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Te author once had the opportunity to examine skeletal material recovered from a collapsed area of a long abandoned historic mine generic medrol 16mg with mastercard. Tough many of the bones were broken buy medrol 16 mg otc, it was impossible to know whether the two victims had expired from asphyxia discount 4 mg medrol fast delivery, dehydration, or the crushing efects of the collapsing shaf. It is important to consider that force applied to one part of the skeleton may be transferred, causing damage elsewhere. Shock from a hard landing may be transferred through the legs, damaging the bones of the pelvis or spine, and vertical loading of the spine from below has sometimes resulted in ring fractures of the skull base. A blow to the lef gonial angle may cause a hinge fracture of the right mandibular ramus when the head is arrested against an unyielding surface, and the same principle applies in the classic contrecoup skull fracture. Reconstruction of a shattered skull, though time-consuming, may provide information about the number and order of strikes, or reveal a pattern that suggests the nature or class of weapon used. In a recent case, the decedent’s skull was crushed by the right rear wheel of the vehicle from which she “fell. Reassembly of some eighty-fve fragments revealed three suspicious patterned injuries that later proved to have been caused when the victim was struck repeatedly with a socket wrench. It is essential that all fragments be examined carefully for transferred evidence or for a more detailed toolmark analysis. Experienced examiners will recall instances of wood splinters, glass fragments, bits of paint, etc. Occasionally, one encounters remains that bear blunt injury defects that appear to have been made by more than one kind of object. Such fndings may indeed represent the work of more than one assailant, but most ofen will have been caused by repeated application of the same object at diferent striking angles, the classic example being crescent and round depressions on a skull from application of the edge and fat face, respectively, of the same hammer. Te author once examined remains bearing several crescent depressions and one elongated full-thickness fracture on the skull, and a small rectangular punch- out on the sternum. Te lug wrench end, applied at an angle, produced the crescent frac- tures while the handle had created the elongated depressed parietal break as well as a defensive fracture of the ulna. Te nib, rectangular in cross section, was a perfect ft for the defect in the sternum. Other examples are provided by roofng hammers, ball peen hammers, single-bladed hatchets, etc. Where blunt force injuries are concerned, a three-dimensional imagination and an occasional stroll through the local hardware store are the examiner’s best analytical tools. Although, strictly speaking, the “fall following a coronary” cited above qualifes as postmortem trauma, the phrase is most ofen used to describe modifcations of remains that occur some time afer death. Forensic anthro- pologists will recognize several categories of efects stemming from natural and anthropogenic causes. As bones disarticulate, they may be scattered by water or wind, depending on the slope of the terrain and the amount of water running across it. Fluvial transport ofen results in damage to ribs and the delicate structures of the skull base, depending on water velocity and distance traveled. As bones dry, some of Forensic anthropology 155 the fat elements of the skeleton may warp and crack, producing damage that might be confused with injury. Similarly, buried remains subject to many cycles of wetting and drying may display breakage of ribs, spinous processes, and other efects. Te weight of soil above a collapsed cofn may produce damage to the rib cage or pseudotrauma in the anterior dentition or deli- cate bones of the maxillofacial area. Large and small mammalian scavengers leave characteristic dental markings, usually perpendicular to the long axis of a bone. When recover- ing scattered remains, it is wise to ask what kinds of animals inhabit the area. Some familiarity with the dentition and the characteristic patterns of scavenging of animals within the area of search is useful. One colleague wryly noted that “if one wants to fnd remains in a large feld, one has only to instruct someone to ‘brush hog’ or till the area. Te most problematic instances of anthropogenic damage are those that produce recovery and processing artifacts. Shovels and trowels in the hands of inexperienced investigators may induce what appear to be blade or chopping defects. Cases involving remains that have been intentionally disarticulated by knife, saw, etc. On these occasions the initial examiner must carefully note and describe any additional cuts that have been made with the autopsy saw for sampling or other purposes, lest these be confused with original marks made by the assailant. Although most anthropogenic arti- facts are easily distinguished from perimortem damage, they ofen provide a skillful cross-examiner with opportunities to confuse a jury, and at the very least, may call into question the skills of those responsible for the recovery and analysis of the victim. Many states operate databases and missing persons clearinghouses for their own jurisdictions. Still other databases specialize in a particular demographic segment of the national population, e. Te latter contains reference samples consist- ing of nuclear and mitochondrial markers from relatives of missing persons as well as mitochondrial and, usually, genomic markers from unidentifed human remains.

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Antimicrobial resistance is a global problem order 4mg medrol amex, and some of our most significant global threats are multi-drug resistant tuberculosis and drug-resistant malaria medrol 4 mg. Today buy generic medrol 16mg on-line, however, I will focus on domestic issues and antibiotic-resistant bacteria. Since then, infections with resistant bacteria have become more common in healthcare and community settings, and many bacteria have become resistant to more than one type or class of antibiotics. Consequently, doctors and nurses today are faced with treating infections where antibiotic options are very limited, and in some cases, where no effective antibiotics exist. When treatment options are limited, healthcare providers might need to use antibiotics that are more expensive or more toxic to the patient. When no antibiotic is effective, healthcare providers may be limited to providing supportive care rather than directly treating an infection -- similar to how medicine was practiced before antibiotics were discovered. As resistance increases, the patient’s risk of dying from infection also increases. When an infection is not effectively treated because of resistance, the microorganisms will persist and potentially spread to others, further extending the resistance problem. Bacteria that are intrinsically resistant or that can acquire resistance will survive and replace the drug- 3 susceptible bacteria. Thus, any antibiotic use will provide a selective pressure that perpetuates resistant bacteria. Antibiotics are the most important tool we have to control many life- threatening bacterial diseases once infection has occurred, yet increasing levels of resistance are compromising the effectiveness of these antibiotics. Bacteria have developed multiple ways of becoming resistant to antibiotics; the more often bacteria are exposed to antibiotics, the more likely they are to survive through one of these mechanisms. Antibiotics are used widely to treat persons in the community and in healthcare settings, and are also used to treat animals in agricultural settings. It is imperative that we assess the use of antibiotics carefully – regardless of setting -- and use them only when necessary, to avoid promoting the development of resistance among bacteria. Resistant infections not only cost more to treat, but also can prolong healthcare use. In a 2008 study of attributable medical costs for antibiotic resistant infections, it was estimated that infections in 188 patients from a single healthcare institution cost between $13. Unfortunately, infections caused by antibiotic resistant bacteria are an everyday occurrence in healthcare settings. Addressing antibiotic resistance requires a multifaceted approach to reduce inappropriate use, prevent disease transmission, and develop new antibiotic agents. Many of these activities are conducted in collaboration with partners including other federal agencies, state and local public health departments, academic centers, and international organizations. Several different surveillance tools have been developed for bacterial resistance because surveillance strategies and objectives vary for different problems. Preventing resistant infections provides the greatest opportunity to limit resistance. Strategies to prevent and control resistant bacteria vary by the pathogen and the setting in which the infection is acquired. For some diseases, like Streptococcus pneumonia, there are vaccines to prevent infections. In all cases, surveillance data are used to monitor the effectiveness of prevention efforts. Part of these efforts includes providing reference laboratory services for state and local public health departments to confirm and characterize unusual antibiotic resistance. New resistance patterns often require the development of new laboratory tools for detection. Outbreaks caused by resistant bacteria can occur in community settings where people are concentrated, such as athletic teams, childcare centers, and prisons, or in healthcare settings, including hospitals, long-term care facilities, and ambulatory care facilities. Healthcare Associated Multi-Drug Resistant Gram-Negative Bacterial Infections The newest resistance challenge in the healthcare setting is multi-drug resistant gram- negative bacteria. Particularly concerning are the carbapenemase-producing bacteria, such as bacteria of the Klebsiella species, among others. Bacteria with the carbapenemase-resistance trait are resistant to a class of drugs that were considered the “last resort” for treating serious infections caused by these bacteria. The antibiotic resistant traits are often located on mobile genetic elements, called plasmids. That means that resistance can be readily transferred from one bacterium to another, facilitating the spread of resistance between bacteria. In addition to these outbreaks, our reference lab has confirmed carbapenemase-producing Klebsiella for 32 other States. Preventing the spread of these resistant bacteria is difficult because patients may harbor the resistant bacteria in their intestinal tracts, but this goes unrecognized because it does not make the patients sick.

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Stangor is the recipient of research grants from the National Institute of Mental Health and from the National Science Foundation discount medrol 4 mg online. He has published seven books and over 70 research articles and book chapters and has served as an associate editor of the European Journal of Social Psychology cheap medrol 4mg with mastercard. He has served as the chair of the executive committee and is currently executive officer for the Society for Experimental Social Psychology purchase medrol 16mg free shipping. Stangor‘s research interests concern the development of stereotypes and prejudice and their influences upon individuals who are potential victims of discrimination. Stangor regularly teaches Social Psychology, Research Methods, and at the graduate level, Fundamentals of Social Psychology and Group Processes. Stangor is chair of the undergraduate committee in the psychology department and has won the distinguished teaching award from the University of Maryland. One important resource was an advisory board of instructors from across the country. Their thoughtful and insightful feedback throughout development was invaluable in creating this first edition. Isaak, University of Louisiana at Lafayette  Kerry Jordan, Utah State University  Jerwen Jou, University of Texas–Pan American  Peggy Norwood, Community College of Aurora  Karen Rhines, Northampton Community College  Eva Szeli, Arizona State University  Anton Villado, Rice University Introduction to Psychology also benefited from reviews at various stages of the book‘s development. Achorn, The University of Texas at San Antonio  Mara Aruguete, Lincoln University  David Carlston, Midwestern State University  Jenel T. Fernando, California State University, Los Angeles  William Goggin, University of Southern Mississippi  Karla A. Lassonde, Minnesota State University, Mankato  Greg Loviscky, Pennsylvania State University  Michael A. Peteet, University of Cincinnati  Brad Pinter, Pennsylvania State University, Altoona  Steven V. Isaak, University of Louisiana at Lafayette, for his work on the accompanying Test Item File and PowerPoint slides; and to Chrissy Chimi and Stacy Claxton of Scribe, Inc. Completion of the book and supplements required the attention of many people, including Michael Boezi, who signed the book and supported my efforts from beginning to end; Pam Hersperger, who managed the book through development; and Gina Huck Siegert, who worked closely with me on all aspects of the project. I was able to give a lecture on the sympathetic nervous system, a lecture on Piaget, and a lecture on social cognition, but how could I link these topics together for the student? I felt a bit like I was presenting a laundry list of research findings rather than an integrated set of principles and knowledge. How could they be expected to remember and understand all the many phenomena of psychology? And why, given the abundance of information that was freely available to them on the web, should they care about my approach? My pedagogy needed something to structure, integrate, and motivate their learning. Eventually, I found some techniques to help my students understand and appreciate what I found to be important. First, I realized that psychology actually did matter to my students, but that I needed to make it clear to them why it did. One of the most fundamental integrating principles of the discipline of psychology is its focus on behavior, and yet that is often not made clear to students. Affect, cognition, and motivation are critical and essential, and yet are frequently best understood and made relevant through their links with behavior. Once I figured this out, I began tying all the material to this concept: The sympathetic nervous system matters because it has specific and predictable influences on our behavior. Piaget‘s findings matter because they help us understand the child’s behavior (not just his or her thinking). And social cognition matters because our social thinking helps us better relate to the other people in our everyday social lives. This integrating theme allows me to organize my lectures, my writing assignments, and my testing. Second was the issue of empiricism: I emphasized that what seems true might not be true, and we need to try to determine whether it is. The idea of empirical research testing falsifiable hypotheses and explaining much (but never all) behavior—the idea of psychology as a science— was critical, and it helped me differentiate psychology from other disciplines. The length of existing textbooks was creating a real and unnecessary impediment to student learning. I was condensing and abridging my coverage, but often without a clear rationale for choosing to cover one topic and omit another. My focus on behavior, coupled with a consistent focus on empiricism, helped in this regard—focusing on these themes helped me identify the underlying principles of psychology and separate more essential topics from less essential ones. Five or ten years from now, I do not expect my students to remember the details of most of what I teach them. However, I do hope that they will remember that psychology matters because it helps us understand behavior and that our knowledge of psychology is based on empirical study. I begin my focus on behavior by opening each chapter with a chapter opener showcasing an interesting real-world example of people who are dealing with behavioral questions and who can use psychology to help them answer those questions.

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