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Associate Professor, Chicago Medical School of Rosalind Franklin University of Medicine and Science

Fearing the oracle and thinking that his father and mother are Polybus and Merope antibiotic resistance biofilm order colchicine 0.5mg visa, Oedipus leaves Corinth in a self-imposed exile antibiotic quick reference purchase colchicine 0.5 mg on-line. During his exile no antibiotics for acne buy 0.5mg colchicine overnight delivery, he comes to a junction of three roads and encounters a train of carriages and men antimicrobial quiz questions discount colchicine 0.5mg with visa. In honor of him rescuing the city, Oedipus is granted the kingship of Thebes and, with it, the widowed queen, Jocasta, with whom he eventually has four children. Many years later, a plague falls over Thebes and Oedipus, now the long-reigning king of Thebes, seeks relief from the oracle at Delphi, who says that the pollution of the city, the man responsible 1 for the killing of the former king Laius, must be killed or driven from the city. Through a series of revelations, Oedipus learns that he had unknowingly fulfilled the oracle: he killed his biological father, Laius, in that dispute at the junction of three-roads and bedded his biological mother, Jocasta. Jocasta hangs herself; Oedipus gouges out his eyes and enters exile, guided by his daughter Antigone. The playwright Aeschylus seems to be referring to the riddle when he has his chorus in the Agamemnon (79-81) refer to themselves and to extreme old age generally as walking "on triple feet". No one, not even the seer Tiresias, could solve the riddle, and it was only Oedipus who succeeded, aided by his wit. There is a reference to the Sphinx in Hesiod (Theogony 326), but no reference to a riddle or to Oedipus. Snyder in their Narrative Prosthesis: Disability and the Dependencies of Discourse (2000). As the riddle depends on a complex understanding of shifting mobility in humans ­ from crawling in infancy (four legs), to walking erect as adults (two legs), to walking with the aid of a cane or crutch in old age (three legs) ­ only someone who has a complex understanding of his own mobility could parse its terms. On the one hand, his name (in Greek,) could be understood to mean something like "Swollen Foot": a combination of the Greek (modern edema, a swelling) and (foot). On the other hand, the first part of the name ­ ­ recalls the Greek verb of knowing. The sphinx is likewise mentioned as a destroyer of the Cadmeans in Hesiod (Theogony 325). More details may have been included in a satyr play by Aeschylus, entitled Sphinx, which was a part of a tetralogy consisting of Laius, Oedipus, and Seven Against Thebes. The Sphinx has appealed to modern literary figures, such as Ralph Waldo Emerson, whose poem "The Sphinx" has drawn attention for its rather obscure nature. The Riddle of the Sphinx serves to open this dissertation, in which I use a variety of ancient Greek art and material culture, literature, architecture, laws, and burial customs to show how ancient Greek communities understood, treated, and in fact accommodated physical disability among their members. Not only does the Sphinx episode depend on disability ­ as, indeed, does the whole play, which features the blind seer Tiresias and, at the end, the blinded Oedipus, as well as old-age related disabilities ­ but the formulation of the riddle itself describes both the life course of humans from infancy to adulthood to and through old age. In the riddle we are expected to understand that humans do not retain the same physical integrity throughout their 3 London, British Museum 1887,0801. He is surrounded by figures identified by inscription as Athena, Apollo, the Dioskouroi, and Aineias. I trace how the intersection of disability with age resulted in different negotiations for disabled infants, children, adults, and the elderly. Throughout the life course, all individuals ­ regardless of disability ­ experience stages of dependency, including infancy, early childhood, and, to a certain extent, old age (Southwell-Wright, Gowland, and Powell 2017:8). A disabled infant, for example, who requires additional care due to a disability will deviate less from her or his contemporaries, who also require a great deal of care and attention, than a disabled adult, who deviates more severely from the requirements attending other, non-disabled adults. The structural accommodations evident in ancient Greek society suggest an implicit, if not explicit, acknowledgement of a range of limitations attendant upon physical disability and an attempt to accommodate individuals with a diversity of somatic realities. That the ancient Greek world facilitated disability ­ providing for it informally but also formally through means like social welfare systems, architectural adjustments, military exemptions, and adjusted employment practices and expectations ­ does not in and of itself indicate whether disabled ancient Greeks were treated well or poorly by their contemporaries. Whatever their quality of life, disabled ancient Greeks were not, in the main, formally barred from participating as active members of their communities. Rose (2003:3) argues that "[D]isability in ancient Greece was treated as a family and civic issue, in which disability status was defined and negotiated between individuals on a case-by-case basis within the community. Those individual negotiations, however, were enabled and facilitated by broader, structural elements of ancient communities that supported participation by disabled members, elements that require an abstract understanding of and appreciation for physical difference.

After each question antibiotic resistant staphylococcus aureus generic 0.5mg colchicine amex, you will be asked to indicate which types of facilities are included in your responses to that question antibiotic resistance of e. coli in sewage and sludge buy cheap colchicine 0.5 mg. Prisoners in Extended Restricted Housing Male (under 18 years old) Male (18-49 years old) Male (50 years or older) Female (under 18 years old) Female (18-49 years old) Female (50 years or older) Total Black Hispanic Asian Other Total Specify the groups included in "Other" 8) How many prisoners infection 5 weeks after hysterectomy cheap 0.5mg colchicine with amex, if any antimicrobial wound cream for dogs cheap 0.5mg colchicine otc, (including both male and female, of every age) in Extended Restricted Housing are housed in double cells? Prisoners in Extended Restricted Housing Identified as Having a Serious Mental Health Issue Male Female Black Hispanic Asian Other Total 10) How many transgender prisoners or pregnant prisoners are in Extended Restricted Housing? Other Form of Continuous/ Protective Disciplinary Administrative Restricted Consecutive Days Custody Custody Segregation Housing Total 15 days up to 1 month 1 month up to 3 months 3 months up to 6 months 6 months up to 1 year 1 year up to 3 years 3 years up to 6 years 6 year or more If the data includes prisoners in the "Other" form of Extended Restricted Housing category, please specify the type of Extended Restricted Housing. Please explain the change in policy and, if possible, email a copy of the relevant policies. Criteria for entry to Extended Restricted Housing Oversight in Extended Restricted Housing Criteria for release from Restricted Housing Mandated time out of cell for Restricted Housing prisoners Programming in Restricted Housing Opportunities for social contact in Restricted Housing Policies or training related to staffing of Restricted Housing Physical environment of Restricted Housing Programming for mentally ill prisoners who have been in Restricted Housing Other Please explain 15) Proposed Changes to Restricted Housing Is your jurisdiction planning any changes to its policies regarding Restricted Housing? If so, please select the appropriate category and explain the contemplated change in policy. Please provide the name, contact information, and title for the person to whom such questions should be directed. Mental disorders are usually associated with significant distress or disability in social, occupational, or other important activities. An expectable or culturally approved response to a common stressor or loss, such as the death of a loved one, is not a mental disorder. Offenders, regardless of diagnosis, indicating a high level of mental health needs based upon high symptom severity and/or high resource demands, which demonstrate significant impairment in their ability to function within the correctional environment. These individuals also must either currently have, or have had within the past year, a diagnosed mental disorder, or must currently exhibit significant signs and symptoms of a mental disorder. A diagnosis of alcoholism or drug addiction, developmental disorders, or any form of sexual disorder shall not, by itself, render an individual seriously mentally ill. The combination of either a diagnosis or significant signs and symptoms of a mental disorder and an impaired level of functioning, as outlined above, is necessary for one to be considered Seriously Mentally Ill. These diagnoses include psychotic disorders, major mood disorders, and specifically identified personality disorders. These disorders would be: Schizophrenic disorder; Major Affective disorder; Other psychotic disorder; Borderline schizotypal personality disorder with the exclusion of an abnormality that is manifested only to be repeat criminal or otherwise antisocial conduct. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. Mental illness is usually associated with significant distress or a disability in social, occupational, or other important activities. The below mentioned numbers represent the total number of inmates in the mental health units for both males and females. These disorders have episodic, recurrent, or persistent features; however, they vary in terms of severity and disabling effects. Such disorders as Schizophrenia, Paranoid and other psychotic disorders, Bipolar disorders (hypomanic, manic, depressive, and mixed), Major Depressive disorders (single episode or recurrent), Schizoaffective disorders (bipolar or depressive), Borderline Personality disorder and Schizotypal Personality disorder. Inmates with current or recent symptoms of the following conditions: · Brief psychotic disorder · Substance induced psychotic disorder C. Inmates with head injury or other neurologic impairments that result in behavioral or emotional control. Inmates with chronic and persistent mood or anxiety disorders or other conditions that lead to significant functional disability. Inmates with a primary personality disorder that is severe, accompanied by significant functional impairment, and subject to periodic decompensation. These symptoms may be acute or chronic in their presentation, cause functional impairment, and could pose a threat to the patients safety in the general population in a correctional setting. The conference, which is expected to draw more than 14,000 investigators, educators, and clinicians, is truly the destination for adult and pediatric pulmonary, critical care, and sleep medicine professionals at every level of their careers. The success of our conference depends on the dedication, creativity, and support of these individuals.

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A few times infection prevention jobs cheap 0.5mg colchicine otc, I have been able to obtain cannabis that can be orally ingested - this was the only treatment that has allowed me to sleep a full night since coming out of the benzodiazepine fog infection after birth purchase 0.5mg colchicine, but unfortunately antibiotics for uti making me nauseous buy discount colchicine 0.5mg line, I do not have safe or consistent access bacteria large intestine generic colchicine 0.5 mg otc. As I continue through my recovery, I have become a voice in Minnesota for the use of cannabis as a therapeutic option for individuals with various conditions. I now work part-time from home, sit on the board of directors for a state-wide professional association, am a national coordinator for regulation of my profession, and co-founded and run a Minnesota non-profit that advocates for the use of cannabis as a safer alternative. I also volunteer heavily in my community, including over 500 hours a year working a crisis line for victims of sexual assault, domestic violence, and other crimes. I strongly urge you to add Post Traumatic Stress Disorder as a qualifying condition for medical cannabis in Minnesota. I deployed to Afghanistan with the 1 O1st Airborne Division from 2009 - 201 Oin support of Operation Enduring Freedom X. A typical encounter would begin with a mortar round or rocket being launched at our base from an unknown position of origin and exploding somewhere within (sometimes close to our position, sometimes distanced. Reactionary procedures for such an attack dictated that all soldiers "gear up" with "full battle rattle" (:flak. During this time, more times than not, additional mortar rounds or rockets would be launched at the base. The closest I ever had an explosion occur was maybe 15 meters from my position in the bunker. After the explosion we heard shrapnel hit the side of the bunker and saw sparks of some sort above us. At that point, you think to yourself: one more round, just a few meters closer and this is it. We fought for this country overseas Sir, we are asking you to fight for us here at home. I am currently enrolled as a medical cannabis patient and have been for nearly a year, now. I believe that I have greatly benefited from utilizing cannabis as a tool for combating symptoms. When I am able to afford the cannabis medicine, my survey scores have consistently been marked as "O" for depression and "0-1" for anxiety symptom relief; "O" meaning symptom not present. I believe it is important for more forms and delivery methods of cannabis to be made available, so that all patients can have access and find what works best for them. Cannabis has also helped me find relief from pain, insomnia, nausea, and has also been an appetite stimulant. I believe everyone has the right to have safe and affordable access to an important tool which provides a multitude of symptom relief, as experienced with cannabis. The night of though I suddenly had contractions so close together literally seconds apart all while they instantaneously reached a pain scale of 20 from a 1-10 range. Later, after she was born several hours, I was to find out that I had a partial placental abruption and this resulted in my daughter being oxygen starved. The doctors thought it was due to my placenta being in the front and with her being past her due date so long. What I do know is that the pain was the worst out of three births that I had ever experienced resulting in having an unscheduled emergency c-section for her and my safety. As a result they had informed me that she had some meconium in her lungs and needed to be kept for observation after going through a painful, emotional and physically exhausting experience. After I had been in my recovery room for an hour or more roughly, the doctors called me to inform me that my newborn daughter was having seizures. When they checked the machines, they found that her brain gas levels were elevated and that she was having brain swelling. They called me and said that they had to do a procedure that would slow down and hopefully stop the swelling in her head. They told me that I might lose my baby but that this would hopefully help her as it was a procedure done on adults who have had strokes. I could barely roll around or move up in bed from my C section let alone deal with what was happening to my baby.

Given the low "numeracy" among Americans (see Health Literacy section below) infection 68 order colchicine 0.5 mg line, this support for consumer comprehension of quality metrics is critically important bacterial vaginosis purchase 0.5mg colchicine mastercard. The Cost of Satisfaction: A National Study of Patient Satisfaction antibiotic resistance factory farming order 0.5mg colchicine overnight delivery, Health Care Utilization antibiotic guidelines 2015 buy colchicine 0.5mg on-line, Expenditures, and Mortality. This is challenging in a population that has frequent changes in eligibility which leads to "churn", or several change in insurance status or type within a 12-month period. Another study found that over 40% of adults have change in eligibility over a 12-month period10 Even a 1-2 month disruption in coverage has been shown to lead to delayed or missed care, cause pent up need, and change utilization patterns. In the Medicaid population specifically, such seemingly brief gaps result in missed medication doses, missed care, and increased emergency room visits. Any attribution methodology must also include a measure of churn and health care coverage disruption and to adjust for this. Further, administrative simplicity that reduces churn is required to prevent gaps in coverage. A policy that allows 12-month continuous coverage after proving eligibility would help mitigate causes of discontinuous coverage. Another barrier to continuous coverage is processing times for eligibility determinations and waiting periods between proving eligibility and accessing care. It is critical that MassHealth be committed to reducing barriers to continuous coverage as it is continuous health insurance coverage that is a prerequisite to access to needed care and appropriate care utilization. Data show that patients who experience gaps in health insurance often lack a usual source of care or primary care provider and then are more likely to rely on emergency departments for care. We seek more information about this part of the waiver proposal, including: How will risk and shared savings be distributed between different provider types? How will quality and performance metrics, that determine payment, be measured across these new linkages? Network Adequacy Ensuring adequate access to care and preserving care relationships are of paramount importance. Especially given provider shortages and disparities in provider density by geography, narrow networks can lead to barriers to care, missed care, and can worsen disparities. Narrow networks are more likely to lead to loss of a trusted provider in order to stay in network. Network adequacy is especially important for service types and vulnerable populations most at risk for disparities. However, many plans renew contracts or change provider networks after a member has enrolled in coverage. This can disrupt existing care relationships despite continuous insurance coverage. Specific network adequacy metrics should include: Wait times to appointment How are the collaborations facilitated? Distance to provider Travel time to provider Minimum provider/enrollee ratios Percentage enrollees who changed primary care providers in a year Percentage of change to provider network per year 6 Doctors for America is a 501(c)(3) national movement that mobilizes physicians and medical students to put patients over politics on the pressing issues of the day to improve the health of our patients, communities, and nation. At the time of enrollment in a plan type, a consumer must be empowered with accurate and easy to access information on the provider network of that plan. Member Experience and Network We have concerns about restrictions on members and providers as described in section 4. For many patients with complex health needs, their most important care relationship and their functional "medical home" may be with a specialist. This applies, for instance, to those undergoing cancer treatments with oncologists, those with multi-system diseases cared for by rheumatologists, or children with complex medical conditions like genetic syndromes. A detailed plan for educating members on this and ensuring members are making informed choices is required, especially in light of the lock in period proposed. There are many reports of "balance billing" by hospitals when patients unknowingly receive care from out-of-network providers in emergency situations, from surgeries, or during hospitalizations. Data show that over 30% of Americans have low health literacy or the inability to understand prescription instructions. Over half of Americans have low health "numeracy" or the inability to use numbers in daily life. Health and Human Services describes the following on health literacy, "The primary responsibility for improving health literacy lies with public health professionals and the healthcare and public health systems. We must work together to ensure that health information and services can be understood and used by all Americans.