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Sanger argued that no woman can call work with poverty-stricken immigrants living in the slums herself free who does not own and control her own of Chicago and her study of the conditions on Ellis Island generic geriforte 100mg on line, body generic geriforte 100 mg on-line. She testified riences there impressed upon her the need for birth before Congress against immigration restrictions and buy discount geriforte 100 mg line, in a control as a mechanism of womens sexual liberation. After distributing contra- work on behalf of immigrants, Abbott is known for her ceptives to approximately 400 women, she was arrested work in support of child labor laws and her role in plan- and ultimately served time in prison for distributing ning the social security system as a member of the then- contraceptives. The following year, she began publica- President Franklin Delano Roosevelts Council on tion of the Birth Control Review and, in 1921, she estab- Economic Security. Seaman pre- diaphragms would cause cancer and madness and that tended to be mentally ill in order to observe and record interference with Gods will would lead to mental and the conditions at that hospital. Finally, in 1937 the American Medical expos in New York World; these articles were later Association recognized the provision of contraception collected and published as Ten Days in a Mad House as a legitimate medical service. Her work precipitated a grand jury investigation eral Comstock Law was overturned in 1938, many states of the conditions in that asylum. It was not until 1965, with the known for her effort to beat Phileas Foggs 80-day tour Supreme Court decision in Griswold v. Connecticut, around the world in Jules Vernes fictional account, that women were assured of their right to privacy that Around the World in Eighty Days. In pioneer of the surgical technique that is used to save 1912, Sanger began writing a column entitled What blue babies. In 1930, she became the Head of nalized the publication, distribution, or possession of the Johns Hopkins pediatric heart clinic. She became information about devices or medications for abortion or interested in studying the condition popularly known as contraception. Family planning, she believed, prevent the babys heart from pumping oxygen into would liberate poor women from the economic the blood. This mechanism is known as the which led them to claim their superiority in other areas BlalockTaussig shunt. Horney argued that environmental and social paving the way for open-heart surgery with the conditions, rather than instinctual or biological drives, heartlung machine. In 1962, Taussig worked to alert as maintained by Freud, determined individual person- physicians about the dangers associated with the use of ality. She objected to Freuds concept of libido, a death thalidomide, prescribed as a sedative during pregnancy. She further asserted that the source of Alice Hamilton (18691970) has become known as much of womens psychological distress was due to a the matriarch of industrial medicine. Her 1910 study of the poisoning New York Psychoanalytic Institute, and, together with of approximately 600 workers implicated seven different Erich Fromm, founded the American Journal of industrial processes as the cause. Harriet Hardy was largely responsible for the Reproductive Health identification of beryllium as the cause of an outbreak Bertha Van Hoosen (18631952), while on staff of of sarcoidosis of the lung among predominantly female Illinois Universitys Medical School, invented what has employees at a fluorescent light plant in Massachusetts. Van exposures were responsible for the outbreak, their find- Hoosen delivered over 2,000 babies using this tech- ings were suppressed as a result of industry pressure. Health and Spirituality Mary Baker Eddy (18211910) is best known as a Pediatrics founder of Christian Science. Although this represents Ethel Collins Dunham (18831969) set the standard a religious or spiritual orientation, its tenets are inti- of care for the treatment of premature infants. Eddys first turn of the 20th century, some cities were experiencing edition of Science and Health, which addressed the a 30% mortality rate among infants under the age of concept of mind healing, was published in 1875. White (18271915) cofounded the Seventh the association between prematurity and infant death. Day Adventist Church, together with her husband Her text, entitled Premature Infants: A Manual for James White, in 1863. During the early 1900s, the United States had one of the highest infant and maternal death rates in the Health Care Western world. In 1908, Baker was appointed to head During the early to mid-1900s, South Carolina was the Bureau of Child Hygiene within New Yorks known for its lack of attention to the health problems Department of Health; this was the first tax-supported plaguing its African American residents. As a public attention was paid to diseases that disproportionately health administrator, Baker worked ceaselessly to affected the African American populace, it was often decrease the rate of infant mortality. Ultimately, Bakers she began a clinic for expectant mothers, infants, and efforts led to a reduction in the rate of child mortality children. American businessmen and, eventually, state and local Evangeline Cory Booth (18651950) was the governments. In 1904, Immigrant Health Evangeline Booth assumed the leadership of the Salvation Army in the United States. Her social reform efforts included the founding of the settlement house, Hull House, to serve Chicagos poor immigrant population.

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Some of the enrichment techniques used for wild felids in captivity include hiding food so that the animal must dedicate time to searching for it; giving a supply of toys and installing platforms that provide the animals with a three dimensional space (Martos quality geriforte 100 mg, this book) discount geriforte 100mg with amex. The effects of environmental enrichment are variable and depend on the technique used and the characteristics of every species and individual cheap 100mg geriforte mastercard. It is important to take into account that, occasionally, environmental enrichment programmes can have negative effects on the animals welfare. For example, in animals housed in groups enrichment can cause an increase in aggression by stimulating competition for resources that did not previously exist. However, this problem usually disappears following an increase in the number of objects or feeding points used for the enrichment, so that the animals have no need to compete with one another (Bloomsmith et al. Furthermore, in order to assess the effect of enrichment upon physiological parameters indicative of chronic stress, it can be useful to analyse the concentration of metabolites of cortisol in the faeces before and after carrying out the programme. Ps y c h o a c t i v e d R u g s Psychoactive drugs can be useful to alleviate specific situations of stress. It is important to take into account, however, that under no circumstance should they be used over a prolonged period of time in order to mask the effects of inadequate housing or husbandry. It is important to note, however, that there is very little information about the use of such pharmaceuticals in non-ungulate mammals, so they must be used with caution. Some species of artiodactyls have been known to perform aggressive behaviours towards people following the administration of long-acting neuroleptics (Ebedes, 1993). Serotinin is a neurotransmitter that has an important regulating effect on the anxiety response. Furthermore, unlike benzodiazepines, it does not interfere with learning and memory. Fluoxetine is a selective inhibitor of serotonin reuptake, and is very useful against aggression problems between cats. The effects of the selective inhibitors of serotonin reuptake may not be immediate and can even take weeks to appear (Overall, 1997). Both drugs have occasionally been used on wild cats in captivity to control fear and aggression. However, they must be used with caution, since there is little information about their possible effects on wild animals. Ph e R o m o n e s Felids possess pheromone-producing glands on the sides of the head (temporal glands) around the mouth (perioral gland) and tail (caudal glands). Temporal and perioral glandular secretions are deposited as the animal rubs its head against an object, or sometimes another animal (Bradshaw and cameron-Beaumont, 2000). The facial pheromones of the cat are of interest in clinical ethology because they can reduce the stress response and aggressive behaviour towards other animals of the same species (Pageat and Gaultier, 2003). The domestic cats facial pheromone has been shown to be effective in other species of cats such as tigers. It is produced by glands within the skin around the abdominal area (Gaultier et al. An appeasing pheromone has recently been isolated in the domestic cat, and work will be carried out promptly to determine whether or not it also has an effect in other cat species. This is especially relevant in captive breeding centres, as lack of adaptation to the environment results in a decrease in reproductive effciency. Environmental enrichment programmes should be part of the day to day husbandry routine for wild cats in captivity. Furthermore, the use of pheromones to prevent or remedy stressful situations is a promising technique that deserves thorough investigation. Effcacy behaviour in mammals Reproduction, nutrition and of dog-appeasing pheromone in reducing stress associated Development 45, 345-351. Interdisciplinary Methods in the Iberian lynx (Lynx pardinus) conservation Breeding programmeme, in: Vargas, A. Unusual gonadal hormone profles in the Iberian lynx as determined by fecal monitoring, in: Vargas, A. Produce una inmensa tristeza pensar que la naturaleza habla mientras el gnero humano no escucha. Este est compuesto por una serie de estmulos ante los cuales el individuo debe reaccionar. En cautividad, las condiciones cambian, el entorno pierde complejidad y se vuelve predecible. Este hecho puede traducirse en una prdida en la riqueza de comportamientos presentados por el individuo 137 que, al no poder realizar determinadas conductas, puede desarrollar otras no naturales que podran llegar a considerarse patolgicas, como las denominadas estereotipias. El objetivo de este captulo es el de recopilar informacin sobre la utilizacin de las tcnicas de enriquecimiento ambiental destinadas a mejorar el bienestar de los felinos. Al fnal del captulo se debatirn algunas aplicaciones del enriquecimiento ambiental en los centros de cra para la conservacin del lince ibrico. Each species is adapted to a given type of environment and has a behavioral repertoire that has been especially developed to survive in it. In captivity, conditions change and the environment becomes less complex and predictable. The fact of not being able to perform a given behavior may lead captive individuals to perform other unnatural behaviors that may in some cases even be pathological in the case of stereotyped behavior.

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Data collected from existing health of patients less than 3 years of age and represents care utilization databases do order 100 mg geriforte visa, however generic geriforte 100 mg online, provide a cohort in which the majority are physiologically insight into the trends in utilization of services for and developmentally incapable of voiding control discount geriforte 100mg free shipping. An important caveat is that Children between the ages of 3 and 11 constitute the undercoding or miscoding may lead to undercounting cohort in which incontinence encounters are most common. Trends in mean inpatient length of stay (days) for children hospitalized with urinary sample sizes in the datasets. These age strata present incontinence listed as primary diagnosis methodological limitations in analyzing nocturnal Length of Stay enuresis, about which awareness increases at about 1994 4. Samples period, the average length of hospital stay increased in which raw counts are less than 30 have been from 4. The longer, on average, for patients admitted to urban analyses reported here are limited by the absence of hospitals than for the total group studied (Table 3). A cohort of 1,251 patients with urinary Inpatient Care incontinence listed as the principal diagnosis was Urinary incontinence is a common reason for identifed. The average length of hospitalization for care-seeking by the pediatric population, but it these patients was 6. The duration was greater requires hospitalization far less frequently than is for older children, averaging 7. Mean inpatient length of stay (days) for children by physicians in offce-based settings. During the same time nationally representative sample of visits to hospital frame, 1994 to 2000, outpatient visits for a primary outpatient departments. Boys made by children with urinary incontinence listed and girls were seen in similar proportions. This represents a rate of 343 visits A detailed assessment of disease states per 100,000 children. Taken together, these data suggest that allowed us to parse the relative proportion of visits urinary incontinence is a relatively common diagnosis for selected diagnoses of incontinence (Table 10). A trend This implies that care delivered in the hospital setting toward increased utilization was seen in both groups should represent a small proportion of overall costs. Because most children with urinary incontinence This trend appears to refect a longer average length receive medical or behavioral treatment, their of hospital stay for the older two groups (Table 4). Fewer than 9 per 100,000 commercially insured children presenting for ambulatory surgical 2% treatment in 1998 and 2000 had incontinence listed 23% 02 years old as any diagnosis. As expected, rates were highest 310 years old among 3- to 10-year-olds (Table 11). Small counts in 1117 years old this dataset preclude reliable estimation of these rates for 1994 and 1996. Stratifcation by race/ethnicity, gender, and geographic region is also impossible with this dataset. Urinary incontinence encompasses for children having commerical health a heterogeneous family of disorders with clinical insurance with urinary incontinence listed as strategies dictated by the underlying condition. Outpatient in children implies either a symptom or a sign, rather physician payments were much lower for children than a specifc disease entity. While patterns of care- covered by managed Medicaid plans, ranging from seeking behavior are often driven by symptoms, $24 in 1994 to $38 in 2000 (Table 14). The differences resource utilization, management strategies, and costs in payments between commercially insured children are generally dictated by the underlying condition. Table to characterize care-seeking for incontinence by 7 shows that there are roughly 225,000 physician underlying diagnosis. Number of plan members per year with a physician outpatient visit for pediatric urinary incontinence, by underlying condition, counta, rateb 1994 1996 1998 2000 Count Rate Count Rate Count Rate Count Rate Commercially Insured Population Spina bifda-associated 2 0. Underlying condition was assigned to the incontinence visit if a diagnosis code for that condition occurred on a claim for that patient that year. Visits to ambulatory surgery centers for urinary incontinence listed as any diagnosis by children having commercial health insurance, counta, rateb 1994 1996 1998 2000 Count Rate Count Rate Count Rate Count Rate Total 20 * 23 * 57 8. Unfortunately, it is diffcult to obtain reliable epidemiologic data for urinary incontinence in children. Stratifcation by smaller age cohorts might a provide more insight into care-seeking patterns and Table 12. Mean inpatient cost per child (in $) admitted with urinary incontinence listed as primary diagnosis, the natural history of incontinence complaints. In most clinical contexts, wetting in Age this age cohort does not require investigation. Direct costs of 146 147 Urologic Diseases in America Urinary Incontinence in Children Table 13. Payments (in $) by children having commercial health insurance for physician outpatient visits with urinary incontinence listed as primary diagnosis Mean Total Total Amount Total Amount Mean Total Total Amount Total Amount Counta Payments Paid by Plan Paid by Patient Counta Payments Paid by Plan Paid by Patient 1994 1996 Total 1,547 45 35 10 2,245 50 40 10 Age <3 27 38 28 9.

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Talking Points: The frst step in getting treated for depression is a physical examination (exam) by a doctor 100mg geriforte amex. Certain medicines and some illnesses order geriforte 100mg on line, such as a viral infection generic geriforte 100mg, can cause the same signs as depression. Once the doctor has ruled out any other illness, the next step is usually a psychological (relates to the mind or emotions) evaluation. The doctor may do this evaluation, but more likely he or she will have the patient see a psychiatrist or psychologist. A psychologist has a degree in psychology from a college or university and cannot prescribe medicine. The doctor will ask about alcohol and medicine taken and whether the patient has thoughts about death or suicide. The doctor will also ask questions about family history: Have other family members had depression? Talking Points: There are two common types of treatment for depression: Medicine. If you are not feeling better after a few weeks, your doctor may have you try different medicines to fnd out what works best for you. Also, if one medicine does not work, you should ask your doctor if you can try another medicine. Never stop taking an antidepressant without talking to the doctor about how to do it safely. You should keep taking the medication, even if you are feeling better, to prevent the depression from returning. Although antidepressants are not habit-forming or addictive, suddenly ending an antidepressant can cause withdrawal problems or lead to a return of the depression. Some people, such as those with continual depression, may need to stay on the medication a longer time. You should not use alcohol or street drugs because they may cause the antidepressants not to work as well. The latest information on medications for treating depression is available on the U. This therapy helps you learn to change the way depression makes you think, feel, and act. Ask your doctor or psychiatrist which professional you should go to for talk therapy. In the meantime there are things you can encourage a person with depression to do Set realistic goals and take a reasonable amount of responsibility. The most important thing anyone can do for the depressed person is to help him or her get a diagnosis and treatment. You can encourage the person to stay with treatment until he or she feels better (it may take several weeks), or to talk to his or her doctor about a different treatment. Sometimes you might need to make an appointment and go with the depressed person to the doctor. It may also mean checking on whether or not the depressed person is taking medication. You should encourage the depressed person to follow the doctors advice about the use of alcohol while on medicine. Invite the person for walks, outings, to the movies, and other activities that they used to enjoy. Do not accuse the depressed person of faking illness or of laziness, or expect him or her to snap out of it. Keep that in mind, and keep telling the depressed person that, with time and help, he or she will feel better. But, we know from research that people with heart disease are more likely than healthy people to suffer from depression. Also, people with heart disease who are depressed have a greater risk of dying after a heart attack and stroke than those who are not depressed. Talking Points: Remember, depression can make it hard to function in everyday life. Depression makes it hard to care about taking medicine or to remember to take medicine. Making lifestyle changes such as increasing physical activity, eating healthy foods, and quitting smoking can seem impossible to someone suffering from depression. Depression may affect heart rhythm, increase blood pressure, and affect the bloods clotting ability. Despite research showing a link between depression and heart disease, depression often is not diagnosed and is left untreated. Persons with heart disease or stroke, their families and friends, and sometimes even their doctors may not see the signs of depression, or may mistake them for the usual feelings that are a part of heart disease or stroke. Doctors trained to see the signs of depression know the right questions to diagnose depression and can treat the person for it. But most people who survive a stroke become depressed because of the changes in their lives.