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By L. Gonzales. Moravian College. 2018.

The strategic aim of such an Action Plan should be an intergovernmental international radiation safety regime for the practice of medicine effective 140 mg malegra fxt. First volume translated into Castilian: Historia de la radiación buy malegra fxt 140mg low cost, la radioactividad y la radioprotección — La Caja de Pandora; con prólogo de Abel J. González, Sociedad Argentina de Radioprotección, Buenos Aires (2012), http://radioproteccionsar. Lahfi The role and relevance of efficacy to the principle of justification in the field of radiation protection of the patient B. Moores A preliminary study on the impact of a redesigned paper based radiology requisition form with radiation dose scale on referring clinicians — As a model for developing countries A. Ascención Ybarra Lessons learnt from errors and accidents to improve patient safety in radiotherapy centers K. Asnaashari Lahroodi Gel dosimetry for radiotherapy patient dose measurements and verification of complex absorbed dose distributions M. Castellanos Film dosimetry for validation of the performance of commercially available 3D detector arrays for patient treatment plan verifications K. Chełmiński Radioprotective effect of bolus on testicular dose during radiation therapy for testicular seminoma J. Cordero Ramírez Issues on patient safety during radiation therapy — Concerns of regulatory authority P. Dubner Organ and effective doses from verification techniques in image-guided radiotherapy V. Dufek Application of the risk matrix approach in radiotherapy: An Ibero-American experience C. Duménigo Neutron contamination in radiotherapy treatments — Evaluation of dose and secondary cancer risk in patients M. Gershkevitsh Direct calibration of Australian hospital reference chambers in linac beams P. Harty Prevention and management of accidental exposures in radiotherapy in the Czech Republic I. Ismail Determination of entrance and exit doses in vivo in radiotherapy photon beams — A simple approach A. Malicki Dose from secondary radiation outside the treatment fields at different treatment distances with the use of multi-leaf collimators, physical and enhanced dynamic wedges R. Melchor Operational health physics during the commissioning phase of the West German Proton Therapy Centre Essen B. Niemeyer Comparison of the energy dependence of two homemade ionization chambers in relation to a standard ionization chamber in low-energy kilovoltage X ray beams, therapy level F. Nyakodzwe Radioprotection of workers with head and neck cancer during radiotherapy L. Pylypenko Doses to critical organs following radiotherapy treatment of lung, larynx and pelvis M. Rahman Radioprotection of paediatric patients in the Department of Radiotherapy of Prof. Ribeiro da Rosa Implementation of safety culture in radiotherapy centers in Brazil L. Teixeira The Australian Clinical Dosimetry Service: A national audit in the Australian context I. Alnaaimi Pearls and pitfalls of the nuclear medicine radioprotection programme in Argentina M. Gil Stamati Dosimetric evaluation of extravasated activity in nuclear medicine scans J. Namías Radiation protection in diagnostic nuclear medicine in Argentina — Current status and recommendations for the future M. Namías Radiation doses to staff in the Nuclear Medicine Department (Szczecin, Poland) in years 2008-2011 H. Piwowarska-Bilska A 10-year retrospective study of radiation exposure of the staff at nuclear medicine department J. Ptáček Evaluation of effective doses for occupational staff and patients in examinations with Mo99-Tc-99m in nuclear medicine in Albania L. Qafmolla Optimization of cardiologic protocols in nuclear medicine examinations S. Desai Thermoluminescent in vivo dosimetry for patient protection in intraoperative radiotherapy — Applications in breast cancer treatment D.

Transmission of bacteria from animals to humans and between captive animals can be more easily prevented and controlled 140mg malegra fxt fast delivery. Monitoring and surveillance Recording the incidence of outbreaks can identify trends in Campylobacter spp generic 140 mg malegra fxt overnight delivery. Monitoring of outbreaks in animals and humans can also help assess the contribution of animals to human illness. Good biosecurity will help protect captive animals from bacteria and prevent cross-contamination: - Have disinfection facilities for hands, footwear, clothing, equipment and vehicles/trailers on entering or leaving areas with livestock and after contact with animals. Vector control - although not the most important mode of transmission, vector control will help prevent/reduce flies mechanically transferring Campylobacter spp. Control of vectors Fence stream banks and watering holes to limit access by livestock to water contaminated by faeces from infected animals and to reduce animals contaminating water courses. Provide clean drinking water in separate watering tanks located away from potentially contaminated water bodies. Chlorinate contained drinking water sources and prevent faecal contamination of food and water where possible. Do not chlorinate natural water bodies as this will have an adverse effect on the wetland ecosystem. Vaccination can prevent abortions in sheep and may be used as prophylaxis for bovine genital campylobacteriosis. Use of artificial insemination techniques rather than natural insemination can control or prevent bovine genital campylobacteriosis. Antibiotics may be used to treat some cases of enteritis and may also prevent sheep and cattle from aborting during an outbreak. Disease is largely uncommon in wild animals therefore control measures are limited. To protect wildlife, wetland management should focus on reducing sources of human and livestock faecal contamination of wetlands. Avoid consuming unpasteurised dairy products and eggs and untreated surface water. Other foods, especially meat should be cooked thoroughly and fruit and vegetables should be peeled or washed thoroughly with uncontaminated water. Good personal hygiene including washing hands thoroughly with soap and warm water: before preparing and eating food; after handling raw food; after going to the toilet or changing a baby’s nappy; after contact with animals; frequently if you have symptoms such as diarrhoea. If campylobacteriosis is suspected, thoroughly wash all dirty clothes, bedding and towels in hot water. It is important to drink plenty of fluids as diarrhoea or vomiting can lead to dehydration and loss of minerals. However, the prevalence of infection in animals is much higher than the incidence of disease and many infected mammals and birds may not show any signs at all. That said, it can occasionally cause mortality in both taxa and may be of greater importance in hosts with con-current disease or subject to other stressors. Effect on livestock Whilst some infected animals may show mild signs such as diarrhoea, many will not show any signs at all. Mortality may be high in young farmed birds but low in older birds and adult sheep and cattle. Some infections may cause infertility and spontaneous abortion in sheep and cattle. Death is rare in healthy individuals but may occur in cancer patients or those that have compromised immune systems. Worldwide, campylobacteriosis is responsible for around 5-14% of all cases of diarrhoea. Economic importance There is potential for significant economic losses to the livestock industry, with poultry particularly affected, due to illness of infected animals and likely trade restrictions imposed during and after an outbreak. Illness in humans can result in significant economic losses due to the time lost from normal activities. Comparison of Campylobacter populations in wild geese with those in starlings and free-range poultry on the same farm. Screening for several potential pathogens in feral pigeons (Columba livia) in Madrid. Coral diseases are a number of diseases that lead to the damage of corals and their structure.

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Main avenues of research 47 Enhanced immune response: modified therapeutic antibodies 120 Engineering of antibody 100 80 60 40 Wildtype antibody 20 Engineered negative 0 control antibody 0 10 20 30 40 50 Antibody concentration (ng/ml) Specifically modified therapeutic antibodies can induce a five to eight times stronger immune response (e generic malegra fxt 140mg overnight delivery. The next drug The next step was to link therapeutic antibodies generation: small with small molecules to form what are known as molecule conjugates small molecule conjugates purchase malegra fxt 140 mg without prescription. Antibodies have a disadvantage that they share with other thera- peutic proteins: they are too bulky to penetrate into the interior of cells. Potential targets are therefore limited to molecules lo- cated outside of or on the surface of the body’s cells. By contrast, many conventional, chemically synthesised small molecule drugs can readily pass through the cell membrane to targets within the cell or even the cell nucleus. Small molecule conjugates combine the specificity of therapeu- tic proteins – especially antibodies –with the broad target range of small molecules. To produce them, researchers have de- veloped complexes, or conjugates, consisting of therapeutic antibodies coupled to low-molecular-weight drugs. In such con- jugates the antibody’s role is to ferry the actual drug directly to its target in the body. Drugs commonly used to destroy cancer cells also attack healthy cells in the body. Once Co plexbinds this occurs, the entire conju- tocell gate is internalised in the cell. In cancer cells the anti- body is digested and releases the small molecule, which Cancercell then destroys the diseased cell. In this way cancer cells Cancercell orzelle can be specifically targeted and adverse effects on Co plexcarries drugintocell healthy cells can be minim- ised. If Entireco plexinsidecell the findings from tests are borne out, the latest gener- ation of these drugs could Cancercell signal a breakthrough not Drugkills cancercell only in cancer therapy but in many other therapeutic Conjugated antibodies combine the specificity of thera- areas where medical science peutic proteins with the broad target range of small mole- has hitherto had to contend cules. The antibodies target a specific structure on the with severe side effects surface of cancer cells. Once the antibody has located its target and bound to it, the conjugated small molecule drug caused by the unspecific is released, penetrates the cancer cell and kills it. Spektrum Akademischer Verlag, Heidelberg, 6th edition 2003 Presentations at a media conference: The Roche Group – one of the world’s leaders in bio- tech, Basel, November 2004 http://www. As well as the therapeutic possibilities it offers, modern biotechnology can lead to novel ways of combating diseases such as diabetes, cancer and rheumatic diseases. For example, early and specific diagnosis, and also tests that can monitor treatment and the course of an illness, can result in more effective treatment of patients. The more doctors know about the causes of diseases, the more ef- fectively they can deal with them. This realisation may sound simple, but translating it into practice remains difficult, be- cause the critical part of treatment is often finding the right diagnosis. It is precisely in this area that biotechnology has made tremendous strides in recent decades. Thus, for example, alleviating pain should not be the only goal when treating patients with chronic pain. It is only when the source of the pain has been identified that steps can be taken to counter it in the long term. Yet pain patients in particular often have to undergo veritable medical odysseys as a result of uncer- tain diagnoses, failed treatments and ever increasing pain. De- spite having similar symptoms, painful rheumatic diseases can be caused by very different disorders, each of which re- Terms quires a distinct treatment. Whether a treatment is suc- Biopharmaceuticals drugs manufactured using biotech- nological methods. The picture is similar with Genome the (largely unalterable) complement of all genes of cancer, where the sheer va- an organism. Genomics the science concerned with the form, function riety of causes requires a new and interaction of the genes of an organism. A tu- Genotype the variants of a given gene possessed by an mor can remain completely organism; as a rule a human can have no more than two variants of each gene – one from the father and the other from the mother. Proteomics the science that deals with the form, function origin and genetic pattern of and interactions of the proteins of a biological system. In this respect, biotechnology has devised new means for identifying the precise molecular causes of such disorders.

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A “seemingly race- neutral concern over crime” became a vehicle to continue to fight racial battles (Loury 2008 purchase malegra fxt 140mg without a prescription, p cheap malegra fxt 140mg visa. Not to be outdone by the Republicans, the Democrats became equally fervent apostles of tough-on-crime policies. With little debate or reflection, the federal and state governments responded to crack specifically and drug use more generally with soaring law enforcement budgets and ever more punitive laws and policies that increased arrests of low-level drug offenders, the likelihood of a prison sentence upon conviction of a drug offense, and the lengths of prison sentences. The federal Anti-Drug Abuse Act of 1986 and the Anti-Drug Abuse Act of 1988 imposed far higher penalties for the sale of crack cocaine than for powder cocaine. Under the notorious federal 100-1 law governing powder and crack sentences, federal defendants with 5 grams of crack cocaine received the same mandatory minimum 5-year sentence imposed on defendants with 500 grams of powder cocaine. Fourteen states also imposed harsher sentences for crack compared to powder cocaine offenses (Porter and Wright 2011), and all states ratcheted up sentences for drug law violations regardless of the drug involved (Human Rights Watch 2000, 2008; Mauer 2006). Harsh penalties for crack were easily enacted because that drug was uniquely linked in the mainstream’s collective consciousness with dangerous, poor, minority inner-city dwellers who supposedly threatened white suburban America. Federal District Judge Clyde Cahill described the racial underpinnings of federal crack sentencing legislation: The fear of increased crime as a result of crack cocaine fed white society’s fear of the black male as a crack user and as a source of social disruption. The prospect of black crack migrating to the white suburbs led the legislators to reflexively punish crack violators more harshly than their white, suburban, powder cocaine dealing counterparts. Clary 1994) When public officials, legislators, and the media talked about crack in terms of addiction and violence, the subtext was understood to be race: [C]rack cocaine was perceived as a drug of the Black inner-city urban poor, while powder cocaine, with its higher costs, was a drug of wealthy whites…. This framing of the drug in class and race-based terms provides important context when evaluating the legislative response. Even so, the racial underpinnings of the war on drugs have changed little (Loury 2008). As Loury observed, “the racial subtext of our law and order political discourse over the last three decades has been palpable” (Loury 2007, p. When Americans are asked to envision a drug offender, they see black men in urban alleyways, not white college kids in their dorms (Tonry 2011). Heightened media and political attention to substance abuse and the drug trade in urban minority neighborhoods has promoted the erroneous public perception that illegal drugs are more prevalent there than in more affluent white neighborhoods. Katherine Beckett’s Seattle research suggests that current racial disparities in drug arrests and case outcomes reflect images and concerns embedded in the national psyche during the “crack epidemic” in the 1980s (Beckett et al. Michelle Alexander insists the conflation of blackness with drug crime continues to provide “a legitimate outlet to the expression of antiblack resentment and animus—a convenient release valve now that explicit forms of racial bias are strictly condemned” (Alexander 2010, pp. Arrests and Imprisonment The modern war on drugs has resulted in a steep rise in the number of Americans arrested and locked up on drug charges. Although the total number of arrests nationwide increased by only 31 percent from 1980 to 2009, the number of drug arrests grew by 186 percent and the drug arrest rate increased from 256 per 100,000 persons to 542 (Snyder and Mulako-Wangota 2012b). Between 1980 and 2003, the number of drug offenders in state prisons grew twelvefold. In 2009, nearly one- quarter of a million persons (242,200) were serving time under state jurisdiction for drug offenses, making up 17. Subscriber: Univ of Minnesota - Twin Cities; date: 23 October 2013 Race and Drugs 1985 811,400 557,696 245,149 8555 69 30 1 1986 824,100 543,521 273,377 7203 66 33 1 1987 937,400 604,032 325,381 7988 64 35 1 1988 1,155,200 696,399 448,623 10,178 60 39 1 1989 1,361,700 797,072 556,579 8049 59 41 1 1990 1,089,500 641,096 439,981 8423 59 40 1 1991 1,010,000 582,731 418,598 8670 58 41 1 1992 1,066,400 625,326 431,249 9825 59 40 1 1993 1,126,300 674,756 440,899 10,644 60 39 1 1994 1,351,400 834,472 503,576 13,352 62 37 1 1995 1,476,100 910,293 550,247 15,559 62 37 1 1996 1,506,200 933,390 555,580 17,230 62 37 1 1997 1,583,600 988,840 575,274 19,485 62 36 1 1998 1,559,100 965,556 575,331 18,213 62 37 1 1999 1,557,100 982,494 555,636 18,971 63 36 1 2000 1,579,566 1,005,853 553,905 19,808 64 35 1 2001 1,586,902 1,014,107 552,382 20,413 64 35 1 2002 1,538,813 997,637 519,875 21,301 65 34 1 2003 1,678,192 1,097,610 557,171 23,411 65 33 1 2004 1,746,570 1,141,852 581,464 23,254 65 33 1 2005 1,846,351 1,202,924 617,744 25,683 65 33 1 2006 1,889,810 1,208,364 656,229 25,217 64 35 1 2007 1,841,182 1,179,813 636,337 25,032 64 35 1 2008 1,702,537 1,093,965 585,118 23,454 64 34 1 2009 1,663,582 1,086,003 554,105 23,475 65 33 1 Source: Snyder and Mulako‐Wangota 2012a. Arrests In 2010, the most recent year for which national drug arrest data are available, almost one in three drug arrestees was black (Federal Bureau of Investigation 2010). At no point since 1985 have blacks accounted for less than 30 percent of all drug arrests. Subscriber: Univ of Minnesota - Twin Cities; date: 23 October 2013 Race and Drugs Click to view larger Figure 1 Rates of Drug Arrests, by Race, 1980 to 2009 Note: National Estimated Source: Snyder and Mulako-Wangota 2012b. African Americans are arrested for drug offenses at much higher rates than whites, as Figure 1 shows. As of 2009, the ratio of black to white drug arrest rates was three to one (see Table 2). Between 1980 and 2009, the arrest rate for black Americans for drug law violations increased from 505 per 100,000 black population to 1,351. Drug Arrests by Race, 1980–2009 (Rates calculated per 100,000 residents of each race) Black rate White Rate Ratio of Black to White 1980 505 226 2.

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In reality discount malegra fxt 140 mg on-line, drug Malaysia dependence is a complex health condition that has a mixture of causes – social safe malegra fxt 140mg, psychological and physical (including, for France example, harsh living conditions, or a history of personal 0 5 10 15 20 25 30 35 40 45 trauma or emotional problems). Countries that have Sample of countries that have consistently treated citizens dependent on drugs as patients in need of resisted large scale implementation of harm treatment, instead of criminals deserving of punishment, have reduction strategies, despite the presence of demonstrated extremely positive results in crime reduction, drug injecting and sharing: health improvement, and overcoming dependence. The consistent implementation researchers in this case also referred to police of this policy has led to an overall reduction in criminal records data. The research shows the number of people addicted to heroin as well that the numbers of charges brought against as a range of other benefts. A key study14 1,476 drug users in the years before and after concluded that: entering treatment reduced by 48 percent. Heavily engaged in Heroin has lost its appeal to the mainstream youth both drug dealing and other forms of crime, they and is considered a ‘dead-end street drug’. The number of problematic heroin users has As these hard-core users found a steady, legal dropped signifcantly and the average age of users means for their addiction, their illicit drug use was has risen considerably. Large-scale, low-threshold reduced as well as their need to deal in heroin drug treatment and harm reduction services and engage in other criminal activities. The heroin substitution program had three effects on the drug market: Medically prescribed heroin has been found • It substantially reduced the consumption among in the Netherlands to reduce petty crime and the heaviest users, and this reduction in demand public nuisance, and to have positive effects on affected the viability of the market. The development and implementation of drug A current example of this process (what may be described policies should be a global shared responsibility, as ‘drug control imperialism’), can be observed with the but also needs to take into consideration diverse proposal by the Bolivian government to remove the political, social and cultural realities. Policies should practice of coca leaf chewing from the sections of the respect the rights and needs of people affected 1961 Convention that prohibit all non-medical uses. As with all multilateral agreements, the However, the idea of shared responsibility has too often drug conventions need to be subject to constant review become a straitjacket that inhibits policy development and modernization in light of changing and variable and experimentation. This analysis strenuously over the last 50 years to ensure that all and exchange of experiences is a crucial element of the countries adopt the same rigid approach to drug policy process of learning about the relative effectiveness of – the same laws, and the same tough approach to their different approaches, but the belief that we all need to have enforcement. As national governments have become exactly the same laws, restrictions and programs has been more aware of the complexities of the problems, and an unhelpful restriction. When these involve a more tolerant approach to drug use, governments have faced international diplomatic pressure to ‘protect the integrity of the Conventions’, even when the policy is legal, successful and supported in the country. These allocation, and implementation have not modernized at negative consequences were well summarized by the the same pace. The growth of a ‘huge criminal black market’, fnanced demonstrated that governments achieve much greater by the risk-escalated profts of supplying international fnancial and social beneft for their communities by demand for illicit drugs. Extensive policy displacement, the result of using scarce investing in supply reduction and law enforcement activities. Geographical displacement, often known as ‘the balloon the punishment of people who use drugs. This structure is premised on the notion that international drug control is primarily a fght against crime and criminals. Unsurprisingly, there is a built-in vested interest in maintaining the law enforcement focus and the senior decisionmakers in these bodies have 4. Drug policies must be pursued in a comprehensive traditionally been most familiar with this framework. The marginalization of the World Health system have been the police, border control and military Organization is particularly worrisome given the fact that authorities directed by Ministries of Justice, Security it has been given a specifc mandate under the drug or Interior. Caitlin Hughes of the University of New strategies will not solve the drug problem, and South Wales and Professor Alex Stevens of the University that the war on drugs has not, and cannot, be won. Hughes and Stevens’ 2010 report detects a slight increase in overall rates of drug use in Portugal in the 10 years since 2. Replace the criminalization and punishment of decriminalization, but at a level consistent with other similar people who use drugs with the offer of health and countries where drug use remained criminalized. Their overall conclusion is that was that the threat of arrest and harsh punishment the removal of criminal penalties, combined with the use would deter people from using drugs. In practice, of alternative therapeutic responses to people struggling this hypothesis has been disproved – many countries with drug dependence, has reduced the burden of drug law that have enacted harsh laws and implemented enforcement on the criminal justice system and the overall widespread arrest and imprisonment of drug users and level of problematic drug use.

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