Condet

Warren J. Manning, MD

• Professor of Medicine
• Department of Medicine
• Beth Israel Deaconess Medical Center
• Boston, Massachusetts

The types of information that may be requested is shown in the Organization Environmental Impacts Checklist anti allergy medicine xyzal buy 200mdi beconase aq overnight delivery. Research in a location designated allergy ucsf order beconase aq 200mdi without prescription, or eligible to be designated allergy report generic 200mdi beconase aq mastercard, a registered historic place allergy symptoms difficulty swallowing generic beconase aq 200mdi overnight delivery. Where applicable, the box for "Historic Places" must be checked on the Cover Sheet. Appendices All information necessary for the review of a proposal must be contained in Sections a through i of the proposal. Special Processing Instructions Proprietary or Privileged Information Patentable ideas, trade secrets, privileged or confidential commercial or financial information, disclosure of which may harm the proposer, should be included in proposals only when such information is necessary to convey an understanding of the proposed project. If this method is used, the statement must be submitted as a single-copy document in the Proposal Preparation Module in FastLane. For proposers who qualify under this latter exception, the box for "Beginning Investigator" must be checked on the Cover Sheet. Collaborative Proposals A collaborative proposal is one in which investigators from two or more organizations wish to collaborate on a unified research project. All collaborative proposals must clearly describe the roles to be played by the other organizations, specify the managerial arrangements, and explain the advantages of the multi-organizational effort within the Project Description. Submission of a collaborative proposal from one organization the single proposal method allows investigators from two or more organizations who have developed an integrated research project to submit a single, focused proposal. Note, however, that if awarded, a single award would be made to the submitting organization, with any collaborators listed as subawards. Submission of a collaborative proposal from multiple organizations Simultaneous submission of proposals allows multiple organizations to submit a unified set of certain proposal sections, as well as information unique to each organization as specified below. All collaborative proposals arranged as separate submissions from multiple organizations must be submitted via FastLane. For these proposals, the project title must begin with the words "Collaborative Research:" If funded, each organization bears responsibility for a separate award. The requirement to check the box only applies to the 33 Proposal & Award Policies & Procedures Guide Detailed instructions for the preparation and submission of collaborative proposals are available in FastLane. The lead organization also must provide the requisite explanation/justification in the project description. These reports should reference the work of the collaborative, while focusing on the distinct work conducted at each funded organization. Note that for some types of vertebrate animals, additional review may be required. Sufficient information must be provided within the 15-page Project Description to enable reviewers to evaluate the: (i) (ii) (iii) (iv) (v) rationale for involving animals; choice of species and number of animals to be used; description of the proposed use of the animals; exposure of animals to discomfort, pain, or injury; and description of any euthanasia methods to be used. Projects involving the care or use of vertebrate animals at an international organization or international field site also require approval of research protocols by the U. If the project is to be funded through an award to an international organization or through an individual fellowship Guidelines to the use of Wild Birds in Research; Guidelines of the American Society of Mammologists for the Use of Wild Mammals in Research; Guidelines for the Use of Fishes in Research; and Guidelines for the Use of Live Amphibians and Reptiles in Field and Laboratory Research. For fellowship proposals submitted by individuals that involve the care and use of vertebrate animals, the proposal should contain the information specified in paragraph b. This site is an excellent resource regarding the conduct of human subjects research in an international setting. The eight categories of research that qualify for exemption from coverage by the regulations are defined in the Common Rule for Protection of Human Subjects. The letter should indicate approval of the proposed activities and must be submitted prior to an award being issued. If available at the time of proposal submission, the determination notice should be uploaded as an "Other Supplementary Document". If the determination notice is not available, and, the decision is made to fund the proposal, a signed copy of the determination notice must be provided to the cognizant program prior to award. Projects Requiring High-Performance Computing Resources, Data Infrastructure, or Advanced Visualization Resources Many research projects require access to computational, data and/or visualization resources in order to complete the work proposed. Typically, such resources will be noted in the proposal under Facilities, Equipment and Other Resources. Frontera is designed to support a small number (~50) of research teams involved with projects requiring the most advanced computational and data capabilities. The Office of Advanced Cyberinfrastructure within the Directorate for Computer and Information Science and Engineering oversees the allocation process for this system.

In addition to providing secure electronic capture of patient data allergy shots when sick purchase beconase aq 200mdi on line, computerized decision support systems can be useful in implementing evidence-based treatment for major depressive disorder (52) allergy treatment albany ny beconase aq 200mdi with amex. Integrate measurements into psychiatric management the integration of measurement tools into psychiatric management allergy testing northampton ma beconase aq 200mdi without a prescription, which has been referred to as measurement-based care allergy shots treatment duration generic beconase aq 200mdi otc, may enhance the quality of care and improve clinical outcomes (40). Clinician-rated and/or self-rated scales can help determine the trajectory of disease course and effects of treatment. Self-rated scales are convenient to use but require review, interpretation, and discussion with the patient. Systematic measurement of side effects can also assist in the provision of treatment. Several self-report rating scales have been developed for assessing side effects of antidepressant treatment and are available in English and Spanish versions. A clinician-administered scale, the Toronto Side Effects Scale, that focuses on antidepressant medication side effects is also available ww1. Major depressive disorder is often a chronic or recurrent condition that requires patients to participate actively in and adhere to treatment plans for long periods, despite the fact that side effects or requirements of treatments may be burdensome. Patients may have strong preferences for modality of treatment or medication choice, particularly if they or a family member have had past experience with the treatment or medication. During the acute phase, patients with major depressive disorder may be poorly motivated, unduly pessimistic about their chances of recovery with treatment, suffering from deficits in memory, or poorly caring for themselves. Practice Guideline for the Treatment of Patients With Major Depressive Disorder, Third Edition maintenance phase, euthymic patients may undervalue the benefits of and focus on the burdens of treatment. The psychiatrist should recognize these possibilities, emphasize the importance of adherence for successful treatment and prophylaxis, and encourage the patient to articulate any concerns regarding adherence. Patient and family attitudes about depression and its treatment can also influence adherence. Family members can play an important role in promoting optimism about treatment, assisting patients with adherence and providing the psychiatrist with input on side effects or other treatment-related concerns that may influence adherence. For example, patients in psychotherapy may experience increased anxiety as they confront fearful or difficult topics. This anxiety, in turn, may decrease adherence to psychotherapy, and patients may begin to arrive late to or miss therapy sessions. In patients who are beginning treatment with a medication, common side effects of medication options should be discussed. Patients should be involved in treatment decisions and encouraged to convey input on side effects that they consider reasonable or unbearable. Side effects such as weight gain, cognitive dulling, sexual side effects, sedation or fatigue, and agitation may represent different burdens to different individuals. Emphasizing the following specific topics improves adherence: 1) explaining when and how often to take the medicine; 2) suggesting reminder systems, such as pill boxes, alarms, etc. Behavioral tailoring, which involves developing an individualized approach to incorporating medication into the daily routine and can also include simplifying the medication regimen, has demonstrated efficacy for individuals with schizophrenia and may also be applicable to individuals with other psychiatric illnesses (54). Adherence may also be improved by minimizing the cost and complexity of medication regimens. Most antidepressant medications are available in generic forms, which are generally less costly. For individuals who cannot afford needed medications, some pharmaceutical companies offer patient assistance programs. Information on such programs is available from pharmaceutical company Web sites, from the Web site of the Partnership for Prescription Assistance 29. Provide education to the patient and the family Education concerning major depressive disorder and its treatments should be provided to all patients. Specific topics to discuss may include that major depressive disorder is a medical illness and that effective treatments are both necessary and available. This information may be especially important for patients who attribute their illness to a moral defect, or for family members who are convinced that there is nothing wrong with the patient. Education regarding available treatment options will help patients make informed decisions, anticipate side effects, and adhere to treatments. Patients with depression can become easily discouraged in treatment, especially if there is less than a full initial response. The psychiatrist should encourage and educate patients to distinguish between the hopelessness that is a symptom of depression and the relatively hopeful actual prognosis. Given the chronic, episodic nature of major depressive disorder, exacerbations are common.

In 2010 allergy forecast houston buy generic beconase aq 200mdi on-line, the most popular channels for selling e-cigarettes and their accessories directly to consumers were websites and third parties allergy medicine alternatives purchase beconase aq 200mdi, such as retail outlets (Linarch Information Solutions 2012) allergy medicine nausea 200mdi beconase aq visa. Many e-cigarette manufacturers and importers allergy warning label generic beconase aq 200mdi free shipping, including the big-brand companies and those supplying products to "vape shops," rely on distributors and retailers to deliver the products to the consumer (Linarch Information Solutions 2012). The emergence of e-cigarette devices and products resulted from the endeavors of a few entrepreneurs and widespread Internet and television advertising (Grana et al. It is noteworthy that the product class took hold when e-commerce was rapidly expanding in the United States, and major social media platforms- such as Facebook (founded in 2004), YouTube (2005), and Twitter (2006)-were emerging. In such an environment, information about a new product like e-cigarettes could be rapidly disseminated across geographic boundaries, and new products and technologies could be speedily adopted. This process is partly reflected by the Google search volume of queries related to e-cigarettes; the volume of queries surpassed those for nicotine replacement therapy products and snus by 2008 (Ayers et al. Manufacturers noticed the fast rise in consumer interest in e-cigarettes, so they quickly pushed to expand the sale of their products to brick-and-mortar retail stores. This growth coincided with a surge in marketing expenditures by the e-cigarette companies across all media platforms (Kim et al. The products sold in these conventional channels were predominantly disposable and rechargeable cigalikes (Giovenco et al. E-cigarettes were more likely to be available in retail locations in neighborhoods with a higher median household income and a lower percentage of African American and Hispanic residents; these sales patterns are consistent with patterns of use of these products observed among youth, young adults, and adults more generally (see Chapter 2). Notably, the price of conventional cigarettes and the existence of comprehensive smokefree laws were inversely associated with the availability of e-cigarettes (Rose et al. Unlike conventional retail outlets, "vape shops" sell a wide range of more complex and powerful tank-style e-cigarettes 150 Chapter 4 E-Cigarette Use Among Youth and Young Adults and many different types of liquids for e-cigarette devices (e-liquids or e-juices) (Sussman et al. First, in the past, most of these establishments offered a wide range of e-cigarettes and e-liquids, allowed users to sample different types of flavored e-liquids at no cost, and permitted the trial use of various types of e-cigarettes. Most of these establishments sell products made by independent companies, as opposed to products manufactured by the major conventional tobacco companies (Kamerow 2014; Sussman et al. As a result, "vape shops" can serve as an information hub where consumers can easily obtain knowledge about (and gain experience with) a wide range of e-cigarettes and related products (Sussman et al. However, the information provided may be misleading or misinterpreted (Cheney et al. Because of the diversity of these products, some of these establishments provided free samples of different flavored e-liquids and allowed trial use of different e-cigarettes before actual purchase in an attempt to compete with traditional retail outlets. Under the deeming rule published in May 2016, free samples of e-liquids containing nicotine were banned (Federal Register 2016). Some "vape shops" also host various events, including competitions (also known as cloud chasing), that build loyal customer bases by creating a sense of community and camaraderie among customers (Sussman et al. Additionally, a 2015 study of "vape shop" owners found that customers view the owners as important sources of health information, which could include information related to cessation (Cheney et al. However, the owners reported (a) obtaining their information from YouTube or industry sources but finding the research hard to understand and (b) looking for government sources but not finding them. Estimates of the number of "vape shops" in the United States have varied greatly due to the lack of a clear definition of what constitutes such an establishment. One high estimate is that in 2014 there were as many as 35,000 such shops in the United States (Kamerow 2014). Product Evolution E-cigarette products have evolved and diversified rapidly since they entered the U. Detailed information about different types of e-cigarette products has been presented elsewhere (Grana et al. Over time, with consolidation of e-cigarette companies and technological improvements, the manufacturing process has become more standardized, enabling the production of e-cigarette products with a more effective and more consistent dose and delivery of nicotine and flavorings, and a more consistent generation of aerosol (Goniewicz et al. Within each product type, there are many different brands, albeit the brands are often very similar. A study examining the growth of brands and flavors between 2012 and 2014 found that older brands were more likely to involve cigalikes, while newer brands were more likely to offer tank-style devices and mods (Zhu et al. As tank systems and mods become more popular, the distinction between a closed system and an open system becomes more important. In this case, the e-liquid is "locked in"; the amounts of e-liquid, level of nicotine, and flavors are dictated by the manufacturer. Because users cannot mix their own e-liquids or refill the cartridges or tanks, there is less risk of spillage, nicotine overdose, and accidental ingestion.

The Acropolis had such ceremonial and religious importance to the Greeks of Athens that the book called the Parthenon (New York: Newsweek allergy symptoms red face beconase aq 200mdi sale, 1973/i) allergy medicine and adderall quality beconase aq 200mdi, by Peter Green and the editors of the Newsweek Book Division allergy san antonio buy beconase aq 200mdi with mastercard, a book which has in it all sorts of color and black and white photographs of the Parthenon and other buildings of the Acropolis allergy symptoms lung congestion buy beconase aq 200mdi low price, might be of interest. Starting with the famous guidebook o ancient Greek cities, shrines, and other important places written by Pausanias during the second century A. Modern archaeological methods have, of course, increased the knowledge enormously during the past century and a half. Maxwell Brownjohn, is a well illustrated volume that would serve admirably as a guidebook were you to travel to Greece and the surrounding area. Praeger, 1969/i) is really a study of site planning by the ancient architects, but it fits well within the archaeological framework, as do its 456 black and white photographs. Five separate Greek and Roman myths, among others, and the archaeological and other evidence are dealt with by five authors in G. Many Greek and Roman Mythologies 177 photographic journey through those principal excavations. Books covering both Greek and Roman archaeology are fairly accessible in better libraries. The major work to seek out is the Princeton Encyclopedia of Ancient Sites (Princeton: Princeton University Press, 1976/i ed. It is large (over 1000 pages, plus maps), and it covers all the sites in world that date from the mid-eighth century B. These are official records of "digs" and are perhaps more technical and comprehensive than the myth student will want. Although there is not quite the spectacular array of books in English devoted to Roman archae,-logy that there is for Greek, there are some excellent sources. Norton, 1976/ip) is a fine, well illustrated survey of archaeological digs in Italy, Etruscan included. Garside and Sophie Wilkins (Ne- York: Bantam, 1972/ip; originally in a shorter hardbound edition published by Alfred A. Knopf, 1951), and Hands on the Past: Pioneer Archaeologists Tell Their Own Stories (New York: Alfred A. Knopf, 1966; Schocken Books, 1973/ip) are excellent companion volumes in which quite a few chapters relate to Greek and Italian finds. Much space is devoted to Greece and Rome in the Larousse Encyclopedia of Archaeology (London: Hamlyn, 1972/ i), ed. Works on Decipherment; Translations Since Gree:c and Latin have come down to us without the need for decipherment, only Linear A and Linear B have posed an important decirtherment problem for philok-gists. Linear A, still not deciphered, is a form of pictographic writing dating from about 1900-1500 B. It dates from around the thirteenth century Cambridge University Press, 1958/i) tells the full story of that decipherment and includes good illustrations of the writing. There is no shortage of available translations of works written in ancient Greece and Rome, all of the principal writings having been translated, and because all of the primary sources for the Greek and Roman myths are to be found among these works, all of the primary sources known still to exist in Greek or Latin have in fact been translated into Englishmost of the main ones many times over. Combellach, is a work you will want in addition to the Iliad and Aeneid as primary source for the Trojan War. Museums have also put out books and booklets in which works of art are used to illustrate the myths (or vice versa). Corbett, is a small book with 49 illustrations of vase paintings and relief sculptures based on Greek myth. A selected number of characters from the myths are dealt with through words and pictures of museum art pieces. Abrams, 1966(i) is a lovely book with close to 200 illustrations of Greek paintings and sculpture featuring scenes from myths. Brill, 1966/i) is a brief, well illustrated source of a more specialized sort that you may wish to look into when working with CybeleAttis. My own A Guide to PostClassical Works of Art, Literature, and Music Based on Myths of the Greeks and Romans (Logan, Utah: 1976/p; distributed by National Council of Teachers of English) is designed to put the user in contact with the main works in the later arts that have been based on Greco-Roman myths. It deals with adaptations in the arts based on the following myths: Perseus-Andromeda, DemeterPersephone, 137. Written by the curator of Greek and Roman art at the museum, it is based on the largest collection of Greek vases in the United States.

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