N. Mojok. Capella University.

Waring order 0.5mg decadron, an endowment in Charles Marion Wolfe Scholarship Fund memory of her husband has been estab- The Fund was established in 1997 through lished in the School of Medicine purchase decadron 1mg mastercard, the income the estate of Doris L buy decadron 1mg fast delivery. Wolfe in memory of her from which is to be used as a scholarship husband, Charles Marion Wolfe, to be used fund for needy and worthy students. Zepp to be rial Scholarship This fund was established used in support of the education of medical in 1996 from the Gladys C. Scholarship Fund This fund was established in 1998 in mem- Watt/Hansell Endowment This fund was ory of Dr. Wegman to provide and opportunity students with preference to those planning for medical students to pursue public health careers in pediatrics. The fund is managed jointly by the Deans of the School of Medicine and Public Health. Theron Hunter Loan Fund Established by Barton have contributed a memorial fund in Dr. In view of Miss Barton’s interest be used for aid in the form of loans to deserv- in young people, the fund is used to assist ing students in the third and/or fourth year medical students who are not in a position to classes of the School of Medicine. Boswell Loan Fund This fund provides Alumnae Association Student Loan Fund loans for medical students. Cargille Student Loan provide fnancial assistance to medical stu- Fund was established in recognition of Dr. Cargille’s great interest in the Johns Hopkins Robert Wood Johnson Foundation Loan University School of Medicine. Fund Established to provide aid to needy Class of 1932 Student Loan Fund The medical students who are female, members Class of 1932 established a long term fund of designated racial minority groups and/or for medical students in January of 1983, rec- from rural areas. Kneale planned lished in 1985 by a 50th Reunion Class to the Fund which was established after Dr. Class of 1952 Revolving Loan Fund Estab- She was a member of the Class of 1923 and, lished in 1987 by the 35th Reunion Classes during her professional career, served as a of 1952 to provide loans to needy medical pediatrician. Maengwyn-Davies Loan Fund Class of 1959 Loan Fund Established in 1985 This is an endowed loan fund established in by the Class of 1959 for the 50th Reunion to 1986. McKinstry Medical Loan Fund band and medical school classmate, Worth This fund was established to be used for indi- B. Ashby) Monroe Memo- their sons requested that her name be added rial Loan Fund This fund was established by to the Fund, which provides loans for fnan- James Monroe, M. It provides loans for needy students Fund This fund was established in 1999 to in the School of Medicine. Edwards is This fund was established in 1971 to provide a 1932 graduate of the School of Medicine. Joseph Earle Moore for students in the to give more to their patients and their profes- School of Medicine. Wesson Memorial Loan Fund The Trustees of the University set aside $100,000 fund was established in 1999, and provides to be used as revolving loan funds for medi- low interest loans to medical students. Wharton have students in the School of Medicine estab- established a loan fund for students in the lished in 1964 under the will of the late Arnold School of Medicine. The elective is intended both for the practice of anesthesiology with students taking students who are considering a career path in anes- a more central role in active patient management. A fully separate introduction to general and regional anesthetic elective does not yet exists. Please see the separate course sic, and cardiovascular pharmacology; complica- description for the Pediatric Intensive Care clerk- tions of anesthesia; and intravenous cannulation ship administered by Dr. Students must have com- In addition, a didactic series is provided specifcally pleted the core anesthesia clerkship prior to this for students; students are encouraged to partici- elective. This course is a necessary prerequisite for most of Selected cases illustrating common and uncom- the advanced anesthesiology electives. Winters, Shaffner, Schwengel, other anesthesia electives and highly recommend- and staff. Prerequisite: Core clerkship in Pediatrics and Clini- cal Preceptorship in Anesthesiology. Nicole Shilkofski Students will be responsible for the preoperative evaluation, intraoperative management, and post- The course is designed for students planning a operative evaluation of children. This course is career in anesthesiology, pediatrics, or a pedi- designed for students planning careers in pediat- atric surgery specialty and encourages students rics, anesthesiology or pediatric surgery. Overnight call with the resident they are “paired” with is optional but encouraged. Limited to one stu- This course is intended for students who have dent per rotation. The problems Didactic lecture on a topic in anesthesiology or an associated with cancer pain will also be part of this anesthesiology related subject such as intensive experience. It is hoped that this course will pro- care, clinical pharmacology, emergency medicine, vide the student with some tools and insight into respiratory care or pain is presented on a regular the management of pain and suffering in patients basis.

Compared to Italian cheap 0.5mg decadron fast delivery, the two Germanic languages clearly exploit their double-layered terminology: in German purchase 1mg decadron with visa, for instance cheap decadron 0.5mg without prescription, almost every term of Latin or Greek origin has a synonym of vernacular origin (Puato 2011: 119), which is often built by substituting the erudite roots, prefixes and/or suffixes with their ‘inherited’ counterparts. In communicating with patients, the use of these ‘doublets’ can enhance comprehension and have an educational effect: “Die Arterien (Schlagadern) und Venen (Bluta- dern) […]”, “Faszien (Bindegewebshüllen)”, “Urethra (Harnröhre)” are just a few examples from the analyzed websites. The following sentence, for instance, avoids Urethra altogether and uses only Harnröhre: “Häufig kann das Prob- Gender Dysphoria 177 lem mit einem durch die Harnröhre geführten endoskopischen Eingriff beseitigt werden”. The following excerpt from a patient brochure on laparoscopic surgery contains very short sentences with simple syntax, word repetitions and explanations of terms in plain lan- guage. See for instance the explanation of the term hormones in this excerpt: (8) Behandeling met geslachtshormonen Hormonen zijn stoffen die op een bepaalde plaats in het lichaam worden gemaakt (de hormoonklier), aan het bloed worden afgegeven en elders in het lichaam hun effect uitoefenen. Zij worden zo genoemd, omdat zij in de geslachtsorganen worden gemaakt en verantwoordelijk zijn voor de ontwikkeling van het lichaam in mannelijke of vrouwelijke richting. Through one of these small incisions a laparoscope is introduced into the abdomen: this is a long, thin tube enabling the doctor to look into the abdomen. Hormones are substances produced in a particular place in the body (hormone gland), they are released into the blood and have an effect elsewhere in the 178 Mariella Magris / Dolores Ross There are only one Italian and one German website providing glossaries of key terms. These glossaries, however, do not cover all specialized terms contained in the texts, they force the reader to interrupt the reading process and definitely do not represent a reader- friendly alternative to lexical clarity of texts. We think that greater attention should be paid to terminological issues, as the terminology of this specific domain includes many neologisms and – as already seen – controversial terms. We have the impression that the authors of the site have made special efforts to guarantee proper communication, as this subject touches on quite delicate questions. The Italian texts are quite impersonal: they never directly address potential readers and refer to them in the third person as persona, soggetto and the like. In Germany and the Netherlands, no court judgment is needed: in Germany two psychological assessments are required, while in the Netherlands the decision is taken by the gender team, which includes physicians from different specialities as well as a psychiatrist. The absence of similar passages in the Dutch and German texts, therefore, might be due not only to differences in communicative style, but also (and perhaps more prominently) to the legal context of the surgical intervention. The next Italian example, on the contrary, is not related to any national specificity, as it points to the side effects, stressing that they can be minor, but also very serious and even life-threatening. Of course, it is fundamental to inform the reader about risks and compli- cations, but not necessarily in such a way as to discourage potential patients. While in German Sie cor- responds to the standard form used in web communication, in Dutch u might seem a formal choice, as in most contexts the second person singular pronoun jij/je is used, but it may have been chosen to express respect towards people with this condition. Uw lichame- lijke geslacht kan in een driejarig traject (achttien maanden preoperatief en achttien maanden postoperatief) worden aangepast aan uw genderidentiteit. In the Dutch excerpt in (14), the authors show a deep understanding of the many individual experiences of being transsexual and of the difficulty of coping with it. Enerzijds zien we dat patiënten vaak jarenlang vermijdingsgedrag hebben laten zien en niet in staat zijn om diepgaande contacten te onderhouden met andere mensen. Your biological sex can be adapted to your gender identity in a 3-year process (with an eighteen-month preoperative and an eighteen-month postoperative phase). On the other hand, we see patients who sometimes try so hard to come to terms with their biological sex, that they show features Gender Dysphoria 181 Another common trait of German and Dutch texts is that they appear to be much more reassuring than the Italian ones. In German, em- phasis is often placed on the possibility of achieving good, sometimes even excellent, results, thanks to well-tested surgical techniques: (15) Mann-zu-Frau-Operationen sind inzwischen zu standardisierten Eingriffen herangereift, die bei sorgfältiger Indikationsstellung und guter Vorbereitung in mehr als 80 Prozent der Fälle nach ein oder zwei Operationen zu guten funk- tionellen und kosmetischen Ergebnissen führen. Dies erfordert viel Erfahrung eines auf Transsexualität hoch spezialisierten Ärzteteams, welches in der Klinik Sanssouci Potsdam fester Bestandteil der transsexuellen Chirurgie ist. As already said, the Italian selected websites are run by public centers, and the same goes for the two Dutch clinics, whereas the German corpus includes some private clinics as well. Moreover, in Italy the sex reassignment surgery is covered by the National Health System (provided that there is a court judgment allowing it), whereas in Germany and the Netherlands it is refunded by health insurance companies. In these two countries, therefore, there could be the need to ‘promote’ this kind of surgical intervention and also the clinics performing it, and this could have influenced the wording of the texts. Conclusion These are in short the first findings of our study, which seem to point to some significant differences between the three countries and lan- guages. As far as communication policies are concerned, while the Italian and German clinics seem to prefer more ‘private’ channels, which imply a direct contact by phone or email, the Dutch clinics attach great importance to online information, aware of the fact that web-mediated communication “has qualified as a powerful strategic resource in healthcare settings”, creating a “new type of self-informed patient” (Vicentini 2013: 53, 54). When considering textual strategies, however, the distinction should be drawn rather between Italy, on the one hand, and Germany and the Netherlands, on the other. The Italian Gender Dysphoria 183 texts appear to be heavily doctor-centered and monological, they present many instances of opacity of medical communication and are definitely not in line with the main functions of patient brochures, i. On the contrary, the German and Dutch websites demonstrate to be aware of the fact that patient brochures are typically used to bridge communication gaps (Montalt-Resurrecció/ González Davies 2007: 59). They show multiple efforts to compensate mismatches of knowledge, through simple syntax, the frequent use of explanations and paraphrases, the combination of specialized and popular terms. Their communication style is more comprehensible for potential patients, and thus more efficient – although comprehensibility is not the only yardstick for measuring the effectiveness of a text (Renkema 2004: 180). This seems to be the background against which the German and Dutch texts have been produced, and it is in line with what we already observed in the field of vaccination programs, where the two language communities have been demonstrated to give much more consideration than the Italian health sector to proper communication for the sake of health literacy and social inclusion (Ross/Magris 2012: 147).

It is considered a ‘white collar’ form of tobacco because it does not induce spitting buy decadron 1 mg with amex. Children should be the prime targets for campaigners; older people respond less to health publicity purchase 1mg decadron otc. Counselling of mothers may reduce passive smoking by children in the home; however 0.5 mg decadron overnight delivery, reductions in passive smoking in England since the 1980s is attributable to less smoking parents and not to parents who 2494 still smoke not smoking near their children. Advertising , which has its political protectors, should be banned, as it tends to target women and young people, emphasising the ‘stylishness’ of smoking. Counter-advertising should be financially supported and tobacco company sponsorship of sports should be made illegal. Involving teenagers in an anti-tobacco company poster campaign may be effective in reducing the number of youngsters who smoke. England has been much slower than Ireland in this regard, and one Bill suggested that formula one racing should be exempt for four years! The Irish Public Health (Tobacco) Amendment Act 2004 is monitored by an Office of Tobacco Control. Health Boards may take proceedings against persons breaching the provisions of the Act. As of July 1, 2009, anyone who sells tobacco must be registered with the Office of Tobacco Control. There is evidence that legislation for smoke-free workplaces does protect non- smoking bar workers. In February 2006, the British Parliament voted for a total ban on smoking in public places. Many authorities have banned smoking in the workplace, public areas, prisons, and restaurants, except in designated areas. In July 2008, the German Constitutional Court upheld the case of small bars that held that because large bars had enough room to divide off areas for smokers the smaller establishments did not have this option, so throwing the German ban into disarray. Smoke-free workplaces protect against passive smoking and encourage smokers to quit or reduce consumption. Stubbs ea (2004) found that smokers and nurses in an English psychiatric hospital were more permissive toward smoking on wards than were non-smokers and psychiatrists. A short- 756 Requirements of a national tobacco control policy are shown in the box. Components of a national tobacco control policy2497 Increase price of and taxes on tobacco at rate above inflation Ban all advertising and sponsorship by tobacco industry Restrict smoking to designated areas (public places and work sites) Reduce passive tobacco exposure, including in utero Target people at-risk for starting to smoke “Proof of age” cards required when purchasing tobacco; retailers to be banned from selling tobacco (or worse, e. However, despite calls for weaker cigarettes, smokers may compensate for low nicotine yield by puffing more often and deeper, and by smoking more cigarettes. From January 2001 all cigarette packets in Canada carried health warnings that occupy 50% of the front of the pack, although attempts to ban sponsorship of public events by tobacco companies was watered down by the Quebec Court of Appeal in 2005. Changing to cigarettes with a lower tar yield may not reduce the chances of myocardial infarction if one continues to smoke. Young Irish children could until recently readily buy cigarettes from retail outlets and retailers are obliged to ensure that prospective customers are at least 18 years of age. Iran and Uruguay have total bans on smoking in public places, Syria following them in 2009. Some American insurance firms owned by tobacco companies have charged smokers almost double for term life insurance! Tobacco companies pressurised companies producing nicotine replacement products to tone down anti-smoking messages. Tobacco dependence is a chronic disorder requiring repeated attempts aimed at eventual abstinence. Practical counselling and social support are important ingredients in management, as are sustained-release bupropion hydrochloride (e. The present author agrees with Howell (2002) that smoking cessation products should be free to all who wish to stop smoking, not just to those who qualify for medical cards. Further research is needed to determine the efficacy of pharmacological interventions. Many adult smokers started by buying three cigarettes from shopkeepers whilst underage, a failure of the state to protect them. Methyl alcohol (methanol) Mortality from methanol2503 (wood alcohol) poisoning is about 20% because of a metabolic acidosis from toxic metabolites (formaldehyde and formic acid2504). Treatment strategies include gastric lavage, ethanol or fomepizole (competes for alcohol dehydrogenase so inhibiting formic acid production), folate, bicarbonate, and haemodialysis. Isopropyl alcohol (isopropanol, rubbing alcohol) This is found in a number of products, e. It is converted to acetone, which can be detected in breath (odour), blood and urine. It can cause euphoria, ataxia, dizziness, headache, nausea, vomiting, haematemesis, nystagmus, confusion, coma, hypotension, and respiratory depression. Most cases respond to supportive measures; gastric lavage and haemodialysis are options.

Results: The karaoke which were held at a banquet deepened the friendship 76 admissions consisted of 63 patients cheap 0.5mg decadron amex, equal gender proportions cheap decadron 1 mg on-line. No accidents such as fall oc- 67% with severe functional impairment and 26% with full function discount 0.5 mg decadron free shipping. On the other hand, a mattress had to be piled up instead of a More than a third had dementia. Only one-ffth were independent bed because preliminary negotiations with hotel staffs were insuf- with mobility. Conclusion: When stroke patients want to make a trip, it is were referred for physiotherapy input, 25% occupational therapy important to secure safety. Many medical staffs who comprehend input, 60% dietetics and 30% for speech language therapist input. The distribution of bed days in sistance to the stroke patients led to make a good trip. Organizing hospital were classifed as: medical treatment 32%, rehabilitation a trip by medical staffs is useful for improving quality of life of 19%, discharge planning 19%, admission under other teams 25% stroke patients at home. For the remain- ing patients, 5% had a 30 day mortality and 20% were readmitted 947 within a month. A dedicated geriatrics ward is warranted to strengthen comprehensive geriatric assessment and multidiscipli- J. Community sup- 1Switzerland, 2University of Lucerne, Department of Health Sci- port services should also be developed urgently to manage such ences and Health Policy, Lucerne, Switzerland, 3Swiss Paraplegic dependent patients after discharge. Conclusion: Learn- man Social Accident Insurance Institution, provides rehabilitation ing mindfulness based techniques yielded positive results for most in accredited rehabilitation centers. Thus, a pilot project to assess quality of rehabilitation processes and results after musculoskeletal injuries in in- and outpatient medical rehabilitation 951 centers was started in Apr 2015 and is scheduled to Mar 2016. Process quality was assessed by a 9-item-question- Galea 1Royal Melbourne Hospital, Department of Rehabilitation Medi- naire measuring e. Quality of treatment outcome was assessed by generic cine, Parkville, Australia, 2University College Dublin, School of and specifc patient-reported outcomes on admission and discharge. After completion of the pilot rial and Methods: A 14-day extensive workshop program (Sep-Oct phase comprehensive analyses of data records are performed which 2014) was conducted at the University Hospital Antananarivo and will offer more signifcant information until the congress in 2016. Antsirabe, with the Department of Health Madagascar, by rehabili- tation staff from Royal Melbourne Hospital, Australia. Other challenges for basic policies on rehabilita- acquired physical injuries are in need of techniques that help them tion included: access to rehabilitation services, geographical cover- to manage distress and pain. Mindfulness meditation can be defned age, skilled work-force shortages, limited info-technology systems; as a moment-to-moment awareness colored by attitudes such as ac- lack of care-models and facility/staff accreditation standards; lim- ceptance and non-judgement. In best practices it was observed that the 1 2 3 3 key feature was also longer vocational processes, which enabled M. The quality of contacts between 1North Stafforshire Rehabilitation Centre, Physical Rehabilitation Employment service and providers enabled trust and innovative Medicine, Stoke-on-Trent, United Kingdom, 2The Robert Jones solutions with career orientation and active labour market policy & Agnes Hunt Orthopaedic Hospital, Midland Centre for Spinal measures. Employers as the main reasons for success exposed posi- Injuries, oswestry, United Kingdom, 3The Robert Jones & Agnes tive attitudes, potentials, ability to learn, talents, professional atti- Hunt Orthopaedic Hospital, Midlands Centre for Spinal Injuries, tudes and concerns of rehabilitees. It was very interesting that that Oswestry, United Kingdom spoke of good impact on the working culture, when they trained and employed person with disability. Training experience gave them better view adequate measures including prioritising the discharge venue and on their abilities, gathering new knowledge, with constant support care package for these complex patients are carefully planned, we of professional workers. All consecutive patients who have passed away within one year post-discharge were included. Results: Out of 380, 954 15 patients who met the criteria were included in this project. An accessible home and environmental modi- morbidities and complications and were largely unavoidable. Material and Methods: The study followed the interactive approach of qualitative design for search the Impact of modifed home environment. In this study 73% samples were 1University Rehabilitation Institute Soča, Development centre for recruited from different villages and 27% from urban. On the ba- Vocational Rehabilitation, Ljubljana, Slovenia sis on multiple responses, all participants were modifed their liv- ing room, toilet, bathroom and kitchen. Information was gathered through Slovenian vocational proved social relationship and communication though participant rehabilitation network specifc questionnaire. In depth interviews had faced interim economic hardship during way to home modi- analysed information from vocational rehabilitation providers, fcation. Overall more than 65% participants had reported that rehabilitees, rehabilitation counsellors at Employment Service in modifed home environment has a vital role to lead a quality and Slovenia and employers. The integrated plan interventions are more effective to rial and Methods: Qualitative study- retrospective cohort study. Subsequently children 1 have contractures, are incontinent and experience pressure sores. Daejeon Wellness Hospital, Rehabilitation, Daejeon, Republic of Not one program is focusing on the development of the child and Korea, 2Daejeon Wellness Hospital, Medical Oncology, Daejeon, its transition phases.