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This would enable road-mapping nanotechnology related applications medicine lodge ks 5mg linagliptin fast delivery, enhancing and broadening their implementation for developing vital sectors in member states treatment 5th metatarsal shaft fracture buy linagliptin without prescription, and support the decision-making processes for policy makers and funding agencies symptoms rotator cuff injury generic linagliptin 5 mg without a prescription, as well as providing an overview of needs treatment jaundice 5mg linagliptin amex, challenges and future opportunities of nanotechnology in member states. Such concerted international efforts would greatly help in the formulation of global goals for responsible nanotechnology, and would have a major impact on the future of our nations for decades to come, leading to betterment of its humanity. Besides, the proposal will also much help in setting up clear global objectives for the usage of large scale facilities. Consultants carefully chosen from the highest caliber scientists (including Nobel Prize recipients) can also contribute in the early phase realization of the center. The criteria in proposal selection will be the scientific merit and originality of the proposal upon a high-level committee decision, based on the foreseen high priority research activities expressing the needs of international partners from academia and industry. Special focus will be on the transfer of discoveries and intellectual knowledge in the areas of nanotechnology to industry partners and on the rapid application and commercialization of this technology to stimulate economic growth in member states. Furthermore, the proposed international initiative and center would represent a fertile ground for giving a chance to specialized international organizations with an interest in nanosciences and its applications. This would ensure the 5 required coherence between research programs in all participating countries. Such organization would join the United Nations family for carrying out the activities necessary to assist and advise partner countries in assessing their needs for capacity building in key areas of nanosciences. As your honor knows that there are many humanitarian concerns that hinder developing nations, which are caught in a "vicious circle of poverty, disease and overpopulation". To date, there has not been much done for systematic prioritization of high-tech applications targeted toward the challenges faced by billions of people living in the 6 developing world. The United States promote a high-tech world, yet the promise of technology remains largely unfulfilled in the developing world! Developing countries should not be viewed as obstacles but rather as resources that must fulfill their potential, along with other countries. Both the United States and developing countries have much to learn, providing opportunities for research and development questions that are still unexplored. The perspective outlook for sustainable development in the United States and the developing world will depend mainly on their ability to work together to achieve common goals for the common good of humanity. President, nanotechnology is now in danger of repeating the unfair trends of biotechnology with respect to the international participation in the dialogue. There is a great concern that developing countries will not have a voice in the international development of nanotechnology. Therefore, encouraging a more equitable sharing of the developing world in the World Science is now highly demanding. With greater responsiveness, the United States and developing countries will learn how to cooperate and work out a more fair system of intellectual 7 property rights. The United States is more able now to play a significant role in the global development of nanotechnology and to take the leadership role in making the poor of the developing world visible and mobilize science and technology to address their crises. Addressing the lack of cohesion in global nanotechnology policy and acceleration of the use of viable nanotechnologies by less industrialized countries to meet critical sustainable development challenge would much contribute to the attainment of the United Nations Millennium Development Goals. President, nanotechnology can be harnessed to address some of the most urgent needs of developing countries. Thus, a long term and concerted plan of action for the development of this powerful emerging technology in developing countries is highly demanding now. Besides, it would also represent a starting-point for enhancing international scientific research with Egypt and other developing countries in the Middle-East area. In order to obtain a share of the current world scientific revolution, true and concerted efforts should be pursued and we should work together for solving problems and facing challenges that could hamper our progress toward our noble aspirations. President, the regional, cultural, and humanitarian civilization dimensions of Egypt make it a favorable environment for the 8 implementation of the proposed giant project. According to Professor Ahmed Zewail (Nobel laureate, 1998 and one of your respectable scientific advisors), the awarding of the Nobel Prize in the Sciences- a first in the history of Egypt and the Arab world-underscores what the people of this nation can achieve on the international level, if they have the proper milieu for utilizing their skills and abilities. We have already seen many developing countries scientists and engineers working in the United States and making significant contributions to science and technology. Egypt now has the necessary infrastructure and political position necessary for achieving a great scientific and technological leap forward that would boost it into the twenty-first century.
The Family Violence Prevention Fund offers a Practitioner Reference Card fvpfstore symptoms kidney pain buy linagliptin australia. Men with histories of physical or sexual violence typically present with angry defensiveness treatment jokes buy linagliptin master card. The State-Trait Anger Expression Inventory-2 treatment definition math purchase generic linagliptin online, for example symptoms of strep purchase linagliptin 5 mg overnight delivery, helps identify men who are excessively angry (Spielberger 1999) by measuring experi ence and expression of anger. Clients should be reassured of the confidentiality of any information they provide. To approach the matter with clients in an open and nonjudgmental way, counselors must explore their own concerns related to sexuality and should always have access to su pervision to help them address this issue. In terms of sexual orientation, for ex ample, counselors should understand how the client self-identifies. Determine whether clients understand the importance of taking measures to prevent the sexual transmission of disease and how to use birth control when necessary. Some clients engage in risky sexual behavior because they do not un derstand the risks involved (and need to be educated), but others may gain pleasure from pursuing risk; the text box on the next page explains the motivations of this particular group of clients. The Sexual Sensation Seeking Scale is an 11-item self-report measure of sensation seeking relat ed to sexual interests, and the Sexual Compul sivity Scale is a 10-item self-report measure of excessive preoccupation with sexual encoun ters. The reliability and validity of these brief scales when used in research on diverse sam ples of men has been documented (Kalichman et al. The Sexual Risk Scale is a 9-item self-report scale that measures risk for exposure to sexually transmitted disease based on engagement in specific sexual behaviors in the previous 6 months (Li et al. Assessing for Shame Clinicians and researchers have repeatedly highlighted the role that shame plays in the socialization of men (Pollack 1998b). Because men tend to be sensitive to experiences that provoke feelings of shame, clinicians need to be aware of how this sensitivity can affect treatment beginning in the screening phase. Although shame is not a male-only problem, the specific reasons men feel shame may be different from the reasons women do-and men may manifest their shame differently than women. On the underlying motivation for high risk behaviors, Zuckerman (1979, 1984, 1994) hypothesized that certain individuals, called sensation seekers, were physiologi cally predisposed to seek out and engage in a variety of different, highly stimulating, novel behav iors. These included recreational activities (such as parachuting or mountain climbing), occupational activities (such as police work or car racing), increased experimentation with various substances (such as alcohol or marijuana), and increased exploration with numerous sexual partners and sexual prac tices. Early definitions of sensation-seeking emphasized the performance of actions that entailed physical risks. However, later research showed that other kinds of risk were also involved in this trait, including legal, social, and financial risks. Burns and Wilde (1995) define risk-taking as any behavior for which there is significant uncertainty regarding potential losses associated with the outcome. When the subjective or perceived benefits of this behav ior exceed the losses, the person is motivated to take the risk. For example, bungee jumping may seem terrifying and very risky, yet is not especially dangerous given appropriate safety precautions. It is possible to experience the heightened arousal associated with this seemingly risky activity without great risk. Thus, being a sensation seeker does not always signify the taking of actual risks. Male and female sensation seekers often take risks, but such activity is more pronounced in men. Shame associated with a socially stigmatized behavioral health problem can cause some men to avoid screening and comprehensive assessment or to resist, in a hostile manner, screening and assessment (Fortenberry et al. Once the screening and assessment process begins, sensitivity to shame may cause men to withhold information about specific thoughts, feelings, and behaviors (MacDonald 1998). Because shame involves an interperson al dimension, fear of shame will frequently be of concern to men as they begin to develop a helping relationship with a clinician (Retzinger 1998). Moreover, shame can influ ence compliance with specific aspects of a comprehensive assessment, particularly medi cal assessment and screening for sexually transmitted diseases (Fortenberry et al. To evaluate shame accurately, clinicians must understand the conceptual differences between 24 shame and other negative emotions, particu larly guilt. To evaluate men for sensitivity to shame, observe for it during the initial inter view (Tangney and Dearing 2002)-clinicians usually can distinguish accurately between shame and other emotions. According to Retzinger (1998), shame generally is not ex pressed verbally, but verbal clues can show that a client may be feeling shame.
The clock dragged man out of the world of seasonal rhythms and recurrence symptoms 1 week before period order 5mg linagliptin amex, as effectively as the alphabet had released him from the magical resonance of the spoken word and the tribal trap medicine 319 cheap 5mg linagliptin amex. This dual translation of the individual out of the grip of Nature and out of the clutch of the tribe was not without its own penalties 340b medications generic linagliptin 5mg with visa. But the return to Nature and the return to the tribe are under electric conditions treatment for piles purchase 5mg linagliptin with mastercard, fatally simple. We need beware of those who announce programs for restoring man to the original state and language of the race. These crusaders have never examined the role of media and technology in tossing man about from dimension to dimension. They are like the somnambulistic African chief with the alarm clock strapped to his back. Mircea Eliade, professor of comparative religion, is unaware, in the Sacred and the Profane, that a "sacred" universe in his sense is one dominated by the spoken word and by auditory media. The clock and the alphabet, by hacking the universe into visual segments, ended the music of interrelation. The visual desacralizes the universe and produces the "nonreligious man of modern societies. When tribal man wanted to build a city or a house, or cure an illness, he wound up the cosmic clock by an elaborate ritual reenactment or recitation of the original process of creation. Whereas modern man feels obligated to be punctual and conservative of time, tribal man bore the responsibility for keeping the cosmic clock supplied with energy. But electric or ecological man (man of the total field) can be expected to surpass the old tribal cosmic concern with the Africa within. Primitive man lived in a much more tyrannical cosmic machine than Western literate man has ever invented. The world of the ear is more embracing and inclusive than that of the eye can ever be. The ear turns man over to universal panic while the eye, extended by literacy and mechanical time, leaves some gaps and some islands free from the unremitting acoustic pressure and reverberation. But it is usually forgotten that without prints and blueprints, without maps and geometry, the world of modern sciences and technologies would hardly exist. In the time of Ferdinand and Isabella and other maritime monarchs, maps were top-secret, like new electronic discoveries today. When the captains returned from their voyages, every effort was made by the officers of the crown to obtain both originals and copies of the maps made during the voyage. The sort of maps in question had nothing in common with those of later design, being in fact more like diaries of different adventures and experiences. For the later perception of space as uniform and continuous was unknown to the medieval cartographer, whose efforts resembled modern nonobjective art. The shock of the new Renaissance space is still felt by natives who encounter it today for the first time. Prince Modupe tells in his autobiography, I Was a Savage, how he had learned to read maps at school, and how he had taken back home to his village a map of a river his father had traveled for years as a trader. He refused to identify the stream he had crossed at Bomako, where it is no deeper, he said, than a man is high, with the great widespread waters of the vast Niger delta. From his tone of voice I could tell that I had offended him in some way not known to me at the time. I understand now, although I did not at the time, that my airy and easy sweep of map-traced staggering distances belittled the journeys he had measured on tired feet. With my big map-talk, I had effaced the magnitude of his cargo-laden, heat-weighted treks. All the words in the world cannot describe an object like a bucket, although it is possible to tell in a few words how to make a bucket. This inadequacy of words to convey visual information about objects was an effectual block to the development of the Greek and Roman sciences. Pliny the Elder reported the inability of the Greek and Latin botanists to devise a means of transmitting information about plants and flowers: Hence it is that other writers have confined themselves to a verbal description of the plants; indeed some of them have not so much as described them even, but have contented themselves for the most part with a bare recital of their names. We are confronted here once more with that basic function of media -to store and to expedite information. Plainly, to store is to expedite, since what is stored is also more accessible than what has to be gathered. The fact that visual information about flowers and plants cannot be stored verbally also points to the fact that science in the Western world has long been dependent on the visual factor.
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We knew that since our controlled subjects were not addicted medications ending in zine linagliptin 5mg cheap, their opiate use would not bring them relief from any incipient withdrawal syndrome medicine 665 buy cheap linagliptin 5mg line. Yet it was hard for the research team to distinguish between the kind of pleasure that comes from the relief of discomfort and that which is purely gratifying medications overactive bladder 5 mg linagliptin sale. Later he described the sense of an immediate effect that propelled him from one state of consciousness "entirely" into another treatment yeast cheap linagliptin 5mg without a prescription. His sense that use was relaxing was similar to that of the next respondent, whose calmer descriptions sounded more convincing to the interviewers. I: Is there anything in particular that pleases you about opiate use as compared with other drugs The next excerpt resembles descriptions of the opiate high given by writers who have used the drug. Almost all of our opiate users described their sensations much more in bodily terms than did our marihuana and psychedelic users. R: Well, the first feeling I can say is, uh, heat, a welling up of warmth that appears all over my body. Warm feeling, associated with a calm, like a descending calm, like a fog settling in, over my whole body. Most subjects attempting to convey their pleasure in the experience explained that the initial sense of physical relaxation gradually turned into a feeling of mental well-being. What may be called the "distancing effect" was an almost universal reaction to an opiate high as distinct from a marihuana or psychedelic high. You know, whatever kind of hole you might have in your being-I think people do, everyone feels lacks of one sort or another-you know, it fills in all those spots. R: I like the feeling of getting totally numbed out, and not having to worry about anything, and having a place. And a loosening up and a kind of general un-uptightness that reflects itself in a lot of areas. In terms of the way I see the rest of my life, it makes everything seem beautiful. These subjective reactions of those who used the drug more or less "medicinally" (as a tranquilizer) but who also insisted on their enjoyment or euphoria made it very hard for us to be clear about the differences of opinion about heroin and euphoria as discussed by McAuliffe and Gordon (1975) (see chapter z). The extent to which most users did not want simply to nod off but wished to enjoy the high came as a surprise to us. Sometimes, but not always, this attitude was associated with a hyperactive personality. I think that anyone who does that is just wasting it or really just trying to put themselves out of the picture. The use of heroin seemed to be idiosyncratic, related to the habits of the individual and his or her choice of special occasions for use. We were surprised how often the special-occasion use of heroin for sexual enhancement was mentioned. For a sexually active person who was a controlled opiate user, the experience of sex tended to fuse with the opiate experience. Several subjects, however, reported a sexual problem that was quite general among opiate users. You see, when I was a kid and just starting to use, I thought it was great with sex. Then, later on, when Susie and I were together for a while, I began to find it very, very frustrating. The following account is typical of several subjects who, like marihuana users, found that the pleasure of eating was consistently enhanced and who were not bothered by nausea. Obviously, most of our users ingested drugs to get high, a goal that would suggest rather spicy and even decadent activities. R: Well, I like going out with my son to take in a movie or go to a sporting event, or something like that. Not everyone, of course-and here is another example of the astonishing diversity of the drug effect-liked to be so active I: What do you usually do after you get high I mean, I would prefer just to lie on my back with my eyes closed, either listening to music or not, either with a friend or not. R: With heroin, I can play the piano and feel very relaxed, and I can really get into it.
Being a part of such a community can provide greater access to sources of emotional support that could combat feelings of margin alization due to heterosexism medications bipolar disorder purchase linagliptin canada, which can oth erwise contribute to distress and mental disorders among gay men (Meyer 1995) medicine 93 3109 order linagliptin 5mg mastercard. These feelings of distress medicine lake generic linagliptin 5mg with visa, coupled with a lack of social support or ineffective coping skills treatment quotes images purchase linagliptin with mastercard, may lead to use of alcohol or drugs. If gay/bisexual men are able to see themselves as part of a larger gay/bisexual community, it may improve their self-esteem and thereby lessen their substance abuse. Some gay men feel con siderably more comfortable in programs or treatment groups that are specifically orga nized to assist gay men, although such options are not available in all areas. Clinicians work ing with self-identified gay men in other treatment settings should speak with them to determine whether they wish to identify themselves as gay. This belief can result from simple misinformation or can be the product of homophobia. However, what is la beled as effeminate behavior has no real rela tion to sexual orientation. Counselors should educate cli ents about sexual orientation and the fact that the degree of masculine or feminine behavior a person exhibits is not related to it. Sexual Performance and Sexual Dysfunction Fracher and Kimmel (1987) identify the three most common sexual complaints of men seek ing therapy-premature ejaculation, inhibited sexual desire, and erectile dysfunction-as is sues of sexual performance. Although men often focus on physical symptoms when seek ing assistance, Fracher and Kimmel note the importance of the response to the symptom. However, a man in recovery may be resistant to such medication- sometimes with good reason-as there have been some reports of abuse of medications like sildenafil (Viagra), especially among gay and bisexual men (Crosby and DiClemente 2004; Smith and Romanelli 2005). Abuse of sildena fil also appears to be more common among men who abuse other substances. Clients considering medication to improve sexual per formance should be cautioned about the po tential for abuse and other health risks. However, this technology also ena bles people to find an "impersonal, detached sexual outlet" (Schwartz and Southern 2000, p. Those who seek sexual partners and gratification over the Internet are engaged in what is often referred to as cybersex. Some participants compulsively search for partners for hours, seeking to create various fantasy scenarios; others spend large sums of money on interactive pornography. Some men believe that cybersex allows them to engage in sexual activity with less anxiety. Men are significantly more likely than women to engage in online sexual activities. In one large study (n=7,037) men were twice as likely as women to report engaging in online sexual activity to deal with stress (rather than as a distraction or for educational purposes); how ever, the same study found no significant dif ference in the number of men (10. Schwartz and Southern (2000) linked compulsive online sexual activity with male substance abuse in a study of 40 people seeking treatment for prob lematic cybersex involvement: 73. The investigation of compulsive online sexual activity is a relatively recent field of study, and screening and treatment approaches are still in development. Cooper and colleagues (2004) found that Internet users who spend more than 11 hours per week engaged in online sex ual activity are also likely to score high on measures of sexual compulsivity, and the num ber of hours spent on such activity may be 56 used as a simple screening question. They also suggest additional therapies to treat other problems that may be at the root of such addiction. Some substance abuse treat ment programs now also offer treatment for sexual compulsivity and addiction, either as an integrated component of substance abuse treatment or as a separate therapeutic effort. Sex Trade Workers Participating in the sex trade is typically not so much a sexual behavior as it is the product of economic necessity and should generally be considered in that light. Poverty may lead adult or adolescent men into prostitution or into ex changing sex for drugs, alcohol, or money. Involvement in the sex trade (which, for men, typically involves sex with other men) appears to be more common among men who identify as gay or bisexual, but even men who identify as heterosexual may engage in sex with men for money. Prostitution also appears to be much more common among younger men, and a number of clients in treatment settings may have participated in the sex trade as juve niles.