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Signs of poisoning occur after a latent period of 12 h to anxiety 9 months postpartum purchase emsam 5 mg on line several days and may include: bruising easily with occasional nose or gum bleeds; blood in stools or urine; excessive bleeding from minor cuts or abrasions; labored breathing; pale mouth and cold gums; anorexia; and general weakness anxiety relief buy emsam 5 mg with amex. Prolonged bleeding may occur from any small wounds and extensive bruising and subcutaneous hemorrhage anxiety chest tightness 5mg emsam for sale. Human Toxicokinetics the metabolic fate of brodifacoum in humans is not well understood. Brodifacoum is much more lipid soluble than warfarin, resulting in a larger volume of distribution. There is extensive hepatic sequestration and prolonged high liver concentrations in the rat. Based on the limited data available, the elimination half-life of brodifacoum in humans ranges from 16 to 36 days. Inducers of the cytochrome P450 system have been reported to reduce the half-life of brodifacoum in animals. Mechanism of Toxicity Brodifacoum, like other hydroxycoumarins, interferes with the production of vitamin K-dependent coagulation factors. The regeneration of vitamin K by vitamin K 2,3-epoxide reductase is prevented by brodifacoum. As a result, dysfunctional decarboxycoagulation factors are produced and coagulation is impaired. Depletion of preformed, circulating coagulation factors must occur before any anticoagulant effects are apparent. Significant toxicity from brodifacoum may be the result of large, one-time intentional ingestions. However, generally, repeated exposures over time are more likely to produce clinical toxicity. Bleeding may occur virtually anywhere although cutaneous, mucosal, urinary, and gastrointestinal bleeding would be expected to be most common. Poisoning due to brodifacoum has led to prolonged periods of anticoagulation, often weeks and in some cases up to 6 months or longer. Serum brodifacoum levels can be measured to confirm exposure, although there are no data to correlate serum levels and extent of toxicity. An elevated serum ratio of vitamin K epoxide to vitamin K is further evidence of the presence of vitamin K reductase inhibition. Chronic Toxicity (or Exposure) Animal Repeated exposures over time can lead to prolonged anticoagulation and appears to require a lower total Brodifacoum 337 dose than acute exposure. Human Repeated exposures over time can lead to prolonged anticoagulation and appears to require a lower total dose than acute exposure. In Vitro Toxicity Data Ames Salmonella tests for genotoxicity have not demonstrated mutagenic effects. The response and duration of a single dose is variable and depends on the severity of the intoxication. Administration of phenobarbital to an adult poisoned with chlorophacinone (another long-acting hydroxcoumarin derivative) resulted in a decrease in the apparent elimination half-life from 22. In the patient with clinical evidence of significant anticoagulation, extreme caution should be exercised with any invasive procedure. With active, uncontrolled, or life-threatening hemorrhage, fresh frozen plasma will provide preformed coagulation factors. Pharmacologic doses of vitamin K allow the production of functional coagulation factors despite the presence of brodifacoum. If released into water, brodifacoum is expected to adsorb to suspended solids and sediment. Further Reading Shepherd G, Klein-Schwartz W, and Anderson B (2002) Acute pediatric brodifacoum ingestions. Specifically, the Agency is concerned about potential dermal and inhalation exposures of handlers during the loading and application of bromadiolone at bait stations. Based on the use patterns, it is possible that applicators may experience dermal exposure during bait station loading. It is formulated as meal bait, paraffinized pellets, rat and mouse bait ready-to-use place packs, and paraffin blocks (all formulations contain 0. Baits and bait packs are placed at 15 ft intervals for rats and 8 ft intervals for mice. The maximum rates of application are 16 ounces of bait for 15 ft intervals for controlling commensal rats and 2 ounces of bait for 8 ft intervals for house mice. According to labels, all baits are to be placed out of the reach of children, pets, domestic animals, and nontarget wildlife; or tamperresistant bait stations may be used. Toxicokinetics Bromadiolone is absorbed rapidly and effectively by the oral route but less effectively by the dermal route. Oral administration of bromadiolone results in substantial retention of the chemical in the liver for an extended period of time. The half-life for the decline of liver bromadiolone concentration was calculated to be 63 days. Therefore, it is unlikely that there will be any exposure through food sources or residues in ground or surface water. At this time, some products containing bromadiolone are intended primarily for homeowner use, and others are intended primarily for occupational use. Initially, a loading dose was given subcutaneously and, subsequently, vitamin K1 was administered daily by gavage for 13 days. The clinical and gross pathology findings indicated hemorrhage-related toxicity in all test-article treated animals. The death rates in vitamin K1-treated animals were 1/5, 2/5, and 5/5 in the 24, 48, and 72 h exposure groups, respectively. With vitamin K1 treatment, the clinical findings (hemorrhagic-related toxicity) were resolved by the fifth day of the antidote treatment, and the decrease in body weight observed during the bromadiolone treatment was also restored in the surviving animals. At the second week of the study, the prothrombin times of the vitamin K1treated animals were essentially comparable to those of the control group. However, for the 48 h exposure group, the prothrombin time was slightly decreased relative to that of the control group. The results demonstrate that vitamin K1 treatment, as employed in this study, can restore the clotting process of an animal that is exposed to bromadiolone below an estimated total dose of 15. Exposures to very high concentrations of bromadiolone would be expected to cause paralysis due to cerebral hemorrhage, leading to hemorrhagic shock and death.

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Multiple studies have evaluated the efficacy of these acids as well as different methods for administering them kitten anxiety symptoms cheap emsam express, and they are effective in reducing Varroa and Acarapis populations anxiety girl cartoon cheap emsam 5 mg overnight delivery, though they do not necessarily provide complete clearance of mites from colonies (reviewed in Sammataro et al anxiety symptoms joints cheap emsam 5mg on line. Formic acid is the only known method of Varroa control that kills both adult phoretic mites and developing mites within sealed honey bee brood cells. Additional advantages of organic acids are that they are hydrophilic and do not accumulate in beeswax, and that to date there is no evidence of mite resistance to them (Rosenkranz et al. Disadvantages of organic acid use include contamination of hive products, and the suggestion (for oxalic and lactic acids) of use in honey bee colonies during broodless periods, which is not possible in all geographic areas and limits use to particular times of year. In addition, results are dependent on vapour pressure and other within-hive conditions, meaning that the effects of treatment are more variable than with some other control measures (Rosenkranz et al. There is some evidence of harm to bees from use of organic acids, and they can be hazardous to human applicators if not handled properly (Sammataro et al. The primary essential oil used in control of Varroa is thymol, which can reduce mite populations by up to 90% (Rosenkranz et al. Other essential oils have been tested against Varroa but none with the consistent success of thymol, though more research is needed (Rosenkranz et al. For Acarapis tracheal mites, menthol has been shown to be an effective control measure, and the only other effective treatment besides formic acid (Sammataro, 2000). As with organic acids, treatment effects are variable and vapour pressure within colonies is an important consideration. Biocontrol of Varroa and other parasitic mites is a control strategy with some preliminary investigations, including laboratory demonstrations of lethality to Varroa of several different bacterial strains (Shaw et al. Biocontrol of parasitic mites (and other parasites and pathogens) thus represents an important knowledge gap. Parasitic mites, especially Varroa, are also controlled by beekeeping practices and other cultural controls. Gravid Varroa females prefer to lay their eggs in drone (male) brood cells relative to worker (female) brood cells. After the drone cells are capped, the drone brood can be removed, thus greatly reducing Varroa populations within a colony (Sammataro et al. Similarly, swarming management can provide some level of Varroa control given that departing swarms leave infected brood behind (Sammataro et al. A cultural practice used in the control of Acarapis tracheal mites is the addition of patties of vegetable shortening and sugar to colony boxes, which may disrupt the "questing" behavior of female mites searching for new hosts (Sammataro et al. These cultural practices are often labour intensive and difficult to implement in large apiary operations (Rosenkranz et al. In solitary bees, thermal shock treatments applied during the most resistant bee stage (dormant prepupa) are used in Japan to reduce numbers of Chaetodactylus mites in Osmia cornifrons populations (Yamada, 1990). More field-scale trials of supporting social immune mechanisms would assist pollinator managers and policy makers in evaluating their implementation. First, development of resistance to insecticides and antibiotics is a well-known phenomenon in agriculture (Brattsten et al. There is a body of evolutionary theory on managing insecticide and antibiotic resistance, and lessons from this work could be applied to treatment of disease and parasites in managed pollinators. For example, the length of treatment, treatment rotations, and treatment combinations could be applied in ways to reduce resistance. Second, there is a well-described relationship in evolutionary theory between transmission of pathogens and virulence (harm to the host), such that increased transmission tends to select for increased virulence. While there is no direct evidence of such a relationship in managed pollinators, this pattern has been detected in a broad range of other host-pathogen systems (reviewed in Alizon et al. Steps could be made to assess this relationship in managed pollinators and potentially to alter management to select for less-virulent parasites and pathogens by reducing parasite transmission rates. There are four main methods of genetic management: 1) traditional trait-focused breeding; 2) maintenance or enhancement of genetic diversity; 3) genetic engineering, i. These objectives have been successful in terms of target trait modification, but there is limited knowledge of how bees originating from such breeding programs perform relative to other lines, in managed apiary contexts, in terms of outcomes such as colony survival and productivity. While there is at least one report of bees from "hygienic" breeding programs outperforming typical (non-hygienic) stocks in terms of both disease resistance and honey production (Spivak and Reuter, 1998), other studies have not seen consistent advantages of bees bred for Varroa resistance 6. This is a recently emerging area of study with limited, but growing evidence that it can have a large impact on disease pressure. Management to support social immunity could include provision of resin-producing plants so that honey bees can gather propolis and not removing propolis from colonies (Simone et al. Maintaining the traits selected for in such breeding programs may be difficult in typical apiary settings for A. In solitary bees, there were unsuccessful attempts in the late 1970s and early 1980s to select univoltine Megachile rotundata strains as a means to avoid an undesired partial peak of emergence in late summer (Parker, 1979; Rank and Rank, 1989). The second strategy is maintaining and/or increasing genetic diversity, as this is known to reduce disease threats and to promote colony health and productivity at a colony level in both Apis (Tarpy, 2003; Mattila and Seeley, 2007) and Bombus (Baer and Schmid-Hempel, 1999). By contrast, other reports show mixed effects of diversity on colony performance, depending on the origin of single versus mixed lines (Oldroyd et al. In addition, beyond just social taxa, all currently managed pollinators are bees (Hymenoptera: Apoidea), which are haplodiploid with a single-locus sex determination system (Beye et al. Still, to our knowledge there are no systematic efforts to increase genetic diversity in any managed bees that have been assessed in a rigorous way. A related issue is not just genetic diversity per se, but maintenance of locally adapted strains. There are trade-offs between these strategies in that breeding and genetic engineering are typically focused on replacing, or increasing the prevalence of particular alleles at particular loci. Still, multiple programs could exist with different goals, such as complementing existing A. There are risks associated with such an effort, and in polyandrous species such as A. These risks should be carefully assessed in the context of potential benefits before development of such transgenic pollinators. The fourth method, which we describe as "high-tech breeding" can be thought of as a middle-ground approach between traditional breeding and transgenic approaches. For example, marker-assisted selection is an approach where genetic, phenotypic, and other markers associated with desired traits are identified in early stages of organismal development, speeding up the process of traditional breeding. Speculatively, additional approaches could include up- or down-regulation or particular genes already present in the genome of managed pollinators. Beekeeping strategies to address pesticide threats remain largely speculative, but include improved nutrition, which has been shown to reduce the negative impacts of exposure to some classes of pesticides (Wahl and Ulm, 1983; Schmel et al. Still, such strategies are likely to be expensive and difficult to implement compared to better management of pesticide application. Commensal or symbiotic macro-organisms have been documented in social bee colonies, including chelifers ("pseudoscorpions") (Gonzalez et al.

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Once a child has been evaluated the school must notify the parents (or guardians) about the results and any decisions that are made anxiety questionnaire for adults discount emsam american express. Reading Comprehension Use the checklist below to generalized anxiety symptoms dsm 5 order 5 mg emsam fast delivery determine if each component is a part of the reading program your school is using anxiety hypnosis cheap emsam 5mg amex. Phonemes are the smallest parts of sound in a spoken word, such as the /s/ in /sit/. Your child should be able to perceive individual sounds, think about them, and manipulate them. If your child does not know letter names and shapes, teach them along with phonemic awareness. Children must understand that letters are representations of sounds before they can learn to read. Phonics instruction teaches children letter-sound correspondences and the alphabetic principle-that there are systematic and predictable relationships between written letters and spoken sounds. Phonics instruction is most effective when it begins early-in kindergarten or first grade-and lasts for about two years. For older students (grades 2-6), ongoing phonics instruction can help bolster skills in reading individual words and reading text out loud, but they also need instruction in spelling, reading fluency, and comprehension. If your child is in kindergarten, first, or second grade, make sure that systematic and explicit phonics instruction is included as part of the reading curriculum. If your child is older and having trouble learning to read, find out if he would benefit by having phonics added to his program. Because fluent readers do not have to concentrate on recognizing the words, they can focus their attention on what the text means. Fluent readers group words to help them understand what they read, so fluency builds a bridge between word recognition and comprehension. Fluency develops as a result of many opportunities to practice reading successfully. Continued reading practice helps word recognition become more automatic, rapid, and effortless. In addition to providing instruction, teachers should assess fluency regularly to make sure students are making progress. There are four types of vocabulary: listening vocabulary, speaking vocabulary, reading vocabulary, and writing vocabulary. For every child, each of these vocabularies may include different, but overlapping, sets of words. Beginning readers use their oral vocabularies as they recognize the sounds in words they are reading. It is much easier for them to read words that are already part of their oral vocabularies. They learn directly when they are plainly taught individual words and word-learning strategies, such as how to use dictionaries, how to use parts of words to figure out meaning, and how to use context to find clues to word meanings. They learn indirectly through conversation, listening to adults read to them, and reading on their own. The teacher should promote word consciousness (an awareness of and interest in words) and should encourage students to engage in word play. Reading to learn subject matter does not occur automatically once students have learned to read; strategies for taking the meaning from text need to be taught. At all grade levels, students can benefit from instruction in how to make sense out of text and how to construct meaning. Comprehension strategies are conscious plans-sets of steps that are used to make sense of the text. Students who use comprehension strategies know when they understand what they read and when they do not. If you think the problems are serious enough to require special attention, ask the teacher if alternate instructional approaches might help address the problem and ask if any have been tried. Ask about the availability of research findings that show the effectiveness of the instructional practices or behavioral programs being used. Observe and provide all the information you can to help the educators develop a better understanding of it. What length of time is allowed for an intervention before determining if the student is making adequate progress? Is the teacher or other person responsible for providing the interventions trained in using them? While variations in the course of development are to be expected, unevenness or lags in the mastery of skills and behaviors, even with children as young as 4 or 5, should not be ignored. The following Learning Disabilities Checklist is designed as a helpful guide and not as a tool to pinpoint specific learning disabilities. The more characteristics you check, the more likely that the individual described is at risk for (or shows signs of) learning disabilities. Check all that apply Gross and Fine Motor Skills Appears awkward and clumsy, dropping, spilling, or knocking things over Has limited success with games and activities that demand eye-hand coordination. Check all that apply Language Demonstrates early delays in learning to speak Has difficulty modulating voice. Poorly aligns numbers resulting in computation errors Has difficulty estimating quantity. Avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort such as homework and organizing work tasks Loses things consistently that are necessary for tasks/activities (i. If you think your concern may be related to any disability or condition, identify that in Column 3. You do not need to know the names of specific tests, just describe the type of testing that is needed to provide information that addresses your concern. If you think your child needs an instructional interventions, accommodations or remedial services (described below), list those in Column 5. When you meet with school personnel, note any agreements you have reached with them, who made the agreement and when. A sample chart is provided; following that is a blank chart for you to print and fill in. Instructional Intervention: Change in instruction that attempts to improve student learning in area of difficulty. Mispronounces words when reading aloud Angela has problems getting organized to do her homework Tape recording Phonics assessment Extra phonics assistance I agreed 3/16 with teacher to help her get started on assignments. I understand that you will send me an evaluation plan explaining the tests that may be given to my child. Once you receive my approval for the evaluation, would you please let me know when the evaluation will be scheduled?

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Important knowledge gaps remain with respect to anxiety buzzfeed buy emsam amex introducing such policies broadly anxiety medication 05 mg buy cheapest emsam. A promising example of this is in Italy anxiety worksheets emsam 5mg otc, where the program is managed as a mutual fund by participating farmer associations (Furlan and Kreuzweiser, 2015). The efficiency of these programmes is generally evaluated based on risk indicators to health and environment, but not considering pollinators specifically (see section 6. Development of specific risk indicators from exposure of pesticides to pollinators would be useful for evaluating possible impacts of such programmes on pollinators. It can be based on health and environmental risk indicators based on pesticide sales and use estimates, toxicity, and of measurements of residues in the environment. Based on risk indicators, Cross and colleagues found a decrease in the average environmental risk of pesticides per hectare for fruit and arable crops between the first introduction of risk-based regulations in 2002, and 2009 (Cross and Edwards-Jones, 2011; Cross, 2013). They combined pesticide usage data with a measure of hazard (toxicity) for each specific chemical, including simple scores for bee and beneficial insect toxicity. Reduced risks were largely due to removal of specific chemicals from the market, but were not consistent across crops as the risk score increased for. There has been continuous, or time-limited, monitoring of poisoning incidents of mainly honey bees in some countries. Evaluations of such monitoring programmes published in the scientific literature include incidents of honey bee and 387 6. Available evidence on the efficacy of these actions provides a mixed and complex picture of the effects of reducing agrichemical impacts on wildlife (Dicks et al. Bee death incidents attributed to pesticide poisoning declined from 23 to 5 per year in this period (Barnett et al. Very few incidents occurred in Canada 2007-2011, but with a sharp increase in 2012 in the Ontario province, where exposure to neonicotinoid dust during planting of corn was suspected to have caused the incident in up to 70% of cases (Cutler et al. Monitoring of bee poisoning from use of neonicotinoid insecticides has taken place in Austria, Slovenia, Italy, and France. More information on the economic benefits (or lack thereof) of pesticide usage would improve the decision base for pesticide users. However, there are few studies addressing impacts specifically on pollinators and pollination (section 2. There are no policies to mitigate impacts of heavy metals and other pollutants specifically on pollinators. Studies of pesticide applicator attitudes suggest that there is potential for voluntary approaches to raise awareness among applicators of habitats sensitive to pesticide drift in rural landscapes (Reimer and Prokopy, 2012). Other important target groups are students in plant protection, agronomy and agriculture in general, and extension personnel who give pest management advice to farmers in particular. Education of extension personnel can serve as effective means of promoting pollinator-friendly practices and avoid unnecessary pollinator exposure to pesticides, as exemplified by a study from Ghana (Hordzi, 2010). It does not adequately address the possible indirect effects of importance to pollination, such as possible changes in the bee foraging behaviour (Arpaia et al. In response to new research, regulatory authorities want to understand why non-target effects are happening and seek to impose mitigation measures. Globally, there is a clear need for comprehensive, transparent, scientific guidelines for selecting the nontarget species to be evaluated, and among those, different species of pollinators need to be considered, not only Apis mellifera. Nature conservation responses are commonly applied to mitigate negative impacts of land use change, such as those identified in Chapter 2. The evidence that loss of habitat has been a driver of pollinator decline is very strong (see section 2. Many studies have examined the response of pollinators to on-ground actions, which inform possibilities for the future. Possible actions range from the protection or maintenance of existing natural habitat to the creation of new habitat patches by ecological restoration. At a larger spatial scale there are also actions that relate to the planning of natural habitat networks and how they spatially relate to one another to ensure that pollinators can disperse and adapt to global change, and that there is the best benefit flow into agricultural landscapes (crop pollination). There is evidence that forage resources commonly limit wild bee populations (Roulston and Goodell, 2011), which suggests that provision of additional appropriate forage resources could have significant population effects, but most studies do not assess these, instead focusing only on activity and frequency of pollinators. Planted forage resources might be focused on native plant species, and therefore be considered part of a nature conservation strategy, but because these plantings are generally integrated into agricultural practice, we have reviewed them in section 6. Forest management practices also influence bee communities, and planted forests have been shown to host significant bee communities in the early stages, but declining as a more closed forest environment develops (Taki et al. In tropical forest successional communities in Kenya, pollinator abundance and diversity actually increased across a gradient from natural forests to cultivated areas (Gikungu, 2006). Greater generalization was found among the bee communities in more mature forests, and more specialized and rare bee species were found in the earlier successional and more open habitats. In general, bees benefit from native plants and non-farmed habitats, but increasing cover of forests with closed canopies is less likely to favour rich bee communities. The Cartagena Protocol does not make a clear reference to pollinators, but they are in the legislation of many countries within the scope of non-target organisms, along with other beneficial species such as those used as biological control agents (Flint et al. Whether these are appropriate surrogate species for wild pollinators has been questioned for toxicological tests of synthetic pesticides (see section 6. Until now, this committee has not required monitoring specifically for pollinators. This section examines nature conservation responses that are intended to or likely to support pollinators and pollination. The nature conservation focus means that the targets are wild pollinators rather than domesticated pollinators. Some studies have shown that restored patches compare well with remnant patches in terms of diversity and identity of dominant pollinators (Forup et al. Bees often require specific nesting resources that can be enriched in a nature conservation strategy. For Osmia bicornis (formerly rufa), a stem-nesting bee in Europe, the provision of nesting material (reeds) in habitat patches in an agricultural landscape led to a local population increase (Steffan-Dewenter and Schiele, 2008) and many other trials establish that appropriate artificial nesting materials are used by a range of solitary bee species (Dicks et al. In contrast, the provision of boxes intended to host bumble bees has had highly variable outcomes (Dicks et al. Honey bees and stingless bees prefer to nest in large old trees, so protection of such trees is important. For example, the stingless bee species Melipona quadrifasciata was shown to nest selectively in the legally protected cerrado tree Caryocar brasilense (Atonini and Martins, 2003) (further discussion of nest sites for social bees is in 6. There is experimental and modelling evidence that pollen flow occurs between remnant and replanted vegetation (Cruz Neto et al. These patterns provide some documentation of the benefits that habitat connectivity can provide. The role habitat connectivity has in maintaining pollinator populations remains unclear, but theory and observations for other taxa suggest that when the amount of natural habitat in the landscape declines below approximately 20% populations risk becoming isolated and connectivity may play an important role in their conservation (Hanski, 2015). Climate change can impact populations in many ways, and in some cases species are expected to shift in distribution. This kind of movement is only possible if suitable habitat for the species occurs at the new locations.

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Judt (Ignacy Maurycy Judt): "The classification of the Jews as race among the Semitic tribes is not rationally grounded anxiety episode purchase emsam 5 mg mastercard. The false identification of philological classifications with racial breakdowns has led to anxiety symptoms confusion order emsam pills in toronto confusion anxiety symptoms or ms buy emsam 5mg with amex. When I speak of Aryans, I by no means have in mind their blood, their hair, or their skulls. Jewish eugenicist Arthur Ruppin: "In our view, social opinion is fully capable of fulfilling its intended function of restraining the psychically or physically hindered from having children. From a letter to the Editor of the New York Times: "[Israel] Zangwills mission here, to prepare the way for the Jews to go to Uganda, lacks full knowledge of conditions, and therefore does not deserve our sympathy. Not Uganda, but America, is the land for the final preparation of the Jew which will befit him to return to the Land of Israel. A preservation of national integrity is impossible except by a preservation of racial purity, and for that purpose we are in need of a territory of our own. If you should ask me in a sense of revolt and outrage: but surely in that case you want segregation at all costs! I would answer that one must not be afraid of words and not of the word,segregation. The Jewish Quarterly Review publishes an article by Jewish-British journalist Lucien Wolf (1857-1930) entitled "The Zionist Peril," in which Wolf characterizes Zionism as "an attempt to turn back the course of modern history, which hereto, on its political side, has had for its main object to secure for the Jewish people an equal place with their fellow-citizens of other creeds in the countries in which they dwell, and a common lot with them in the main stream of human progress. A second factor acting as a,guardian of the races is constituted by the further elimination of racially alien children whom 3. A Micro-Chronology of Jewish Eugenics 137 sexual selection determines shall henceforth be expelled by virtue of their birth. In observing the struggle for existence, particularly in the animal world, we encounter acts that far outshadow in viciousness and unfairness the most extreme spawn of the phantasy as judged by our ethical concepts. But seen from the lofty viewpoint of the teachings of evolution, this,viciousness reveals itself as the expression of the deepest wisdom. When a surgeon calmly amputates a limb, intending to preserve the body of a patient from a general infection who is ill because of his heredity so as to preserve his life and spiritual development, a fool observing the operation would experience horror over the,viciousness of the physician. American inventor Max Levy (1857-1926): "I see no reason why the Jews, any more than any other man or animal, should be above the conditions which govern the development of species. The influence of the environment upon the origin and development of species has been clearly set forth by Spencer, Huxley, Darwin, and other exponents of the theory of evolution, and the same class of considerations that effects the physical development of species is clearly shown to exert an equally powerful influence on the development of civilization. Thus, Jewish history is no longer the product of some extraterrestrial God influencing the masses, who are merely passive plasma for a moral and self-defining divine artist, but rather are the product of the abilities and demands that individual people brought with them and kept alive by virtue of inheritance. A Micro-Chronology of Jewish Eugenics 139 senness, which was then stubbornly inherited because it titillated the vanity of the community. The prohibition of mixed marriages was the chief racestructuring factor that activated inheritance in its supreme efficacy even as these advantages were passed on from generation to generation and steadily accrued thanks to inbreeding. It was in this fashion that a people could arise that Ibsen termed,humanitys nobility. Eichholz at a London meeting of the Maccabeans on the Jewish population of the United Kingdom: "There was among the Jewish population a great deal of material to investigate from the point of view of deterioration, and also from the opposite and more important standpoint of amelioration, and he hoped some investigation would be made either by the Maccabeans or the Statistical Society, or by a joint committee of both. There was a field for useful enquiry of an eugenic nature among the Maccabeans themselves. The University of London had recently instituted a lectureship in National Eugenics, and they would probably be asked to assist the lecture or Mr. To these arguments the upholders of the purity of the race reply: (1) the intermarriages mentioned in the Bible are few in number and with cognate tribes; (2) proselytes were the chief sources from which the early Christian Church drew its members, thus removing them from contact with Judaism; (3) the severity of the punishment attached by the Church to intermarriage proves how infrequent intermarriages must have been; (4) the conversion of the Chazars was merely nominal, and it has left traces on only the few Karaites of South Russia: the other Russian Jews came from Germany, as is shown by the German dialect they 2. A Micro-Chronology of Jewish Eugenics 141 use; (5) the differences of type may have been produced by social differences and are not so great when a series is taken into consideration. The upholders of the purity point out: (6) That cohanim, or members of the priestly caste, were and are not allowed to marry a proselyte, and must, therefore, have preserved their purity of descent; (7) that the marked resemblance of Jewesses throughout the world, showing as they do less variation among the females of the race, conforms to the biological test of purity of breed; (8) that mixed marriages in the present day are markedly infertile, which would reduce the influence of such intermarriages in an increasing geometrical ratio; (9) the rarity of instances in historical sources of proselytism in mixed marriages since the Middle Ages; (10) the prepotency of Jewish blood, as shown by the marked Jewish type of even the remoter offspring of Jews that have intermarried; (11) the stringent social separation, which can be historically proved throughout the Christian centuries; (12) the existence of marked Jewish type in the features and bodily measurements of contemporary Jews wherever found. Jewish-Viennese writer Stefan Zweig (1881-1942) in an early poem: "I hear my blood through the midnight. Eugenics-Society member Edgar Schuster co-authors with Sir Francis Galton Noteworthy Families: An Index to Kinships in Near Degrees between Persons whose Achievements are Honourable, and Have Been Publicly Recorded. Gelber as "the seminal fictional text of racialist Zionism," maintains that racial admixture is the common enemy of both Aryans and Jews and objects against "a foreign, Semitic race mixing itself in, changing its [the Germanic] racial character and usurping its rights, without having any justification. From an article entitled "Negro Eugenics" (New York Times): "most negroes who excel in the arts and professions do possess an infusion of white blood. But so, also, do nearly all negroes on this hemisphere, and in most instances a previous admixture is discoverable through African ancestry with the ancient Hamitic and Semitic stocks. The Torah surely prohibited [only] the woman herself, and it makes no difference where the genitive organs are from. Aside from this, sex prohibitions do not apply to an organ, which has no life of its own, and is more like a piece of meat; there is not even a rabbinical prohibition. The story of the Arab who bought a haunch in the market, made a hole in it and performed a sex act with it (Avodah Zarah 22a). If so, in our case there is no possibility of a sexual prohibition" (Emphasis in original). A Micro-Chronology of Jewish Eugenics 143 material for Galton and his coadjutors in investigating the new science of eugenics. Jewish-Austrian biologist Paul Kammerer (1880-1926), a socialist and outspoken proponent of Lamarckian eugenics: "Are we slaves of the past or master-workmen forging the future?


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Three in 1 anxiety eating buy discount emsam line,000 live births were referred to anxiety symptoms worse in morning buy emsam online from canada a health facility from another nonfacility location during the same period anxiety zig ziglar buy emsam mastercard. The majority of live births (97%) were not referred but came directly from home to the health facility (Table 9. Patterns by background characteristics Every 14 out of 1,000 births taking place at public health facilities were referred from another facility. Similarly, every 18 out of 1,000 births at private facilities were referred from another facility. Among live births that took place in a public facility, 2 of 1,000 were referred from another nonfacility location; among births occurring in a private facility, 6 of 1,000 were referred from a nonfacility location. Rates of referral from another health facility are 17 in 1,000 births in urban areas and 15 in 1,000 births in rural areas. Referral to a high-level facility capable of managing obstetric and newborn complications can prevent maternal and neonatal mortality. In the majority of delivery referrals (58%) in the 5 years preceding the survey, the time taken to decide on the referral and reach the facility was more than 1 hour. A quarter of births (25%) were accompanied by a health provider when they were referred to the facility. In rural areas of Nigeria, major health facilities are far away from communities, roads are bad, and populations are sparse. These factors are significant contributors to delays in reaching an appropriate source of care. Skin-to-skin care, immediate drying, and delayed bathing are key interventions that can help newborns regulate their temperature. Among the most recent live births in the 2 years preceding the survey, 12% of newborns had skin-to-skin contact immediately after birth, 77% were wiped dry within minutes after birth, and 13% were bathed 24 or more hours after birth (Table 9. Patterns by background characteristics Fourteen percent of newborns delivered in urban areas receive skin-to-skin thermal care, as compared with 11% of newborns delivered in rural areas. Eighteen percent of live births delivered at health facilities receive skin-to-skin thermal care, compared with 8% of births delivered elsewhere. Among live births delivered at a health facility, 22% were bathed 24 or more hours after birth as recommended by national guidelines. On the contrary, 78% of newborns not delivered in a health facility were bathed less than 6 hours after birth. Newborns whose mothers had more than a secondary education were more likely to have skin-to-skin contact immediately after birth than newborns whose mothers had no education (20% versus 9%). Omphalitis, a potentially life-threatening infection of the umbilical cord, can cause neonatal sepsis and eventually death. Eleven percent of most recent live births in the 2 years preceding the survey had chlorhexidine applied to the cord (Table 9. Thirty-eight percent of newborns had nothing applied to the cord, while 32% had other antiseptic materials applied (Table 9. It is encouraging to note that 78% of newborns had nothing harmful applied to the cord after birth. Patterns by background characteristics First-order births more often had chlorhexidine applied to the cord than sixth- or higher-order births (13% and 9%, respectively). Sixteen percent of births in urban areas had chlorhexidine applied to the cord, as compared with only 8% of births in rural areas. In Nigeria, 42% of mothers who gave birth in the 2 years preceding the survey reported seeing someone for a check within the first 2 days after birth, with 36% reporting that they were checked within 4 hours after giving birth (Table 9. Most women (35%) receiving postnatal care reported seeing a doctor, nurse, or midwife for their postnatal check (Table 9. Trends: the proportion of women age 15-49 with a live birth in the 2 years preceding survey who received a postnatal check within 2 days after delivery has increased over the last decade, from 30% in 2008 to 42% in 2018. The proportion of women with a postnatal check during the first 2 days after birth increases with increasing education and wealth. Thirty-eight percent of infants born in the 2 years before the survey received a postnatal check during the first 2 days after birth; however, 60% did not receive a postnatal check (Table 9. The majority (33%) of babies who received a postnatal check were seen by a doctor, nurse, or midwife (Table 9. A quarter of newborns (25%) had at least two signal functions performed during the first 2 days after birth (Table 9. Patterns by background characteristics Newborns delivered in a health facility were more likely to receive a postnatal health check within 2 days of birth than those delivered elsewhere (80% and 9%, respectively) (Figure 9. Only 17% of newborns in the North West received postnatal care during the first 2 days after birth, compared with 72% of newborns in the South West. By state, the proportion of newborns receiving postnatal care during the first 2 days after birth ranged from 6% in Kebbi to 82% in Osun. Socioeconomic disparities exist among women whose babies received a postnatal check. Seventyseven percent of babies born to women with more than a secondary education received postnatal care within the first 2 days after birth, as compared with only 16% of babies born to women with no education. Babies born to women in the lowest wealth quintile were much less likely (15%) to receive postnatal care within 2 days of birth than babies born to women in the highest quintile (71%). The least and most common problems women face in accessing health care are getting permission to go for treatment (11%) and getting money for treatment (46%), respectively (Table 9. Women with five or more children more often reported getting money for treatment (51%) and distance to a health facility (29%) as problems than women with no children (42% and 22%, respectively). Overall, women from the North East more often reported having at least one problem in accessing health care than those from the South West (69% versus 37%) (Table 9. The proportion of women reporting at least one problem in accessing health care ranges from a low of 13% in Osun to a high of 91% in Adamawa. The proportion of women who reported at least one problem in accessing health care decreases with increasing education and wealth. Prolonged obstructed labour that does not receive prompt medical care stops the blood supply to the tissues of the vagina, bladder, and/or rectum. This compression and the resultant loss of blood supply produce necrosis of the compressed tissues. The findings indicate that 31% of women have heard of fistula symptoms, while less than 1% have experienced such symptoms (data not shown separately). The percentage of women with knowledge of fistula has remained stagnant at 31% over the last decade. In this table, it is assumed that women who did not give birth in a health facility did not receive a caesarean section. For 29% of these children, advice or treatment was sought on the same or next day. Fever: Advice or treatment was sought for 73% of children under age 5 who had a fever in the 2 weeks before the survey. This chapter presents information on birth weight and vaccination status for young children. Birth weight is a good summary measure of multifaceted public health problems including long-term maternal malnutrition, ill health, and poor health care during pregnancy.

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Uses Captafol is a widely used broad-spectrum contact fungicide belonging to anxiety symptoms heavy arms emsam 5 mg cheap the class of sulfanilamides anxiety job interview order emsam 5mg fast delivery. It is effective for the control of a wide variety of fungal diseases in plants and is widely used outside the United States to anxiety symptoms unreal discount emsam 5 mg overnight delivery control foliage and fruit diseases on apples, citrus, tomato, cranberry, sweet corn, barley, wheat, and several other plants. Captafol is also extensively used as a seed protectant in cotton, peanuts, and rice. Mechanism of Toxicity the primary toxicity following captafol exposure probably occurs through a hypersensitivity mechanism. Another test for captafol-induced eye irritation in rabbit showed corneal opacity and iris and conjuctival irritation, all symptoms being present for 21 days. Captafol was reported to be teratogenic and to cause fetal developmental abnormalities at high (maternally toxic) doses in hamsters. Captafol was, however, found to have no effect on embryonic development in rabbits and monkeys. In a 2 year rat feeding study, a dose-related increased incidence of neoplastic nodules in the liver of females was reported. There is sufficient evidence in experimental animals for carcinogenicity of captafol. Human Captafol is also known to be a skin sensitizer and has been reported to cause both allergic and contact dermatitis in humans. Breakdown products may contribute to the skin irritation and sensitization associated with captafol. Clinical Management Exposed eyes and skin should be flushed with copious amounts of water. Artificial ventilation may be provided and symptomatic treatment may be administered as necessary. The primary symptoms of captafol exposure reported in humans include contact dermatitis and conjunctivitis. Persons with a skin rash following exposure to captafol were found to have systemic as well as dermal disorders. Other findings following captafol exposure include protein and urobilinogen in the urine, depression of liver function, anemia, and depression of blood cholinesterase activity. However, due to a higher level of toxicity in animal models following intraperitoneal exposure, parenteral exposure may present a greater hazard potential. Captafol is stable under ordinary environmental conditions and rapidly degrades in soil, the rate of degradation being a function of soil type and pesticide concentration. Captafol and/or its metabolites and degradates are readily absorbed by roots and shoots of plants. It is considered only moderately to very highly toxic to freshwater invertebrates. Chronic Toxicity (or Exposure) Animal Rats exposed to captafol at dietary levels of 1500 and 5000 ppm demonstrated growth depression, some liver and kidney changes, as well as an increased mortality. The Occupational Safety and Health Administration threshold limit value for captafol is reported to be 0. Captan 409 Miscellaneous Captafol is a colorless to pale yellow in color with a distinct odor. Some common trade names of products containing captafol include Crisfolatan, Difolatan, Difosan, Folcid, Haipen, Kenofol, Pillartan, and Sanspor. Further Reading Tamano S, Kawabe M, Sano M, Masui T, and Ito N (1993) Oral Toxicity Study of Captafol in B6C3F1Mice. This article is a revision of the previous print edition article by Todd A Bartow, volume 1, pp. A small portion of captan given orally was metabolized into thiozolidine-2-thione-4-carboxylic acid, a salt of dithiobis(methanesulfonic acid) and the disulfide monoxide derivative of dithiobis(methanesulfonic acid). Mechanism of Toxicity Liver enzymes were modulated after repeated captan exposures at relatively high dosages. In vitro studies showed that captan caused swelling of mitochondria in rat liver and loss of intracellular potassium in human erythrocytes. Captan inhibits mitochondrial function nonspecifically, leading to uncoupling of oxidative phosphorylation. Exposure Routes and Pathways Exposure to captan may occur through dermal, oral, or inhalation route during manufacture or application of captan, or consumption of agricultural products with captan residues. Generally, captan has been found to have low toxicity to laboratory animals after oral dosing. Human Toxicokinetics Captan is readily excreted after either oral or systemic dosing. Twenty-four hours after treatment in rats, B75% of captan is eliminated in urine and Captan has a low acute toxicity potential. High captan exposures can reduce egg production in chickens but have no effect on fertility or hatching. Dietary captan (10 000 ppm for 54 weeks) caused marked growth depression in both male and female rats. Testicular atrophy was observed at autopsy in some animals consuming 10 000 ppm captan in the diet. At high dosages, captan increased tumorous cancer in female mice and in male rats. Captan is similar in structure to other pesticides (folpet and captafol) that also cause cancer in test species. Teratogenicity studies with rats, rabbits, hamsters, and dogs have given both negative and positive results. Further Reading Clinical Management Intoxication after acute captan exposure is unlikely; treatment is symptomatic. Chemical Structure and Uses Carbamate compounds are usually subdivided into at least three main groups with respect to their structure and general use (see Figure 1): insecticides, herbicides, and thio- or dithiocarbamates. Approval does not signify that the contents necessarily reflect the views and policies of the agency nor does mention of trade names and commercial products constitute endorsement or recommendation for use. Carbamate Pesticides 411 O R O C N R Insecticides and herbicides S R S C N R Dithio Figure 1 General formulas for carbamates. The inhibition of acetylcholinesterase activity is thought to precipitate a toxic response through the short-term increase in the concentration of acetylcholine at cholinergic junctions. Because of this unstable inhibition, great care must be taken when analyzing cholinesterase inhibition in tissues from carbamate-treated animals to prevent reactivation of the enzyme activity.


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Although pro-eugenics books still predominate anxiety symptoms blood pressure discount emsam 5mg otc, the stress by book publishers on an association of eugenics and racism can be said to anxiety group therapy generic emsam 5 mg with mastercard have begun anxiety symptoms lasting all day best purchase for emsam. Jewish-Hungarian anthropologist Raphael Patai: "As far as the significance of the Jewish Nobel record goes, I leave it to the reader to draw his own conclusion from the fact that the Jews, who constitute less than a half a percent of mankind, have won more than 15 percent of the prizes generally recognized as the highest accolade of modern times. A study of Blooms Syndrome in Israel: "An effort was made to identify all individuals with Blooms syndrome living in Israel between September 1971 and September 1972. Each of the eight individuals located were Jewish and could readily be classified Ashkenazic. Persons on Welfare who consent to sterilizations will receive a one thousand dollar cash bonus. Third, all prison inmates will be give [sic] a three-year reduction in their prison sentences if they consent to sterilization. David Bleich indicates that the elimination of Tay-Sachs Disease is a goal to which all concerned individuals subscribe, but that, while the couple may quite properly be counseled with regard 4. A Micro-Chronology of Jewish Eugenics 287 to the risks of having a Tay-Sachs child, failure to bear natural children is not a halachically viable alternative. He further voices concern that if the fetus is found to have Tay-Sachs Disease by prenatal testing, abortion may not be sanctioned in Jewish law. Bleich concludes that screening programs for the detection of carriers of Tay-Sachs Disease are certainly to be encouraged. He is critical of Rabbi Eliezer Yehudah Waldenberg and points out that the latters permissive ruling on abortion for Tay-Sachs Disease is contrary to the decisions of other contemporary rabbinic scholars including Rabbi Moshe Feinstein. Some members, fellows, and officers of the (British) Eugenics Society (renamed the Galton Institute in 1989): University of California biology professor D. Davidson, President of the Institute of Jewish Affairs Lord Arnold Abraham Goodman, Mrs. Jewish-American zoologist, egalitarian, and prominent opponent of eugenics Stephen Jay Gould reviewing reprint of Allen G. Ropers 1913 Ancient Eugenics: "Roper continually invokes Platos myth of the metals (Republic, Book 3) to affirm the innateness of unequal worth and the layering of men into social classes as a reflection of nature. But he seems to forget that Plato, at least, had the decency to brand it as a lie manufactured in the interest of social stability. Kope, and Kaziemira Domaniewska-Sobczak in the Genetics of the Jews: "Each major community as a whole bears some resemblance to the indigenous people of the region where it first developed and, within each community there is some relation between the compositions of the separate Jewish sub-communities (national, etc. These admixtures are readily explained by slavery and concubinage by Patai and Wing (1975). The result of this interest in the United States has been the,Americanisation of the Holocaust. The,Holocaust is now considerably less important in Europe where it physically took place than it is in America where it has been embraced as a statement of faith. David Bleich: "The Gemara, Yevamot 64b, declares that a man should not marry into an epileptic or leprous family, i. This ruling is obviously a eugenic measure designed to prevent the birth of defective children. While natural misfortunes may not be avoidable, man does not have the right to act in a manner which will result in harm to others. It follows, a fortiori, that overt intervention in natural processes which might cause defects in the fetus would be viewed by Judaism with opprobrium. Ira Levins (1929-2007) 1976 novel, the Boys from Brazil, is made into a screenplay by Heywood Gould, starring James Mason, Gregory Peck, and Laurence Olivier (production budget $12,000,000). In France a,New Right movement is promoted by Figaro magazine and the Club de lHorloge, rejecting both Marxism and materialism and reaching back to European cultural and aristocratic traditions. The group asserts that racial genetic differences must be recognized and opposes "race-mixing," which they perceive as a source of "maximum genetic disorder" that can only lead to "an immense retrogradation" of European stocks. American Jewish intermarriage rate for 1980s: 41% (up from 28% in 1970s, and 13% prior to 1970). Historian Daniel Winkler: "Racism, class bias, and violation of reproductive freedom are not part of the core notion of eugenics. It is most plausible to view eugenics as sharing moral dilemmas with much of public health, and the critical issues of distributive justice. Many had become atheists, so that they rejected being assigned to Jewry by the extreme right. Julian Simon (1932-1998) writes the Ultimate Resource, discounting concerns regarding overpopulation and resource exhaustion. Bastian Tills German-language study of German psychiatry appears, attempting to trace a trajectory leading from eugenics to euthanasia. Gottesman steps down as vice-president of the American Eugenics Society, having served five years and been a member since 1969. Hershler is of the opinion that gene therapy and genetic engineering may be prohibited because he who changes the [Divine] arrangement of creation is lacking faith [in the Creator], and he cites as support for his view the prohibition against mating diverse kinds of animals, sowing together diverse kinds of seeds, and wearing garments made of wool and linen (Leviticus 19:19). According to the 1990 National Jewish Population Survey, less than a quarter of those who identify themselves as Jewish agree that "the Torah is the actual word of God. Web site announcement: "The Center for Jewish Genetic Diseases at the Mount Sinai Medical Center in New York City is the first center in the world devoted to the study of diseases that affect Ashkenazi Jews. Established in 1982, the Center has a twofold mission: 1) to improve the diagnosis, treatment, and counseling of patients and their families suffering from Jewish genetic diseases and 2) to conduct intensive research to combat these inherited diseases. During the Centers history, its researchers have been awarded over $50 million in research and training grants by the National Institutes of Health. The Center has become the focus for the training of young physicians and scientists in the care of patients and in laboratory research to improve the diagnosis and treatment of Jewish genetic disorders. In addition, we have established a masters degree program to train genetic counselors, which focuses primarily on the genetic and psychosocial counseling involved with the diagnosis, management, and treatment of patients and families with Jewish genetic diseases. A "Theoretical Letter Concerning the Moral Arguments against Genetic Engineering of the Human Germline Cells" resolves "that efforts to engineer specific genetic traits into the germline of the human species should not be attempted. The document is circulated and was evidently drafted by Jeremy Rifkins Foundation on Economic Trends in Washington. Fischer Publishers brings out Ernst Klees study of the destruction of "life not worth living" under National Socialism. A Micro-Chronology of Jewish Eugenics 293 can countries, Israel is now moving rapidly towards a late modern type of family situation, characterized by high levels of contraception, of female employment, of divorce, with declining fertility which may approach zero population growth in the not too distant future. The Central Conference of American Rabbis (Reform Movement) reaffirms its 1948 resolution that a child is presumed to be Jewish if one parent is Jewish, as long as the parents and child identify with Judaism.

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The proportions of women and men who know about both methods are lowest in the North East (62% and 58% anxiety symptoms skin rash order emsam no prescription, respectively) and highest in the South East (77% and 88% anxiety symptoms dizziness buy cheap emsam on line, respectively) anxiety jelly legs order emsam now. Among men and women alike, knowledge of both prevention methods increases with increasing education and wealth. For example, women with no education (61%) are less likely to know of the prevention methods than those with more than a secondary education (85%). Similarly, 81% of women in the highest wealth quintile know of both methods, as compared with only 57% of women in the lowest quintile. The percentage of men with comprehensive knowledge ranges from 29% among those age 15-19 to 52% among those age 40-49. The percentage among men increased from 52% to 62% over the same period (Figure 13. Percentages vary by age, from 68% among women age 15-19 to 81% among women age 30-39. Patterns by background characteristics Overall, there are minimal differences in discriminatory attitudes between women and men in urban areas (57% each) and rural areas (61% and 59%, respectively). The proportion of women and men with discriminatory attitudes generally decreases with increasing education; 61% of women and 66% of men with no education have discriminatory attitudes, as compared with 46% of women and 43% of men with more than a secondary education reported (Figure 13. The percentage of women with discriminatory attitudes decreases from 68% among those in the lowest wealth quintile to 56% among those in the highest wealth quintile. Among men, the percentage decreases from 71% among those in the lowest wealth quintile to 54% among those in the highest quintile. In the 12 months before the survey, 9% of women reported having sexual intercourse with a person who neither was their husband nor lived with them, and fewer than 4 in 10 of those women (36%) reported using a condom during the last sexual intercourse with such a partner (Table 13. Among men age 15-49, 13% reported having two or more sexual partners in the 12 months before the survey, and 16% reported having sexual intercourse with a person who neither was their wife nor lived with them. Almost 6 in 10 of those men (65%) reported using a condom during the last sexual intercourse with such a partner (Table 13. Patterns by background characteristics Women in urban areas are more likely (11%) than women in rural areas (7%) to have had sex in the last 12 months with a person who neither was their husband nor lived with them. They are also more likely to have used a condom during the last sexual intercourse with such a partner (37% versus 34%). The percentage of men who used a condom during their last sexual intercourse with a non-marital or non-cohabiting partner was higher among those with more than a secondary education (73%) than among those with no education (41%). Women living in urban and rural areas reported comparable numbers of lifetime partners (2. Transactional sex is the exchange of money, favours, or gifts for sexual intercourse. The percentage of men who have paid for sex increases from 1% among those age 15-19 to 7% among those age 30-39. Among men who paid for sex in the last 12 months, almost three quarters (74%) reported using a condom during the last paid sexual intercourse (Table 13. Trends: the percentage of men who reported having ever paid for sex did not change between 2013 and 2018 (5% in both years). However, condom use during last paid sexual intercourse increased from 66% to 74%. Ninety-six percent of men age 15-49 have been circumcised, 26% by health professionals and 60% by traditional practitioners or family and friends (Table 13. Patterns by background characteristics Men age 15-19 (32%) are more likely than men age 40-49 (20%) to have been circumcised by a health professional. In contrast, men age 40-49 are more likely to have been circumcised by traditional practitioners or family and friends (65% and 55%, respectively). The proportion of men who have been circumcised by a health professional varies markedly by zone, from 12% in the North East to 45% in the South East. Twelve percent of young women and 2% of young men age 15-24 had sexual intercourse before age 15 (Table 13. As a result of early female marriage, a higher proportion of young women (53%) than young men (14%) reported having sex before age 18. Trends: the percentage of young people age 15-24 who had sex before age 15 has decreased slightly since 2013, from 17% to 12% among women and from 3% to 2% among men. While there has also been a decrease in the percentage of young men age 18-24 who have had sex by age 18, the percentage among young women has increased slightly (from 52% to 53%). Patterns by background characteristics Young women in rural areas (17%) are more likely to have sex before age 15 than their urban counterparts (6%). The percentage of young women age 18-24 who had sexual intercourse before age 18 decreases with increasing education, from 82% among those with no education to 17% among those with more than a secondary education. The percentage of never-married respondents who have never had sexual intercourse decreases sharply with age; 91% of young women and 94% of young men age 1517 have never had sex, as compared with 29% of young women and 50% of young men age 23-24. The percentage of never-married young men age 15-24 who have never had sexual intercourse is higher in rural areas than in urban areas (84% versus 77%); there is only a marginal difference between young women in urban and rural areas (74% versus 73%). The proportion of never-married respondents who have never had sexual intercourse decreases with increasing education, from 91% among young women and 95% among young men with no education to 55% among young women and 61% among young men with more than a secondary education. Young men (15%) are also more likely than young women (13%) to have had intercourse with a non-marital, non-cohabiting partner in the last 12 months. Thirty-eight percent of young women and 62% of young men used a condom during their last sex with a non-marital, non-cohabiting partner. Patterns by background characteristics the proportion of respondents who used a condom during their last sex with a non-marital, noncohabiting partner is higher in urban than rural areas; 39% of young women and 67% of young men in urban areas used a condom during their last sexual intercourse with such a partner, as compared with 36% of young women and 56% of young men in rural areas. Among men, the percentage who reported using a condom during their last sexual intercourse with such a partner increases from 63% among those with a secondary education to 73% among those with more than a secondary education. Lifetime risk of maternal death: the lifetime risk of maternal death indicates that one in 34 women in Nigeria will have a death related to maternal causes. In most developing countries, reproductive health is a major concern, and there is a need for reliable data on maternal deaths. This model has been associated with human, health system, and socioeconomic factors such as poverty, poor emergency obstetric services, and fatalistic beliefs. These problems have contributed to a high incidence of infectious diseases, postpartum haemorrhage, hypertensive disorders, unsafe abortions, and prolonged labour, which have led to high adult and maternal mortality in Nigeria. Estimation of mortality rates requires complete and accurate data on adult and maternal deaths. This chapter presents information on the levels of and trends in adult mortality and maternal mortality in Nigeria. The chapter includes a summary measure (35q15) that represents the probability of dying between exact ages 15 and 50-that is, between the 15th and 50th birthdays. The respondent was then asked to provide a list of all children born to her mother, starting with the first born, and the survival status of each sibling.

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In addition anxiety xanax benzodiazepines buy generic emsam 5 mg online, both rely on the same two subscales anxiety symptoms last all day purchase 5 mg emsam, verbal and performance anxiety yahoo order 5mg emsam overnight delivery, to measure a variety of behavioral functions, thus providing a type of continuity from the preschool to the school-aged child for repeated assessment of behavioral function. Appropriate statistical controls or subject matching must be undertaken to evaluate the contributions of these variables to outcome measures. While these developmental and intelligence tests may clearly be important to the determination of the levels and conditions of exposures to a toxicant associated with adverse behavioral function, they are less useful, as noted previously, in providing a precise delineation of the behavioral functions actually affected by a chemical. Measures such as intelligence test scores are global measures in that they rely on the integration of all behavioral functions. Even performances on subscales of these tests are jointly dependent on integrative motor, sensory, and cognitive functions. Thus, even a preferential deficit on a verbal scale, which is clearly geared toward cognitive function, may not provide a precise understanding of the nature of the behavioral deficit. To achieve a true understanding of the behavioral processes affected by a chemical will necessarily require direct measurement of those specific functions, much as is done in the experimental animal studies described previously. Some neuropsychologists have recognized this problem and have begun to employ measures of specific behavioral functions such as learning, memory, sustained attention, and abstract thinking in an attempt to determine the source of the deficits in global intelligence test scores produced by lead exposure. The repeated learning paradigm actually originated in studies using human subjects and was later adapted for nonhuman primates and rodents. Procedures such as delayed matching to sample and operant psychophysical procedures have also been used across species with appropriate parametric modifications. These types of paradigms may play a more significant role in future developmental studies of children because they provide direct and specific measures of behavioral functions that are more difficult to differentiate in standardized tests. Adult Assessments Assessments of behavioral toxicity in adults frequently occur in the context of occupational exposures to chemicals. Like studies carried out in school-aged children, these evaluations have relied largely on standardized tests, including intelligence tests. They also tend to employ a broad variety of tests so that numerous behavioral functions can be tested, particularly when the effects of a toxicant are ill-defined. As such, the same considerations must be taken into account with respect to the choice of tests utilized. These include validity, reliability, and sensitivity, as well as standardization issues related to the population from which test norms were derived. One distinction between many of the studies of behavioral toxicity in children and adults is that while the former have tended to be primarily longitudinal in nature, following the effects of toxicant exposures to children across the course of development, most of the occupational exposure studies are cross-sectional studies that encompass only a single time point of measurement of behavioral function. The series of verbal tests includes information (general information questions), comprehension (interpretation test), arithmetic, similarities (between nouns), digit span (repeating sequences of digits), and vocabulary. The performance tests include digit symbol (associating digits with symbols), picture completion, block design (duplicating block patterns), picture arrangement, and object assembly. Memory dysfunction has been a frequent complaint in populations of workers exposed to various neurotoxicants and is tapped by several different tests used in a human testing context. As indicated earlier, this test requires the subject to recall a series of digits, and the length of the list is successively increased contingent upon the subject correctly recalling the members of the list. As is the case with experimental animal studies, more complex versions of these tests have been devised and implemented. In procedures such as continuous recognition memory or memory scanning, subjects may be shown a list of digits or letters and then shown, after a delay interval, a longer list of various digits or letters and asked to recall those that were on the original list. Analogies to such tests are embodied in procedures such as the Benton Visual Recognition Test, which requires a subject to reproduce a drawing or geometrical design. Paired-associates learning is also frequently used in a memory context in occupational exposure test batteries as well as in studies with children. In these paradigms, a list of paired words is read to the subject, who must then recall the second member of the pair when the first is read after a delay. The task can be made relatively simple by using pairs which have some type of obvious relationship or made more difficult by having pairs with no apparent relationship. In addition, the task can be used in a repeated learning context, much as the repeated acquisition paradigm described earlier, by using new lists of paired-associates after the subject masters the initial list. This particular approach has a long history of use with human subjects and has been found to be sensitive to toxicants such as lead. Measures of vigilance, attention, or distractibility are also frequently included in assessments of occupational behavioral toxicology. These range from very simple procedures, such as reaction time, to more complex tasks, such as simulated cockpit or tracking tasks. Even reaction time can be varied from a very simple to a highly complex procedure. In a simple reaction time task, the subject is typically presented with some type of screen on which a single visual stimulus will appear at intermittent and unpredictable intervals. The subject must respond on the single response manipulanda as soon as the stimulus appears. Complex reaction time presents the subject with multiple stimuli as well as multiple response options. For example, there may be four different stimuli, each of which is presented at random and unpredictable intervals. The appropriate response depends on which of the stimuli is presented, and the subject is asked to respond on the appropriate manipulanda as quickly as possible after detecting the stimulus. Thus, the more complex reaction time task involves not only attending to the screen to detect the stimulus presentation but also making a decision as to the correct manipulanda and then executing the response. Obviously, the number of options can be modified to fit the experimental situation. Behavioral Toxicology 243 One of the important parameters of the reaction time task is the rate at which the attention of the subject deteriorates, such that reaction time is slowed down or even that the subject misses stimulus presentations entirely. This rate of deterioration of performance will depend on many factors, one of which is the rate at which stimuli are presented to the subject and another being the length of the session during which reaction time is measured. While one might intuitively think that the slower the rate of presentation, the more rapid the rate of deterioration of performance, in fact sometimes the opposite is true. A very rapid rate of presentation of stimuli can render the subject exhausted and less alert or less motivated. With respect to session length, one typically expects to see a gradual decrement in performance as the session progresses, such that an adequately long session must be implemented to catch this function. Finally, a critical variable in reaction time studies is the prominence of the stimuli used. In fact, this parameter can be manipulated to change the sensitivity and difficulty of the task. Reaction time tasks are by no means limited to the presentation of discrete visual stimuli. Other variants have included those in which the subject must respond to a stimulus that is different from a continuously presented array of stimuli. In this procedure, the subject is instructed to respond when the hand of a clock ticks off 2 s at once rather than the typical 1 s tick; the 2 s tick is an infrequent and unpredictable occurrence. In other situations, a continuous presentation of letters or numbers may be presented and the subject instructed to respond to one particular letter or number whenever it appears.


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