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By: S. Chris, M.A.S., M.D.

Professor, Osteopathic Medical College of Wisconsin

Forms of Authority-Weber described three kinds of authority: charismatic hypertension 4 mg purchase plendil paypal, traditional blood pressure medication nightmares order 2.5 mg plendil amex, and rational-legal arteria3d full resource pack purchase on line plendil. Charismatic authority cannot be transferred to another person, so it is inherently unstable as a permanent source of power. When a group shares customs, traditional authority may be fairly stable as it is commonly acknowledged. Modern governments are based on a system of rational-legal authority in which power is assigned to particular offices, and is defined and limited by a set of rules and procedures. The power is invested in the position, so that people lose their authority when they leave a position. Even presidents may lose their power if they are found to be abusing the authority of their office. Because authority is recognized as legitimate by others, it is the most stable type of power. Distinguishing Between Government and NationState-A nation-state consolidates power over a large geographical territory. The United States is a nation-state with the power of the states superseded by the power of the federal government. The nation-state is a fairly recent development; for most of human history dispersed groups have exercised self-government or regulation. Today almost every single person in the world is part of the more than 100 existing nation-states. The nationstate has the ultimate authority over its citizens, and only properly appointed state representatives may act on behalf of the nation-state. When the function of the government is separate from other social institutions, it is called the state. The emergence of the state, separate from the institutions of the family and religion, is associated with agriculture and industrialism which produce surpluses resulting in inequality among citizens. A Functionalist View of the NationState-According to functionalists, the nation-state is necessary for the smooth functioning of society. English philosopher Thomas Hobbes argued that people act according to their own selfish interests, and the state is necessary to control these selfish impulses. Similarly, Йmile Durkheim feared that the rapid social change brought by industrialism would produce conflict. Durkheim felt the state was necessary to provide centralized regulation or else people would undermine the social order as they attempted to act in their own self-interest. Functionalist Talcott Parsons also believed that a system of external controls was necessary in order for government to carry out the functions of mobilizing resources for the common good. A Conflict Perspective of the NationState-From a conflict perspective, the state exists to serve the interests of the elite. However, he argued that the state was inherently slanted toward the interests of the elite or privileged, unless it was replaced with a social contract through which all pledged obedience to the "common will," or the welfare of all. Karl Marx argued that the nature of society was determined by the relationship between those who own the means of production and those who do not. According to Marx, in industrial society fewer and fewer people own the means of production. Marx argued that the state served the interests of the ruling class or bourgeoisie by providing a means of controlling the proletariat. Control is achieved through the promotion of an ideology that encourages acceptance of the legitimacy of the system, rather than the exercise of force. Marx felt that the state would serve the bourgeoisie until the proletariat recognized its own selfinterests and created a revolution. A brief "dictatorship of the proletariat" would eventually lead to the final stage of historical development-communism. Under the communism envisioned by Marx, the state would serve a purely administrative role, and the control of resources would rest in the hands of the public. He did not foresee the difficulty of reducing the power of state bureaucracy and of persuading government officials to relinquish their power. Global Political Systems Globally, there are two polar types of government: democracy and totalitarian. Democracy-The classic conception of democracy, inspired by the ancient Greeks, was a form of self-government involving the political participation of all citizens. A second conception of democracy involves elected officials carrying out the wishes of the majority of citizens.

Otherwise: Failure to blood pressure zinc buy cheap plendil 2.5mg on line thrive Feeding problems Prolonged jaundice Constipation Pale blood pressure young adults cheap plendil 5 mg online, cold prehypertension and anxiety purchase plendil pills in toronto, mottled dry skin Coarse facies Large tongue Hoarse cry Goitre (occasionally) Umbilical hernia Delayed development Acquired Females>males Short stature/growth failure Cold intolerance Dry skin Cold peripheries Bradycardia Thin, dry hair Pale, puffy eyes with loss of eyebrows Goitre Slow-relaxing reflexes Constipation Delayed puberty Obesity Slipped upper femoral epiphysis Deterioration in school work Learning difficulties Figure 25. Early treatment of congenital hypothyroidism is essentialtopreventlearningdifficulties. Withneonatal screening, the results of longterm intellectual devel opmenthavebeensatisfactoryandintelligenceshould be in the normal range for the majority of children. Summary Congenital hypothyroidism · Isidentifiedonroutineneonatalbiochemical screening(Guthrietest) · Althoughpresentantenatally,treatmentstarted soonafterbirthresultsinsatisfactory intellectualdevelopment. There is an increased risk in children with Down or Turner syndromeandofdevelopingotherautoimmunedisor ders. Hypoparathyroidism in infants is usually due to a congenitaldeficiency(DiGeorgesyndrome),associated with thymic aplasia, defective immunity, cardiac defects and facial abnormalities. In older children, hypoparathyroidism is usually an autoimmune disor derassociatedwithAddisondisease. In pseudohypoparathyroidism there is endorgan resistancetotheactionofparathyroidhormonecaused byamutationinasignallingmolecule. Serumcalcium andphosphatelevelsareabnormalbuttheparathyroid hormone levels are normal or high. Other abnormali ties are short stature, obesity, subcutaneous nodules, short fourth metacarpals and learning difficulties. Treatment of acute symptomatic hypocalcaemia is withanintravenousinfusionofcalciumgluconate. The 10%solutionofcalciumgluconatemustbedilutedas extravasation of the infusion will result in severe skin damage. Chronic hypocalcaemia is treated with oral calciumandhighdosesofvitaminDanalogues,adjust ingthedosetomaintaintheplasmacalciumconcen trationjustbelowthenormalrange. Antithyroid peroxisomal antibodies may also be present which mayeventuallyresultinspontaneousresolutionofthe thyrotoxicosisbutsubsequentlycausehypothyroidism (socalledhashitoxicosis). The firstline of treatment is medical, with drugs such as carbimazole or propylthiouracil that interfere with thyroid hormone synthesis. There is a risk of neutropenia from antithyroid medication and all families should be warnedtoseekurgenthelpandabloodcountifsore throat and high fever occur on starting treatment. Medical treatment is given for about 2 years, which should control the thyrotoxicosis, but the eye signs maynotresolve. Radioiodine treatment is simple and is no longer considered to result in later neoplasia. Followup is always required as thyroxine replacement is often needed for subse quenthypothyroidism. Dehydra tion may follow a gastroenteritislike illness, from whichthechildrecoversuntilthenextepisode. Diagnosis this is made by finding hyponatraemia and hyperka laemia,oftenassociatedwithametabolicacidosisand hypoglycaemia. Cushing syndrome Glucocorticoidexcessinchildrenisusuallyasideeffect of longterm glucocorticoid treatment (intravenous, oralor,morerarely,inhaled,nasalortopical)forcondi tionssuchasthenephroticsyndrome,asthmaor,inthe past, for severe bronchopulmonary dysplasia (Box 25. Thisunwanted sideeffect of systemic corticosteroids is markedly reduced by taking corticosteroid medication in the morningonalternatedays. The dose of glucocorticoid needs to be increased by three times at times of illness or for an operation. Most obese children from dietary excess are of aboveaverage height, in contrast to children with Cushing syndrome, who are short and have growth failure. IfCushingsyndromeisapossibility,thenthenormal diurnal variation of cortisol (high in the morning, low at midnight) may be shown to be lost ­ in Cushing syndromethemidnightconcentrationisalsohigh. Pituitary adenomas are best treated by transsphenoidal resection, but radio therapycanbeused. However,as the prognosis for most patients depends upon the speedofdiagnosis,alldoctorsneedtobefamiliarwith their variable presentation and diagnosis. It is often assumedthatapreciseknowledgeofalargenumber ofbiochemicalpathwaysisnecessarytomakeadiag nosis, but in fact a more than adequate diagnostic approachcanbebasedonthecorrectuseofonlyafew screeningtests. Presentation An inborn error of metabolism may be suspected beforebirthfromapositivefamilyhistoryorprevious unexplaineddeathsinthefamily. Many affected children are fairhaired and blueeyed and some develop eczema and seizures.

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Minnie does not react with despair heart attack 85 blockage buy plendil 2.5 mg cheap, but seizes on the knowledge with pride blood pressure risks order plendil 10mg without prescription, dedicating her life to blood pressure medication omeprazole plendil 2.5mg fast delivery the improvement of African Americans, founding a school for freedpeople in the Reconstruction South. There she displays her courage and virtue, even as she is forced to confront the challenges posed by racist whites. As Minnie embraces her identity, she also provides an object lesson in racial improvement, one Harper uses to address a range of issues, from woman suffrage to community building, as well as the demand for racial equality. Shortly before the end of Reconstruction she published another serialized novel, Sowing and Reaping (1876­7), again in the Christian Recorder. In this novel, Harper ignored racial issues as such to focus on her strong interests in Christian morality and, especially, temperance. Such a focus on ``uplift' was itself to be an important element in Reconstruction-era fiction, as writers sought to inculcate what they saw as necessary virtues in developing African American communities. This focus is also apparent in at least some of the writing of Thomas Detter, a businessman who had made his career in California and Nevada since the 1850s. Detter wrote a number of short pieces, some in the abolitionist ``tragic mulatto' tradition. He also produced a pioneering short story, ``Uncle Joe,' a literary setting of an African American folk-tale. His most ambitious work, however, was a novella, Nellie Brown; or, the Jealous Wife (1871). The story focuses primarily on white characters, although Detter includes a few black servants who play an essential role in the plot. As the title indicates, the main character is Nellie Brown, a woman whose jealousy, combined with the bad influence of corrupt friends, nearly destroys both her marriage and her husband. It is a retelling of world history from the creation account of Genesis through the prophecies of the book of Revelation as a story of continuing conflict for world supremacy African American Narratives 281 between the two key kingdoms. Filled with mythological elements and personified forces, the narrative also sets the historical fight against slavery and prejudice, even denominational rivalries, within the rubric of the larger cosmic battle Blackson sets forth. Given the relatively small number of recovered works, it is difficult to generalize about Reconstruction-era literary activity on the part of African American writers. The Reconstruction era itself was a period of high hopes and real achievement for African Americans. Under the aegis of Reconstruction policies, African Americans had found many reasons for optimism. Participating effectively in politics, especially in the liberated Southern states, they could also perceive signs, at least, that prejudice was weakening. A wave of institution-building gave reason for hope, and helped to create the foundation for a growing middle class. Its ultimate goal was racial equality, and the assimilation of African Americans into the American mainstream. That goal underlay what might be called the genteel protest inherent in the kinds of characters and stories such writers as Collins and Harper created, and the emphasis on ideals of virtue in their works, and those of Detter. The post-Reconstruction period, from 1877 to 1914, was to see both new possibilities and new complications for African American literature. At the same time, Reconstruction policies at the national level were being steadily abandoned after 1877, initiating a significant decline in the fortunes of African Americans through the early years of the twentieth century. In the South, where most lived, this decline was marked by disfranchisement and the development of a ``Jim Crow' society in which virtually all institutions and facilities came to be segregated by law. Campaigns of violence and intimidation, including riots and the most gruesome forms of lynching, helped enforce the emerging segregated social and political order. Academic, scientific racism and notions of ``Social Darwinism,' which reached their highest level in the late nineteenth century, celebrated white superiority while asserting the innate intellectual and moral inferiority of nonwhite peoples. Especially important was that body of literature known as the ``plantation tradition,' including works by such writers as Thomas Nelson Page, Irwin Russell, and Joel Chandler Harris. Making broad use of dialect ­ a burlesque representation of African American folk speech ­ it helped to create images of African Americans as a simple-minded, dependent, childlike people, and of an Old South in which black people, loyal and devoted to their masters, had been happy and content as slaves. All these developments did much to shape the content and trajectory of African American writing.

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Kellogg: Our camp meetings are the greatest and most efficient mode of witnessing to blood pressure bottom number over 100 order cheap plendil online the truth and making it impressive arteria lacrimalis purchase genuine plendil line. The smaller children are gathered into a large tent blood pressure medication without food cheap plendil 2.5 mg with visa, and special instruction adapted to their years is given them. All these meetings are carried on in an orderly manner, and they have a telling influence. But now we see that the effort made after our camp meeting is more effective in holding the people than that which we gain while the meeting is in session. The afterwork secures from forty to fifty converts, and the experiences of these converted ones have a great influence upon their friends and relatives. But this is a very meager estimate of the work that has been done by our camp meetings in this country. This is presented to me as one of the best methods we can use to reach all classes. These camp meetings, into which were poured careful planning, money, and the best dedicated talent available, enriched the church in Australasia in converts from all classes, but often from among the experienced and the better educated. Thus were provided some who would enter the business operations and management of the various activities and institutions in a rapidly growing work. Few of these [428] converts were wealthy, but there was furnished a sound backlog of resources that was much needed. Thus evangelism, together with the training of the youth of the church in the Avondale school, very largely supplied the ministerial and related needs of the cause, such as literature evangelists and Bible instructors. Semmens, nurses trained at Battle Creek, opened a little medical institution in Sydney. Edgar Caro, of the New Zealand Caro family, having graduated as a physician at the American Medical Missionary College in Battle Creek, joined the forces in Sydney. The name of the institution was changed to the "Medical and Surgical Sanitarium" of Summer Hill (Australasian Union Conference Record, July 15, 1898). The Union Conference Record of January 15, 1899, carried the following notice: Sanitarium Training School for Nurses the Sanitarium school for nurses is an institution for the training of young men and women to engage in various lines of medical and other philanthropic work under the direction of regularly organized missionary boards of the Australasian Medical Missionary and Benevolent Association. As to what might be expected in training and financial arrangements, the notice stated: the Course: the course of instruction covers a period of three years, the terms commencing April 1 and October 1 each year. Remuneration: During the first year of the course, students receive uniforms and books, besides room, board, and tuition, and are required to work full time- ten hours each day. Rand joined the forces, bringing the medically trained staff to four-two physicians and two graduate nurses. God blessed the work carried by the dedicated personnel laboring with limited facilities in cramped quarters. Loughborough, and others sent some funds with which to make a beginning in the erection of a well-planned medical institution. This gave heart to all the workers and led to a forward-looking action of the Medical Missionary Association on April 27, 1899. Further steps in the development of the medical work can be seen in the annual report of the Sanitarium at Summer Hill, given at the July union conference session and recorded in the July 26 Union Conference Record: the matter of more suitable accommodation for the Sanitarium work was again very earnestly considered, and it was decided [on April 27] that in view of the encouraging prospect for means, we should proceed at once with preliminary steps. Morse were appointed a committee on location for a sanitarium and plans for the same. It was reported that at the end of June there were twenty-one employees in the little Medical and Surgical Sanitarium of Summer Hill. Firm Plans for Erecting a Sanitarium In connection with the union conference session held at Cooranbong, a formal meeting was held of the Australasian Medical Missionary and Benevolent Association on Thursday morning, July (1899) the Work in Australia Comes of Age 469 20 and recorded in the July 24 Union Conference Record. That we earnestly invite a hearty cooperation of our conferences and associations, and friends of our cause in general, in the erection and equipment of a medical and surgical sanitarium, to be located in the vicinity of Sydney; and that we suggest that this enterprise be undertaken according to plans for a building capable of accommodating one hundred patients. This was followed by two lengthy resolutions relating to finance, the opening sentence reading: That we undertake to raise the sum of Ј8,000 for the purpose named in the foregoing resolution. The resolutions appealed to the constituency for strong support and the exercise of self-denial and "strict economy, that all may have means to offer for this cause.

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To advertise the evangelistic meetings you generic 2.5 mg plendil fast delivery, which was a new thing for that area pulse pressure aortic regurgitation order plendil 10mg mastercard, a special camp meeting issue of the Bible Echo hypertension vision order plendil, dated October 15, was published. As they called on people, they gave a hearty invitation to attend the camp meeting and sold copies of the Echo. Some eight thousand copies were sold, and another eight thousand copies of the special cover, carrying an advertisement of the coming meeting, were given away. Daniells, conference president- one local conference at that time took in all of Australia-pointed out to believers, many of them new church members: (1894) the Ashfield Camp Meeting in New South Wales 191 There are many reasons why this meeting should be held, and why we may look for most excellent results. When God established His people Israel in the land of Canaan, He knew the temptations that would be brought to bear upon them, and as one of the safeguards against their being led into apostasy, He established three annual gatherings at which they were to meet together for praise and worship, to recount His mercies and His deliverances, and to encourage one another in the way of obedience. There are many educational advantages to be enjoyed at these general convocations, which to those persons who wish to become laborers with God in the work of uplifting fallen humanity will be of inestimable value. Therefore we say to our brethren, Prepare for the camp meeting; begin at once; work in faith, and let as large a number as possible receive its benefits. As church members came in on Friday, October 19, they found more than fifty white canvas family tents among and under the shade trees. The tents [167] were arranged in rows, with streets named after the Reformers, as was often done in America. Daniells spoke Sabbath morning, reading as his text, "Draw nigh to God, and he will draw nigh to you" (James 4:8). Far from boasting or calling attention to herself, but ever eager to know whether her ministry was effective, she wrote of her observation to O. Olsen concerning this Sabbath-afternoon meeting: One man whose hair is white with age said, "I never heard such preaching as that woman gave us since I 192 Ellen G. A large sign over the entrance to the enclosed grounds read, "Whosoever Will, Let Him Come" (Manuscript 1, 1895). In response to the advertising, Sabbath afternoon the attendance began to accelerate, and Ellen White reported to Olsen: On Sunday we had an immense congregation. The large tent was full, there was a wall of people on the outside, and the carriages filled with people in the street. The tents are a great surprise and curiosity to the people, and indeed, these white cotton houses interspersed among the green trees are a beautiful sight. White as she presented the love of God and its effect upon the heart and character. Ministerial workers watched with deep interest the size of the crowds attending the weekend and evening meetings. The large pavilion, which will accommodate from six to eight hundred persons, is filled every night, and sometimes there are two or three hundred standing outside. She listed the principal speakers as Pastors Corliss, Daniells, Cole, Colcord, Hare, Baker, and herself. From observation and from special insights divinely revealed, she understood the nature of the trouble. True, they had beautiful grounds well laid out; they had the best speakers who could be brought together; they had crowds of people exceeding in number their fondest hopes; but there were deep-seated problems not visible to the throngs on the grounds. Jealousies existed between key workers at the camp, and a spirit of criticism prevailed. Sunday night, in vision, she seemed to be laboring with them, "speaking to them under the influence of the Spirit of God, and pointing out the necessity of earnest work in our own individual cases if we would have the deep moving of the Spirit of God in our midst" (Manuscript 41, 1894). What took place Friday morning she reported in several letters and in her diary: this morning my work was in the large tent. The enemy seemed determined that I should not bear my testimony; there was not much vitality in the atmosphere, but I thought I would try. I then felt that Satan was trying to hinder me, and I went the third time, and the Lord gave me power to bear a decided testimony to those assembled, especially [169] 194 Ellen G. The power of the Holy Spirit came upon me, and I gave a decided testimony of reproof because of the lack of love and sympathy and courtesy toward brethren in the ministry. There is a sad dearth of real courtesy, sympathy, and tender regard and confidence. Writing further of the experience, she related: After breakfast I met with the ministers in the reception tent, and bore them a decided testimony, addressing them by name. Brother A confessed in a very tender spirit to Brother B, and Brother B confessed that he had not had that love and tender regard for his brethren that he should have had. From this time there was altogether a purer and more holy atmosphere in our meetings.

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