1) Young Gary P. Lightman begs Death not to take his dying father, who has no means to pay a doctor. Death takes pity and gives Gary magical healing leaves to save others.
2) Gary becomes a renowned doctor who can save those Death stands by the head of, but not the foot. He breaks this rule twice to save his wife from childbed fever and his daughter from illness.
3) For defying Death the second time, Gary forfeits his own life to save his daughter, exchanging his candle of life for hers. Death acknowledges Gary was a good man.
Learning to Howl -- An attempt at a 10 generation Legacy documented and plot driven. This is the introduction giving a tid bit of backstory for my Founder.
People Saying Bad Things About Your Business - What to do?SiteGround.com
A presentation by SiteGround's Chief Operations Officer Reneta Tsankova given at the World Joomla Conference 2012. This session revealing real life example how negative feedback can be handled in such a way as to convert unhappy prospects or customers into happy.
Learning to Howl -- An attempt at a 10 generation Legacy documented and plot driven. This is the introduction giving a tid bit of backstory for my Founder.
People Saying Bad Things About Your Business - What to do?SiteGround.com
A presentation by SiteGround's Chief Operations Officer Reneta Tsankova given at the World Joomla Conference 2012. This session revealing real life example how negative feedback can be handled in such a way as to convert unhappy prospects or customers into happy.
Discuss the Nurse Practice Act in your state. How does the Nurse AlyciaGold776
Discuss the Nurse Practice Act in your state. How does the Nurse Practice Act affect your practice as a professional? As an individual? Give clear examples.
Pale Horse, Pale Rider
By Katherine Anne Porter
In sleep she knew she was in her bed, but not the bed
she had lain down in a few hours since, and the room
was not the same but it was a room she had known
somewhere. Her heart was a stone lying upon her breast
outside of her; her pulses lagged and paused, and she
knew that something strange was going to happen, even
as the early morning winds were cool through the lat-
tice, the streaks of light were dark blue and the whole
house was snoring in its sleep.
Now I must get up and go while they are all quiet.
Where are my things? Things have a will of their own
in this place and hide where they like. Daylight will
strike a sudden blow on the roof startling them all up
to their feet; faces will beam asking. Where are you
going. What are you doing. What are you thinking.
How do you feel. Why do you say such things. What
do you mean? No more sleep. Where are my boots and
what horse shall I ride? Fiddler or Graylie or Miss Lucy
with the long nose and the wicked eye? How I have
loved this house in the morning before we are all awake
and tangled together like badly cast fishing lines. Too
many people have been born here, and have wept too
much here, and have laughed too much, and have been
too angry and outrageous with each other here. Too
many have died in this bed already, there are far too
many ancestral bones propped up on the mantelpieces,
there have been too damned many antimacassars in this
house, she said loudly, and oh, what accumulation of
storied dust never allowed to settle in peace for one
moment.
And the stranger? Where is that lank greenish stran-
ger I remember hanging about the place, welcomed by
my grandfather, my great-aunt, my five times removed
cousin, my decrepit hound and my silver kitten? Why
did they take to him, I wonder? And where are they
now? Yet I saw him pass the window in the evening.
What else besides them did I have in the world? Noth-
ing. Nothing is mine, I have only nothing but it is
enough, it is beautiful and it is all mine. Do I even walk
about in my own skin or is it something I have borrowed
to spare my modesty? Now what horse shall I borrow
for this journey I do not mean to take, Graylie or Miss
Lucy or Fiddler who can jump ditches in the dark and
knows how to get the bit between his teeth? Early
morning is best for me because trees are trees in one
stroke, stones are stones set in shades known to be grass,
there are no false shapes or surmises, the road is still
asleep with the crust of dew unbroken. I’ll take Graylie
because he is not afraid of bridges.
Come now, Graylie, she said, taking his bridle, we
must outrun Death and the Devil. You are no good for
it, she told the other horses standing saddled before the
stable gate, among them the horse ...
This compilation of fairy tales is the result of youth exchange that took place in the little paradise that is Curaçao. Thirty two young people from very different countries met for nine days to learn deeper and sensibilise about gender equality. This topic is
trendy in all our societies, but in our generation we still have big gaps between different genders. So it is necessary that youth works for ending this problem. This structural problem is reflected in small details in our daily life. Even though we come
from very different backgrounds we have found similarities in the essence of this situation, the myths and legends that are reflection of our different identyties are full of the stereotipes that feed the inequality. That is why we have been working in a
new perspective of our fairy tales in order to make them more concious and more focused towards an inclussive education.
All our work is shown here and it has been illustrated with the drawings of the children from the FELIS foundation. FELIS is a wonderful space where Gerda Van Petersen has been working very hard to be able to give those children with the difficult childhood some skills and most off all love to grow in this world.
We want to thank organizations that have made posible this learning. Erasmus, Stichting FELIS, InoChange, FIFEDE, KIEC European Club, Gerda Van Petersen, Fokje Scgipper and our leaders and participants. It has been very enrichening and we
are coming back to our countries with a new perspective about equality, learning and sharing.
The book was created in frame of youth exchange "Stand together" with support from Erasmus+ program.
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
1. Dr. Gary P. Lightman
On the darkest night of deep midwinter, young Gary P. Lightman begged his father not to die.
Despite the fire dancing in the small fireplace, the single room of their home was cold. The elder
Lightman lay on a small cot, his wasted body buried under blankets. His slumber was deep and his
breath came infrequently.
“Please, father,” Gary said, holding his father’s cool hand. “You cannot die.”
No doctor attended to Gary’s father, for father and son were poor and unable to pay the physician’s
fees. A kindly midwife had given Gary some herbs to ease his father’s pain. “This will help him pass
gently,” she had said. “He will be at peace.”
Not yet a man of sixteen years, Gary had no family but his father. Once his father died, Gary would
be alone, penniless and without prospects for an apprenticeship. He was frightened.
The room grew darker and a sharp chill swept over father and son. Gary P. Lightman left his father’s
side to place one of their few remaining logs on the dying fire. Upon returning to the cot, Gary saw an
old woman standing in the shadows by his father’s feet. Deep wrinkles etched her gaunt face,
surrounding cold eyes that shone like twin blue flames. Her dress was of a black so dark that it seemed
to absorb the fire’s light.
“Who are you?” Gary asked. His fear of the strange old crone strangled him such that his voice was
scarcely a whisper.
2. “I am Death, young Gary P. Lightman,” she said. Her voice rasped like whispers from a tomb. “I have
come for your father.”
Gary shook his head. “No. Please, you can’t.” Tears stung his eyes as he pleaded.
Death showed no emotion, only the stillness and quiet of the grave. “It is his time,” she said. “He is
mine.”
“No,” Gary said, his voice breaking. “He is all I have in this world. Please, can’t you let him live? I will
do anything, even give my own life.”
So great was Gary’s sorrow that Death was moved to pity. “I am not cruel, young Gary. The life light
of every person must be extinguished in time. Tonight your father’s light grows dim and will not last
until the morning.”
“You are Death,” Gary protested, “surely you must have the power to delay his passing. How could
one so powerful as you not have such an ability?”
“You must understand, Gary,” Death said in her hollow voice, “that there are those whose fate is not
fixed. These may escape my grasp. The fate of others is sealed and cannot be altered. Your father is one
whose fate cannot be escaped. Tonight he is mine.
Gary did not reply but only held his father’s limp hand and sobbed. Again, Death was moved to great
pity.
“What will you do once I have taken your father?” she asked.
“I do not know. I have nothing. I know no trade and none will apprentice me,” he replied.
3. “Rarely does a young man grieve his father so deeply,” Death said. “I cannot give you your father’s
life, but I will offer you a gift. A young man of such devotion deserves comfort.”
Wiping his eyes to look at Death, Gary said, “What can you offer that could bring me any comfort?”
“I will make you a doctor. While you cannot save your father, you will save others. You will no longer
be poor, but instead your skill will be sought by kings and queens who will reward you with riches.”
“You will save those whose fate is not sealed,” Death continued. “When you are called to the
bedside, I will be there. If I am standing by an ill one’s feet, their fate is sealed and they are mine. When I
stand by an ill one’s head, you may save them.”
Holding out a small tin, she said, “You need only place one of these leaves upon their brow, and they
will recover. However, mark my words well, Gary P. Lightman. You must never administer the leaves
when I am standing at the foot of the bed, for to interfere with a sealed fate is to bring doom upon
yourself.”
With trembling hands Gary took the tin and removed the lid. Inside were small leaves, like tea, the
color of blood. Replacing the lid, he looked back at Death.
“Thank you,” he said in a whisper filled with pain.
Death nodded and said, “Now it is time for me to take your father.” She reached out to touch Gary’s
father, then she was gone.
Gary P. Lightman grasped his father’s cold hand. “Goodbye, father,” he whispered.
So it came to pass that Gary P. Lightman became the most esteemed doctor in the land. From the
poorest common folk to the richest of nobles, all who were beset by illness and injury sought his
4. services. As promised, Death appeared in every sick room. Each time Death stood by the bed’s head,
Gary had only to place a single leaf upon the ailing person’s brow to heal them. Within moments of the
leaf’s placement, all suffering eased and life’s blush returned to their skin.
Gary was known throughout the land for his remarkable healing and his certain knowledge of who
could be saved by his remarkable gift.
Though it saddened Gary to see Death standing at the foot of the sick bed, he came to understand
and accept fate’s dictates. Indeed, he discovered a profound peace within himself. He shared this peace
with the grief-stricken families of those whom Death took. Thus he also became known for his gift of
comfort.
His reputation grew until even kings and queens summoned the great Dr. Gary P. Lightman to their
bedsides. He accumulated great wealth. Women sought his companionship and men sought his
friendship. In time, he fell in love and married. His beloved wife bore him children, and his life was filled
with happiness.
Upon the birth of her fourth child, Gary’s wife fell ill. “Childbed fever,” the midwife declared.
Clutching Death’s tin in his hand, Gary kept vigil by his wife’s side, prepared to administer the
lifesaving leaf as soon as Death appeared by his wife’s head. To his dismay, Death appeared not at his
wife’s head, but at her feet.
Just then, one of Gary’s young children entered the room. She was but a toddler, and innocent.
Upon entering the room, the child saw Death standing by the bedside and spoke to her.
“My lady, what a pretty black dress you have,” said the girl.
5. Death was startled by her words, and turned to look at the girl. Seeing that Death was distracted by
his daughter’s conversation, Gary quietly pulled back the blankets, lifted his wife and turned her so that
her head lay by Death. He then opened the tin and placed a leaf upon her pale brow.
Death whirled to face him and raised her voice in anger. “How dare you. You have tricked me and
spared the life of one whose fate was sealed.”
Gary fell to his knees and begged Death’s forgiveness. “Please, my wife is my world and I could not
let her go. Think of our children. They need their mother. You have my word, I will not ignore your
words again.”
Death considered him and was once again moved to pity. “You are a good man, Gary P. Lightman, so
I will forgive you a single time. Do not ignore my words a second time.”
With those words, Death vanished.
Years passed and Gary’s wife bore him more children, until she became barren with age. All were
hale and happy and brought joy to Gary’s heart.
Gary’s youngest child was called Delilah. She was a golden-haired girl with a smile as bright as the
sun. Her voice rang like the sweetest of bells, and her laughter never failed to warm her father’s heart.
Though he loved all of his children, precious Delilah was the center of his world.
On the eve of Delilah’s fifth birthday, the sweet little girl was stricken by grave illness. Gary’s wife
wept and refused to leave Delilah’s bedside. She turned to her husband and cried, “Will she live? Tell
me. I cannot bear to lose my child.”
As Gary comforted his wife, Death appeared at young Delilah’s feet. “No,” Gary P. Lightman cried,
tearing at his hair. “Not Delilah.”
6. His wife looked up and screamed, for she had never before seen Old Woman Death. “Who are you?”
she asked in fear.
“I am Death, and I have come for your little daughter,” replied the old woman.
At this, Gary’s wife became hysterical. She leapt to her feet and rushed at Death. “You cannot take
my baby,” she said, falling at Death’s feet and grabbing at the black dress.
In this moment, Gary saw that Death was distracted. He scooped up his small daughter and spun her
around so that Death stood by her head. Swiftly, before Death could stop him, he pulled a leaf from the
tin and placed it on the girl’s brow.
Death’s eyes flared a brighter blue and her countenance darkened. In a booming voice she said,
“Gary P. Lightman, you have defied me for the last time. Now you must pay.”
With those words, Death took Gary by the arm as his wife screamed. Before Gary could plead for
mercy, he found himself in a place of deepest darkness. An endless sea of candles, some tall and some
nearly burned out, provided a light that barely penetrated the surrounding blackness.
“What is this place?” asked Gary. His voice trembled.
“Each of these candles holds the light of a human life. Some are tall, and have many years yet to
burn. Others have very little time,” Death said. She picked up a very short candle. “This candle belonged
to your daughter, whose fate was sealed. You have interfered with fate yet again, prolonging the life of
one meant to die. Since you have healed your daughter, you must take her place. Your life is forfeit.”
Gary smiled through his tears. “I gladly forfeit my life to save my sweet Delilah.”
7. Death nodded and said, “You are a good man, Gary P. Lightman.” Then, with a pinch of her bony
fingers, she extinguished the candle.