By O. Malir. Kennedy-Western University.

Acupuncture for chronic shoulder pain in persons with spinal cord injury: a small-scale clinical trial purchase amantadine 100 mg amex. Effects of ear points’ pressing on parameters related to obesity in non- obese healthy and obese volunteers buy amantadine 100 mg without a prescription. Physicians’ attitudes toward complementary or alter- native medicine: a regional survey generic amantadine 100 mg online. Complementary medicine and the general practitioner: a survey of general practitioners in the Wellington area generic amantadine 100mg. Cost effectiveness analysis of a randomised trial of acupuncture for chronic headache in primary care discount 100 mg amantadine with visa. Cost effectiveness of complementary treatments in the United Kingdom: systematic review. A randomised controlled trial of acupuncture care for persistent low back pain: cost effectiveness analysis. Randomised controlled trial of a short course of traditional acupuncture compared with usual care for persistent non-specific low back pain. Acupuncture use in the United States: Findings from the National Health Interview Survey. Efficacy of P6 acupuncture in the treatment of nausea and vomiting during pregnancy. Treatment of low back pain by acupressure and physical therapy: randomised controlled trial. Chinese medicine users in the United States part 1: utilization, satisfaction, medical plurality. A controlled trial of traditional Chinese medicinal plants in widespread non-exudative eczema. Efficacy and tolerability of a Chinese herbal medicine concoction for treatment of atopic dermatitis: a randomized, double-blind, placebo- controlled study Br J Dermatol 2007;157:357–63. Chinese medicinal herbs to treat the side-effects of chemotherapy in breast cancer patients. A double-blind placebo-controlled randomized study of Chinese herbal medicine as complementary therapy for reduction of chemotherapy- induced toxicity. Podophyllotoxin intoxication: toxic effects of Bajiao- lian in herbal therapeutics. The prevalence, use and harmful potential of some Chinese herbal medicines in babies and children. Rapidly progressing interstitial renal fibrosis in young women: association with slimming regimen including Chinese herbs. Misuse of herbal remedies: the case of an outbreak of terminal renal failure in Belgium (Chinese herb nephropathy). Pathological aspects of newly prescribed nephropathy related to prolonged use of Chinese herbs. London: British Medical Association/Royal Pharmaceutical Society of Great Britain, September 2008. Chinese herbs: risk, side effects and poisoning: the case for objective reporting, and analysis reveals serious misrepresentation. Report of Pharmacovigilance of herbal medicines – current state and future directions at the Royal College of Obstetrics and Gynaecology London from 26 to 28 April 2006. Prescription for Extinction: Endangered species and patented oriental medicines in trade. Reducing frailty and falls in older persons: an investigation of tai chi and computerized balance training. Intense tai chi exercise training and fall occurrences in older, transitionally frail adults: a randomized, controlled trial. Balance and strength training in older adults: intervention gains and Tai Chi maintenance. The effects of Tai Chi on bone mineral density in postmenopausal women: a systematic review. A randomised controlled trial of Tai Chi and resistance exercise on bone health, muscle strength and balance in community-living elderly people. Other related systems that are less well known in the west but may be just as popular in some areas of south and south-east Asia include unani, siddha and jamu.

Perussel’s law “There is no job so simple that it cannot be done wrong”; see also murphy’s law order 100 mg amantadine visa. Peto’s paradox The incidence of cancer should be proportional to the number of cells and the number of cell divisions resp purchase 100 mg amantadine overnight delivery. It also includes pharmacists’ remuneration when the latter is separate from the price of medicines cheap 100mg amantadine amex. Final expenditure on pharmaceuticals includes wholesale and retail margins and value-added tax cheap amantadine 100mg visa. Phenotypes result from the expression of an organism’s genes as well as the influence of environ- mental factors and possible interactions between the two; this contrasts with the genotype of an organism (inherited instructions it carries within its genetic code) cheap amantadine 100 mg on-line. Not all organisms with the same genotype look or act the same way, because appearance and behaviour are modified by environmental and develop- mental conditions. Also in the same way, not all organisms that look alike nec- essarily have the same genotype; see also allele, gene, genetic variance, genome, genotype. P powder inhaler drug delivery systems which are specifically designed for the delivery of drugs to the lungs, either using a dose premetered at the factory (metered and dispensed in a sealed unit) or a volumetric metering system which is activated by the patient for every dose; particles must be in the respirable range of <5. These are generally used for minor defects in packaging or other printed materials ( http://www. The categories define also the depth of recall/level in the distribution chain to which the recall is to extend (wholesaler, retailer, user/consumer); over the years, the number of prod- uct recalls shows an upward trend in almost all categories of products; see also

Fifteen patients were interviewed over a period Human Services’ Commission on Nursing (Decem- of eight months purchase amantadine 100 mg overnight delivery. Once the descriptions of the pa- ber amantadine 100mg mastercard, 1988) we were told that “the perspective and tients’ experiences were obtained generic amantadine 100mg free shipping, the phenomeno- expertise of nurses are a necessary adjunct to that logical method of reflecting buy generic amantadine 100mg on-line, intuiting discount amantadine 100 mg line, analyzing, of other health-care professionals in the policy- and synthesizing was used to interpret the descrip- making, and regulatory, and standard setting tions. The call or challenge being posed We found that there were many anxiety-produc- to nurses is to help create the needed changes in the ing experiences on the first day in the day hospital, health-care system today. I called to the community but very few anxiety-reducing experiences that of- of nurses where I work and we joined together to fered the patient comfort and support. For while the impor- tients who left the study at this time found no tance of organized nursing power cannot be anxiety-reducing experiences at all. Subsequently, overemphasized, it is the individual nurse in her recommendations were made to pay particular at- day-to-day practice who can actualize or under- tention to reducing the anxiety of the patient on mine the power of the profession. This is an example of how, through strove to acknowledge and support one another as this method, corrective measures can be formu- individuals of worth so that we in turn could max- lated and outcomes can be tested. The concept of research as praxis is also illus- In settings such as hospitals, the time pressure, trated in this research project. On an individual the unending tasks, the emotional strain, and the basis, the nurses related that they experienced an conflicts do not allow nurses to relate, reflect, and increased awareness of the need to be open to the support one another in their struggle toward a cen- patients’ expressions of themselves. This isolation and alienation the interviews of a patient who had had a particu- does not allow for the development of either a per- larly difficult course of treatment, one of the nurses sonal or professional voice. Within our community who was on her treatment team remarked, “We of nurses it became clear that developing individual weren’t listening to what she was telling us—we voices was our first task. She to become more articulate and clear about function noted with some surprise that her initial impres- and value as nurses. The theme of developing an sion that a patient she was working with was hostile articulate voice has pervaded and continues to and withholding had given way to the realization pervade this group. There is an ever-increasing that this patient—as a result of the negative symp- awareness of both manner and language as we in- toms of schizophrenia—was quite empty and was teract with one another and those outside the really giving us all that she had to give. The resolve for an articulate voice is even interactions with this patient, the nurse was em- more firm as members of the group experience and pathic and supportive rather than judgmental and share the empowering effect it can have on both angry. It has been said that “those that express themselves unfold in health, beauty, and human potential. Another group experience in which Humanistic Group members offered alternative approaches Nursing Theory was utilized was the formation of a to various situations that were utilized and subse- community of nurses who were mutually strug- quently brought back to the group. Zderad proposed, “each person might be practice is: Is this particular intersubjective- viewed as a community of the beings with whom transactional nursing event humanizing or she has meaningfully related” (1978, p. Nurses as clinicians, teachers, a potential resource for expanding herself as a researchers, and administrators can use the “knowing place. Through this under- could truly appreciate the unique competence of standing we are given direction for expand- one another, they were able to reflect that apprecia- ing ourselves as “knowing places” so that we tion back. Through this reflection, members began can fulfill our reason for being, which, ac- to internalize and then project a competent image cording to Humanistic Nursing Theory, is of themselves. They learned that this positive mir- nurturing the well-being and more-being of roring did not have to come from outsiders. This reciprocity is a self-enhancing process, for “the degree to which References I can create relationships which facilitate the Barnum, B. Nursing theory: Analysis, application, growth of others as separate persons is a measure of evaluation. Conduct your own awareness ses- strive to do this for one another and the profession sions: 100 ways to enhance self-concept in the classroom. Paper sounded in and exemplified by the following presented at the Syracuse Veteran’s Administration Hospital, description of examining a pregnant woman: New York. Perceiving, behaving, and becoming: 100 the information [on her and her fetus] from ways to enhance self-concept in the classroom. Secretary’s com- from humanity to maintain the humanness mission on nursing, final report. New creasingly concerned with cost containment, York: National League for Nursing. Orem Introducing the Theorist Views of Human Beings Specific to Nursing Summary References Introducing the Theorist She argues that nursing is distinguished from other human services and other forms of care by the way Dorothea E.

Because mustard is an oily substance cheap amantadine 100mg overnight delivery, it persists in the environment in which it is released order amantadine 100 mg with amex, extending its From: Clinical Forensic Medicine: A Physician’s Guide purchase amantadine 100 mg without a prescription, 2nd Edition Edited by: M order amantadine 100 mg online. Mucosal membranes purchase amantadine 100mg without prescription, such as the eye, respiratory tract, and skin, develop blisters, slough, and can fully incapacitate the individual for long time periods. It should be noted that the term gas may not be completely correct because many of these agents are not true gases but rather are solid particles that can be dispersed. The effective- ness of the crowd-control agent depends on the delivery of adequate amounts and sufficient contact with susceptible surfaces so that the desired effect is achieved. Therefore, temperature, wind conditions, method of delivery, for- mulation and potential barriers (such as clothing, masks, and eye protection), and ability to decontaminate interject variability into the response. World War I was the first modern forum that tested chemical weapons to control large numbers of individuals. Since then, agents with wider safety mar- gins have been developed that promote dispersal of large numbers of individu- als without significant morbidity and mortality. Chemical crowd-control agents can also be used by terrorists to incite fear or panic in crowds, and there is always the potential for accidental dispersal in a public forum or, rarely, the potential for self-abuse. There is considerable debate concerning the use of chemical agents for crowd control. There are five major concerns about the use of these agents by law enforce- ment: 1. The potential for any ancillary exposure to health care providers, and to bystand- ers (1–4). Concern about the long-term effects from repeated exposure and from occupa- tional exposure (5). Some of these issues become more complicated because chemical con- trol agents are increasingly popular with civilians as readily available, often legal, self-defense weapons. There have been several incidents in the United States and in other coun- tries that question the appropriateness of use of chemical crowd-control agents (5,6). When used appropriately, crowd-control agents have a good safety mar- gin and generally do no permanent harm. Despite all of the controversy surrounding chemical control agents, they offer a less hazardous method of restraint than other potentially lethal alternatives, such as firearms. These agents are available in varying concentrations, with several vehicles, in aerosols or foams and in particulate form with dispersal devices. Essentially a means of less lethal chemical warfare, chemical crowd- control products are used as defensive agents to temporarily incapacitate indi- viduals or disperse groups without requiring more forceful means. These agents share common effects that include lacrimation, ocular irritation and pain, dermal irritation, blepharospasm, conjunctivitis, transient impairment of vision, and mild to moderate respiratory distress (11–13). Some corneal defects after exposure have been noted, but whether this is a direct tissue effect of the agent, the vehicle, or dispersant or a result of rubbing the ocular surface is unknown 182 Blaho-Owens (14). Other more severe effects, such as pulmonary edema, have been documented when con- centrations are several hundred-fold above what produces intolerable symp- toms or with trauma associated with the explosive device used to deliver the chemical agent (6,15). All of these clinical effects produced by chemical crowd-control agents render the recipient temporarily unable to continue violent action or resist arrest. Because they all share a high safety ratio, are effective at low concen- trations, and can be used without direct forceful contact by the law enforce- ment officer, they are ideal agents for control of either the individual offender or riot control. Because of their relative safety, these agents are generally excluded from international treaty provisions that address chemical weap- ons. The United States, England, Ireland, France, China, Korea, Israel, and Russia are just some examples of countries that use these compounds as riot control agents. The legal availability to law enforcement and the general pub- lic differs between countries; however, most can be easily obtained through international markets or ordered through the Internet. For large crowds, “bombs” have been devel- oped that can be dropped from aerial positions producing wide dispersal of the compound. They are also formulated in grenades or canisters, which can be propelled by either throwing or with a projectile device. The most common method of dispersal is by individual spray cans that deliver a stream, spray, or foam containing the agent. These individual dispersal units were designed to render immediate incapacitation to an offender without the use of more forceful methods, thereby providing an extra means of control in the ladder of force used by law enforcement.

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