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Bush terminates the program in 1992 and antimicrobial bag generic colchicine 0.5 mg otc, as of 2016, four patients remained in the program, which is admin istered by the University of Mississippi. Congress on August 2, 1977, President Jimmy Carter endorses the fndings of the Shafer Commission and famously says that “penalties against posses sion of a drug should not be more damaging to an individual than the use of the drug itself. Ofcials of the Clinton administration announce that the actions in Arizona and California are in confict with fed eral law, and any person acting under the provisions of either act will be subject to federal prosecution. Institute of Medicine issues its report called Marijuana and Medicine: Assessing the Science Base on the medi cal uses of marijuana. Chronology 333 2004 The citizens of Montana vote about two-to-one to allow the use of marijuana for medical purposes. In 2011, both houses of the state legislature vote to repeal that vote, essentially eliminating the use of medical marijuana in the state. Congress may criminalize the production and use of home-grown marijuana, even in states where the use of the drug for medical purposes is legal. Leonhart, administrator of the Drug Enforcement Administration, denies the request, indicating that marijuana has “a high potential for abuse. Voters in Washington adopt a similar law that permits possession, but not growing, of marijuana. It is the frst country in the world to create such a comprehensive legal approach to the use of marijuana. Supreme Court, arguing that the state’s marijuana laws confict with federal laws on the growing and consumption of marijuana. The use of recreational marijuana is approved in both Alaska and Oregon, with both laws taking efect over time at later dates (2015 and 2016). Supreme Court declines to hear the suit brought by the states of Nebraska and Oklahoma with regard to the legality of Colorado’s marijuana laws. Medical marijuana is approved for the frst time in Arkansas, Florida, and North Dakota, while Montana voters expand the circumstances under which the drug can be used for medical purposes. This page intentionally left blank GlossaryGlossary Introduction Discussions of marijuana may involve terminology that is unfamiliar to the average person. In some cases, the terms used are scientific, technical, or medical expressions used most commonly by professionals in the field. In other cases, the terms may be part of the “street slang” that users themselves employ in talking about the drugs they consume, the paraphernalia associated with drugs, or the experiences that accompany marijuana use. This glossary lists and defines a few of the terms needed to understand explanations provided in this book. Its systematic name is 6,6,9-trimethyl-3 pentyl-benzo[c]chromen-1-ol, and its chemical formula is C21 H 26O2. Glossary 339 drug diversion Providing a drug to an individual who is not authorized to use it. Marijuana plants grown in hydroponic settings are said to have uniquely desirable qualities over those grown in soil. Food and Drug Administration that allows researchers to test new drugs prior to approval. The compound is commonly known 9 as delta-9-tetrahydrocannabinol (Δ -tetrahydrocannabinol). Dispensatory of the United Drug Enforcement States, 212 Administration, 261–262 District of Columbia, 113, Indian Hemp Drugs 142, 153, 206 Commission, 243–245 Index 349 industrial hemp research, Drug Abuse Information legitimacy of, 272–274 and Treatment Referral Leary v. United States, Hotline, 217 248–251 Drug Abuse Ofce and Marihuana problem Treatment Act of 1972, in New York City, 216 247–248 Drug Free America Marihuana Tax Act, Foundation, Inc. Bush Fifth Amendment, 72 administration, 152 First Annual Hemp History George Mason University, Week, 201 196 First Christian Church, 226 George School, 212 352 Index Georgetown University Law Harrington, Michael J. Lester, 152 208–209 Guilford College, 212 Heckler, Margaret, 195 Gunjah Wallah Company of hemp New York City, 37 carbon dating, 3 Gutenberg’s frst Bible, 26 ditchweed, 12 feral, 12 Hague, Te, 57, 181 Indian, 32, 58 Hague Convention, 60 marijuana vs. Drug Enforcement Africa, 21–23 Administration, China, 12–17 261–262 Europe, 23–29 Hemp Oil Canada, Inc. United States, 71, 73, Resource Center, 196 248–251 Louisiana, 68 legalization of marijuana, 136 decriminalization and, Magic Soaps, 200 88–105 Magna Carta, 26 government research Magnoliophyta, 4 support and, 148–150 Magnoliopsida, 4 resistance to , 115–116 Maine, 61 See also decriminalization “Marihuana: A Signal of of marijuana Misunderstanding,” legalization of medical 74–75 marijuana, 105–110, Marihuana problem in New 138–140 York City, 247–248 arguments in favor of, Marihuana Reconsidered, 105–109 152 arguments in opposition Marihuana Tax Act, 36, of, 109–110 65–67, 158–159, 171, legislature on medical 212, 246–247 marijuana, 136 marijuana legitimacy of medical attitudes about use of, marijuana, 166–170 86–87 Index 357 chemicals in, 134 Marriage Guide; Or, Natural controversies about use of, History of Generation: 87–105 A Private Instructor for data on use of, 237–243 Married Persons and edible, 164 Tose about to Marry, hemp vs. Anslinger, 180–183 Playboy Foundation, 218, Hemp Industries 229 Association, 198–201 Pleasant Hill Baptist Church, International Association 228 for Cannabinoid Poland, 24 Medicines, 204–206 policies on marijuana John Gettman, 196–198 common sense, 170–173 John W. Hufman, origins of, 158–161 201–204 Index 363 Keith Stroup, 227–230 in United States, 58–82 Lyster Hoxie Dewey, See also prohibition on 185–186 Cannabis sativa in Marijuana Policy Project, United States 206–208 prohibition on Cannabis National Institute on Drug sativa in United States Abuse, 216–218 attitudes about use of, National Organization for 86–87 the Reform of Marijuana controversies over use of, Laws, 218–219 87–105 Ofce of National Drug Eighteenth Amendment, Control Policy, 219–222 59 Raphael Mechoulam, federal legislation on, 208–211 63–80 Raymond P. Drug Enforcement patterns of use in, 82–86 Administration, recreational marijuana, 232–235 legalization of, 112–115 William B. Sue, 154 Schwarzer, William, 96 Soros, George, 215 scientifc name for Cannabis South Dakota, 144 sativa, 4 Spanish conquest of South Scotland Yard, 134 America, 30 Scranton, William M. Mel, Drug Abuse Prevention, 186–187 78 Sembler Company, 186–187 Spice, 9 semieniatka, 24 St. Department of Veterans University of Maryland Afairs, 221 University College, 197 U. Department of Health, Committee to Education and Welfare, Investigate Crime in 152 Interstate Commerce, U. He is the author of more than 400 textbooks, ency clopedias, resource books, research manuals, laboratory manu als, trade books, and other educational materials. He taught mathematics, chemistry, and physical science in Grand Rap ids, Michigan, for 13 years; was professor of chemistry and physics at Salem State College in Massachusetts for 15 years; and was adjunct professor in the College of Professional Studies at the University of San Francisco for 10 years. His other recent books in clude Physics: Oryx Frontiers of Science Series (2000), Sick! The chronological scope of the work stretches from the late 3 to the early th 7 century. The aim of the thesis is, primarily, to analyse aspects of bathing during this period that have not been previously addressed in detail (such as medicinal uses of bathing) and to examine the issues that have been discussed in the past but had not been answered unequivocally, or which have not been treated in an exhaustive manner – such as the matters of nudity and equality in a bath-house environment, or of Christian attitudes to bathing in this context. The thesis also considers what the knowledge of the subject topic contributes to our understanding of the period of Late Antiquity. The thesis examines the changes that occurred in the bathing culture during Late Antiquity and their causes, exploring in detail the impact of Christianity on bathing customs, and devotes special attention to how the perceptions of bathing were presented in the contemporary sources. This will be achieved by investigating passages from a wide range of texts mentioning baths and bathing and subsequently drawing conclusions based on the analysis of the primary sources. New Revised Standard Version, HarperCollins 1989 3 Introduction this thesis examines the cultural, religious and therapeutic functions of Roman baths during Late Antiquity, as they are presented in a wide range of primary literary sources as well as examining how these subjects are addressed in current research. My aim is, primarily, to analyse previously unresearched aspects of bathing during this period (such as medicinal uses of bathing) and to address the issues that have been discussed in the past but had not been resolved conclusively (such as the matter of nudity and mixed sex bathing). In particular, I intend to examine the changes that occurred in the bathing culture during this time and devote special attention to how the perceptions of bathing were presented in the contemporary sources. In particular, I wish to identify and examine the possible roles and functions of bath-houses for the Romans. I am going to examine the descriptions of bathing and bathers and attempt to determine the reasons for which bath-houses enjoyed such high popularity in Roman society in Late Antiquity. By doing this, I aim to further expand the understanding of one of the most important elements of the social life in the Roman Empire. Furthermore, I intend to determine the extent to which the Romans themselves of that time (or more specifically, the educated elite who produced the literary sources I will be using) appreciated – or not – the significance of bathing for their society and its place in everyday life. In the first chapter in particular, I will attempt to determine the extent to which bath-houses served as cultural institutions and places of social interaction, and whether the importance of bath-houses as places where such activities took place changed during this period. Accepting the view that Late Antiquity was a period of change and transformation (an issue that will be discussed in a later part of the introduction), I will attempt to identify, examine, analyse and summarily discuss the factors that contributed to the changes in the infrastructure necessary to support bathing – such as water supply systems and the bath-houses themselves during this time period. This will be followed in the second chapter by an attempt to establish whether it is possible to talk about the significance of Christianity in the developments concerning, and transformation of, bathing in Late Antiquity. The degree of continuity and change in bathing practices and social norms will be examined from the perspective of how – if at all – the ascendant religion made its mark on them, and whether the potential changes might have been the result of factors other than the new religion. In particular I will be examining the attitudes of representatives of the Church towards baths and bathing, focusing on such aspects as the perceptions of, and attitudes to the human body and sexuality, wealth and luxury, social life and the influence, if any, of bathing culture and customs on the language and activities of the Church in general. In the third chapter I am going to attempt to establish the degree to which bathing and washing were incorporated into the medical practice of the day, basing my inquiry primarily on the medical compendium of Paul of Aegina, but also on the perception of medical profession in the texts of authors without a medical background. My secondary goals here are going to include determining the degree of continuity and possible differences in the use of water and bathing in the medical profession during the Late Antiquity compared to the earlier period, and ascertaining the importance of bath-houses and bathing in general to the medical profession during this time. Chronological and geographical boundaries the geographic focus of the dissertation is primarily on the areas that originally constituted the Eastern Roman Empire, and that subsequently came to be called the Byzantine Empire.

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In the age when the threat of usurpation (and antibiotics not helping uti buy 0.5mg colchicine overnight delivery, indeed, successful usurpations) was quite common, ensuring loyalty of the city’s inhabitants was a necessity for any ruler who hoped to enjoy a long reign, and providing and maintaining capital’s infrastructure were among the most straightforward measures for achieving that. For the sake of completeness, it is necessary to devote attention to the construction efforts, maintenance and destruction of bath-houses. By examining these activities it will be possible to draw some general conclusions regarding the status of baths in the Roman society, and ascertaining the amount of attention the general state of baths and their maintenance received from the authors of primary sources will allow concluding on the extent of their importance for the communities in which they were taking place. In this context I am also going to examine the evidence concerning the reliance of Roman-style bathing on political stability and, to a lesser degree, on willingness of the emperors and the most influential and wealthy citizens to build and sponsor public baths, and the infrastructure necessary for their functioning. This will be followed by an analysis of the potential symbolic meanings the presence of baths may have had for the communities which were utilising them. This will be followed by an exploration of the role of the bath-houses in the consciousness of Romans themselves as well as foreigners who became aware of this – typically Roman – phenomenon of communal bathing. What was an outsider’s perception of a bath house, his reaction to the foreign custom? In what behaviour and actions, if any, this perception resulted, and what, in turn, was the Roman reaction to the outsiders’ behaviour regarding the baths? This will be followed by an overview of the question of nudity in the bathing environment in the Roman society and the possibilities it created for – perceived or real – equality among the bathers. This is closely related to the issue of whether men and women bathed together, if so, to what extent this was taking place, and what (if any) was the general attitude within the Roman society towards this issue. In turn, this analysis will serve as an introduction to a broader overview of baths as meeting places in general. This overview will include an in-depth look at the social functions the baths have served and activities they facilitated. In particular, I am going to examine the everyday interactions between the bathers, leisure activities that occurred in bath 12 houses, and some of the more specific behaviours, such as displays of wealth and social status by the elite, and the ways in which these displays were achieved. Finally, I am going to examine the evidence pertaining to situations not related to bathing or activities associated with it that did take place in baths. Such situations include, for example, utilising bath-houses for purposes for which they were not designed or for which baths were not suited. I will also look into certain behaviours that were singled out as unusual, for one reason or another. These will include, but will not be limited to , examples of bathing outside of the standard bathing facilities and the potential implications thereof. This will be followed by an overview of the potential risks of bathing and detrimental effects it might have had on bathers (this particular theme will be examined in more detail in chapter three), with a brief overview of some of the more drastic events that took place in bath-houses and an examination the reactions of the authors of the primary sources to these. The main primary sources which I will be using in this chapter will include the works of Ammianus Marcellinus, the historians of the Church Sozomen and Socrates, the history of Zosimus, works of Procopius, laws, the later chronicles of John Malalas, Theophanes the Confessor and the Easter Chronicle, as well as witnessed by the early Church authors, especially John Chrysostom. A few of the sources dealing primarily with the West will also be examined (such as the Letters of Sidonius Apollinaris), as they can be useful in drawing conclusions of a more general nature. Even a brief overview of the extant sources shows that almost invariably the references to bathing contained in the primary material are incidental. While such circumstances may on some occasions limit the researchers to reliance on anecdotal evidence, supported only by limited archaeological data and forcing them to make extrapolations, it may also be considered an unexpected boon. While a subject of major importance to the author can often be expected to have been covered with an agenda in mind, bath-houses and bathing more often than not serve as a background to other events, and thus their presented appearance can be deemed to be as close to reality as possible (or, at the very least, reality as perceived by the authors). In cases where bath-houses or bathing did become the main focus (at least temporarily) additional care will be taken to identify possible biases and distortions. Taken together, the insights gained from examining the various aspects of bathing and of the attitudes towards it should allow a reconstruction of one of the most important institutions in the daily life of Romans in the period of Late Antiquity. The study will be concerned with Christianity, for the most part, but also Judaism and the traditional Roman cults and beliefs. Here I am going to discuss in detail the place of baths in a society that was becoming predominantly Christian, and attempt to answer the question of what changes, if any, the advent of Christianity brought to the bathing culture. I am going to begin doing so by examining the guides for Christians discussing the acceptable types of behaviour, such as the early Christian Instructor nd (written at the end of 2 century) of Clement of Alexandria. This work provides guidance on everyday life for Christians, often referring to the Scripture as well as a plethora of pagan authors, and the advice offered shows a strong influence of 15 Stoicism. Tertullian’s apologetic work is another useful source on early Christian attitudes towards the issues of daily life (including bathing), one stressing the overall 16 compatibility of Christian teaching and values with the norms of the Roman society. I am also going to examine homilies, particularly those by John Chrysostom, to determine whether the early Christian teaching on the subject of bathing changed significantly over time. I will subsequently look into the question of whether there were any specifically Christian attitudes to baths and bathing that were different from non-Christian ones; I will also address the issue of whether Christianity as whole can be treated as a factor of cultural change in relation to bathing, or whether some specific trends within the religion can be identified as having particularly strong impact. Another question I wish to explore is the influence of the bath-related terminology on the Christian discourse relating to baptism; to what extent, and in what context words previously used to described mundane activity came to be used to denote one of the most important rites of the ascendant religion, and why? I am also going to briefly look at the Christian interpretation of martyrdom (prior to Christianity 15 Clement of Alexandria, Christ the educator, S. Osborn, Tertullian, first theologian of the West, Cambridge University Press2003, p. A historical and literary study, Oxford 1971 is another useful study of the theologian’s life and work. Since baths were commonly associated with healing and medicine, some attention will also be devoted to Christian attitudes towards this aspect of bath-houses, in the particular context of miracles and supernatural healing, and a comparison will be made with the earlier accounts dealing with this question. Examining this area will necessarily mean creating some overlap between chapters two and three; this, however, should allow a more in-depth look at the matter as it will be explored from different angles and perspectives; in this chapter, the focus is going to be primarily on the more general Christian attitudes and ideas. Attention will also be devoted to the popular beliefs associated with bathing – beliefs and behaviour that lies beyond the mainstream religious or cultural currents; or, at least, behaviour indicated as such by the authors of the surviving sources. Subsequently, I am going to examine the extent to which Christian authors associated baths and bathing with wealth and luxury, and whether it affected their attitudes towards the institution itself. It will additionally be noted whether such attitudes were new or uniquely Christian or, on the contrary, were a continuation of earlier trends. I will also devote attention to Jewish bathing customs during this period, and to the degree in which they resembled (or differed from) traditional Roman bathing, as well as potential reactions of the representatives of different religious groups to the bathing practices of their respective ‘outsiders’. Among the major sources used in this chapter are going to be the orations and homilies of John Chrysostom, which provide plentiful insights on the everyday behaviour of Christians (at least those living in large cities) and on the attitude of clergy – as opposed to monks and ascetics – towards bathing. As someone who studied under Libanius and received Christian education, the ascetic-turned-priest preached in a manner that earned him the nickname ‘Golden Mouth’. More importantly, from the preserved records of his preaching emerges a vivid picture of the life and habits of contemporary Christians. Works of the other great theologians of the age, such as Gregory of Nazianzus or Gregory of Nyssa offer similar insights. I shall also look into some of the older texts, such as the guide of Clement of Alexandria, Apostolic constitutions as well as the Canons of the Church. This author’s compendium is the most complete summary of medical knowledge of the time; based on the foremost authorities of Late Antiquity, knowledge preserved in Paul’s work is, unavoidably, abbreviated when compared to the original treatises from which it was drawn. However, it is also a product of the scientific culture of the time, a distilled version of the results of earlier research, assembled in an accessible and easy to use manner; I am going to discuss this matter in more detail in the chapter itself. The overarching theme of this chapter is going to be the analysis of a number of aspects of bathing in the context of medical profession, primarily the extent to which bath-houses and bathing were employed by medical practitioners and, to a lesser extent, the theoretical underpinnings thereof. The properties of different types of water and their particular therapeutic benefits, as described by ancient medical writers, are going to be examined first. This will be followed by a detailed examination of the bathing in the regimen prescribed for healthy people, and remarks on the theoretical underpinnings of such advice. The question of applicability of bathing in general for the ill is going to be discussed next. This will allow me to determine the general interest of medical profession in the uses of water, and establish the basic concepts related to it. Subsequently, an extensive overview of the prescribed bathing treatment, according to the type of advised bathing, is going to be discussed. The focus will be, in particular, on the circumstances in which bathing in pure water, in various types of mineral waters and in water with the addition of a wide range of substances was deemed beneficial to the patients. This is going to be followed by a quick overview of the significance of bath-houses for the medical profession for reasons not directly linked to bathing. Subsequently, I am going to take a more detailed look at a number of sources written by authors who were not professionally involved in medical practice, but who nonetheless mentioned this subject while discussing bath-houses. The very fact that such remarks can be found attests the widespread (though not necessarily based in 16 proper medical knowledge) associations between baths and health. Thus, in the end, the question of knowledge of medicine among non-medical authors is going to be examined – with particular attention to their attitudes to medicine and bathing. I have devoted much attention to Hippocratic writings, as they constitute a basis for much of the later ancient medical knowledge; by comparing them with later treatises, it is possible to establish – at least to a certain degree – the extent of new research done by physicians and the direction it took. At the same time, it allows one to see how much of the old knowledge was incorporated into the new texts without significant changes, and to examine the general attitude to science in Late Antiquity, on the specific example of medicine.

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Medical officers in factory towns collected statistics on house-fly pop­ ulations as their colonial colleagues antibiotic prophylaxis for dental procedures order generic colchicine pills, such as Ronald Ross (see page 188), investigated mosquitoes. Educational developments had made them conspicuous; they were socially recalcitrant and likely to transmit their menace; they came to serve as models of biological degeneracy. What was to be done with Children being ‘disinfected’ at children who could not learn? In Britain, as elsewhere, institutions begat institu­ a cleansing station in London, tions: elementary schools led to special schools for the blind, the deaf, for crip­ 1912. Doctors got involved, especially at the turn of the century when ‘degeneration of the physi­ cal stock’ became an issue in all Western countries. From about 1870, doctors had presented themselves as experts on physical constitutions and inheritance; after 1900, they could learn from the new science of genetics that stupidity resulted from a single, recessive Mendelian gene. Although few clinicians were much involved in practice with mental defectives and most public-health officers were suspicious of hereditarian arguments, many doctors took an interest in eugenics the new science of better breeding. For some it became a great white hope a way from urban degrada­ tion to national strength and order. Eugenic enthusiasm extended across most of the political spectrum, from those who despised the poor to those who wished them free from the burdens of excessive reproduction. For most of these public medical programmes, support came chiefly from the state, sometimes from charitable associations (which often acted as ‘pioneers’), and to a limited extent from the private market (for example, for private sanatoria). Some of them also began to produce ‘biologicals’, such as vaccines and antisera, sometimes ‘taking over’ such production from the public laboratories in which it had been pio­ neered. All these new products involved extensive collaboration between compa­ nies, universities, hospitals, and the new research institutes sponsored by states and/or charity. One sees here the beginning of the modern medico-industrial com­ plex, not least in questions of standardization, legislation, and clinical trials. These operations were needed or wanted by self-financing patients as well as by the poor, and they were often performed in patients’ homes. The growth of private practice in operative surgery meant that innovative surgeons could become very rich they thought Medicine, Society and the State 327 like inventors and rubbed shoulders with financiers and major industrialists. But as surgeons came to demand elaborate anti­ septic or aseptic routines, and as they undertook more and more operations, it became convenient to use private nursing homes or, where possible, public hospitals. In as much as medical and surgical advances allowed the institutions of medi­ cine to appeal to the self-interest of the better-off, they helped produce a funda­ A tuberculosis sanitorium mental transformation in the political economy of medicine, visible especially in built at Paimio, Finland, to a design by Alvar Aalto, North America, where many rapidly growing communities lacked established 1929-33, exemplifies the medical institutions. These hospitals, whether private or charities, competed for paying medicine and modernist patients, who by the mid-1890s constituted most of the intake. Indeed, the distinction between them began to blur as hospitals became more central to both kinds. In most Western countries one sees new ‘professional movements’ within this new medical economy. While the leading practitioners and educators the institution men were negotiating with governments or steering the medical aspects of wel­ fare schemes, many other doctors, especially general practitioners, felt desperately squeezed between the advance of state medicine, the encroachments of charity medicine, and the increasing ability of organized labour to employ doctors. Friendly societies had employed doctors from the early nineteenth century, especially in the industrial areas of Britain (see page 308). By the end of the cen­ tury, they were becoming a major element in medical provision for the working classes. More workers could and would pay collectively for medical care, and doc­ tors were worried by this growth of patient-power. The entry of women into med­ icine as nurses, midwives, even as women doctors seemed an additional threat to those average general practitioners whose ideology combined patriarchy with small capitalism. The comments of one doctor sums up attitudes of many of his colleagues at the time: 328 The Cam bridge Illustrated H istory of M edicine Many of the most estimable members of our profession perceive in the medical education and destination of women a horrible and vicious attempt deliberately to unsex themselves in the acquisition of anatomical and physiological knowl­ edge the gratification of a prurient and morbid curiosity and thirst after forbid­ den information and in the performance of routine medical and surgical duties the assumption of offices which Nature intended entirely for the sterner sex. Medical syndicalism was much in evidence in Britain, France, and Germany Elizabeth Blackwell around 1900. In Britain in 1911, the doctors reluctantly Medical College, New York State, in 1849. Her pioneering accepted National Health Insurance for working men, largely because the state work led to the opening of the scheme incorporated, and so controlled, the medical activities of friendly soci­ Women’s Medical College in eties. In fact, most doctors soon found that their new relationship with the state New York in 1868. Her sister was both more comfortable and more remunerative than their previous condition. Emily was also a distin­ They were represented on the local insurance committees, and, because they were guished doctor. National Health Insurance thus further differentiated the general practitioner from the hospital doctor, as it also helped establish a stable relationship between the working man and his ‘panel doctor’. The war against the Boers in South Africa at the turn of the nineteenth century had served to worry the British state, not least because of the poor physical health of most of the young men who volunteered to fight. But the First World War of 1914-18 transcended all these in its scale, its horrors, and its duration. For a few years, the major combatant countries were forced to construct medical organizations far larger than their previous (and con­ tinuing) civilian systems. Away from the battle-lines, in the cities of Britain, col­ leges and mansions were taken over as hospitals. Nursing became a major sector of war-work for women, and many doctors learned to work in a large, co-ordi­ nated system some learned to see the advantages. In the emergencies of war, ‘planners’, medical specialists, and medical women found opportunities normally denied them. Much of the system disappeared as the war ended and institutions were returned to their previous medical or non-medical functions, but some new pat­ terns of practice could be carried over, and the expectations of many doctors were Medicine, Society and the State 329 permanently changed. War-time medicine had aimed to return soldiers to action, so the emphasis of specialists, whether in psychiatry or in cardiology, was on functional disabilities; civilian workers, especially in the armament factories, were the sub­ jects for extensive researches on ‘fatigue’. These functionalist attitudes, and the claims of physiologists to a role in scientific management, also carried over into post-war restructuring. For example, at the prestigious Manchester Technical Col­ lege a physiologist was chosen to head a new department of industrial adminis­ tration. Medical teachers and researchers in Britain benefited considerably from war-time projects and from the conviction among higher civil servants that sci­ ence could render medicine more efficient. In the 1920s, the Medical Research A surgical operation (and Council was dominated by medical scientists who had the ear of government and demonstration) in 1907, in who tended to be scornful of mere clinicians, not least the stars of Tondon private one of the American hospitals practice. Prestigious clinicians reacted by pulling in money for new research char run for and by women. Nor could they counter effectively the claims of medical scientists that disciplined research would eventually provide remedies for disease, and that meanwhile the education of doctors in scientific methods would help create a more efficient health service by eliminating ineffective, if habitual, practices. Because the British state was now paying much of the cost of general medical care for working men, there was also a financial incentive to study common dis­ eases and to develop a science of ‘social medicine’. This broader vision of public health, incorporating social sciences and the new science of nutrition, was devel­ oped by medical ‘progressives’, many of whom were sympathetic to the Labour Party, then replacing the Liberals as the opposition to the Conservatives; some of them were impressed by the organization and scope of ‘socialized medicine’ in the Soviet Union. The lock-up surgeries run by British general practitioners, and the overcrowded outpatient departments of the charity hospitals, seemed wasteful and haphazard by comparison. At the end of the First World War, medicine had formed part of national plans for a more collective Britain a land fit for heroes. A new Ministry of Health was set up and a report (1921) produced by Lord Dawson, an eminent physician based in London, looked to the benefits of state organization, a rationalization of health care based on district hospitals, and primary health centres staffed by general practitioners. But this plan, like so many other hopes, faltered and faded in the economic slump of the 1920s. The decline of the old staple industries severely restricted state spending until the mid-1930s (and rearmament). Little was spent on new hospitals, and there were few major legislative initiatives compared to the 20 years before the First World War. Partly as a result of the war, and partly as a result of successful campaigns for extension of the vote, women came to play a larger role in politics. Women’s polit­ ical groupings, of both left and centre, campaigned for more maternity hospitals, better midwifery, and better antenatal care. Municipalities and central govern­ ment obliged, still driven by worries over the quantity and quality of the imperial population. But apart from their ‘maternity benefits’, most women, as ‘non-work­ ers’, remained outside the state medical-insurance system, even when this was extended to cover almost all working men. Women and children were compara­ tively dependent on medical charities, to which working men would now be referred only for specialist or accident care.

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Majors only or permission of undergraduate research and critical thinking skills instructor bacteria kingdoms purchase discount colchicine on line. Majors only or permission of Foundations of the discipline, history, core instructor. Majors only the ever increasing amounts of data available to or permission of instructor. Major this course is designed to provide a solid topics include cognition; user needs assessment, foundation in data communication and networking. Also this course will introduce the students to the field examines programming basics, networks, the of intelligence studies and to the U. This course introduces students to the collection Covers design, organization, implementation, and and integration of publicly available information maintenance of digital information spaces for and its uses in addressing specific information or human access, navigation, and use. Will library/information science such as emerging not count toward the English major. Will not count toward the Microcomputer hardware and software for libraries English major. Will not count toward the Theoretical aspects, planning and production of English major. Focus may be on one, two, or all special population materials for effective use in three genres or on works from any combination of youth services and programs in public and school nationalities. Will not count toward the Literature from the Neoclassic to the Modern English major. Focus on values/ethics, race, An introduction to the occult tradition as a major ethnicity and gender; thinking and writing skills. May be taken Examines major literary works of the 20th Century twice for credit with different topics. We will strive to understand the colonial help relate the present to the recent past. Will not encounter as it has shaped and continues to count toward the English major. Thematic focus includes self, marriage, ethnicity and gender; thinking and writing skills. Literary texts as historical, social, political, Course examines the intersections of race, psychological, philosophical, religious, etc. Will not count groups, provides a conceptual grounding in how toward the English major. Special courses personalities of the Old (Fall semester) and New in writing may also be offered under this title. May be Course examines selected world authors, beyond taken twice for credit with different subject matter. College Algebra may be skills in survey courses, class requires intensive taken either for General Education credit or as reading, a grasp of current scholarship, and preparation for a pre-calculus course. Riemann-Stieltjes integrals, uniform convergence, Linear equations and functions, mathematics of Fourier series, Lebesgue measure and integration finance, differentiation and integration of on R. Differentiation, limits, differentials, extremes, Numerical solution of algebraic and indefinite integral. Antiderivatives, the definite integral, applications, Regular languages, grammars and finite states series, log, exponential and trig functions. Topics this course provides prospective middle school include bijective proofs, arrangements and teachers with initial skills to develop an inquiry permutations, sets and multisets, the Principle of based learning environment that facilitates high Inclusion-Exclusion, partitions, generating academic achievement for all students, focusing functions, recurrence relations, and the Polya on curriculum and learning at the task and lesson theory of counting. Assumes familiarity with industrial the course covers research literature relevant to relations system. Integrates business active involvement of students in developing and core, International business, concentration, area practicing the skills needed to be a successful studies & required overseas experience manager. Data based cases will be used this capstone course integrates the major topics by students to assess managerial and supervisory of management. Students will acquire a broad skills and to measure organizational functioning view of organizations, learning to analyze and work design. Attention is paid to the impact academic component focused on professional of marketing on other functional areas of business development skills and an on-site experiential as well as society. Thesis selling techniques and developing effective development supports critical investigation to interpersonal communications skills. A study of research methods and techniques First order linear and nonlinear differential applicable to problem solving in marketing. Includes the institutions, principles and effort of firms, and coordination with other major methods involved in the solution of these business functional areas on specific problems. Includes pertinent academic component focused on professional management theories and practices in analyzing, development skills and an on-site experiential organizing, planning and controlling retail learning experience comprised of at least 120 operations, both large and small. Thesis tools available to the marketing manager and the development supports critical investigation to various types of decisions made in the develop explanations or solutions to academically promotional area. Emphasis is Schmidt algorithm, linear transformations and placed on developing the problem-solving and matrix representations, determinants, decision-making skills required of the sales eigenvalues, diagonalization, quadratic forms. Includes the teaching of mathematics in middle level characteristics of the markets and channels of education. This course provides students with an opportunity Divisibility, prime numbers, Fundamental Theorem to develop algebraic knowledge needed for further of Arithmetic, Diophantine equations, the algebra study in several fields such as engineering, of congruencies, number functions and other business, science, computer technology, and selected topics. The written contract An introduction to the basic algebraic structures; required by the College of Arts and Sciences groups, rings, integral domains, and fields; specifies the regulations governing independent homeomorphisms and isomorphisms. Fundamental theorem of arithmetic, modular Focus on disease states and the role of bacteri, arithmetic, Chinese remainder theorem, Mersenne viruses, fungi, rickettsiae and other pathogenic primes, perfect numbers, Euler-Fermat theorem, organisms. Written contract by Department is necessary prior Topics include host-parasite interactions, microbial to registration. These pathogens will be studied this course focuses on advanced principles of with respect to their morphology, cultivation, industrial microbiology/biotechnology. It will mechanisms of pathogenicity, laboratory expose student to the many applications of diagnosis, and epidemiology. Emphasizes the important fungi (yeasts and molds) important to interdependence of physiological and genetic microbiologists and environmental scientists. A qualitative Traces the development of mathematical ideas in study of the dynamics and general circulation of Western culture. This Two-course sequence covering: predicate course includes several integrated lab calculus and classical model theory; transfinite set investigations. Working in behavioral healthcare requires the Among the topics which might be included are: application of specific knowledge and skills. This Financial Mathematics, Linear and Exponential open enrollment course offers a practical Growth, Numbers and Number Systems, multidisciplinary look at service delivery. Students Elementary Number Theory, Voting Techniques, will examine their career and educational goals in Graph Theory, and the History of Mathematics. This course is designed to provide students with Topics will be selected from propositional logic, an understanding of the significant issues and set theory, relations and functions, equivalence trends in behavioral health delivery systems in relations, Boolean algebra, cardinality, and limits. Modules may begin Justice involvement, co-occurring disorders, with a historical perspective of the treatment of a funding streams, and evidence based practices specific population or a treatment strategy but will will be discussed. Observations and experiences will be collect and analyze data; identify and conduct discussed in biweekly class meetings. Students approaches for functional assessment; identify, are required to spend 120 hours (an average of 8 select, and implement functional interventions; hours per week for 15 weeks)in an agency. This course will provide an overview of research Students will conduct an independent research and clinical techniques related to the assessment, project in behavioral health (mental health and/or diagnosis and treatment of alcohol/drug use and substance abuse) under the guidance of a faculty the intersection with criminal behavior and the mentor. Course investigates legal and the necessary skills for successfully applying for ethical issues that influence the practice and helps and transitioning into a graduate training program students develop skills in ethical decision-making. Student must have a contract with real research contexts preparing students to an instructor. Emphasis on survey research, A hospital clinical course on the analysis of evaluation of data, and report writing. Request for enrollment must be leadership values & attributes by understanding made prior to registration in the form of a written Army rank, structure, & duties. Mobius geometry, elliptic and A 35 day internship at Fort Knox, Kentucky that hyperbolic geometry. Uses challenging scenarios homeomorphisms, connectedness, compactness, to develop self-awareness & critical thinking skills. Students will study techniques to ideate, basis of analog systems design and construction.

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Beneviste suggested in his research that the actions of biomolecules (histamine antibiotic used to treat cellulitis buy colchicine overnight delivery, ca#eine, nicotine, adrenaline, insulin, etc. It’s because the body can be treated just as e#ectively, perhaps more e#ectively with electromagnetic energy versus chemical supplements and drugs. Let’s now look at the "aws in genetic determinism and the germ theories of disease. Modern medicine preys on these outdated models, making you a victim to genes and germs. In light of new evidence, our understanding of biology based on Darwinian evolution and genetic determinism is dying fast. Like Newtonian physics, these diehard notions seem to persist as a collective belief throughout academia, medical and scienti$c communities. Although Darwinism has been around since 1859, it is still unable to answer many questions related to the evolution of species. Darwinism cannot explain the spike in new species that have appeared on earth some 530 million years ago. His theory states that new species gradually evolve via a spontaneous increase in the natural mutation of genes. What’s interesting for me as a physicist is that punctuated equilibrium mirrors quantum mechanics whereby electrons make “all or nothing” jumps from one energy level to another in atoms with no transition or intermediary steps. Another di&cult question for staunch Darwinists is to explain the sudden leap in intelligence that occurred with the Neanderthals around 35,000 years ago. Techniques like tool making, farming, agriculture, animal keeping, and many other practices allowed mankind to live a more comfortable existence. Perhaps the real problem with Darwin’s evolutionary theory is rooted in incorrect assumptions and theories about genetic mutations. Bruce Lipton Did you know that the human body has only 33% more genes than a roundworm? It is well known that there are 100,000+ unique proteins in the human body, and only 30,000 genes. Science now shows only a very small percentage of diseases are genetic (<5%, typically only where someone is born with a birth defect but even those have been known to heal! Meyers One of the hottest topics in health today is the emerging science of epigenetics, which is the study of the complex interactions of genes and the environment’s impact on human development. What the cutting-edge research of epigenetics demonstrates is how our thoughts and our environment have a powerful in"uence on our health and can actually activate chemical switches in the body that regulate gene expression. When we get issues running in the family such as cancer, doctors immediately look to a genealogy chart and look for cancer in the genes. Studies have now been done with adopted children who are brought into a family with a history of cancer. Harvard geneticist John Kearns did an amazing experiment that shows how powerful environmental factors can be in our genetics. Kearns did is he placed bacteria that could not digest milk sugar (lactose) into an environment that only contained lactose, so it was their only possible source for food. Genes are no longer deterministic; they are only potentials (again mirroring quantum $eld theory). We’ll see a new model in the next chapter about how your genes are not the controllers of your biology; they are merely antenna’s that take orders from your body’s energetic and intelligent holographic $eld via biophotons. According to this germ theory of disease, we are victims of germs and these bugs can strike anyone unknowingly. However germs do change in the body, your blood does move, and life is a process in motion, not a $xed state. Meyers We now know through the use of dark$eld microscopes, that microorganisms are pleomorphic (from latin pleo = “many”; morph = “form”) that they can often change forms. To understand how pleomorphism works, let’s look at the pioneering research of Antoine Bechamp and Claude Bernard. Bechamp discovered little organisms, which he called microzyma; they are seed bacteria that morph into bene$cial or malevolent organisms depending on the environment or terrain. Much like a stem cell can di#erentiate into all the organs and tissues in your body, a microzyma can morph into any type of bacteria, virus or parasite depending on the terrain; hence the term pleomorphism. It was Bechamp who discovered the pleomorphic nature of germs, but it was Claude Bernard who further developed the idea of the “biological terrain” and more clearly explained how pleomorphism works. A healthy terrain or environment in the body creates healthy and bene$cial organisms (like acidophilus for example); an unhealthy terrain creates pathogenic organisms. So here we can better appreciate Louis Pasteur’s deathbed quote, saying that the “the microbe (germ) is nothing. However, since the “germ” is so pro$table for modern medicine, it seems that the medical world has written o# Pasteur’s $nal statements as the madness of a dying man. Perhaps he was $nally getting clarity on the truth, or feeling remorse for his plagiarism of Antoine Bechamp. In Ethel Douglas’s excellent book, Pasteur Exposed, she describes Louis Pasteur as an ambitious self-promoter. She shows how Pasteur blatantly plagiarized Bechamp’s work in his research on the mysteries of fermentation and also the causes of disease in silkworms. So while Bechamp spent years proving that germs were only the consequence of disease and not the cause; Louis Pasteur’s theory ended up being much more simpli$ed (and tremendously more pro$table). If plants require healthy soil, then the cells in our body also need a healthy terrain or soil to thrive. Here are some commonly known parameters of a healthy "uid or terrain that we mentioned in chapter 1, but it bears repeating. In contrast to Louis Pasteur’s germ theory of disease, the “biological terrain” model is very empowering in that it no longer makes us a victim to germs (just as we saw we are no longer a victim to our genetics). Disease does not come from outside of us, but is developed within us, as is our health. Many of us don’t realize that although there were 50 million deaths during the black plague, there were over 200 million survivors. I just want to be clear that the road to natural healing is not a quick $x or magic pill and may be di&cult at $rst, because it involves a whole new way of living, eating, breathing, and reconnecting to the earth and its elements. Conclusion In this section the blatant errors of our modern healthcare system have been exposed as an outdated model resting on physics of the 17th century. We are not victims of determinism, our bodies are not physical machines or bags of chemical reactions; and our bodies cannot be understood by dissection and reductionism alone. As we’ll see in the next section, the human body is holographic, interconnected, and primarily energetic. We reside as consciousness empowered to create health and take control of our lives. You have to give your body the elements of health it needs while removing all sources of toxicity (including toxic people! Depending on where you are with your overall health and diet, it may take some willpower and coaching to get on the right path to better health, but it’s well worth the e#ort. Hopefully it makes sense to you that our current model of health and medicine should be based on current understandings in physics and not the physics of the 17th century! Next we are going to explore the current understandings in quantum $eld theory and the holographic model of the universe as applied to the human body with recent breakthroughs in biophysics and quantum biology. Likewise, there appears to be one fundamental force that heals; although the myriad schools of medicine all have their favorite ways of cajoling it into action. Robert Becker We’ve seen modern physics turn Newton’s universe upside down, we’ve revealed the deterministic, solid, and mechanical universe as an outdated and incorrect model of reality. Quantum $eld theory shows the primacy of energy and information $elds in the universe, the interconnectedness of all things, and the reign of consciousness, choice and free will. We are certainly not biological machines that have learned to think, with consciousness only being a byproduct. Let’s propose a new model of the human body that’s in line with quantum $eld theory, the holographic universe, recent discoveries in biophysics and holistic integrative medicine. In this chapter we’ll get a better understanding of what we’ll call the bio-energetic holographic body. It consists of measurable electric $elds, magnetic $elds and even detectable photons of light (called biophotons which we’ll explain soon). We source energy from the food we eat, the water we drink, the sunlight we are exposed to , the air we breath, and from the surrounding geomagnetic and Schumann frequencies of the earth. We are an open system deeply connected to the planet we live on, capable of reversing entropy while creating order and life. In this chapter we’ll see that the human body is not only physically made from the building blocks of earth, food, water, air, and oxygen.

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This was set in motion ten thousand years ago when the opioids of annual grass seeds clicked into the pleasure centers of the human brain antibiotics for uti nitrofurantoin cheap 0.5 mg colchicine fast delivery, and ever since we have been invincible as a cohort, or so we’ve convinced 258 The Vegetarian Myth ourselves. Our very creation myth tells us to dominate, to conquer, to go forth and multiply. No hunter-gatherer is told by god to willfully overshoot the land’s carrying capacity, and no marginally rational person would listen to such a god. Tese people had no way to understand how manu factured goods came into existence, and a whole range of religious practices sprang up almost overnight to try to propitiate the spirits to bring more. But Cargoist faiths rest upon the quicksand of fundamen tal ignorance lubricated by superfcial knowledge,”17 writes Richard Heinberg. We’ve taken the energy that was stored—the wood, coal, oil, and gas—and used it to extract nonreplicable re sources, like soil and metal, in the service of expanding our species and at the cost of most others. It’s the psychology, which, with equally simple addition, is one part ignorance, one part entitlement, and one part denial. If we want peace, democracy, and human rights, we must work to create the ecological con ditions essential for those things to exist: i. Social liberals and progressives who fail to talk openly about population and resources issues and to propose work able solutions are merely helping to create their own worst nightmare. Instead, industrial civilizations are going to clutch entitlement with one hand and denial with the other. Please, show me the evidence, because I am not looking forward to the next ffty years. Without an unassailable commitment to justice and democracy, the contraction of both population and consumption promises to be heartless as well as relentless. We will not get from here—a planet being sundered before our eyes—to anywhere but hell without a complete revisioning of our way of life. Tose of us in rich nations have to accept that we can’t do whatever we want, we can’t have whatever we want, we can’t take whatever we want. The planet has limits: ultimately only so much sunlight falls each day, and only so much of any biotic community can go to feed our species without damage to its integrity. Agriculture destroys the boundaries of living communities like rivers, prairies, forests, soil. Globalization is a contemptuous disregard for the bound aries of local cultures and economies. Once that’s in place, emotionally, intel lectually, morally, it can extend itself until it encapsulates the whole culture and every relationship in it. In the here and now, the system that we live under is a seam less excuse for hierarchy. I mean a psychology based on entitlement, emotional numbness, and a dichotomy of self and other. Masculinity is required in any militarized culture, because those are the psychological traits necessary in soldiers. One can only kill on command if the human impulse to care for one another has been subdued or eradicated. The constant need to turn others into Others is one result: the re jected, “soft” parts of the self are projected outward so they can be destroyed. The Viet Nam vets who sufered the worst post-traumatic stress weren’t the ones who survived atrocities, but those who com mitted atrocities. But once the psychological process is in place, the category “female” can easily be flled in by any group that a hierarchical society needs dominated or eradicated. A personality with an endless drive to prove itself against another, any other, combined with the entitlement that power brings creates a violation imperative. This means that men in patriarchy feel mascu line, like “real men,” only when they break boundaries. It is a simple imperative, repeated over and over to men, starting when we are small boys. The phrase is usually con nected to one man’s demands that another man be “stronger,” which is traditionally understood as the ability to suppress emotional reactions and channel that energy into controlling situations and establishing dominance. When we become men—when we accept the idea that there is something called masculinity to which we should conform—we exchange those aspects of ourselves that make life worth living for an endless struggle for power that, in the end, is illusory and destructive not only to ourselves but to others. Psychological profles of rapists have found “that they are ‘ordinary’ and ‘normal’ men who sexually as sault women in order to assert power and control over them. When men are stripped, put in postures of submission, and then photographed, the power is obvious, the oppres sion clear, and the world is outraged. Meanwhile, women and girls are bought, sold, raped, and displayed as a matter of course, and the world can’t get enough. But we will also never stop racism, and that insight is one that the Left is refusing to grapple with. It’s possible to have a culture that lives within its landbase with out respecting human rights, as discussed earlier. But I believe that the dominant culture will never untangle misogyny, racism, and mili tarism from anthropocentrism, even if that were a morally defensible project. Alongside agriculture, this culture also has to abandon the project of masculinity. As Derrick Jensen says: Another way to talk about people not caring what happens to the world is to talk about rape and child abuse. If normal people within this culture are raping and beating even those they purport to love, what chance is there that they will not destroy the salmon, the forests, the oceans, the earth? For instance, the leading religions of the planet are all variations on the theme of domination, and they’ve had a few thousand years to prove that yes, they really mean it. The planet is in shreds; the indigenous displaced; slavery a way of life only temporarily veiled by distance and fossil fuel; male supremacy is saturated with sexual sadism; all of it a dictate from the big boy himself. But at least admit that both beauty and justice have been a net loss under their reign. But we could rationally To Save the World 263 choose a spiritual base on which to build the culture we need. Writes Stephen Harrod Buhner: The most “primitive” peoples, living deeply embedded in their “environment,” all practice ceremonies and rituals that afrm and nourish the interconnectedness, the interbeing of the human tribe with the rest of the Earth family. This would indicate that the propensity to lose this connection is not just a modern phenomenon but is rooted deep within our human ity. We moderns, however, in our arrogance and “enlighten ment,” have ridiculed such practices, attempted to assign them to the realm of superstition. Having ridiculed such rituals, we did not participate in them; not participating in them, we lost our place in the world. Our spiritual practices, whether ancient or new, must provide for recognition of the sentience of those beings and an attitude of abiding humility and awe for our living planet. Perhaps there are beliefs and practices of our varied cultures that can be brought along, anything to do with political resistance, compas sion, justice, resilience, tolerance. But the core of dominator religions will always remain authoritarian, fundamentalist, hierarchical, and biocidal. And these kinds of personal choices, particularly when they involve buying something, have been embraced by the main stream environmental movement as solutions. And this reifying of individual action cuts right to the heart of the diver gence between liberals and radicals. The crucible of social reality is the realm of ideas, in concepts, language, attitudes. Radicals see society as composed of actual institu tions—economic, political, cultural—which wield power, including the power to use violence. Liberal ism is individualist, locating the basic organization of society in the individual. Hence, liberal strategies for political change are almost exclusively individual actions. For radicals, the basic social unit is a class or group, whether that’s racial class, sex caste, economic class, or other grouping. In contrast, radicals believe that identifying your interests with others who are dispossessed—and developing loyalty to your people—is the frst, crucial step in building a liberation move ment. Liberals essentially think that oppression is a mistake, a misun derstanding, and changing people’s minds is the way to change the world. Radicals understand oppression as a set of interlock ing institutions, and, one way or another, the strategy for liberation involves direct confrontation with power to take those institutions apart. The Left in this country has embraced liberalism to the point of becoming completely unhitched from any notion of actually being efective.

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Paclitaxel and carboplatin (preferred) Once every 3 weeks 3–6 cycles for endometrioid tumors Carboplatin and liposomal doxorubicin Once every 4 weeks 6 cycles for high-grade serous tumors Docetaxel and carboplatin Once every 3 weeks Supportive care Next steps Supportive care is treatment given to relieve the See When treatment is over on page 50 to learn symptoms of cancer or the side efects of cancer about monitoring for the return of ovarian cancer treatment antibiotic resistance argument best purchase colchicine. It aims to improve quality of life and relieve and what to do if ovarian cancer comes back. First steps Surgery the clinical (pre-surgery) stage is based on the In women who are willing and able to have it, results of initial testing you had to diagnose ovarian surgery is the recommended frst treatment for cancer. These tests are explained in more detail in the decided by a gynecologic oncologist prior to Testing for ovarian cancer chapter. The omentum and nearby lymph Review of your family history nodes will also be removed. This the results of these tests provide important is called debulking surgery or cytoreductive information needed to plan treatment. It aims to remove all visible disease in uses the results of these initial tests to: your body. Next steps the clinical stage provides a "best guess" of Treatment after surgery for stages 2–4 ovarian how far the cancer has spread. Having surgery frst may not be an option for some women based on the size and location of the tumor. A pelvic exam may also be done at the After surgery, platinum-based chemotherapy is same time. One of Imaging tests (as needed) the regimens (paclitaxel and cisplatin) also uses intraperitoneal chemotherapy, in which medicine Completion surgery is put directly in the abdomen. Testing during chemotherapy However, surgery may be performed after 4–6 cycles During treatment, your doctor should monitor how based on the clinical judgment of the gynecologic well the chemotherapy is working and assess for side oncologist. Stages 2, 3, and 4 – Chemotherapy after surgery Medicines included in regimen How often and for how long? Bevacizumab is added for cycles 2–6 and may be continued by itself for up to 22 cycles. Treatment after surgery and chemotherapy depends Stable disease is cancer that didn’t get better or in part on how well chemotherapy worked, and worse during treatment. If you were treated with a chemotherapy regimen that An outcome or improvement related to treatment is included bevacizumab (Avastin), see Guide 6. The four main possible the cancer got better or stayed the same, you have treatment responses are described next. Options after chemotherapy with bevacizumab (Avastin) You are in complete or partial remission Option 1: Maintenance therapy with bevacizumab (Avastin ). Begin monitoring for the return of Option 2: Maintenance therapy with olaparib (Lynparza ) cancer. Options after chemotherapy without bevacizumab (Avastin) You are in complete remission Option 1: Join a clinical trial. Begin monitoring for the return of Option 2: Watch-and-wait (no treatment) cancer. See When treatment is Option 3: Maintenance therapy with olaparib (Lynparza ) (for Ü over on page 50. Recurrence therapy can include chemotherapy, targeted therapy, immunotherapy, and hormone therapy medicines. Options for recurrence therapy include chemotherapy, targeted therapy, immunotherapy, and hormone therapy. There are ways to treat many symptoms, so tell your treatment team about any that you have. At your cancer center, cancer navigators, social workers, and other experts can help. They will include information in the treatment plan to help you manage your fnances and medical costs. Supportive care Supportive care is treatment given to relieve the symptoms of cancer or the side efects of cancer treatment. Next steps See When treatment is over on page 50 to learn about monitoring for the return of ovarian cancer and what to do if ovarian cancer comes back. If the cancer responds to chemotherapy, activities, or who have other serious health conditions. After surgery, you may have more chemotherapy followed Chemotherapy frst by maintenance therapy. It is Begin treatment for persistent disease important that a gynecologic oncologist is involved If the cancer got worse (progressed), begin in this assessment and treatment decision. See page 32 for the goal of surgery is to remove as much of the more information on this type of cancer as possible, as well as the ovaries, fallopian chemotherapy. After surgery, you will likely have more chemotherapy followed by maintenance therapy. Treatment options for persistent ovarian cancer include: Join a clinical trial that is testing newer medicines. Supportive care is treatment given to relieve the symptoms of cancer or side efects of cancer treatment. It may also be given along with recurrence treatment or treatment within a clinical trial. Many of efects, staying connected with your the tests are only done on an as-needed basis. This primary care doctor, and living a healthy means that your doctor will decide whether you need lifestyle. Genetic counseling is Monitoring for the return of a discussion with a health expert about the risk cancer for a disease caused by changes in genes. This is recommended because some health problems, Staying alert for the return of cancer is just as including ovarian cancer, can run in families. If ovarian cancer does come important to know if you have any genetic mutations back, catching it early will give you the best chance because you may be a candidate for certain newer of beating it. When treatment is over, you should continue to see See Guide 8 for the recommended follow-up your cancer doctor on a regular basis. There are a few steps you can take that will follow-up care includes managing side efects, staying make a big diference in your overall health, including: connected with your primary care doctor, and living a healthy lifestyle. Your primary care doctor should tell you what cancer Cancer survivorship begins on the day you learn you screening tests you should have based on your have ovarian cancer. In addition, your treatment plan should include a schedule of follow-up cancer tests, treatment of long Maintaining a healthy body weight by exercising term side efects, and care of your general health. Your primary care doctor Eating a healthy diet with lots of plant-based After fnishing cancer treatment, your primary care foods and drinking little to no alcohol. Your cancer doctor and primary doctor should work together If you are a smoker, quit! The have any symptoms and no cancer can be seen tests you may have are described next. The type and inhibitors (eg, olaparib, rucaparib, and niraparib) may extent of surgery depends on how far the cancer has be particularly efective at treating ovarian cancer in spread. More information on tumor marker tests can be found You had chemotherapy in Part 2, Testing for ovarian cancer. If you were in complete remission after platinum based chemotherapy and cancer returned, the Treatment of platinum-sensitive and platinum treatment options depend on: resistant ovarian cancer that returns after treatment is explained on the next pages. Cancer that returns more than 6 months after fnishing platinum-based chemotherapy is called platinum-sensitive. The options for treating platinum-sensitive disease depend If you were in complete remission after platinum on whether you have a biochemical, clinical, or based chemotherapy and cancer returned more radiographic relapse. This Enroll in a clinical trial that is testing newer is called cytoreductive surgery. Guide 9 Start recurrence treatment with platinum-based presents the recurrence therapies recommended chemotherapy. Guide 10 for next steps based on how well See Guide 9 for the platinum-based recurrence treatment works. Option 3: Watch-and-wait (no treatment) Option 1: Enroll in a clinical trial that is testing newer medicines.

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And if one of the chief purposes of alien visitations is admonitions about global dangers antibiotic 33 x buy colchicine 0.5 mg without prescription, why tell it only to a few people whose accounts are suspect anyway? He published a book it caused quite a sensation, I recall in which he described how in the desert nearby he had encountered nice looking aliens with long blond hair and, if I remember correctly, white robes who warned Adamski about the dangers of nuclear war. The first alien abduction story in the modern genre was that of Betty and Barney Hill, a New Hampshire couple, she a social worker and he a Post Office employee. If Dr Simon had pronounced their account authentic, the sales of the book might have gone through the roof and his own financial reward been considerably augmented. In 1894 the International Census of Waking Hallucinations was published in London. More rarely, people sense a haunting aroma, or hear music, or receive a revelation that arrives independent of the senses. Hallucinations may be a neglected low door in the wall to a scientific understanding of the sacred. Of course they called to me often during my life with them to do a chore, to remind me of a responsibility, to come to dinner, to engage in conversation, to hear about an event of the day. After some days, the control group is a little groggy, but the experimental group the ones who are prevented from dreaming is hallucinating in daytime. Whatever their neurological and molecular antecedents, hallu cinations feel real. Psychedelic-induced religious experiences were a hallmark of the western youth culture of the 1960s. He is so absorbed by the view of the outside world that he fails to visualize the interior of the room at all. Night falls, but the fire still burns brightly in the fireplace and illuminates the room. This illusion becomes dimmer as the fire dies down, and, finally, when it is dark both outside and within, nothing more is seen. The dream is an experience during which, for a few minutes, the individual has some awareness of the stream of data being processed. Hallucinations in the waking state also would involve the same phenomenon, produced by a somewhat different set of psychological or physiological circumstances. It appears that all human behaviour and experience (normal as well as abnormal) is well attended by illusory and hallucina tory phenomena. However, none of this makes hallucinations part of an external rather than an internal reality. Five to ten per cent of us are extremely suggestible, able to move at a command into a deep hypnotic trance. This amounts to over 50 million schizophrenics on the planet, more than the population of, say, England. Nightmares, because of their vividness and compelling effective intensity, are particularly difficult for the child to judge realistically. When a child tells a fabulous story a witch was grimacing in the darkened room; a tiger is lurking under the bed; the vase was 102 Hallucinations broken by a multi-coloured bird that flew in the window and not because, contrary to family rules, a football was being kicked inside the house is he or she consciously lying? A few parents may be unclear about the distinction between reality and fantasy themselves, or may even seriously enter into the fantasy. Are we to imagine two different groups of children, one that sees imaginary earthly beings and the other that sees genuine extraterrestrials? It makes good evolutionary sense for children to have fantasies of scary monsters. It is telling that alien abductions occur mainly on falling asleep or when waking up, or on long automobile drives where there is a well-known danger of falling into some autohypnotic reverie. Might these stories have something to do with sleep and, as Benjamin Simon proposed for the Hills, a kind of dream? Baker argues that these common sleep disturbances are behind many if not most of the alien abduction accounts. We know from early work of the Canadian neurophysiologist Wilder Penfield that electrical stimulation of certain regions of the brain elicits full-blown hallucinations. A continuum of spontaneous temporal lobe stimulation seems to stretch from people with serious epilepsy to the most average among us. As the possibility of extraterrestrial life began to be widely popularized especially around the turn of the last century by Percival Lowell with his Martian canals people began to report contact with aliens, mainly Martians. Martians are innocent of science, philosophy and souls, she was told, but have advanced technology. And after the surface of Venus was found to be hot enough to melt lead, there were no more visiting Venusians. Thomas Hobbes, Leviathan (1651) he gods watch over us and guide our destinies, many human Tcultures teach; other entities, more malevolent, are responsi ble for the existence of evil. Both classes of beings, whether considered natural or supernatural, real or imaginary, serve human needs. So in an age when traditional religions have been under withering fire from science, is it not natural to wrap up the old gods and demons in scientific raiment and call them aliens? Socrates described his philosophical inspiration as the work of a personal, benign demon. But all later Platonists, including the Neo-Platonists who powerfully influenced Christian philosophy, held that some demons were good and others evil. They taught that all of pagan religion consisted of the worship of demons and men, both misconstrued as gods. In the Middle Ages, as in classical antiquity, nearly everyone believed such stories. Mare, despite its Latin meaning, is the Old English word for incubus, and nightmare meant originally the demon that sits on the chests of sleepers, tormenting them with dreams. Many leading Protestants of the following centuries, their differ ences with the Catholic Church notwithstanding, adopted nearly identical views. The more who, under torture, confessed to witchcraft, the harder it was to maintain that the whole business was mere fantasy. In a credulous age, the most fantastic testi mony was soberly accepted that tens of thousands of witches had gathered for a Sabbath in public squares in France, or that 12,000 of them darkened the skies as they flew to Newfoundland. Innocent himself died in 1492, following unsuccessful attempts to keep him alive by transfusion (which resulted in the deaths of three boys) and by suckling at the breast of a nursing mother. To take an example almost at random, in 1994, for a fee, a group of postal inspectors from 114 the Demon-Haunted World In the witch trials, mitigating evidence or defence witnesses were inadmissible. There were strong erotic and misogynistic elements, as might be expected in a sexually repressed, male-dominated society with inquisitors drawn from the class of nominally celibate priests. The confessions of witchcraft could not be based on hallucinations, say, or attempts to satisfy the inquisitors and stop the torture. Those who raise such possibilities are thus attacking the Church and ipso facto committing a mortal sin. Witchcraft of course was not the only offence that merited torture and burning at the stake. In the sixteenth century the scholar William Tyndale had the temerity to contemplate translating the New Testament into English. When Tyndale tried to 116 the Demon-Haunted World publish his translation, he was hounded and pursued all over Europe. Eventually he was captured, garrotted, and then, for good measure, burned at the stake. His copies of the New Testament (which a century later became the basis of the exquisite King James translation) were then hunted down house-to-house by armed posses Christians piously defending Christianity by preventing other Christians from knowing the words of Christ. In the last judicial execution of witches in England, a woman and her nine-year-old daughter were hanged. The products of these demon-mediated unions are also, when they grow up, visited by demons. And these creatures, we recall, are well known to fly; indeed they inhabit the upper air. But most of the central elements of the alien abduction account are present, including sexually obsessive non-humans who live in the sky, walk through walls, communicate telepathically, and perform breeding experi ments on the human species. Is there any real alternative besides a shared delusion based on common brain wiring and chemistry? Parallels to incubi include Arabian djinn, Greek satyrs, Hindu bhuts, Samoan hotua poro, Celtic dusii and many others.

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Migration also takes place as workers seek employment in rubber plantations ardis virus discount colchicine 0.5mg free shipping, and gold and jade mines. Internal migration is increasingly an issue, requiring better urban health-service planning. Similar exposures to similar risks also exist among migrant workers working across the borders in neighbouring countries. At least 3 million people from Myanmar migrated to neighbouring countries for economic, social and political reasons. Root causes like poverty and conflict will need to be considered for dealing flexibly with the issue of migration to neighbouring countries. Bago, Kayin, Mon, Sagaing and Yangon are well-off regions/ states, with poverty incidences below 18%. United States sanctions included a ban on all imports from Myanmar, a ban on exports of financial services by United States citizens to Myanmar, and an asset freeze on certain named institutions of Myanmar. United States sanctions were said to be the most significant foreign policy intervention in the domestic affairs of Myanmar, and the main objective of the policy was isolation with the aim to force political reform; however, there was a great impact on ordinary citizens. Myanmar’s closest neighbouring countries, which used to be importing countries, have become net exporters as a result of the sanctions. The 2003 United States ban on Myanmar imports had a deep impact on employment, especially in the garment industry, resulting in an estimated loss of 50 000–60 000 jobs (Andréasson, 2008). Sanctions have multiple effects on health as will be shown in subsequent chapters. With this caveat, the economic indicators of Myanmar for the years 2007–2011 are as shown in Table 1. Improving government revenues is crucial for funding public expenditures on education and health. The rule by democratic government, under the Constitution of 1947, lasted for only about one and a half decades. The 8888 Nationwide Popular Pro-Democracy Protests, also known as the People Power Uprising, involved a series of marches, demonstrations, protests and riots in the Socialist Republic of the Union of Burma. The military staged a coup on 18 September 1988 and the country again came under military rule, with the total absence of a constitution. As of February 2011, there are elected chairpersons and vice-chairpersons of the upper and lower houses of parliament. The region and state-level assemblies, as well as a president and vice presidents elected by the parliament also came into existence. Opposition and ethnic parties hold the remaining the seats in the upper and lower houses. When President U Thein Sein publicly called for national reconciliation, good governance and anticorruption in his inaugural address in March 2011, observers were surprised by the new political message from Nay Pyi Taw. These are a few examples showing that significant change is being planned for the near future in Myanmar. These will be the baseline for making comparisons with new data to be reported in 2015 and later. Social-movement organizations such as students’, workers’ and peasants’ unions were not allowed during the military rule. However, many small community groups working on humanitarian issues have emerged, especially in the wake of Cycline Nargis in 2008. During the new government’s rule, formation of civil society organizations has been permitted and media freedom has been granted. Although these organizations are not formally involved in health policy-making in Myanmar, a few civil society organizations have started acting as advocates for policy changes in other fields. For example, many of the environment-related civil society organizations actively participated in successfully advocating the new civilian government in 2011 to stop construction of Myit-Sone Dam on the upper Ayeyawady River in Kachin State. It is a big challenge for the new government to achieve a successful political transition that can ensure macroeconomic stability and sustained improvement in the lives of ordinary people. It is also a challenge for the government to enact successful economic reform while maintaining political stability and a continued shift away from the authoritarian past. In Myanmar, life expectancy at birth increased for both males and females between 1980 and 2011 (Table 1. Improvement of adult mortality rate among females outpaced that among males between 1999 and 2010. There was a sharp increase in deaths due to injuries, contributed mainly by “unintentional injuries” other than road traffic accidents, poisonings, falls, fires and drowning in 2008 as a result of deaths inflicted by Cyclone Nargis. A total of 7429 adults participated in the survey, with an overall response rate of 99. In general, nearly 17% of the respondents were current smokers; and the current smoking prevalence rate among males was nearly six times that among females. In 2010, the price of a popular cigarette brand in Myanmar was said to be 500 kyat for a packet of 20 cigarettes, and was the cheapest among all the brands available in Myanmar (Asian Pacific Pediatric Association, 2012). This relatively low price facilitates consumption by youths and lower economic groups. Nearly 31% of the male respondents and only 1% of the female respondents were current alcohol drinkers, showing significant abstainer prevalence among women. Despite reductions in recent years, malaria also remains a leading cause of mortality and morbidity, responsible for 8. Malaria is re-emerging due to climatic and ecological changes, migration and natural-extraction industries, artemisinin resistance, and changes in behaviour of vectors. In Myanmar, 71% of the population lives in malaria risk areas (29% in high-risk areas, 24% in moderate-risk areas, and 18% in low-risk areas). Myanmar is committed to comply with the Artemisinin Combination Therapy policies including through the Global Fund programmes. However, artemisinin monotherapy is still in use in some private-sector situations. This situation indicates the need to further investigate how “safe” the drinking water is and how “sanitary” the sanitary facilities that people accessed are, as well as food safety. For example, the survey found that 68% of households had access to improved water sources. However, at the point of consumption, the water was probably being contaminated because only 17% of households had a safe method to extract drinking water from its storage containers. The study also showed that 83% 22 of households reported that they had a latrine at home. Among these households, about 89% could be classified as having improved latrines. In other words, among all households, the proportion of households having improved sanitation facilities was 75. In big populous cities like Yangon and Mandalay, food and beverages prepared and sold by vendors or hawkers on the streets are popular places for people to have their meals. These also are potential sources for transmission of water-borne diseases like gastroenteritis where hygienic practices are not observed by the food handlers. In Yangon, there are said to be over 50 000 such food stalls in six downtown townships11 (Aye Min Thein, Yangon City Development Committee, personal communication, 2013). Unhygienic practices were observed among the majority of the food handlers, such as not handling food with gloves, not covering food properly to protect it from flies or dust, and not using sufficient water for washing plates. This is an indication of the seriousness of unhygienic conditions prevailing in the roadside food stalls. Diarrhoea is a common childhood problem in Myanmar and Rotavirus is said to be the single most important aetiological agent of diarrhoea. One study showed that diarrhoea was the cause of 18% of all hospitalizations of children under five years of age, and Rotavirus was identified in 53% of the stool specimens tested (Kyaw-Moe et al. Further analysis is needed to validate the drop in coverage rates and determine its causes. However, there are discrepancies between what is estimated by the World Bank and what was found in surveys conducted in Myanmar. For example, according to the year book, the figures for 2000, 2005 and 2010 are 48. This is probably due to under-reporting because of the inherent weaknesses in the vital registration system of Myanmar.