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By: H. Spike, M.A., M.D., M.P.H.

Deputy Director, University of Texas Southwestern Medical School at Dallas

The tax hypertension nursing intervention generic 40 mg valsartan mastercard, he admits blood pressure normal zone order 40mg valsartan visa, would be hard to establish hypertension screening icd 9 cheap valsartan 40mg without prescription, but it would be offset in rich countries by lower drug prices arrhythmia electrolyte imbalance purchase valsartan 80 mg amex. Even so, the tax and thus the incentives could vary considerably, presumably with consequences of different magnitude for the global burden of disease. There may well be good reasons for an account of international justice to consider the interests of those affected by current property right protections more carefully than those agreements now do ­ but that takes us into more contested terrain than the minimalist strategy. The harms are often not deliberately imposed, and sometimes benefits were arguably intended. In any case, great care must be taken to describe the baseline against which harm is 206 Section 2: Issues measured. Such a complex story about motivations, intentions and effects might seem to weaken the straightforward appeal of the minimalist strategy, but the complexity does not undermine the view that we have obligations of justice to avoid harming health. In any case, international harming is only one of three causes of international health inequalities. International health inequalities are also the result of (1) domestic failures to promote population health adequately or fairly and (2) differences across countries in levels of human and natural resources and in the natural conditions that contribute to the prevalence of disease (such as malaria). Thus the minimalist strategy fails to address many inequalities that some believe raise questions of international justice. If we abandon the idea that such relations can arise only within states, we may find attractive the view argued for by Cohen and Sabel (2006). They sketch three types of international relationships that might give rise to obligations of justice going beyond humanitarian concerns, international agencies charged with distributing a specific good, cooperative schemes and some kinds of interdependency. These may range from an obligation to give more weight to the interests of those who are worse off if it can be done at little cost to others, to obligations of equal concern, perhaps yielding far more egalitarian obligations. I shall illustrate each of these relationships and the obligations they give rise to with examples focused on key issues of global health. The organization would be charged with being unfair if it ignored the health of some and attended more to the health of others. Consider now the international bodies that establish rules governing intellectual property rights, including those that are key to creating temporary monopolies over new drugs. Suppose we conclude that this mutually cooperative scheme generates considerations of equal concern, or at least that it must be governed by a principle of inclusion. Now, however, we have a new basis on which to defend the justice of Pogge-style incentives. Such an incentive scheme, supplementing existing property rights or modifying them appropriately, would greatly enhance the benefits to those who are largely excluded from benefit for a significant period of time, and it would do so at only modest cost to those profiting from the endeavour. Minimally, it illustrates what a more inclusive policy should include; one can build into it even stronger egalitarian considerations, if the cooperative scheme gives rise to concerns about equality and not simply inclusion. Exactly what form the policy would take, or the justification for it deriving from the form of cooperative scheme involved, remains a task for further work. Consider again the example of the brain drain of health personnel from low- and middle-income countries to wealthier ones. Still, the decisions different countries make about training of health personnel and about access to their territories have great mutual impact on them. There is an important interdependency affecting their well-being, specifically, the health of the populations contributing and receiving health personnel. The British decision in 2000 to recruit 30,000 new nurses from developing countries rather than try to train more greatly affected the fate of people being served by health systems in southern Africa. Arguably, this relation of interdependence brings into play obligations of inclusion, perhaps those of equal concern, going beyond in any event humanitarian considerations. These obligations can be translated into various policy options that address the brain drain: it may be necessary to restrict the terms of employment in receiving countries of health workers from vulnerable countries; it may be necessary to seek compensation for lost training costs of these workers; it may be important to contribute aid to contributing countries aimed at reducing the push factors; it may be necessary to prohibit active recruitment from vulnerable countries. We might combine these relationships of interdependence with the relationships and obligations that arise from cooperative schemes. The International Organization for Migration, established in 1951 to help resettle displaced persons from the Second World War, now has 112 member states and 23 observer states. Suppose it took on the task of developing a policy that helped to coordinate or manage the frightening health personnel brain drain. Minimally, it might seek internationally acceptable standards for managing the flow ­ standards on recruitment, on compensation, on terms of work. More ambitiously, it might seek actual treaties that balanced rights to migrate with costs to the contributing countries, countering at least some of the pull factors and even providing funds that might alleviate some of the push factors underlying the brain drain. Such a cooperative endeavor would reflect the common interest in all countries of having adequate health personnel ­ and thus being able to assure citizens a right to health and health care ­ as well as the common interest in protecting human rights to dignified migration.

The link becomes even deeper when we think about what it means algebraically to do linear algebra with parameters blood pressure of 90 60 cheap valsartan 40 mg online. However heart attack kid generic 80 mg valsartan fast delivery, therearemanysituations where the parameters appear polynomially and denominators cause problems heart attack signs order valsartan 80 mg mastercard. Splines and Modules For another example of how linear algebra relates to modules arteria elastica 80 mg valsartan with mastercard, we turn to the study of multivariate splines. In practice, the degrees of the polynomials are fixed in advance, but we will postpone doing so in order to reveal the underlying algebraic structure. To obtain a C 1 spline, the polynomials must satisfy spline module (9) has Hilbert function (10), which is a polynomial ink fork <:: 2. The examples discussed so far were chosen to illustrate how the theory of modules over polynomial rings = linear algebra with parameters = symbolic linear algebra arises naturally in a variety of applied contexts. This subject also has a rich theoretical side that uses sophisticated tools from algebraic geometry and commutative algebra, yet its central problem is solving linear equations over polynomial rings. Computer Algebra and Applied Algebra the last forty years have witnessed the emergence of substantial computational power and the discovery (in some cases, rediscovery) of fundamental algorithms for symbolic computation. These interlinked developments have resulted in a tremendous burst of research, both pure and applied. Books in this area range from undergraduate textbooks to technical monographs, some aimed at researchers in algebraic geometry and commutative algebra, others intended for more diverse audiences. Computer algebra encompasses a wide variety of subjects, including coset enumeration, Galois theory, modular arithmetic, symbolic integration, symbolic summation, difference equations, power series, and special functions, among others. As one might expect, polynomials play an important role in computer algebra, where one finds algorithms for greatest common divisors, factorization, Grabner bases, resultants, characteristic sets, quantifier elimination, and cylindrical algebraic decomposition. Introductions to computer algebra include the survey [21 and the texts [31, [41, [91, [131, [141, [20], [281, and [291. Computer algebra can be used to solve problems in robotics, splines, integer programming, differential equations, statistics, coding theory, computational chemistry, computer-aided geometric design, geometric theorem proving, and systems of polynomial equations. These and other applications are described in [21, [6], [81, [101, [151, and [281. The bibliographies of these books reveal a vast literature of applications of computer algebra. How does computer algebra relate to the applications of polynomial algebra described earlier in the article? For those parts of the applied mathematics community where the computational tools are of paramount importance, the computer algebra books mentioned above may be the solution. It is straightforward to reduce (8) to a system of linear equations involving the coefficients of f1, fz, f3, f4. Solving these equations by standard techniques gives a good method for finding splines. But since we understand the module (9), we can answer this question instantly: the splines of degree::s; k are given uniquely by 91 · (1,1,1,1)+gz · (O,x 2,x 2,0) + 9 3 · (y 2, y 2, 0, 0) + 94 · (x 2, y 2, 0, 0), where 91,gz,g3,andg4 have degrees at most k, k- 2, k- 2, and k- 4, respectively. In geometric modeling, the idea of fixing the degree of a moving line or surface has also proved to be useful; see [51 for a survey. In general, there is a lovely interplay between working with polynomials of fixed degree (studied via linear algebra) and polynomials of arbitrary degree (studied via modules). This is why applied mathematics may want to think about how to give its students better access to algebra. This question can have many different answers: · Some students learn algebra as an undergraduate mathematics major. The last bullet reflects the reality that applied mathematics is an immense enterprise. In spite of my belief in the value of abstract algebra, it is not essential that all applied mathematicians learn the subject. For the first four bullets, let me offer some reflections on the role of algebra in each situation.

Scripps established a marine biological institute in La Jolla percentil 95 arteria uterina purchase valsartan 40mg fast delivery, and the local chamber of commerce organized a fund-raising committee to support its work blood pressure patch discount 80 mg valsartan fast delivery. This marine research center was the forerunner of the Scripps Institution of Oceanography blood pressure quotes cheap valsartan 40 mg fast delivery, which in turn became the nucleus of the San Diego campus in the 1960s heart attack fever 80 mg valsartan with visa. The essential ingredients for a regional high-tech center-an entrepreneurial culture, a world-class research faculty, and a community interested in technology as an engine of economic growth-were in place in the 1980s. The University of Chicago would always remain his ideal of the university as the conservator of humanistic learning. Stanford opened up another dimension, more dynamic, entrepreneurial, and outward-looking. Long after leaving Stanford, he acknowledged a permanent debt to Terman: If there is a model for me in academic life, it is Fred Terman. During much of that time, Fred was provost of the campus, working closely with President [Wallace] Sterling. If West Coast technology firms were going to compete 102 Entrepreneurial President successfully with their eastern rivals in the postwar world, they would need to be part of a community: "Such a community is composed of industries using highly sophisticated technology, together with a strong university that is sensitive to the creative activities of the surrounding industry. The company he and Pat Suppes founded as a result of their work in computer-based learning, Computer Curriculum Corporation, gave him firsthand experience of academic entrepreneurship that was unusual among 1970s academics. Silicon Valley had demonstrated how productive, not just economically but also intellectually, such collaborations could be. He and Roosevelt feared that the enormous scientific successes of that effort could not be sustained without a clearly articulated strategy for supporting science in the postwar world. Much of its persuasive power derives from the bold simplicity of its rationale for supporting and applying research. Bush reasoned that industry had little incentive to invest heavily in basic research because its results were not proprietary and might be profitably applied by rival firms. American research universities would produce the pool of fundamental knowledge on which industry and the military could draw. Federal support for university research would be channeled through a system of grants to individuals or teams of researchers, with each grant awarded to projects whose scientific merit had been endorsed through a process of peer review. Science, the Endless Frontier gave research universities a dominant role in the American scientific enterprise, a reality that was never directly stated in that document. The United States began a decline in output per worker per hour that reversed a nearly century-long global lead in productivity growth. Japan led the pack, not only in adapting and improving on existing American technology in products from cameras to automobiles but also in establishing its own scientific research base. Between 1967 and 1984 Japan was the only industrial nation in which the number of patents per scientist and engineer increased rather than decreased. They were early signs of a trend toward a closer integration of American universities and American industry, something he had seen up close at Stanford and in Silicon Valley. Terman showed what could be accomplished by a judicious leveraging of institutional strengths and an entrepreneurial perspective. Bush defined the place of the research university in the larger landscape of American science, and Atkinson considered Science, the Endless Frontier "one of the great documents of American history. A strategy of promoting innovation and closer ties between universities and industry, he told the governor, would demonstrate his political commitment to restarting the stalled California economy. Its fifty recommendations ranged from trade policy to educating more technologically literate citizens. Local venture capitalists were more likely to go to Silicon Valley, five hundred miles to the north, for investment opportunities. As its name implies, the program brought together university researchers with entrepreneurs, angel investors, and venture capitalists from around the country. In 1980 no new engineering programs had been established in the University of California system for twenty years. The faculty senate was reluctant at first, fearing that an engineering school might drain resources from other departments and that a school might isolate students from other disciplines.

How will success be measured and how will you continue to fund this project once grant funds are expended? The lack of pedestrian-vehicle conflict and the increase in use of the intersection by pedestrians will measure the success of the project heart attack quizzes discount valsartan 80 mg online. By providing a safer and more accessible crosswalk for people will automatically be a measure of success blood pressure medication alcohol buy valsartan 40mg amex. To begin and complete construction before students return for the Fall 2012 semester would be ideal hypertension uncontrolled icd 9 code buy valsartan 160 mg line, however blood pressure lowering herbs order 80 mg valsartan with amex, time will be short. Only 3/11 of the project has been completed due to Public Works wanting to overlay Tennessee and Kentucky streets within the next few months. Existing Land Uses in the Oread Neighborhood Land Use Acres Percent Single-Dwelling Residential 51. Program or Activity Information xx New Program or Activity Name of Program or Activity Requested $10,000. The condition of the stairs and the sidewalk present dangerous conditions and make walking the hill more difficult and unsafe. Leading north on the east side of Louisiana Street past 17th Street and Edgehill Road and continuing north up the hill, the sidewalk and stairs are in disrepair. Walking up this hill is difficult for many people, and the sidewalk and stair condition present even more challenging and dangerous conditions for all people to transverse. The area is in a public easement and it is utilized by hundreds of people on a weekly basis. The percentage of low-moderate income residents in Oread Neighborhood is 78% according to the City of Lawrence 2006-2007 Annual Performance Report. A safer, cleaner, well-maintained neighborhood will be more inviting to visitors, businesses, homeowners, and residents. From the concept of the project idea to the outline and funding request, the process to request funds for stairway and sidewalk repairs has been a collaborative process. Due to the nature of the project, it is a very high likelihood the project will be successful in both the implementation stages as well as the sidewalk and stairway functionality of providing more safe and secure walking environment for pedestrians. A safer sidewalk free from hazardous conditions will invite residents and visitors to utilize the sidewalk. The project will encourage stability in the neighborhood, encourage residents to be more active in the neighborhood, provide safer walking conditions, and foster a sense of community. Upon reward notification, it would be desirable for the City of Lawrence to immediately initiate the planning and approval process, and if possible, implement the project by repairing the stairway and stonewall before more sections and cause more hazardous conditions and more costly repairs. This information is useful in setting and implementing specific efforts to accomplish the mission and goals set forth by the Oread Neighborhood Association. Community Commission on Homelessness: Aggressive Panhandling Discussion on strategies to reduce and confront situations City Commission Meeting: 9th & Vermont Redevelopment Project & 1040 Vermont building construction Historic Resource Commission: Administrative Reviews on various Oread properties Planning Commission Meeting - Agenda: Rezoning for multi-use at 1701 Mass St. What resources are currently available to dedicate to the program or activity, including staff, volunteers, existing funds and community partners? The gardens and walls serve as an attractive, beautified entrance to Oread Neighborhood and provide a landscaped buffer between Memorial Stadium, Mississippi Street, and the Oread Neighborhood. This would complement other major public improvements in the direct vicinity of the Oread Hotel and the gateway to the University of Kansas campus. Sections of the limestone wall, primarily on the north side of 12th Street, are collapsing and threatening to fall onto the street. Not only does this cause a safety hazard for pedestrians and vehicles, it diminishes the character and appearance of the neighborhood. Also, the public easement rock gardens dividing 12th Street down the middle, require constant attention and maintenance in order to be aesthetically pleasing and prevent overgrowth and possible disrepair to 12th Street. This grant will provide the necessary funds to pay for the City of Lawrence to repair sections of the stonewall and rock garden walls, as well as assist in the maintenance and upkeep of the rock garden landscaping. The capital improvement project will bring neighbors together to accomplish a common goal, building a stronger sense of community and stability within the neighborhood, and encouraging more long-term residents and homeownership. The population of Oread Neighborhood is 4,749 residents according to the 2007 City of Lawrence Action Plan. The coordinator works approximately 12 hours per week and all other work is provided by neighborhood volunteers. The coordinator will continue to function as a liaison during each phase of the project. This relationship has been successful, and will continue to be successful through the implementation of the project.

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