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Transection of a branch of the middle meningeal artery Bleeding from torn bridging veins Rupture of a preexisting berry aneurysm Rupture of an arteriovenous malformation Cortical bleeding occurring opposite the point of a traumatic injury 473 symptoms nervous breakdown generic 500 mg hydrea. A 27-year-old woman presents with the acute onset of severe headaches and vomiting medications for factor 8 cheap hydrea 500mg with mastercard. Physical examination reveals stiffness in her neck medicine youtube hydrea 500mg sale, but papilledema is not present. A lumbar puncture reveals blood within the cerebrospinal fluid, but the cell count and the glucose levels are within normal limits. The signs and symptoms in this individual are most likely the result of an abnormality located at which one of the following anatomic sites Anterior thalamic nucleus Circle of Willis Medial inferior pons Superior cerebellar artery Superior sagittal sinus Nervous System 549 474. A 25-year-old man fell out of a kayak on a rain-swollen river and remained underwater for approximately 5 minutes before being rescued. He was immediately taken to the hospital and put on a ventilator, but never regained consciousness. The next day he was pronounced dead after an electroencephalogram did not detect brain activity, and deep tendon reflexes and a respiratory drive were not found. Histologic sections from which of the following areas are most likely to show the earliest changes of acute neuronal injury, such as the formation of red neurons Dorsomedial nucleus of the hypothalamus Nucleus ambiguus of the lateral medulla Sommer sector of the hippocampus Substantia gelatinosa of the spinal cord Ventral posterolateral nucleus of the thalamus 475. A 63-year-old man presents with progressive uncontrolled movements of his left hand. Tau positive inclusions were found in astrocytes and neurons in these atrophic regions. A 79-year-old woman who lived alone and had a medical history of poorly controlled chronic hypertension died while at home. During the autopsy the pathologist finds a recent intracerebral hemorrhage involving the putamen. Histologic sections from this area reveal lipid and hyaline material to be deposited in the walls of cerebral arterioles, an abnormality that is associated with the formation of which of the following types of aneurysm Histologic examination of the brain from a 39-year-old man who died from encephalitis finds numerous microglial nodules composed of mononuclear cells, microglia, and scattered multinucleated giant cells. Which one of the following is most likely to be present within the cells of these microglial nodules Cytomegalovirus Herpes simplex virus Human immunodeficiency virus Poliovirus Rabies virus 478. A lumbar puncture is performed on a patient with headaches, photophobia, clouding of consciousness, and neck stiffness. Pressure Increased Increased Increased Decreased Increased Gross Appearance Cloudy Clear Clear Clear Clear Protein Increased Increased Increased Decreased Increased Glucose Decreased Normal Normal Normal Normal Inflammation Neutrophils Lymphocytes Mononuclear cells Lymphocytes Mixed a. A 42-year-old immunosuppressed man presents with rapidly progressive neurologic symptoms including mental deterioration, visual loss, abnormal speech, and ataxia. Radiographic studies demonstrate multifocal lesions in the white matter without mass effect (no shift in the cerebral hemispheres is seen). A stereotactic brain biopsy reveals irregular areas of demyelination at the periphery of which are oligodendrocytes with markedly enlarged nuclei that have a "ground-glass" appearance. Cysticercosis Neuroborreliosis Neurosyphilis Progressive multifocal leukoencephalopathy Subacute sclerosing panencephalitis 480. Physical examination of a 34-year-old woman with the new onset of an intention tremor finds medial rectus palsy on attempted lateral gaze in the adducting eye and monocular nystagmus in the abducting eye with convergence. An apical lung cancer A pituitary adenoma Diabetes mellitus Multiple sclerosis Tertiary syphilis 552 Pathology 482. A 45-year-old man presents with weakness and cramping that involves both of his hands. Physical examination reveals atrophy of the muscles of both hands, hyperactive reflexes and muscle fasciculations involving the arms and legs, and a positive Babinski reflex. Her family relates several recent episodes where she left home by herself, got lost in her own neighborhood, and could not find her way back. Within 2 years she had to be admitted to a nursing home, where she died 3 years later. Autopsy revealed bilateral, symmetrical atrophy of the frontal lobes with wide sulci and narrow gyri. Microscopic examination of tissue taken from this area revealed bundles of filaments in the cytoplasm of neurons and focal collections of neuritic processes surrounding central amyloid cores. Which one of the listed enzymes is responsible for the production of these abnormal amyloid cores A 65-year-old man presents with bradykinesia, tremors at rest, and muscular rigidity. In this patient, from which one of the following sites would biopsies most likely reveal intracytoplasmic eosinophilic inclusions within neurons Basal ganglia Caudate nucleus Hippocampus Midbrain Substantia nigra Nervous System 553 485. Shy-Drager syndrome, a Lewy body disease, is characterized by orthostatic hypotension, impotence, abnormal sweating, increased salivation, and pupil abnormalities. A 41-year-old man presents with involuntary rapid jerky movements and progressive dementia. He soon dies, and gross examination of his brain reveals marked degeneration of the caudate nucleus. Workup finds obstructive hydrocephalus due to an infiltrative tumor located in the posterior fossa and originating from the midline of the cerebellum. What is the most likely diagnosis for a tumor located in this location in this child The mass is removed and histologic sections reveal sheets of cells with clear halos ("fried-egg" appearance) and scattered calcification. The presence of which one of the listed abnormalities within this type of tumor is associated with a better response to chemotherapy A 44-year-old woman presents with the new onset of seizures along with increasing frequency of severe headaches. Workup reveals a large, ill-defined, necrotic mass that involves both the right and left cerebral cortex. Histologic sections from this lesion reveal a hypercellular tumor with pseudopalisading of tumor cells around large areas of serpentine necrosis. Her past medical history is otherwise unremarkable, and she has no previous history of seizure activity. Which of the following histologic changes is most likely to be seen in a biopsy specimen taken from this tumor Antoni A areas with Verocay bodies A whorled pattern with psammoma bodies Endothelial proliferation with serpentine areas of necrosis "Fried-egg" appearance of tumor cells without necrosis True rosettes and pseudorosettes Nervous System 555 491. Physical examination finds bilateral sluggish light reflexes and a bitemporal hemianopsia. No papilledema is present, and her urine specific gravity is within normal limits.
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This objection is based on the argument that no attempt has so far been made by psychologists to medicine lux hydrea 500mg low cost define the influence of social factors as against that of biological factors treatment yeast overgrowth order hydrea 500mg online. And it is true that in psychoanalytical literature one encounters attitudes which suggest that instinct symptoms 4 days after conception discount hydrea 500mg on-line, independent of any molding influences from the outside world, is all that matters. Yet this view does not form part of Freudian psychology, which states very clearly that psychological development is due to the mold ing of instincts by influences from the outside world. Even the Oedipus relationship is not a biological but a social phenome non, determined by the patriarchal structure of the family. Surely neither the Marxist nor the psychoanalyst can have any objection to the view that psychological development results from the conflict between individual needs and social limitations (which also includes the conflicts of the Oedipus age). Another area of controversy concerns the respective spheres of competence in the explanation of ideologies. The Marxist says: Religion is a social phenomenon whose origins are demonstrably to be found in concrete conditions of production. On this point there exists practically no possibility of compromise, but only of methodological clarification. It cannot explain why a particular religion arises and gains ground as a social phenomenon in a particular historical period. And psychoanalysis has never claimed to be Psychoanalysis in the Soviet Union 83 able to explain religion as a whole. Where, however, the ma jority of individuals in the same social situation practice similar rites, psychoanalysis can uncover the meaning of those rites as it appears typically among all those who practice them. Un doubtedly Marxism alone is capable of showing why the Jewish religion is different in character from the Christian, and these again from the Buddhist; it can find connections with the social and economic mode of existence of the Jews (or Christians or Indians) to explain the specific nature of each religion. Likewise, psychoanalysis cannot explain the disappearance of religion under socialism or the phenomenon of the religious inquisition in the Middle Ages unless it applies Marxist viewpoints when interpreting these phenomena, but, in that case, it is no longer functioning purely as a theory of psychology. The handling of the problem of symbolism by some authors -which, even from the purely psychoanalytical point of view, is incorrect or at least extremely one-sided-has done much harm to the cause of psychoanalysis in Soviet Russia. For in stance, certain psychoanalytical writings on the agriculture of primitive races convey the impression that land cultivation is only a symbolic action and nothing more. Symbolic speculations of this kind must discredit psychoanalysis in the eyes of even the most well-disposed Marxist, for the outsider cannot be expected to distinguish between psychoanalysis and pseudo-psychoanaly sis. Marxist thinking, being absolutely materialist-orientated, resists not symbolism as such but its misuse; but then, so does the thinking of a clinical psychoanalyst. Every object and every activity has its rational meaning; it may become a symbol, but does not by any means have to become one. Objects and activities owe their existence, not to their symbolic meaning, but to their value as utility articles or commodities-or, in the case of activities, as productive work. Airplanes and railways are not made because they are symbols of instinctual ideas, but because certain production conditions lead to their being invented and made. In the fifth century, when phallic ideas were no different from what they are today, the same man could certainly not have designed an airplane. We have to admit that this argument, often advanced by Marxists, is objectively faultless. This is not the place to show in detail that such cases cases where psychoanalysis goes beyond its proper sphere and. When, once in a while, psychoanalysis is correctly represented, Marxists refuse to recognize it as "Freudian. The editorial board of the Moscow journal Pod Znameniem Marxisma, where the Russian text of this paper was published, felt itself obliged to add an editorial note to the effect that it did not agree with my account of psychoanalysis. And two Com munists expressed the view that what I said in my article was very conVincing, but was not Freudian psychoanalysis as they knew it. This means two things: first, that the development of psychoanalytic theory over the last few years has blurred the pure, empirical and scientifically unassailable features of psycho analysis, so that today we can almost speak of two kinds of psychoanalysis; second, that the Marxists have no objection to scientific psychoanalysis. In the article by Sapir2 published in reply to mine, the theories of the unconscious, of repression, of the instincts and other cardinal elements of psychoanalysis are recognized. My overall impression in Moscow was that the Marxist theoreticians will accept psychoanalysis if they are presented 2 Sapir: "Freudism, Sociology, Psychology," Pod Znameniem Marxisma, No. Here is the difference between the position of psychoanalysis in bourgeois countries and in the Soviet Union: in Germany and America psychoanalysis only began to be recog nized when it became nonmaterialist, that is to say idealist, in some of its most important aspects (deviation from the theory of the libido, emergence of the death-wish theory, the incorrect -in my opinion-application of psychology to sociology and cultural history, etc. In the Soviet Union it is precisely these aspects of psychoanalysis which are objected to, while the core of psychoanalytic theory could readily be accepted. Jurinetz, in his critique of psychoanalytic theory, actually speaks of a "decay" of original, scientific psychoan alysis. I must add that many Marxists-partly because their knowl edge of psychoanalysis is poor, and partly for reasons of per sonal resistance-show a lack of obj ectivity in their criticisms. To some extent these criticisms come from medical men of the older generation who. Their uninformed attitude is greatly confirmed by the lack of unity on theoretical issues among psychoanalysts today. The true Marxist, however, is so objectively oriented by his general attitude to life and society, he is so immune from every form of mysticism or idealist thought, that the plain facts about psychoanalysis are bound to achieve recognition in the end. Salkind, trying to attack my lecture at the Communist Academy, could fin ally find nothing more to say than that I had taken a very diplomatic line: I had spoken about psychoanalysis as a science, but not about so-called Freudism. In my final contribution I was able to quote Freud himself, who has spoken against the interpretation of psycho analysis as a world philosophy, i. For the Marxist, a theory is of great interest only if it also has practical significance. The question has been asked again and again: What is the practical significance of psychoanalysis for socialism Rosenstein showed us the "psychotherapy room," where a picture of Freud hangs on the wall. We were also able to note with satisfaction that many young doctors, both at the venerological dispensary and in the psychoneurological institute, have an attitude of complete understanding and appreciation vis-a-vis psychoanalysis and apply it in practice when assessing cases. Professor Rosenstein, the chief of the institute, is a de clared friend of psychoanalysis. It is characteristic of Soviet medicine as a whole that it is paying more and more attention to mass prophylaxis. Extensive and interesting statistical and other research is being carried out at all institutes with a view to developing this field of study. Some statistics concerning the sexual life of the masses have already been obtained, the questions being formulated in a manner which could not even be dreamt of in Western countries, where they would be considered "shocking. Hence the interest in prophylaxis of neuroses is very great, and concrete questions are being addressed to psycho analysis in connection with this subject. In our countries, because of the concentration on individual therapy, the question of prophylaxis has not yet been broached. The statement that only a theory of neuroses which proceeds by causal investigation can furnish the fundamentals of prophylaxis of neuroses was received with great attention,3 but concrete results are still awaited. Batkis) great 3 the question was discussed at a lecture on "Psychotherapy or Prophy laxis of Neuroses," to which I was invited by the psychoneurological institute. Psychoanalysis in the Soviet Union 87 interest was also shown in the practical application of psycho analysis at the Sexual Advice Bureau for Industrial and Office Workers in Vienna.
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A gap analysis of the en re implementa on ecosystem is likely to treatment menopause discount hydrea master card influence the speed or scale at which a given technology included in a "Matrix Model" built through the process described in part C can be introduced medicine overdose buy 500 mg hydrea with amex. However treatment impetigo cheap 500mg hydrea otc, it is important to note that, if a technology included in the "Matrix Model" is needed for a given student(s), gaps iden fied during the analysis of the ecosystem should not be allowed to inhibit provision of that technology. Rather, steps should be taken to resolve the gaps, so that the technology in ques on may be provided as planned. Depth and Breadth: One of the cri cal factors to consider in iden fying interven on outcome measures is determining the depth and breadth of impact. Data on the number of people reached is important in helping to determine the cost of taking an ini a ve to scale but is an insufficient picture of the actual progress made by students and reflects efficiency rather than effec veness. A deeper inves ga on of impact upon the learning process and progress is likely to best support a cost benefit analysis in the future. In other forms of interven on for students with disabili es, notably those involving assis ve technology and therapeu c interven ons, more holis c impact measures have been developed. Cost-Effectiveness: There is a clear educa onal need to provide accessible learning materials, integrated with accessible and assis ve technologies. The most cost-effec ve way to deliver access to literacy and other basic educa on is through an inclusive approach (Hayes, Turnbull and Moran, 2018, p. By increasing access to technology for all pupils, the marginal costs of mee ng the needs of those with a disability are negligible as a result of the scale of such provision. The extent to which an interven on offers cost effec veness is determined by the outcome measures. For students with disabili es, measures should encompass much wider facets of development than simple literacy scores. As a result, the focus of future research should seek to address which form of technology has the greatest learning impact, moving on from discussion as to whether technology interven on itself is beneficial. Understanding the effect of investment on enhanced quality of life and employment prospects adds significant value to the investment. A response strategy will need to be costed and planned for should these have presented significant barriers to access or improved learning during pilo ng. Do weaknesses exist in pedagogy, content knowledge, integration or selection of technologies, classroom management, specialist support needed, leadership, etc To what extent do students have access to devices with accessible learning content in their school, home and community What are the opportunities and barriers to procuring technologies on a larger scale, and to wider dissemination and production of accessible content Are there cost, maintenance, human resource and/or other constraints which might need to be overcome before expanding Are there serious climate effects that could be engendered by taking this project to scale Are there ways to cope with the environmental pollution the program may create at scale There is a need to inves gate the form of interven on that has the greatest impact on learning and lives of those with a disability. Interven ons include not only the elements of teaching and learning, but also any innova ons in delivery, organiza on and prac ce. This can provide an increased understanding of which interven on factors are most essen al to support the learning of students with disabili es. In each case it is important that that exploitation and dissemination of the outputs and deliverables is identified as a requirement. There has not yet been a direct investment in accessible and assistive technologies as a focus of a project or initiative. It identifies and brings to scale promising edtech solutions for addressing barriers that prevent children with disabilities from learning to read. These efforts have significantly increased the amount of books and teaching materials available to children with disabilities, particularly in low-resource contexts. The fund is distributed through an open call for proposals that are linked to a cohort of successful applicants. Awardees receive not only funding, but also mentoring from business advisors and experts in the field within which the innovation is being introduced. The program provides access to advanced Microsoft Azure cloud computing resources to individuals and organizations working on empowering people with disabilities across the world. Microsoft fund and run an annual Hackathon around the theme of accessibility each year. The integration of the Microsoft Ability Hack into the broader diversity, access and inclusion agenda implemented by the company increases the likelihood of the projects produced by employees and students being brought to market. The scale of the project allows for hack to be stored and 68 distributed, and an analysis of what facilitates success to be offered. This incentive program encourages the development of technological solutions for people with disabilities to improve their quality of life and better integrate them into society, the community, and the labor market. Mentoring includes support for go-to-market efforts, research and regulation strategy, finance and funding processes, alongside any other challenges the entrepreneurs identify. The designs and instructions that the makers create are then available for distribution and fabrication locally. The poten al growth of virtual conferences and exhibi ons has been suggested as a way forward for bringing together widely and thinly spread communi es, as is the poten al of inves ng in dissemina on of research in a series of regional events, targe ng specific communi es. The use of social media to share and distribute findings and outcomes is also welcomed, but content needs to be curated and maintained for ease of access. Create open licensed training materials for use in both commercial and non-commercial ventures, to support capacity building in local languages Increase availability of open licensed digital content for early literacy and numeracy Increase availability and use of content crea on tools in different languages Support public and private sector localiza on of technologies that have proven impact in other se ngs. Encourage the private sector to build service offerings through open source products with seed funding and the use of universal service funds. The evidence produced through a study of available research suggests that there is considerable actual and poten al value in addressing the challenge of global literacy and numeracy by inves ng in technology to address individual needs. However, such an approach needs to consider ac on for access across the delivery chain and the suppor ng ecosystem. Interven ons should consider not only the technology to be used, but interven ons to build capacity around implementa on. The greatest single barrier to the impact of technology is the ability of teachers to use the tools provided in crea ve and meaningful ways. In this model, the benefits of universal design will support all students with benefits of scale and reduced pressure on teachers to make every accommoda on of needs on an individual basis. Maestre "A Pilot Study of the Use of Emerging Computer Technologies to Improve the Effec veness of Reading and Wri ng Therapies in Children with Down Syndrome". Mul media instruc on: the runaway train the spontaneously changes direc on and speed. Kim, Paul, Elizabeth Buckner, Hyunkyung Kim, Tamas Makany, Neha Taleja, and Vallabhi Parikh. Launching StoryWeaver Hindi: "A fun, exci ng YouTube channel where you can now watch your favorite stories!
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The parallel Engels draws between production and pro creation as determining forces in history requires some emenda tion medicine jobs purchase genuine hydrea line. Sex 6 medications that deplete your nutrients discount hydrea 500mg, however medications on airline flights hydrea 500mg generic, is almost always engaged in for pleasure or to relieve bodily tension. For the greater part of human history the link between sexual intercourse and paternity was not even known. Beyond this, sexual desire, which makes its appearance in early childhood, precedes the possibility of procreation in the life of everyone. Consequently, as a material need, as a subjective aspect of the "real individual," sex is essentially the drive for sexual pleasure. To grasp the latter admission in the proper per spective one must replace the causal model into which it is often forced with a dialectical one. On the basis of the dialectic, mutual interaction (or reciprocal effect) exists between all elements in reality. His claim regarding the primacy of economic factors is an empirical generalization based on a study of real societies, and not an a priori truth about the Introduction xxii world. Consequently, Marx himself could call attention to the predominant role that war and conquest seem to have played in the development of ancient societies, and Engels could say that before the division of labor reached a certain point, kinship groups bore the chief responsibility for determining social forms. Basing himself primarily on the anthropology of Malinowski, Reich emphasizes the importance of the marriage dowry (arranged as a form of tribute between previously warring primal hordes) in establishing both clan exogamy and the incest taboo; whereas Engels, under the influence of Morgan and Darwin, attributes both developments to natural selection. Marx had mentioned sex as a natural and human power, as a way of relating to nature, along with eating, seeing, working and many other human conditions. He did declare, as we saw, that the quality of the sexual relationship offers the clearest insight into the degree to which man the animal has become a human being. For very different reasons, Marx and Freud had underestimated the influence on character and social devel opment of the area of life investigated by the other. Sartre has recently remarked that most Marxists treat man as if he were born at the time of applying for his first job. Though they overlap, these two ways of dividing time are not fully integrated, either conceptually-so that one is forced to think of one or the other-or practically so that followers of Marx and Reich often dismiss economic or psychological factors (depending on the school) in accounting for social change. This contrast between the two thinkers is nowhere so clearly drawn as in their treatment of contradictions. So it is that attracting more and more workers into towns to reproduce the conditions necessary for the production of capital results eventually, through social activity and combina tion, in the abolition of competition between workers which is a necessary condition for the production of capital. For Marx, the content of contradictions is always provided by the particular society in which their resolution takes place. As a kindred thinker to Marx, Reich too is particularly attuned to contradictory tendencies in the material he examines. Introduction xxiv Yet, with few exceptions, the contradictions he believes will be resolved in capitalism possess a content that is derived from patriarchal society as such. This is the case with the contradiction between repression strengthening marriage and the family nd, in virtue of the sexual misery caused, undermining them; and likewise of the contradiction he sees between repression pro ducing a character structure which inclines youth to accept parental authority (and by extension all forms of authority) and simultaneously provoking sexual rebellion against parents (and by extension all forms of authority). Without roots in the particular society in which they are found (capitalism), it is not altogether clear how these contra dictions contribute to the demise of this society, nor why its demise will necessarily lead to the resolution of these contradic tions. And adding that repression is greater in the capitalist era does not solve the problem. Even sexual alienation is affected, for to the extent that its peculiarly capitalist features are over shadowed by patriarchal ones it becomes, for the time span with which Marx is concerned, an ahistorical phenomenon. Thus, a form of sexual alienation, as Reich was forced to admit, could exist even in the Soviet Union, still a patriarchal society. He himself offers a good example of the alternative when he speaks of the capitalist economy fostering family ideology while simultaneously undermining it through inner family tensions caused by unemployment and forcing women to go to work. In this way, that is, through the operation of typical capitalist trends, the family whose ideological function is necessary to capitalism is rendered increasingly dysfunc tiona1. Marxists have always managed better to explain the transi tion from slavery to feudalism and from feudalism to capitalism than to explain the onset of class society and, as events show, its eventual replacement by communism. And, conceptually, from a patriarchal social relation, sexual re pression must be broken down into slave, feudal, capitalist and even "socialist" social relations, in order to capture its special contribution to each period as well as the opportunities available in each period Jor its transcendence. Reimut Reiche, in his book Sexuality and the Class Struggle, argues that the spread of sexual education, the avail ability of birth control pills and abortions, the easy access to cars (if not rooms) in which to make love, etc. The market has been able to absorb even these needs, turning their satisfaction into a profit able business venture for some section of the capitalist class. For him, the focus of interest has changed from finding out why sexuality is being denied to discovering how in the very means of its satisfaction it is being manipulated to serve the ends of the capitalist system. A recent poll of eighteen-year-old college students in the United States, for example, shows that 44 percent of the women and 23 percent of the men are still virgins, and one expects that a far greater percentage have known only one or a Introduction xxvi few encounters. As for capitalist reforms blunting the revolutionary edge of sexual protest, it must be admitted that this can happen. What remains to be seen, however, is whether the new contradictions embodied in these reforms simply make the old situation more explosive. At what point in making marriage un necessary for sex will young people stop getting married in order to have sex When will the rebellion that has known some success in sexual matters be directed against intolerable condi tions elsewhere Put in Reichian terms, how long could capital ism survive with a working class whose authoritarian character structures have b een eroded through modifications in their sexual lives The origins of the March Twenty-second Movement in France illus trate this point well. In February 1 967, the French Trotskyist, Boris Frankel, spoke on Reich and the social function of sexual repression to a crowd of several hundred students at the Nanterre branch of the University of Paris. I can personally attest to the enthusiastic response of the audience, for I was there. The same struggle is being repeated with local variations at universities and even high schools throughout the capitalist Introduction xxvi i world. Generally lacking, however, is the clear consciousness of the link between restrictions on sexual liberty and the capitalist order that one found at Nanterre. M arx also says that the forces of production have their subjective side, which is the "qualities of the individuals," and refers to the "communal domestic economy" which replaces the family in communist society as a "new productive force. The integral I 9 2 9 text may be consulted in English in Studies on the Left for July-August 1 9 6 6; t h i s translation of the I 934 edi tio n is based on it. All of the footnotes added in 1 9 34 are so annotated by Reich him self; and the final section, a response to left-wing critics, such as S apir and Fromm, and to the pattern of the experience g ained since I 9 2 9, was added in 1 9 3 4. Fo rewo rd to the 1 9 3 4 E d i ti o n this first comprehensive view of the connections between dialec tical materialism and psychoanalysis, written in 1 9 27-28, was published in 1 9 29 by the journal Under the Banner of Marxism in the Russian and German languages. A French-language ver sion is included in my book La crise sexuelle (Paris, 1933). The Sex-Pol Press has now arranged republication of the treatise as a separate brochure, due to the considerable interest shown in it.
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Writing as a physician interested in the mind symptoms 9dp5dt buy generic hydrea 500 mg on-line, Cartwright suggested that white owners seek to medicine to reduce swelling safe hydrea 500mg make good impressions on men and women and children purchased at auction symptoms lactose intolerance discount 500 mg hydrea amex. He explained: coming therefore to a new and strange country, among stranger Negroes and finding that they had plenty to eat and only moderate work to perform and had an impartial protector in their overseer, who would see that they were not imposed on, they as a matter of fact will naturally become contended and happy and, when they get sick, that happy and contented vein of humor running through them will often keep them up, through hard spells of sickness that would kill dejected, desponding and dissatisfied Negroes. In every way, to be "Black" meant, prima facie, to be a combination of the deviant, the criminal and the poor. Bockoven argues that "the greatest requirement of all [in moral treatment] was that the physician spare no effort in gaining the confidence and good will of his patients and strive to discover their experiences and supply their needs. The rural land proved cheaper places upon which to build, however seclusion stimulated public intrigue. His observations were regarded generally to be as insightful about American thinking as they were about his official charge to describe prison conditions. Once New York devised the "Auburn system" of prison organization it led to the creation of Auburn State Prison (1819-1823); then to Ossining Penitentiary (commonly known as "Sing Sing"); Pennsylvanians devised their own system and implemented it in Pittsburgh (1826) and in Philadelphia (1829); Connecticut built Wethersfield Penitentiary (1827) and Massachusetts reformed Charlestown Penitentiary (1829). Maryland (1829) and New Jersey (1830) also build prisons; Ohio and Michigan built penitentiaries in the 1830s and Indiana Wisconsin and Minnesota built state penitentiaries in the 1840s. Of principal interests was the work of Edward Livingston to erect a penal code for the state of Louisiana. Livingston knew and corresponded with Jeremy Bentham as well as other continental legal theorists. See David Brion Davis, "The Movement to Abolish Capital Punishment in America, 1787-1861," the American Historical Review 63:1 (October 1957): 31-32 5 318 whites Tocqueville discerned that "The Americans of the South of the Union have discovered more intellectual securities for the duration of their power. Walter Johnson has argued that, "Using the ideological imperatives of slave-holding culture-whiteness, independence, rationality, necessity, patriarchy, honor, paternalism-they [white people] produced, in the classical formulation, freedom out of slavery. I propose that the prevailing logic in the management of slaves was scientific and not rhetorical. Managing any inmate or captive population presented logistical challenges and in the nineteenth century moral managers of all stripes looked to scientific concepts like physiognomy, phrenology and ethnology to under-gird their principles of moral management. Certainly for Cartwright, the science in medicine influenced heavily his concept of the proper regulation of captive laborers. When science gets applied to populations, to what populations does it get applied and how I suggest that science under-girded the establishment and day-to-day regulation of large-scale labor-based reform institutions- spinning mills, plantations, asylums and prisons - that proliferated during the early to middle nineteenth century. I focus specifically on how science concepts were used in the "moral management" of blacks, slave and free. Scientific travel narratives and ethnological observations were 12 13 Alexis de Tocqueville, Democracy in America 1, (Vintage Edition, 1990), 379 Johnson, Soul By Soul, 116 319 the scholastic modus operandi of the Plantation Handbooks on "moral management" of blacks in the United States, the West Indies and throughout the Caribbean. The entire field of "Negro Diseases" was replete with empirical statements; claims culled from the traditions of natural history and taxonomy about the manners, morals and habits of the populations to-be-controlled. Just as racial classification is evaluation, so too is the discussion of "Negro Management" via "Plantation handbooks" evidence of applied science. Torpidity15 of body and hebetude of mind16 are the effects thereof, which disappear under bodily labor, because that expands the lungs, vitalizes the blood, and wakes him up to a sense of pleasure and happiness unknown to him in the vegeto-animal or hibernating state. Both the Association and its Journal sustained that there were fundamental, natural distinctions between blacks and whites that prevented them from receiving similar political or medical treatment. The Association of the Medical Superintendents, organized in 1844, had membership composed exclusively of heads of asylums. David Rothman argues, "Institutional affiliation, not research or private practice, defined the profession. Just as there was a committee on architectural construction and the population capacities of various institutions, the committees also presided over "separate structures for colored persons" and the "best role of chapels and chaplains" in asylum construction. Rothman claims that, "Before the civil war, practically no one in the United States protested the simple connection between insanity and civilization. But rather than point with pride to these attitudes or achievements, they saw only the most pernicious effects. England provided an example of the birth pangs of Originally founded in 1844, this organization was later named the American Psychiatric Association, the first association of professional physicians in the U. The American Medical Association was founded in 1847 20 Rothman, the Discovery of the Asylum, 134 21 On architectural considerations based on housing blacks vs. Rothman argues, "A logical deduction from this doctrine was that primitive communities ought to be free of the disease, and so although writers cited only the crude observations of travelers and adventurers for proof, the popular idea went unchallenged. He viewed that if the British enslaved Africans as divinely decreed, then they could erase their poverty and embolden their indigent classes: "all those negroes who have no masters to take care of them, and all those white people who have no slaves to work for them, but make negroes of themselves by doing drudgery-work. Reformer Dorothea Dix traveled the entire United States advocating that state legislatures fund mental asylums and, testifying before U. Congress, she observed that "those tracts of North America inhabited by Indians and the sections chiefly occupied by the Negro race produce comparatively few examples" of insanity. Sanford Challaie, an official of the insane asylum at Jackson, Louisiana and specialist in medical jurisprudence reported to the legislature that slaves did not lose their minds because of "the protection that the law guarantees to them, the restraint of a mild state of servitude, [and] the freedom of all anxiety respecting their present and future wants. Winterbottom declares that among the African tribes near Sierra Leone, "a mania is a disease which seldom if ever occurs. Prichard and his Dorothea Dix, "Memorial Praying a Grant of Land for the Relief and Support of the Indigent Curable and Incurable Insane in the United States," 30th Congress, 1st session, (1848) 29 Dr. This observation was made by Von Humboldt, and it has been confirmed by travelers who in late times have made the most accurate researches into the history if the tribes in the interior of this continent, and particularly by the scientific men who were sent by the government of the United States in 1819, on the expedition from Pittsburgh to the Rocky Mountains. Prichard argued: "If there were as great a proportion of individuals predisposed to insanity in a nation of Negroes as Americans as in England or France, it is difficult to suppose that the disease itself would either not exist or be a rare phenomenon, nor could the existence of idiots have escaped the observation of travelers, who were scientific men and physicians, if there had been as many in Guinea or in Louisiana as there are in Wales and Scotland. Cartwright felt it was his duty to investigate the research problem he claimed to inherit: What to do with the Negro As he framed it, Washington and Jefferson formed the very basis of his research questions into "Negro Diseases and Peculiarities. Rules for the treatment of patients differed depending on the treatment outcomes desired. For Pinel and the generations of medical practitioners he influenced, treatment outcomes were both curative (an end unto itself) and productive (a means to a further end). French physician Philippe Pinel first described moral treatment in his groundbreaking Treatise on the Medical and Philosophical cause of mental Disease and Mania published in 1801. Fusing moral and slave management, Cartwright asserted that: the extension of the cotton and sugar culture, so far from being misfortunes to the slaves, has tended, more than anything else, to ameliorate their condition; because the product of their labor is thereby sufficiently valuable to enable their masters to supply them with all the necessary comforts of life being prompted thereto, if not by humanity, by the motives of interest. From these "motives of interest," just as an asylum patient was to be reinserted into society as a functioning member and returned his or her rights and privileges as citizens, so too should a slave take up his or her position in society as a well-cared for, productive laborer. Cartwright thought it necessary to provide a theoretical framework for what had been only a series of ill-described behaviors called "rascality," but behaviors that were getting in the way of profits. In order to encourage a male-dominated slave force to work harder under increasingly dangerous conditions some plantation Cartwright, "How to Save the Republic," 189 Ibid.
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A sequence is a recognized pattern that results from a single preexisting abnormality; that is medications heart disease order hydrea 500mg, a sequence refers to treatment 6th feb cardiff order hydrea 500 mg amex the combination of a primary defect along with its secondary structural changes medicine rising appalachia lyrics order genuine hydrea. Examples of this include the Pierre Robin sequence and the oligohydramnios sequence. The Robin sequence is characterized by the triad of micrognathia, cleft palate, and glossoptosis. In this disorder the primary defect is the micrognathia and this leads to the secondary structural changes. In the oligohydramnios (Potter) sequence the primary defect is the oligohydramnios (which may have several causes, such as renal agenesis) and this leads to the secondary structural changes seen as the classic facial appearance (flattened facies). A classic example of a disruption is rupture of the amnion in utero forming amniotic bands that can wrap around, compress, and possibly amputate arms or legs. Finally a deformation is an alteration of a normally formed body part by mechanical forces. For example, a prolonged breech presentation can dislocate the hip and produce a flattened, elongated "breech head. This later syndrome refers to a group of related disorders characterized by defects in collagen synthesis or structure. The skin in these patients is fragile and hyperextensible, while the joints are hypermobile. It is the most common lethal genetic disease that affects Caucasian populations in the United States (1 in 3200 live births), but is rare in African-Americans (1 in 15,000 live births) and Asians (1 in 31,000 live births). The probability that a child will inherit a particular gene found on only one chromosome of a chromosome pair from one parent is 1 in 2. This is the same probability (25%) that a child will inherit a normal gene from both parents, that is, the child is homozygous normal. The remaining possibility, which is 50%, is the chance that a child will be a heterozygous carrier of the disease. This can be seen in the following Punnett Square where "C" is the normal gene and "c" is the abnormal gene. Also note that with autosomal recessive disorders one-third of normal appearing offsprings are homozygous normal noncarriers and two-thirds are heterozygous carriers. The principle, which assumes random mating, states that given gene frequencies p (for an allele A) and q (for another allele a), then the aa genotype (homozygous) is q q and the Aa genotype (heterozygous carriers) is 2pq. Diagnosis requires biopsy demonstration of excess liver glycogen plus either absent or low liver glucose-6-phosphatase activity, or a diabetic glucose tolerance curve, or hyperuricemia. The lack of sphingomyelinase in type A is the metabolic defect that prevents the hydrolytic cleavage of sphingomyelin, which then accumulates in the phagocytic cells of the liver (causing hepatomegaly), spleen (causing splenomegaly), lymph nodes (causing lymphadenopathy), and bone marrow. In the brain ballooning degeneration of neurons is diffuse, and a "cherry-red spot" of the retina may be present. Patients who have the type A form usually show hepatosplenomegaly at 6 months of age, progressively lose motor functions and mental capabilities, and die during the third year of life. Type B is characterized by organomegaly, but lacks the involvement of the central nervous system seen in type A. These patients are prone to development of subluxation of the spine, which can produce quadriplegia. Many lysosomal enzymes in these patients, such as acid hydrolases (which includes glycoprotein and ganglioside sialidases), do not reach the cellular lysosomes and are instead secreted into the plasma. These cytoplasmic inclusions are lysosomes that are swollen with many different types of contents. I cell disease is a slowly progressive disease that starts at birth and is fatal in childhood. Alkaptonuria (ochronosis) is caused by the excess accumulation of homogentisic acid. This results from a block in the metabolism of the phenylalanine-tyrosine pathway, which is caused by a deficiency of homogentisic oxidase. Excess homogentisic acid causes the urine to turn dark upon standing after a period of time. Infants are normal at birth, but rising phenylalanine levels (hyperphenylalaninemia) result in irreversible brain damage. A lack of the enzyme fumarylacetoacetate hydrolase results in increased levels of tyrosine (tyrosinemia). Chronic forms of the disease are associated with cirrhosis of the liver, kidney dysfunction, and a high risk of developing hepatocellular carcinoma. Maple syrup urine disease is associated with an enzyme defect that causes the accumulation of branched-chain -keto acid derivatives of isoleucine, leucine, and valine. Albinism refers to a group of disorders characterized by an abnormality of the synthesis of melanin. Two forms of oculocutaneous albinism are classified by the presence or absence of tyrosinase, which is the first enzyme in the conversion of tyrosine to melanin. Albinos are at a greatly increased risk for the development of squamous cell carcinomas in sun-exposed skin. The General Pathology Answers 135 number of chromosomes found in germ cells (23) is called the haploid number (n), while the number of chromosomes found in all of the remaining cells in the body (46) is called the diploid number (2n). Interestingly, they are also associated with abnormalities of the placenta, including cystic villi and partial hydatidiform moles. Triploid karyotypes are usually due to double fertilization of a haploid ovum by two haploid sperm, that is, there is a total of 69 chromosomes, 46 of which are from the father. Do not confuse triploid with trisomy; the latter refers to the presence of three copies of one chromosome, which results in 47 chromosomes. Nondisjunction is the failure of paired chromosomes or chromatids to separate at anaphase, either during mitosis or meiosis. Nondisjunction during the first meiotic division is the mechanism responsible for the majority of cases of trisomy 21. An isochromosome results from abnormal division of the centromere along a transverse plane. In contrast, deletion of both ends of a chromosome with fusion of the damaged ends produces a ring chromosome, while two breaks occurring within a single chromosome with the reincorporation of the inverted segment produces an inversion. Finally, a reciprocal translocation between two acrocentric chromosomes is characteristic of the Robertsonian translocation (centric fusion), which results in the formation of one large metacentric chromosome and a small chromosomal fragment, which is usually lost. Nondisjunction during mitosis 136 Pathology of a somatic cell early during embryogenesis results in mosaicism in about 2% of patients with Down syndrome. Translocation of an extra long arm of chromosome 21 causes about 5% of Down syndrome cases. An important type of translocation, the Robertsonian translocation (centric fusion), involves two nonhomologous acrocentric chromosomes with the resultant formation of one large metacentric chromosome. Carriers of this type of translocation may also produce children with Down syndrome.
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The condition of a lymph node often reflects health of the area from which it receives lymph medications 2 generic hydrea 500 mg without a prescription. If a specific area is infected treatment zamrud discount hydrea 500 mg otc, the lymph nodes in that area tend to treatment jones fracture order hydrea enlarge as the germinal centers begin producing additional lymphocytes in response to the antigens delivered to the node. For example, a horse with strangles, a bacterial infection of the nasal cavity and pharynx, frequently shows enlargement of the mandibular and retropha- ryngeal lymphocenters. The lymph nodes at these locations receive their afferent vessels from the nasal cavity, mouth, and pharynx. Neoplastic (cancerous) cells may spread throughout the body by way of the lymphatic channels; this is metastasis. When a tumor (cancer) is removed surgically, it may also be necessary to remove the regional lymph nodes draining the cancerous area to prevent further spread of the condition if it is suspected that neoplastic cells have infiltrated the nodes. The meat inspector uses his or her knowledge of the lymphatic system to determine whether a given part of a carcass should be condemned. An enlarged node may indicate infected or cancerous tissue in the region of the body draining to the node and necessitate condemnation of all or part of the carcass. Hemal nodes are small dark red or black nodes in cattle and sheep, usually in the dorsal parts of abdominal and thoracic cavities. Selected Lymph Nodes (Lymphocenters) of Cattle Name of Node Mandibular Parotid Retropharyngeal Deep cervical Superficial cervical (formerly prescapular) Axillary Mediastinal Intercostal Sternal Bronchial Lumbar Iliosacral Celiac Cranial mesenteric Subiliac (formerly prefemoral) Superficial inguinal (scrotal or mammary) Ischiatic Popliteal Location Intermandibular space Rostroventral to external meatus of ear Dorsal to pharynx Dorsolateral to trachea, divided into cranial, middle, & caudal groups Cranial to shoulder joint On medial aspect of shoulder near brachial plexus Within the mediastinum, divided into cranial, middle, and caudal groups Between ribs near thoracic vertebrae Deep surface of sternum Associated with major bronchi Group of nodes around aorta at level of last thoracic and first few lumbar vertebrae Group of nodes around terminus of abdominal aorta Group of nodes around origin of celiac a. Cranial to thigh in flank region Bulls, cranial to external inguinal ring; cows, dorsocaudal part of udder Group of nodes lateral to sacrotuberous ligament Caudal to stifle joint course of small blood vessels and have blood within their sinuses. It is attached to the stomach either directly by connective tissue, as in the ruminants, where it adheres closely to the rumen, or by the gastrosplenic ligament. Extensions of the capsule, trabeculae, penetrate into the interior of the organ, forming a connective tissue framework. The shape of the spleen varies considerably from one species to another, being long and thin in the pig, oblong in cattle, and sickle-shaped in the horse. The parenchyma (substance) of the spleen consists of red pulp and white pulp. The white pulp is lighter colored, as it is composed largely of lymphatic nodules, which are constructed much like the follicles of lymph nodes. The association of blood capillaries with the white pulp ensures that blood will be exposed to populations of immune cells. In addition to important immunologic functions, the spleen functions as a storage area for red blood cells, so the size of the spleen varies from time to time even within a given individual, as well as from species to species, depending on the number of red blood cells in the spleen at a given time. The spleen is also an important site where senescent (old and wornout) red blood cells are removed from the circulation, broken down, and their iron stored. These blood-related functions are associated with the red pulp of the splenic parenchyma. The spleen can be removed (splenectomy) without significant impairment to a mature animal. Tonsils In the most traditional sense, a tonsil is an unencapsulated aggregate of lymphatic nodules associated with the pharyngeal mucosa. These aggregates lack afferent lymphatic vessels, instead relying on their proximity to the epithelial surface to make contact with antigens. Many tonsils are characterized by deep invaginations on their epithelial surfaces called crypts, which presumably increase the surface area for contact with lymphatic tissue. Although the word tonsil is usually reserved for the lymphatic organs associated with the pharynx, identical histological elements are found in the mucous membranes of the prepuce and vagina and in the submucosa of the intestinal tract. Thymus the thymus is an organ of immature animals, undergoing involution at puberty, although never completely disappearing. It lies cranial to the heart, with portions extending along the trachea craniad into the ventral neck. The connective tissue components of the thymus form a loose areolar network that divides the organ into grossly visible lobules. Whether or not the blood is oxygenated, vessels that carry blood away from the heart are called arteries, and vessels that carry blood toward the heart are called veins. Circulation to the lungs (pulmonary circulation) is functionally and anatomically separate from circulation to the rest of the body (systemic circulation). Conceptually, it is therefore useful to regard the heart as two separate pumps housed within the same organ; one is a low-pressure pump that directs blood returning from the body to the lungs. The base is directed dorsad or craniodorsad and is attached to other thoracic structures by large arteries, veins, and the pericardial sac. The apex of the heart is directed ventrad and is entirely free within the pericardial sac. The surface of the heart is covered with visceral pericardium, which the pericardial space separates from the parietal pericardium. The parietal pericardium is attached by fibrous tissue to overlying pericardial pleura (not shown). Pericardium the heart is partially surrounded by a serous membrane called the pericardium. The pericardium, like other serous tissues (the pleura and peritoneum), creates a closed cavity (the pericardial space) that contains only a small amount of fluid for lubrication. The heart is invaginated into the pericardium much like a fist thrust into an inflated balloon (see. The inner layer, which is intimately adherent to the outer surface of the heart, is called visceral pericardium, or epicardium. The outer layer, called parietal pericardium, is continuous with the visceral layer at the base of the heart and is reinforced by a superficial fibrous layer (the fibrous pericardium), which in turn is covered by a layer of mediastinal pleura (also called pericardial pleura). The parietal pericardium, fibrous pericardium, and mediastinal pleura together form the pericardial sac, which is grossly identifiable as a thin but tough tissue surrounding the heart. In cattle, the apex of the heart contacts the dome of the diaphragm, and the reticulum in the abdominal cavity lies on the caudal side of the diaphragm. Sharp metallic objects (most commonly, bits of wire) that are swallowed often accumulate in the reticulum. The contractions of this organ can cause these foreign bodies to penetrate the adjacent diaphragm and the pericardial sac, resulting in an infection of the sac called traumatic pericarditis, one manifestation of hardware disease. The tissues of the pericardium thicken, and fluid builds up within the pericardial sac, which leads to heart failure in affected cattle. Cardiac Anatomy the heart wall consists of three layers: an outer serous covering called epicardium, an inner endothelial lining called endocardium, and a thick muscular layer called myocardium. The endocardium is a layer of simple squamous endothelial cells that lines the chambers of the heart, covers the heart valves, and is continuous with the lining of the blood vessels. The heart is divided into right and left sides, which correspond to the low-pressure (pulmonary circulation) and high-pressure (systemic circulation) systems mentioned earlier. Each side has two chambers: an atrium, which receives blood by way of large veins, and a ventricle, which pumps blood from the heart through a large artery.
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Demonstrate the ability to medications in carry on generic 500 mg hydrea with amex write appropriate educational and behavioral goals and objectives medications like abilify order line hydrea. Demonstrate skill in curricular planning and implementation for academics medications with pseudoephedrine cheap hydrea 500mg on-line, socialization, play, imagination, communication and independence. Demonstrate the ability to use discrete trial data in the design and/or modification of services. Demonstrate knowledge of appropriate instructional levels and environments for students. Reflect knowledge of growth and development in curricular planning and expectations. Demonstrate the ability to assess and program services that support transition, vocational development and independence. Complete observation forms and reflections upon each visit for targeted population. Submit a completed, comprehensive portfolio demonstrating competencies obtained in the Autism Spectrum Disorders Add-on Endorsement Program. Share with classmates the skills they have enhanced/developed and the changes they have made in their classrooms as a result of the information acquired in this training component. Complete any other assessment procedure required by the instructor(s) providing the program. Complete all individual and group activities at a level of quality established by the instructor; and 3. Component evaluation will consist of instructor and participant assessment of how well component activities help participants to master competencies and objectives. Program Completion Satisfactory completion of all required training activities in each module/component and demonstration of mastery of all competencies within are required for program completion. Methods for determining a participant has obtained all the competencies required for the specialization area are addressed within the coursework requirements and reflected in the Matrix. The successful completion of each required course will document that the participant has attained the competencies and skills addressed in and specific to the course. Proof of successful course completion and the awarding of inservice points will be maintained by the district professional development office. At the conclusion of each course, each participant successfully mastering the competencies therein will be awarded inservice credit per the Master Inservice Plan. Upon successful completion of all four required courses, the professional development office will provide the participant with a Certificate of Completion noting that the participant has successfully completed the Add-on Endorsement Program: Autism Spectrum Disorder. Successful completion of each course, coupled with the submission of the portfolio, will be deemed adequate demonstration of competence. Competency Verification College and/or university coursework may be substituted for portions of the Autism Spectrum Disorder Add-on Endorsement requirement. Consideration will be given to students who have successful completion with a grade of B or better of a college/university course with verification from the district instructor that there is reasonable equivalence between the college/university courses and the district add-on courses. Decisions will be made at the local level, in collaboration with the district teacher certification office and the professional development office. Evaluation Plan the overall effectiveness of the Autism Spectrum Disorder Endorsement Program will be determined by participant assessment, training component assessment, and program assessment techniques using the strategies described below: 1. Individual participants will be evaluated based on competency acquisition as verified by the instructor in accordance with approved competency demonstration methods and criteria. Each training component will be evaluated by utilizing district staff development program procedures. The program will be assessed by participants; instructors; staff development personnel; and district exceptional student education administrative and supervisory staff to determine: program effectiveness, program efficiency in terms of management, operation, delivery and cost effectiveness. Additional evaluation procedures may be developed and implemented as needed by the district. Any program revisions resulting from these evaluation procedures will be reported to the Florida Department of Education. Participants, instructors, and district staff will evaluate the program in the following areas: Scope and sequence of courses Instructional materials Relevance to effective teaching and learning Adequacy of preparation for teaching assignment/study In addition, in order to assess overall effectiveness of the program, participants completing the program will be asked to complete an online exit survey which will provide feedback regarding the management and operation of program activities. Districts may be able to participate in Florida Diagnostic and Learning Resources System-sponsored courses that are offered free of charge. Staff development personnel will monitor administrator time and effort to ascertain intangible program costs. An annual review of the efficacy of the program will be conducted by Exceptional Student Education administration in the school district via continuous programmatic review of data collection previously noted above in Program Evaluation, Evaluation Plan. The carry-over effects of the training will be measured by direct observation, status of highly qualified personnel, and the provision of quality educational services. The data obtained in this continuous review cycle will be used to revise the program as necessary as well as to inform the next areas of professional development offered outside of the endorsement program. Participant files will include a copy of the Plan of Study, schedule of courses, and a timeline with a projected date for completion. Candidate Application and Admission the individuals designated above will share the process for application, admission, and verification of the Autism Spectrum Disorder Endorsement Program. Permanent substitutes with valid full-time Florida Temporary or Professional Education Certificates are eligible to enroll in the program. Enrollment preference will be given to educators who are currently classified as in need of Autism Spectrum Disorder Endorsement to meet employment requirements. Other participants will be admitted to the Program as part of their Individual Professional Learning Plan or to earn inservice credit for recertification purposes. Advisement Individualized advisement will be provided by the appropriate district personnel in collaboration with the course instructor on matters related to the endorsement offerings, training requirements, and progress toward completion of the Autism Spectrum Disorder Endorsement Program. The district will ensure that staff members are available to assist candidates with the initial program orientation, inservice training requirements, and progress toward successful program completion. Participants receive one inservice point for each clock hour of component participation, up to 60 hours per component. When participants have completed all program completion requirements thereby demonstrating mastery of competencies and objectives, program completion is verified. Transfer and Utilization of Credit (College or Inservice) Equivalent or higher content level college credit obtained from a regionally accredited institution of higher education with an approved Autism Endorsement Program may be used to satisfy component requirements. College course(s) are converted to inservice points with each semester credit hour equivalent to twenty (20) inservice points. Certification of Completion When participants have completed all program requirements thereby demonstrating mastery of competencies and objectives, program completion is verified. Since records are kept during each step of the Autism Spectrum Disorder Endorsement Program by district staff development personnel, a professional development tracking system, or other inservice tracking systems, documentation is easily accessed by district staff to verify successful completion of all components. Through the eLearning program management tool and email, facilitators and participants discuss implementation, and the facilitator becomes the gatekeeper for quality control. It is through this meaningful dialogue that learning is demonstrated and quality is maintained for all learners, no matter where they are located. The inservice components are appropriate for any teacher seeking renewal of a professional teaching certificate and, as such, they may be considered for the program as a third 3 priority. Other certified teachers who express an interest in the program may participate on a space available basis.