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Ma- suggest the importance of skills training for adolescent refugees by terial and Methods: In the day care center of Yangming Branch quality keflex 250mg, building their capacities buy keflex 250 mg with amex. Taipei City Hospital, Taiwan, we arrange recreational therapy programs to stimulate cognitive functions, gross and fne motor function, and equilibrium. Conclusion: Day care center of Yangming Branch, Taipei City Hospital, Taiwan, a N. According to our experiences, recreational therapy can help icine, Kuala Lumpur, Malaysia, 3University Malaya, Rehabilitation disabled dementia patients improve or maintain their functional Medicine Department, Kuala Lumpur, Malaysia and psychological status. The authors believe that the programs can apply not Introduction/Background: Diabetic Charcot foot can cause gross only to hospital-based day care center, but also in non-hospital- structural deformities of the foot and ankle, and subsequent skin based day care centers. Chung have equal study is to explore complications of diabetic charcot foot in particu- contribution to this poster. Moridnia 1Shahid Beheshti University of Medical Sciences, Clinical Re- mortality rate during the follow-up period was 15. The mean survival time based on Kaplan- Maier Survival Analysis search Development Center of Shahid Modarres Hospital and is 44. The remaining 83 alive sample population Physical Medicine and Rehabilitation Research Center, Tehran, (84. Conclusion: Recurrent new philosophy which tries to lead clinical services to effective and ulcer in Charcot foot patients has high predilection towards limb advantageous ways with the least side effects and errors. Members of faculty, participants who referrals from all states in Malaysia for intensive spinal rehabilita- had attended workshops and physicians who spent more time on tion program or other specialised rehabilitation programs that are research and article review had more knowledge (p=0. Hence, epidemiology data on spinal cord 3 most common sources used for research were PubMed, Google injured patients that was analysed in this study should represent scholar and Cochrane, respectively. Material and Methods: cal practice, the most common source used was reference books Data on all new patients admitted to Spinal Rehabilitation Ward in (86. Analysis was done on the incidence, with getting access to associated databases and lack of suffcient age, gender and level of injury. Results: From Aug 2014 until Nov activity in judging and analyzing related articles. Age group of the studied population are as shown in with its concepts and applications. It may also of benefts for effcient resource allocation for the rehabilitation management of spinal cord injured 1Thomas Jefferson University, Rehabilitation Medicine, Philadel- patients in Malaysia. Material and Methods: The authors reviewed a sample of 220 discharges from J Rehabil Med Suppl 55 Poster Abstracts 237 Thomas Jefferson University Hospital rehabilitation unit readmit- to prevent absenteeism due to sickness. Readmissions were categorized as: (1) from the reha- questionnaire focusing on the organizational setting and its impact bilitation hospital to the acute hospital or (2) from the community on employee wellbeing – reported as mental energy, work-related to the acute care hospital. The questionnaire measures good into categories to provide meaningful information to implement and poor work environment factors to help managers improve or- policies to minimize readmissions. The questionnaire was validated qualitatively plete management, (2) recurrences, and (3) development of new and quantitatively. Cases with new conditions: thors followed a company undergoing organizational change and 36 (73%. Cases with ers uncertain about employee mental status can measure employee new conditions: (54%). Cases with incomplete care or recurrences: wellbeing easily and cost effectively to prevent illness. Conclusion: (1) Most of the cases were readmitted to created a method, statistically evaluated, to proactively identify acute hospitals before completion of their rehabilitation hospital good and poor work Environments to promote healthy co-workers. Japan, 2Fujita Health University, School of Medicine, Toyoake, Hashemi2 Japan, 3Fujita Health University Hospital, Department of Reha- 1 bilitation, Toyoake, Japan, 4Fujita Health University Banbuntane Physical Medicine and Rehabilitation Research Center of Shahid Beheshti University of Medical Sciences and Clinical Research De- Hotokukai Hospital, Department of Rehabilitation, Nagoya, Japan velopment Center of Shahid Modarres Hospital, Physical Medicine 2 Introduction/Background: Previous studies have shown that toe and Rehabilitation, Tehran, Iran, Physical Medicine and Reha- clearance during the swing phase affects the risk of tripping; this bilitation Research Center of Shahid Beheshti University of Medi- is considered a predominant cause of falls. In healthy subjects, toe cal Sciences, Physical Medicine and Rehabilitation, Tehran, Iran, clearance is obtained mainly by lower limb movements. However, 3Arak University of Medical Sciences-Vali-Asr Hospital, Physical in stroke patients, the compensatory movements are more important Medicine and Rehabilitation, Tehran, Iran in obtaining toe clearance. The purpose of this preliminary study is to clarify the system of obtaining toe clearance in stroke patients in Introduction/Background: Trend to non surgical treatments in mus- comparison to healthy subjects. Material and Methods: Thirteen pa- plications and studies in Iran have been started about 15 years ago. A motion analysis system, the Kinema- in musculoskeletal disorders in Iran from 2000 and 2015. Material Tracer® (Kissei Comtec, Nagano), was used for the kinematic anal- and Methods: A review of literatures in Google scholar, PubMed, ysis of the gait. Then was conducted to fnd the difference between the patients with hemi- studies which were related to musculoskeletal disorder were selected. The studies peaked in 2015 when 14 literatures by circumduction, and the elevation of the pelvis by the unaffected were published. About one third of the all studies were randomized limb were signifcantly greater (2. The component analysis 817 of the toe clearance may help targeted rehabilitation to improve toe clearance and potentially reduce the risk of falls. The Swedish Social Insurance Agency was able to decrease sick days in the period between 2000 and 2010 but K.

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Basic clinical laboratory parameters for evaluation of lipid metabolism - principle of ana- lytical methods cheap keflex 500 mg with visa, sources of errors 750mg keflex free shipping, drug interference in laboratory testing, patient preparation, specimen, reference ranges, indications for investigation, results interpretation, recommended ranges. Steps and approaches in the choice of clinical laboratory parameters in cases of disturbed lipid transportation. Reference ranges – populational constructed (definition, reference groups, reference status, reference condition, choice of statistical method, performance, disadvantages) individual (performance, ad- vantages). Requirements to the criteria of diagnostic reliability of clinical laboratory tests in different group of diseases. Permanent, long-term and short-term acting factors on the biological variation of the results – examples. Influence of medical procedures and medicines on the clinical laboratory results (chemi- cal and pharmacological interferences). Instructions for control of medicinal effects on the clinical laboratory investigations. Specimen collection for clinical laboratory investigation – basic rules and requirements. Closed system for biological samples collection – advantages for the clinic, advantages for the laboratory. Venous blood collection clinical laboratory investigation – basic procedures and sources of errors. Storage of the biological samples for analysis and transportation to the laboratory – requirements and sources of errors. Urine for clinical laboratory investigation – basic rules and requirements for urine collection, storage and transportation to the laboratory. Cerebrospinal flu- id, body fluid punktats and stool - basic rules and requirements for urine collection, storage and transportation to the laboratory. Osmolality and osmolarity - methods of investigation, reference ranges, result interpretation. Sodium and chloride – common data for the parameters, indications for investigation, principles of the analytical methods, reference ranges, result interpretation. Potassium - common data for the parameter, indications for investigation, principles of the analytical methods, reference ranges, result interpretation. Total and ionized calcium, total and ionized magnesium - common data for the parameters, indications for investigation, principles of the analytical methods, reference ranges, result interpretation. Inorganic phosphate - common data for the parameter, indications for investigation, principles of the analytical methods, reference ranges, result interpretation. Serum Iron and Iron Binding Capacity - common data for the parameters, indications for investigation, principles of the analytical methods, reference ranges, result interpretation. Diabetes mellitus – metabolism disturbance of: glycolysis, gluconeogenesis, glycogenolysis and glycogen synthesis, ketogenesis, ketonuria, glucosuria, osmotic diuresis, polyuria. Glucose in the blood - common data for the parameters, indications for investigation, principles of the analytical methods, reference, borderline and pathological ranges, result interpretation. Evaluation of gliycemia for preceded period of time: glycated proteins - glycated hemoglobin HbA1; HbA1c and fructosamine: common data for the parameters, indications for investigation, patient preparation, specimen, reference ranges, informative content and re- sults interpretation. Selection of clinical laboratory tests in detecting and tracking disturbance of carbohydrate metabolism in patients with diabetes mellitus - basic, extended and specialized laboratory tests (glycated proteins, microalbuminuria) and their discussion. Total protein - common data for the parameters, principles of the analytical methods and interferences, indications for investigation, patient preparation, reference ranges, result inter- pretation. Major protein fractions – electrophoreses: indications for investigation, result interpretation, informational value. Individual proteins – proteins of the acute phase – types, analytical methods for investigation, indications for investigation, patient preparation, reference ranges, results in- terpretation. Immunoglobulins in the serum – common data for the parameters, classification, dynam- ic in prenatal and early postnatal period, methods of investigation, results’ interpretation. Urea - common data for the parameter, principles of the analytical methods, source of errors, indications for investigation, patient preparation, reference ranges, result’s interpretation. Creatinine - common data for the parameter, principles of the analytical methods, source of errors and interference, indications for investigation, patient preparation, specimen, ref- erence ranges, result’s interpretation. Uric acid - common data for the parameter, principles of the analytical methods, source of errors and interference, indications for investigation, patient preparation, specimen, reference ranges, result’s interpretation. Evaluation of the results of a study of nonproten nitrogen containing substances – advantages and disadvantages. Transaminases in serum – general information, principles of analytical methods, sources of errors, indications for analysis, biological material, reference ranges, interpretation of results. Alkaline and acid phosphatase in serum - general information, principles of analytical methods, sources of errors, indications for analysis, biological material, reference ranges, interpretation of results. Lactate dehydrogenase and creatine phosphokinase in serum - general information, prin- ciples of analytical methods, sources of errors, indications for analysis, biological material, reference ranges, interpretation of results.

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However keflex 250mg overnight delivery, we hope that the chapters in this volume will provide the opportunity for discussion and collaborative information- sharing cheap keflex 750mg without a prescription, and stimulate debate among all those scholars and practitio- ners interested in the relationship between health issues and language. Introduction While phobias, such as arachnophobia or claustrophobia, are part of mankind’s make-up, no phobia has captured society’s attention and imagination over the centuries more grippingly than the fear of infection and death from pandemics. Boccaccio’s gruesome witticism that the victims of the Black Death often ate lunch with their friends and dinner in Paradise with their ancestors (see Section 2) is a testament to the fact that, far from being a figment of the imagination, pandemics have had a devastating impact on society for hundreds of years, seven being recorded between 1816 and 1975 for cholera alone. The Spanish flu pandemic killed an estimated 75 million people while th the 14 century Black Death pandemic is believed to have killed one third of the population of Europe. If medieval authors, such as Boccaccio and Chaucer, drew inspiration from the Black Death, it is because, together, fact and fiction pack a powerful punch when raising pandemic-linked fears. This has attracted several writers: from Virgil, with his description of an anthrax epizootic (Sternbach 2003: 463-4), to today’s epidemic- inspired and ominously-named novels, such as Follett’s 2007 World Without End and Cook’s Outbreak. Precisely because of their foundations in historical reality, the popular press (Gwyn 1999; Jen 2008), in particular, has engaged in fear-mongering that plays on these apprehensions. Special report: Inside the global race to avert a pandemic’ (September 2005) and ‘H1N1: As students head back to school this September, swine flu could infect millions. What concerns us in this chapter, however, is the fact that fears of being infected by plagues, and succumbing to them in a very short span of time, are mostly expressed indirectly, eschewing words such as fear, apprehension, scare, hysteria, panic or lexical equivalents. As a deliberate act of arousing public fear or alarm about a particular issue, fear-mongering is made more effective in terms of newsworthiness and reader impact through indirect reference to the unknown than through specific description of fears or reassuring positive messages. Compare Time’s positively- oriented ‘Polio’ cover (March 1954) about John Salk’s 1954 success- ful field trials of inactivated poliovirus vaccine with Newsweek’s negatively-oriented title ‘A back door for Ebola: smuggled bushmeat could spark a U. If, as the examples given above show, fear-raising, with its focus on the hypothetical and sensational, is indirect, then the techniques used to reconstruct the expression of fear in English-language texts also need to be indirect. This has long been recognised by specialists in The Language of Fear: Pandemics and their Cultural Impact 27 medical communication (Lakoff 2008, Schell 1997, Strassberg 2004, Strong 1990) but calls for models and techniques of text analysis, which, though focused on the contemporary world, are also diachronic in nature, i. This chapter thus reports on research designed to extend and consolidate our understanding of the language of fear as it pertains to epidemics and pandemics. The first, now completed stage, involved the construction of a model characterising the cultural evolution from the Elizabethan period to the current times in relation both to the changing interpretations of what epidemics and pandemics are, and to the changing nature of the fears they generate (Section 2). The tentative conclusion reached is that separating the different and some- times contradictory strands involved helps shed light on the ‘language of fear’ and the manipulation of these fears over the centuries by writers in many different English-language text types (Section 5). Developing a cultural model Given the factual and fictional intertwinings mentioned above, the term pandemic might be thought, in the tradition of folk etymology, to be a hybrid term derived from epidemic and pandemonium that blends their reference to the medical and the fearful. Although the latter word is a hybrid coined by Milton in 1667 for use in Paradise Lost (Allen 1962: 207), the term pandemic (Greek 28 Anna Loiacono pan- ‘all’ + demos ‘people’) is modelled on epidemic. Significantly, as a term, epidemic dates back to Hippocrates but has undergone semantic changes (Martin/Martin-Granel 2006: 976) as medicine, and social perception of it, has evolved: (1) For Hippocrates, an epidemic meant a collection of syndromes occurring at a given place over a given period, e. Much later, in the Middle Ages, the long and dramatic succession of waves of The Plague enabled physicians of the time to identify this disease with increasing precision and certainty; they began to recognize epidemics of the same, well-characterized disease. Then, with the historic contributions of Louis Pasteur and Robert Koch, epidemics of a characteristic disease could be attributed to the same microbe, which belonged to a given genus and species. The last stage in the semantic evolu- tion of the term epidemic was the progressive acquisition of the notion that most epidemics were due to the expansion of a clone or clonal complex of bacteria or viruses known as the epidemic strain. More recently, microevolu- tion of a clone of a bacterium (the epidemic strain) was shown to occur during an epidemic with person-to-person transmission. Despite having no etymological connection with panic or pandemo- nium, the term is vested with considerable ambiguity: a scientific term in the hands of, for example, epidemiologists and the statistics- oriented texts they produce, but also a fear-provoking term in other texts and contexts such as journalism, novels and films presenting pandemics as out-of-control global epidemics. Specifically, attitudes towards pandemics suggest that a diachronic pathway needs to be traced in terms of how different social layers perceive their fears of disease and communicate them (see Loiacono 2012b for a multi-tier approach to the analysis of medical communication). This ‘human ap- proach’ to fear of disease, and its interpretation, embraces a complex rational-to-irrational cline, implying various perspectives: the lay- man’s, the doctor’s, the politician’s, the reporter’s and so on (Loiaco- no 2012b: 83-86). Medicine, itself, straddles these layers and is subject to an uninterrupted cycle of separating and associating scienti- fic and social aspects; all of us, in our different ways, are caught up in the ensuing conflicts and fears that this cycle generates as the follow- ing webnews report (Mukpo 2014) dramatically highlights: The Language of Fear: Pandemics and their Cultural Impact 29 (2) According to Nyenswah [Liberia’s Assistant Minister of Health], rural belief in juju – West African magic – is also contributing to the challenges officials face. This report, typical of contemporary ‘health news’ reporting in its expression of multiple and often conflicting fears, describes respectively: the explicitly- mentioned fears of rural communities; doctors’ implied fears of being rejected professionally (as well as being physically ejected from their ‘workplace’); the fears, euphemistically described as ‘challenges’, facing West African government health officials who are incapable of containing the epidemic. One of the implied meanings of this text, and it is not the only one, is ‘Who can blame these villagers as regards their fears about medical mismanagement by international organisations who are supposed to be protecting the rich and the poor on an equal footing? The following report (Pilkington 2014) explains why: 30 Anna Loiacono (3) The United Nations is facing a huge new lawsuit over the outbreak of cholera in Haiti that has widely been blamed on its peacekeepers, after 1,500 Haitian victims and their family members sued the international body in a federal court in Brooklyn in a class action. In an age sensitive to political, economic and legal factors associated with pandemics, the science of epidemiology, with its basis in statistics, plays a key role in the culture underpinning pandemics but does not appear to have contributed to its definition or to the reasons for declaring the existence of a pandemic. Interestingly, Doshi (2011: 534) singles out the cultural origins of the confusion, identifying fear of contagion deriving from virus mutation as the basis for the naïve catastrophic/non-catastrophic dichotomy associated with predicting pandemics: (4) Virus-centric thinking is also at the bottom of the current practice of dichoto- mizing influenza into ‘pandemic’ and ‘interpandemic’ or ‘seasonal’ influenza on the basis of genetic mutations in the virus. This approach, however, ignores the fact that the severity and impact of epidemics, whether caused by influ- enza viruses or other pathogens, occur along a spectrum and not in catastro- phic versus non-catastrophic proportions. The Language of Fear: Pandemics and their Cultural Impact 31 st Effectively, Doshi is implying that the 21 century management of pandemics and epidemics (as indicated in Table 1 below) is still ‘plagued’ by thinking carried over from earlier stages. Thus, among the various implications associated to these events, and the analysis of them performed by Doshi (2011) and others, is the conclusion that outdated cultural models are being adopted, and that a model, which sifts out the various layers of medical, linguistic and cultural evolu- tion, is needed.

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