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These views antibiotics drugs in class order azromax 250 mg mastercard, in turn bacteria synonym order 250 mg azromax fast delivery, can differ from those of the general public or sectors with particular ownership rights or concerns antibiotic x 14547a buy azromax 250 mg visa. The significance of cultural heritage places in living communities (irrespective of the cultural context) is often not related primarily to archaeological or informational values and may be in direct conflict with the opinions of the "expert antibiotic resistance facts order azromax online pills. The Western view of heritage value is dominant in the international heritage management discourse and is reflected in doctrines such as the Operational Guidelines to Shrine at the Bayon, 2007. The ongoing use of ancient temples and statues forms part of a continuing cultural and spiritual tradition at Angkor, Cambodia. This systemic dominance has been exacerbated by the professionalization of archaeology and by the incorporation of expert (rather than community) values in legal and administrative cultural heritage management systems. There are particularly sensitive cultural issues surrounding the excavation and conservation of sites containing human remains. The challenge is to find the correct balance between the scientific and humanist values attributed to such sites and the remains they contain. The excavation and study of human remains can provoke emotionally charged, disparate, and strident positions with no middle ground, even among people from the same cultural group. However, there are success stories, and these typically involve acknowledgment of the perspective of different stakeholders and their active participation in management decisions. The selected readings provide examples of the conservation and management of sites with different values, the conflicts that may arise with fabric-focused conservation practice, and inspiring examples of techniques and approaches for resolving the conflict inherent in diverse understandings of the values of archaeological sites. Lukis of Wath and other so-called archaeologists, at Rudstone near Bridlington, on the estate of Sir Henry Boynton. It puzzles me to think how men of right feeling, of any religion, of disciplined will, can possibly allow these teachers of religion to practice so irreligious and sacrilegious an act. Here we see men in holy orders, who, as such, are supposed to teach the doctrine of the Resurrection, having plenty of leisure, act as recklessly as if they believe it not. After 30 years of love and pursuit of antiquities I must, I fear, no longer venture to esteem myself to be an archaeologist, if this is archaeology and if these infatuated men are archaeologists. I have the honour to be, Sir, your obedient servant, Alfred Vaughan Walters Winchester -The Times (12 November 1870) Sir,-all archaeologists will sympathise with the spirit in which Mr. Walters might have given a brother clergyman credit for treating the relics of the dead with respect; for my own part I care little whether 2000 years from hence my bones are crushed by the plough or dug up by some future Greenwell and placed in a Museum-though, as a matter of choice, I should prefer the latter. Walters supposes that the condition of the ancient Britons who were buried centuries ago in the Yorkshire tumuli can be influenced by the zeal of archaeologists or the use of a steam plough. It is a familiar story, but worth repeating, that as the barge made its way down the river the men of the neighbouring villages fired guns as for a funeral, while the women followed along the bank, tearing their hair, and uttering that shrill quavering cry of mourning for the dead, a cry that has doubtless come right down from the days of the Pharaohs themselves. Mace, the Tomb of Tutankhamen (1923) It would appear that this document [the Venice Charter] was written in the context of the western approach to this matter, and in fact runs counter to the very basic philosophical tenet of the Chinese perspective of the world. If a certain validity is ascribed to the Chinese approach-and we would argue that this cannot be denied-then the Venice Charter should not be looked upon as the universal document, applicable across the human experience, but rather as one which has been written to address western experience only. These sites have often been found or elucidated by archaeological research, and have great value because archaeologists can use survey and excavation to extract important results. But the actual value is not archaeological: archaeology is just the method by which we access the informational value and find out more about the cultural value. It is these broader cultural values (of which informational or research value is only one) it seemed to me, as a wide-eyed visitor to the Old World, to be the most important overarching value of these sites. This includes their value as a source of pride to the people of the region and as an educational tool for them and other visitors. It includes their value as historical markers, and their important symbolic richness. So I would be inclined to call them "heritage" sites rather than archaeological sites, and to manage them for the conservation of all these values. With the development of international, though largely European-based, principles and doctrinal charters, conservation practices focused on the preservation of material remains and the effects of time on the physical fabric. In recent years, this approach is being challenged in its preference for the monumental and its neglect of the associated emic values and intangible qualities accompanying many traditional sites. Yet by viewing all history as continuous change, conservation can seek ways to make the past relevant through both critical distance and empathetic engagement. For many other groups, material culture provides physical resources, linked to history and the past, which are drawn on in an active process to create, recreate, or maintain cultural and social identities. This situation then has the potential to increase conflict and tensions between archaeologists and indigenous or other interest groups with a cultural and historical stake in the past. Smith, "Archaeological Significance and the Governance of Identity in Cultural Heritage Management" (2005) Much of the role of archaeology worldwide and its relationship with history and traditions hinges on perceptions of the value and role of material culture.
For example antibiotic resistance graph buy generic azromax 500 mg, a particular study may focus on how mass communication campaigns change social norms associated with secondhand smoke among individuals antibiotics for sinus infection how long does it take to work azromax 100mg on-line. The study may discover subsequent changes virus protection for mac cheap azromax american express, not only in social norms among individuals antibiotics for resistant sinus infection purchase azromax amex, but also in social policies, such as restriction of smoking in public places. In other words, communications focused on changes in social norms around tobacco among individuals may either directly or indirectly contribute to social policies on restricting tobacco use in public places. From this example, it could be argued that organizing tobacco-related communications research n the relevance of this history for the study of media effects in tobacco-related communications is important given the driving concern about the impact of tobaccorelated content in media. This history includes media such as advertising and movies; the impact on the public in general and children in particular; and the use of mass media to reduce, if not eliminate, tobacco use among the American public through education and policy advocacy campaigns. The context of tobacco-related communications research is critical to understanding this work. Typical of earlier stages in the history of communications research, both the tobacco industry and the government took an abiding interest in examining the impact of communications on tobacco use, though for different reasons. Each new finding was subject to different interpretation-social action and policymaking thus generating fodder for continuing controversy. The Role of the Media along levels of analysis could provide a more holistic understanding of the impact of communications on tobacco use and control for individuals, groups, institutions, and the broader society. Similarly, tobacco companies may promote the idea that any restrictions on smoking in public are an infringement on individual rights and potentially reduce support for public policies to regulate smoking. In the interpretation of research, findings seldom divide neatly and exclusively along discrete levels. In the sections that follow, research in media studies is discussed along the three levels of analysis/frameworks: individual, social network/organizational,* and societal. Individual-Level Analyses and Tobacco-Related Communications Understanding the effects of communications on individuals has been the most common and dominant level of analysis in media studies. This work had considerable influence on understanding the mechanisms that could explain the effects of media in promoting * or preventing tobacco use through commercial advertising or public health communication campaigns or tobaccorelated content in mass media. Similarly, most mass media interventions in tobacco control also focused on changing the cognitions, affect, and behaviors of individuals (chapters 11 and 12). Early persuasion models that focused on individual effects suggested that advertisements brought about behavior changes through a hierarchy or chain of contingent conditions. These models assume that a break in the chain of contingency or a reduced outcome at any of the steps will lead to little or no response to the advertising. Many of Another approach is to examine the social-network and organizational levels separately. Theoretical Underpinnings of Media Research these models also assume that attitudes and behaviors in response to persuasive messages are developed consciously and rationally,18 though it is equally conceivable that the processes that McGuire and others postulate operate at an automatic or unconscious level. Expectancy-Value Theories of Attitude and Behavior Change Like these early models, expectancy-value models implicitly assume that individuals have control over their choices and that they base their choices on information available to them. The expectancy-value models include two components as predictors of attitudes, or in the case of decision models, behavioral choice. The two components are an expectancy-the likelihood that the decision is associated with a particular outcome-and a value, that is, the positive or negative valence associated with that outcome. In health behavior research, a number of these expectancy-value models (and variants) have been popular. At the same time, a persuasive message should try to reduce the perceived benefits of continued smoking as well as the barriers to changing the behavior, perhaps by increasing necessary skills to quit or perceived self-efficacy that quitting is possible and beneficial. Attitudes and norms are, in turn, influenced by underlying beliefs driving those attitudes and norms. For different groups of people, different consequences of performing the behavior may be salient and may be held with different belief strengths. Similarly, health communications may increase the salience and the strength of a belief Monograph 19. The increase in negative attitudes is linked to decreased progression toward intention to smoke and actual smoking behavior. They proposed the Integrative Model of Behavior (Integrative Model), arguing that there are only a finite number of determinants that lead to behavior change. The Integrative Model incorporates the construct of selfefficacy, originally proposed by Bandura in his social cognitive theory. Intentions, in turn, are determined by attitudes toward the behavior, the perceived norms concerning the behavior, and self-efficacy in performing the behavior. Attitudes, perceived norms, and selfefficacy are functions of underlying beliefs associated with each of them.
The duration of the evaluation is determined by the referral question(s)/needs [i treatment for dogs with diarrhea imodium buy discount azromax on line. There is a trade-off in terms of the depth and breadth of an evaluation and the time it takes to administer antibiotic 100 mg 100mg azromax with visa, score and analyze data antibiotic 1338 purchase azromax discount. Longer evaluations allow for more in-depth study of neuropsychological functions holistic antibiotics for sinus infection discount 100 mg azromax, while shorter evaluations limit the detail in which some neuropsychological functions can be assessed. The neuropsychological evaluation is often completed in one day, but in some cases, may be completed over two or more days. Breaks are usually anticipated during longer neuropsychological assessment batteries. Scott neuropsychological evaluation is a procedure that is covered (paid for) by insurance companies. Some examples of commonly used neuropsychological tests for each domain are provided in Table 1. There are three issues: (1) specify the referral question(s) you would like answered (see above); (2) providing any previous medical records of the patient documenting or 22 M. For the clinical neuropsychologist, the referral will be received, and the patient you referred may receive an informational letter, history form, or other information as provided by any other specialty physician. Once you make a referral, you will receive a neuropsychological evaluation report, to which we now turn. While there is considerable variability, the neuropsychological report will often include the typical information of most consultations. The more unique aspect of the neuropsychological evaluation is typically the inclusion of a list of either scores (may be standard or percentiles, sometimes raw scores) or description of neuropsychological test scores. Test scores are based on a normative comparison standard, with the 50th percentile being the population average. Multiple different normative groups have been developed, such that normative comparisons are often provided for individuals of similar age, level of education, and in some cases, gender and ethnicity. Then these are adjusted for individual level comparisons, and evaluation of performances are provided in terms of descriptors (low average, average, high average, etc. A listing of qualitative descriptors and approximate 1 the Neuropsychology Referral and Answering the Referral Question 23 corresponding percentiles is provided in Chap. The clinical neuropsychological consult report is often similar to reports provided by other medicine subspecialists who provide a clinical encounter report rather than a technical consult/procedure report. Can be subdivided into "mild-to-moderately impaired" and "moderate-to-severely impaired" "Moderately-to-severely impaired" Scores between 0. Recommendations may include initiating pharmacological treatment (if otherwise medically indicated), obtaining further clinical correlation for identified neuropsychological deficits, along with other important components of treatment planning. Currently, clinical neuropsychologists have prescription authority in two states (New Mexico and Louisiana). In these cases, a clinical neuropsychologist with prescription authority will also communicate if any medications were prescribed. Examples of neuropsychological evaluation reports are provided in the Appendices below. If you are unable to find desired information quickly in the neuropsychological consult report, we encourage you to call or email the consulting clinical neuropsychologist for clarification. Reading Between the Lines: Appreciating Subtlety in Neuropsychological Consult Reports We provide this section to inform our referring physicians, and as a notice to our colleagues to assure the neuropsychological evaluation clearly answers the referral question(s). Neuropsychologists are trained from a philosophy of science background, and this training background often imbues the neuropsychological report. Within this tradition, scores or data obtained from a person cannot "prove" the existence of dysfunction, but rather allows the clinician to reject a null hypothesis (rule out a potential cause for the observation). The opinion itself is often expressed in language such as "The neuropsychological study found deficits in " or "Neuropsychological data are most consistent with. Yet neuropsychological evaluations directly answer the referral question, based on language supporting one hypothesis over another; but it is sometimes a matter of reading between the lines. Often followed by explanation dysfunction the study quality was either poor due to lack of adequate patient effort and/or psychiatric overlay Phrase to describe where dysfunction occurs.
Some traits that smokers are perceived to have would be seen by many people as negative antibiotic 2012 order azromax on line amex. Thus antibiotic resistance health care cheap azromax 250mg without a prescription, adolescents see smokers in terms of traits that some typically consider negative antibiotic yogurt interaction order azromax with amex. This finding is consistent with the thesis that adolescents are motivated to smoke antibiotic yellow tablet discount azromax on line, in part, by the images they feel they can achieve or reinforce. Nonrandomized Studies Aitken and colleagues91 examined whether 6- to 17-year-olds could identify cigarette brands after viewing advertisements with no brand showing. Across three brands, 38% to 83% of those age 12 and 13 years and 52% to 95% of older teenagers could identify the brands. They matched advertisements to thumbnail sketches of the type of person who smoked a brand. Yet, these studies do not demonstrate that cigarette marketing influences adolescents to have these favorable images of smokers. Reynolds, executive Claude Teague wrote: the fragile, developing self-image of the young person needs all the support and enhancement it can get. The sample consisted of 18to 34-year-olds who smoked Marlboro Red or Marlboro Lights. Without seeing any marketing materials, participants answered the question, "What comes to mind when you think of Marlboro Finally, participants viewed a list of descriptions of different types of people, and researchers asked them "to rate each item on how well it describes Marlboro, the person. Research planning memorandum on some thoughts about new brands of cigarettes for the youth market. The Role of the Media and Lucky Strike) to 534 adolescents in grades 6 through 12 from seven schools in four U. They obtained ratings for each advertisement of how frequently the adolescents had seen the advertisement, how well they liked it, and the degree to which the advertisement made smoking appealing. These adolescents saw Marlboro and Camel advertisements more frequently than they saw advertisements for other brands. A larger proportion of these students liked these advertisements (44% Marlboro and 64% Camel) more than the other advertisements and found them more appealing than advertisements for other cigarettes. The findings suggest that brands whose advertising is seen more favorably by youth are more popular with youth. Arnett93 conducted a study indicating that the more youth-popular cigarette brands were perceived more positively by adolescents than was advertising for a brand not popular with youth. He presented two advertisements for each of five youth-popular brands (Marlboro, Newport, Camel, Kool, and Winston) and one for a non-youth popular brand (Merit) to 400 12- to 17-year old American adolescents. They rated how much they liked the advertisements and how much they thought the advertisements made smoking appealing. The adolescents liked all but two of the advertisements for the youthtargeting brands significantly more than they liked the Merit advertisements. They rated one Marlboro advertisement, two Camel advertisements, and a Kool advertisement as making smoking significantly more appealing than did the Merit advertisement. They liked the Marlboro advertisements significantly more than they liked advertisements for Newport cigarettes. Unger and colleagues94 assessed brand recognition among 386 8th-grade students for cigarette, alcohol, and other advertisements that had brand information removed. Like the Arnett study cited above, this study suggests that adolescents more readily recognize the advertisements for the cigarette brands that are more popular with youth. This makes it highly likely that adolescents in each condition are equal at the outset. If one group has a more positive attitude or image of smokers, it is due to the exposure (intervention). She randomly assigned 178 5th, 7th, and 9th graders to look at a magazine with four cigarette advertisements or at the same magazine without any cigarette advertisements.
Neuropsychological evaluations can be crucial for the management of a patient antimicrobial yarns buy generic azromax, including making diagnoses common antibiotics used for sinus infection buy cheap azromax on-line, evaluate treatment effectiveness antibiotics for uti emedicine buy 250 mg azromax overnight delivery, predict outcome from treatment (or disease course) infection toe discount azromax 100mg on line, delineate treatment needs and/or develop treatment programming. For the practicing neuropsychologist, the referral is the first and perhaps most important step in providing a neuropsychology service, whether that be a request for an outpatient neuropsychological evaluation, inpatient consult, or providing cognitive rehabilitation. There are several aspects of the referral which are important, both for the neuropsychologist and the referring provider to consider. The referral question(s) should be well delineated, as the question(s) will guide the type and timing of the neuropsychological consult. Cognitive patterns and progression in multiple sclerosis: Construction and validation of percentile curves. Hippocampal adequacy versus functional reserve: Predicting memory functions following temporal lobectomy. Risk of processing speed deficits among patients with relapsing and remitting and secondary progressive multiple sclerosis. Structured cueing on a semantic fluency task differentiates patients with temporal versus frontal lobe seizure onset. Visual confrontation naming outcome after standard left anterior temporal lobectomy with sparing versus resection of the superior temporal gyrus: A randomized prospective clinical trial. Evaluating the contributions of state-of-the-art assessment techniques to predicting memory outcome after unilateral anterior temporal lobectomy. Functional outcome 10 years after traumatic brain injury: Its relationship with demographic, injury severity, and cognitive and emotional status. Neuropsychological assessment and employment outcome after traumatic brain injury: A review. Prediction of functional outcomes after traumatic brain injury: A comparison of 2 measures of duration of unconsciousness. Should include symptoms/diagnosis warranting neuropsychological consult] [Brief summary of presenting patient complaints, if any. Example might be: "Patient is a 30-year-old right handed Caucasian male statuspost left middle cerebral artery ischemic stroke (date) with mild right hemiparesis and language problems referred to assist with diagnosis and treatment planning. Presence/ absence of suicidal and/or homicidal ideation, intent or plan along with hallucinations or delusions should be specified. We advise the clinician to specify inclusion of symptom validity measures as such, and not identify specific test names in keeping with recent recommendations. Examples Paragraph Format the patient exhibited deficits in areas of attention/executive functions, verbal memory, and language functions. Language screening was functional, but there were deficits in confrontation naming and verbal fluency. Strengths were basic span of attention, gross receptive and expressive language functions, and visuoperceptual skills. No constructional apraxia Executive functions (insight, judgment, reasoning): Insight and judgment [intact, poor, etc. Personality/psychological/emotional functioning: [brief summary of results of any personality/psychological functioning. May also include quality of life variables, as well as any behavioral apathy and other neurovegetative symptoms. If combined with recommendations, recommendations should flow from interpretation. For example: Initial results of the neuropsychological evaluation were reviewed with [as much detail as is necessary]. We recommend including time spent with patient completing neuropsychological evaluation. Example may be "A total of hours of neuropsychological services (including interviewing, administering, scoring, interpretation, and report writing) completed by Dr. For example: Neuropsychological evaluation was abnormal with deficits in memory and language.
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