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Academia Medicine, 2023
This case study focuses on the evaluation of a patient with both upper and lower gastrointestinal (GI) complaints in the outpatient setting, that is, how the evaluation skipped over several crucial diagnostic steps, and how this impacted the patient. Special care is given to the patient’s perspective, differential diagnosis, recommended laboratory testing, and their corresponding costs, taking on a patient-centered approach to the evaluation, diagnosis, and treatment of illness. In this case, sufficient medication history was not obtained, causing the patient to undergo an expensive and unnecessary procedure. Acquiring this information is the cornerstone of an effective patient-physician relationship. Based on the history, a standardized diagnostic approach can be employed, given the likelihood of certain diagnoses. Often, the workup should start with less invasive and expensive tests. However, it is important to consider each isolated case, as a more aggressive approach may be indicated in certain instances. Special attention to communication between the patient and provider is key in ensuring that the patient understands what is happening in their medical care, which improves their communication with relevant information to the care provider, and through such understanding, our patients are better able to provide informed consent.
The Risk of Relatedness:Intersubjectivity Theory in Clinical Practice, 2008
We were celebrating. Celebrating the end of my girl friend´s midterm exams at the University of California. This was 1968, the height of the rock-love-peace-higher-consciousnessthrough-drugs movement.Like many of our contemporaries, we destained the numbing effect of alcohol and preferred what we then thought was the consciousness-raising effect of other drugs. Doors of Perception, Aldous Huxley wrote, the rock group The Doors took their name from that title. We had smoked marijuana and each taken one benzedrine tablet, an amphetamine. We got into an argument. My girl friend said she needed some air and went outside. She came back and laid down, complaining of a headache. Suddenly she went into convulsions that rocked her entire body in a wave-like motion. Her eyes crossed. I panicked, not knowing what I was seeing, except that something was very wrong. We had no telephone. I ran outside, knocking on neighbors´doors. No-one answered. I ran down the street looking for a pay phone. I wet my pants. I called an ambulance. I got a continuous busy signal. I called up the only person I knew who had a car. We drove her to the hospital. I held her in my arms. She groaned. I told the doctors about the convulsions and what we had taken. I was petrified. California State Troopers lingered outside. In those days,any drug meant jail. The doctor said:"Serves you-1-right". They pumped her stomach. They misdiagnosed her. They told me she would come out of the coma. It was just a matter of time. In shock,I let my friend drive me home. He said, "shé ll be fine". She wasn´t. I phoned her parents. They flew down in a private plane. She died twenty hours later of an aneurism. The father, a miltary man, said she was a victim of her times. The mother said she had had a history of headaches. For me, time stood still. I saw everything in reverse: what was light was dark, what was dark was light, like the negative of a photograph, no color. I felt like I was endlessly falling. I tried to continue my psychology studies, but in statistic seminars, the computers and the numbers left me bolting for the door, senselessness sucking at my feet like quicksand. My girlfriend lost her life just when her life was beginning to flower. I was never the same. For a while, I was near-crazy. A rip had been torn in the basic fabric of life. In retrospect I dealt with the incomprehensibility of death by trying to challenge it. When someone you love is ripped from you in a matter of seconds, you try to deal with what can´t be dealt with. The outrage. The utter helplessness. The irrevocability. No deals can be made. Your mind tries to wrap around it and slips from whatever isn´t there, from what is forever lost.
Incontro del Papa con il Collegio Cardinalizio, alla vigilia del Concistoro pubblico ordinario (Città del Vaticano, 23 Novembre 2007).
Voce della Chiesa in "Tempi di Unità" - Periodico della Comunità di Gesù - Quadrimestrale, Giugno-Dicembre 2007.
The aim of this research was to investigate the impact of parental involvement on the achievement score of elementary-level students. Parental involvement was the independent variable and the achievement scores of students were the dependent variable. Whereas, demographic variables like school status, SES, and parents' qualifications were also important. This study was comparative in nature and all elementary-level schools were taken as population. Elementary campuses of boys and girls were conveniently selected from the public sector in Faisalabad and taken as accessible population. From this accessible population, a sample of 376 students (307 male and 69 female) were drawn who have passed the elementary exams. Demographic sheets, copies of elementary result cards, and questionnaires were collected in order to find out the impact of parental involvement on the achievement scores of students at the elementary level. Descriptive statistics (mean, standard deviation, frequency) was employed along with ANOVA, and t-test for data analysis. Keeping in view the results taken from Punjab Examination Commission, significant differences between the academic performance of the children belonging to the businessmen class and the job holders' class were noticed. Further, it was also determined from the dished-out results that the difference in academic achievement level is significant when more involvement of parents was there.
Pythagorean Harmonics and Fibonacci Series coupled in Riemann’s Zeta Function, Penrose-Hameroff Microtubules and an Acoustic Quantum Code, 2023
A relationship between Pythagorean numerology and the Fibonacci series of numbers emerges from Riemann's Zeta function and prime number distribution modelled on a Gaussian probability distribution of the integers. A relationship between a 33-tiered DNA/RNA sequencing mode interwoven with a 12-dimensional cosmology is indicated in the construction of a Maria matrix of the integer count. The importance of quantum 'sacred Pythagorean' geometry is emphasized in nature's efficiency of compressing information in the pentagonal symmetry of Penrose tiling, quasi-crystalline structures and the structure of acoustic-musical sound wave propagation then applied to biological systems. 1. The Maria Code and the Euler-Riemann Fibonacci-Lucas Series of Integers 2. The Acoustic Quantum Code of Meijer-Geesink for a Model of Universal Consciousness and Interference patterns in EMR Eigenfrequencies 3. The Penrose-Hameroff Microtubular Quantum Geometry in DNA/RNA
Anales De Historia Antigua Medieval Y Moderna, 2006
In Morocco, water resources are becoming increasingly scarce. In addition, they are facing several pressures, including increased demand and the negative effects of climate change. In response to this situation, the Moroccan government has increased its efforts in terms of intervention and policy, whether at the technical, legal and/or institutional level. Adopted in 2009, the latest national water saving and irrigation program envisages the conversion of traditional irrigation systems to localized irrigation. This work aims at evaluating the economic and water resources impacts of this program in the Tadla-Azilal sub-basin. The application of an integrated management model shows that after reconversion, the total agricultural gross margin in the area would increase by 2%. Changes will be made in crop rotation, including the replacement of certain crops by others that have become much more profitable. The application of specific water volumes at times of peak plant demand will result in increased yields of all crops. Finally, water consumption will be significantly reduced in all the studied units and groundwater will be less solicited than before.
Biochemistry and Molecular Biology Education, 2007
The first paper in this two-part miniseries on conceptual understanding discussed expert and novice conceptual knowledge, the multifaceted nature of conceptual understanding, and the cognitive skills essential for constructing it. This second article presents examples of instruments for the assessment and development of five facets of conceptual understanding that require competence in the cognitive skills of mindful memorization, integration, transfer, analogical reasoning, and system thinking. We also argue for the importance of explicitly assessing these facets of conceptual understanding as part of all biochemistry and molecular biology curricula so as to develop expert knowledge in our students.
SMPIT Al-Multazam 2, 2024
Sejarah pemberontakan indonesia (PKI, DI/TII, APRA & Andi Aziz)
Επιμέλεια κειμένων αλΕΞανδρα ςφυροΕρα, Τανια παναγου, μαρια κουΤςουμπου, ΞΕνια Χαραλαμπιδου ςελιδοποίηση / Επεξεργασία εικόνων / Εκδοτική επιμέλεια κικη μπιρΤαΧα Εκτύπωση / Βιβλιοδεσία PRintfaiR iSBn 978-960-386-505-6 © 2021 οργανισμός διαχείρισης και ανάπτυξης πολιτιστικών πόρων διεύθυνση Εκδόσεων και Ψηφιακών Εφαρμογών πανος ΒαλαΒανης Roland Étienne antoine HeRmaRy νοΤα κουρου αννα a. λαιμου Βαςιλης κ. λαμπρινουδακης λινα γ. μΕνδωνη γιαννης παπαδαΤος Επιστημονική επιτροπή ἔ ξ ο χ ο ς ἄ λ λ ω ν ΤιμηΤικος Τομος για Την καθηγηΤρια Ευα ςημανΤωνη-μπουρνια Επιμέλεια B a ς ι λ η ς κ. λαμ π ρ ι ν ο υ δ α κ η ς , λ ι ν α γ. μ Ε ν δ ω ν η μ α ρ ι α κ ο υ Τ ς ο υ μ π ο υ , Τ α ν ι α π α ν α γ ο υ α λ Ε Ξ α ν δ ρ α ς. ς φ υ ρ ο Ε ρ α , Ξ Ε ν ι α Χ α ρ α λ α μ π ι δ ο υ υπουργΕιο πολιΤιςμου και αθληΤιςμου οργανιςμος διαΧΕιριςης και αναπΤυΞης πολιΤιςΤικων πορων αθηνα 2021 Η Εύα Σημαντώνη-Μπουρνιά στα Ύρια (καλοκαίρι 1997). π Ε ρ ι Ε Χ ο μ Ε ν α μνήμης πολύτιμα αναθήματα… λινα μΕνδωνη 11 ςημΕιωμα Των ΕπιμΕληΤων 15 Εργογραφια Ευας ςημανΤωνη-μπουρνια 16 ςυνΤομογραφιΕς-ΒραΧυγραφιΕς 21 κυκλαδίτες τεχνίτες στην αττική; mε αφορμή κάποια «κυκλαδίζοντα» αγγεία του ύστερου 8ου αι. π.Χ. από την ακαδημία αλΕΞανδρα αλΕΞανδριδου 23 οχυρωμένη θέση των πρώιμων ιστορικών χρόνων στη δυτική λοκρίδα πανος ΒαλαΒανης, Εφη μπαζιωΤοπουλου 39 μία ιδιότυπη πυξίδα της αρχαϊκής εποχής στο Εθνικό αρχαιολογικό μουσείο ΕυαγγΕλος π. ΒιΒλιοδΕΤης 55 the terraces of the temples at Karthaia and their development over time. new interpretations tHemiStoKliS BiliS 67 Εκλεκτικές συγγένειες. αττικό αγγείο του υστεροελλαδικού ιιιγ Εικονιστικού-πυκνού ρυθμού στο μυκηναϊκό άστυ της νάξου ανδρΕας γ. ΒλαΧοπουλος 83 κεραμικά εργαστήρια και κοινότητες πρακτικής στην αττική κατά τους γεωμετρικούς και πρώιμους αρχαϊκούς χρόνους: με αφορμή έναν νέο κρατήρα του εργαστηρίου του διπύλου από τον μαραθώνα αττικής Βικυ ΒλαΧου 107 an archaic bone figurine from Hyria on naxos leonidaS K. BouRniaS 127 the whirlwinds of the Odyssey miRiam CaSKey 139 Style and function of Geometric coarse jars from naxos: examples from inland and coastal regions of the island Xenia CHaRalamBidou 147 διακόσμηση και αφήγηση από τον βοιωτικό κεραμεικό του 8ου αι. π.Χ. «Ἀγγεῖον σχήματος περίπου ρυθμοῦ γεωμετρικοῦ μετὰ διακοσμήσεως λίαν περιέργου» αναςΤαςια γκαδολου 163 ιστορία και υλικός πολιτισμός στην καρθαία, σε χρόνο παρελθόντα και ενεστώτα παναγιωΤης δουκΕλλης ténos, rupture et transformation d'un univers religieux : mais d'où vient Poséidon ? Roland Étienne H σταδιακή ανάταξη του αρχαίου πύργου στην αγία μαρίνα κέας κωςΤας ζαμπας παραστάσεις κενταυρομαχίας σε θραύσματα ανάγλυφων αγγείων από τη μήλο αγγΕλος ζαρκαδας αρχαϊκός πίθος με ανάγλυφη διακόσμηση από τη μήλο φωΤΕινη ν. ζαφΕιροπουλου κείων μελιτουργίαν γΕωργιος α. ζαΧος μία mensa ponderaria από τη δήλο στην αίγινα και ένα σωματείο ρωμαίων εμπόρων ςοφια ζουμπακη φάτνες και άλογα πΕΤρος θΕμΕλης le retour d'ulysse sur un relief « mélien » de mégara Hyblaea (Sicile) antoine HeRmaRy Small fragments of big pots from large islands alan JoHnSton three male heads from the Sanctuary of apollo Pythaios / Pythaeus at Halasarna (modern Kardamaina), Kos GeoRGia KoKKoRou-alevRaS αρχαία λατομεία μελάνων νάξου και κολοσσικά αγάλματα μανολης κορρΕς a new orientalising attico-Cycladic coarse ware style from Xobourgo on tenos nota KouRou αρχαία κορησία. νεότερα δεδομένα από τις σωστικές ανασκαφές της αρχαιολογικής υπηρεσίας μαρια κουΤςουμπου ναξιακές σφίγγες ΒαςιλΕιος κ. λαμπρινουδακης 375 νέα πρωτοκυκλαδικά αποκτήματα του αρχαιολογικού μουσείου νάξου: ζητήματα προέλευσης και ερμηνείας Ειρηνη λΕγακη, μαυροΕιδης μαυροΕιδοπουλος 393 Restaurations antiques de sculptures archaïques de l'acropole d'athènes, 2 : le cas du « Cavalier perse » evRidiKi leKa 407 Το πρόπυλο του ανδήρου του ναού της «αθηνάς» στην καρθαία. νέες αρχιτεκτονικές παρατηρήσεις μαρια μαγνηςαλη 425 Βιογραφία ενός αντικειμένου: πειθάλιμος και πάλι αλΕΞανδρος μαζαρακης αινιαν 441 κιονωτοί κρατήρες στο βόρειο αιγαίο: Εισαγωγές και τοπική παραγωγή στην αρχαϊκή εποχή ΕλΕνη μανακιδου 455 Ξενοφῶν, πάριος τεχνίτης τῶν ἀρχαϊκῶν χρόνων αγγΕλος π. μαΤθαιου 471 Ένας ελευσινιακός «κέρνος» «πομπηιανής» τεχνοτροπίας ΧριςΤινα μηΤςοπουλου 475 Θέαντος καλός. Ένα χάραγμα σε υστεοροαρχαϊκό σκύφο από το ιερό της Ειλειθυίας στην ολυμπία αλικη μουςΤακα, Χαραλαμπος κριΤζας 501 Ταφικά αγγεία Ύστερης κορινθιακής περιόδου από τη ςικυώνα φωΤΕινη μπαλλα 513 πήλινο ανθρωπόμορφο ειδώλιο της πρώιμης Χαλκοκρατίας και οστέινα του τύπου της «σπάτουλας» από το κουκονήσι (λήμνος) ΧρηςΤος μπουλωΤης 529 eine fragmentarische terrakotta-volute aus Paros. akroter-Wandverkleidung-altarvolute? aenne oHneSoRG 543 ιερά και λατρείες στην αρχαία Άνδρο λυδια παλαιοκραςςα-κοπιΤςα 553 ςφραγίσματα εμπορικών αμφορέων από την κέα Τανια παναγου 567 the Painter of athens 897: an athenian late Geometric vase-painter at home and abroad JoHn K. PaPadoPouloS Cycladic finewares at Zagora, andros: Disiecta membra StavRoS a. PaSPalaS animal-shaped standard-weights in the aegean of the mycenaean era naya PolyCHRonaKou-SGouRitSa d'une statue disparue de Praxitèle à une divinité mystérieuse dans la maison de l'Hermès à délos fRançoiS QueyRel die Grotte Roï-Spilia auf Südeuböa. ein pastorales Heiligtum? KaRl ReBeR η κεραμική από τον γεωμετρικό οικισμό των κουκουναριών πάρου † δημηΤριος ςκιλαρνΤι a new look at old finds: the bronze handle nam X15463 from thessaly and the sanctuary of athena Polias at Phthiotic thebes maRia StamatoPoulou «φρέαρ γυμναστηρίου 1954». μία άγνωστη ανασκαφή στο ιερό δήμητρος στη Χώρα της νάξου αλΕΞανδρα ς. ςφυροΕρα η λατρεία της δήμητρος στην Άνδρο και ο ομηρικός ύμνος εἰς Δημήτραν μιΧαλης a. ΤιΒΕριος Πάνθ' ὑπὸ μίαν Μύκονον... παναγιωΤης ι. ΧαΤζηδακης γεωμετρική πυξίδα με εικονιστικές παραστάσεις χορού από την Άνοιξη αττικής αθηνα ΧαΤζηδημηΤριου νέα στοιχεία για την κεραμική γεωμετρικών χρόνων από την Εύβοια στο Εθνικό αρχαιολογικό μουσείο μαρια Χιδιρογλου Kneeling males. a group of archaic Samian plastic vases and Kolaios' dedication in the Heraion of Samos elena WalteR-KaRydi tabula gratulatoria πινακΕς / PlateS
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