montfermeil, france ( ap ) - - the streets in one of the paris region ' s toughest housing projects, burgeoning with immigrants, bear names like cezanne, picasso and utrillo, as if to stamp the french heritage onto the psyches of its residents. but neither the names of the great masters nor the idyllic images conjured up by the name of the project, les bosquets, or the groves, capture the daily realities of the french - style ghetto, an enclosed world where many residents don ' t speak french. delinquency soars and the unemployment rate is estimated at some 40 percent, nearly four times the national rate. montfermeil ' s town hall could not provide an official figure. just 17 kilometers ( 10. 5 miles ) from paris, les bosquets is light years from the world of parisians. les bosquets, like other projects that surround the big cities of france, belies this nation ' s special brand of integration whereby newcomers from afar assimilate into the french culture, becoming one with it whatever their origins. despite quiet debate, french authorities, whatever their political colors, have stood by a french model that ' s colorblind to differences, in total contrast to the u. s. notion of a vibrant melting pot. the story of france is often viewed as the antithesis to the u. s., one in which race and ethnicity are not counted in the government census and minority rights need not exist, due to residents who share a common identity of " french. " many french shudder at the word " multiculturalism. " but housing projects such as les bosquets, often cut off by poor public transport from the cities, raise questions about how much assimilation is really happening in france and whether the french model of integration, long the nation ' s pride, is wearing thin. even muslim immigrants from france ' s former north african colonies, many in their third generation, and making up a large portion of residents of les bosquets, are far from melding with the mainstream. for patrick simon, a leading demographer, the french model has a basic flaw that is becoming increasingly evident as time goes by. " it ' s a model founded on the invisibility of differences, " simon said. the problem is that minorities are increasingly visible, many of them with origins in france ' s former colonies in muslim north africa, and because " we see them, we can ' t ignore their existence. " even second


of differences, " simon said. the problem is that minorities are increasingly visible, many of them with origins in france ' s former colonies in muslim north africa, and because " we see them, we can ' t ignore their existence. " even second - and third - generation citizens of foreign origin are perceived as different and treated thus. statisticians are not allowed to count people by their origins, complicating research. but the postcard vision of france with church steeples perched over a contented populace that ' s wearing berets and carrying baguettes has been upended in the seine - saint - denis region northeast of paris. french kings are buried in the great cathedral of saint - denis, the main town, but traditional minorities have become the majority in the region. a study by simon puts immigrants and their descendants through the second generation at 75 percent of the city ' s population. it includes people from french overseas departments ( 8 percent ), who are french but of color. the jobless rate was 16. 5 percent in 2009, according to insee, the national statistics agency. but the economic leaders are in the white minority, simon said, putting new stress on the notion that immigrants and their children are being successfully assimilated. in les bosquets, the most widespread complaint remains poor public transport and the isolation that keeps les bosquets at a distance from mainstream france. it takes nearly 90 minutes to get to paris. " they ' ve done everything to keep us closed among ourselves, " said a 34 - year - old born in france of algerian parents. " it is they who don ' t want us to integrate. " like most residents of the projects, the man, who works with a private fire department, refused to identify himself by name. discrimination is a fact of life in france for minorities, and a poll by the ipsos firm published this year in the daily le monde showed no sign that that might lessen. a full 70 percent of those questioned felt there were " too many foreigners in france. " the finger was pointed, above all, at those of the muslim faith.


kelvin lukaggregates of misfolded α - synuclein proteins are not just hallmarks of parkinson ’ s disease, they actually initiate pathology, according to a report out today ( november 15 ) in science. a single injection of the aggregated proteins, known as lewy bodies, into the brains of healthy mice caused the propagation of such aggregates across networks of brain cells as well as the destruction of dopaminergic neurons, a key feature of parkinson ’ s disease. “ there had been this [ question ] with the lewy bodies as to whether they were sort of tomb - stone evidence of the disease occurring, or were more involved in the process, ” said gary miller, a professor of neurology at emory university in atlanta, georgia, who was not involved in the study. “ what this shows is that they are clearly part of the process. ” parkinson ’ s disease is one of a number of neurodegenerative conditions, including alzheimer ’ s and prion diseases, that are characterized by the accumulation of protein aggregates in the brain, miller explained. in prion diseases, misfolded proteins recruit and misfold more of the same protein, which in turn recruit and misfold additional proteins, and so on. “ people suspected something similar might be occurring with α - synuclein in parkinson ’ s, ” said miller. “ this paper now shows a pretty crisp representation of this seeding of the α - synuclein that can propagate this pathogenic aggregation. ” in addition to the presence of lewy bodies, the death of dopaminergic neurons in a part of the brain called the substantia nigra is a major feature of parkinson ’ s. indeed, it is this cell loss that causes the characteristic tremors, rigidity, and movement difficulties associated with the disease. but it wasn ’ t entirely clear how the death of dopamine neurons and the presence of lewy bodies were connected, explained virginia lee, director of the center for neurodegenerative disease research at the university of pennsylvania in philadelphia. the goal, “ was to somehow connect the dots to see whether we could provide a direct link between the [ lewy body ] pathology and the dopaminergic cell loss, ” she said. “ and in a nutshell, we were successful. ” lee ’ s team injected aggregates of misfolded α - synuclein protein into a region of the brain called the striatum — chosen because it directly connects


” she said. “ and in a nutshell, we were successful. ” lee ’ s team injected aggregates of misfolded α - synuclein protein into a region of the brain called the striatum — chosen because it directly connects to dopaminergic neurons in the substantia nigra, she explained. dissection and observation of the brains 30, 90, and 180 days later revealed a time - dependent spread of lewy bodies into the substantia nigra and other connected brain regions, and an accompanying time - dependent loss of dopaminergic neurons. the mice also displayed progressive deterioration in certain motor functions. “ one of the interesting aspects of this study is that they showed it happens in wild - type mice, ” said timothy greenamyre, director of the pittsburgh institute for neurodegenerative diseases in pennsylvania. “ there was some conjecture that this process of α - synuclein aggregation and transmission may depend on an aberrant template — an α - synuclein mutation, for example — and that ’ s clearly not the case, ” he said. the fact that misfolding and aggregating an otherwise normal protein can invoke parkinson ’ s disease pathology and deterioration of motor function in healthy mice might be a cause for concern, said michel goedert, a neurobiologist at the medical research council laboratory of molecular biology in cambridge, uk. “ the question is, how similar is this phenomenon to what you get in prion diseases? ” he said. prions are known to transmit from person - to - person, albeit rarely and by unconventional routes. if misfolded α - synuclein somehow made it from one person to another, could it also cause disease? there is no evidence to suggest parkinson ’ s disease can be similarly transmitted, goedert said, but “ it ’ s something in the long run that needs addressing. ” regardless of the degree to which α - synuclein acts like a prion, the finding that its aggregates propagate from neuron to neuron should help researchers work out the cellular mechanisms of disease progression, said goedert — and more importantly, learn how to stop it. k. c. luk et al., “ pathological α - synuclein transmission initiates parkinson - like neurodegeneration in nontransgenic mice, ” science, doi : 10. 1126 / science. 1227157, 2012.


the apocalypse, or book of revelation, is not only the last book of the new testament, but its most difficult, puzzling, and terrifying. it provided challenges to medieval illustrators and was the source for a number of popular images, such as christ in majesty, the adoration of the lamb, and the madonna of the apocalypse and contributed to the widespread use of the evangelists ' symbols. selected images from apocalypse then : medieval illuminations from the morgan, an exhibition held at the morgan are presented here. the exhibition celebrates the completion of a facsimile of the morgan ' s las huelgas apocalypse — the latest dated ( 1220 ) and largest surviving manuscript of a spanish tradition of illuminated commentaries on the apocalypse by the monk beatus of liebana. the series of manuscripts constitutes spain ' s most important contribution to medieval manuscript illumination. the las huelgas apocalypse contains three sections : the prefatory cycle, the apocalypse, and the book of daniel. in addition to forty - nine images from the las huelgas apocalypse, six images from other manuscripts in the morgan ' s collections, including the earliest beatus painted by maius and one by the master of the berry apocalypse, are in this presentation. last judgment ( rev. : 20 : 11 – 15 ) christ the judge sits at the top in a mandorla supported by two angels. below, in three registers, are six pairs of seated saints ( probably apostles ), each pair with a saint standing behind. these bless the elect, represented by groups of nimbed saints. the registers at right contain the damned. the men at the top clasping hands are those damned together ; below, men suffer individually ; at bottom, the damned are tortured in a lake of fire with ovenlike walls. maius tells us that he made this book so that the " wise may fear the coming of the future judgment of the world ' s end. " the use of bands of color and miniatures extending over two pages represent maius ' s contribution to the beatus tradition. these pages are from one of the earliest surviving illuminated manuscripts in the spanish tradition. written and illuminated by maius ( ca. 945 ) in the famous tower scriptorium of the monastery of san salvador de tabara, it is the most important spanish illuminated manuscript in the united states.


annette smith, left, betty frierson and ruth edwards, members of the indy connection quilters, work on the next quilt for the lynch quilt project titled red rum summer. / frank espich, the indianapolis star indianapolis - - quilts are supposed to be warm and comforting. but artist lashawnda crowe storm ' s quilt is provocative and disturbing - - and purposely so. the quilt, " her name was laura nelson, " depicts the life - size image of the lynching of a black woman a century ago. and now it is available at the indianapolis central library for all to see and ponder and discuss. the quilt will be shown through march 23 as part of the library ' s " meet the artists " exhibit, which includes pieces from 15 local black artists. the piece drew some strong reactions from those who walked by the exhibit on sunday. " i find it very offensive, " said randolph davison, 55, an african - american and retired serviceman from gary. " we ' ve been through enough and don ' t need remembrances like this. " davison said a piece like this does not belong in a public library. " it makes me want to cry, " he said. tamara moore, 37, a white woman from indianapolis, was with her 7 - year - old daughter, samantha, when they came across the quilt. samantha seemed confused by the image, but her mother was clearly outraged by it. " why would they make a quilt like that? it ' s horrible, " moore said, who also said she didn ' t think it belonged in a public library. the artist says such a response is a good thing. for many, crowe storm said, viewing the quilt is like opening a wound. no wound heals, she said, until it bleeds. " something that needs to be addressed is this history of racism, " crowe storm said. " lynching was really about controlling a population to stay in their place. " community leaders and scholars say the quilt is a reminder of a time in history many would rather ignore. there is no ignoring this quilt. the woman ' s image comes from a black - and - white photo of a lynching near okemah, okla., on may 25, 1911. in a sea of soft white fabric bordered by black and red, the body of laura nelson dangles from a rope, head cocked sharply to the side on her broken neck. " the art form is very important in the telling of the stories of black people, " said


soft white fabric bordered by black and red, the body of laura nelson dangles from a rope, head cocked sharply to the side on her broken neck. " the art form is very important in the telling of the stories of black people, " said valerie grim, chairwoman of indiana university ' s department of african american and african diaspora studies. " lynching, as a reality of black people, was one of the worst moments in the history of america. " the quilt reminds us of terrible deeds and ugly times. the wounds of slavery, racism and oppression still linger in the u. s., grim said, and it ' s important to face our past, regardless of how uncomfortable it makes us. teaching the young the rev. charles harrison, pastor at barnes united methodist church, said he understands that many will be hurt by the image on the quilt. still, he thinks it is an important teaching tool. " for those who are old enough to remember the dark past, it ' s a reminder, " said harrison, the president of the ten point coalition, a faith - based anti - crime group that counsels inner - city youths. " sometimes, we have to remind ourselves and the younger generation of the heavy price that was paid by those who were part of the civil rights movement. " john h. stanfield ii, a professor in iu ' s department of african american and african diaspora studies, said the library must be responsible in how it presents the quilt. " the quilt is not only an art piece, " stanfield said, " but also a device that should be used to educate the public about the horrors of lynching. " the quilt, he said, might be a catalyst for discussion and action. " ready or not, our moment for serious discussion has arrived, " stanfield said. " none of us, irrespective of our ancestry, can afford to remain ignorant, naive, prejudiced or fearful about racial differences. " opening a dialogue stanfield said the library must ensure that the quilt does more than simply shock and disturb. jackie nytes, the indianapolis public library ' s chief executive officer, said the quilt is part of a broader educational effort. " it ' s not an easy subject, no doubt about it, " nytes said. " neither were the aids quilts when those were circulated around the country. " the quilt confronts patrons as they step off an escalator on the library ' s third floor. a black nylon partition keeps the public a little more than an arm '


" neither were the aids quilts when those were circulated around the country. " the quilt confronts patrons as they step off an escalator on the library ' s third floor. a black nylon partition keeps the public a little more than an arm ' s length away. although the quilt is not under guard, library staff are always in the vicinity. " for any parents who find themselves in the situation of walking past it with their child, i hope they are able to say : ' this was a very sad time in american history, and we don ' t do this anymore, ' " nytes said. " this is a learning moment. we don ' t do our kids any favors by pretending it didn ' t happen. " exhibit curator tony radford said a committee that accepted the crowe storm quilt believed it was designed to enlighten, educate and heal. the display includes signs explaining the artist ' s background and goals for the piece. " ( february ) is black history month, and this is part of our history, our culture, " said radford, also an artist who will have some pieces on display in the exhibit. " art is not always going to be pretty flowers. " part of our past thousands of men and more than 100 women were lynched in america between 1850 and 1950, but crowe storm said laura nelson was the only woman she could find who was photographed in the noose. having a woman on the quilt was important, crowe storm said, because she hopes her piece brings up issues of gender and violence. " lynching is not just a black history ; it ' s an american history, " crowe storm said. " we must begin to address it as a nation, or we won ' t be able to move forward. " copyright 2013 usatoday. com read the original story : quilt depicting horrors of lynching stirs emotions


csiro mine safety tech becomes archaeological tool zebedee helps map ancient cave etchings a 3d mapping technology announced earlier this year by australia ’ s science agency csiro is being used to help map what might be the world ’ s oldest cave etchings. during december, csiro scientists undertook an exploration on behalf of the adelaide museum, in which they took the technology known as zebedee into the delicate koonalda cave in south australia. the cave was used as a flint mine by australian aborigines as far back as 30, 000 years ago, the cave includes markings known as “ finger flutings ”, apparently made by dragging the hand across the soft limestone walls. enter zebedee, a 3d mapping system created by the csiro and licensed to uk company geoslam. the handheld system gathers a real - time point cloud of its surroundings without needing systems like gps as a reference ( handy, since gps doesn ’ t work underground ). zebedee consists of a lightweight lidar ( light detection and ranging ) set, along with inertial measurement. and yes, its inventors – robert zlot and mike bosse of the csiro ’ s autonomous systems lab – say its name was inspired by the character in the magic roundabout. new scientist describes the expedition to map the caves here - and the purpose of the finger flutings still remains a mystery. however, with the 3d maps, researchers can at least examine the cave from their desktop, without the six - hour drive to reach the caves. ®


ruins show ' lost city ' of the incas was part of vast complex david keys – the independent november 7, 2003 the world ' s most famous " lost city " - the inca ruins of machu picchu in peru, found in the early 20th century - was part of a much larger complex, according to sensational new archaeological discoveries. while investigating a mountain ridge facing the andean city, an anglo - american expedition has discovered a previously unknown series of high - status sacred ceremonial buildings scattered over at least a square mile of jungle. so far, using airborne infra - red reconnaissance and exploration of the jungle itself, the team - led by the british explorer hugh thomson and the american archaeologist gary ziegler - have found 33 previously unknown buildings. they also found seven others which had originally been located by the american explorer hiram bingham in 1912, but the whereabouts of which had been lost, as bingham left no compass bearings. preliminary examination of the ruins suggests that the complex was a large religious centre used for ceremonies and astronomical observations. the new area istwo miles from machu picchu itself. the expedition has identified, as well as the buildings, eight plazas, seven 10ft - highplatforms and a series of walled walkways connecting structures. the buildings include a massive storehouse, a probable sun temple ( resembling in several ways the great sun temple in the inca capital, cuzco, 45 miles away ), and a two - storey observatory, for watching solar equinoxes and solstices. the archaeologists believe that the complex was probably built by the inca emperor pachacuti in the mid - 15th century. the complex, known as llactapata, appears to have been constructed along with machu picchu as part of one overall plan. buildings in both machu picchu and llactapata are aligned with each other and with mount machu picchu, which dominates the site. the ruined fortress city of machu picchu ( " manly peak " ) consists of about 200 buildings at an altitude of 8, 000ft. it was probably used to provide seasonal high - status accommodation and some ceremonial facilities for the ruler and his entourage, with room for 1, 200 people, possibly during the winter when cuzco became very cold. llactapata, on the other hand, appears to have been more ceremonial in nature. the sites therefore complemented each other and formed a greater whole facing each other across the aobamba river. mr ziegler said : " this is an important


over 8, 000 websites created by students around the world who have participated in a thinkquest competition. compete | faq | contact us water, water, everywhere... we, as humans, must learn to comprehend the tremendous power water has over us all. without this simple hydrogen - oxygen substance, life would cease to exist. yet, the simple fact remains that we are depleting our water resources at an alarming rate and we must understand the fact that water is finite, even though the capability remains to produce this substance. water is something we should cherish, value, and respect ; for without it, we would be no more. " water, water, everywhere... " is an educational site that digs deep into all aspects of water, a truly fascinating substance. from scientific aspects to health benefits and consequences to its sheer destructive force, this in - depth look at water will help provide the basic, fundamental education necessary to help not only save a life, but the lives of countless billions. 2001 achievement award jaredplainview - old bethpage / jfk hs, plainview, ny, united states chean fonksabah tshung tsin secondary school, kota kinabalu, malaysia 19 & under carol calderwoodcalderwood household, north lambton, australia onno fabertechnische universiteit delft, wijk bij duurstede, netherlands social sciences & culture > education social sciences & culture > education > homework & study guides english, spanish, dutch


librarian of congress james billington points to a correction in the rough draft of the declaration of independence written by thomas jefferson, friday, july 2, 2010, at the library of congress in washington. recent imaging of the document clearly confirmed that jefferson originally wrote " subject " then changed it to " citizen. " ( ap photo / susan walsh ) washington — preservation scientists at the library of congress have discovered that thomas jefferson, even in the act of declaring independence from england, had trouble breaking free from monarchial rule. in an early draft of the declaration of independence, jefferson wrote the word " subjects, " when he referred to the american public. he then erased that word and replaced it with " citizens, " a term he used frequently throughout the final draft. the library released news of the struck word for the first time on friday. fenalla france, a research chemist at the library, said her lab made the discovery last year by using hyperspectral imaging, using a high resolution digital camera that compiles a series of images to highlight layers of a document. some of those invisible layers — like erased text and even fingerprints — pop into view on a computer screen. in switching from " subjects " to " citizens, " france said it appears jefferson used his hand to wipe the word out while the ink was still wet. a distinct brown smudge is apparent on the paper, although the word " subjects " is not legible without the help of the digital technology. " this has been a very exciting development, " france said, calling the findings " spine - tingling. " historic, handwritten documents reveal clues about the past that word processors cannot illuminate, said james billington, librarian of congress. " it shows the progress of his mind. this was a decisive moment, " billington said. " we recovered a magic moment that was otherwise lost to history. " accompanied by police escort, the document was unveiled outside its protective case for the first time in 15 years on friday morning for a demonstration of the hyperspectral imaging technology. it normally can only be viewed through a 130 - poundb oxygen - free safe. donning a pair of white researchers ' gloves, maria nugent, director of the library of congress ' top treasures collection, slowly lifted a piece of off - white corrugated cardboard to reveal the rough draft of the declaration, which includes handwritten corrections by both john adams and benjamin franklin. " that ' s a pretty good editorial committee, " said billington, who was present for the procedure. the rough draft


tornadoes in may, 2000 the tornado history project generates approximate paths through separate historical archives provided by the storm prediction center ( spc ) and the national climatic data center ( ncdc ). paths generated from the ncdc data are typically more detailed, but neither archive gives exact path information. there are several reasons that paths may be inaccurate : - tornado touchdown and liftoff coordinates were recorded with only 2 digits of decimal precision ( i. e. [ 33. 72, - 86. 15 ] vs [ 33. 71689, - 86. 15463 ] ). as a consequence, the observed points on the map may be slightly off from actual. note that beginning in 2009, up to 4 digits of decimal precision are given. - coordinates have not historically been calculated via gps ( global positioning system ). thus, tornado touchdown and liftoff coordinates should be considered as estimates only. - tornadoes may not have been in contact with the ground for the entire path as depicted on the map. storm damage in any location depicted under the " path " should not be inferred. - although paths are drawn as straight lines between any two sets of coordinates, the tornado may have " zigzagged " in some way. - although paths are drawn as uniform thin lines on the map, it is likely that the tornado changed size over its lifetime. damage in any location depicted under ( or not under ) the " path " should not be inferred. even with the above in mind, the data is the best available. if you see a path that is depicted incorrectly, please post a comment in the tornado forum indicating why you belive the path to be incorrect. paths generated from ncdc data are typically more detailed due to the way coordinates are listed in each archive : - spc database - a maximum of 2 coordinates ( touchdown and liftoff ) is given for each tornado, or each state segment of a tornado if it is a multi - state tornado. thus the vast majority of paths are depicted as simple straight lines. - ncdc database - some tornadoes have mutliple sets of coordinates within any state, generally corresponding to entry and exit points by county. thus, since more coordinates have been used to draw the path, the depicted path should be more accurate. having said that, most tornadoes do not have additional path data in the ncdc archive. when they do, paths are drawn from the ncdc data. the following statistics and definitions are derived from the storm prediction center ( spc ) historical tornado archive. the tornado


, most tornadoes do not have additional path data in the ncdc archive. when they do, paths are drawn from the ncdc data. the following statistics and definitions are derived from the storm prediction center ( spc ) historical tornado archive. the tornado history project can not guarantee the accuracy of the underlying data within the spc historical tornado archive. however, the data as presented here is guaranteed to match the spc data, except where noted. some definitions will not be given since they are obvious ( i. e. " date ", " time ", etc... ) special note : this site uses a unique index number to identify each tornado. this index number is not a part of the official historical tornado archive. e ( error ) ( tornado search table only ) - a yellow box indicates that the tornado record contains a suspected error. a red box indicates that the tornado record contains an error and has been modified from the official source. hover over the box for the error text. map / forum ( tornado search table only ) - clickable icons for further content related to a tornado. state - the state or states affected by a tornado. fujita - the fujita scale is an attempt to classify damage from a tornado. f0 being the least damaging, f5 the most. for 2007 and beyond, the enhanced fujita ( ef ) is given. fat. - the number of fatalities attributed to the tornado. inj. - the number of injuries attributed to the tornado. width - width in yards. it is unclear if this indicates a maximum width or mean width. length - length of tornado path in miles. note the entire track length is not necessarily all on the ground ( some tornadoes " hop and skip ". ) damage - prior to 1996, this is a range by dollar amount. for 1996 and later, actual damage estimates are in millions. crop loss - added in 2007. given in millions of dollars. lat / lon - contains two sets of coordinates : - touchdown latitude / longitude - for single state tornadoes, and the overall record for multi - state tornadoes, the approximate touchdown location in decimal degrees. for the state specific records of multi - state tornadoes, entry point into the state in decimal degrees. - liftoff latitude / longitude - for single state tornadoes, and the overall record for multi - state tornadoes, the approximate liftoff location in decimal degrees. for the state specific records of multi - state tornadoes, the exit or lift - off point from the state in decimal degrees. st. #.


tv is one of the most popular forms of media. as much as there are many people who might want to dispute this, a majority of people still find themselves drawn to the entertainment box. radio which was more popular in the previous generation is slowly losing its glory. this is mostly because there are numerous gadgets that can be used to listen to music. podcasts for example can be used in place of the radio. this is one of the things that is increasingly gaining popularity in social media. some of the basics that involve the podcasts include : this is a combination of the words “ broadcast ” and “ ipod ” ; podcasts are a kind of digital media that is episodic. users can download to this media via web syndication when they have subscribed. they take the form of the audio although there are video podcasts where slideshows are used. in the past, they were only used by the techie demographic but the general public son caught up. content used in the podcasts usually ranges from culture, sports, music and magic among many others. social media and podcasts podcasts were introduced almost at the same time as social media. most people understand social media as fancy web 2. 0 terminologies that are related to facebook and twitter which are a means of opening up communication as well as interactions between organizations and their followers, fans and audience, brands and persons. the podcasts allow for a wider interaction with people mostly because of the syndication feeds. feeds permit the users to download the podcasts once they have been released and listen to them using a variety of mediums. this is different from the radio where you have to tune in at a specific time or date. most of the time, the people who have produced the podcasts will become the producers and vice versa thus they end up holding conversations with each other. podcasting calling usually calls for active participation and listening. content and freedom podcasts empower both the consumer and the producer. listeners can choose the time they want to listen to the content. anyone with a computer and microphone can participate as it does not have too many restrictions. they have become one of the most unique ways of sharing information / content. podcasts have broad audience, do not have any restrictions, can be used easily as it does not have difficult applications and is one of the major forms of media which gives people voice to be heard. more on podcast transcription


euglobulin lysis time ( elt ) is a blood test that looks at how fast clots break down in the blood. euglobulin clot lysis ; fibrinolysis / euglobulin lysis ; elt a blood sample is needed. for information on how this is done, see venipuncture the laboratory specialist will run tests on the blood sample to see how fast blood clots dissolve. the dissolving of blood clots is called fibrinolysis. no special preparation is usually needed. when the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. afterward, there may be some throbbing. this is one of the best tests to tell the difference between primary fibrinolysis and disseminated intravascular coagulation. the test can also be used to monitor patients who are on streptokinase or urokinase therapy for acute mi ( heart attack ). a normal value will range from 90 minutes to 6 hours. euglobulin clot lysis is normally complete within 2 to 4 hours. note : normal value ranges may vary slightly among different laboratories. talk to your doctor about the meaning of your specific test results. a longer - than - normal elt time may be due to : a shorter - than - normal elt time may be due to : the test may also be done to diagnose or rule out : there is very little risk involved with having your blood taken. veins and arteries vary in size from one patient to another and from one side of the body to the other. taking blood from some people may be more difficult than from others. other risks associated with having blood drawn are slight but may include : heavy exercise can cause a shorter - than - normal elt time. increasing age and certain medicines, including corticosteroids, acth, streptokinase, and urokinase can cause a longer - than - normal elt time. lijnen hr, collen d. molecular and cellular basis of fibrinolysis. in : hoffman r, benz ej jr., shattil sj, et al, eds. hoffman hematology : basic principles and practice. 5th ed. philadelphia, pa : churchill livingstone elsevier ; 2008 : chap 119. schafer a. hemorrhagic disorders : disseminated intravascular coagulation, liver failure, and vitamin k


infant language researcher earns top faculty award on the green | roberta golinkoff, h. rodney sharp chair in the school of education, is not only an educator in the traditional sense of the word, teaching students in university classrooms, she is also an educator of the public. she writes and speaks to diverse audiences of researchers, parents, teachers and healthcare professionals about how children learn. in recognition of her work, golinkoff was selected as the 2011 recipient of the francis alison award, the university ’ s highest faculty honor, which was established in 1978 to recognize scholarship, professional achievements and dedication. she also is a faculty member in the departments of psychology and of linguistics and cognitive science. early in her 36 - year career at ud, golinkoff developed a method to assess language comprehension in babies who do not yet speak. because of her research, it is now known that infants do not sit passively while words wash over them, but instead they are actively analyzing what they hear and extracting language ’ s rules and regularities. letters from golinkoff ’ s scholarly peers underscore the importance of her work, noting that she has “ altered our understanding of how children learn language and develop thought. ” yale university ’ s edward zigler, the driving force behind head start in the 1960s, says that he “ would be hard pressed to name a scholar that i admire more than roberta. ” to support her work, golinkoff has received sizable grants from the national science foundation, the national institutes of health and the national institute of children ’ s health and human development. she has also won a prestigious john simon guggenheim fellowship and a james mckeen cattell sabbatical award. in 2009, the american psychological association awarded her the distinguished service to psychological science award, and this spring she received the urie bronfenbrenner award for lifetime contribution to developmental psychology in the service of science and society. golinkoff ’ s books include einstein never used flash cards : how our children really learn and why they need to play more and memorize less, which explores the importance of play in children ’ s lives. she has given a congressional briefing and continues to present at the u. s. department of education on early childhood education.


spinal fusion is surgery to permanently join together two or more bones in the spine so there is no movement between them. these bones are called vertebrae. you will be asleep and feel no pain ( general anesthesia ). the doctor will make a surgical cut to view the spine. this may be done : - on your back or neck over the spine. you will be lying face down. muscles and tissue are separated to expose the spine. - on one side of your belly, if you are having surgery on your lower back. the surgeon will use tools called retractors to gently separate, hold the soft tissues and blood vessels apart, and have room to work. - with a cut on the front of the neck, toward the side. other surgery, such as a diskectomy, or a foraminotomy, is almost always done first. the surgeon will use a graft ( such as bone ) to hold ( or fuse ) the bones together permanently. there are several different ways of fusing vertebrae together : - strips of bone graft material may be placed over the back part of the spine. - bone graft material may be placed between the vertebrae. - special cages may be placed between the vertebrae. these cages are packed with bone graft material. the surgeon may get the graft from different places : - from another part of your body ( usually around your pelvic bone ). this is called an autograft. your surgeon will make a small cut over your hip and remove some bone from the back of the rim of the pelvis. - from a bone bank, called allograft. - a synthetic bone substitute can also be used. the vertebrae are often also fixed together with rods, screws, plates, or cages. they are used to keep the vertebrae from moving until the bone grafts fully healed. surgery can take 3 - 4 hours. vertebral interbody fusion ; posterior spinal fusion ; arthrodesis ; anterior spinal fusion ; spine surgery - spinal fusion why the procedure is performed spinal fusion is most often done along with other surgical procedures of the spine. it may be done : spinal fusion may be done if you have : - injury or fractures to the bones in the spine - weak or unstable spine caused by infections or tumors, a condition in which one vertebrae slips forward on top of another - abnormal curvatures, such as those from scoliosis you and your doctor can decide when you need to have surgery. risks for any surgery are : risks for spine surgery are : -


a condition in which one vertebrae slips forward on top of another - abnormal curvatures, such as those from scoliosis you and your doctor can decide when you need to have surgery. risks for any surgery are : risks for spine surgery are : - infection in the wound or vertebral bones - damage to a spinal nerve, causing weakness, pain, loss of sensation, problems with your bowels or bladder - the vertebrae above and below the fusion are more likely to wear away, leading to more problems later before the procedure always tell your doctor or nurse what drugs you are taking, including medicines, herbs, and supplements you bought without a prescription. during the days before the surgery : - if you are a smoker, you need to stop. patients who have spinal fusion and continue to smoke may not heal as well. ask your doctor for help. - two weeks before surgery, your doctor or nurse may ask you to stop taking drugs that make it harder for your blood to clot. these include aspirin, ibuprofen ( advil, motrin ), naproxen ( aleve, naprosyn ), and other drugs like these. - if you have diabetes, heart disease, or other medical problems, your surgeon will ask you to see your regular doctor. - talk with your doctor if you have been drinking a lot of alcohol. - ask your doctor which drugs you should still take on the day of the surgery. - always let your doctor know about any cold, flu, fever, herpes breakout, or other illnesses you may have. on the day of the surgery : - you will usually be asked not to drink or eat anything for 6 - 12 hours before the procedure. - take your drugs your doctor told you to take with a small sip of water. after the procedure you will stay in the hospital for 3 - 4 days after surgery. you will receive pain medicines in the hospital. you may take pain medicine by mouth or have a shot or an intravenous line ( iv ). you may have a pump that allows you to control how much pain medicine you get. you will be taught how to move properly and how to sit, stand, and walk. you ' ll be told to use a " log - rolling " technique when getting out of bed. this means that you move your entire body at once, without twisting your spine. you may not be able to eat for 2 - 3 days. you will be given nutrients through an iv. when you leave the hospital, you


getting out of bed. this means that you move your entire body at once, without twisting your spine. you may not be able to eat for 2 - 3 days. you will be given nutrients through an iv. when you leave the hospital, you may need to wear a back brace or cast. your healthcare team will tell you how to take care of yourself at home after spine surgery if you had chronic back pain before surgery, you will likely still have some pain afterward. spinal fusion is unlikely to take away all your pain and other symptoms. it is hard for a surgeon to always predict which patients will improve and how much relief surgery will provide, even when using mri scans or other tests. losing weight and getting exercise will increase your chances of feeling better. future spine problems are possible for all patients after spine surgery. after spinal fusion, the area that was fused together can no longer move. therefore, the spinal column above and below the fusion are more likely to be stressed when the spine moves, and may have problems later on. weinstein jn, tosteson td, lurie jd, et al. surgical versus nonsurgical therapy for lumbar spinal stenosis. n engl j med. 2008 ; 358 : 794 - 810. brox ji, nygaard øp, holm i, keller a, ingebrigtsen t, reikeras o. four - year follow - up of surgical versus non - surgical therapy for chronic low back pain. ann rheum dis. 2010 sep ; 69 ( 9 ) : 1643 - 8. curlee pm. other disorders of the spine. in : canale st, beatty jh, eds. campbell ' s operative orthopaedics. 11th ed. philadelphia, pa : mosby elsevier ; 2007 : chap 41. weinstein jn, tosteson td, lurie jd, et al. surgical versus nonoperative treatment for lumbar spinal stenosis four - year results of the spine patient outcomes research trial. spine ( phila pa 1976 ). 2010 jun 15 ; 35 ( 14 ) : 1329 - 38. matz pg, holly lt, groff mw, et al ; joint section on disorders of the spine and peripheral nerves of the american association of neurological surgeons and congress of neurological surgeons. indications for anterior cervical decompression for the treatment of cervical degenerative radiculopathy. j neurosurg spine. 2009 aug ; 11 ( 2 ) : 174 - 82. da


shots - health blog tue january 24, 2012 common chemicals could make kids ' vaccines less effective originally published on tue january 24, 2012 4 : 07 pm the more exposure children have to chemicals called perfluorinated compounds, the less likely they are to have a good immune response to vaccinations, a study just published in jama, the journal of the american medical association shows. the finding suggests, but doesn ' t prove, that these chemicals can affect the immune system enough to make some children more vulnerable to infectious diseases. for decades now, pfcs have been used in nonstick coatings, stain - resistant fabrics and some food packaging. and because they persist in the environment for years, they have become common around the globe. " you can find them in polar bears, " says dr. philippe grandjean, the study ' s lead author who works at both harvard and the university of southern denmark. studies in animals have shown that pfcs can weaken the immune system. grandjean wanted to know whether this was happening in children. so he led a team that studied nearly 600 kids in the faroe islands, which lie about halfway between scotland and iceland. the faroese have levels of pfcs similar to those of u. s. residents. grandjean figured if the chemicals were having an effect, it would show up in the way kids ' bodies responded to vaccinations. normally, a vaccine causes the production of lots of antibodies to a specific germ. but grandjean says the response to tetanus and diphtheria vaccines was much weaker in 5 - year - olds whose blood contained relatively high levels of pfcs. " we found that the higher the exposure, the less capable the kids were in terms of responding appropriately to the vaccine, " grandjean says. the results raise the possibility that " the immune system is not really developing optimally. " the health effects of pfcs are still poorly understood. but in the past decade, government scientists have become increasingly concerned about possible links to developmental problems in children. as a result, the environmental protection agency has taken steps that have resulted in some pfcs being phased out. these chemicals aren ' t as frightening as some found in the environment, says dr, alan ducatman from west virginia university, which has been part of a large study of a pfc known as c8. " but they are clearly problematic, " he says, adding that the c8 study also found some evidence of an effect on the


faroese have levels of pfcs similar to those of u. s. residents. grandjean figured that if the chemicals were having an effect, it would show up in the way the kids ' bodies responded to vaccinations. normally, a vaccine causes the production of lots of antibodies to a specific germ, but grandjean says that response was less pronounced in the children whose blood contained higher levels of pfcs. grandjean : we found that, the higher the exposure, the less capable the kids were in terms of responding appropriately to the vaccine and some of the kids were more or less incapable. hamilton : the study looked at the responses to vaccines for diphtheria and tetanus in children from five to seven years old. grandjean says the result suggests these kids have a blunted response to other vaccines, as well, and perhaps bigger problems. grandjean : of course, we worry that something more serious is going on here, that the immune system is not really developing optimally. hamilton : if so, children with higher levels of pfcs might be less able to fight off infectious diseases. alan ducatman from west virginia university has worked on something known as the c8 health project, which has been studying the health effects of one particular pfc in ohio and west virginia. he says results from the new study are consistent with some of their own findings regarding pfcs and immune function. alan ducatman : pfcs have certainly undergone a transformation in our perspective on them over one decade. hamilton : ducatman says consumers in the u. s. have reason to be concerned, even though companies here have phased out some pfcs and some exposure levels have begun falling. ducatman says pfcs are not the most frightening chemicals out there. ducatman : but they are also clearly problematic and something to think about and, to the degree that levels are going down in the united states, we should also acknowledge that they ' re not going down in other parts of the world and, in fact, there are places where they may even be going up. hamilton : grandjean says china is one country that appears to be using more pfcs these days and they are putting them in products that get sold in the u. s. grandjean : we may just be importing products with the same compounds instead, so i don ' t think that we have solved the exposure problem yet and i think it needs international attention. hamilton : it ' s getting some. global treaties


osteoporosis, a term meaning “ porous bones, ” is a silent disease that occurs as a result of reduced bone formation and increased bone resorption. 1 these factors compromise bone structure, leading to microfractures, which can later develop into clinical fractures. 2 complications of fractures include disability, body deformity, depression, pain, and death. 2 prevention of osteoporosis entails identifying secondary causes in order to modify risk factors, if applicable. treating osteoporosis involves the use of prescription medications, calcium and vitamin d supplementation, and nonpharmacologic therapies, such as appropriate diet, exercise, and smoking cessation. the impact of a pharmacist ’ s knowledge of osteoporosis management can help ensure the proper use of medications, appropriate vitamin supplementation, and patient counseling on recommended lifestyle changes. osteoporosis is present in 44 million americans, and the majority of this population is over 50 years of age. 3 women aged 50 years and older have a 50 % chance of breaking a bone due to osteoporosis. 4 to compare the incidence of other disease states with the prevalence of osteoporosis in women, the risk of hip fracture is more than the collective risk of uterine, ovarian, and breast cancer. 4 complications of hip fractures include an increased risk of future fractures and mortality. within the first year of a hip fracture, the risk of mortality increases 10 % to 20 %, and future fracture risk multiplies by 2. 5 - fold. 2 therefore, the impact on the economy is evident, due to an increase in hospital admissions, physician appointments, and enrollment in nursing homes. 2 the leading causes of osteoporosis are separated into nonmodifiable and modifiable risk factors ( table 1 ). 4 women are more at risk for osteoporosis after menopause due to a reduction in estrogen, which plays an important role in bone protection. 4 in addition, peak bone mass occurs between the ages of 18 and 25 years and slowly declines from this age onward. 2 one study completed in 2007 specifically evaluated risk factors for osteoporosis in postmenopausal women. 5 the results of this study demonstrated an increased risk of osteoporosis in women with a history of fracture, total body weight less than 127 lb, and the use of anticoagulants, such as warfarin or he


. 5 the results of this study demonstrated an increased risk of osteoporosis in women with a history of fracture, total body weight less than 127 lb, and the use of anticoagulants, such as warfarin or heparin. a reduction in the progression to osteoporosis was established in women with multiparity or a history of breastfeeding. 5 in addition, certain medications can lead to bone loss ( table 2 ). 6 the diagnosis of osteoporosis is determined by measuring one ’ s bone mineral density ( bmd ), which serves as a predictor of future fracture risk. the national osteoporosis foundation ( nof ) provides guidelines on the most up - to - date recommendations regarding diagnostic criteria ( table 3 ). 2 the world health organization ( who ) defines varying degrees of bone loss by t - scores. 2 the significance of a t - score compares bmd to that of a “ young normal ” adult of the same gender. additionally, the guidelines specify certain populations that are recommended to receive bmd testing ( table 4 ). 2 a fracture risk calculator, known as frax, calculates the 10 - year probability of a hip fracture and major osteoporotic fracture ( available at www. shef. ac. uk / frax ). this advanced tool provides the most accurate results in women with a low hip bmd. 2 the nof guidelines indicate which individuals should receive pharmacologic therapy for osteoporosis. treatment for osteoporosis should be considered for postmenopausal women aged 50 years and older with any of the following : 1 ) fracture of the hip or vertebrae ; 2 ) t - score less than or equal to - 2. 5 ; or 3 ) t - score between - 1. 0 and - 2. 5 and a 10 - year risk of a hip fracture of at least 3 % or a major fracture greater than or equal to 20 % based on the who algorithm. 2 in addition, therapy can be initiated based on patient preference, even if the patient does not meet the above criteria for treatment. the following medications are approved for treatment based on data from clinical trials demonstrating reductions in risk of fracture : bisphosphonates, calcitonin, selective estrogen receptor modulator ( serm ), parathyroid hormone, and denosumab ( table 5 ). 2 in addition, phase ii and iii trials of several new agents are underway to


and studied the efficacy of continuing alendronate for another 5 years or discontinuing therapy after 5 years. 9 discontinuing alendronate therapy after 5 years did not significantly increase the risk of fracture, whereas subjects continuing alendronate therapy maintained mean serum bone turnover markers and bmd similar to baseline levels of the fit trial. the use of bisphosphonates beyond 5 years is patient specific and appears to be most beneficial in patients with a high fracture risk. 9 proper administration of bisphosphonates is essential to improve absorption and reduce the risk of adverse effects. alendronate and risedronate are taken first thing in the morning, with 6 to 8 ounces of water on an empty stomach. it is important for patients to remain sitting or standing and to avoid medications, eating, and drinking liquids, except water, after administration for the next 30 minutes. ibandronate follows the same administration instructions, but requires a 60 - minute time period before food intake and lying down. 7 however, delayed - release risedronate ( atelvia ), a new formulation, may provide patients a convenient alternative ; it should be taken right after breakfast with 4 ounces of water once weekly. it should not be chewed, cut, or crushed. patients need to wait 30 minutes before lying down and avoid taking concurrent medications and supplements. 10 zoledronic acid given as a yearly iv infusion can be used in patients who experience intolerable adverse effects or are unable to properly administer oral formulations. 7 this medication was studied in the health outcomes and reduced incidence with zoledronic acid once yearly ( horizon ) pivotal fracture trial, which compared zoledronic acid 5 mg iv infusion every 12 months with placebo for a total of 36 months. 11 zoledronic acid showed significant reductions in morphometric vertebral fractures by 70 % and hip fractures by 41 % compared with placebo. 11 bisphosphonate therapy should be avoided in patients with a creatinine clearance of less than 30 or 35 ml / min, depending on which agent. 7 in october 2010, the fda added the risk of atypical femur fractures to bisphosphonate labels. 12 the two types of fractures observed under study were below the hip joint ( subtrochanteric femur fracture ) and at the long part of the thigh bone ( diaphyseal femur fracture ). in combination, these fractures are very uncommon and account for less than


observed under study were below the hip joint ( subtrochanteric femur fracture ) and at the long part of the thigh bone ( diaphyseal femur fracture ). in combination, these fractures are very uncommon and account for less than 1 % of all hip and leg fractures. 12 patients should be educated to report any thigh or groin pain to their health care provider. in july 2011, the fda announced reported incidences of esophageal events and esophagitis with oral bisphosphonates. 13 these events have been noted to occur in patients who do not use proper administration technique of the oral dosage form. to date, the fda has not determined whether esophageal cancer risk is increased by oral bisphosphonate use. 13 patients are reminded to discuss the risks versus benefits of bisphosphonates and to contact their health care provider if they experience pain while swallowing, difficulty swallowing, or worsening heartburn. 13 calcitonin : there are two calcitonin agents ( fortical, miacalcin ) currently fda approved for the treatment of osteoporosis in women who are postmenopausal for at least 5 years. calcitonin is involved with calcium regulation and directly inhibits osteoclastic bone resorption. 7 both medications are generally safe and offer different routes of administration — intranasal and sc. a study published in 2000 compared the efficacy of alendronate versus calcitonin for osteoporosis in postmenopausal women. increases in bmd and reductions in bone turnover were significantly greater at 12 months with alendronate compared to intranasal calcitonin. the results of this study further verify the use of bisphosphonates as first - line agents, but offer calcitonin as a therapeutic alternative for osteoporosis. 14 selective estrogen receptor modulator ( serm ) : raloxifene is the only serm approved by the fda for the prevention and treatment of osteoporosis in postmenopausal women. it is also indicated for breast cancer prevention. raloxifene has similar effects as estrogen in preventing bone loss, but potentially antagonizes estrogen in uterine and breast tissue. in addition, raloxifene increases bmd and reduces bone resorption. over 3 years, raloxifene has shown vertebral fracture reductions of 30 % in


study was to assess denosumab versus placebo over 3 years in the primary end point of reducing new vertebral fractures. results demonstrated a 69 % reduction in vertebral fractures and a 61 % reduction in multiple new vertebral fractures with denosumab, which was statistically significant compared to placebo. 16, 17 the efficacy of this medication compared to existing therapies is limited, due to the lack of head - to - head studies. denosumab is expensive compared to other therapeutic options, but an advantage is biannual sc injections. overall, denosumab serves as a therapeutic option for patients who are unable to tolerate bisphosphonates due to esophageal irritation or for patients with low levels of adherence. 16, 17 estrogen / hormone therapy ( et / ht ) : based on the nof guidelines, et / ht is not approved for the treatment of osteoporosis. this statement is based on the associated increased risk of stroke, pulmonary emboli, myocardial infarction, breast cancer, or deep vein phlebitis with these agents. although fda approved indications include prevention of osteoporosis and alleviation of symptoms associated with menopause ( i. e., vasomotor symptoms, vulvovaginal atrophy ), et / ht is not recommended as a first - line agent for osteoporosis prevention. 2 future therapies : there are several agents for the management of osteoporosis completing phase ii and phase iii trials that employ different mechanisms of action compared with current therapies. odanacatib, a phase iii agent, inhibits cathepsin k, which is produced by osteoclasts and functions to degrade bone. 17 two anabolic agents studied for postmenopausal women with osteoporosis, mk - 5442 and amg 785, are undergoing phase ii trials that are expected to be completed in 2012. mk - 5442 targets the calcium - sensing receptor ( casr ) on the parathyroid gland. 17 during hypocalcemia, the casr is activated, causing the release of parathyroid hormone, which increases calcium levels in the blood. 17 mk - 5442 is known as a calcilytic drug, due to its hypocalcemic mimicking properties. 17 in addition, amg 785 is a scler


cardiovascular disease, or diabetes. the recommendations are based on dietary reference intakes ( dris ), which are the total requirement from diet and dietary supplements ( table 6 ). 18 the amount of daily calcium required is based on the quantity of elemental calcium in each product. maximal absorption of calcium occurs at 500 to 600 mg per dose. 1 calcium supplementation should be divided throughout the day, usually twice daily, to achieve maximal absorption. each otc product has varying amounts of calcium and vitamin d. in general, calcium carbonate products have a higher percentage of elemental calcium ( table 7 ). 19 common side effects are constipation, bloating, and flatulence. these products should be separated from certain medications such as iron, tetracyclines, and fluoroquinolones, because they can interfere with absorption. 7 the gold standard of monitoring osteoporosis therapy is to evaluate bmd of the hip and spine by a central dual - energy x - ray absorptiometry ( dxa ) scan every 2 years and at the occurrence of clinical fractures. 2 frequent monitoring of medication safety is also important, and adverse effects are listed for each drug class in table 5. conclusion and the pharmacist ’ s role the best way to treat osteoporosis is to prevent its occurrence. modification of risk factors is imperative, and pharmacists can play a large role in this area. pharmacists can counsel patients — especially women, who are at an increased risk for osteoporosis — to increase their intake of foods and drinks rich in calcium and vitamin d ; offer strategies to quit smoking ; encourage 30 minutes of weight - bearing and muscle - strengthening exercise at least three times per week ; and, most importantly, recommend appropriate calcium and vitamin d supplementation and any required prescription medications for osteoporosis. pharmacists can determine the best therapeutic option for patients based on efficacy, tolerable adverse effects, contraindications, and medication adherence. patients require counseling on proper dosing, administration, and adverse effects to promote the safe use and monitoring of medications for osteoporosis. medication adherence and monitoring of bmd by central dxa is critical to reduce fracture risk and progression of osteoporosis. refer to table 8 for useful online resources for patients and pharmacists regarding osteoporosis management. 1. osteoporosis. mayo clinic. osteoporosis / ds00128.


) : a randomized trial. jama. 2006 ; 296 : 2927 - 2938. 10. atelvia ( risedronate sodium ) package insert. north norwich, nj : norwich pharmaceuticals, inc. ; january 2011. 11. black dm, delmas pd, eastell r, et al. once - yearly zoledronic acid for treatment of postmenopausal osteoporosis. n engl j med. 2007 ; 356 : 1809 - 1822. 12. fda : possible increased risk of thigh bone fracture with bisphosphonates. fda news release. october 13, 2010. ucm229171. htm. accessed june 15, 2011. 13. oral osteoporosis drugs ( bisphosphonates ) : drug safety communication — potential increased risk of esophageal cancer. fda. july 21, 2011. ducts / ucm264087. htm. accessed august 7, 2011. 14. downs rw jr, bell nh, ettinger mp, et al. comparison of alendronate and intranasal calcitonin for treatment of osteoporosis in postmenopausal women. j clin endocrinol metab. 2000 ; 85 : 1783 - 1788. 15. prolia ( denosumab ) package insert. thousand oaks, ca : amgen manufacturing ltd ; june 2010. 16. cummings sr, san martin j, mcclung mr, et al ; freedom trial. denosumab for prevention of fractures in postmenopausal women with osteoporosis. n engl j med. 2009 ; 361 : 756 - 765. 17. rachner td, khosla s, hofbauer lc. osteoporosis : now and the future. lancet. 2011 ; 377 : 1276 - 1287. 18. dietary reference intakes for calcium and vitamin d. institute of medicine of the national academies. november 30, 2010. calcium - and - vitamin - d. aspx. accessed april 5, 2011. 19. comparison of oral calcium salts. pharm / prescriber letter. 2008 ; 24 : 241008. to comment on this article, contact


the university of wisconsin press environment / natural history companion to a sand county almanac interpretive and critical essays edited by j. baird callicott the first sustained study of leopold ' s seminal book as a work of art, philosophy, and social commentary. aldo leopold ' s a sand county almanac is the bible for the modern american conservation movement, its capstone essay, " the land ethic, " repeatedly invoked by scholars, professionals, and environmentally aware citizens everywhere. this volume engages leopold ' s work from several disciplinary perspectives — biography, social and intellectual history, natural history, resource management, literary criticism, and philosophy. the contributors to this volume include some of the leading scholars of leopold and of environmental ethics in the nation : curt meine of the university of wisconsin – madison ; susan flader of the university of missouri – columbia ; peter fritzell and dennis ribbens of lawrence university ; roderick nash of the university of california at santa barbara ; edwin p. pister of the california department of fish and game ; holmes rolston iii of colorado state university ; john tallmadge of carleton college ; and wallace stegner of stanford university. " an indispensable collection. " john murray, bloomsbury review j. baird callicott, who is editor of as well as the principal contributor to this volume, is regents professor of philosophy and religion studies in the institute of applied science at the university of north texas. for more information regarding publicity and reviews contact our publicity manager, chris caldwell, phone : ( 608 ) 263 - 0734, email : email @ example. com 308 pp. 6 1 / 8 x 9 1 / 4 cloth $ 27. 95 t paper $ 20. 95 s e - book $ 9. 99 t adobe digital edition about our e - books click here for a further explanation of the shopping cart feature. home | books | journals | events | textbooks | authors | related | search | order | contact if you have trouble accessing any page in this web site, contact kirt murray, web manager. e - mail : firstname. lastname @ example. org or by phone at 608 - 263 - 0733. updated july 15, 2010© 2010, the board of regents of the university of wisconsin system


the dutch united provinces declared their independence from spain in 1579 ; during the 17th century, they became a leading seafaring and commercial power, with settlements and colonies around the world. after a 20 - year french occupation, a kingdom of the netherlands was formed in 1815. in 1830 belgium seceded and formed a separate kingdom. the netherlands remained neutral in world war i, but suffered invasion and occupation by germany in world war ii. a modern, industrialized nation, the netherlands is also a large exporter of agricultural products. the country was a founding member of nato and the eec ( now the eu ), and participated in the introduction of the euro in 1999. in october 2010, the former netherlands antilles was dissolved and the three smallest islands - bonaire, sint eustatius, and saba - became special municipalities in the netherlands administrative structure. the larger islands of sint maarten and curacao joined the netherlands and aruba as constituent countries forming the kingdom of the netherlands. read more. the university of sint eustatius school of medicine invites you to discover your future : fulfillment of a dream to practice as a medical doctor. this occurs on the caribbean island of sint eustatius, locally known as statia. committing oneself to study medicine at a foreign medical school in a remote caribbean locale presents special challenges, particularly to those considering a change in career. nevertheless, for those bearing strong character and intellect with the intense desire to provide service to those in need, the experience is educationally, socially, and professionally enriching. to those seeking such enrichments, the university of sint eustatius school of medicine bids you welcome, and invites you to explore the statia experience for yourself. the university of sint eustatius school of medicine was founded by experienced and highly regarded medical school educators and administrators committed to educating future physicians in a student - centered physician - driven learning environment – one that promotes academic excellence with personal and professional integrity at an affordable cost. the founders obtained the support for a medical school from the enthusiastic native people and government of the island of sint eustatius ( statia ). subsequently, the university of sint eustatius was awarded a charter, which was signed by the minister of education, the minister of health, and the governor of sint eustatius on april 21, 1999. on may 27, 1999 the education committee on foreign medical graduates ( ecfmg ) confirmed the eligibility of graduates from the university of sint eustatius school of


health, and the governor of sint eustatius on april 21, 1999. on may 27, 1999 the education committee on foreign medical graduates ( ecfmg ) confirmed the eligibility of graduates from the university of sint eustatius school of medicine to register for the united states medical licensing examinations ( usmle ). the university of sint eustatius school of medicine opened the doors to its first class of students on september 1, 1999, and was subsequently listed by the world health organization ( who ) in 2000. the mission of usesom is to develop skilled and compassionate physicians, through innovative educational approaches in conventional and complementary health sciences, to serve the expanding global need for comprehensive, quality health care. students and graduates of the university of sint eustatius school of medicine will be eligible to be registered by the educational commission for foreign medical graduates ( ecfmg ) for steps 1 and 2 of the united states medical licensing examination ( usmle ). our medical graduates will therefore be able to enter a residency or fellowship program in the united states that is accredited by the accreditation council for graduate medical education ( acgme ). the university of sint eustatius offers a comprehensive m. d. degree program, including training in the basic sciences and in clinical education. depending on qualifications, a student may enter at either of these levels of training. since the university of sint eustatius offers 1 academic years ( 3 terms ) within one calendar year, students actually complete the programs in less calendar time than traditional 4 - year medical programs in the u. s. medical terminology ( 4 credits ) this basic course will provide the necessary framework to learn basic rules and elements of medical terms. the course will focus how to break down medical terms by knowing the meaning of the prefix or suffix. by learning the individual parts of a medical word, students will be able to understand the complex medical terms and their definitions. students will be able to identify medical abbreviations, spell and pronounce basic medical terminology. general biology with lab 1 ( 4 credits ) this course is to provide students with the concepts and factual knowledge in biology. it covers the biological principles, organization of living matter, structure and functions of cell, tissues, organs and systems of the human body. it deals with fundamental life processes and concepts common to all living organisms. emphasis is on the application of biological principles and concepts in the field of medicine. course includes lab work. inorganic chemistry with lab 1 ( 4 credits ) this course provides the students with the fundamental concepts


fundamental life processes and concepts common to all living organisms. emphasis is on the application of biological principles and concepts in the field of medicine. course includes lab work. inorganic chemistry with lab 1 ( 4 credits ) this course provides the students with the fundamental concepts of the chemical processes, enabling students to use chemical concepts in daily living and in the understanding of biochemistry. it covers matter, nomenclature of chemical compounds, chemical composition and properties of compounds and modern atomic theory. it includes atomic structure, chemical bonding ; solutions and gas laws. topics are developed by thoughtful integration of laboratory and problem based instruction. english composition i ( 4 credits ) this course is designed to give students practice in writing. it helps students to understand the functions of writing and to communicate effectively. students participate in a variety of writing tasks including preparing descriptions, writing summaries of readings, preparing drafts, and writing compositions. college algebra ( 4 credits ) the design of this course is to provide a solid foundation in algebra. the topics include the fundamentals of algebra, relations, functions, solutions of first - and second - degree equations and inequalities, systems of equations, matrices and determinants, binomial theorem, polynomial functions, exponential and logarithmic functions, analytic geometry. the concepts examined in this course will include, critical thinking and decision making. computer science ( 4 credits ) this computer science course is designed to give the students the fundamental knowledge and introduction with regard to database management, presentation, web design search engine optimization and other critical disciplines that are necessary in today ’ s workplace. emphasis will be placed on making technology the asset / tool and assisting the student with the technological challenges the will confront. this course will all for independent projects dealing with real world applications and situations. general biology with lab ii ( 4 credits ) this course emphasizes on developing an understanding the concepts of biology as a living process rather than a body of facts. it helps the students to understand the concepts of cell physiology and structure. all human systems, including the structures, actions and processes of the human body are covered. it enables the students to apply the biological knowledge and critical thinking to medical, environmental and social concerns. course includes lab work. inorganic chemistry with lab 11 ( 4 credits ) the course is developed to emphasize the applications of chemistry in the field of medicine. chemical reactions, equilibrium, acids and bases, electrochemistry and topics related to biochemistry are included. this course enables the students to improve their problem solving skills, and mathematical skills. the course structure is designed to enhance the connections between theory


of medicine. chemical reactions, equilibrium, acids and bases, electrochemistry and topics related to biochemistry are included. this course enables the students to improve their problem solving skills, and mathematical skills. the course structure is designed to enhance the connections between theory and practice by engaging students in sessions of integrated laboratory and lecture. english composition ii ( 4 credits ) this course is designed to develop the writing skills of students. the course emphasizes precision in grammar, maturity of style and diction, clear organization of material, skill in methods of objective analysis and interpretation of literature. students will develop skills in critical thinking, organization, and clear precise communications. biostatistics ( 4 credits ) this course is an introduction to statistical concepts and analytical methods as applied to data in biomedical sciences. it emphasizes the basic concepts of quantitative analysis of data, and statistical inferences. topics include probability, frequency distributions, central tendency and dispersion ; hypothesis testing, confidence intervals for means, variances and proportions ; the chi - square statistics ; data analysis and linear correlation. the course provides students a foundation to evaluate information critically. physics with lab i ( 4 credits ) this course is a conceptual study of units and dimensions of physical quantities, vectors, kinematics, laws of motion and its applications, work and energy, properties of matter, sound, oscillations, gravitation, fluid mechanics and thermal physics. students perform experiments dealing with the basic laws of mechanics, vibration, circular motion, fluids, heat and thermal properties of materials. physiology i ( 6 credits ) this course is designed to provide students with an understanding of the function and regulation of the organ systems of the body and physiological integration of the systems to maintain homeostasis. course content will include study of the musculoskeletal, circulatory, respiratory, digestive, urinary, immune, reproductive, and endocrine systems. students receive a quantitative and integrated concept of sub cellular, cellular and organ system functions. organic chemistry with lab i ( 4 credits ) this course covers basic principles of structure and nomenclature of organic compounds, both aliphatic and aromatic. it emphasizes on the principles of chemical reactions of organic compounds related with the synthesis or degradation of biomolecules in human metabolism. saturated hydrocarbons, unsaturated hydrocarbons, cis - trans isomerism and addition reactions are covered. lab activities include the use of models for the design of hydrocarbon and isomer structures. experiments such as purification or separation, physical characterization, reaction types,


##saturated hydrocarbons, cis - trans isomerism and addition reactions are covered. lab activities include the use of models for the design of hydrocarbon and isomer structures. experiments such as purification or separation, physical characterization, reaction types, and synthesis of organic compounds are included. human anatomy with lab i ( 5 credits ) this is a basic course which provides knowledge of the structure and functions of human body. students will understand the key principles in human anatomy and recognize the unique role of anatomy in clinical settings. the course covers the anatomical terminology to describe the basic structures of the human body. students work as a member of a laboratory team. histology and cell biology ( 6 credits ) this course will introduce the student to the molecular and biochemical bases for cell structure and function. lectures and lab will explore the microscopic anatomy of cells, tissues and organs. physics with lab ii ( 4 credits ) this course provides basic knowledge in biophysics. it enables the students to understand the concepts of human physiology. the course includes basic principles of electricity, electromagnetism, light and optics. modern physics consists of quantum physics, relativity, atomic physics, nuclear physics and nuclear medicine. the course is designed to increase problem - solving and analytical thinking skills. students perform experiments based on the principles of electricity, optics and atomic physics. physiology ii ( 6 credits ) this course provides the students with a high level of understanding of the physiological basis of medicine. the essential concepts of physiology and mechanisms of body function are presented at various levels of organization, ranging from cellular and molecular to tissue and organ system levels. emphasis is placed on understanding the integrated regulation of various body processes among the major systems. organic chemistry with lab ii ( 4 credits ) this course is a further study of the chemistry of carbon compounds from a functional group perspective. the course covers structure and nomenclature of specific organic compounds like alcohols, thiols, aldehydes, ketones, amines, esters and carboxylic acids. emphasis is given on reactions, preparations, uses, and simple mechanisms. lab activities are focused in the detection and identification of the presence of the functional groups studied in the course in molecules of biomedical relevance as proteins, drugs, and others. human anatomy with lab ii ( 5 credits ) this course is a study of human body by regions and systems. the course emphasizes the aspects of clinical anatomy. it provides the knowledge of the role of human anatomy in health and disease. anatomy laboratory course provides laboratory experiences that apply to the topics and concepts covered in the fundamental


study of human body by regions and systems. the course emphasizes the aspects of clinical anatomy. it provides the knowledge of the role of human anatomy in health and disease. anatomy laboratory course provides laboratory experiences that apply to the topics and concepts covered in the fundamentals of anatomy. general psychology ( 6 credits ) the course is an introduction to topics in the field of psychology. the course content includes the biology of behavior, learning, memory, cognition, motivation, emotion, personality, abnormal behavior and its therapies, social behavior and individual differences. the course includes coverage of dealing effectively with the demands of everyday life, interpersonal relationships, and approaches to personal growth. the basic sciences program takes place during 15 - week terms on the island of sint eustatius. summer and winter breaks are short by u. s. standards, permitting three academic terms in any given calendar year. students also have the option of completing their 5th semester in the united states, which further reduces students ’ total time away from their home country. the basic sciences consists of training in multiple disciplines taught in a 5 - term format. most courses are taught in double 50 - minute blocks, 3 - 5 times per week. training in some disciplines may span two terms. for students needing extra preparation for the basic sciences program, the university offers an extended program involving an extra 4 - month term of pre - basic sciences coursework ( e. g., medical physics, chemistry in medicine. ). to optimize learning, the courses in the extra term are taught in an integrated, clinically - relevant fashion. introduction to clinical medicine : this course is crucial to students entertaining the possibility of a vocation within the medical profession. as multiple university medical educational institutions have shown, the introduction of clinical medicine at the earliest possible juncture during the assimilation of the basic sciences coursework provides the greatest benefit to the student. this course introduces students to the background and procedural functions of a physician such as : the psychological mind - set, professionalism, skill sets, medical decision making, ethical conundrums, differential diagnosis, and finally making a diagnosis and treating the same real patient predicated on that diagnosis. thus, the clinical medicine course fully outlines for students, all the aspects of being a physician, which contribute to both the hard work and incredible rewards of practicing the ‘ art ’ of medicine. professionalism & patient - doctor skills i this course consists of fifteen weeks of lecture during which time students will be educated on what it means to be the doctor, what is expected in terms of


and incredible rewards of practicing the ‘ art ’ of medicine. professionalism & patient - doctor skills i this course consists of fifteen weeks of lecture during which time students will be educated on what it means to be the doctor, what is expected in terms of personal deportment, professionalism, appearance, and cultural awareness. students will practice what they have learned in the classroom and will also observe at the a local, pharmacy, laboratory, and at an in - patient and out - patient hospital, with clinical mentors from 4th and 5th terms. gross & developmental anatomy gross structure and development of organs and systems of the human body.. this course is dedicated to teaching developmental aspects of major organ systems, integrated with a discussion of the gross anatomy of the human body. within the course, an emphasis is placed on applied and clinical aspects of gross and developmental anatomy. in addition to didactic lectures and cadaveric dissection, the learning of anatomy is enhanced with the help of small group discussions in the laboratory with computer software, study of x - rays, ct scans, mris and osteology. histology and cell biology microscopic structure and function of cells, tissues and organs. formal lectures and student presentations explore the microscopic anatomy of cells, tissues and organs. emphasis is placed upon the correlation of structure with function. epidemiology, biostatistics and preventive medicine. epidemiologic principles, measurements, investigations and research designs will be discussed. students will gain experience in applying epidemiologic methods in clinical problem solving and decision making. principles of biostatistics as they apply to medicine will be covered. students are expected to build upon and in turn demonstrate their knowledge in the process of testing hypotheses and making inferences from various types of data. disease trends in human populations and methods of disease prevention will also be explored. public health systems and medical care organizations will also be reviewed. students participate in practical instruction through their participation in community health care projects. ethics & patient - doctor skills ii students will be instructed on the moral and legal concerns in medicine, through didactic lectures :. the course will explore complex issues pertaining to confidentiality, informed consent, mental competency, obstetric / pediatric ethics, physician - assisted suicide and conflict of interest situations current laws, regulations and judicial precedents governing ethical matters in medicine will also be discussed.. students will be instructed in physical and practical skills involving a stethoscope, otoscope, ophthalmoscope, tuning forks, reflex


situations current laws, regulations and judicial precedents governing ethical matters in medicine will also be discussed.. students will be instructed in physical and practical skills involving a stethoscope, otoscope, ophthalmoscope, tuning forks, reflex hammer, laryngoscope, vaginal specula, surgical gloves, gowns, hats, booties, surgical instruments, suture material, casting material, syringes, needles, and other medical instruments essential to a physican ’ s main functions. students will also gain valuable hospital experience with 5th term mentors. biochemistry and genetics structure and function of carbohydrates, lipids, proteins, and other important biomolecules. lectures will cover important topics such as structure - function relationships in molecular diseases, enzyme characteristics and kinetics, bioenergetics, metabolism and metabolic interrelationships of important biomolecules, the molecular basis of metabolic diseases, the biochemistry of hormones and cell signaling, and biochemical principles in nutrition. in lab activities, students will be instructed on the basic tests and procedures used in general practice, including pregnancy tests, urine reagent strips and tablets for the detection of glucose and ketonic bodies, and glucometers for monitoring diabetic patients. basic genetics and its relevance to inherited disorders. this course covers topics including the structure and function of genes, the general organization of the human genome and the principles of mendelian and non - mendelian genetics as applied to disease. chromosomal abnormalities, cytogenetics in principles and practice, population genetics as applied to issues of human health and the use of genetics in medicine will also be covered. principles of molecular recognition, the control of cellular proliferation and the organization, replication and repair of the genome will also be emphasized. gene expression, mutation, molecular genetics and the techniques of molecular biology will also be covered. basic human biological processes. both normal and abnormal physiological states, as seen in both everyday life and in the clinical setting, will be examined fully. specifically, the mechanical, biomedical, and regulatory processes of major organ systems including cardiovascular, respiratory, renal, endocrine, gastrointestinal, and neural will be covered. clinical correlation is stressed via case studies of patients with major organ system dysfunction. structure and function of the brain, spinal cord and peripheral nervous system. students will gain knowledge of neuroscience through didactic sessions and laboratory dissections of the human brain and spinal cord. this will promote a clinically relevant understanding


major organ system dysfunction. structure and function of the brain, spinal cord and peripheral nervous system. students will gain knowledge of neuroscience through didactic sessions and laboratory dissections of the human brain and spinal cord. this will promote a clinically relevant understanding of a functional and dysfunctional nervous system. through the integration of neuroanatomy, physiology, pharmacology, and biochemistry, students will converse fluently in the language of the nervous system. emphasized are the clinical examination and the correlation of findings with neuroimages. communication & patient - doctor skills didactics iii : as part of this course, lectures will discuss patient medical history including how it is gathered and recorded. students will learn how to glean patient information by from dialogue, neurolingusitics ( body language ) medical records, and other healthcare professionals.. the didactics will include the patient ’ s demographics, chief complaint, family, social, review of systems, and past medical history. the course will also explain the function as well as how to use soap notes. with 5th term mentors, physicians, and clinical asst. students will gain practical knowledge of recording patient history. the biological and psychological bases of mental illness. major psychiatric disorders are covered with an emphasis on diagnostic features, neurobiological correlates, and psychotherapeutic and biological treatments. during practical role - play exercises, students will gain experience conducting mental status exams, interviewing for specific neuropsychiatric disorders, and managing suicidal behavior. microorganisms causing infectious diseases. the course will cover the classification, laboratory identification, pathogenesis and clinical manifestations of disease processes and treatment strategies. major human diseases of bacteria, viruses, fungi, protozoa and helminths will be presented in lectures. student experiences within the laboratory will supplement didactic instruction. fundamental concepts of immunology are covered and integrated as various diseases are discussed. the study of basic reactions of cells and tissues to abnormal stimuli that underlie all diseases. students examine the mechanisms of injury and disease processes and the body ' s response. lectures cover cell injury, acute and chronic inflammation, ischemia and necrosis, neoplasia and mechanisms of pathogenicity. infectious disease and response to infectious agents are covered. physical diagnosis & patient - doctor skills iv : didactic lectures will demonstrate to students how to peform head to toe physical examinations of mock and real patients. students will be introduced to clinical skills such as : auscultation of cardiac, pulmonary, and gas


& patient - doctor skills iv : didactic lectures will demonstrate to students how to peform head to toe physical examinations of mock and real patients. students will be introduced to clinical skills such as : auscultation of cardiac, pulmonary, and gastrointestinal sounds ; otoscopy, including the otoscope, its practical use and functions in the observation of adults and children ; ophthalmoscopy, including the ophthalmoscope, with instruction on how to use it for observation ; performing interpretation of 12 lead electrocardiograms ; using doppler devices in order to auscultate fetal heartbeats and find arteries and veins ; phlebotomy and starting an intravenous line ; suturing - two handed, one - handed, and instrument - tie ; the use of airway and respiratory care instruments and maneuvers in critically ill patients ; administering oxygen through use of the nasal cannula, face mask, and non - rebreather mask, ambubag - mask, ambubag - endotrachael tube manual ventilation, laryngoscope, endotrachael tubes and endotrachael intubation ; cardio - pulmonary resuscitation, advanced cardiac life support, percussion of body cavities and organs ; pelvic, rectal, and speculum examinations in vitro and on live models and patients ; central intravenous line placement, gowning and gloving in preparation for surgery ; casting and immobilization of the extremities of injured or post - operative patients ; the use of splints, plaster and fiberglass glass casting materials and their application on live patients injections ; intradermal, subcutaneous, and intramuscular injection techniques ; lumbar puncture, epidural and subarachnoid ( spinal ) anesthesia ; local anesthetic techniques, including local, ring, and nerve blocks. an integration of anatomy, histology, physiology, biochemistry, microbiology and pathology in the understanding of complex actions of drugs on the living organism. the main focus of this course is to provide future doctors with a basic understanding of the functions of drugs in the treatment of patients. basic principles of pharmacology including absorption, distribution, metabolism, excretion, drug toxicity and drug - drug interactions will be presented together with the principles of drug - receptor interactions. after basic concepts are covered, the pharmacology of all major organ systems will be explored, including the


distribution, metabolism, excretion, drug toxicity and drug - drug interactions will be presented together with the principles of drug - receptor interactions. after basic concepts are covered, the pharmacology of all major organ systems will be explored, including the autonomic and central nervous systems and the cardiovascular, respiratory, renal, and blood systems. the anti - microbial and cancer chemotherapeutic agents and the basic principles of toxicology will also be covered. students will gain an understanding of patho physiology manifestations and the management of common diseases. pulmonary, cardiac, gastrointestinal, endocrine, rheumatic, orthopedic, renal, neurologic and hematology organ systems will be covered. course includes laboratory hours. introduction to clinical medicine : didactic lectures : system by system look at clinical patho physiology as elucidated by demonstrating thorough knowledge of the basic sciences and the art of differential diagnosis. clinical experience will be specifically tailored by the clinical staff and assistants to the areas in which there is more practical hands - on technical skills or more information acquiring skills needed. the students will be evaluated purely on their clinical skills and ability to communicate their findings to their colleagues. there will be a clinical medicine “ grand rounds ” monthly. introduction to clinical medicine : this course is crucial to students entertaining the possibility of a vocation within the medical profession. as multiple university medical educational institutions have shown, * the introduction of clinical medicine at the earliest possible juncture during the assimilation of the basic sciences coursework provides the greatest benefit to the student. this course introduces students to the background and procedural functions of a physician such as : the psychological mind - set, professionalism, skill sets, medical decision making, ethical conundrums, differential diagnosis, and finally making a diagnosis and treating the same real patient predicated on that diagnosis. thus, the clinical medicine course fully outlines for students, all the aspects of being a physician, which contribute to both the hard work and incredible rewards of practicing the ‘ art ’ of medicine. fundamentals of clinical medicine : ( usmle review ) this course provides students with an overview and synthesis of materials covered in the basic sciences program in preparation for the successful writing of usmle step 1. presentations will focus on the systems and disciplines which are central to the usmle step 1, including anatomy, behavioral sciences, biochemistry, immunology, medical genetics, microbiology, pathology, pharmacology, and physiology, etc. students will also have access to