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When the Diagnosis Is Multiple Sclerosis: Help, Hope, and Insights from an Affected Physician - Original PDF

نویسندگان: Kym Orsetti Furney M.D. خلاصه: THE NAME , “MULTIPLE SCLEROSIS ” I have a very hard time with the name of this illness—“multiple sclerosis.” It has such a horrific sound to it. Even after seven years, I rarely say the words multiple sclerosis aloud. I much prefer the more appealing sound of MS. In speaking to others with multiple sclerosis (MS), I have learned that I am not alone with this preference. At the time I was diagnosed, I was somewhat familiar with this illness, hav- ing intermittently cared for multiple sclerosis patients in the hospital. Most of the patients I had seen were diagnosed with MS in the 1970s or 1980s, a time when medication for relapse prevention was not yet available. Others, who were frequently in the hospital, had a variant of MS called “primary progressive multiple sclerosis,” which can lead to significant disability fairly quickly. As a physician, I thought their situations were so very sad, as many patients had developed poor functioning of their arms, legs, bladder, or speech. I rarely had the opportunity to see the MS patients who had very little disability, since they were seen in the outpatient setting. So when I finally had it con- firmed, that yes, these bizarre symptoms I had been having were in fact due to multiple sclerosis, I conjured up the worst possible images of what might happen to me. While many of you may not have had the opportunity to meet patients with more advanced stages of MS, I suspect that your reaction to the diagnosis of MS may have been quite similar to mine. Many people still carry an image of multiple sclerosis as an illness that picks an individual out of the prime of his or her life, and leaves that person wheelchair bound and severely disabled. Fortunately, for the majority of women and men who are newly diagnosed with relapsing–remitting MS in the new millennium, this is not an inevitable outcome. And yet, while we know that medications now exist to prevent relapses, this knowledge does not necessarily make the initial journey any 2 When the Diagnosis Is Multiple Sclerosis easier. We did not sign up for this club. We did not ask to play this game. The anger, the grief, and the uncertainty about the future can be overwhelming. Give yourself time. It will be possible to feel in control again.

Medical Ethics A Very Short Introduction Tony Hope - Original PDF

نویسندگان: Tony Hope خلاصه: The fox represents those who pursue many ends, often unrelated and even contradictory, connected, if at all, only in some de facto way, . . . [who] lead lives, perform acts, and entertain ideas that are cen- trifugal rather than centripetal . . . seizing upon the essence of a vast variety of experiences . . . without . . . seeking to fit them into . . . any one unchanging, all-embracing, . . . unitary inner vision. Berlin gives as examples of hedgehogs: Dante, Plato, Dostoevsky, Hegel, Proust, amongst others. He gives as examples of foxes: Shakespeare, Herodotus, Aristotle, Montaigne, and Joyce. Berlin goes on to argue that Tolstoy was a fox by nature but believed in being a hedgehog. 4 Medical Ethics 2. Are you a hedgehog or a fox? I am a fox, or at least would like to be. I admire the intellectual rigour of those who try to produce a unitary vision, but I prefer the rich, contradictory, and sometimes chaotic visions of Berlin’s foxes. I do not, in this book, attempt to approach the various problems I discuss from one single moral theory. Each chapter considers an issue on which I argue for a particular position, using whatever methods of argument seem to me to be the most relevant. I have covered different areas in different chapters: genetics, modern reproductive technologies, resource allocation, mental health, medical research, and so on; and have looked at one issue in each of these areas. At the end of the book I guide the reader to other issues and further reading. The one perspective that is common to all the chapters is the central importance of reasoning and reasonableness. I believe that medical ethics is essentially a rational subject: that is, it is all about giving reasons for the view that you take, and being prepared to change your views on the basis of reasons. That is why one chapter, in the middle of the book, is a reflection on various tools of rational argument. But although I believe in the central importance of reasons and evidence, even here the fox in me sounds a note of caution. Clear thinking, and high standards of rationality, are not enough. We need to develop our hearts as well as our minds. Consistency and moral enthusiasm can lead to bad acts and wrong decisions if pursued without the right sensitivities. The novelist, Zadie Smith, has written: There is no bigger crime, in the English comic novel, than thinking you are right. The lesson of the comic novel is that our moral enthusiasms make us inflexible, one-dimensional, flat. This is a lesson we need to take into any area of practical ethics, including medical ethics. What better place to start this tour of medical ethics than at the end, with the thorny issue of euthanasia? 6 Medical Ethics Chapter 2 Euthanasia: good medical practice, or murder? Good deeds do not require long statements; but when evil is done the whole art of oratory is employed as a screen for it. (Thucydides) The practice of euthanasia contradicts one of the oldest and most venerated of moral injunctions: ‘Thou shalt not kill’. The practice of euthanasia, under some circumstances, is morally required by the two most widely regarded principles that guide medical practice: respect for patient autonomy and promoting patient’s best interests. In the Netherlands and Belgium active euthanasia may be carried out within the law. Outline of the requirements in order for active euthanasia to be legal in the Netherlands 1. The patient must face a future of unbearable, interminable suffering. 2. The request to die must be voluntary and well-considered. 3. The doctor and patient must be convinced there is no other solution. 4. A second medical opinion must be obtained and life must be ended in a medically appropriate way.

Killing Hope_ US Military and CIA Interventions Since World War II. Part 1-Zed Books Ltd (2003) - Original PDF

نویسندگان: William Blum خلاصه: Introduction A Brief History of the Cold War and Anti-communism Our fear that communism might someday take over most of the world blinds us to the fact that anti- communism already has. —Michael Parenti1 It was in the early days of the fighting in Vietnam that a Vietcong officer said to his American prisoner: "You were our heroes after the War. We read American books and saw American films, and a common phrase in those days was "to be as rich and as wise as an American". What happened?"2 An American might have been asked something similar by a Guatemalan, an Indonesian or a Cuban during the ten years previous, or by a Uruguayan, a Chilean or a Greek in the decade subsequent. The remarkable international goodwill and credibility enjoyed by the United States at the close of the Second World War was dissipated country-by-country, intervention-by-intervention. The opportunity to build the war- ravaged world anew, to lay the foundations for peace, prosperity and justice, collapsed under the awful weight of anti-communism. The weight had been accumulating for some time; indeed, since Day One of the Russian Revolution. By the summer of 1918 some 13,000 American troops could be found in the newly-born Union of Soviet Socialist Republics. Two years and thousands of casualties later, the American troops left, having failed in their mission to "strangle at its birth" the Bolshevik state, as Winston Churchill put it.3 The young Churchill was Great Britain's Minister for War and Air during this period. Increasingly, it was he who directed the invasion of the Soviet Union by the Allies (Great Britain, the US, France, Japan and several other nations) on the side of the counter-revolutionary "White Army". Years later, Churchill the historian was to record his views of this singular affair for posterity: Were they [the Allies] at war with Soviet Russia? Certainly not; but they shot Soviet Russians at sight. They stood as invaders on Russian soil. They armed the enemies of the Soviet Government. They blockaded its ports, and sunk its battleships. They earnestly desired and schemed its downfall. But war—shocking! Interference—shame! It was, they repeated, a matter of indifference to them how Russians settled their own internal affairs. They were impartial—Bang!4 What was there about this Bolshevik Revolution that so alarmed the most powerful nations in the world? What drove them to invade a land whose soldiers had recently fought alongside them for over three years and suffered more casualties than any other country on either side of the World War? The Bolsheviks had had the audacity to make a separate peace with Germany in order to take leave of a war they regarded as imperialist and not in any way their war, and to try and rebuild a terribly weary and devastated Russia. But the Bolsheviks had displayed the far greater audacity of overthrowing a capitalist- feudal system and proclaiming the first socialist state in the history of the world. This was uppityness writ incredibly large. This was the crime the Allies had to punish, the virus which had to be eradicated lest it spread to their own people. 6 The invasion did not achieve its immediate purpose, but its consequences were nonetheless profound and persist to the present day. Professor D.F. Fleming, the Vanderbilt University historian of the Cold War, has noted: For the American people the cosmic tragedy of the interventions in Russia does not exist, or it was an unimportant incident long forgotten. But for the Soviet peoples and their leaders the period was a time of endless killing, of looting and rapine, of plague and famine, of measureless suffering for scores of millions— an experience burned into the very soul of a nation, not to be forgotten for many generations, if ever. Also for many years the harsh Soviet regimentations could all be justified by fear that the capitalist powers would be back to finish the job. It is not strange that in his address in New York, September 17, 1959, Premier Khrushchev should remind us of the interventions, "the time you sent your troops to quell the revolution", as he put it.5 In what could be taken as a portent of superpower insensitivity, a 1920 Pentagon report on the intervention reads: "This expedition affords one of the finest examples in history of honorable, unselfish dealings ... under very difficult circumstances to be helpful to a people struggling to achieve a new liberty."6 History does not tell us what a Soviet Union, allowed to develop in a "normal" way of its own choosing, would look like today. We do know, however, the nature of a Soviet Union attacked in its cradle, raised alone in an extremely hostile world, and, when it managed to survive to adulthood, overrun by the Nazi war machine with the blessings of the Western powers. The resulting insecurities and fears have inevitably led to deformities of character not unlike that found in an individual raised in a similar life- threatening manner. We in the West are never allowed to forget the political shortcomings (real and bogus) of the Soviet Union; at the same time we are never reminded of the history which lies behind it. The anti-communist propaganda campaign began even earlier than the military intervention. Before the year 1918 was over, expressions in the vein of "Red Peril", "the Bolshevik assault on civilization", and "menace to world by Reds is seen" had become commonplace in the pages of the New York Times. During February and March 1919, a US Senate Judiciary Subcommittee held heatings before which many "Bolshevik horror stories" were presented. The character of some of the testimony can be gauged by the headline in the usually sedate Times of 12 February 1919: DESCRIBE HORRORS UNDER RED RULE. R.E. SIMONS AND W.W. WELSH TELL SENATORS OF BRUTALITIES OF BOLSHEV1KI— STRIP WOMEN IN STREETS—PEOPLE OF EVERY CLASS EXCEPT THE SCUM SUBJECTED TO VIOLENCE BY MOBS

Naval Forces' Defense Capabilities Against Chemical and Biological Warfare Threats - Original PDF

نویسندگان: Committee for an Assessment of Naval Forces' Defense خلاصه: U.S. naval forces must be prepared to respond to a broad array of threats. Of increasing importance are those from chemical and biological warfare (CW and BW). To help review its current state of preparedness, the Chief of Naval Operations asked the National Research Council (NRC) to assess the U.S. Navy’s defense capabilities against CW and BW threats. In particular to what extent are they being developed to enable naval forces to sense and analyze quickly the presence of chemical and biological agents, withstand or avoid exposure to such agents, deal with contamination under a broad spectrum of operational conditions, and over what period will these capabilities be realized. This report presents the results of that assessment. It provides an overview of the potential threats, and an evaluation of the Navy’s operations, non-medical programs, and medical countermeasures designed to confront those threats. The report also presents a series of general and specific findings and recommendations based on these assessments.

You Are What You Read - Original PDF

نویسندگان: Robert DiYanni خلاصه: We are what we read, according to Robert DiYanni. Reading may delight us or move us; we may read for instruction or inspiration. But more than this, in reading we discover ourselves. We gain access to the lives of others, explore the limitless possibilities of human existence, develop our understanding of the world around us, and find respite from the hectic demands of everyday life. In You Are What You Read, DiYanni provides a practical guide that shows how we can increase the benefits and pleasures of literature by becoming more skillful and engaged readers. DiYanni suggests that we attend first to what authors say and the way in which they say it, rather than rushing to decide what they mean. He considers the various forms of literature, from the essay to the novel, the short story to the poem, demonstrating rewarding approaches to each in sample readings of classic works. Through a series of illuminating oppositions, he explores the paradoxical pleasures of reading: solitary versus social reading, submitting to or resisting the author, reading inwardly or outwardly, and more. DiYanni closes with nine recommended reading practices, thoughts on the different experiences of print and digital reading, and advice on what to read and why. Written in a clear, inviting, and natural style, You Are What You Read is an essential guide for all who want to enrich their reading—and their life.

Northanger Abbey - Original PDF

نویسندگان: Jane Austen خلاصه: .

The sociology of community connections - Original PDF

نویسندگان: John G. Bruhn خلاصه: The Sociology of Community Connections is about how we interact and connect with one another as individuals and groups in a variety of social situations. We interact out of necessity and connect as a consequence of choice, and it is our connections that create community. Networks of communities that are interdependent, diverse, and responsive to change, yet cohesive, provide the infrastructure for a healthy society. In today's world, our societal infrastructure is continuously being tested by forces and demands that attempt to alter it, and thereby change the nature of how we connect within our various communities. We need to analyze these forces and demands and understand the impact they have on our connections so that, individually and collectively, we can create more social capital than we use. In the last decade, as the world has become smaller and more interdependent, the definition of community has changed. In our society--indeed, in the world--there seem to be more broken and fragmented relationships than in the past, an absence of connections where they appear to be needed, an uncertainty and lack of trust in relationships we have sustained, and a tendency to select, restrict, and even plan those connections that promote self-interest. This graduate-level text explains how our early connections and attachments are formed and discusses past and present conceptions of community. A major portion of the book describes how the sociology of connections takes place in a variety of communities such as: immigrant and ethnic communities, the fragmented communities of the poor and homeless, communities experiencing crises, communities of exclusion and excluded communities, religious communities, cyber communities and solitary communities. The Sociology of Community Connections is highly recommended for classes in sociology, social work, social and cultural anthropology, community psychology, communications, criminal justice, and urban planning.

Handbook of Research on Discourse Behavior and Digital Communication - Original PDF

نویسندگان: Rotimi Taiwo خلاصه: With the growth and advancement of digital communication technology over the past decade and the advent of modern telecommunications and the Internet, the structure of human behavior and social interaction has been redesigned. The Handbook of Research on Discourse Behavior and Digital Communication: Language Structures and Social Interaction is a compendium of over 50 scholarly works on discourse behavior in digital communication. The diverse, but related disciplinary perspectives presented in this handbook further establishes how modern communication technologies are shaping discourse and social interaction all over the world; providing a comprehensive overview of empirical, as well as theoretical issues on digital communication from various regions of the world.

How Canadians Communicate II - Original PDF

نویسندگان: Edited by David Taras, Maria Bakardjieva, and Frits Pannekoek خلاصه: Building on How Canadians Communicate this second volume embarks upon a new examination of Canada’s current media health and turns its attention to the impact of globalization on Canadian communication, culture, and identity. This new collection of essays includes contributions from experts from a wide range of specialties in the areas of communication and technology. Some, as the editors point out, are optimistic about the future of Canadian media, while others are pessimistic. All, however, recognize the profound impact of rapidly changing technologies and the new globalized world on Canadian culture. The contributors highlight the new tools such as blogs, Blackberries, and peer-to-peer networks that are continuously changing how Canadians communicate. And, they explore the various ways in which Canada is adapting to the new climate of globalization, suggesting new and innovative paths to further define and strengthen our uniquely Canadian cultural identity.

Nazi Soundscapes - Original PDF

نویسندگان: Carolyn Birdsall خلاصه: Following the formation of the German National Socialist Party in the 1920s, various forms of sound (popular music, voice, noise and silence) and media technology (radio and loudspeaker systems) were configured as useful to the partys political programme. Focusing on the urban soundscape of Düsseldorf, the author makes a persuasive case for investigating such sound events and technological devices in their specific contexts of production and reception. Nazi Soundscapes identifies strategies for controlling space and reworking identity patterns, but also the ongoing difficulties in manipulating mediated sounds and the spaces of listening reception, whether in the home, workplace, the cinema, public rituals or with wartime siren systems. The study revises visualist notions of social control, and reveals the disciplinary functions of listening (as eavesdropping) as well as the sonic dimensions to exclusion and violence during Nazism. An essential title for everyone interested in the links between German political culture, audiovisual media and urban history, Nazi Soundscapes provides a fascinating analysis of the cultural significance of sound between the 1920s and early 1940s.