributions of human beings cannot be judged by how we ft into the mold of normalcy, productivity, or cost-beneft. People who are diferent from us (whether in color, ability, age, or ethnic origin) have much to share about what it means to be human. For example, the culture typically invalidates our bodies, denying our sexuality and our potential as parents. Tese cultural impulses are complexly intertwined with the issue of prenatal testing. People with diferent kinds of disabilities may have complex feelings about prenatal screening tests. While some disabled people regard the tests as a kind of genocide, others choose to use screening tests during their own pregnancies to avoid the birth of a disabled child. Many people with dwarfsm, for example, are incensed by the idea that a woman or couple would choose to abort simply because the fetus would become a dwarf. When someone who carries the dwarf ism trait mates with another with the same trait, there is a likelihood of each partner contributing one dominant dwarfsm gene to the fetus. Disability Rights and Selective Abortion 109 Tose who challenge selective or eugenic abortion claim that people with disabilities are the ones who have the information about what having a disability is like. The medical system, unable to cure or fx us, exaggerates the sufering and burden of disability. Only we can speak about our real lives, our ordinary lives, and the lives of disabled children. The reproductive technology market has, since the mid-1970s, gradually changed the experience of pregnancy. Some prenatal care facilities now present patients with their ultrasound photo in a pink or blue frame. Usu ally prospective parents summon up the most stereotyped visions of disabled people derived from telethons and checkout-counter charity displays. This is not to say that all women who elect selective abortion do so based on simple, mindless stereotypes. They made the deci sions they felt were the only ones possible for them, given information they had been provided by doctors, counselors, and society. Together, these strains frequently push prospective parents to succumb to the medical control of birth, while passively colluding with pervasive disability discrimination. Health care providers are trying, despite the proft-based health care system, to improve life for people they serve. Physicians, by the very nature of their work, ofen have a distorted picture of the lives of disabled people. Most doctors have few opportunities to see ordinary disabled individuals living in their communities among friends and family. Moreover, among the priority conditions for prenatal screening are diseases that occur very infrequently. Tay-Sachs disease, for example, a debilitating, fatal disease that afects primarily Jews of eastern European descent, is ofen cited as a condition that justifes prenatal screening. Tose who advocate selective abortion to alleviate the sufering of children may ofen raise that cornerstone of contemporary political rhetoric, cost-beneft. Of course, cost-beneft analysis is not woman-centered, yet women can be directly pressured or subtly intimidated by both arguments. It is notable that families with disabled children who are familiar with the actual impact of the disabilities tend not to seek the tests for subsequent children. In addition, it is important to recognize that promotion and funding of prenatal tests distract attention and resources from addressing possible environmental causes of disability and disease. Disabled People and the Fetus I mentioned to a friend, an experienced disability activist, that I planned to call a conference for disabled people and genetics professionals to discuss these controversial issues. When we refer to the fetus as a disabled (rather than defective) fetus, we personify the fetus via a term of pride in the disability community. In biology class their teachers, believing themselves to be liberal, raised abortion issues. This issue of the humanness of the fetus is a tricky one for those of us who identify both as pro-choice feminists and as disability rights activists. Our dual perspective ofers important insights for those who are debating the ethics of the new reproductive technologies. Disentangling Patriarchal Control and Eugenics from Reproductive Freedom The issue of selective abortion is not just about the rights or considerations of disabled people. When disability rights activists challenge the practice of selective abortion, as we did in Vancouver, many feminists react with alarm. In the disability community we make a clear distinction between our views and those of anti-abortion groups. Tere may have been eforts to court disabled people to support anti-abortion ideology, but anti-abortion groups have never taken up the issues of expanding resources for disabled people or parents of disabled children, never lobbied for disability legislation. Oppressive assumptions, not inherent characteristics, have devalued who this fetus will grow into. This justifcation rein forces the idea that women are horribly oppressed by disabled children. When disability is sanctioned as a justifcation for legal abortion, then abortion for sex selection may be more easily sanctioned as well. Some proponents argue that prenatal tests are feminist tools because they save women from the excessive burdens associated with raising disabled children. Women still do the vast majority of child care, and child care is not valued as real work. Selective abortion will not challenge the sexism of the family structure in which women provide most of the care for children, for elderly parents, and for those disabled in accidents or from nongenetic diseases. It provides temporary relief that both masks and exacerbates the underly ing problems. The job of helping disabled people must not be confused with the traditional devaluing of women in the caregiver role. Indeed, women can be overwhelmed and oppressed by their work of caring for disabled family members. It is caused by lack of com munity services and inaccessibility, and greatly exacerbated by the sexism that isolates and overworks women caregivers. Almost any kind of work with people, if sufciently shared and validated, can be meaningful, important, joyful, and productive.

Despite the diversities medications with aspirin cheap careprost 3ml on-line, many activities and programs for radiation safety education have been established including many networks medicine woman order generic careprost canada. This presentation will discuss on the current situation of radiation safety practice in Asia Oceania as well as current radiation safety educational programs medications you should not take before surgery cheap careprost generic. Radiation safety education is key in addressing the radiation protection principles in any radiology practice treatment 1st line buy cheap careprost 3ml on line. Radiation safety training is also becoming part of ongoing training of interventional radiologists symptoms 4 days after conception buy careprost 3ml with visa. This talk will focus on the various educational initiatives in the United States and the various resources available for radiation safety 98941 treatment code purchase careprost mastercard. This talk will also discuss on how to develop and establish radiation safety education for all those utilizing radiation. Individual experts from professional organisations develop education resources based on scientific evidence and knowledge, organisations and agencies advocate for their adoption by regulatory authorities and radiology practices, and radiologists learn from these principles and use them in practice. Professional organisations such as the International Society of Radiology, the Radiological Society of North America and United Nations agencies such as the World Health Organisation and International Atomic Energy Agency are some of the collaborators. The International Basic Safety Standards provide guidance to improve radiology practice and radiation safety. The Bonn call-for-action identified priorities to improve radiation safety in the next decade. These recommendations include the strengthening of radiation safety education and training. Many open access radiation safety education resources are available to radiologists. Radiologists play leading roles in the improvement of quality care and radiation safety through content development, training delivery and practical use of radiation safety measures and tools. Photoacoustic imaging is regarded for its ability to provide in-vivo morphological and functional information about the tissue. With the recent advent of targeted contrast agents, photoacoustics is capable of in-vivo molecular imaging, thus facilitating further molecular and cellular characterization of tissue. This presentation is designed to provide both a broad overview and a comprehensive understanding of photoacoustic imaging. With a brief historical introduction, we will examine the foundations of photoacoustics, including relevant governing equations, optical/acoustic properties of the tissues, laser-tissue interaction, system hardware and signal/image processing algorithms. Specifically, penetration depth and spatial/temporal resolution of photoacoustic imaging will be anlyzed. Techniques to increase contrast and to differentiate various tissues in photoacoustic imaging will be presented. Furthermore, design, synthesis and optimization of imaging probes (typically, nanoconstructs or dyes) to enable molecular/cellular photoacoustic imaging will be presented. Special emphasis will be placed on contrast agents capable of multiplexed imaging, multi-modal imaging and image guided therapy including drug delivery and release. The presentation will continue with an overview of several commercially available and clinically-relevant systems capable of photoacoustic imaging. Regulatory aspects of photoacoustic imaging systems and imaging contrast agents will be presented. Finally, current and potential biomedical and clinical applications of photoacoustics will be discussed. Through the introduction of ultrasound contrast agents, the sensitivity and specificity of ultrasound for detection and characterization of focal lesions has been substantially improved. Recently, targeted contrast-enhanced ultrasound imaging (ultrasound molecular imaging) has gained great momentum in preclinical research by the introduction of ultrasound contrast agents that are targeted at molecular markers over expressed on the vasculature of certain diseases. By combining the advantages of ultrasound with the ability to image molecular signatures of diseases, ultrasound molecular imaging has great potential as a highly sensitive and quantitative method that could be used for various clinical applications, including screening for early stage disease (such as cancer); characterization of focal lesions; quantitative monitoring of disease processes at the molecular level; assisting in image-guided procedures; and, confirming target expression for treatment planning and monitoring. In this refresher course the concepts of ultrasound molecular imaging are reviewed along with a discussion on current applications in preclinical and clinical research. The design of such therapeutic intervention should assure that drug deposition or action enhancement take place only in the disease site, with the general goal to improve the therapeutic index. Ultrasound imaging can be used for targeted focusing of ultrasound energy in the areas of disease. Second approach suggests attaching microbubbles to the drug or a drug carrier (including nucleic acid drugs). Microbubbles can be complexed with drug or gene carrier nanoparticles, so that local action of ultrasound would result in triggered drug release/deposit or transfection in the ultrasound-treated area. Third approach involves targeted microbubble design, as in ultrasound molecular imaging. Combination of targeted microbubbles with drug carrier makes possible unfocused ultrasound use, to act only in the areas of the target receptor expression, where microbubbles adhere and ultrasound energy is then deposited. Lately, formulation moved from microbubbles to smaller nanodroplet drug carriers, to reach interstitium, where drug release could take place upon ultrasound treatment. Overall, combination of ultrasound imaging, including contrast (molecular) imaging, focused ultrasound, and drug carrier systems will lead to novel image-guided therapies, especially applicable in the era of personalized medicine. This talk will attempt at giving a structured overview over this vast arsenal of potentially useful approaches by focusing on those that have the highest potential for clinical translation. The Radiology department at the Churchill Hospital in Oxford is conducting a number of trials in these areas, and has designed these trials around interventions to measure the effect of these new techniques. It has also taken the opportunity to raise the profile of Radiology within the University, to promote greater collaboration with basic scientists, attracting increased funding, and opportunities for scientists and physicians. This includes the rationale for the decisions made at the outset, such as age range, frequency of screens, centralisation of service and responsibility of the screening process to the end of primary surgery. While these advances offer improvements and new possibilities, they challenge the conventional way a system is to be tested. In addition, given the interventional nature of the modality, there is an increasing need for the medical physicist to be more operationally engaged with the use and optimization of the technology. This lecture aims to offer a historical perspective on these topics and an outline of major priorities for fluoroscopic physics service. Quality control testing procedures for image quality evaluation, radiation dose measurement and other mechanical performance characteristics are essential for optimizing equipment performance and ensuring patient and staff safety. New metrics and analytics to better quantify high contrast resolution, low contrast resolution, temporal resolution, and 3D imaging will be examined. Changes in testing protocols necessary to address new hardware technologies, new acquisition methods, state-of-the-art image processing and analysis will be reviewed. A recently developed "physics testing mode" that the vendors will provide in the near future will be described. Proper configuration of acquisition parameters (focal spot size, voltage and added filter, tube current, pulse width, pulse rate, scatter removal) as a function of patient size from the smallest neonate to the largest bariatric patient is key to providing diagnostic image quality at properly managed radiation doses. In addition, one must ensure that the detector dose as a function of filter type and thickness, pulse rate, field of view, and complexity of the examination is properly configured. This presentation will review the four elements with an emphasis on some recent enhancements. The content of the exam is 30 percent fundamental core questions and the remainder represents recent advances in the field for each of the Medical Physics disciplines. The Diplomate must take an exam in each discipline in which certification is being maintained. Details of the exam, its content, any study guides useful for preparing for the exam are discussed. These are widely accepted imaging techniques that are becoming important diagnostic tools for forensic pathologists. Imaging findings provide additional objective evidence that can be easily displayed. In some cases, forensic imaging may support evidence from accident or crime scene investigations or may be the sole finding to support a theory for the mechanism and cause of injury or death. Such studies may influence jury members and contribute in securing either a criminal conviction or acquittal where appropriate. In this course, radiologists are paired with a forensic pathologist to discuss cases that they typically encounter in practice. The cases will be presented to the audience in a systematic manner with imaging and autopsy findings to teach the audience how imaging is used in the court to supplement the testimony of the medical examiner or expert radiologist. Examples include the meaning of hyoid fracture in strangulation; assessment of perforating gunshot wounds; the significance of intravascular air; and, the appearance of stillbirth versus live birth in infant death. By provide a common dataset and common set of evaluation metrics, they also facilitate a fair and rigorous evaluation of algorithms. Challenge organizers often sequester the test data from the training data, further enhancing the rigor of the evalation. These efforts can introduce problems in medical imaging to experts in other domains such as image processing and machine learning and serve as a means to bring in to medical images a range for expertise from other domains. They also serve to allow computer scientists access to clinical data which they may not otherwise have. Many challenges have also highlighted the need for collaboration as the best results are often obtained by combining a range of complementary techniques. We will discuss recent challenges from a number of domains including imaging and bioinformatics, explore the informatics infrastructure to host and participate in challenges and discuss the needs for future challenges including those in radiomics and radiogenomics. Quantitative imaging and analysis methods are actively researched by the community. Certain quantitation techniques are gradually becoming available both in the commercial products and clinical research platforms. As new quantitation tools are being introduced, tasks such as their integration into the clinical or research enterprise environment, comparison with similar existing tools and reproducible validation are becoming of critical importance. Such tasks require that the analysis tools provide the capability to communicate the analysis results using open and interoperable mechanisms. The use of open standards is also of utmost importance for building aggregate community repositories and data mining of the analysis results. The goal of this course is to build the understanding of the interoperability as applied to quantitative image analysis, with the focus on clinical research applications. This is especially important in the emerging field of radiomics where large data sets and huge numbers of image features lead to an increased risk of spurious correlations which are not actually driven by biology. A number of public databases have since been created by governments and other organizations to help facilitate the sharing of data sets. It is now up to the imaging research community to begin taking advantage of these resources. Other disciplines such as genomics and proteomics are significantly leading imaging in the adoption of these new open-science workflows. Endometriosis is a common cause of pelvic pain and infertility, affecting as many as 10% of premenopausal women. Radiologists should be familiar with the various imaging manifestations of endometriosis, especially those that allow its differentiation from other pelvic lesions. Benign endometriomas can exhibit restricted diffusion and should not be confused with ovarian cancer. Although women with endometriosis are at risk for developing clear cell and endometrioid epithelial ovarian cancers (ie, endometriosis-associated ovarian cancers), imaging findings such as enhancing mural nodules should be confirmed before a diagnosis of ovarian malignancy is suggested. The presence of a dilated fallopian tube, especially one containing hemorrhagic content, is often associated with pelvic endometriosis. Deep (solid infiltrating) endometriosis can involve the pelvic ligaments, anterior rectosigmoid colon, bladder, uterus, and cul-de-sac, as well as surgical scars; the lesions often have poorly defined margins and T2 signal hypointensity as a result of fibrosis. The presence of subcentimeter foci with T2 hyperintensity representing ectopic endometrial glands within these infiltrating fibrotic masses may help establish the diagnosis. Utilization of best current therapies results in an overall five-year relative survival rate for all stages combined to be only 15%, necessitating the use of alternative therapies. Image-guided ablation of lung malignancies is a revolutionary concept whose clinical applications are just beginning to be developed. Almost all image-guided ablative procedures can be performed in an outpatient setting, mostly with conscious sedation. Contraindications are few and include uncontrollable bleeding diathesis and recent use of anticoagulants. Image-guided ablation of lung malignancies is performed with two basic rationales. These are patients who are not candidates for surgery because of co-morbid medical contraindications to surgery, like poor cardiopulmonary reserve or patients refusing to undergo operation. This cohort could potentially derive significant benefit form a minimally invasive alternative therapy. In the second group it is used as a palliative measure as follows: (a) to achieve tumor reduction before chemotherapy (b) to palliate local symptoms related to aggressive tumor growth, such as chest pain, chest wall pain or dyspnea (c) hematogenous painful bony metastatic disease (d) tumor recurrence in patients who are not suitable for repeat radiation therapy or surgery Image-guided ablation is expanding treatment options for the local control of non-small cell lung cancer and metastatic disease. A mentoring relationship includes an experirenced individual possessing generativity and experience, and also a receptive advisee who values the contributions of the mentor in facilitating the advisees success. Many organizations have attempted to create formal mentoring systems with varying degrees of succcess. The three portions of this presentation will focus on processes and systems that can be implemented in creating a formal mentoring system, along with benefits and limitations of the same. A second portion will focus on the complex balancing interplay between mentors, advisees, and the goals of the mentoring engagement. The third portion will specifically focus on best mentoring practices for success in healthcare. The relationship is a balance of self-discovery, guided development and occasional intervention/rescue. Expectations and responsibilities of both the mentor and the mentee should be defined and agreed to . The author will describe approaches that are helpful in recognizing and balancing trade-offs in a mentoring relationship.

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