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Annotation: Harry Wu symptoms 7 weeks pregnant cheap carbidopa 110 mg without a prescription, founder of the Laogai Research Foundation and author of Laogai: the Chinese Gulag medications rheumatoid arthritis generic 125 mg carbidopa visa, uses this book to recall his time in the Chinese penal system medications with pseudoephedrine order discount carbidopa on line. This book provides one of the few comprehensive first-person reports of the terrors of the Chinese labor camps red carpet treatment carbidopa 110mg overnight delivery. Although the government of China has been charged by many international organizations with having a gruesome human rights record, on anything from freedom of speech to freedom of religion, the accusations of state-sanctioned torture undoubtedly have caused some of the strongest reactions around the world. This article seeks to address the various manifestations of torture that take place inside two of the most prominent public institutions in China: the prisons and the mental hospitals. By utilizing these institutions as tools of torture, the government is able to stifle political and religious freedoms. Defining Torture To understand how the use of torture is constructed through the exploitation of public institutions, it is first necessary to define the term torture. It does not include pain or suffering arising only from, inherent in or incidental to lawful sanctions. Justifying Torture: the "Counterrevolution" and Crimes of "Social Dangerousness" Despite the fact that the release of information to the world community is tightly controlled inside China, the testimony of Chinese torture survivors and reports from various journalists have revealed many instances of state-sanctioned torture. These sources, as well as reports from international organizations, have made it clear that China utilizes torture as a tool to oppress individual rights and to punish political oppositionists. Legal norms inside China that support this oppression are exemplified through crimes of "counterrevolution" or "social dangerousness. In China, however, this term refers also to those who pose a threat to the social order of the country. The Chinese government utilizes torture as a means to secure the compliance of citizens who have dissenting ideological or political opinions. Medical explanations for how ideological differences can constitute illnesses are incredibly common in China. These citizens are often diagnosed with "paranoid psychosis," which suggests that their political mania or political delusions concern the policies of the State Party. It is obvious to many members of the international community that many Chinese citizens are being psychiatrically misdiagnosed or arrested for behaviors that are not recognized as crimes under international standards. Torture in China: the Cultural Debate To understand why China utilizes widespread and systematic torture, it is important to examine the historical and cultural aspects of this practice. This explains why the use of torture in China has been condemned by so many members of the international community. But from the Chinese perspective, it is the well-being of the group or the whole, not of the individual, that holds precedence, and this significant cultural difference is vital in realizing why achieving individual rights in China has been so difficult. State Prisons One of the most common means of utilizing a public establishment to carry out torture activities in China is through extracted confessions from persons held in custody inside the state prisons. As reported by numerous human rights organizations, torture inside prisons, often conducted with the goal of securing a confession, occurs in different forms, such as beatings, electric shock treatments, sleep deprivation, the denial of food supplies, cigarette burns, submersion in water or even sewage, and forcing bound prisoners to stay in one position for extended periods of time. Additionally, prisoners who confess (often untruthfully) face the possibility of being sentenced to serve time in one of the various labor camps run by the Chinese government. In many cases, those who confess are subjected to extreme sentences for small crimes, or even sentenced to death. Often, it is the police officers who are perpetrating these crimes due to pressure from higher authorities to gain a confession and close the case or even to advance their personal careers. While these occurrences are still pervasive, according the United Nations, it is important to note that the Chinese government has officially made obtaining confessions through the use of torture illegal, and that the rates of torture do seem to be slowly declining. Immediately after his arrest, Wang was transferred and held for seven years in an institution for the mentally and criminally insane because of his "diagnosis" as a "paranoid psychotic. Many of these political dissenters have reportedly been confined in specific forensic hospitals known as Ankang, operated by the Ministry of Public Security. International human rights groups and Falun Gong organizations abroad believe that hundreds of members of this group have been wrongfully detained in these "hospitals" and claim that some of them have even died as a result of their treatment. Because of their often unjust confinements, patients have become mentally unstable due to "prison psychosis. Interrogations and forced written confessions are forms of mental torture that are used in tandem with physical abuse, such as in the prominent case of Chen Lining, who was a Party member arrested for opposing the policies of the Mao regime.

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The increased self-awareness and desire for independence creates important questions that a urologist must develop the skills to answer symptoms retinal detachment trusted carbidopa 300mg. This is the set of principles that governs the move from care in a pediatric setting to adolescent and adult health care medicine vs medication generic carbidopa 110 mg on-line. Transition is a multi-faceted process designed to encourage a patient who is able to accept full responsibility for medical decision making and care with an adult urological care team treatment of schizophrenia cheap 300mg carbidopa overnight delivery. Many recommend beginning the process of transition at around the age of 12 years (or earlier) to provide ample time for all parties involved to develop the skills and understanding required by age 18 years symptoms restless leg syndrome generic 300 mg carbidopa fast delivery. Many tools for the transition and additional information can be obtained online (gottransition. While the basis of this chapter is to discuss genital anomalies in adolescence, our analysis and recommendations necessarily extend into adult life. The general philosophy is to avoid elective genital operations with risks to future sexual function or fertility until a time at which the patient is able to give his or her own informed consent. There remains substantial variation in initial assessment and technique, as well as cultural differences as they relate to penile length and circumcision status. A standardized assessment of cosmesis hypospadias objective penile evaluation for patients with hypospadias now exists as an adjunct to the validated self-appraisal instruments hypospadias objective scoring evaluation and pediatric penile perception score. Existing reports are limited by small numbers of patients (particularly with proximal hypospadias) where chordee is noted as an impediment. The etiology of a weak ejaculate may be lack of normal corpus spongiosum, with loss of elasticity in a reconstructed urethra or a urethral stricture. Urethral diverticula or sacculation and less commonly pooling in a persistent urogenital sinus, as well as retrograde ejaculation or scarred ejaculatory ducts should also be considered. In particular, tube grafts demonstrate very poor outcomes after puberty,37,44 thus staged reconstruction is more often used by adult urethral surgeons. Treatment options for recurrent stricture should be based on the location and length of the stricture as well as the time from repair to presentation. Early strictures tend to be anastomotic and demonstrate better likelihood for patency after endoscopic management. Among young men with hypospadias repaired in childhood, some authors report greater shyness, enuresis, neurotic symptoms (depression, anxiety) and delayed sexual debut. Surprisingly, lower paternity rates and increased rates of seeking treatment for infertility were noted among men with isolated hypospadias, raising the possibility of problems related to semen delivery or factors not accounted for by semen quality alone. Standardized urinary symptom measureweak ejaculate to assess for urethral sacculament tools should be employed after puberty tion/diverticulum. The genital anomalies in exstrophy and epispadias are the same, but may be less severe in the latter. Indeed, in babies born with very minor epispadias, there may be almost no genital anomaly at all. Magnetic resonance imaging investigation of the normal and the exstrophy penis has established that the total corporeal length is 60% greater in normal men (16. The abnormalities may be exaggerated by recession of the suprapubic area (Figure 9-2), absence of the mons pubis, and normal scrotal size. The pubic bone diastasis is important; penile length is greater if this is 3 cm and shorter if it is 4 cm. Pelvic closure performed in infancy may be effective in producing a normal penis, at least in childhood. Currently published data suggest that the Kelly operation, which may give an excellent result for bladder function, results in suboptimal cosmesis of the penis and abdominal wall compared with other techniques. In adult men, the prostate is of normal weight for age but lies completely behind the urethra. The verumontanum, which is normally positioned, is a useful landmark for surgery in later life. In the natural state, the erect epispadiac penis has a tight dorsal chordee of varying severity (Figure 9-3). Cavernosography in these cases shows the site of the maximal curvature at the point where the corpora emerge from the pubic rami.

The sample size of rational marijuana abstainers was too small for meaningful comparisons of boys and girls separately medications migraine headaches discount generic carbidopa canada, and so analyses were done across-sex using Mann-Whitney U tests (N = 27) medications given before surgery discount carbidopa 110mg otc. As expected symptoms kidney disease buy cheap carbidopa 300mg on line, there were no early personality differences between rational abstainers and experimenters medicine look up drugs generic 300mg carbidopa mastercard. However, there were, as expected, numerous Time 2 parent differences: parents of abstainers were more monitoring (z = 2. For the four-point Recreation Plus scale, the coefficients are considerably better; the Coefficient of Reproducibility is. The cutting points (see appendix A) are: recreational use of alcohol (2b and above on D); recreational use of marijuana (2b and above on C); and more than minimal experimental use of psychedelics (2 and above on E) or any use of other illicit drugs (1 and above on F or G). The four-point Recreation Plus scale was constructed from an attempt to discover empirically the best scale inherent in our data. The best descriptive pattern of drug usage is based on cutting points at recreational usage and contains only alcohol, marijuana, and other illicit drugs. The cutting points for the four-point Recreation Plus scale were determined empirically according to the procedure outlined by Guttman (1947), where cutting points within the response categories are selected to: (a) minimize errors in the scales, and (b) When never have more errors than nonerrors within a category. Caffeine and tobacco were excluded because they lowered the coefficient of scalability whenever they were included, regardless of the cutting point used. Indeed, I critiqued the steppingstone hypothesis as an exemplar of specious causal attribution Baumrind 1983). Moreover, we do not represent our Guttman scales to be a natural progression that establishes a developmental sequence of adolescent drug involvement (Kandel 1980). In order for a dimension to qualify as a developmental function, it must be unitary and generalize across stimuli and tasks. In specifying a developmental sequence, according to Wohlwill, the investigator would describe the invariant stage sequences, identifying the discrete steps in their appropriate order and coupled with at least approximate indications of the age intervals corresponding to the appearance of each step. The dimension described by the developmental function would in theory be universal, and in practice be generalizable across a wide range of situations. In establishing the stage-sequentiality of a particular developmental sequence, it must be demonstrated that behaviors characteristic of later stages are transformations of earlier stages of activity. It Is through this relationship of transformation that different structures of activity are viewed as stages in a single developmental continuum, not simply as a sequence of isolated forms of activity (Langer 1989). To the extent that the structure of a domain of behavior is bonded to structures appearing both earlier and later in the course of ontogenesis by relations of necessity, the sequence of attainment of those structures must be situationally invariant. To demonstrate only that behaviors emerge at different points in the course of development for a particular sample is not to demonstrate that they are stages in the same developmental process. In the developmental literature, a Guttman scale is sometimes equated with a developmental sequence of stages. A Guttman scale is simply a description of a response pattern at a given moment in Drug time and cannot be extrapolated to past or future times. Whereas Piagetian stages necessarily imply a culturally invariant causal relationship, the 24 empirical fact of a sequence of drug use demonstrated by a Guttman scale analysis Is dependent upon such contingent factors as price, availability, legal sanctions for possession or sale, and social stigma attached to use. Only 36% (49) of our subjects had never tried marijuana; whereas 55% (75) of our subjects had never tried tobacco. Whereas only 10% (6) of our subjects who had tried tobacco had never tried marijuana, 37% (32) of our subjects who had tried marijuana had not tried tobacco. The low use of tobacco relative to marijuana is probably due to the fact that Berkeley had mounted a vigorous antismoking campaign directed towards high school students at the time our data were collected (in 1978-79) and apparently it had been successful. By contrast, adult attitudes towards marijuana use were complacent, if not actually permissive. A generalization applicable to both samples is that use by adolescents of substances acceptable to the community precedes their use of substances that are strongly negatively sanctioned by the community. Our purpose in these analyses was to determine the direction, rather than the magnitude, of a relationship. The significant personal and familial antecedents of the six-point Initial Use scale are as follows: For girls, progression in initial use is associated at age 4 with dominance (r =. Progression is associated at age 9 negatively with parental restrictiveness (r = -. The significant personal and familial correlates of the four-point Recreation Plus scale are interesting for girls in that there are no linear relationships, but there are nonlinear relationships between recreational use categories and personal characteristics at age 4 and at age 9.

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Once the neural plate is established symptoms tonsillitis order generic carbidopa pills, signals for segregation of the brain into forebrain schedule 8 medications victoria cheap 110 mg carbidopa with amex, midbrain medications names and uses order carbidopa with visa, and hindbrain regions are derived from homeobox genes expressed in the notochord medicine with codeine purchase 110 mg carbidopa with visa, prechordal plate, and neural plate. Thus, new genes have assumed the patterning role for these regions of the brain, which evolutionarily constitute the "new head. Dorsal view of a late presomite stage embryo at approximately 18 days showing development of the neural plate in the cranial region (blue area). Together, they form the sympathetic trunks on each side of the vertebral column. Other sympathetic cells migrate to the heart, lungs, and gastrointestinal tract, where they give rise to sympathetic organ plexuses. Because the visceroefferent column extends only from the first thoracic to the second or third lumbar segment of the spinal cord, white rami are found only at these levels. Other fibers, the gray communicating rami, pass from the sympathetic trunk to spinal nerves and from there to peripheral blood vessels, hair, and sweat glands. Here, they differentiate into large acidophilic organs, which form the fetal cortex, or primitive cortex, of the suprarenal gland. Shortly afterward, a second wave of cells from the mesothelium penetrates the mesenchyme and surrounds the original acidophilic cell mass. These cells, smaller than those of the first wave, later form the definitive cortex of the gland. After birth, the fetal cortex regresses rapidly except for its outermost layer, which differentiates into the reticular zone. Chapter 18 Visceroefferent column (intermediate horn) Dorsal root ganglion Central Nervous System 317 Dorsal horn Ventral horn Sympathetic ganglion Collateral ganglion Intestinal tract Sweat gland Hair White communicating ramus Gray communicating ramus Cervical ganglia Right and left sympathetic trunks ("chains") Superior Middle Inferior Skin Blood vessel Blood vessel Thoracic ganglia Celiac ganglion A Prevertebral Superior (preaortic) mesenteric ganglion ganglia Inferior mesenteric ganglion Aorta Paravertebral ganglia Lumbar ganglia B Ganglion impar Sacral ganglia Figure 18. Drawing illustrating the organization of the sympathetic ganglia into right and left trunks (chains) parallel to the vertebral bodies. They stain yellow-brown with chrome salts and hence are called chromaffin cells. Postganglionic fibers arise from neurons (ganglia) derived from neural crest cells and pass to the structures they innervate. After closure of the neural tube, the brain consists of three vesicles: the rhombencephalon (hindbrain), mesencephalon (midbrain), and prosencephalon (forebrain). The rhombencephalon is divided into (1) the myelencephalon, which forms the medulla oblongata (this region has a basal plate for somatic and visceral efferent neurons and an alar plate for somatic and visceral afferent neurons). The diencephalon consists of a thin roof plate and a thick alar plate in which the thalamus and hypothalamus develop. The lamina terminalis is used by the commissures as a connection pathway for fiber bundles between the right and left hemispheres. Eventually, nuclear regions of the telencephalon come in close contact with those of the diencephalon. Cerebrospinal fluid is produced in the choroid plexuses of the third, fourth, and lateral ventricles. The brain is patterned along the anteroposterior (craniocaudal) and dorsoventral (mediolateral) axes. In this regard, organization of the sensory and motor cell bodies for these nerves is similar to that for spinal nerves. This outgrowth, the cochlear duct, penetrates the surrounding mesenchyme in a spiral fashion until the end of the eighth week, when it has completed 2. Its connection with the remaining portion of the saccule is then confined to a narrow pathway, the ductus reuniens. These thickenings, the otic placodes, invaginate rapidly and form the otic or auditory vesicles (otocysts). During later development, Cut line for B Otic vesicle Optic vesicle Invaginating neural tube Otic placode A B Endoderm Pharynx Figure 19. The cochlear duct is then separated from the scala vestibuli by the vestibular membrane and from the scala tympani by the basilar membrane. The lateral wall of the cochlear duct remains attached to the surrounding cartilage by the spiral ligament, whereas its median angle is connected to and partly supported by a long cartilaginous process, the modiolus, the future axis of the bony cochlea. They are covered by the tectorial membrane, a fibrillar gelatinous substance Endolymphatic sac and duct Ultricular portion of otic vesicle attached to the spiral limbus that rests with its tip on the hair cells.

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As organisms move away from sensorimotor links that subserve particular behaviors symptoms bronchitis 110mg carbidopa with amex, they develop structures that carry information in a form accessible to an open-ended range of applications medications zanaflex order carbidopa discount. Rather than acquiring a set of interactive contingencies of the sort needed to guide a specific behavior medications that cause high blood pressure carbidopa 300 mg amex, they store information in a format that can be applied in a diversity of ways nature medicine buy carbidopa us, should the situations arise. In search of the ultimate evidence: the fastest visual reaction adapts to environment, not retinal locations Boris M. Velichkovsky and Sebastian Pannasch Psychology Department, Dresden University of Technology, D-01062 Dresden Germany. Both emphasize external properties of the world, challenging views based on the analysis of internal visual processing. Even in this case, permanence in the environment, not on the retina, explains the dynamics of habituation. Every forty years, somewhere in the world, there is a rebellion against passive, mirror-like theories of cognition. For instance, a sensorimotor treatment of perception was the established approach in Russian "psychology of activity" (see Velichkovsky et al. In this commentary, we describe new data relevant to the world-as-its-own-model hypothesis. If there is a neurophysiological transition from proximal to distal representations somewhere in the brain, what does it mean for perception All phenomena considered by O&N involve cortical processing that can include not just one but several transitions from retinotopic to spatial coordinates; hence, it is rather tempting to relate them to phenomenal perception. With its reaction time of only 100 msec, the distractor effect is the fastest optomotor reaction in humans. This effect is also evoked by acoustic signals, so it could be related to orienting reaction (Pannasch et al. One possible reason could be that we used a gaze-contingent paradigm presenting distractors in the same area of the retina. Full-screen copies of nineteenth century paintings were presented to the subjects on a 17inch computer monitor with instructions to study them for a recognition test. After the initial phase of 20 sec, distractors (circular patterns of 4 degrees diameter) appeared within approximately every seventh fixation. Distractors were presented for 75 msec either in the lower right part of the picture, 12 degrees from the center, or in the respective location of visual field. After 12 distractors, the first picture was replaced by the next picture, and so on. No effect is observed either in space or in retinal coordinates for 50 msec delay. Motor involvement is necessary only during the phylogenetic and ontogenetic development of perceptual mechanisms. In the case of the same retinal location, there is a significant distractor effect [F(1,6) 11. According to a recent analysis, the distractor effect seems to be mediated by midbrain optomotor circuits (Reingold & Stampe 2000). They are retinotopically organized and too fast for an involvement of higher-level representations. Our results demonstrate that in this case the permanence in space, that is, in the outside world not on the retina, causes the decline in the saccadic inhibition. The decline can be explained by a genuine habituation or by a form of adaptation mediated by sensorimotor activity: distractors with an invariant position in the world are more easily explored and lose their novelty more quickly. This testifies to the fact that the environmental dependency is not due to an immaterial symbolic act.

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