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Among the titles appearing on the newstands were: "Youth Gone Loco" (Christian Century) depression cherry review cheap zoloft 100mg mastercard, "Marihuana: Assassin of Youth" (American Magazine) depression test bei kindern order zoloft 25mg amex, "Uncle Sam Fights a New Drug Menace-Marihuana" (Popular Science Monthly), "One More Peril for Youth" (Forum), "Sex Crazing Drug Menace" (Physical Culture), "The Menace of Marihuana" (American Mercury), "Tea for a Viper" (New Yorker), and "Exposing the Marihuana Drug Evil in Swing Bands" (Radio Stars). Although most of these articles appeared after enactment of federal antimarihuana legislation, most of them drew their information from the files of the Bureau of Narcotics just before Anslinger prepared his assault on Capitol Hi11. It is a narcotic used in the form of cigarettes, comparatively new to the United States and as dangerous as a coiled rattlesnake. This law gave each state the power to arrest addicts for possession of oulawed drugs, and in so doing effectively closed the loophole that undermined the Harrison Act. For example, by 1935 only three states out of the twelve that had adopted it included marihuana in its list of proscribed drugs. By 1936, all eighteen of the states that adopted the act that year included marihuana. Yet, far from being whipped into a panic over the "killer drug," most Americans seemed totally unconcerned or aware that there was a drug menace threatening the country. By making the United States a party to international restric-tions on the drug, it would be placed in the position of agreeing to international sanctions without having domestic sanctions: Once the United States became a signatory to an international treaty, Anslinger felt that Congress would have to adopt federal antimarihuana legislation despite opposition on constitutional grounds to any law restricting can-nabis on the basis of current federal tax or interstate laws. As one of the American delegates to the conference, he urged the other members to include control of cannabis in any drug treaty that they, as representatives of their respective governments, might adopt. Anslinger left Geneva despondent, refusing to sign any of the reso-lutions adopted by the convention because no provisions had been adopted for punishment of "illegal cultivation and gathering of can-nabis" and because the provisions that had been adopted were "in-adequate as far as cannabis was concerned. Carl Voegtlin, and asked in all sincerity whether the doctor thought that marihuana really did produce insanity! As presented to Congress, the antimarihuana bill stipulated that all handlers of cannabis had to be registered and pay a special occupational tax. Written forms had to be submitted and filed for every transaction involving cannabis, and payment of a transfer tax of one dollar per ounce had to be paid each time the drug was delivered to an authorized recipient. Hester told the House Committee on Ways and Means that the Treasury Department had taken it upon itself to call for federal laws against marihuana after a two-year study by the Bureau of Narcotics revealed that the drug was "being used exten-sively by high school children in cigarettes. After the Treasury Department presented its case it was time to hear from the other side. According to the provisions of the bill, industrial uses of the plant were to be protected from interference by defining the term "marihuana" to exclude the mature stalk and its compounds or manu-factures. Seeds, however, had not been excluded from the definition of marihuana, even though there was a recognized industrial use for them in producing oil for the paint and varnish industries. The reason for not excluding marihuana seeds was that they contained minute amounts of the intoxicating substance produced by the plant. The failure to exclude marihuana seeds from the law brought a cry of protest not only from the paint and varnish makers but also from the birdseed industry, which used millions of pounds of cannabis seed a year as bird food. The birdseed representative appeared almost too late to present his case, explaining that the birdseed industry had only just realized that marihuana was another name for the hemp plant! When asked whether the seeds had the same effect in pigeons as in humans, the birdseed spokesman replied that he had never noticed any special effect. Marihuana seeds would be excluded from the definition of marihuana, provided that they were sterilized, a process that would ensure that they could not be used to grow new plants. But as yet no one has been produced from the Bureau of Prisons to show the number of per-sons addicted to marihuana. An informal inquiry shows that the Bureau of Prisons has no information to this point. Inquiry into the Office of Education, and they certainly should know something of the prevalence of the habit among school children of this country, if there is a prevalent habit, indicates that they had not occasion to investigate it and know nothing of it. Although he assumed that there must be some basis to all the furor over marihuana in the press, Woodward asked why the facts upon which these statements had been made had not been introduced as firsthand testimony. Since when, he wanted to know, did press coverage constitute anything more than heresay. Unfortunately, I had no knowledge that such a bill as this was proposed until after it had been introduced. Chairman," Woodward said, "why this bill should have been prepared in secret for 2 years without any intimation even to the profession, that it was being pre-pared. By bringing it up without any prior warning, it forced the opposi-tion to prepare a last-minute case. Morris Fishbein, editor of the Journal of the American Medical Association, had sanctioned publication of an article in Hygeia which claimed that marihuana was an inciter of sex crimes, murder, and insanity19), but for other reasons. Enforcement of the Harrison Act and Prohibition had led to a certain amount of annoyance and outright harassment of physicians.

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This disease causes poor muscle tone (hypotonia) and persistent muscle weakness in infants anxiety 1-10 scale proven zoloft 25 mg. Older children and adults typically experience mild disabilities that worsen slowly with time mood disorder with known etiology purchase 25mg zoloft with mastercard, if at all. Due to chronic muscle weakness, many people develop skeletal deformities, including joint dislocations and scoliosis, or curvature of the spine that can compress vital internal organs. People with this disease should be cautious about surgery because they face an especially high risk of malignant hyperthermia, a potentially fatal reaction to certain anesthetic drugs (see "Anesthesia," page 5). Treatment: Someone with a severe form of central core disease might need a walker or other support devices for mobility, but many people require none. Unlike the case for other myopathies, people with this disease can benefit from exercise. Scoliosis and other skeletal problems can usually be corrected by use of orthopedic devices or by surgery. Onset: birth to adulthood Symptoms: the disease gets its name from the fact that the muscle cells contain abnormal clumps of threadlike material - probably disorganized filament proteins - called nemaline bodies (nema is Greek for "thread"). It causes weakness and poor tone (hypotonia) in the muscles of the face, neck and upper limbs, and often affects the respiratory muscles (those that control breathing). Usually, infants with the disease lack the muscle strength and tone required for simple postures and movements. Although many infants with the disease die from respiratory failure or lung infections, some survive to adulthood. Affected children usually attain motor milestones slowly, and at puberty they might experience further weakening, necessitating use of a wheelchair. For adults, even noncongenital forms of the disease can cause life-threatening respiratory problems. Adults also might experience swallowing and speech problems, and those with restricted mobility might develop scoliosis. Treatment: An infant with nemaline myopathy usually requires a feeding tube to deliver nutrition and mechanical ventilation to support respiration. Children and adults also can benefit from respiratory support, since respiratory failure during sleep can be a persistent danger. Mobility and strength can be improved significantly by physical and orthopedic therapies. Infantile-onset nemaline myopathy tends to be the most severe type, but these children sometimes survive to adulthood. Nemaline myopathy Also called: rod body disease Causes: this disease is caused by a variety of genetic defects, each one affecting one of the filament proteins required for muscle tone and contraction. Because of its X-linked inheritance pattern, it affects boys far more commonly than girls. The other forms of centronuclear myopathies are less severe and are called autosomal, which is a reference to their inheritance pattern. Contractures (joints frozen in place because of muscle weakness) may develop, particularly in the hips and knees. Treatment: Until recently, nearly all infants with X-linked myotubular myopathy died within their first few months of life. X-linked myotubular myopathy affects mostly boys and causes severe weakness noticeable at birth. Myotubular myopathy Causes: the most common and severe form of centronuclear myopathy is myotubular myopathy, which is caused by defects or deficiencies of myotubularin, a protein thought to promote normal muscle development. Inheritance: X-linked Onset: congenital (present at birth) Symptoms: X-linked myotubular myopathy usually affects only boys, and causes severe muscle weakness and hypotonia noticeable at birth and sometimes before. The weakness and hypotonia interfere with posture and movement, and cause lifethreatening difficulties with feeding and respiration. Sometimes, failure or infection of the lungs causes death in early infancy, but others survive into childhood. Autosomal centronuclear myopathies Causes: As of 2009, two genes have been found that, when flawed, cause an autosomal form of centronuclear myopathy. One gene is for the amphiphysin 2 protein, which normally is involved in maintenance of the membrane surrounding muscle fibers.

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Like most of the European observers bipolar depression dsm code buy zoloft 100 mg line, Chardin did not experience the effects of cannabis firsthand mood disorder medication list discount 25 mg zoloft, but merely related what he had seen and been told. Regarding cannabis, Chardin distinguishes between the bueng used by the Persians and that used in India. Persian bueng, he says, is actually a mixture of cannabis, opium, and nux vomica, which is also called "Poust. They say it is less inhumane than killing them, as is done in Turkey, or in blinding them as the Persians do. Yet another monarch to be caught up in the ebullience of the times was the king of Denmark. Less interested in staking claim to new territories than in learning more about the culture of the Arab world, the king agreed to finance an expedition to the unmapped regions of Yemen, a hitherto isolated re-gion of Arabia once known as the Incense Trail. The fact-finders were five prominent scholars-a botanist, a zoologist, a philologist, an artist, and a mathematician. Each was to exercise his skills as best he could in learning about Yemen and its people. When the expedition ar-rived in the country, the villages were primitive outposts built either of stone in the highlands or of mud in the low regions. Of the five explorers, only one, the mathematician Carsten Niebuhr, survived, and even he contracted malaria. Seven years after he had first set out, Niebuhr finally returned to Denmark and filed his report to the king. In 1772, he formally pub-lished his observations in a book which he called Travels in Arabia. Like many of his fellow explorers who had witnessed and been intrigued by the widespread use of bangue or hashish, Niebuhr reflects in his book the European fascination with the popularity of these drugs among non-Europeans. One of our Arabian servants, after smoking Haschisch, met with four soldiers in the street, and attacked the whole party. Notwithstanding his mishap, he would not make himself easy, but still imagined, such was the effect of his intoxication, that he was a match for any four men. Typically, however, these texts were rather cautious in their advocacy of hemp as a therapeutic agent. Although as early as 1621 Robert Burton had suggested that can-nabis might be of value in the treatment of depression,36 this proposal was never tried in England. The New London Dispensatory, published in 1682, contained only a brief reference to hemp seeds, claiming that they cured coughs and jaundice but filled the head with vapors," but the Complete English Dispensatory of 1720 took issue with the recommenda-tion to use hemp seeds in treating jaundice, asserting that such recom-mendation is "not hitherto with authority enough to bring them into prescriptions of any kind. Other uses for the concoction were in drying up tumors and dissolving deposits in the joints. The Edinburgh New Dispensary of 1794 carried a relatively long de-scription of the effects of hemp in medicine, indicating that its popular-ity in this regard had begun to increase. Culpeper repeats many of the claims for cannabis contained in the previously mentioned dispensatories and adds a few from the classical writings of Galen and Pliny, including some of his own recommendations. For example, he mentions that cannabis "dries up the natural seed for procreation," and "being boiled in milke and taken, helps such as have a dry hot cough. The decoction of the roots eases the pains of the gout, the hard humours of knots in the joints, the pains and shrinking of the sinews, and the pains of the hips. The fresh juice mixed with a little oil and butter, is good for any place that hath been burnt with fire, being thereto applied. Until that time, it was sparingly used as a folk remedy for certain disorders, but it never enjoyed any popularity and there is absolutely no indication that the English ever became intoxicated as a result of eating cannabis leaves or seeds. The variety of cannabis that grew in file:///I /drugtext/local/library/books/marihuana/5. However, almost as soon as Linnaeus dubbed hemp Cannabis sativa, other botanists began to argue that there were two distinct types of hemp plant and therefore it was a mistake to lump all hemp-like plants under one name. In 1783, Lamarck contended that the European hemp plant and the Indian hemp plant each warranted its own name. The latter, he noted, contained far more resin than the European plant and it also appeared noticeably different in other distinct ways. Because of these differences, Lamarck reserved the name Cannabis sativa for the European plant and gave the name Cannabis indica to the Indian plant-indica referring to its place of origin. Lamarck was not the first or the only scientist to point out the differences between the two plants, but he was the first to contrast clearly the two types, and his arguments were very convincing. This early argument as to whether there is one species of cannabis which includes many different varieties or several different species still remains to be settled.

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Collaborators can be individuals or organizations who believe in this common cause for public health and wish to bipolar depression relationship purchase zoloft 50mg mastercard provide resources to depression rates generic 50 mg zoloft otc ensure that the commu nity can sustain itself and continue its mission, including hosting community activities and training sessions around the world. If you are interested in joining the journey, check out Chapter 2 ("Where To Begin") for how to get started. Chapter 2 Where to Begin Chapter leads: Hamed Abedtash & Kristin Kostka "A journey of a thousand miles begins with a single step. Our work benefits a range of individuals and organizations, in cluding patients, providers, and researchers, as well as health care systems, industry, and government agencies. This benefit is achieved by improving both the quality of health care data analytics as well as the usefulness of healthcare data to these stakeholders. We believe observational research is a field which benefits greatly from disruptive thinking. Collaborators do not have to be data holders to be considered active members of the community. Under the categories are subforums and these subforums can further have more subforums. The topics (commonly called threads) come under the lowest level of subforums and these are the places under which forums members can start their discussions or posts. Past events have in cluded a phenotype hackathon, and data quality hackathon, and opensource software documentationathon. In all of these events, there is a shared desire to solve a common problem but also a shared interest in providing a welcoming environment that encourages learning and continuous improvement on the process of collaborative problemsolving. Workgroup participation is open to all who have an interest in contributing to the project objectives and goals. Workgroups may be long standing, strategic objectives or shortterm projects to accomplish a specific need in the community. Workgroup meeting cadence is determined by the project leadership and will vary from group to group. To improve the quality of the Standardized Vocabularies by increasing their coverage of international coding systems and clinical aspects of patient care in order to support the standardized analytics developed by other working groups. Population Develop scientific methods for observational Level research leading to population level Estimation estimates of effects that are accurate, reliable, and reproducible, and facilitate the use of these methods by the community. Metadata Our goal is to define a standard process for & storing human and machineauthored Annotations metadata and annotations in the Common Data Model to ensure researchers can consume and create useful data artifacts about observational data sets. Open to all Open to all Open to all who identify with this mission Leaders within the community 18 Chapter 2. Proprietary algorithms and software solutions are welcome but are not the main focus of our software development efforts. Wikipedia (Wikipedia, 2019a) defines it as "the movement to make scientific research (including publications, data, physical sam ples, and software) and its dissemination accessible to all levels of an inquiring society, amateur or professional," and goes on to state that it is typically developed through col laborative networks. Information technology has led to an explosion of data generation and analysis methods, and for individual re searchers, it is very hard to keep up with all literature published in their area of expertise. This holds even more true for medical doctors who have a practice to run as their day job, but still need to keep abreast of the latest medical evidence. In addition, there is growing concern that many experiments may suffer from poor statistical designs, publi cation bias, phacking and similar statistical problems, and are hard to reproduce. The traditional method of correcting these concerns, peer review of published articles, often fails to identify and tackle these problems. The special 2018 Nature edition on "Chal lenges in irreproducible research"3 includes several examples of this. A group of authors attempting to apply systematic peer review on the articles in their field found that, for var ious reasons, it was very hard to get the errors they identified rectified. Experiments that have a flawed design to begin with are especially hard to correct. In the words of Ronald Fisher: "To consult the statistician after an experiment is finished is often merely to ask him to conduct a post mortem examination. In the period leading up to the studyathon, the participants pro pose medically relevant research questions to study, and one or more research questions are selected to study during the studyathon itself. Much of the actual studyathon time is devoted to discussing the statistical approach (see also chapter 2), the suitability of the data sources, the results which are interactively produced and the followup questions that are inevitably raised by these results.

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On a tour to depression test scale purchase zoloft 50 mg overnight delivery the United States in 1938 depression symptoms treatment and causes buy zoloft 50 mg free shipping, the director had hoped to convince the American public that she was a filmmaker and not a Nazi. Hoping to have a ban on her film in Germany lifted, she appeared before the Filmbewertungsstelle (Committee of Film Review) in 1958, arguing that "until its premiere, no National Socialist official had seen any of the film," and that the movie "had no scenes that glorified the National Socialist regime" (Graham 1993, 280). Many critics, however, argue that her friendship with Hitler, her previous film Triumph of the Will, and the tone of the movie indicted her sincerity (see Schneider and Stier 2008; Sontag 1975; and Witte 1993, among others). It focuses on performance, endurance, physical prowess, and athletic form as they are found in any sporting event that includes the best in the field. She herself had been a dancer and athlete, and thus the aspect of beauty was important to her. That is, Riefenstahl herself has placed the film in a context of Nazi Germany and not in an 92 German Culture through Film apolitical international arena. The film has three major themes-individual accomplishment in sports; the power of competition to create community; and the identification of a new Germany, both mythic and modern, gracious and strong. The fledgling state of Nazi Germany found in Triumph of the Will here becomes Nazi Germany, the inheritor of Western antiquity and new leader in Europe. Yet just how apolitical such a reading could be is open to debate since Riefenstahl released different language versions of the film in different countries. Each had its own audio track, and a few added or deleted scenes in order to appeal to the viewers in the targeted countries (Downing 2003, 174). Nevertheless, all seem to devote significant footage to events where non-German athletes were often the victors, even though that meant excluding shots of Germans. She highlights the successes of African American track star Jesse Owens in his events. She devotes a ten-minute sequence to the decathlon, where the top three participants were Americans, and includes the awards ceremony as three U. In events where Germans are strong, she of course focuses on their accomplishments. Moreover, in the German language version, there were more shots of German athletes. Her crew filmed from high platforms and from within special trenches so as to capture action from every perspective. Hans Ertl, her preferred cameraman, constructed special cameras and a boat to film swimmers and divers from the best perspective, including underwater (Thurman 2007). Her crew also filmed with cameras specifically constructed to race along on tracks next to the runners. Finally, Riefenstahl used footage from practice sessions, a time when there was more room for the camera team to maneuver, for the best angles; and when she had not obtained good results filming some contests, she had the winners reenact the competitions. From the five-hour pole-vaulting event, she created a ten-minute sequence in which athletes appear silhouetted against an ominous sky until they become forms in shadow. Arguably the most famous sequence of the movie is a nearly five-minute diving sequence that supports apolitical and ideological readings of the film. As the sequence begins, Riefenstahl chooses shots that focus on individual divers as they spring from the board, glide through the air, and enter the water. As the sequence continues, the tempo increases such that the time between dives is reduced at the same time that less emphasis is placed on divers entering the water. Eventually the Olympia 93 shots focus on the start of the dive, as athletes spring from the board and glide, even fly, through the air. In one instance, a reverse shot carries a diver first into the air then backward so he soars like a bird. Increasingly the divers are filmed from below, silhouetting their bodies against clouds in the sky. Finally, divers, singly and in twos, are filmed falling off the high platform, their arms outstretched as if falling on faith that they will be caught, as indeed the angle that highlights their silhouettes sailing through the sky suggests. Detractors, on the other hand, might say that the divers have been transfigured into objects or film props for illustrating the idea of sacrifice. During the parade of nations, how do the athletes from various countries pay respects to the dignitaries on the rostrum? Describe any moments in the film which you think specifically glorify the Third Reich. The audio tracks for the German- and English-language versions of the film differ somewhat.


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This makes it harder for younger attorneys to depression after divorce cheap zoloft 50 mg otc elbow their way to depression symptoms bupa discount 50mg zoloft with mastercard the trial counsel table. Fewer clients are able or willing to pay for more than a single principal lawyer to try a case. Regrettably, a lack of mentoring and trial opportunities is depleting the stable of jury-ready counsel for civil cases. This situation is compounded by the major impact that the decline in the attorney job market has had on new law graduates attempting to gain footholds as litigators. Newly admitted attorneys, especially sole practitioners, are struggling to find paying clientele, and fewer all the time have the experience, guidance, or capital to take on a jury trial. The longer that lawyers must wait to get jury trial experience, the less likely they are to become proficient trial attorneys. The future of our civil jury system could be at risk if there are not enough lawyers who can credibly try a case to a jury. Without lawyers who can effectively and persuasively present cases to jurors, it is an open question how the jury system in civil cases will fare in the future. The new law essentially shifts the powers that redevelopment agencies once had to cities and counties, as well as to housing authorities that assume the functions of a former redevelopment agency in which the property was transferred from that successor agency to the housing authority. The Polanco Act was created in 1990 to help redevelopment agencies respond to brownfield, properties where hazardous substances are present or potentially present and therefore difficult to redevelop or reuse. The Polanco Act was used to promote cleanup and reuse of sites that might otherwise remain idle. It promoted cleanup not only by allowing a redevelopment agency to obtain property in a redevelopment project area by eminent domain, purchase, or lease but also by giving the agency the power to order responsible parties to clean up contamination. If the responsible party failed to do so, the redevelopment agency could clean the property or arrange for a third party to conduct cleanup and then seek to recover cleanup costs from the responsible parties. As an incentive, redevelopment agencies could use a portion of the property taxes to help pay for improvements. This latter power led to the demise of the Polanco Act and the redevelopment agencies because, at the height of the 2011 budget crisis, Governor Jerry Brown and others pushed to eliminate redevelopment agencies, arguing that the state could no longer afford them. The redevelopment agencies had collected about $5 billion annually that would otherwise have gone to local government services but contributed only $1. The dissolution of redevelopment agencies delayed cleanup of contaminated properties and, in some instances, brought it to a halt, eliminating a vital tool to address urban decay and foster commercial and residential growth in communities. Buildings contaminated with asbestos, lead-based paint, metal dust, and mold remained neglected. Subsurface soils and groundwater sat polluted with hazardous wastes, including those discharged from dry cleaners, metal finishing shops, machine shops, electronics manufacturers, auto repair facilities, and industrial manufacturing. Many argued that a program was needed to address brownfields and foster redevelopment, growth, and renewal in order to continue the work that redevelopment agencies had started. A blighted area is one in which the local agency determines there are vacancies, abandonment of property, or a reduction or lack of proper utilization of property, and the presence or perceived presence of a release or releases of hazardous material that contributes to the vacancies, abandonment of property, or reduction or lack of proper utilization of property. To be a bona fide prospective purchaser, a party must conduct all appropriate inquiry15 into existing contamination before acquiring contaminated property, exercise all appropriate care, and take reasonable steps to stop continuing releases and prevent future releases of hazardous substances. Remediation methods inconsistent with redevelopment schedules may be precluded from implementation or require revisions. A local agency may set deed restrictions that limit the use of the property to protect human health and the environment by, for instance, prohibiting the use of groundwater as potable water or banning the storage of hazardous wastes or excavation below a certain depth. Local agencies may also determine future land uses independently or with the cooperation of developers. Despite similarities, the new law also differs significantly from the former one, mostly because of the distinct functional characteristics between redevelopment agencies and cities, counties, and other local agencies. For example, under the Polanco Act, redevelopment agencies could acquire access to properties only by eminent domain, purchase, or lease. In contrast, the new law allows local agencies to enter and access contaminated properties for site assessment and cleanup upon providing notice to owners. This expanded authority provides local agencies with a means to access brownfields in a manner more expeditious and affordable than those provided under the Polanco Act.

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Virus is spread through direct and indirect contact with infected feces and by airborne transmission Incidence has declined since the Salk and Sabin vaccines were made available in the 1950s Signs and symptoms of polio in both the nonparalytic and paralytic forms include the following: a anxiety breathing exercises cheap zoloft 100mg. Intestinal upset Often depression definition causes buy cheap zoloft 50mg, people with the nonparalytic form of polio recover completely In the paralytic form, extensive paralysis of muscles of the legs and lower trunk can occur Special considerations a. Caring for a patient with paralytic polio who has respiratory paralysis may require advanced airway support to ensure adequate ventilation b. Additional resources and manpower may be needed to prepare the patient for transport H. Cognitive deficits of language and communication, information processing, memory, and perceptual skills are common b. Physical deficit can include ambulation, balance and coordination, fine motor skills, strength, and endurance c. Expect to spend additional time at the scene to provide care to these patients Spina Bifida 1. Congenital defect in which part of one or more vertebrae fails to develop, leaving part of the spinal cord exposed I. Condition ranges in severity from minimal evidence of a defect to severe disability In severe cases, the legs of some children may be deformed with partial or complete paralysis and loss of sensation in all areas below the level of the defect Associated abnormalities may include: a. Others will need extended on-scene time for assessment and management, and perhaps additional resources and manpower to prepare the patient for transport J. Damage occurs to muscle receptors that are responsible for transmitting nerve impulses, commonly affecting muscles of the eyes, face, throat, and extremities 3. Can occur at any age, but usually appears in women between age 20 and 30, and in men between 70 and 80 years of age 5. Can often be controlled with drug therapy to enhance the transmission of nerve impulses in the muscles 9. This does not prepare the entrylevel student to be an experienced and competent driver. Paramedic-Level Instructional Guideline the intent of this section is to give an overview of operating during a multiple casualty incident when a multiple casualty incident plan is activated. Paramedic-Level Instructional Guideline the intent of this section is to give an overview of operating safely in and around a landing zone during air medical operations and transport. Patient requires time-sensitive assessment or intervention not available at local facility. This does not prepare the entry-level student to become a vehicle extrication expert or technician. Risks and Responsibilities of Operating in a Cold Zone at a Hazardous Material or Other Special Incident A. Paramedic-Level Instructional Guideline the intent of this section is to give an overview of operating during a terrorist event or during a natural or manmade disaster. Risks and Responsibilities of Operating on the Scene of a Natural or Man-Made Disaster A. Escape plan and a mobilization point at a terrorist incident Care of emergency responders on scene a. Analyze the role of poison control centers in providing assistance in poisoning cases. Evaluate commonly available xenobiotics and household chemicals that are harmful to children in a single dose. Apply knowledge of toxidromes in designing a treatment plan for the acutely poisoned patient. Justify the role of qualitative versus quantitative toxicology testing in the treatment of acutely poisoned patients. This is not unique to the United States, and various reports note that unintentional poisoning deaths are a global health concern. Since 2000, more than 300,000 people in the United States have died of opioid overdose, many because of unintentional poisoning (Rudd 2016). Unintentional poisoning resulting in injury in pediatric patients is not a new phenomenon (Franklin 2008). Before its existence, reliable information was lacking on active ingredients in household products, and information was minimal about managing such exposures. Poison control centers not only interpret and provide clinical treatment recommendations for treating poisoned patients, but are also integral in collecting epidemiological data on the incidence and severity of poisonings, linking epidemiologic data as part of public health surveillance, reducing health care costs to prevent unnecessary hospitalizations through improving patient care, and providing education to members of the health care community. About 75% of these exposures can safely be managed on-site and not in health care facilities.

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Child Care Subsidy will be terminated if the Parent has not requested mood disorder quotes quality 25mg zoloft, and the Department has not approved depression definition causes discount zoloft 100 mg without prescription, an extension beyond two (2) consecutive weeks of being absent for Reasonable Cause. When a Child Care Provider reports to the Department that a Child had two hundred and fifty (250) hours or twenty-five days (25) or more Unacceptable Absences within the previous twelve (12) months, unless approved by the Department, Child Care Subsidy will be terminated. Maine residency, once established, continues until a new, fixed and permanent home is acquired. Describe the violations that lead to discontinued assistance and provide the citation for this policy or procedure. Note: Responses should exclude reporting requirements for a graduated phase-out, which were described in question 3. If the Lead Agency chooses the option to terminate assistance, as described in section 3. Check and describe any additional reporting requirements required by the Lead Agency during the 12-month eligibility period. Describe: Any additional reporting requirements that the Lead Agency chooses, as its option to require from parents during the 12-month eligibility period, shall not require an office visit. In addition, the Lead Agency must offer a range of notification options to accommodate families. Describe: d) Families must have the option to voluntarily report changes on an ongoing basis during the 12-month eligibility period. If the Gross Income or Allowable Net Income decreases; the parent fee can be lowered. Examples include developing strategies to inform families and their providers of an upcoming redetermination and the information that will be required of the family, pre-populating subsidy renewal forms, having parents confirm that the information is accurate, and/or asking only for the information necessary to make an eligibility redetermination. In addition, states and territories can offer a variety of family-friendly methods for submitting documentation for eligibility redetermination that considers the range of needs for families in accessing support. Maine Page 92 of 259 Advance notice to parents of pending redetermination Advance notice to providers of pending redetermination Pre-populated subsidy renewal form Online documentation submission Cross-program redeterminations Extended office hours (evenings and/or weekends) Other. In addition to income and the size of the family, the Lead Agency may use other factors when determining family contributions/co-payments. Note: To help families transition off of child care assistance, Lead Agencies may gradually adjust co-pay amounts for families determined to be eligible under a graduated phase-out. No Longer Eligible $2,992 $3,912 $4,833 $5,754 $6,674 $299 $391 $483 $575 $667 (f) the CoPayment in Column (e) is What Percenta ge of the Income in Column (d)? Effective Date: 10/01/2018 the fee is a dollar amount and: the fee is per child, with the same fee for each child. The contribution schedule varies because it is set locally/regionally (as indicated in 1. Describe: the fee is a percent of income and: the fee is per child, with the same percentage applied for each child. The fee is per child, and a discounted percentage is applied for two or more children. Describe: Lower co-payments for a higher quality of care, as defined by the state/territory. Does the Lead Agency waive family contributions/co-payments for any of the following? Effective Date: 03/15/2020 No, the Lead Agency does not waive family contributions/co-payments. Yes, the Lead Agency waives family contributions/co-payments for families with an income at or below the poverty level for families of the same size. Yes, the Lead Agency waives family contributions/co-payments for other criteria established by the Lead Agency. With the plan in place, the department began a case by case review to waive parent fees. Lead Agencies must employ strategies to increase the supply and to improve the quality of child care services, especially in underserved areas. This section addresses strategies that the Lead Agency uses to promote parental choice, ensure equal access, and increase the supply of child care. Even if a parent chooses to enroll his or her child with a provider who has a grant or contract, the parent will select the provider, to the extent practicable. If a parent chooses to use a certificate, the Lead Agency shall provide information to the parent on the range of provider options, including care by sectarian providers and relatives.

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In addition depression era recipes zoloft 50mg low price, our trade secrets may otherwise become known or be independently discovered by competitors depression hotline purchase zoloft 25 mg. To the extent that our consultants, contractors or collaborators use intellectual property owned by others in their work for us, disputes may arise as to the rights in related or resulting know-how and inventions. Under this agreement, or the Novartis Agreement, we granted Novartis a co-exclusive license to develop such products worldwide, an exclusive license to commercialize such products outside the United States and a non-exclusive license to support us in commercializing such products in the United States if we request such support. We are responsible for 38% of the joint development costs worldwide and Novartis is responsible for the remaining 62% of the joint development costs worldwide. We will also receive 50% of gross profits on sales of any products commercialized pursuant to this collaboration in the United States and 45% of gross profits for specified European countries and Japan. For each of these profit share countries, each party will be responsible for its respective commercial sharing percentage of all joint commercialization costs incurred in that country. For all other countries where we are not sharing profits, Novartis will be responsible for all commercialization costs and will pay us a royalty in the mid-teens on all net sales of product sold by Novartis, its affiliates and sublicensees, with such percentage subject to reduction post patent and data exclusivity expiration and subject to reduction, capped at a specified percentage, for royalties payable to third party licensors. With respect to the United States, specified European countries and/or Japan, we may elect for such region to either reduce by 50% or to eliminate in our development and commercialization cost sharing obligation. If we elect to reduce our cost sharing percentage by 50% in any such region, then our profit share in such region will also be reduced by 50%. If we elect to eliminate our development cost sharing obligation, then such region will be removed from the profit share, and instead Novartis will owe us royalties on any net sales of product for such region, as described above. We are eligible to receive royalties on any net sales of licensed products by Janssen, its affiliates and sublicensees at a rate ranging from high-single digits to low teens based on the aggregate annual net sales of licensed products worldwide and based on the country of sale. The contingent payments are triggered upon the activities expected to be undertaken by Janssen. We are eligible to receive royalties on net sales of licensed products by Janssen, its affiliates and sublicensees at a rate ranging from mid-single digits to low teens based on aggregate annual net sales and based on the country of sale. We received an upfront payment of $500,000 in May 2014 and are eligible to receive an additional $2. In addition, we are eligible to receive royalties in the high single digits based on net sales of the product. Merck License Agreement In connection with the acquisition of Aduro Biotech Europe Holdings, Europe B. Under the Merck Agreement we are eligible to receive future contingent payments, including up to $310. In addition, we are eligible to receive royalties in the mid-single digits to low teens based on net sales of the product. In September 2015, we entered into a Share Sale Agreement with Aduro Netherlands Coцperatief U. Under the agreement, or the Karagen Agreement, we were also granted an option to designate a particular disease or condition to be added to the field of use under our exclusive license. Under the Karagen Agreement, we are obligated to use commercially reasonable efforts to develop and commercialize licensed products in the United States and the European Union. Under the Karagen Agreement, we are required to make milestone payments totaling up to $900,000, in aggregate, for the achievement of specified development and regulatory milestones as well as royalties based on net sales of products by us, our affiliates and sublicensees at rates ranging in the low single-digit percentages, determined by whether the disease field is an exclusive or non-exclusive disease field, subject to minimum annual royalties and standard reductions. In addition, we are required to pay Karagen a percentage of consideration received from any sublicensing arrangements ranging from the mid-single digits to the midteen digits determined by the current stage of development of the relevant licensed product at the time of the sublicense grant, or by whether we have exercised our option to add a designated field of use to its exclusive license, as applicable. The Karagen Agreement will expire, on a country-by-country basis, upon the expiration of the last-to-expire valid claim within the licensed patent rights. In May and October 2016, the parties amended the license to further expand its scope, which now covers all products covered by the licensed intellectual property. We are required to pay an annual license maintenance fee until our first sale of a product covered by the licensed patent rights. Competition the biotechnology and pharmaceutical industries, and the immuno-oncology subsector, are characterized by rapid evolution of technologies, fierce competition and strong defense of intellectual property. A wide variety of institutions, including large pharmaceutical companies, specialty biotechnology companies, academic research departments and public and private research institutions, are actively developing potentially competitive products and technologies. We face substantial competition from biotechnology and pharmaceutical companies developing immuno-oncology products. While we believe that our product candidates, technology, knowledge and experience provide us with competitive advantages, we face competition from established and emerging pharmaceutical and biotechnology companies, among others.

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Reimer and Reimer note depression definition essay discount 25 mg zoloft fast delivery, "The German term for coming to depression symptoms physical cheap 50 mg zoloft with visa terms with the past through film, Vergangenheitsbewдltigungsfilm, implies that film can be used as a means for reflection on and judgment and internalization of the past" (Reimer, 2). The tradition began with Trьmmerfilme ("rubble films"), such as Die Mцrder sind unter uns (The Murderers Are Among Us, 1946), which dealt with questions of guilt and atonement and sought "to come to grips with the recent past against the still contemporary background of ruined cities" (Kaes 1989, 12). It touched on universal issues and the experience of war, but it did not force spectators to identify with the Nazi leadership presented. Filmmakers like Bernd Eichinger realized the potential in the Nazi story of reaching mass audiences. For that reason, the discussion mostly focused on the film genre and its claim of authenticity and how this presumed authenticity was achieved. Therefore, our discussion will focus on the issue of authenticity and whether the movie is giving a false sense of what happened, deliberately or not. A lot of discussion, especially in Germany, centers on the question of whether "authenticity" is desirable or potentially dangerous with its various ideological implications. To them it seems wrong to call an art product authentic since Downfall is not a documentary but a recreation of historic events. Critics also see this procedure as dangerous since a lot of people might take what they see as real and as reflecting the events. As the movie switches its point of view between the bunker, the Hitler 290 German Culture through Film Youth, and outside events, this linkage has been criticized by Wim Wenders as resulting in a fragmented and contorted narrative perspective (Radke). Der Untergang is trying to strike a balance between historical accuracy and conventional movie making. Most intriguing for them was the "upstairs/downstairs" scenario of the movie that showed the Nazi leadership in a confined space from which they directed the rest of the country after having lost any grasp on reality. Therefore, Eichinger and Hirschbiegel decided to divide the movie into two different spheres, the quiet subterranean bunker with its dark color tones opposite the war scenes above. The movie characters are divided between these areas, Hitler and Traudl Junge in the bunker scenes and Schenck and Peter on the outside. Both spheres compensate each other well-the noisy and chaotic battle scenes are compensated by the sometimes-heated dialogues in the underground. Because they are largely fictional characters (Peter) or characters made up from fictional and authentic elements (Schenk), these outside scenes appear more stereotypical and fake than those involving the Nazi leadership. Since the action takes place mostly in the bunker, a somber end-of-the-world atmosphere prevails. In this starkly reduced setting, the main components play out in a stage-like mise-en-scиne. As is normal in war, the participants did not see the big picture, neither soldiers nor civilians. They are largely cut off from communication; no news is passed along in the trenches or in combat areas. Therefore, Hirschbiegel did not mix this limited perspective with outside information such as documentary footage. Bruno Ganz, who played Hitler in the movie, was definitely a major factor in creating the eeriness audiences were supposed to feel when watching Hitler in the bunker scenes. Danusha Goska wonders whether "humanizing" Hitler could recruit new Nazis since this is the major Der Untergang 291 concern mentioned by critics. This horrifying scene does not happen in silence-the oldest daughter resists, apparently suspecting something fishy is going on. It is an important scene because it represents the mad dedication to National Socialism and the madness to die for the cause, as her farewell letter indicates that is read in a voice-over: "The world that comes after the Fьhrer and National Socialism is not any longer worth living in and therefore I took the children with me, for they are too good for the life that would follow, and a merciful God will understand me when I will give them the salvation. This scene is not only terrible to watch, it is also brilliantly set in scene and adds another story line not previously represented in the movie. In Der Untergang, Joseph Goebbels declares that the Germans chose their own fate and should not be surprised to have their throats slashed at the end of the war, which puts the entire dilemma back into the hands of the Germans. Goebbels acts like a criminal who when caught implicates the ones he lured into the horrible situation.


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