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The tumor cells may secrete estrogens and cause precocious sexual development in girls or increase the risk for endometrial hyperplasia and carcinoma in women erectile dysfunction drugs in nigeria buy generic viagra jelly online. Less commonly granulosa cell tumors can secrete androgens and produce masculinization impotence and smoking best order viagra jelly. Sertoli-Leydig tumors (androblastomas) also may secrete androgens and produce virilization in women erectile dysfunction and stress order viagra jelly 100mg amex. The tumor cells may stain positively with inhibin, but CallExner bodies are not present. Granulosa cell tumors vary in their clinical behavior, but they are considered to be potentially malignant. Pseudomyxoma peritonei refers to the formation of multiple mucinous masses within the peritoneum. This condition results from the spread of mucinous tumors, either from metastasis or rupture of an ovarian mucinous cyst. Most cases, however, probably result from spread of a mucinous tumor located in the appendix (mucocele). This condition is difficult to treat surgically and if widespread can lead to intestinal obstruction and possibly death. A variety of other tissues-such as cartilage, bone, tooth, thyroid, respiratory tract epithelium, and intestinal tissue- may be found. The presence of skin and skin appendages gives the tumor its other name, dermoid cyst. Dermoid cysts are benign, but in less than 2%, one element may become malignant, most frequently the squamous epithelium. In contrast to the characteristic histologic findings with a dermoid cyst, an ovarian Brenner tumor histologically is similar to the transitional lining of the renal pelvis or bladder. Chronic salpingitis would reveal the presence of chronic inflammatory cells, such as lymphocytes and macrophages, within the fallopian tubes, while histologic sections from an ectopic pregnancy would reveal chorionic villi, and possibly, fetal tissue. Examples of ovarian stromal tumors include thecomas, fibromas, granulosa cell tumors, and Sertoli-Leydig cell tumors. Histologically, thecomas are composed of spindle-shaped cells with vacuolated cytoplasm. They are vacuolate because of steroid hormone (estrogen) production, which can be stained with an oil red O stain. The stromal cells of the ovary are the precursors of endocrine-active cells, so it is easy to understand that neoplasms derived from these stromal cells are often associated with hormone production. For example, granulosa cells normally secrete estrogens, thecal cells normally secrete androgens, and hilar cells (Leydig cells) may secrete androgens. Excess androgen production in females may lead to masculinization and produce symptoms such as amenorrhea, loss of secondary female sex characteristics, and the development of secondary male characteristics, such as hirsutism, temporal balding, and deepening of the voice. Ovarian tumors associated with excess androgen production include androblastomas (Sertoli-Leydig cell tumors). Other ovarian diseases associated with excess androgen production include polycystic ovarian disease and hyperthecosis. Excess estrogen production is associated with precocious puberty in the young and with endometrial hyperplasia and cancer in older women. Ovarian tumors that may secrete estrogens include granulosa cell tumors and thecomas. Causes of secondary amenorrhea include pregnancy (the most common cause), hypothalamic/pituitary abnormalities, ovarian disorders, and end organ (uterine) disease. Withdrawal bleeding following progesterone administration indicates that the endometrial mucosa had been primed with estrogen, which in turn indicates that the hypothalamus/ pituitary axis and ovaries are normal. Decreased gonadotropin levels decrease estrogen levels, which results in amenorrhea and an increased risk for osteoporosis. Because of the decreased estrogen levels, a progesterone challenge does not result in withdrawal bleeding. Ovarian conditions, such as surgical removal of the ovaries, would most likely produce elevated gonadotropin levels due to the lack of negative feedback from estrogen and progesterone. Because of the decreased estrogen levels, a progesterone challenge would not result in withdrawal bleeding. Factors that predispose an individual to abruptio placenta include use of certain drugs (cocaine, alcohol, tobacco), maternal hypertension, preeclampsia, multiparity, and increasing maternal age. Placenta accreta refers to the absence of the decidua and the direct attachment of the placenta to the myometrium. It is an important Reproductive Systems Answers 463 cause of postpartum hemorrhage because the placenta fails to separate from the myometrium at the time of labor. The hemorrhage can be lifethreatening, and a total hysterectomy is the treatment of choice. In both placenta accreta and placenta previa the villi are histologically normal and there is no trophoblastic proliferation. In contrast, gestational trophoblastic disease refers to abnormal proliferation of trophoblastic tissue and includes hydatidiform mole, invasive mole, and malignant choriocarcinoma. The most common location for extrauterine implantation is the fallopian tube (85% of cases), with rare implantation in the ovary or abdomen. It is always worthwhile to repeat a laboratory test when the result is unexpected. Tubal pregnancy is not uncommon and should always be considered if endometrial samples suggest gestational change without chorionic villi. When convulsions develop in an individual with preeclampsia, the condition is then referred to as eclampsia. These signs and symptoms result from abnormal placental implantation with incomplete conversion of the blood vessels of the decidua. Normally the blood vessels of the uterine wall at the site of implantation increase in diameter and lose their muscular components. These changes increase the blood flow to the placenta and are the result of increased production of prostacyclin (a strong vasodilator) and decreased production of thromboxane (a potent vasoconstrictor). These changes do not take place at the implantation site in patients who develop preeclampsia. This causes placental ischemia and damages the endothelial cells of the blood vessels of the placenta. This endothelial damage disrupts the normal 464 Pathology balance between vasodilation and vasoconstriction. Risk factors for the development of preeclampsia include nulliparity, twin gestation, and hydatidiform mole.
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The development of psychoanalytical pedagogy i s inhibited by two ideological limitations of the b ourgeois analysts: first erectile dysfunction drugs from india buy viagra jelly 100 mg online, by their refusal to erectile dysfunction treatment uk order viagra jelly paypal cope with the contradic tion between the removal of sexual repression and bourgeois sexual in hibitions in childre n and adolescents; and secondly by their biological view of the child-parents contlict erectile dysfunction doctor nashville viagra jelly 100 mg cheap. Like Marxism, it is a product of the capitalist era, except that its connection with the economic basis of society is less direct. It is a reaction to the ideological superstructure-the cultural and moral conditions of modern man in society. The conditions particularly involved are the sexual ones which devel oped out of ecclesiastic ideologies concerning sex. The bourgeois revolution of the nineteenth century swept away almost all feudal methods of production and created its own liberal ideas in oppo sition to religion and its. The break with religious morality, however, had already begun, as for instance in France at the time of the French Revolution; the bourgeoisie seemed to be carrying within it the seeds of a new morality, opposed to the morality of the Church in general and particularly in the sexual sphere. The damming up of sensuality, monoga mous marriage, the chastity of young girls and hence also the fragmentation of male sexuality, all acquired a new meaning this time a capitalist one. The bourgeoisie, having overthrown the feudal system, took over to a large extent the ways of life and the cultural needs of the feudal world; it had to barricade i ts elf against "the people" by moral laws of its own, and thus imposed increasingly greater limitations on the primitive sexual needs of man. Sexual freedom in the middle class is completely denied-except in marri age-for economic reasons; the young males of the bourgeoisie look to the young women and. The insistence on chastity for girls of the bourgeoisie is therefore further intensified -because of the ideological opposition of the classes-and a double standard of sexual morality arises on a capitalist basis. As in a vicious circle, this double standard of sexual morality has a disintegrating effect on the sexuality of the men and an annihi lating one on that of the women, who, as a result of their early development, remain "chaste"-i. Yet the con tinuing repression and debasement of sexuality is dialectically transformed into a force which destroys the institution of mar riage and the ideology of sexual morality. The first stage of the breakdown of bourgeois morals is revealed in the sudden over whelming prevalence of psychological illness. Official science, itself caught up in sexual repression, despises sexuality as a subject for research and looks with contempt upon the writers and poets who become more and more preoccupied with this burning question. It dismisses the continued increase of psycho- Dia lectica l Ma teri a l ism and Psychoa n a l ysis 51 logical illness, of hysteria and a general nervousness as imagi nary, or ascribes them to overwork. At the end of the nineteenth century, as a reaction against science being the servant of morality and as a portent of the second, scientific phase of the downfall of bourgeois morality, a scientist appears within the bourgeois class itself who claims that the highly nervous state of modern man is a consequence of cultural sexual moralitt3 and that, generally speaking, neuroses are by their specific nature sexual illnesses resulting from excessive restriction of sexual freedom. This scientist, Freud, is ridiculed and outlawed by official science; he is presented to the outside world as a charla tan. The theory horrifies and outrages the whole bourgeois world-not only its scientists-because it strikes at the very roots of sexual repression, upon which so many conservative ideologies are based (religion, morality, etc. Bourgeois youth begins to protest against the parental home and creates a "youth movement" of its own. Be cause it has no connection with the working-class struggle, this movement soon disintegrates; but not until it has, at least in part, achieved its purpose. Voices are raised in the liberal bourgeois 53 Freud, Die "KlIltllrelle" Sexualmoral lind die m odern e Nervositiit ("Civilized" Sexual Ethics and Modern Nervous Sickness), English Stand ard Edition, Vol. Freud ascribed the resistance he e ncountered to the infantile complexes and repressions of those offering it. Sexual oppression serves class rule; ide ologically and structurally re produced in the ruled, sexual oppression represents the most powerful and as yet unrecognized force of oppression in general. Bourgeois society resisted Freud because he appeared to present a mortal threat to the continuing existence of its ideological apparatus. Freud himself never admitted this c ausal connection; indeed, he was displeased when others pointed it out. Sexual economy takes up the social function of psycho analysis at the point where the representatives of psychoanalysis put it down. But all these phenomena, some of which accompanied the birth of psy choanalysis and some of which preceded it, die out as soon as matters become really serious; nobody dares to pursue the ideas to their conclusions or to draw logical consequences; economic interest still has the upper hand, and in fact brings about an alliance between bourgeois liberalism and the churches. Just as Marxism was sociologically the expression of man becoming conscious of the laws of economics and the exploita tion of a majority by a minority, so psychoanalysis is the expres sion of man becom ing conscious of the social repression of sex. But whereas one class exploits and another is exploited, sexual repression extends over all classes. Seen from the viewpoint of the history of man, sexual repression is even older than the exploitation of one class by another. As capitalism developed, however, and as the ruling class, in the interests of its own continued profit and existence, began to take social policy measures and to prac tice so-called "welfare, " the ideological bourgeoisification of the working class set in; and this process is still becoming more intense day by day. Thus the effects of sexual repression spread to the proletariat, but without ever becoming as extreme as they 5 5 (1934) A correction here. Sexual repression was not absent in the proletariat; because of a different social situation it was present in a different form. A proletarian child enjoys great sexual freedom and at the same time suffers extremely severe sexual oppression. This creates a special structure which i s fundamentally diffe rent from that, say, of the petty-bourgeois structure. Dia l ectica l Materi a l ism a n d Psychoa n a l ysis 53 are in the lower-middle class, which is "more Catholic than the Pope" and follows the moral ideals of its model-the upper middle class-more closely than that class does itself. The upper middle class began long ago to liquidate its own standards of morality for its own members. The history of psychoanalysis in bourgeois society, then, is connected with the attitude of the bourgeoisie to sexual repres sion, or, to put it another way, to the removal of sexual repres sion. He believed from the start that the world would, in one way or another, suppress his discoveries because it could not tolerate them. Clearly he must have been thinking only of the bourgeois half of the world, for the proletariat as yet knew nothing of psychoanalysis and did not know that it existed. But what does the bourgeois world make of psychoanalysis when it does not con demn it out of hand On the one hand there are the sciences, in particular psychology and psychiatry, on the other hand the lay public. When Freud began to construct his psychology of the ego on the basis of his sexual theory, you could almost hear the sigh of relief being heaved all over the scientific world: at last the man was beginning to set a limit to his absurdities, at last the "higher force" in man was coming into its own, and, when all is said and done, morality. After that, it was not long before people were talking only about "ego ideals" and sexuality was forgotten-the stereotype excuse being that it "went without saying. Under the pressure of bourgeois sex morality, psychoanalysis has been seized upon as a fashionable craze for the superficial satisfaction of lascivious desires. Special societies and discussion clubs for psychoanalysis are being formed in America; the market is good and must be exploited; the public indulges its un satisfied sexuality; and at the same time this craze which they dare to call psychoanalysis is an excellent source of income. Dialectica l Materi a l ism a n d Psychoa nalysis 55 So-called psychoanalysis has become good business. One splinter movement follows another; the pressure of sexual repression is too great for the analysts them selves. Jung stands the whole of analytic theory on its head and turns it into a religion in which there is no longer any mention of sex.
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The epithelium is of the stratified squamous type erectile dysfunction san francisco buy viagra jelly 100mg cheap, being more or less keratinized in accordance with the roughness of the usual feedstuff erectile dysfunction drugs used buy genuine viagra jelly online. The tunica muscularis of the esophagus consists of two layers that cross obliquely in the proximal esophagus erectile dysfunction ginkgo biloba 100mg viagra jelly with mastercard, assume a spiral configuration in the midesophageal region, and form an inner circular and an outer longitudinal layer in the more distal parts. The muscle changes from striated to smooth in the caudal third of the esophagus in the horse and just cranial to the diaphragm in the pig; it is striated throughout its length in the ruminants. Fundus Saccus Cecus Cardia Esophagus Pylorus Body Duodenum Pyloric Region Figure 20-8. Nonruminant Stomach In nonruminants (horse and pig), the stomach is just caudal to the left side of the diaphragm. The old term monogastric is discouraged because it perpetuates the misconception that ruminants possess more than one stomach, although the ruminant actually has a single stomach with multiple compartments. The simple stomach is grossly subdivided into the cardia (entrance), fundus, body, and pyloric region (outflow); the pyloric region features a dense, palpable sphincter muscle called the pylorus that controls gastric emptying into more distal parts of the digestive tract. The esophagus joins the stomach at the cardia, a part of the stomach so named because of its proximity to the heart. The walls surrounding the cardia (where the lumen of the esophagus becomes continuous with that of the stomach) feature a thickening of the muscle that constitutes a functional sphincter, the cardiac sphincter. This muscle is especially well developed in the horse, where its strength and configuration make it difficult or impossible for the horse to vomit. This arrangement results in a very short concave side between the cardia and pylorus, known as the lesser curvature, and a much longer convex side, the greater curvature. In the horse, the fundus is enlarged to create a blind sac, the saccus cecus, the mucosa of which is stratified squamous and nonglandular. The porcine stomach features a similar albeit smaller outpocketing called the gastric diverticulum; the mucosa of this feature of the pig stomach is of the typical glandular, columnar type. The body of the stomach is the expansile part that is defined externally by the greater curvature. It narrows as the stomach arcs ventrad and to the right, becoming the pyloric region. A very strong sphincter, the pylorus, regulates the outflow of the stomach in this region. In the pig (and in the equivalent region of the ruminant stomach), the pylorus features a muscular and fatty enlargement, the torus pyloricus. The tunica muscularis of the stomach features three discontinuous layers of smooth muscle: an outer longitudinal, a middle circular, and an inner oblique layer. Immediately surrounding the cardia is an area of stratified squamous epithelium called the esophageal region. This nonglandular region is limited in swine but is expanded in the horse, in which it lines the saccus cecus. It is the esophageal region of the stomach that is so markedly expanded in ruminants, where it lines the forestomach. Exclusive of the esophageal region, the mucosa of the simple stomach is glandular. Grossly, the mucosa here is thrown into prominent gastric folds that allow the stomach volume to expand to accommodate meals. On the microscopic level, the columnar epithelium of the tunica mucosa undulates in deep infoldings that create depressions called gastric pits. A transition from the stratified squamous epithelium of the esophageal region to columnar epithelium in the glandular part of the stomach demarcates the beginning of the cardiac gland region. This transition is grossly obvious in the horse, where it is called the margo plicatus. The cardiac glands that give this region its name are short, branched tubular glands whose major secretory product is mucus. The equine cardiac gland region is small, but it covers nearly half of the interior of the porcine stomach. The fundic gland region lines much of the interior of the stomach (and certainly more than just the fundus). Fundic glands are simple tubular glands that open into the gastric pits, where they discharge their secretions. The pyloric gland region corresponds more or less to the pyloric region of the simple stomach. The pyloric glands are histologically similar to the cardiac glands, and like them, they secrete mucus. Enteroendocrine cells are scattered throughout the mucosa of the glandular stomach. These secrete hormones that affect the secretory and muscular activity of the gut and its accessory organs. Ruminant Stomach the ruminant stomach is actually a single stomach modified by marked expansion of the esophageal region into three distinct and voluminous diverticula, the rumen, reticulum, and omasum, collectively known as the forestomach. These are lined with nonglandular stratified squamous epithelium and comprise a series of chambers where food is subjected to digestion by microorganisms before passing through the digestive tract to the smaller glandular portion of the stomach in the ruminant, the abomasum. Ruminoreticulum Because of their functional and anatomic relatedness, the reticulum and rumen are often collectively called the ruminoreticulum. The opening of the esophagus (the cardia) is about the level of the middle of the seventh intercostal space, and it opens into the dorsal space that is common to both the rumen and reticulum. The mucosa in the region of the cardia forms two heavy muscular folds that together create a groove extending from the cardia to omasum. This is the sulcus ruminoreticularis (variously called the esophageal, gastric, or reticular groove). In nursing ruminants, the act of suckling initiates a reflex contraction of the muscular walls of the sulcus, transforming it from a groove to a closed tube that connects the cardia with the omasum. By this reflex, swallowed milk bypasses the ruminoreticulum and is instead delivered to the more distal parts of the stomach; this ensures that the milk will not be allowed to sour in the forestomach. Its mucosa is thrown up into intersecting ridges that give the reticulum its common name, the "honeycomb. E, esophageal region; C, cardiac gland region; F, fundic gland region; P, pyloric gland region. B) Internal anatomy; grooves on the exterior of the stomach correspond to raised, muscular ridges ("pillars") on the interior of the stomach. The location of the reticulum immediately caudal to the diaphragm places it opposite the heart, with only the muscular diaphragm between, so that these sharp objects may also be driven into pleural and pericardial spaces. The reticulum and the rumen (colloquially known as the paunch) are divided ventrally by a thick, muscular ruminoreticular fold. The rumen extends from this fold to the pelvis and almost entirely fills the left side of the abdominal cavity; its capacity depends on the size of the individual but in adult cattle ranges from 110 to 235 L (about 30 to 60 gallons). The rumen is subdivided internally into compartments by muscular pillars, which cor- respond to grooves visible on the exterior of the rumen.
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Instructional Strands Instructional Strands with Major Competencies Instructional StrandInstructional StrandCoaching Theory Theory and Practice of Coaching a Specific Sport Human Growth and Development Instruction as It Relates to erectile dysfunction doctors in cincinnati discount 100mg viagra jelly fast delivery Athletic Coaching Biomechanical Foundations Human Psychology Physiological Principles Legal Aspects Public Relations Principles Human Growth and Development Instruction as It Relates to men's health erectile dysfunction pills purchase viagra jelly from india Athletic Coaching Biomechanical Foundations Sport Injuries Human Psychology Sport Management Instructional Strand-Care and Prevention of Athletic Injuries Biomechanical Foundations Sport Injuries Substance Use and Abuse Nutrition Principles the Athletic Coaching Endorsement Program will be provided through an inservice program of three inservice training components worth sixty inservice points each. Participants will be offered various delivery models including online, face-to-face, and blended models. All professional learning will be delivered using the learningforward Standards for Professional Learning. Training Components (see pages 8-14) (Numbers in parentheses in the specific objective listings refer to competency numbers. Identify the importance of a selected interscholastic sport as a lifelong activity 2. State the importance of a selected interscholastic sport as a part of our culture (4, 5) 3. Identify the rules and terminology used in a selected interscholastic sport (54, 55) 4. Identify the strategies of team and/or individual play in a selected interscholastic sport (2, 3, 14) 5. Identify the strategies of individual position play in a selected interscholastic sport (14) 6. Exhibit knowledge of safety practices necessary to participate in a selected interscholastic sport (20) 7. State the physical fitness value derived from participation in selected interscholastic sport (32) 8. Identify the skills necessary to participate in selected interscholastic sports (2, 3) 9. State the social skills derived from participation in selected interscholastic sports (25) 10. Identify positive sportsmanship techniques in participating in selected interscholastic sports (24) 11. Identify new methods and techniques for more effective coaching in selected interscholastic sports (2) 12. Identify innovative methods of organizing and administering selected interscholastic sports (54) 13. Identify national, state, and local policy revisions that will affect the administering of a selected interscholastic sport (49) 14. Exhibit a basic understanding and knowledge of sports medicine as it pertains to selected interscholastic sports (15-20) 15. Describe tort liability in athletics related to: (45) a) Adequate care b) Proper supervision 3. Identify the constitutional rights of student athletes: (46) a) Identify ethnic or other discrimination b) Identify appropriate disciplinary techniques c) Identify decision-making strategy in eliminating athlete(s) from the team 4. Identify appropriate state/local policy and procedure regulations governing athletic participation (48) 6. Identify legal precedents and actions in athletic coaching related to: (49) a) Sexual misconduct b) Sexual harassment c) Assault/battery 9. Identify the characteristics of student athletes related to: (1) a) Normative differences in chronological age b) Maturational differences c) Readiness to learn, train, and compete 11. Distinguish the experiences appropriate for student athletes at various stages of growth development (2) 12. Select individualized, age appropriate, non-injurious training methods for student athletes (54) 13. Demonstrate current knowledge of normal human anatomical features and abnormal deviations 18. Identify key biomechanical principles appropriate to athletic coaching including: a) Demonstrate understanding of physics principles which form the basis of skills acquisition b) Demonstrate knowledge of biomechanical concepts as applied in athletic coaching 19. Demonstrate understanding of exercise physiology as it relates to athletic coaching: (30, 31, 33, and 35) a) the ability to implement appropriate sport training program(s) b) Appropriate environmental conditions and their effects on training and learning (temperature, humidity, lighting, etc. Demonstrate understanding of body composition factors related to athletic performance potential: (34) a) Body weight as it affects performance b) Body fat percentage related to conditioning 21. Identify theoretical principles and strategies for successful athletic coaching (54) 23. Describe managerial skills in use of equipment, facilities, and the deployment of personnel (55) 24. Demonstrate knowledge of evaluation techniques for: (57, 52) a) Personnel b) Program 26. Demonstrate ethical behaviors and decision-making in personal relations with others (58) 27. Demonstrate thorough knowledge of athletic nutrition and ability to advise athletes concerning nutrition (40-44) 2. Display abilities in selection of appropriate athletic injury treatment modalities (16, 46) 4. Distinguish the acceptable selection and usage of rehabilitation and reconditioning techniques (17) 6. Show evidence of knowledge of and application for playing conditions and for athletic facilities in order to facilitate injury prevention and enhance athletic performance (17) a) Selection of appropriate athletic uniforms (15-23) b) Protective equipment (15-23) c) Sanitary maintenance of the foregoing (15-23) 8. Identify major characteristics of illegal substance use problems to include the effects and dangers of drug use including performance enhancing drugs; recommend/refer identified athletes appropriately (36-39) 10. Demonstrate knowledge of appropriate health-related policies and procedures (13) a) Procedures for obtaining parental medical consent (13) b) Establish policy/guidelines regarding health of athletes (21-23) c) Referral procedures (21-23) d) Arranging for medical examination (21-23) e) Knowledge of role importance of athletic trainer (21-23) f) Arranging for on-call physician (21-23) 11. Exhibit a basic understanding of anatomy and physiology as related to sports medicine (21-23) 13. This individual will also have successful experience as a professional learning trainer. Program Completion Satisfactory completion of individual components for add-on endorsement purposes may be demonstrated through: 1. Verification of successful demonstration of all applicable competencies and products within the component by means of approved Professional Learning Catalog component from another district where the component is part of an approved Athletic Coaching Endorsement Program in that district and where reasonable equivalency between the components can be established through a review of the component objectives; or 3. Official transcript from a college or university documenting successful completion of a course, the catalog description of which establishes a reasonable equivalence to the District component. In general, competency demonstration will be done through products, tests, classroom demonstrations, and/or portfolios; however, procedures for evaluation of competency achievement within components will vary depending on the nature of the competency.
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This course provides a professional development opportunity for transition professionals young healthy erectile dysfunction cheap viagra jelly 100mg fast delivery. The tenets of transition taxonomy and predictors of post-school success erectile dysfunction forums buy viagra jelly 100mg without a prescription, such as family involvement and interagency collaboration impotence under hindu marriage act order viagra jelly 100mg overnight delivery, are embedded throughout the course. The interrelatedness of the transition-related federal indicators, including how they support student success. Identify the key concepts of self-determination and self-advocacy for students with disabilities and describe related federal and state legislation. The activity includes a rubric the participant will use to evaluate the secondary transition program in their school or district. In addition, the participant must identify one new service the school/district could offer, one strategy to better prepare families to provide transition activities for their student, and one way in which the school/district can improve facilitation of services between the school/district and agency/community resources. Follow-up activity information that can be used by the supervisor to ascertain successful completion of the activity is provided to the participant. Demonstrate knowledge of the components of language and understanding of language as an integrative and communicative system. Demonstrate knowledge of L2 (second language) teaching methods in their historical context. Organize learning around standards-based content and language learning objectives for 5-3 1-704-020 60 students from diverse backgrounds and at varying English proficiency levels. Plan for instruction that embeds assessment, includes scaffolding, and provides re- teaching when necessary for individuals and small groups to successfully meet English language and literacy learning objectives. Understand and apply knowledge of the role of individual learner variables in the process of learning English as a second language. Demonstrate understanding of how L1 literacy influences L2 literacy development in English. The development and implementation of strategies for the student case study may be credited towards the sixty (60) hours of inservice requirement for up to a maximum of thirty (30) inservice points/hours. Demonstrate knowledge and sensitivity to multicultural and diverse student populations; create a positive and supportive environment to accommodate the diverse cultural backgrounds of students. Recognize major differences and similarities among various cultural groups in the U. Demonstrate ability to work cooperatively with the community and express to the community that its participation is wanted and needed. Develop cross-cultural awareness and understanding of the major cultural groups represented in the local school district, and at the individual schools, in order to 12. The district-developed portfolio may be credited towards the sixty (60) hours of inservice requirement for up to a maximum of thirty (30) inservice points/hours. Upon successful completion of the component, participants will be able to modify curriculum and offer instruction and evaluation compatible with student language diversity. Understand and apply knowledge of concepts of cultural competence, particularly knowledge about how cultural identities affect learning and academic progress for students from diverse backgrounds and at varying English proficiency levels. Demonstrate awareness of current research relevant to best practices in second language and literacy instruction. Identify and understand the nature and role of culture, cultural groups, and individual cultural identities. Organize treatment language learning objectives for students from diverse backgrounds and at varying English proficiency levels. Participants will engage in independent study, review web sites and professional articles, review key terms, complete online learning activities, take assessments and pass with 80% or greater accuracy rate. When appropriate, participants will complete and submit the following items as verification for district-awarded independent study credit. Participants are required to follow all district procedures established for utilizing the independent study in-service option. Participants will also complete a pre/post survey to gauge growth in addition to a participant satisfaction survey. Evaluation Methods for Staff Code: D-Other Changes in Practice Evaluation Methods for Students Code: D-Observation of Student Performance Who will use the evaluation impact data gathered Impact data will be used by participants, school administration, academic coaches, and district personnel and will inform decisions with regard to needed additional professional learning based upon reflective opportunities. Participant pre/post survey is designed to assess individual growth as a result of the module. Districts will have the opportunity to review the required documents submitted by participants. They will then make relevant revisions to ensure a successful learning experience. Distinguish between visible, surface characteristics of culture and the many subtle, invisible manifestations of culture known as deep culture. Recognize the stages of culture adaptation for newcomers to any culture and demonstrate awareness of the behavioral characteristics that may be associated with each stage of adjustment and which often appear as classroom problems. Become aware of the wide diversity within any given cultural group and how to use cultural information without stereotypes or preconceived ideas concerning cultural characteristics. Understand and accept the influence that home, school, and community relationships have on academic achievement and school adjustment of students. Develop strategies and activities that promote parent, school, and community relationships with the classroom. Understand the process of literacy development and be able to identify various stages of literacy. Describe the similarities in the processes of language acquisition and literacy development. Identify and understand the many uses of language and literacy and the importance of early exposure to the complete range of language uses. Utilize instructional approaches and techniques that integrate language and curricular content learning. Analyze and utilize strategies that combine language and thinking skills and that are related to the content of the curriculum. Develop a lesson plan within a thematic unit using strategies designed to teach language and content simultaneously. Develop strategies that infuse multicultural information throughout the curriculum. Understand the role and function of assessment in the education of Limited English Proficient students. Identify types of tests and select those appropriate for language minority students and for the particular goals of testing. Plan instructional activities that are appropriate to the stage of language acquisition of the student. Adapt classroom activities and procedures so they maximize second language acquisition and learning, taking into account similarities and differences between first and second language acquisition. Recognize Opportunities for promoting literacy across a broad range of uses, utilize those opportunities, and design and implement appropriate literacy activities. Conceptually integrate all sections of the course and note how they fit together or complement each other.
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The serous membrane lining a body cavity is called the parietal serous membrane (parietal pericardium erectile dysfunction treatment in ayurveda order viagra jelly with visa, parietal pleura erectile dysfunction medication class buy genuine viagra jelly on-line, and parietal peritoneum) erectile dysfunction 32 generic viagra jelly 100 mg fast delivery. The continuity of each serous sac is maintained by connecting layers of serous membrane that extend from the visceral layer of each serous membrane to the parietal layer of the same serous membrane. The names of these connecting layers of serous membranes are based on the specific areas they connect, and they are discussed in some detail along with the relevant systems later in this book. Robert Hooke of England used the term cell to describe the cavities he saw in sections of cork. In 1665, Hooke published a description of cork cells based on a study done with his improved compound microscope. In 1839 Matthias Schleiden, a German botanist, and Theodor Schwann, an animal anatomist, formulated the cell theory, which set forth the concept that "the elementary parts of all tissues are formed of cells in an analogous, though very diversified, manner, so that it may be asserted that there is one universal principle of development for the elementary parts of organisms, however different, and that this principle is the formation of cells. In biology, particularly animal biology, the term cell refers more specifically to the individual units of living structure rather than the compartments that may contain them. There actually are no compartments as such in most tissues (with the exception of bone and cartilage), but the living units, cells, are found in groups in which mainly adjacent cells restrain individual cells. As early as 1772, Corti observed the jellylike material in the cell that later was called protoplasm. It is the unit that makes up all tissues, organs, and systems, which in turn make up the total animal. These properties include homeostasis, growth, reproduction, absorption, metabolism, secretion, irritability, conductivity, and contractility. Conductivity is an important functional characteristic of both nerve and muscle cells, whereas contractility is a property of muscle cells. Homeostasis is the tendency for living things to attempt to maintain a state of relative stability. At the whole-animal level or at the cellular level, all living things respond to stresses placed upon them by changes in their environment. An increase in the size of a structure due to an increase in the number of cells is called hyperplasia. Failure of a tissue or organ to develop is called aplasia, while incomplete development or defective development of a tissue or organ is called hypoplasia. Reproduction of a cell or of an organism implies the ability to produce more cells or more organisms that are essentially the same as the original. Some fully differentiated cells, for instance nerve cells, do not normally retain the ability to reproduce in the adult. Cells may be found in solutions whose composition is quite different from that of the fluid within the cells. To maintain intracellular homeostasis in these conditions, the passage of particles and water in and out of the cell must be regulated. Absorption is the process of taking dissolved materials or water through the cell membrane into the substance of the cell. This can be a passive process dependent on the forces of diffusion and osmosis, an active process requiring the expenditure of energy from adenosine triphosphate, or the result of electrochemical ionic forces and affinities that require no direct expenditure of energy. In endocytosis the exterior cell membrane moves to surround extracellular materials in a membrane pocket. This membrane vesicle detaches from the inner surface of the cell membrane and moves into the interior of the cell. If a large amount of particulate material is endocytosed by ameboid movements of a cell, the process is more specifically termed phagocytosis. This ability is characteristic of some white blood cells, which engulf large particulate matter, tissue debris, or bacteria. After a phagocytic vesicle enters the substance of a cell, it may fuse with a different type of membrane vesicle, a lysosome that was produced within the cell. Lysosomes are specialized membrane vesicles that contain enzymes, also produced within the cell. This fusion permits the lysosomal enzymes to act upon the contents of the phagocytic vesicle in a small, local area that is isolated from the cytosol. Most types of cells are capable of endocytosing small amounts of fluid containing dissolved particles. Metabolism refers to the sum total of the physical and biochemical reactions occurring in each cell and therefore in the entire animal. Reactions that build and maintain cellular components are called anabolic, and those that break down cellular components or constituents are called catabolic. The oxidation of carbon compounds to carbon dioxide and water, with the release of energy, is a catabolic reaction. Membrane-bound secretory vesicles containing substances synthesized within the cell and packaged by the Golgi apparatus migrate in the cytoplasm to the plasma membrane. Irritability (also called excitability) is the property of being able to react to a stimulus. The reaction must necessarily consist of one of the other properties of protoplasm, such as conduction, contraction, or secretion. Conductivity is the property of transmitting an electrical impulse from one point in the cell to another. Muscle cells are specialized for contractions, although many other cells and cell organelles also contain contractile proteins and exhibit limited movement. Chemical Composition of the Cell Chemical composition of various parts of the cell plays an important role in cellular function. The approximate composition of protoplasm by constituent is water, 85%; protein, 10%; lipid, 2%; inorganic matter, 1. Water is by far the largest constituent of protoplasm, which is largely a colloidal suspension in water. Most body water is within cells, and this fluid volume is called intracellular fluid. Unique interstitial fluids include the cerebrospinal fluid, the fluid in the joints, the fluid in the eyes (aqueous and vitreous humors), and the serous fluid in the visceral spaces. The percentages for the different types of body fluids vary from one animal to another. Factors affecting these percentages include condition (amount of fat), age, state of hydration, and species. Water is constantly lost from the body, and it must be replenished if the animal is to remain in water balance and not become dehydrated. Most is lost via the urine, but it is also lost in the feces and by evaporation from body surfaces, such as the skin and respiratory passages. Water replacement is almost entirely by drinking, because minimal amounts of water are produced in the bodies of domestic animals as a result of cellular metabolism (metabolic water). Chemical bonds between amino acids at distant points in the chain produce the three-dimensional shape of the protein molecule.
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For example erectile dysfunction doctor montreal order viagra jelly now, a common error found in literacy programs is the lack of text to impotence grounds for divorce in tn quality 100mg viagra jelly speech op ons in the language of instruc on xalatan erectile dysfunction cheap viagra jelly 100 mg without prescription. In addi on, the procurement should clarify the disability category(ies) and learning func on these technologies are trying to support (See Annex A for more informa on on features of accessible (general) and assis ve technologies). It is important to iden fy what local sources are available and if they have sole vendor or distributor rights within the market. There may be op ons to secure ac va on codes for so ware, where the so ware is downloaded from the web directly. Increasingly so ware for mobile devices is only available through an online marketplace such as the Apple App or Google Play stores. Seeking solu ons to funding through this mechanism is challenging, but the very low cost of such apps might lend itself to providing funding to a school or district to download and install such apps rather than purchasing them directly through a Request for Proposal. Such enhanced provision could include development of services based upon 3D prin ng of aids and appliances to support specific needs. These services would then have the capacity to market themselves beyond educa on where aids are equally necessary. Likewise, communi es can also be a helpful resource in the procurement and repairs of assis ve technologies. In this sec on, we consider those challenges, and in the next sec on, we explore a model of technology ecosystems that might assist in overcoming some short-term and long-term challenges over me. A recent study stated that, "Educa onal technology will con nue to be implemented incrementally in many parts of the developing world. Secondary barriers included school level factors, such as organiza onal culture, and teacher level factors, such as beliefs about teaching and technology and openness to change. Due to the fast pace of technology development, technologies are o en placed on the market without undergoing rigorous research. There are several barriers to accurately measuring the impact of a specific technology on the learning of students with disabili es. These include lack of universality of learning assessments between and within countries, especially where the students have had significantly reduced opportuni es for language development. The cost of procuring assis ve technology on a larger scale can serve as a barrier in many low-income countries. Assis ve devices can come with addi onal costs which also need to be factored into their affordability. The One Laptop Per Child program is an important example of a costly program which did not factor in important educa on supports to make it cost-effec ve (see case study in Sec on B2). Cost-effec veness research in this area is limited (For more informa on, see Part F). The promise and problem with technology in special educa on: Implica ons for Academic Learning. It can be challenging to set up academic communities for students with disabilities, which is made of people who understand how to communicate with students or are like them. The main issue is that it is hard to find others who either share their differences or live with people with similar differences. They often seek out the support needed in physical communities, and a virtual community can be a lifeline. With appropriate support, the community can function as a resilient and flexible network of support. Participants can build webs of personal relationships that aid them in organically developing their interests and abilities so they can thrive in all facets of their lives. Students with disabilities often encounter attitudinal barriers in which peers and mentors do not understand the frequently complex ways in which access barriers manifest. In this case, attitudinal barriers include communication/language attitude and ability attitude. As a result of societal and attitudinal barriers, students with disabilities remain underrepresented in school. Furthermore, they may have learning strategies influenced by their modes of communication/language and learning styles compared to their peers without disabilities. For example, deaf students are inclined to be visual students whereas peers without disabilities rely on auditory input for language development. With the majority of classes made up of peers without disabilities, instructions tend to be multi-modal to meet their needs but not the minority members such as students who are deaf or blind. Also, they risk exclusion in the absence of appropriate accommodations, especially in informal interactions with peers and mentors. Equity challenges include, but are not limited to, ease of use of web and mobile applica ons for students with physical disabili es, verbal, pictoral or vibra ng reminder/instruc on apps 88 Hayes, Anne M. If technologies are introduced based on the use of the "Matrix Model", and if students with disabili es become accustomed to using those technologies for learning purposes, and if those technologies then have to be withdrawn from the learning environment because local systems cannot sustain them, then the students with disabili es may be placed at a tremendous disadvantage in con nuing their learning. In part, this is because the challenges listed above would all need to be addressed for this integra on to succeed. Integra ng any technology into any learning environment requires addressing a broad range of factors that are o en conceptualized as making up a single "technology implementa on ecosystem. Groups of stakeholders using the planning tools in sec on C to iden fy which technologies are needed to support maximal literacy and numeracy gains for their students will automa cally find themselves interac ng with stakeholders from across the "implementa on ecosystem" in their context. Roles and responsibili es in the system of actors from different sectors are summarized in the chart below. Bringing the perspec ves of individuals with a disability to the decision-making process, ensuring that assis ve technology decisions are based upon student needs and evidence-based prac ces. Ensuring sustainability of products and services, based upon making enough margin to sustain the business while offering products and services that are scalable. Advocacy (par cularly for cost control), innova on, procurement, distribu on, training support, monitoring and evalua on, data-sharing, etc. Businesses founded on the use of openly licensed products and materials can offer a means of purchasing services within the ecosystem to address needs (training, support, digital content etc. In some countries, partnerships have provided the basis of Assis ve Technology Associa ons such as Assis ve Technology Industry Associa on in the United States or Bri sh Assis ve Technology Associa on in the United Kingdom. Organiza ons like these may have a board of directors or steering group that is comprised from all sectors to ensure that all voices are heard, and the needs of the local market are addressed. It may also act 54 as a representa ve body to government to ensure that the need for assis ve technology is addressed. In the rest of this sec on, we consider two of the ecosystem elements in par cular: design and cost. Op ons for what technologies can be placed into the "Matrix Model" in any context will be largely driven by what occurs in this part of the ecosystem. Technology design philosophies have developed in parallel with disability philosophies -from the medical model, where disabled students were pa ents who needed cures, to the special educa on model, where disabled students need separate educa on, to human rights model where disabled students are considered part of the human tapestry of diversity and have equal legal, social and educa onal rights as others. Assis ve design focuses on developing a separate service or product to help a person with a disability perform tasks through augmenta on of his/her exis ng abili es, "restoring" func on so a person can be like their peers.
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According to erectile dysfunction treatment boston medical group purchase viagra jelly 100mg line the Department of Defense (2015) erectile dysfunction solutions viagra jelly 100mg generic, in 2014 83% of all officers in the Services (Navy erectile dysfunction and diabetes leaflet purchase 100mg viagra jelly visa, 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. When compared to those who are older, the young-old experience relatively good health and social engagement (Smith, 2000), knowledge and expertise (Singer, Verhaeghen, Ghisletta, Lindenberger, & Baltes, 2003), and adaptive flexibility in daily living (Riediger, Freund, & Baltes, 2005). The young-old also show strong performance in attention, memory, and crystallized intelligence. This group is less likely to require long-term care, to be dependent or poor, and more likely to be married, working for pleasure rather than income, and living independently. Overall, those in this age period feel a sense of happiness and emotional well-being that Source is better than at any other period of adulthood (Carstensen, Fung, & Charles, 2003; George, 2009; Robins & Trzesniewski, 2005). It is also an unusual age in that people are considered both in old age and not in old age (Rubinstein, 2002). For example, congestive heart 377 failure is 10 times more common in people 75 and older, than in younger adults (National Library of Medicine, 2019). In fact, half of all cases of heart failure occur in people after age 75 (Strait & Lakatta, 2012). In addition, hypertension and cancer rates are also more common after 75, but because they are linked to lifestyle choices, they typically can be can prevented, lessoned, or managed (Barnes, 2011b). Oldest-old: this age group often includes people who have more serious chronic ailments among the older adult population. Females comprise more than 60% of those 85 and older, but they also suffer from more chronic illnesses and disabilities than older males (Gatz et al. In a study of over 64,000 patients age 40 65 and older who visited an 30 emergency department, the 20 admission rates increased with age. Thirty-five% of admissions 10 after an emergency room visit 0 were the young old, almost 43% 65-74 75-84 85+ were the old-old, and nearly half were the oldest-old (Lee, Oh, Admissions Death Park, Choi, & Wee, 2018). The most common reasons for hospitalization for the oldest-old were congestive heart failure, pneumonia, urinary tract infections, septicemia, stroke, and hip fractures. In recent years, hospitalizations for many of these medical problems have been reduced. However, hospitalization for urinary tract infections and septicemia has increased for those 85 and older Levant et al. Those 85 and older are more likely to require long-term care and to be in nursing homes than the youngest-old. However, most still live in the community rather than a nursing home, as shown in Figure 9. In 2015 there were nearly half a million centenarians worldwide, and it is estimated that this age group will grow to almost 3. Most centenarians tended to be healthier than many of their peers as they were growing older, and often there was a delay in the onset of any serious disease or disability until their 90s. Additionally, 25% reached 100 with no serious chronic illnesses, such as depression, osteoporosis, heart disease, respiratory illness, or dementia (Ash et al. Centenarians are more likely to experience a rapid terminal decline in later life, meaning that for most of their adulthood, and even older adult years, they are relatively healthy in comparison to many other older adults (Ash et al. According to Guinness World Records (2016), Jeanne Louise Calment has been documented to be the longest living person at 122 years and 164 days old (See Figure 9. There are many theories that attempt to explain how we age, however, researchers still do not fully understand what factors contribute to the human lifespan (Jin, 2010). According to Jin (2010), modern biological theories of human aging involve two categories. The first is Programmed Theories that follow a biological timetable, possibly a continuation of childhood development. This timetable would depend on "changes in gene expression that affect the systems responsible for maintenance, repair, and defense responses," (p. The second category includes Damage or Error Theories which emphasize environmental factors that cause cumulative damage in organisms. Based on animal models, some genes promote longer life, while other genes limit longevity. Specifically, longevity may be due to genes that better equip someone to survive a disease. For others, some genes may accelerate the rate of aging, while others decrease the rate. To help determine which genes promote longevity and how they operate, researchers scan the entire genome and compare Source genetic variants in those who live longer with those who have an average or shorter lifespan. Evolutionary Theory: Evolutionary psychology emphasizes the importance of natural selection; that is, those genes that allow one to survive and reproduce will be more likely to be transmitted to offspring. Genes associated with aging, such as Alzheimer Disease, do not appear until after the individual has passed their main reproductive years. Consequently, natural selection has not eliminated these damaging disorders from the gene pool. If these detrimental disorders occurred earlier in the development cycle, they may have been eliminated already (Gems, 2014). This is known as the Hayflick limit, and is evidenced in cells studied in test tubes, which divide about 40-60 times before they stop (Bartlett, 2014). It can stop replicating by dying, called Adapted from National Institute on Aging apoptosis. Or, as in the development of cancer, it can continue to divide and become abnormal. While they may be turned off, they are not dead, thus they still interact with other cells in the body and can lead to an increase risk of disease. Understanding why cellular senescence changes from being beneficial to being detrimental is still under investigation. This is usually not a concern as our cells are capable of repairing damage throughout our life. The free radicals are missing an electron and create instability in surrounding molecules by taking electrons from them. Some free radicals are helpful as they can destroy bacteria and other harmful organisms, but for the most part they cause damage in our cells and tissue. Free radicals are identified with disorders seen in those of advanced age, including cancer, atherosclerosis, cataracts, and neurodegeneration.