Cardiac shunt

A cardiac shunt is a pattern of blood flow in the heart that deviates from the normal circuit of the circulatory system. It may be described as right-left, left-right or bidirectional, or as systemic-to-pulmonary or pulmonary-to-systemic. The direction may be controlled by left and/or right heart pressure, a biological or artificial heart valve or both. The presence of a shunt may also affect left and/or right heart pressure either beneficially or detrimentally.
Terminology.
The left and right sides of the heart are named from a dorsal view, i.e., looking at the heart from the back or from the perspective of the person whose heart it is. There are four chambers in a heart: an atrium (upper) and a ventricle (lower) on both the left and right sides. In mammals and birds, blood from the body goes to the right side of the heart first. Blood enters the upper right atrium, is pumped down to the right ventricle and from there to the lungs via the pulmonary artery. Blood going to the lungs is called the pulmonary circulation. When the blood returns to the heart from the lungs via the pulmonary vein, it goes to the left side of the heart, entering the upper left atrium. Blood is then pumped to the lower left ventricle and from there out of the heart to the body via the aorta. This is called the systemic circulation. A cardiac shunt is when blood follows a pattern that deviates from the systemic circulation, i.e., from the body to the right atrium, down to the right ventricle, to the lungs, from the lungs to the left atrium, down to the left ventricle and then out of the heart back to the systemic circulation.
A left-to-right shunt is when blood from the left side of the heart goes to the right side of the heart. This can occur either through a hole in the ventricular or atrial septum that divides the left and the right heart or through a hole in the walls of the arteries leaving the heart, called great vessels. Left-to-right shunts occur when the systolic blood pressure in the left heart is higher than the right heart, which is the normal condition in birds and mammals.
Congenital shunts in humans.
The most common congenital heart defects (CHDs) which cause shunting are atrial septal defects (ASD), patent foramen ovale (PFO), ventricular septal defects (VSD), and patent ductus arteriosi (PDA). In isolation, these defects may be asymptomatic, or they may produce symptoms which can range from mild to severe, and which can either have an acute or a delayed onset. However, these shunts are often present in combination with other defects; in these cases, they may still be asymptomatic, mild or severe, acute or delayed, but they may also work to counteract the negative symptoms caused by another defect (as with d-Transposition of the great arteries).
Acquired shunts in human.
Biological.
Some acquired shunts are modifications of congenital ones: a balloon septostomy can enlarge a foramen ovale (if performed on a newborn), PFO or ASD; or prostaglandin can be administered to a newborn to prevent the ductus arteriosus from closing. Biological tissues may also be used to construct artificial passages.
Evaluation can be done during a cardiac catheterization with a "shunt run" by taking blood samples from superior vena cava (SVC), inferior vena cava (IVC), right atrium, right ventricle, pulmonary artery, and system arterial. Abrupt increases in oxygen saturation support a left-to-right shunt and lower than normal systemic arterial oxygen saturation supports a right-to-left shunt.
Samples from the SVC & IVC are used to calculate mixed venous oxygen saturation
and Qp:Qs ratio
where formula_3 is the pulmonary vein, formula_4 is the pulmonary artery, formula_5 is the systemic arterial, and formula_6 is the mixed-venous The Qp:Qs ratio is based upon the Fick principle and it is reduced to the above equation and eliminates the need to know cardiac output and hemoglobin concentration.
Mechanical.
Mechanical shunts such as the Blalock-Taussig shunt are used in some cases of CHD to control blood flow or blood pressure.
Reptile.
All reptiles have the capacity for cardiac shunts.


Minister for Mental Health (Western Australia)

Minister for Mental Health is a position in the government of Western Australia, currently held by Roger Cook of the Labor Party. The position was first created after the 2008 state election, for the government of Colin Barnett. The minister is responsible for the state government's Mental Health Commission.


Laurie Clements Lambeth

Laurie Clements Lambeth (born Newport Beach, California) is an American poet, specializing in the topic of disability. She was raised in Laguna Beach and Palos Verdes, California. She graduated from the University of Houston with an MFA and PhD. Her work has appeared in "The Paris Review", "Indiana Review", "Mid-American Review", "Seneca Review", and "The Iowa Review". She lives in Houston, Texas.
Life.
Laurie Clements Lambeth was born in Newport Beach, and grew up in places like Laguna Beach, Santa Ynez, and Palos Verdes. She was diagnosed with relapsing-remitting multiple sclerosis at seventeen years of age. This event in her life influenced her to become a poet. Lambeth has shared her personal story on the National MS Society Website, where she discusses her disease and its influence on her poetry: "I was diagnosed at the age of 17, so MS has defined much of my adult life. I consider what goes on in my body an important factor of who I am; we are intricately linked, MS and me"
. One of her symptoms from her disease is numbness. She explains that "living with numbness opened my perception of what is me and what is outside of me". Lambeth has said that she probably would not have pursued poetry without having been diagnosed with MS and experiencing the different symptoms that has opened her eyes to herself. She writes poetry that looks into the individual body's form within the context of the world. She went on to graduate with a BA from Loyola Marymount University, Los Angeles, California, as well as an MFA and PhD in creative writing at the University of Houston, where she was awarded the Michener Fellowship and Inprint Fellowship, in honor of Donald Barthelme.
Lambeth has appeared in many journals during her career, such as "The Paris Review", "Indiana Review", "Mid-American Review", "Seneca Review", and "The Iowa Review". She has also produced a popular book of poetry entitled "Veil and Burn". She has recently appeared in the anthology "Beauty is a Verb: The New Poetry of Disability". She currently lives in Houston, Texas, with her husband and dog,
where she works on her poetry and is an avid horsewoman, having ridden and trained horses competitively for many years.
Reviews.
From the opening lines of "Veil and Burn" readers know they are in for something special and not the usual first book of poems. Laurie Clements Lambeth has given us a book of poetry about disability that is at once both searing and sensuous. This in itself may not seem surprising coming from a poet who is the book review editor for the Disability Studies Quarterly, but what one does not necessarily expect is the deftness of the organizational structure.
A simple online search of Laurie Clements Lambeth will bring up the most popular topic that is spoken about her, her novel "Veil and Burn". As a writer with a disability her novel is described as being: "Concerned with physical experience, pain, and disability, "Veil and Burn" illuminates an intense desire to feel through the Other, embrace it, become it, and in the transformation, to understand the suffering body. In poems about animals, artifacts, and monsters, Lambeth displays a fascination for all bodies while exploring their pain, common fate, alienation, and abilities. Hovering between poem and prose fragment, between the self and fellow creatures, Laurie Clements Lambeth celebrates physical sensation, imbuing it with lyric shape, however broken, however imprisoned the shape may be." Her poetry is very much involved with her disability and what it "celebrates".
Most of the reviews or descriptions of this book involve the progressive loss of vision. Lambeth, in an interview, also expresses how "the prose fragments explore vision loss and fear of blindness, something I felt was too melodramatic or maudlin for poetry, their positioning against the poems and their spar[s]eness are what I feel bring the book together through tension—what can and can’t be sung". Her view of a subject being "melodramatic" shows that Lambeth does not see her disability as something about which to be overly dramatic. Much of her work deals with the symptoms and sensations that MS has brought her. "Veil and Burn" is also supposed to be an unraveling of what MS does to her body's functioning. It "is not an ode to false hope, a cheery eyeing of her place in heaven, or a Spartan vow to overcome. It is a clear-eyed seeing of the worth of the material world".
Lambeth does not seem to be a poet who writes for a disability movement or create sympathy towards people with a disability and she does not try to play with the notion of being strong and overcoming the struggles that MS has brought her.
An interesting thing to find out about her book is the reason why she named it the way she did. "The title "Veil and Burn" then speaks to these two modes—more effusive poems and spare prose—and enlarges the concept of "Gauze Fragment," which seeks representation of my vision loss in an old Hollywood trick: veiling the camera lens to soften wrinkles in close-up and burning the veil with a cigarette to let the actor's wet eyes sparkle through". This stands as a reassurance of her perhaps more positive perception of herself and MS as they coexist and her eyes are opened to the beauty and life that occurs with MS.
In her opening poetics, "Reshaping the Outline," in her section of the anthology, "Beauty is a Verb: The New Poetry of Disability", Laurie Clements Lambeth describes a conversation she had with her doctor, in which her doctor informed her that writing was not going to make her MS better, to which she replied, "Oh, I’m perfectly aware of that. I’m under no illusions that anything at all will make me better." She goes on to say of that experience, "I wanted to tell her that my writing and my disease have existed side by side from the moment I was diagnosed at seventeen, my new physical life giving birth to my life in words". Lambeth explains that she has experienced a deepened sense of disability since she has been writing about it in her poetry. For her, this process sets something undesirable aside, so that she can "investigate it, sculpt it, and create something outside of my body that is vividly physical, in subject and in form". One can see this in her poetry without being told. Her poetry embodies a movement and physicality that enlivens the subject matter and heightens the sense of disability that comes with MS.
This is particularly true in her poems, "Hypoesthesia" and "Dysaesthesia," which she put into this anthology because "these narrative lyrics attempt to describe lack of sensation (numbness), or the feeling of pain without source, dyseasthesia: “wrong feeling"...the feeling in each is a sense of hesitancy, disruption in fluidity, reflective of the inability to share physical experience, even at our most intimate or domestic movements." These poems serve to describe her MS in a very physical form, allowing the reading to come close to an understanding of her disability. The movement of lines and the subject matter are compelling as insights into Lambeth’s life.
However, perhaps, of the poetry Laurie Clements Lambeth includes in this anthology, nothing is more manifesting of her disability than the poetry that does not seem to manifest it at all, for example, "The Shaking." Due to the fact that "The Shaking" is a carefully constructed villanelle describing the frustrations of her shaking, we are forced to see how she carefully manipulates her experiences to oppose the shaking she must come to terms with. There is a sense of catastrophe waiting behind the shaking that emotionally rips her from those she loves in the earthquake of her nervous system. She seem to be reminding herself that it seems worse than it is, and yet as it worsens, she wonders if she will have the strength to continue. As comfort fades into panic in the face of the future, containing the experience and eliminating the physical shaking from her poetry allows her to discuss it in an organized way, enforced by the complicated structure of the villanelle. As she deals with her "unfair" disease, it seems that the only thing really "strong enough to hold back its shaking" is the complicated structure of her contained poems that allow her to stop shaking long enough to come to terms with it.


Mycoses (journal)

"Mycoses: Diagnosis, Therapy and Prophylaxis of Fungal Diseases" is a monthly peer-reviewed medical journal covering mycology. It is published by Wiley-Blackwell. The editor-in-chief are Oliver Cornely, Jacques Meis and Martin Schaller. It is the official publication of the Deutschsprachige Mykologische Gesellschaft. The journal covers the pathogenesis, diagnosis, therapy, prophylaxis, and epidemiology of fungal infectious diseases in humans and animals as well as on the biology of pathogenic fungi.
History.
The journal was established in 1957 by Heinz Grimmer (Wiesbaden) and published by Medizinische Verlags Anstalt (Berlin) under the title "Mykosen" (German for "mycoses"). It was originally published in German, but switched 1988 to English. At that time the title was changed to "Mycoses".
Abstracting and indexing.
According to the "Journal Citation Reports", the journal has a 2018 impact factor of 3.065.


Ayurscientifica


Mental health care in South Africa

Mental illness is very prevalent in South Africa, yet the country lacks many of the necessary resources and policies needed to execute an effective mental health strategy. Many factors including violence, communicable disease, and urbanisation have increased the prevalence of mental disorders in the country. The way in which these mental disorders are treated has changed over the years.
For a while, mental health care was mainly institutionalised. However, in 1997, following the White Paper Act, the South African government moved to deinstitutionalize mental health care and relegate it to the primary care setting. However, current data indicates that the goal of deinstitutionalization and effective primary mental care has still not been fulfilled.
African Traditional Medicine still plays a huge role in African society. Even though it often functions in an inhibitory manner, a comprehensive health plan with a focus on collaboration between traditional practices and Western medicine could prove very beneficial. Another factor regarding the very nature of mental disorders complicates this issue even further.
A complete cure of a mental disorder is nebulous and can only be attained gradually with time. For this reason, mental illness is hard to cure among such a paucity of resources. Without the necessary intermediate care and continuity in therapy, many patients regress when released from the hospital.
Deinstitutionalisation and primary health care.
Prior to 1997, mental health care in South Africa was mainly institutionalised, and little emphasis was placed on the development of curative therapies. Due to a paucity of resources, it was more cost effective to simply isolate mentally unstable individuals rather than invest in effective, yet costly care. Following the 1997 White Paper Act and the National Health Act 61 of 2003, the government made an attempt to deinstitutionalize mental health care and transfer the bulk of this responsibility to the level of Primary Health Care (PHC).
General category psychopharmacological drugs, which had previously only been available at mental institutions, are now present with 96% availability at primary health care facilities. However, it was found in a study conducted by the World Health Organization that approximately 56% of mental health care still takes place in an institutionalised setting. In the country of South Africa, there are only 290 registered psychiatrists, providing a physician to population ratio of 1:183,000. With PHC facilities, there are only 0.04 psychiatrists per in-patient bed.
Primary health care facilities are so severely understaffed that a physician often does not have time to do anything other than refer a mental case to the district hospital. In addition, less serious cases such as depression are often overlooked and rarely diagnosed. Doctors need to prioritise their work and spending time on a mood disorder case is seen as an ineffective use of their time.
There is also a lack of communication between primary health care facilities and district hospitals. PHC physicians often refer mental cases to the district hospital, but rarely hear feedback on the case. Since the primary care physician never learns about the new diagnoses or changes in treatment, he is unable to provide adequate follow-up care. Not only does this break the continuity of care, but it also obstructs physicians from learning about these mental disorders and the appropriate treatments necessitated for different sets of symptoms. This severely restricts any potential for a more autonomous primary care division.
Lack of official health policy.
The quality of mental health care varies greatly from district to district. For instance, general psychotropic medications such as anti-psychotics and anti-epileptics are present with 81–100% availability in 4 provinces, 21–50% in 1 province, and 0% in another province. The South African government has yet to institute a set of firm health protocols. The policies outlined in the 1997 "National Health Policy Guidelines for Improved Mental Health in South Africa" were supposed to be the official health policy document. However, in interviews conducted between WHO representatives and South African Department of Health officials, it was found that more recently instituted policies contradicted statutes set out in the National Health Policy bill. Therefore, since adherence to this bill is virtually nonexistent, South Africa does not really possess a national health policy.
In order for the Department of Health to create an effective health policy, it first needs to establish standards for data collection and indicators to be applied to statistical analysis. Although protocols regarding data collection and reporting exist, the sheer lack of personnel among PHC facilities makes such requirements impractical. Only 75% of PHC mental facilities transmit some sort of statistical data to the health department, and much of this data is often incomplete and far from rigorous.
Additional problems.
In a study conducted in 2009 it was found that of the 16.5% of people suffering from mental disorders, only 25% had received treatment. It has been found that the very factors that contribute to this high prevalence of mental illness also serve to inhibit its treatment. Communicable disease, civil strife, and poverty run rife throughout South African society. However, faced with limited resources, the South African government must prioritise its problems, and mental illness does not often take precedence. As a result, many mental health facilities remain both severely understaffed and underfunded.
An additional problem resides in the high turnover among hospital staff. The unique nature of psychiatric illness necessitates a certain degree of experience before effective treatment can be rendered. However, many nurses leave before they are fully trained. This is largely due to the lack of oversight from mental health specialists as many nurses stationed at the primary care facilities have little to no interaction with them. As a result, this lack of direction results in the nurses becoming overwhelmed and eventually many will burn out and transfer. Any progress made in the training of these nurses will be lost and the training process must be started again.
Additionally, the psychiatric nurses in the district hospitals lack specialisation. Due to staff shortages, it is necessary to rotate nurses through all areas of the hospital. As a result, the nurses caring for the psych patients have varying degrees of experience and many possess minimal familiarity with mental illness.
Another problem is the lack of intermediate care once a patient is released from the hospital. Services such as support groups, special housing, and supported employment are virtually nonexistent in South Africa. The Mental Health Care Act of 2002 states that follow-up care should be provided for chronic cases within available resources. However, due to the lack of resources, this intermediate care is never provided. Once treatment at a mental health facility is completed, the patient is handed back into the care of his fellow villagers and they are informed of the discharge instructions. However, a lack of adherence to these instructions results in many patients regressing after being released.
Origins of mental health issues in South Africa.
Many factors including work-related stress, disease, poverty, abuse, sexual violence, as well as the decay of the traditional value system are contributing to the high occurrence of mental health issues in South Africa. In a study conducted by the Mental Health and Poverty research Program, it was found that approximately 16.5% of the adult population in South Africa suffers from mental illness, with 1% suffering from a severe life debilitating mental disease. 30% of South Africans are likely to suffer a mental illness in their lifetimes, depression being the most common ailment.
However, these statistics may be an underestimation. Among the native population, many still hold to the traditional belief that mental illness results from a demonic possession. As a result, many individuals for fear of social ostracism, keep their mental illness secret instead of seeking the much needed medical attention. This means that there is still a significant population suffering from mental illness that is currently unrepresented in mental health statistics.
Post-traumatic stress disorder.
Probably one of the largest contributors to the high frequency of mental disorders is violence. Of the adult population ages 16 to 64, it was found that 23% were exposed to a traumatic event of violence in the past year. These traumatic events include acts such as fighting a war, being tortured, or participating in violence. Among this population, it was determined that mental illness including symptoms of Posttraumatic stress disorder (PTSD) was 8.5 times more prevalent than among the general population.
Substance abuse.
Another factor contributing to mental illness in South Africa is substance abuse. Many provinces are used as drug trafficking routes, and as the South African government lacks the necessary resources to control this problem, many of these illicit drugs find their way into local populations as a drug. In addition, the availability of the wild growing "Cannabis" plant allows for its rampant abuse among all age categories. It was found that 52% of street children smoke the Cannabis plant and 22% on a daily basis. Educational campaigns are limited, and as a result, many do not realise the impinging health effects that will result from substance abuse.
Disease as a trigger.
Diseases such as malaria, typhoid fever, and HIV provide a significant contribution to the prevalence of mental illness. Some of these diseases such as cerebral malaria can bear a direct physiological effect on the mental functionality of the patient. However, even more poignant is the ability of disease to strike a radiating blow to the patient's emotional psyche. For instance, the prevalence of mental illness among those suffering from HIV is 43.7% compared to the 16.5% observed among the general population. This data indicates that disease delivers equal emotional damage as it does physiological harm.
Exposure to Western cultural pressures.
Both growth of the industrial sector and rapid urbanisation are undermining the social fabric of traditional society. The alluring financial and social prospects of an urban environment draw many young individuals splitting up families and villages. The family network which was once regarded as the emotional, moral, and social centre of the community is now being undermined.
As a result, many who are drawn to the city lose touch with their traditional roots and begin to lose a sense of purpose and direction as the focus is turned to utilitarian and hedonistic endeavours. In addition, they no longer have the invaluable social support structure that was once provided by family networks and village communities.
The role of African traditional medicine.
African Traditional Medicine still plays a large role in African society. It was found that 45% of the black patients that attended a community mental health clinic had consulted a healer for their problem. Additionally, 26% were simultaneously seeking treatment from both the traditional healers and the psychiatrists. Traditional healers are often instrumental in treating mental illness. Psychological healing relies more on a cultural and emotional understanding than it does on possessing medical knowledge.
In an interview, Dr. Mustafa Elmasri, a Gaza psychologist with over twenty years of experience describes how he has often collaborated with African Traditional Medicine. Instead of labelling traditional healers as primitive and demonic, he worked with them and even trained some of them in scientific methods for identifying certain mental illnesses such as epilepsy and psychosis. Dr. Elmasri found that "traditional healers were the key partner beyond the patients and their families in gaining an understanding of the psychological experience and access to social support structures".
Beliefs are fundamental to behaviour, and therefore a deeper understanding of traditional medicine will help to improve the effectiveness of psychological care. Dr. Elmasri also recounts how he occasionally refers mild stress cases to the healers as these patients require a holistic approach from individuals that they know and trust. The Traditional Health Practitioners Bill in South Africa, No. 25 of 2004 made attempts for the "formalization, regulation and professionalization" of traditional medicine doctors. However, this bill has never been put into effect and formal collaboration between Western and traditional medicine has yet to be established.
The Westernised approach to treating mental illness often ends up worsening the patient's condition. In a three decade long study conducted by the World Health Organization which includes data from 30 research sites in 19 countries, it was found that people diagnosed with schizophrenia experienced better outcomes among "developing" countries than they did in Europe and the United States. Much of this trend is attributed to socio-cultural conditions such as "increased family involvement, informal economies, less segregation of the mentally ill and community cohesion".
Effective treatment of mental illness necessitates the recognition and identification of cultural differences. For example, in Western society, many derive a sense of self-worth from their ability to survive in a competitive economy. However, the informal economies of the developing nations allow for less stressful work-related roles. Therefore, conducting therapy in South Africa with an emphasis on "valued citizenship" does nothing more than create an intangible goal which will simply cause added stress to the individual. Effective treatment must be uniquely targeted to each culture with careful consideration to the socio-cultural conditions and "contextually relevant coping mechanisms". Neglect to recognise these essential cultural factors will result with impotent and detrimental treatment.


Clinomorphism

Clinomorphism is the deliberate or unintentional simplification, alteration, or amplification of the term for a medical condition (usually for dramatic effect). A caricature to which sufferers of (or care providers for those with) the condition may object is an example of simplification, while frequent overuse of a medical term, in the absence of bona fide symptoms, might be considered an amplification.
Issues.
Clinomorphism is in fact often both a contributory factor in as well as being the result of the mythology and popular misconception of many medical conditions.
Clinomorphism is usually the basis for controversy in medical conditions such as posttraumatic stress disorder, myalgic encephalomyelitis (chronic fatigue syndrome), ADHD, and dyslexia where consensus is not easily established concerning the validity of the conditions and clinomorphism is in fact seen as pejorative, so that clinomorphic references to these conditions are ascribed respectively to being "cowardice", "malingering", "disobedience" and "stupidity".
Clinomorphism, whilst being a linguistic behaviour which exemplifies particular "errors" and deliberate misrepresentations, may also be a natural tendency in the sense that it is potentially an understandable consequence of the need to abbreviate or to simply use a clinomorphism as a metaphor to convey an otherwise difficult to describe idea, in much the same way as anthropomorphism might be (where one attributes the human characteristics or presence of a mind to anything nonhuman, purely for ease of description of a particular phenomenon, rather than as a result of holding a genuinely animistic or pantheistic belief).
An example of clinomorphic tendency would be in the case of autism or Asperger syndrome where particular characteristics of these syndromes (such as the limitations on the ability of a sufferer to form a mental model of the state of mind of another person) would be clinomorphically used as a metaphor or simile for someone's behaviour, where the individual being described clinomorphically is not in fact believed by the utterer to be a sufferer of the condition in question.
The danger is that this will be seen as an offensive misrepresentation of and disrespect towards the condition of an actual sufferer, and thus such clinomorphism (even as a metaphorical convenience) would need to be restricted to discreet private discourse, or avoided altogether.
Examples.
Tourette syndrome.
Tourette syndrome is typically clinomorphically depicted as being a condition of involuntary (and often unconscious) outbursts of offensive language or behaviour, usually on account of being unable to repress (or unaware that they are articulating) involuntary responses.
The typical clinomorphism of Tourette is both an oversimplification and a conflation of various aspects and conditions pertaining to some persons with Tourette syndrome. Some people with Tourette syndrome do have involuntary offensive speech which is termed coprolalia and is sometimes clinomorphised into the term "compulsive swearing" or "compulsive profanity", terms which have clinomorphic currency outside the use of the term "Tourette's". However, coprolalia is actually a relatively rare symptom of Tourette's.
Today, the use of the term Tourette's is deemed incorrect. The correct usage is Tourette syndrome. This may seem like a minor or nitpicky distinction, but as with other disorders (such as Down syndrome), the possessive is discouraged.
Autism.
Autism is clinomorphically seen as a condition where the autistic individual is essentially mentally retarded and a human calculator at the same time, a cultural perception exemplified by the movie "Rain Man". In reality, although as many as 10% of individuals with autism spectrum disorders may display splinter skills such as memorization of trivia, autistic savant prodigies are extraordinarily rare; conversely, though autism is associated with mental retardation, many individuals with autism spectrum disorders are not mentally retarded. In fact, most individuals with autism spectrum disorders have an average IQ.
OCD.
Obsessive-compulsive disorder and obsessive-compulsive personality disorder are two distinct psychological disorders, but media portrayals are often very simplistic and do not reflect the difference between the two. Though disorders can manifest themselves in a very wide range of symptoms, portrayals often tend towards caricature, and emphasize only the most stereotypical of symptoms.
In addition, the phrase "obsessive-compulsive" is often casually used to describe behavior which may be picky or pedantic, but is not at all close to the diagnostic criteria for obsessive-compulsive behavior.
Mood swings.
Often individuals who are "moody" or have mood swings say they are bipolar. Bipolar disorder is an often severe mood disorder characterized by periods of days, weeks, or months of deep depression, alternating with periods of normal mood and/or manic episodes, which are not just periods of "high energy" or "productivity", though these may be a symptom of mania.


Disability in Uruguay

Disability in Uruguay is often described historically and culturally by the medical model of disability. Much of current government policy surrounds the use of trained and paid caregivers for people with severe disabilities and many people who need assistive devices have not been able to access these.
In 2008, Uruguay adopted the Convention on the Rights of Persons with Disabilities. The government has worked to make more places physically accessible and to provide interpreters for Uruguayan Sign Language (LSU) which is recognized as a minority language.
History.
In the early history of Uruguay, people with mental disabilities were often not treated. However, one of the first patients taken into the Charity Hospital of Montevideo in 1788 was a person who was brought in due to a mental disorder. During the Uruguayan Civil War in 1843, medical care was disrupted. After the civil war, an influx of physicians from England and France helped develop more technical knowledge of psychiatry. Uruguay established its first mental institution in 1860. Reforms took place in the late 19th century, leading to the creation of "therapeutic communities" and "sheltered homes" in the early 20th century. In much of the early half of the 20th century, care for mental disabilities was only available in Montevideo.
Special education in Uruguay was created in 1910 by the Council for Primary Education ("Consejo de Educación Primaria"), setting up schools for students who were Deaf or who had speech disorders.
In Uruguay, the Deaf community and the community of people with disabilities are allies, but are not closely connected due to a difference in their histories. Groups representing people with disabilities began to push for their rights in the 1980s. Also in the late 1980s, Uruguay created a proposal for bilingual education for Deaf children which was intended to serve as a model for other countries. Prior to the 1980s, few Deaf individuals went on to secondary school and many in the community were pathologized. After changes in the law and encouragement of bilingual education, more in the Deaf community are accessing education and went on to university.
Demographics.
The rate of people with disabilities in Uruguay, according to a 2006 survey done by the National Institute of Statistics and the Honorary National Commission on Disability found that it was at 9.2 percent overall. The capital city of Montevideo had a higher rate of people with disability than the rest of the country at 11.5 percent and more of these people were living in poverty.
People with disabilities in Uruguay have a significantly lower rate of economic participation than people without disabilities.
Policy.
Governmental policy in Uruguay has increasingly become "rights-based" in focus. This is in contrast to the country's initial medicalized basis for instituting policy for people with disabilities. Around 2005, the government transferred the National Disability Programme from the Ministry of Health to the Ministry of Social Development.
Since around 2005, when Frente Ampilo (FA) took control of the government, special attention has been paid to the role of unpaid caregivers in Uruguay. In older welfare programs in the country, the role of unpaid caregivers was largely ignored. In recent years, starting in 2012, programs to professionalize caregivers has provided an income for these formerly unpaid laborers who provided services to children, the elderly and people with disabilities. The care system was formally launched in 2016 and provides training for caregivers.
The first time the category of "disabled" was included in the national census was in 2011.
Non-governmental organizations.
The first organization led by people speaking Uruguayan Sign Language (LSU), was the Uruguayan Association of Deaf People ("Asociación de Sordos del Uruguay" ASUR), founded in 1928. In the 1980s, another group began to work with ASUR, the Deaf People's Research and Development Centre ("Centro de Investigación y Desarrollo para la Persona Sorda" CINDE), and advocated for civil rights for the Deaf community. Other organizations for the Deaf community in Uruguay exist in towns throughout the country.
Movimiento Estamos Tod@s En Acción (META) is an international group for young people with disabilities. META has membership in 10 different countries, including Uruguay.
Legislation.
The Criminal Code, Article 30, provides for individuals who have committed a criminal offense to not face liability for their actions if they have a mental disability. Psychiatric care and hospitalization is regulated by Law No. 9581.
The National Disability Programme was established by Article 256 of Act No. 18,172.
In 2008, Uruguay adopted the Convention on the Rights of Persons with Disabilities, through Act No. 18,418. In 2010, Uruguay protected individuals with disabilities in Act No. 18,651 which protects their rights to access health care, education and which provides benefits and financial help as needed.
The Care Act (No. 19,353) passed in November 2015 makes caregiving an act that all children, the elderly and people with disabilities have the right to access.
Law No. 19,529 on Mental Health was passed in August 2017. The law relies on the medical model of disability.
Education.
People with disabilities in Uruguay are less likely to get a higher education than people without disabilities. A study done in 2004 found that children between the ages of 4 and 15 with disabilities only attended school at 88 percent of the non-disabled population and that only 32 percent complete primary school. UNICEF reported in 2017 that 1 in 3 children with severe disabilities did not have access to education and that 1 out of 4 children with disabilities go on to complete secondary education.
As of 2017, schools in Uruguay were still not prepared to include children with disabilities into their classrooms.
The Deaf community of Uruguay are taught in Uruguayan Sign Language (LSU). The Council for Primary Education ("Consejo de Educación Primaria") in 1987 created a proposal for bilingual education for LSU speakers in schools. The 2008 General Education Law refers to the use of "mother tongues" in article 40 and pushes towards a more bilingual method of instruction including sign language. A law passed in 2001 designates LSU as the "natural language" for the Deaf community in Uruguay, as does the 2008 General Education Law. In 2008, the National Administration of Public Education (ANEP), instituted mandatory bilingual education for natural speakers of LSU.
Accessibility.
In 2008, laws were passed to provide physical accessibility to all public areas and also to provide public information access. Parking spaces reserved for people with disabilities is only available in areas for shopping, hospitals and government buildings.
Less than 50 percent of individuals with disabilities who need an assistive device said that they had received one, according to a 2011 census.
A prosthetic lab in Uruguay was created in 2011, through a cooperation agreement with Cuba. In 2013, the National Centre for Technical and Technological Assistance was created to provide aid to people with disabilities.
Interpreters for the Deaf in city government exists most often in Montevideo, with less access in other cities. Some news programs also provide interpreters. Uruguay has also mandated that all television channels needed to have interpreters for other types of programs and complete the project in 2020. However, the Deaf do not have adequate access to interpreters in the health system as of 2012.
Cultural attitudes.
Disability activists in Uruguay reject the medical model of disability and focus instead on a human-rights approach to dealing with issues relating to people with disabilities. However, there is still an overall cultural attitude that relies on the medical model when thinking or talking about people with disabilities.
The Uruguayan Deaf community uses Uruguayan Sign Language ("Lengua de Señas Uruguaya", LSU). The Deaf community in Uruguay have often been treated as speakers of a "minority language" in the country where Spanish is the national language.
Sport.
Since 2015, Uruguay has been hosting an Inclusive Surf Festival to raise awareness about human rights for people with disabilities. The festival, held at Brava Beach in Montevideo, has helped raise money and bring disability rights activists in Uruguay together.


Enough Said (song)

"Enough Said" is a song performed by American recording artist Aaliyah. The song features additional vocals provided by Canadian rapper Drake. Originally recorded prior to the singer's death in a plane crash in 2001, Drake later finished the track with producer Noah "40" Shebib in 2012.
"Enough Said" was released by Blackground Records through their SoundCloud account on August 5, 2012. It was sent to US urban and rhythmic radio stations on August 21. The song charted at number 55 on the "Billboard" Hot R&B/Hip-Hop Songs.
Composition.
"Enough Said" is a hazy R&B song with a sparse electronic backing track. It opens with low-end sounds that reveal hypnotic percussion. The song's lyrics implore a lover to disclose and communicate: "I can tell it's somethin' up with you, tell me do you wanna talk about, talk about ... I hate to see you feel this way". Aaliyah sings the song's "yeah yeah yeah" hook with understated vocals, and Drake occasionally interjects with the line "yo, what's up" before rapping a single verse.
Critical reception.
Marc Hogan of "Spin" called the song "a welcome return from a late great, overseen with obvious ... devotion" from Drake, who "mostly manages to stay out of the way on this one, confidently embodying the character of Aaliyah's repressed boyfriend without stifling the track with "too" much reverence." Bruna Nessif of E! Online felt that "it's hard not to feel some goosebumps rise at the first sound of Aaliyah's soft voice, but quickly, listeners can find themselves taken by the single and moving their head to the smooth beat". MTV's Nadeska Alexis commented that Shebib's production "complements Aaliyah's vocals nicely on the track." Gerrick D. Kennedy of the "Los Angeles Times" felt that "Drake still deserves to be applauded for the track", despite his "usual struggling-with-fame-pathos" rap verse and its diverse reception with fans of Aaliyah, writing that "rarely do artists get the chance to revive their inspirations, certainly not as deftly as he's done with the track.
By contrast, Jody Rosen of "Rolling Stone" panned Drake's rap as a "desecration" and "desultory boasting, pointless 'wass ups,' slapped on like gaudy graffiti tags." He gave the song three-and-a-half out of five stars and asserted that, without his contribution, it would be "an engrossing record, with eerily stark production from Noah '40' Shebib: a great fit, and a worthy tribute, to R&B's most avant-garde diva." Robbie Daw of Idolator criticized his rap as "ill-advised" and "ho-hum", and stated, "this is not the 'tribute' we would have liked to hear."


Matthew Newcomen

Matthew Newcomen (c. 1610 – 1 September 1669) was an English nonconformist churchman.
His exact date of birth is unknown. He was educated at St John's College, Cambridge (M.A. 1633). In 1636 he became lecturer at Dedham in Essex, and led the church reform party in that county. He assisted Edmund Calamy the Elder in writing "Smectymnuus" (1641), and preached before parliament in 1643. He was multi-talented, excelling in preaching and debate, and was offered several lucrative positions.
He protested against the extreme democratic proposals called "The Agreement of the People" (1647), and was one of the commissioners at the Savoy Synod of 1658. When the Act of Uniformity was passed in 1662, Newcomen lost his living, but was soon invited to the pastorate at Leiden, where he was held in high esteem not only by his own people but by the university professors. He died of plague in 1669.


Journal of Epidemiology and Biostatistics

The Journal of Epidemiology and Biostatistics is a peer reviewed journal for epidemiological and biostatistical studies. It is published by Martin Dunitz Ltd, part of Taylor & Francis Group. It covers Biology, Mathematics and Statistics and Public Health. In 2002 the title was changed to Journal of Cancer Epidemiology and Prevention.


Silvestro Chiesa

Silvestro Chiesa (1623-1657) was an Italian painter of the Baroque period, active mainly in his natal city of Genoa. He was a pupil of Luciano Borzone. Died as a young man during the plague in 1657.


Georgy Gruzinsky

Prince Georgy Aleksandrovich Gruzinsky (; 2 November 1762 – 15 May 1852) was a Russian nobleman of royal Georgian descent. An influential landowner and official in Nizhny Novgorod, he was known for his authoritarian rule over his estates as well as charity. During Napoleon's invasion of Russia in 1812, he raised a local militia force to fight the French.
Family background.
Prince Georgy Gruzinsky was born into the family of Alexander Gruzinsky of the House of Mukhrani, claimant to the throne of Georgia, and his wife Daria Menshikova. Georgy was, thus, grandson of Bakar of Kartli and great-grandson of King Vakhtang VI of Kartli on his father's side and great-grandson of the Russian statesman Aleksandr Menshikov on his mother's side.
Career.
Prince Georgy succeeded to the familial domain of Lyskovo on the Volga, which he ruled as a local "tsar". Beyond Lyskovo, Gruzinsky owned estates in the cities of Nizhny Novgorod and Moscow. Lyskovo at that time housed St. Nino's Cross, the principal relic of Georgian Christianity, brought from Ottoman-occupied Georgia for Georgy's grandfather Bakar.
Prince Georgy was enlisted in the Saint-Petersburg Infantry Regiment in 1768 and retired with the rank of major in 1778. Beyond Georgian and Russian, he commanded French, German, and Italian, and was interested in history, geography, architecture, mathematics, physics, military engineering, and artillery. A theatre lover, he formed and sponsored a troupe for his own entertainment. He was elected marshal of the nobility of the Nizhny Novgorod Governorate for two consecutive three-year terms in 1795 and again in 1798. Soon Gruzinsky fell in disfavor with the tsar Paul I. He was found guilty of cruel treatment of his peasants and various machinations, but Gruzisnky evaded the court sentence by faking death and staging his own funeral, having bribed local officials. He remained in obscurity until the accession of Alexander I who made him, in 1802, an Actual Chamberlain and appointed to a Court of Conscience in Nizhny Novgorod whence he resigned in 1804. He was reelected as the governorate's marshal of nobility in 1807 and continued to serve in this capacity for the following 21 years until removed by Nicholas I for disregard of the Russian laws.
During Napoleon's invasion of Russia in 1812, Gruzinsky organized and headed the Nizhny Novgorod militia, which amounted to 12,440 men and fought under General Nikolay Muromtsyev against the Grande Armée until the fall of Paris in 1814. After the war, Gruzinsky spent the rest of his life in Lyskovo, dispensing charity. In the 1820s, he hosted and supported Anton II, a Georgian prelate dispossessed by the Russian authorities of his office. In 1852, Gruzinsky died at the age of 89 at his estate, allegedly in a fury at the sight of a peasant entering his house with a hat. He was interred at a familial burial ground at the Transfiguration Church of Lyskovo.
Marriage and children.
Georgy Gruzinsky was married to Princess Varvara Nikolayevna Bakhmetyeva, by whom he had two children: Anna (31 January 1798 – 17 July 1889) and Ivan; the latter died at a very young age. Furthermore, Prince Gruzinsky had several purported extramarital children, where of Andrey Medvedev and Yevgraf Stogov are better known. Gruzinsky himself claimed Medvedev as his son in order to prevent his daughter Anna from marrying him. In despair, Medvedev took monastic oath and became a well-known cleric in Nizhny. Anna eventually married Count Alexander Pyetrovich Tolstoy, without children.


Disappearance of Sofia Juarez

Sofia Lucerno Juarez (born February 5, 1998) was a 4-year-old American child who disappeared in Kennewick, Washington in 2003. Her case involved the first use of an Amber alert in the state of Washington. As of 2021, Juarez's whereabouts and the circumstances of her disappearance remain unknown.
Background.
Juarez lived in a house on the 100 block on East 15th Avenue in east Kennewick, Washington. She lived with her mother, Maria Juarez; her grandmother, Ignacia Prado Juarez; her grandmother's boyfriend, Jose Lopez Torres; her siblings, including a younger brother; her six aunts and uncles; and other relatives. Maria Juarez had moved to Washington from California to live with her mother about two years prior, but their family was originally from Mexico. At the time of the disappearance, Maria Juarez was 20 years old. Juarez's father, Andres Gutierrez Abrajan, had no contact with the Juarez family and denied being Sofia's father. Sofia's grandfather, Jose Luis Juarez, did not live at the residence but would join the family shortly after the disappearance.
Juarez was 4 years old at the time of her disappearance. She had black hair and brown eyes, with a mole under one eye and a birthmark on her lower back. At the time of her disappearance she stood tall, weighed , and was missing her four upper front teeth. She also had pierced ears.
Disappearance.
Juarez disappeared on Tuesday, February 4, 2003, one day before her fifth birthday. She had been playing with some of her relatives, variously described in the media as her brother or young aunts and uncles. Jose Lopez Torres, her grandmother's boyfriend, was preparing to leave for a nearby convenience store and had asked the children if they wanted to join him. Although the others refused, Sofia decided to take him up on the offer at the last minute. Torres, however, was not aware she had changed her mind and left the house without Sofia.
Around this time, Sofia entered her bedroom to ask her mother for a dollar to spend at the store. Maria watched Sofia leave the room and heard her close the door as she left the house. The last confirmed sighting of Sofia was by her mother, when she left the room at around 20:25 PST that evening. When she left the house, Juarez was wearing a red long-sleeved shirt, blue overalls, violet socks, white Converse sneakers, and gold hoop earrings. Although temperature outside was roughly , she left the house without a coat.
After arriving at the store, Torres purchased milk and made a call at a payphone to relatives in Mexico before returning home at 21:45. Back at the house, he and Maria became aware of the miscommunication and that Sofia had nonetheless left the house to join him. Other family members had believed Sofia was playing in the house or outside. After quickly searching for her daughter, Maria contacted police at 21:23.
Investigation.
Initial searches.
Detective Sgt. Randy Maynard was the on-duty patrol sergeant supervising all police traffic in Kennewick on the night Juarez disappeared. Maynard found the circumstances of the report - particularly the time of day, cold weather conditions, and Juarez's age - made it unlikely that she had wandered off or was hiding. Police arrived at the Juarez home at 21:26, three minutes after the call was made. Two officers were tasked with searching the house and yard while another officer interviewed Maria Juarez. The search radius was increased to a radius centred on the house. Six or eight uniformed officers from the local police department were available to assist in the search, but hundreds of officers and firefighters from nearby detachments joined the investigation. One of the first officers to respond to the scene was Sgt. Ken Lattin, who would later serve as lead investigator on the case.
It was quickly ruled out that Juarez had gone missing due to an injury or becoming lost, and her case was almost immediately treated as a likely abduction. An Amber alert - the first in Washington's history - was issued by the Office of Emergency Management shortly after authorities confirmed she was not in the home. The alert was cancelled after 36 hours, though police claim it had a pronounced effect on the community and was responsible for them receiving thousands of tips in the early days of the investigation. Other reports suggested police had only received 184 tips in the first 8 days of the investigation. After the Amber alert expired, Kennewick police Sgt. Rick Dopke reassured the media they were "still treating it as an abduction".
Volunteers participated in a search of rural areas outside Kennewick on the day after the disappearance, but police ended the use of volunteer searchers on February 6. False rumors circulated early in the investigation suggested Juarez had been found, but all were denied by police. The state police union offered a $5,000 reward for information leading to her return. On February 8, police searched three residences in Kennewick and Burbank with police dogs; the Burbank home belonged to the mother of murderer Jeremy Vargas Sagastegui, who objected to police searching her home and claimed detectives were attempting to pressure her and her sons into admitting to an attack on Juarez. A fourth home was searched three days later after the man who lived there made a suspicious comment about the disappearance in a sexually-explicit phone call to a stranger; police later determined he had no connection to the case, but charged him with telephone harassment. Police dive teams began searching the Columbia River for Juarez's body on February 13, but found nothing. A military helicopter equipped with infrared detection equipment was lent to the search by the Washington Army National Guard, surveying areas in and near Kennewick where investigators discovered a pair of overalls and girl's shoes, though neither belonged to Sofia.
For the first 45 days after Juarez was reported missing, the entire Kennewick police department was focused on solving her case, as were agents from the Federal Bureau of Investigation. At least four detectives served as lead investigator on the case in the first eight years of the investigation. According to police, the role of lead investigator is assigned to a different person every few years to bring new perspectives to the forefront.
Juarez's mother, Maria, and her grandmother, Ignacia, travelled to Puebla, Mexico in March 2003 to search for leads in the investigation.
Public response.
A candlelit vigil and march was held for Juarez on February 11, 2003, one week after the disappearance. The vigil began at the Juarez home and saw about 300 people march from the house to St. Joseph's Church. By the third week of the search for Sofia, the Juarez family had removed the public memorial established outside their home.
On March 1, 2003, NASCAR racer Damon Lusk, a graduate of Kennewick's Kamiakin High School, participated in the Busch Series race with a 20x50-inch photo of Juarez emblazoned on his car's trunk. Lusk and Tommy Baldwin Racing had announced they would donate the space seventeen days into the search for Juarez, forfeiting sponsorship revenue in the hopes that it would raise awareness for her case.
Juarez's case was featured on "America's Most Wanted" less than three weeks after she had vanished. The initial broadcast generated 13 phone tips from as far afield as New York. She was also featured on subsequent episodes in September 2003 and March 2004.
Juarez has been featured in two campaigns to raise the public profile of missing persons in Washington using semi-trailer trucks as mobile billboards. The first was carried out with the company Gordon Trucking. The "Homeward Bound" awareness campaign, a collaborative effort between the Washington State Patrol Missing and Unidentified Persons Unit and Kam-Way Transportation, unveiled trucks bearing Juarez's likeness on February 4, 2021. The trucks showcase details of cases such as Juarez's as they travel through the Pacific Northwest and beyond. In her Homeward Bound posters, a photo of Juarez at age 4 appears next to an age-progressed photo of how she may have looked at age 17.
Her missing poster has been exhibited in Times Square, New York City; and at the annual Benton-Franklin Fair & Rodeo in Kennewick.
Current status.
In late 2007 or early 2008, Maria Juarez's family moved back to California. In mid-2008, she gave birth to another child. Maria Juarez died in Sacramento on January 10, 2009 from medical complications, nearly six years after her daughter's disappearance. She was cremated and on January 16 her funerary procession carried her ashes from the corner of East 15th Ave and Washington Street to the St. Joseph's Church, the same route followed by the February 2003 candlelit vigil for her daughter. In statements to the media after her death, Maria's family stated that she had never given up hope Sofia would eventually be found.
In 2015, Kennewick Police Chief Ken Hohenberg asked retired Richland police Capt. Al Wehner to review nine cold cases from the area. Juarez's disappearance is one of the cases Wehner has looked into, and as of February 2021 he was the lead investigator. A new police effort to further the investigation was launched in December 2020. Sgt. Randy Maynard also remains part of the search. According to police, their case file on the Juarez case is more than 20,000 pages long. In May 2021, a video on TikTok was published with a 22-year-old woman who resembled age-progressed images of Sofia, leading the Kennewick Police to open an investigation into the video.
Theories.
Police believe Juarez attempted to follow her grandmother's boyfriend to the store after realizing he had left without her. Although it was located only a few blocks from the home, Juarez never arrived at the store. Video surveillance taken from the store confirmed Torres's version of events was accurate. Kennewick Police Chief Marc Harden told the media in 2003 "everyone and no one is a person of interest". In a 2011 interview, police detective Sgt. Randy Maynard said he believed Juarez was still alive: "My gut is that she’s alive ... If she’s deceased, we’d have found her remains". In 2013, Sgt. Ken Lattin told media "we don't have any evidence that she's still alive, we don't have any evidence that she's not still alive".
Possible sightings.
The shortest route to the store would have taken Juarez west on the street where she lived - East 15th Ave - and then north on Washington Street. A local resident who lived on Washington Street reported to police that she had spotted a young girl crossing the street in front of her car while she was stopped at either 14th or 15th Ave. Police believe this was the last sighting of Juarez.
A relative of Juarez, who was 10 years old at the time, also claimed to have seen her the evening of her disappearance, though his account has not been confirmed. According to this version of events, Juarez was seen walking down the driveway outside her home with a man dressed in a black sweatshirt, black pants, and black shoes.
Witnesses also reported seeing two suspicious vans in the area around the time of Juarez's disappearance. The first was a panel van seen in the area around the time of the disappearance, described as a mid-1980s model with silver or light blue paint and no windows along the body. The second was a full-size, mid-1990s model van with faded orange paint and a license plate containing the letters "JJ", allegedly driven by a white man roughly 35-40 years old with a thick blond beard. It is unknown if either vehicle or their drivers had any role in the disappearance. Another witness also suggested they had seen a teenage Hispanic boy and a young Hispanic girl around the time Juarez left the house.
False leads.
Pieces of a skull were discovered by a farmer in a field south of Ritzville on August 12, 2006 after a fire destroyed a patch of waist-high weeds which had obscured the bones. The field had previously been searched in 2003 after Juarez's disappearance, and again in 2004 following the disappearance of 11-year-old Cody Haynes. The remains were sent to the King County Medical Examiner's Office to be DNA tested, but the results were inconclusive. In 2007, radiocarbon dating revealed the skull fragments were at least 600 years old, and could not have belonged to Juarez or Haynes.
In 2011, police detective Wes Gardner (then the lead investigator on the case) told media that he was working with the Long Beach Police Department to investigate a tip which suggested a teenager named "Sofia Juarez" of a similar age had been found on Facebook living in Long Beach, California. It was ultimately found that this was not the same girl who had disappeared in 2003.
Abduction by family.
Juarez's father, who had never had a relationship with Sofia, was cooperative with investigators. He was ruled out as a suspect within forty-eight hours of her disappearance, providing a verifiable alibi to police.
Detective Sgt. Randy Maynard has claimed that someone close with the Juarez family previously suggested there were concerns that someone in the extended family was unhappy with the way Maria Juarez was raising her daughter, raising the possibility that Sofia had been abducted by a family member and taken elsewhere, possibly to Mexico.
Abduction by strangers.
Sofia's mother, Maria Juarez, claimed after the disappearance that her daughter was shy and would not have gone with any stranger willingly. Maria Jaurez believed that Sofia would only have gone away willingly with somebody she was familiar with. Investigators have looked into the possibility that Juarez was abducted by a stranger and murdered, or may remain alive but held against her will. Early on the investigation, known sex offenders in the area were contacted by police; at the time, Kennewick was home to 167 registered sex offenders.
A recurring theory investigated by the Kennewick Police Department suggests that Juarez was struck by a driver. According to this version of events, Juarez was hit by a vehicle while crossing East 15th Avenue and injured. The occupants of the vehicle exited to check on her and found she was alive, but rather than contacting authorities decided to put her inside the vehicle and leave the scene, transporting her to another location where she was murdered and buried. Various local sites, including Hover Park in Finley and Jump Off Joe south of Kennewick, have been suggested as possible burial sites. Detective Sgt. Randy Maynard has claimed that tipsters repeatedly named specific individuals with ties to the local drug culture and histories of narcotics use as the culprits, and that these persons have been thoroughly investigated, as have the vehicles they were operating at the time of Juarez's disappearance. Although search warrants were executed against the suspects, forensic analysis conducted by the Washington State Patrol crime lab and the FBI failed to produce any evidence confirming these accusations. Investigators consider the story to be nothing more than an urban legend.
Another tip reported repeatedly to police suggests that Juarez was murdered and her body was buried in the hills near Kennewick, and that she had been exhumed and reburied multiple times to hide evidence from investigators.


Gossain

Gossain or Gosain or Gussain or Gosyne is a Hindi word derived from "lord of senses". It is used as a title in various Indian religious traditions.
These include:


For the Night

"For the Night" is a song by American rapper Pop Smoke, featuring fellow American rappers Lil Baby and DaBaby, from Pop Smoke's posthumous debut studio album, "Shoot for the Stars, Aim for the Moon" (2020). It was written by the three rappers and its producers, CashMoneyAP, Palaze, and Wylo. The song was released as the fifth single from the album on October 3, 2020, by Victor Victor Worldwide and Republic Records, while an extended play (EP) was released for the song a few days later.
"For the Night" is a hip hop, trap, and soul song with lyrics about nighttime events. The single debuted and peaked at number six on the US "Billboard" Hot 100, giving Pop Smoke his first, DaBaby his fourth, and Lil Baby his fifth top-10 hit in the US. The song reached the top-five on the "Billboard" airplay Hot R&B/Hip-Hop Songs and Rhythmic charts and was certified quadruple platinum by the Recording Industry Association of America (RIAA). It entered the top-10 on record charts in Portugal, New Zealand, Canada, and Greece. Critics named "For the Night" one of the best songs of 2020, noting the rapper's performances and instrumentation.
Background.
Pop Smoke found the song's original beat on Danish record producer Palaze's YouTube channel. French producer CashMoneyAP reworked the song with Palaze, Daniel Mxras, Jess Jackson, and Mike Dean. CashMoneyAP added keys and bass while helping Palaze add drums. Pop Smoke's team was surprised when he recorded his vocals as it was the first time they heard him singing. Pop Smoke's team went to the Bahamas to work on his album when he played "For the Night" without warning to them. Record executive Steven Victor lauded the song and said they wanted to include vocals by American rapper Lil Baby. Victor thought having Lil Baby on "For the Night" would be creatively and sonically good as Pop Smoke had always wanted to work with him.
The track was supposed to feature Lil Baby and American rapper YoungBoy Never Broke Again, and YoungBoy wanted to be included in the track. CashMoneyAP decided not to feature him because he felt the rapper was not a good pick. After 50 Cent joined Victor on completing Pop Smoke's album, he called American rapper DaBaby to also be part of the song. DaBaby initially did not know that Lil Baby was part of the track. Jackson's main challenge was hot to combine Lil Baby's timbre work with DaBaby. Jackson and Mike Dean mixed and recreated all of the music from scratch while keeping CashMoneyAP's drums.
Writing and composition.
"For the Night" was written by Pop Smoke, Lil Baby, DaBaby, CashMoneyAP, Palaze, and Wylo. It was produced by CashMoneyAP and Palaze while Wylo, Jess Jackson, and Mike Dean were credited as additional producers. "For the Night" is a hip hop, trap, and soul song consisting of an acoustic guitar, folk flutes, heavily autotuned vocals, and processed moans on Lil Baby and DaBaby. The three rappers dream about events that normally happen during the night. DaBaby pays tribute to Pop Smoke with the line, "Rest in peace to the Pop, make me smoke ya".
Critical reception.
Critics called "For the Night" one of the best songs of 2020, such as the "Los Angeles Times" August Brown who said it was a "convincingly dragged-out, haunting angle on his craft at the precipice of global stardom". They suggested it could be a "monster hit" and a "social media ready smash". Hannah Giorgis from "The Atlantic" opined that the song evokes the "recklessness of a summer party or the languid flirtation of stoop-side conversations". While Wongo Okon of "Uproxx" labeled the track as sinister, "The Wall Street Journal"s Mark Richardson considered it more welcoming than Pop Smoke's earlier songs.
Other critics highlighted the song's vocals and instrumentation, Ashton Howard of "Earmilk" declaring the rappers delivered a "phenomenally charismatic appearance". Journalists for "Billboard" and "Variety" complimented his flexibility, particularly his ability to step outside to try different genres beyond drill. Juan Gutierraz called it a "well-balanced rap tune" due to DaBaby's "baritone staccato flow" counterpointing the "higher auto-tuned voices" of Lil Baby and Pop Smoke. Giorgis stated Lil Baby and DaBaby add "arioso and vigor" to the song, and "Slant Magazine" Charles Lyons-Burt praised DaBaby's vocals as "tough-talking" and having a "chest-puffing brio".
However, the vocals and instruments incorporated had lesser reviewers. "Pitchfork"s Alphonse Pierre cited the song as an example of the misuse of more popular rappers on "Shoot for the Stars, Aim for the Moon"; he argued they blurred the "animated personality and charisma" of the rapper, particularly calling "For the Night" a "forced Rap Caviar-bound marathon with Lil Baby and DaBaby". "The Independent" critic Roisin O'Connor also declared the song's autotuned vocals and folk flutes seemed outdated in comparison to Pop Smoke's gruff.
Release and commercial performance.
"For the Night" was released on Pop Smoke's posthumous debut studio album "Shoot for the Stars, Aim for the Moon", as the third track on July 3, 2020. The song was later released as the album's fifth single on October 3, 2020, by Victor Victor Worldwide and Republic Records. An EP for "For the Night" of the same name was released on October 7, 2020. The EP also features "Hello", "The Woo", "Got It on Me", "Creature", and "Aim for the Moon.
Following the release of "Shoot for the Stars, Aim for the Moon", "For the Night" debuted and peaked at number six on the US "Billboard" Hot 100, giving Pop Smoke his first, DaBaby his fourth, and Lil Baby his fifth top-10 hit in the US. The song simultaneously peaked at number four on the US Hot R&B/Hip-Hop Songs and number one on the US Rhythmic charts, with the latter becoming Pop Smoke's first song to top the chart and any "Billboard" chart altogether. "For the Night" remained atop the Rhythmic chart five nonconsecutive weeks, making it Pop Smoke's longest reign at number one. The Recording Industry Association of America certified the single a quadruple platinum certification, which denotes four million units based on sales and track-equivalent on-demand streams.
The single also reached the top 10 in Canada, New Zealand, Norway, Switzerland, and Portugal. It peaked at number one in Greece's singles chart. The song was certified double platinum in Australia by the Australian Recording Industry Association while being certified gold in Austria and the United Kingdom by the International Federation of the Phonographic Industry and British Phonographic Industry, respectively.
Credits and personnel.
Credits adapted from Tidal.


Jun Sadogawa

, better known by his pen name , was a Japanese manga artist from Tone, Ibaraki, Japan. In 2000, he won an honorable mention in the 55th "Weekly Shōnen Champion" "Newcomer Award", sponsored by Akita Shoten, for his work "Twin Burner". His debut work "Muteki Kanban Musume" was published from 2002 to 2006. Sadogawa committed suicide by hanging on August 13, 2013 at age 34. He was serializing his manga "Amane Atatameru" at the time of his death.


Acrosyringeal nevus of Weedon and Lewis


Pigmented actinic keratosis


Hold My Hand (Michael Jackson and Akon song)

"Hold My Hand" is a duet performed by American singer-songwriter Michael Jackson and American singer-songwriter Akon, from Jackson's first posthumous album "Michael". The song was originally recorded by Akon and Jackson in 2007. The song was an international top 10 hit in nations such as Austria, Belgium, Denmark, Germany, Hungary, Italy, New Zealand, Norway, Poland, Spain, Sweden, Switzerland and the United Kingdom.
Background.
Co-writer Claude Kelly told HitQuarters that "Hold My Hand" was originally written with Whitney Houston in mind. Akon and Kelly had been in the studio working on songs for Houston's "I Look to You" album and while on his own Kelly completed the song from a track Akon had left. After hearing the song later, Akon said that he loved it and wanted to keep it for himself, so he wanted to record his own version of it. Shortly afterwards Akon went to Las Vegas to work on what would have been Michael Jackson's next album. While there, Jackson heard the song and loved it, and decided he wanted to contribute to it. When Kelly was asked what he thought it was about the song that struck a chord with both Akon and Jackson, he said that it was the song's theme of friendship and togetherness. "Hold My Hand" was recorded by Jackson and Akon in 2007. Akon finished the rest of his vocals for the song in 2010, a few days before the release. A handwritten note from Jackson belonging to his estate indicated his desire that “Hold My Hand” be the first single on his next project. However, in its unfinished state, the song leaked out in 2008. This would be the last new song leaked during Jackson's lifetime. Due to the leak, the song was subsequently pulled from Akon's track listing for his 2008 album, "Freedom". Akon regretted the decision after Jackson died the next year and decided to finish the song in his honor.
Akon commented, “The world was not ready to hear ‘Hold My Hand’ when it leaked a couple years ago. We were devastated about it. But its time has definitely come; now in its final state, it has become an incredible, beautiful, anthemic song. I'm so proud to have had the chance to work with Michael, one of my all time idols.” Before the official release of the song, Akon stated on Twitter that the final version would have more of Jackson's vocals. The song was released globally on Monday, November 15, 2010, at 12:01am EST. It was available to stream from Jackson's official website. Jackson's nephew, Taj Jackson, posted a message saying that his uncle was proud of the song. "I'll never forget that smile he had on his face as the song played through the speakers [in his room] at the Palms Hotel in Vegas." The song is the second collaboration between the two artists and the second consecutive duet single release for Jackson, following "Wanna Be Startin' Somethin' 2008". That song proved a commercial success and charted within the top 20 in several countries.
Music video.
On Monday, November 22, 2010, the filming for the official video began in Tustin, California, a main filming location being the airship hangars at Marine Corps Air Station Tustin. There was a casting call posted up on Jackson's official website, saying that they were "looking for his fans of all ages who want to be a part of this iconic event." On December 4, 2010, a 30-second teaser of the video was released on Michael Jackson's official YouTube channel and the official website. It featured clips from Jackson's "" DVD and clips of fans dancing. The video debuted at midnight December 9, 2010 on worldwide websites, including MichaelJackson.com. The video showed Jackson in concert (from Dangerous World Tour in Bucharest and HIStory World Tour in Munich), Akon singing and children dancing in the dress of Jackson, as well as sentimental scenes of children, families, and elderly people holding hands and a woman weeping. The video was directed by Mark Pellington.
Critical reception.
The song received mostly positive reviews in contrast to the negative reviews of the previous promotional single "Breaking News." Ashante Infantry, entertainment reporter for the "Toronto Star", called it a "catchy, well-meaning addition to Jackson's catalog." She also wrote, "Buoyed by strings and a backing chorus, the singer applies his angelic tenor to soaring phrasing that models the uplifting purport of the tune’s love and unity lyrics in the spirit of 1995’s "You Are Not Alone", Jackson’s last No. 1 hit." "Huffington Post" commentator Joe Vogel praised it as "a simple, but powerful song that embodies so much of what fans loved about Michael Jackson. Like U2’s "One" it is a “love song” that expands outward making the personal something more profound and universal", and added that "With its catchy chorus and majestic crescendo it has all the makings of a big hit." Vogel also noted the first line of the song, "This life don't last forever," was a "poignant reminder of the transience of life." MTV's Gil Kaufman stated that "the uplifting 'Hold My Hand' is one of Jackson's classic love ballads, a heart-stirring call to unity," and that it ended with "a majestic feel." "Newsday" music critic Glenn Gamboa said that the tune "finds Jackson in fine voice." He also remarked, "Now this is more like it." Gerrick D. Kennedy of the "Los Angeles Times" music blog wrote that the "mid-tempo uplifting track is classic M.J."
Negative reviews however came from "Yahoo! Music", where commentator Chris Willman argued that the single stole elements from the Hootie & the Blowfish song of the same name, and "Minneapolis City Pages" where commentator Ray Cummings said "there's no way to reasonably avoid being disappointed and dispirited by its thinness." Michael Roffman from "Consequence of Sound" called the track "highly irritating" and "incredibly repetitive", where "Akon belts out the same thing again and again in an equally monotonous pitch", adding that "as a lead single it was tepid and incredibly campy.""Boston Herald" critic Jed Gottlieb described the song as "an average, Auto-Tuned Akon croon" without "the snap, crackle and pop of a finished King of Pop product." Gottlieb also wrote, "Jackson is grumbling from his grave." Jason Lipshutz from Billboard said, it "isn't a classic Jackson single," but Michael Jackson's "diehards should delight in hearing a stylish pop production that doesn't dwell on the singer's troubled life."
Commercial performance.
The song debuted at number 53 on the Hot R&B/Hip-Hop Songs chart the week of November 27, 2010. It also became Michael Jackson's 48th hit on "Billboard" Hot 100, and debuted at number 84. It debuted on the Adult R&B chart at number 16 as the chart's highest start in 2010 the same week. The song is Jackson's first top 40 hit on the "Billboard" Hot 100 since 2002's "Butterflies". The song debuted at number 24 on the Billboard Jazz Songs Chart on the week of January 15, 2011, as Jackson's first single on this chart, it peaked at number 16. According to SoundScan, the song has sold 304,000 copies by the middle of January 2011.


Therapeutics Initiative

The Therapeutics Initiative (TI) is an independent organization at the University of British Columbia (UBC) which looks at the effectiveness of medications and provides education to health care providers in British Columbia about the use of medications. It was founded in 1994 by the British Columbia Ministry of Health. In 2013 support for the initiative was taken over by UBC.
When requested it additionally looks at specific medications to generate reports for PharmaCare. These reports are generated without look at costs just medication effects. This is done independently of the pharmaceutical industry and government.
They additionally publish the "Therapeutics Letter" and are part of the International Society of Drug Bulletins.
Controversy.
In 2008 a pharmaceutical task force created by the British Columbia government published a report on the Therapeutics Initiative. The task force members included Russell Williams who was then head of Canada’s Research-Based Pharmaceutical Companies (Rx&D) and employees of Angiotech Pharmaceuticals. They recommended closing the TI.


American Society of Exercise Physiologists

The American Society of Exercise Physiologists is a non-profit professional organization for exercise physiologists. Founded in Minnesota in 1997, its vision is to establish board-certified exercise physiologists as experts in the application of "exercise as medicine" to benefit society. As the scientific body of exercise physiology has some overlap with athletics and sports training, the organization advocates for the unique contributions of exercise physiologists and attempts to enhance their public sector job opportunities.
ASEP has created a Code of Ethics and a Board of Accreditation that has accredited seven academic institutions. Its Board of Certification has certified over 200 EPCs in the United States. ASEP leaders believe that exercise physiology is not defined by research, but by the power of exercise as medicine. They believe exercise physiology is the recognition of the physiology that underpins activity; the delivery of health and fitness analysis, improvement and maintenance; the rehabilitation of heart disease and other chronic diseases and disabilities; and the supervision of athletes and people with an interest in athletics and sports training.
"The Journal of Exercise Physiology-online" is the official ASEP peer-reviewed electronic research journal, featuring original exercise physiology research, reviews and editorials. "The Professionalization of Exercise Physiologyonline" is the first journal that publishes articles about professionalism in exercise physiology. An official monthly newsletter, ASEPNewsletter, keeps members informed of professional issues and events in exercise physiology. ASEP also maintains a membership directory, career opportunities and resources, board certification, professional networking and development opportunities, annual meetings, student services and a political support base.


UNICEF UK

UNICEF UK, also known as the United Kingdom Committee for UNICEF, is one of 36 UNICEF national committees based in industrialised countries. The national committees raise funds for the organisation's worldwide emergency and development work. In 2007, UNICEF UK raised £41.3 million for UNICEF’s work with children worldwide. UNICEF UK also advocates for lasting change for children. For example, it works to change government policies and practices that are detrimental to children’s rights in the UK and internationally.
Internationally, UNICEF is the leading children’s organisation, reaching children in more than 150 less-developed countries around the world. It works with local communities, organisations and governments to make a lasting difference to children’s lives.
The organisation's global reach allows it to share knowledge across borders, while its local presence – over 85 per cent of UNICEF staff work in developing countries – means it can deliver assistance where it is needed most. With its worldwide presence, UNICEF can respond rapidly wherever disaster strikes, delivering life-saving help for children.
UNICEF believes that every child should have clean water, food, health care, education, and a safe environment in which to grow up. The organisation upholds the UN Convention on the Rights of the Child and works to hold the international community responsible for their promises to children.
UNICEF is not funded by the UN. Instead, it relies on voluntary donations to fund its work for children worldwide. UNICEF UK raises funds for these programmes through donations, the sale of cards and gifts, partnerships with companies and special events. UNICEF UK is a registered charity.
UNICEF ambassadors.
UNICEF UK has a long history of support from its ambassadors and high-profile supporters, who play a vital role in promoting UNICEF, advocating and fundraising on its behalf. Ambassadors help the organisation reach a wider audience, enabling it to highlight work undertaken to improve the lives of the most vulnerable children around the world.
All UNICEF ambassadors have been appointed because they have already demonstrated a commitment to the organisation’s work. They dedicate time and energy in a variety of ways: visiting projects in the field and emergency situations, speaking to the media about what they have seen, or lobbying and raising money.
Current UNICEF UK ambassadors and high-profile supporters include Michael Sheen , David Beckham, Martin Bell , Orlando Bloom, Charley Boorman, Millie Bobby Brown, Sir Alex Ferguson, Ralph Fiennes, Ryan Giggs, Ewan McGregor, Jemima Khan, Sir Roger Moore, James Nesbitt, Vanessa Redgrave, Tom Hiddleston, Rita Ora, Olivia Colman and Robbie Williams.
Corporate partners.
UNICEF is supported entirely by voluntary contributions and the support from corporate partners makes a significant contribution to its work. Companies that currently have a corporate partnership with UNICEF UK include 2021 Rugby League World Cup, Barclays, easyJet, Marks & Spencer, IKEA, Manchester United, EE, Pampers and Vodafone.
Cards and gifts.
UNICEF was the first charity to produce and sell cards for the purpose of raising funds. The very first UNICEF card was a Christmas card created in 1949. The card was a reproduction of a painting, sent as a thank you to UNICEF in 1947, by seven-year-old Jitka Samkova. Jitka’s village in Czechoslovakia had received UNICEF emergency assistance after the Second World War.
Since 1949, UNICEF has continued to sell cards and gifts in order to raise money for children living in poverty around the world.
Inspired Gifts.
In 2004 UNICEF UK expanded its range of cards and gifts to include a selection of ‘Inspired Gifts’. These offer an opportunity to give a present which makes a real difference to the lives of children. The choice of Inspired Gifts is wide; however the selection changes periodically, depending on where the need is greatest. A typical range could vary from a cold-box vaccine carrier which helps to ensure that vaccines for children reach their destination in perfect condition, to a midwife kit which helps to safely deliver over 50 babies.
Convention on the Rights of the Child.
The 1989 United Nations Convention on the Rights of the Child is a comprehensive human rights treaty which enshrines specific children’s rights in international law. These rights define universal principles and standards for the status and treatment of children worldwide.
The Convention spells out a specific role for UNICEF, in its capacity as the UN body responsible for the rights of children. UNICEF is required to promote the effective implementation of the Convention and to encourage international cooperation for the benefit of children. UNICEF is also entitled to be represented when each country’s implementation of the Convention is considered by the Committee every five years.
Emergency response.
When an emergency strikes, UNICEF staff in the area react rapidly and the first aid usually arrives within 48 hours. Emergency specialists assess the immediate need, focusing on women and children. With permanent offices in the field, UNICEF is well placed to coordinate relief by road and air. Following emergency relief efforts, UNICEF works to promote long-term rehabilitation and improve conditions for children.
Programmes in the UK.
In the UK, UNICEF seeks to improve baby health and nutrition through its Baby Friendly Initiative in UK health care centres. It also champions child-centred education based on the UN Convention on the Rights of the Child through its Rights Respecting Schools Award initiative. UNICEF UK is a member of The National Council for Voluntary Youth Services (NCVYS).
Other areas of work.
UNICEF’s other priorities include education for all, child survival, HIV and AIDS and child protection.
Education.
On education, UNICEF is committed to giving girls and boys equal learning opportunities. It works to remove barriers that keep girls from attending school and to ensure that, once enrolled, they go on to graduate. UNICEF also supplies educational materials, mobilises teachers, registers children, prepares school facilities and develops curricula in countries affected by conflict and other emergencies.
Child survival.
In terms of child survival, UNICEF is seeking to completely eradicate polio, to increase the percentage of children protected against malaria by mosquito nets, to protect children in the early years of life by promoting exclusive breastfeeding and to reduce the risk of children dying from diarrhoeal diseases by improving access to water and sanitation facilities.
HIV and AIDS.
In 2005, UNICEF launched a five-year global campaign, Unite for Children, Unite against AIDS, to raise awareness about how HIV and AIDS are destroying the lives of children. The campaign aims to achieve four goals by 2010: to prevent new infections among young people by 25 per cent; to prevent mother-to-child transmission of HIV in 80 per cent of cases; to provide treatment for 80 per cent of HIV-positive children; and to protect, care for and support 80 per cent of children affected by HIV and AIDS, including those who have lost their parents to the disease.
Child protection.
Protection from exploitation is a universal right of every child, as laid out in the UN Convention on the Rights of the Child, and UNICEF places a high priority on protecting children from all forms of violence and abuse. For example, in Sierra Leone, UNICEF helped more than 3,600 child soldiers leave army life, while in Burkina Faso, UNICEF’s support helped secure passage of legislation that made female genital mutilation a punishable offence.