"Buy danazol overnight delivery, women's health clinic coventry".

By: K. Frillock, M.B. B.A.O., M.B.B.Ch., Ph.D.

Clinical Director, Burrell College of Osteopathic Medicine at New Mexico State University

For urban political ecology menstrual gas buy discount danazol, our results suggest a serious and renewed Turfgross subjects 109 engagement with human ideology menopause question best danazol 200mg, experience menstrual reg by natures sunshine buy danazol 100 mg visa, and desire menstrual cycle 7 days order genuine danazol line. For lawn owners, including the authors themselves, these results suggest a critical appraisal of the political and ecological economy of our own identities. More generally, there is a growing acknowledgment that the demands of lawn care, when met by input-oriented control solutions, inevitably involve a certain degree of risk, sometimes made manifestly obvious in cases of acute exposure (as in the case of Suzanne above). Even the Scotts Company, the industry leader in lawn chemical retail sales with 52 percent of market share, explained to its investors in 2001, "We cannot assure that our products, particularly pesticide products, will not cause injury to the environment or to people under all circumstances" (United States Securities and Exchange Commission 2001:16). Anglo-Americans originally introduced these landscapes from Eurasia, along with almost all of their constituent species, including Bahiagrass (Paspalum notatum), Bermudagrass (Cynodon spp. As a result, and despite its cultural significance throughout North America, the turfgrass lawn is an exogenous ecosystem in Canada and the United States, where it dominates, and the requirements for its propagation are high as a result. Though these species are robust, the climatic demands of many regions, including the humid south, the arid west, and the frigid north, all make tremendous demands on homeowners seeking to nourish exotic monoculture, specifically the use of pesticide and fertilizer inputs. The deposition of these chemicals is largely unregulated and has been identified as a serious ecosystem risk in both the United States and Canada (Fuller et al. Indeed, many of the same chemicals for which registration and training are required in the agricultural sector, are sold over-the-counter to lawn owners in unregulated quantities (Guerrero 1990). Case reports of childhood tumours and leukemia associated with lawn chemical usage began to emerge in the late 1970s and 1980s, with a growing body of work substantiating In the nature of cities 110 these concerns. Though the effects of 2,4-D, the most common of all yard herbicides, on human health are generally debated, expert panels have concluded that the weight of evidence supports the possibility that exposure can cause human cancers (Ibrahim et al. So too, neurotoxins like chlorpyrifos appear far more significant than has been generally accepted to date (Zartarian et al. This is especially true for children; pesticide usage, specifically including Diazanon as well as yard weed herbicides, has been shown to be associated with childhood brain cancer (Davis et al. More troubling, lawn chemicals, rather than residing on lawns where they have a relatively short half-life, are commonly tracked into homes and deposit on clothing, where they represent ongoing exposure risks, and where they become considerably more persistent than previously thought. These chemicals accumulate in house dust and on surfaces and carpets where small children-precisely the group whose risk levels are highest-are disproportionately exposed (Lewis et al. Controlled studies demonstrate that measurable quantities of herbicides are absorbed by dogs and remain in their urinary system for several days after lawn exposure, underlining the possible exposure impacts on other mammals, including humans (Reynolds et al. Chemicals and other inputs on lawns have been demonstrated to have severe and detrimental ecological effects, moreover. The fragmentation of the landscape by lawns also adversely affects reproduction, survivorship, and dispersal of birds species (Marzluff and Ewing 2001). In sum, the Turfgross subjects 111 lawnscape as an exogenous monoculture demands and receives increasing quantities of inputs per unit land. Pressures for the development of the lawn monoculture are most evident at the local scale where the economy of urban development assures a steady supply of spaces for management and an enforced demand for normative lawn aesthetics. Producing customers: the formulotor industry Much of the expansion of turf chemical use parallels changes in the industry of turf chemical production. In particular, the formulator industry-companies that purchase raw chemical inputs to combine them into consumer chemical products -have dramatically changed their relationship to consumers in recent years. Specifically, since the late 1980s, formulator firms have turned to "pull" marketing: direct advertising by mail, radio, and television. This departs radically from traditional ("push") marketing, where formulator companies fill seasonal bulk orders to independent retail hardware and garden stores, who interact with customers (Baker and Wruck 1991; Williams 1997). This change in strategy is notably recent and has been received by the trade as revolutionary, innovative, and crucial for industry survival (Journal of Business Strategy 1989; Cleveland Plain Dealer 2000; Robbins and Sharp 2003a and b). The strategy requires a shift of resources towards the production of image and brand recognition and the devotion of significant budgets towards market research and the investigation of household chemical habits, with the specific goal of changing them. Scotts, the industry leader, commonly spends twice as much as traditional firms to advertise its product, spending millions of dollars on television advertising, where traditionally such expenses were shouldered by retailers (Jaffe 1998; Scotts Company 2000). This marketing revolution has proven somewhat successful and consumer spending on lawn chemicals has increased in many markets, despite declines in other areas of herbicide and insecticide sales (National Gardening Association 2000). Why increase a long-shunned and somewhat risky shift to direct marketing strategies and shoulder the considerable costs associated with it? The answer to this question centres on the narrowing margins in the industry, which have created an imperative to expand the number of chemical users and the intensity of chemical use per lawn. Firstly, the industry has become increasingly reliant on big box discount stores and home improvement warehouses, as small hardware stores and other traditional retailers shun the In the nature of cities 112 standing warehouse stock required for seasonal industries like lawn care, and as they disappear altogether (Bambarger 1987; Cook 1990; Williams 1997). Mass sales and bulk wholesaling reduces formulator industry receipts as a result (Scotts Company 2002).

order danazol online pills

They note that rather than a disembodied women's oral health issues buy 200mg danazol amex, distanced minstrel knight tyrant purchase danazol on line amex, and unbiased understanding of the world menopause depression treatment cheap generic danazol canada, objectivity is a white menopause 18 year old purchase generic danazol, male, privileged perspective (Cope 2002; Harding 1986, 1987). As such, objectivity fails to account for the full spectrum of perspectives, knowledges, and evidence (Kobayashi 1994; Sundberg 2003). Building from these insights, Donna Haraway offers a "feminist objectivity" that she terms situated knowledges (Haraway 1988: 581). Now axiomatic to feminist scholarship, situated knowledges calls for an accounting of the history, race, class, gender, and geography ­ the situation ­ of knowledge producers (Schumaker 2001). So doing, it celebrates the partiality of the perspective that each person has while being sensitive to the structures of power that shape them (Mcdowell 1992). Feminist scholars contend that through an attention to partial perspectives, scholars develop more objective and more responsible knowledge(s), and critical engagement, rather than critical distance, becomes the goal of research (Kobayashi 1994; Rose 1997). To incorporate partial perspectives, Linda McDowell writes that "we must recognize and take account of our own position, as well as that of our research participants, and write this into our research practice" (McDowell 1992: 409, original emphasis). In response to provocations like this, scholars seek to account for their situated knowledges "by reflexively examining [their] positionality" (Rose 1997: 305, our emphasis; see also: Kobayashi 1994; Sultana 2007). Reflexivity refers to the next step, whereby the researcher reflects on her positionality and makes it "visible" (see Chapter 8, this volume) with the goal of rendering authorial transparency (Staeheli and Lawson 1995). In calling on researchers to be reflexive, these scholars assert that particular characteristics and their relationships to the broader terrain of power must be accounted for in all aspects of the research process, from research design to access to the field to data collected to analysis and to the scholarship produced (Mollett 2013; Sultana 2007; Sundberg 2003). Quite simply, knowledge is shaped by the people and places involved in its creation; in order to fully render that knowledge, we must reflect on our position and how it shapes our research. We are almost exactly the same age (Abby is three weeks older), and we are both single women. In 2008 and 2009, when we conducted the bulk of our research, Abby was a PhD student at the University of Wisconsin and Thoko was a community health worker who had completed the first year of a tertiary degree but had stopped studying and returned home due to a lack of funds. While this description of our individual characteristics and institutional homes is surely illuminating, it is only partially so; we must also account for our positions in the context of the multidimensional landscape of power (Rose 1997). Abby is from a capital-rich country, she is highly educated, she is white, and in 2008 and 2009 the stipend from her research grants allowed her to live very comfortably with electricity, running water, security, and a car. So here we have a conundrum: two researchers working on the same project in radically different "positions" vis-а-vis the terrain of power. From the reflexive description of our positionalities and what you know about the global terrain of power and how it intersects with race, class, gender, and geography (Mollett 2013; Sultana 2007; Sundberg 2003), this analysis makes sense. And yet, as we will see, this reading does not always fit our experience (see also Sultana 2007). After all, our relationship and the relationships we had with the people with whom we conducted our research ­ our entanglements ­ shaped our positionality in both small and big ways and changed that positionality over time. Relationships and research methods Researcher­research assistant relationships A few scholars have written specifically about the relationship between academic researcher and research assistant (our relationship) (Rosaldo 1993; Sanjek 1993; Schumaker 2001). Much of this work notes the absence of attention to the research assistant in scholarly work. It also points to many of the hierarchies we detail above ­ researchers as "usually white and mostly male" and therefore in a position of power, and research assistants as "mainly persons of color" and therefore not in a position of power (Sanjek 1993: 13). Nguse impact of research assistants on scholarship, often seeing them as "cultural brokers" and as instrumental to research completed (Schumaker 2001; see also Bank 2008). Taken together, these works challenge the "myth of the lone ethnographer" (Rosaldo 1993), drawing attention to the important (if limited) role research assistants play in the sorts of community-based research that we conducted. Our relationship and experience certainly fits with much of what scholars have written ­ Thoko not only helped Abby with language (Gade 2001; Sharp 2005), she also helped Abby fit in culturally (with greetings, dress, behavior, and so on), especially initially (Sultana 2007). But this was only half of the equation; Abby helped Thoko understand how a researcher puts together a project and what Donna Haraway and others write about situated knowledges. While these two forms of expertise carry different currency in the political-economy of higher education, in Pholela this was often reversed. Most importantly, it was the combination of these two forms of expertise ­ shared, discussed, and processed together ­ that undergirds the knowledge (and the diffraction pattern) we produce. In explaining the idea of diffraction, Karen Barad focuses on the importance of the apparatus ­ the equipment used in an experiment ­ for the production of difference in scientific research. In many senses, we are the apparatus through which the stories we collected are diffracted.

Order danazol online pills. Sinkhole Swallows Ga. Fast Food Restaurant.

These include pregnancy kink generic danazol 50mg mastercard, whenever possible women's health boot camp buy danazol 50 mg without prescription, having the patient in a quiet room pregnancy 8 weeks 5 days discount danazol 200 mg with amex, with a window pregnancy mood swings safe danazol 100mg. Sleep is essential and consequently the room should be darkened and very quiet at night, and all non-emergency procedures. In cases where these environmental measures are ineffective, pharmacologic treatment may be considered with either an antipsychotic or, in certain emergent cases, lorazepam. Antipsychotics are indicated for treatment of hallucinations or delusions, and are also effective for agitation. A secondgeneration agent, such as risperidone, is often used, and, in practice quetiapine and olanzapine are also utilized. The first-generation agent haloperidol is also often used, with initial doses of 2­5 mg. Repeat doses, in approximately similar milligram amounts, may then be given every hour or so until the patient is calm, limiting side-effects occur, or a maximum dose is reached: rough guidelines for dose maxima are 5 mg for risperidone, 150 mg for quetiapine, 20 mg for olanzapine, and 20 mg for haloperidol. In cases when the patient responds satisfactorily, a regular daily dose is ordered for the next day (with the total daily dose approximately equivalent to the total required initially), divided into two or three doses. Provision is also made for further as-needed doses, with the total daily dose being adjusted according to the amount needed in p. The eventual maintenance dose is then continued until the patient has been stable for a significant period of time, at which point it may be gradually tapered. Lorazepam is very commonly used, and given the rapidity of its effectiveness when given intravenously, has a place in emergent situations; however, given that lorazepam may also worsen confusion, it is appropriate to substitute another agent as soon as this is practical. Once patients have been stabilized, general rehabilitation efforts may be started, including physical, speech, and occupational therapy. Eventually, most patients are transferred to a specialized rehabilitation facility, where these general efforts are continued. The Glasgow Coma Scale (Teasdale and Jennett 1974) is designed for evaluating patients in the acute phase, and involves assessing three clinical features: eye opening, motor response, and verbal response, with, as noted in Table 7. Patients with total scores of 8 are said to have a severe injury, those with scores from 9 to 12, a moderate injury, and those with scores of from 13 to 15, a mild injury. Post-traumatic seizures may occur during the acute phase, and these are discussed further, below. Chronic phase As the delirium gradually clears, almost all patients will be left with one or more chronic sequelae (Rao and Lyketos 2000), and these are discussed below, beginning with cognitive deficits, which are almost universal. In some cases these may be quite mild and not terribly limiting; however, in others they amount to a clear, and disabling, dementia. Most patients show improvement over the first 6 months, with some further, but not as impressive, gains over the next 6 months: however, after 12 months, little further spontaneous recovery can be expected. Importantly, in assessing patients with cognitive deficits it is critical to check for the presence of depression, which, in and of itself, may cause cognitive impairment. Pharmacologic treatment may include donepezil, amantadine, bromocriptine, or methylphenidate. Amantadine, in doses of 100 mg in the morning and 100 mg in the early afternoon, may likewise improve cognitive performance (Meythaler et al. Overall, it may be prudent to begin with either donepezil or amantadine, holding methylphenidate as a distant reserve. Anosognosia Anosognosia is characterized by a failure to appreciate the severity of a deficit, or even its existence. Clinically significant anosognosia is found as a persistent symptom in almost one-half of patients (Flashman and McAllister 2002). Interestingly, the anosognosia appears selective, in that although patients tend to acknowledge such deficits as hemiplegia, they are much less likely to appreciate their cognitive deficits (Sbordone et al. Aphasia is particularly common, and, to a variable degree, is found in the vast majority of cases (Levin et al. Agitation Agitation is common and tends to fluctuate in severity, and may occur in up to two-thirds of all patients in the first few months (Nott et al. Up to one-third of patients may also exhibit aggressiveness, which may be either verbal or physical (Tateno et al. In evaluating agitated patients, consideration must be given to the possibility that the agitation in question is not directly due to the head injury but is rather secondary to other causes, such as pain, delusions of persecution, akathisia or disinhibition secondary to alcohol or benzodiazepines. Antipsychotics, such as the second-generation agents risperidone, quetiapine, or olanzapine, may be utilized.

buy danazol overnight delivery

Climate adaptation has been linked to the concept of adaptive capacity ­ the potential to respond to climate risks women's health center at evergreen danazol 200mg with mastercard. While some see climate adaptation as a new field menstruation pronunciation order danazol 100 mg online, others have pointed out the legacies from cultural ecology in 312 Climate change and climate governance geography and anthropology and the risks of reinventing the wheel (Bassett and Fogelman 2013 women's health clinic vernon bc discount 50 mg danazol free shipping, Head 2010 menopause urination buy discount danazol 200 mg, Tschakert 2012). Studies of community and agricultural adaptation dominate; usually based on observations and interviews with local decision makers and residents and often focusing on adaptation to current climate variability rather than future climate changes. Bassett and Fogelman (2013) claim that the majority of adaptation studies focus on technical adjustments or modest development reform and do not pay attention to transformative adaptation that tackles the social roots of vulnerability. I would suggest, however, that there are studies that pay considerable attention to the deep-rooted institutional barriers to successful adaptation and to the differential ability to adapt within society by women and the poor. For example, Mark Pelling studies the political ecology of flooding in Guyana in historical and political context, arguing that development programs have undermined grassroots agency and options for adaptation (Pelling 1999). On the Mexican Caribbean coast he shows how structures of legitimation and domination have produced rigid governance that impedes transformative adaptation in communities (Manuel-Navarrete et al. Neil Adger, who sometimes identifies as a political ecologist, is perhaps the best-known scholar of adaptation. Indigenous adaptations are another emerging area of inquiry using concepts from political ecology ­ including regional work in Australia (Leonard et al. Climate adaptation is one topic where insights from scholars have had a significant impact on public policy and on international climate governance. For example, Saleemul Huq has published many articles where he argues for the value of local knowledge and adaptation strategies developed in the global South and for equity in climate financing (Ayers et al. But he also participates in the climate negotiations ­ helping to draft text and advising negotiators and activists ­ and started a grassroots adaptation program in Bangladesh. In the United States, Susi Moser is well known for her commitment to co-producing her research with communities and is a voice for the need to clearly communicate adaptation research to citizens and policy makers making it relevant on the ground (Moser and Dilling 2007, Moser 2010). The onset of climate change, and the risks that warming will exceed 4 degrees C, means that adaptation is joining mitigation and carbon markets in the world of international development, finance, and local, national, and international politics. There are many unresolved questions for the political ecology of climate adaptation (Liverman and Billett 2010). How can we ensure that high technology and large-scale options (such as sea walls or large dams) do not swamp effective small-scale local actions (such as crop diversity or ecosystem protection)? And how can we ensure that aid for climate adaptation is appropriate, equitable, accessible to women and people of color, and does not divert from other human development priorities? How can we connect our critical scholarship to action on the ground or to influence policy? There is a movement that suggests perhaps reducing emissions will be so difficult, and the risk of warming so great, that we should consider options for geoengineering the planet as a 313 D. As yet political ecology has hardly begun to engage with questions about the governance and socio-ecological impacts of geoengineering although there is a growing literature from science studies and critical international relations (Lцvbrand et al. Conclusion this chapter set out to show that political ecology has a lot of offer in how we understand the human dimensions of climate change ­ whether explicitly named, or reflected in research that takes political economy, human agency, and nature seriously, revealing narratives that can create or oppose injustice. Although one might view political ecology and critical climate change research as following parallel paths there are important examples of cross-fertilization and future opportunities. The influence of political ecology on vulnerability is perhaps the most significant, not only in the early impact of critical hazards scholars but also in the flow of ideas from political ecology work on governmentality, feminist political ecology, and neoliberalism. In the case of emissions and of climate policy the flow of ideas has been more from critical international relations and political economy to political ecology in the critique of emission responsibilities and of carbon markets. The debate about carbon offsets continues ­ although the market has not grown as fast as anticipated because of carbon market uncertainties, low prices, and a backlash against offsetting. Students in a recent graduate seminar ­ looking to design their own studies ­ were frustrated at how many articles in political ecology and environmental governance argued mostly from theory and were thin empirically, and how few critical articles discussed research design, methods, or positionality, provided summary statistics on fieldwork, analyzed biophysical data, or used quotes from interviews as evidence or to give voice to local people. In discussion we identified reasons that included a desire to demonstrate theoretical sophistication, innovation and anti-positivist stance, normative commitments to telling a convincing story and making a strong argument, lack of time and resources to extend case studies to comparative cases and baselines or to analysis of material nature, protecting individual informants, or poor recordkeeping. In order to address these frustrations and provide clearer guides to others, political ecologists could do a better job of discussing their methodology in their publications and include more quotes and references to field data. What political ecology gains from a focus on climate change is an engagement with one of the most existential and political environmental issues of our time ­ with serious implications for global geographies, social and environmental justice ­ and with a growing community of scholars and publics who wish to understand and act in small and larger ways to influence the future. Narain (1991) Global Warming in an Unequal World: A Case of Environmental Colonialism.