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In other parts of the world pulse pressure example best order vasodilan, indigenous peoples are using research methods that are better suited for their collective communities and that prehypertension and ecg purchase vasodilan with visa, for example prehypertension diabetes buy discount vasodilan 20 mg online, regard ceremony just as important in research (Smith heart attack kiss order vasodilan 20mg without a prescription, 2012; Wilson, 2008). Culturally appropriate interventions the idea of creating social work interventions that are integrated with cultural practices is being considered more and more by African social work scholars and practitioners. Osei-Hwedie and Jacques (2007), Gray, Coates and Yellow Bird (2008), Gray, Coates, Yellow Bird and Hetherington (2013), Butterfield and Abye (2013), Spitzer, Twikirize and Wairire (2014), Noble, Strauss and Littlechild (2014) are all edited books with chapters devoted to African interventions that work. More recent books and journal articles include Laird (2003), Patel (2005), Coates, Gray and Hetherington (2006), Earle (2008), Kabeera and Sewpaul (2008), Sewpaul (2008), Ellis, Devereux and White (2009), Gray and Coates (2010), Kreitzer and Jou (2010), Mwanza (2010), Engelbrecht and Kasiram (2012), Groch, Gerdes, Segal and Groch (2012), Lombard, Kemp, Viljoen-Toet and Booyzen (2012), Ochen, Jones and McAuley (2010), Patel, Kaseke and Midgley (2012), Roestenburg and Oliphant (2012), Olaore and Drolet (2016), Spitzer (2017) and Ibrahima and Mattaini (2018), to name a few. These have written on social work interventions that work in Africa, examining positive local cultural interventions that enhance the wellbeing of the individual, community, and country, as well as on the challenges in creating culturally relevant social work education and practice. As has been stated on many occasions, colonial empires brought their social services agencies, mainly remedial, to these countries, and these organisations continue to function. Social work education should critically look at the relevance of these governmental and non-governmental organisations to analyse their current usefulness. African articles and books For many years, very few African social work scholars were writing about social work in Africa. Today, there is an increase in writing and this allows for the use of African social work articles and books in the classroom, instead of relying on Western articles and books. Southern Africa leads the way in social work articles and books but now articles are coming from West, Central and East Africa as well. Sharing knowledge is crucial for continuing the growth of the profession in Africa. In Ghana, Anansi is a storyteller and sometimes a trickster and this is a story that concerns the importance of sharing knowledge: There is a story of Anansi who was given all the wisdom in the world in a clay pot by the Lion King. At home Anansi looked into the pot and saw depths of wisdom he did not know about. So, he put all the knowledge in the world into a pot, hung the pot around his neck and climbed up a coconut tree so that nobody else could have access to that knowledge. He had hung the pot right in front of him, so he had some difficulty in climbing the tree. He suggested to his father to put 50 Social Work Practice in Africa: Indigenous and Innovative Approaches the pot of knowledge on his back for that would facilitate the climbing. Anansi did not like being told by a child what to do but did so anyway and found the climbing to be easier that way. However, he slipped, and the pot smashed down to the ground and all of the wisdom in the pot flew to all parts of the world. The point of the story: Nobody can claim to know everything and so must be open and ready to acquire new knowledge. Field education may look very different in African countries due to the fact that there are still many rural areas. In Ghana, we found that students of social work at university had no experience of living in rural areas and, therefore, one month of field education in rural areas, often without running water and electricity, was a difficult but good experience for them. Some of the critical issues around field education are, for example: the length of time of an assignment in the field; the lack of trained supervisors; the lack of choice of assignment; or problems regarding the integration of theory and practice. That means that the ethical principles will be adhered to , including the acceptance of all students, independent of their ethnicity, sexual orientation, class, gender, ability, etc. An inclusive and safe environment is also highly relevant to a culturally relevant curriculum. Issues in social work can be very contentious when students with different sets of values, developed from their ancestors, their family, from social media, friends, academic articles, etc. It is, therefore, essential that the classroom is a safe place to discuss different viewpoints in such a way that different or opposite perspectives are respected. Culturally Relevant Curriculum for Social Work: An Ethical Imperative for our Time 51 Or would another student from a different part of Africa and with a different ethnic background, labelled as a refugee, feel safe in a classroom Ndura (2006, 98) speaks to this issue: Educational programs should develop awareness of and appreciation for people from different ethnic groups and their experiences.

Do not use a comma at the start of an indirect or partial quotation: He said the victory put him "firmly on the road to a first-ballot nomination blood pressure 4060 20mg vasodilan amex. Use parentheses arrhythmia jet purchase genuine vasodilan on line, however blood pressure chart age wise purchase vasodilan 20 mg without prescription, if a state name is inserted within a proper name: the Huntsville (Ala pulse pressure fluid responsiveness purchase vasodilan no prescription. Follow it with a regular space and an ellipsis: I no longer have a strong enough political base. When the grammatical sense calls for a question mark, exclamation point, comma or colon, the sequence is word, punctuation mark, regular space, ellipsis: Will you come When material is deleted at the end of one paragraph and at the beginning of the one that follows, place an ellipsis in both locations. In all the decisions I have made in my public life, I have always tried to do what was best for the nation. However, it has become evident to me that I no longer have a strong enough political base in Congress. As long as there was a base, I felt strongly that it was necessary to see the constitutional process through to its conclusion, that to do otherwise would be. Substitute a dash for this purpose, however, if the context uses ellipses to indicate that words actually spoken or written have been deleted. Many combinations that are hyphenated before a noun are not hyphenated when they occur after a noun: the team scored in the first quarter. But when a modifier that would be hyphenated before a noun occurs instead after a form of the verb to be, the hyphen usually must be retained to avoid confusion: the man is wellknown. The principle of using a hyphen to avoid confusion explains why no hyphen is required with very and -ly words. But if a combination such as little-known man were not hyphenated, the reader could logically be expecting little to be followed by a noun, as in little man. Instead, the reader encountering little known would have to back up mentally and make the compound connection on his own. When large numbers must be spelled out, use a hyphen to connect a word ending in -y to another word: twenty-one, fifty-five, etc. Because they do not appear on some news service printers, there is also the danger that material inside them may be misinterpreted. The temptation to use parentheses is a clue that a sentence is becoming contorted. If a sentence must contain incidental material, then commas or two dashes are frequently more effective. There are occasions, however, when parentheses are the only effective means of inserting necessary background or reference information. Do not use (cq) or similar notation to indicate that an unusual spelling or term is correct. For the form of frequently used abbreviations, see the entry under the full name, abbreviation, acronym or term. Or, to cause full stops and throw emphasis on each element, break into separate sentences: Did he plan the riot Continue in this fashion for any succeeding paragraphs, using close-quote marks only at the end of the quoted material. If a paragraph does not start with quotation marks but ends with a quotation that is continued in the next paragraph, do not use close-quote marks at the end of the introductory paragraph if the quoted material constitutes a full sentence. Use close-quote marks, however, if the quoted material does not constitute a full sentence. Another application of this principle may be seen in the cross-references at the end of entries in this book. Because some entries themselves have a comma, a semicolon is used to separate references to multiple entries, as in: See the felony, misdemeanor entry; pardon, parole, probation; and prison, jail. See the dash entry for a different type of connection that uses dashes to avoid multiple commas. If a coordinating conjunction is present, use a semicolon before it only if extensive punctuation also is required in one or more of the individual clauses: They pulled their boats from the water, sandbagged the retaining walls, and boarded up the windows; but even with these precautions, the island was hard-hit by the hurricane. Unless a particular literary effect is desired, however, the better approach in these circumstances is to break the independent clauses into separate sentences. It explains fundamental principles of libel law and relevant First Amendment principles for working writers and editors.

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Women can also develop femalepatterned baldness as their hair becomes less dense and the scalp becomes visible (Martin blood pressure chart poster cheap vasodilan 20 mg without a prescription, 2014) what is pulse pressure yahoo order vasodilan 20 mg free shipping. Source Skin: Skin continues to dry out and is prone to more wrinkling blood pressure chart readings for ages buy genuine vasodilan, particularly on the sensitive face area blood pressure natural remedy order vasodilan canada. As we get older, our skin dries and loses the underlying layer of fat, so our face no longer appears smooth. Loss of muscle tone and thinning skin can make the face appear flabby or drooping. Although wrinkles are a natural part of aging and genetics plays a role, frequent sun exposure and smoking will cause wrinkles to appear sooner. Dark spots and blotchy skin also occur as one ages and are due to exposure to sunlight (Moskowitz, 2014). Sarcopenia: the loss of muscle mass and strength that occurs with aging is referred to as sarcopenia (Morley, Baumgartner, Roubenoff, Mayer, & Nair, 2001). Sarcopenia is thought to be a significant factor in the frailty and functional impairment that occurs when older. The decline of growth and anabolic hormones, especially testosterone, and decreased physical activity have been implicated as causes of sarcopenia (Proctor, Balagopal, & Nair, 1998). This decline in muscle mass can occur as early as 40 years of age and contributes significantly to a decrease in life quality, increase in health care costs, and early death in older adults (Karakelides & Nair, 2005). Exercise is certainly important to increase strength, aerobic capacity, and muscle protein synthesis, but unfortunately it does not reverse all the age-related changes that occur. The 308 muscle-to-fat ratio for both men and women also changes throughout middle adulthood, with an accumulation of fat in the stomach area. Thinning of the bones with age can change the shape of the rib cage and result in a loss of lung expansion. Age related changes in muscles, such as the weakening of the diaphragm, can also reduce lung capacity. Both of these changes will lower oxygen levels in the blood and increase the levels of carbon dioxide. In middle adulthood, these changes and their effects are often minimal, especially in people who are non-smokers and physically active. However, in those with chronic bronchitis, or who have experienced frequent pneumonia, asthma other lung related disorders, or who are smokers, the effects of these normal age changes can be more pronounced. Sensory Changes Vision: A normal change of the eye due to age is presbyopia, which is Latin for "old vision. When we look at something far away, the lens flattens out; when looking at nearby objects tiny muscle fibers around the lens enable the eye to bend the lens. With age these muscles weaken and can no longer accommodate the lens to focus the light. They are most noticeable if you are looking at the sky on a sunny day, or at a lighted blank screen. Floaters occur when the vitreous, a gel-like substance in the interior of the eye, slowly shrinks. As it shrinks, it becomes somewhat stringy, and these strands can cast tiny shadows on the retina. In most cases, floaters are harmless, more of an annoyance than a sign of eye problems. However, floaters that appear suddenly, or that darken and obscure vision can be a sign of more serious eye problems, such a retinal tearing, 309 infection, or inflammation. During midlife, adults may begin to notice a drop in scotopic sensitivity, the ability to see in dimmer light. By age 60, the retina receives only one third as much light as it did at age 20, making working in dimmer light more difficult (Jackson & Owsley, 2000). Night vision is also affected as the pupil loses some of its ability to open and close to accommodate drastic changes in light.

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Life expectancy at birth did not change from 2016 for the non-Hispanic black population (74 blood pressure pregnancy range buy generic vasodilan 20 mg on line. Much of this decline has been attributed to the increase in sedentary lifestyle and obesity arteriovenous graft order discount vasodilan on line. Since 1980 prehypertension bp order generic vasodilan canada, the obesity rate for children between 2 and 19 years old has tripled blood pressure medication good or bad discount vasodilan 20mg online, as 20. Obesity in children is associated with many health problems, including high blood pressure, type 2 diabetes, elevated blood cholesterol levels, and psychological concerns including low self-esteem, negative body image and depression. Excess weight is associated with an earlier risk of obesity-related diseases and death. In 2007, former Surgeon General Richard Carmona stated, "Because of the increasing rates of obesity, unhealthy eating habits and physical inactivity, we may see the first generation that will be less healthy and have a shorter life expectancy than their parents" (p. Gender Differences in Life Expectancy Biological Explanations: Biological differences in sex chromosomes and different pattern of gene expression is theorized as one reason why females live longer (Chmielewski, Boryslawski, & Strzelec, 2016). Males can only express their X chromosome genes that come from the mother, while females have an advantage by selecting the "better" X chromosome from their mother or father, while inactivating the "worse" X chromosome. This process of selection for "better" genes is impossible in males and results in the greater genetic and developmental stability of females. In terms of developmental biology, women are the "default" sex, which means that the creation of a male individual requires a sequence of events at a molecular level. This activity and change in the direction of development results in a greater number of disturbances and developmental disorders, because the normal course of development requires many different factors and mechanisms, each of which must work properly and at a specific stage of the development. Although women are slightly more prone to autoimmune and inflammatory diseases, such as rheumatoid arthritis, the gradual deterioration of the immune system is slower in women (Caruso, Accardi, Virruso, & Candore, 2013; Hirokawa et al. Estrogens also have antioxidant properties that protect against harmful effects of free radicals, which damage cell components, cause mutations, and are in part responsible for the aging process. Testosterone levels are higher in men than in women and are related to more frequent cardiovascular and immune disorders. The level of testosterone is also responsible, in part, for male behavioral patterns, including increased level of aggression and violence (Martin, Poon, & Hagberg, 2011; Boryslawski & Chmielewski, 2012). This lack of judgment affects lifestyle choices, and consequently many more boys and men die by smoking, excessive drinking, accidents, drunk driving, and violence (Shmerling, 2016). As dangerous jobs previously mentioned, male behavioral patterns and lifestyle play a significant role in the shorter lifespans for males. One significant factor is that males work in more dangerous jobs, including police, fire fighters, and construction, and they are more exposed to violence. According to the Federal Bureau of Investigation (2014) there were 11,961 homicides in the U. According to the Department of Defense (2015), in 2014 83% of all officers in the Services (Navy, Army, Marine Corps and Air Force) were male, while 85% of all enlisted service members were male. As mentioned in the middle adulthood chapter, women are more religious than men, which is associated with healthier behaviors (Greenfield, Vaillant & Marks, 2009). Lastly, social contact is also important as loneliness is considered a health hazard. Nearly 20% of men over 50 have contact with their friends less than once a month, compared to only 12% of women who see friends that infrequently (Scott, 2015). Age Categories in Late Adulthood There have been many ways to categorize the ages of individuals in late adulthood. These categories are based on the conceptions of aging including, biological, psychological, social, and chronological differences. Young-old: Generally, this age span includes many positive aspects and is considered the "golden years" of adulthood.