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Sheisworriedtodiscoveravulnerablespotin herself: undoubtedly this pain is slight compared with a burn or a 368 toothache; but in an accident or illness 3m antimicrobial gel wrist rest purchase colchicine 0.5 mg visa, pain was always abnormal antibiotic resistance natural selection purchase 0.5 mg colchicine with visa, whiletheyouthfulbreastisnormallythecenterofwhoknowswhat indefinableresentment antimicrobial chemicals discount colchicine 0.5 mg with amex. Somethingishappening bacteria wanted poster buy 0.5mg colchicine mastercard,somethingthatisnot an illness, but that involves the very law of existence and is yet struggleandsuffering. Ofcourse,frombirthtopubertythelittlegirl grew up, but she never felt growth; day after day, her body was presentlikeanexactfinishedthing;nowsheis"developing":thevery word horrifies her; vital phenomena are only reassuring when they havefoundabalanceandtakenonthestableaspectofafreshflower, apolishedanimal;butintheblossomingofherbreasts,thelittlegirl feels the ambiguity of the word "living. Sheisusedtoafree-flowingheadofhair that falls like a silken skein; but this new growth under her arms, beneathherbelly,metamorphosesherintoananimaloralga. Whether she is more or less prepared for it, she foresees in these changes a finality that rips her from her self; thus hurled into a vital cycle that goes beyond the moment of her own existence, she senses a dependence that dooms her to man, child, and tomb. Arms, legs,skin,muscles,andeventheroundbuttocksshesitson,allhave had until now a clear usefulness; only the sex organ defined as urinarywasabitdubious,thoughsecretandinvisibletoothers. Her breasts show through her sweater or blouse, and this body that the littlegirlidentifiedwithselfappearstoherasflesh;itisanobjectthat otherslookatandsee. And another: "I still remember the strange confusion I felt when a friend of my age, but moredevelopedthanIwas,stoopedtopickupaball,Inoticedbythe openinginherblousetwoalreadyheavybreasts:thisbodysosimilar to mine, on which my body would be modeled, made me blush for myself. Thisdisgustisexpressedinmanyyounggirlsbythedesiretolose weight: they do not want to eat anymore; if they are forced, they vomit; they watch their weight incessantly. A precocious puberty worsened her troubles, mixing fears of modesty with fears of growing up: "Since men like plump women, I want to remain extremely thin. Theappearanceof menstruationdroveherhalf-mad;believingthatshewastheonly one in the world having the monstrosity of pubic hair, she labored up to the age of twenty "to rid herself of this savage decoration by depilation. Hermotherdiedwhenshewaseighteen,andshethenimposeda strictregimeonherself:twoclearbouillonsoups,aneggyolk,a spoonfulofvinegar,acupofteawiththejuiceofawholelemon, was all she would take in a day. Stekelrecounts,amongothers,awomanwho"asayounggirl blushed so pathologically and violently that for a year she wore bandagesaroundherfacewiththeexcuseoftoothaches. When the girl findssuspiciousstainsonherunderwear,shethinksshehasdiarrhea, a fatal hemorrhage, a venereal disease. According to a survey that Havelock Ellis cited in 1896, out of 125 American high school students36atthetimeoftheirfirstperiodknewabsolutelynothingon the question, 39 had vague ideas; that is, more than half of the girls were unaware. Even if cautious advice saves her from excessive anxiety, she is ashamed, she feels dirty: she rushes to the sink, she triestowashorhideherdirtiedunderwear. One eveningwhilegettingundressed,IthoughtIwassick;itdidnot frightenme,andIkeptmyselffromsayinganythinginthehope that it would disappear the next day. It was so hot that the diamond-shaped tiles of the hallway were warm under my naked feet. When I then got into bed, Mama opened my bedroom door: she came to explain things to me. I am unable to remember the effect her words had on me at that time,butwhileshewaswhispering,Kakipokedherheadin. Two memories all of a sudden come back: a few months earlier, coming back from a walk with Kaki, Mama and I had met the old doctor from Privas, built like a logger with a full white beard. A little later, coming back from Paris, Mamaputawaysomenewlittletowelsinthechestofdrawers. Ilookedatmy 373 sisterwithhatredbecauseshedidnotyetknow,becauseallofa sudden she found herself, unknown to her, endowed with an overwhelming superiority over me. One month later, I had to face the facts and accept the evil definitively, in a heavy stupor this time. Afriendtoldmethat,motherless,shelivedbetweenherfatheranda primary school teacher and spent three months in fear and shame, hiding her stained underwear before it was discovered that she had begunmenstruating. Evenpeasantwomenwhomightbeexpectedto be hardened by their knowledge of the harshest sides of animal life are horrified by this malediction, which in the countryside is still taboo:Iknewayoungwomanfarmerwhowashedherunderwearin secretinthefrozenbrook,puttinghersoakinggarmentdirectlyback on her naked skin to hide her unspeakable secret. Butthisisnotonlyaboutbeinginabadmood;mostmothersfailto givethechildthenecessaryexplanations,andsosheisfullofanxiety before this new state brought about by the first menstruation crisis: she wonders if the future does not hold other painful surprises for her; or else she imagines that from now on she could become pregnantbythesimplepresenceorcontactwithaman,andshefeels realterrorofmales. AsThydeMonnierrecounts: Some of us had become "big girls" during vacation; others wouldwhileatschool,andthen,oneaftertheotherinthetoilets inthecourtyard,wheretheyweresittingontheir"thrones"like queens receiving their subjects, we would go and "see the blood. Theonly novelty is the disgusting event repeated monthly; there are children thatcryforhourswhentheylearntheyarecondemnedtothisdestiny; whataddstotheirrevoltisthatthisshamefuldefectisknownbymen as well: what they would like is that the humiliating feminine condition at least be shrouded in mystery for them. Day andnightshehastothinkofchangingherprotection,watching herunderwear,hersheets,andsolvingathousandlittlepracticaland repugnant problems; in thrifty families sanitary napkins are washed eachmonthandtaketheirplaceamongthepilesofhandkerchiefs;this wastecomingoutofoneselfhastobedeliveredtothosehandlingthe laundry:thelaundress, servant, mother, or older sister.

Ofcoursethisexplanationis somewhat humorous; but-except in cases of jealous and exclusive passion where the man wants the woman in her entirety-this conflict antimicrobial therapy buy 0.5mg colchicine visa, in tenderness antibiotics for acne infection purchase colchicine 0.5 mg with visa, desire bacteria definition biology order 0.5 mg colchicine amex, even love antimicrobial hypothesis buy generic colchicine 0.5 mg on-line, is always present; the man always has "something else to do" with his time, whereas she is trying to get rid of hers; and he does not consider the hours she devotes to him as a gift but as a burden. Generally, he consents to tolerate it because he knows he is on the privileged side, he has a "guilty conscience"; and if he has any goodwill, he tries to compensate for the unequal conditions with generosity; however, he 854 giveshimselfcreditforbeingcompassionate,andatthefirstclashhe treats the woman as ungrateful, he gets irritated: I am too generous. Thisexplainsthecrueltyof which the woman often shows herself capable; she feels "selfrighteous" because she has the bad role; she does not feel any obligation to accommodate the privileged caste, she thinks only of defending herself; she will even be very happy if she has the opportunitytodisplayherresentmenttotheloverwhohasnotbeen able to satisfy her: since he does not give enough, she will take everything back with fierce pleasure. Then the wounded man discovers the total price of the relationship whose every minute he disdained:heagreestoallthepromises,evenifitmeanshewillagain considerhimselfexploitedwhenhehastohonorthem;heaccuseshis mistressofblackmailinghim:sheblameshimforhisstinginess;both consider themselves frustrated. Here too it is useless to allocate excusesandcriticism:justicecanneverbecreatedwithininjustice. It isimpossibleforacolonialadministratortoconducthimselfwellwith the indigenous population, or a general with his soldiers; the only solution is to be neither colonialist nor military leader; but a man cannotpreventhimselffrombeingaman. Sohereheis,thusguiltyin spiteofhimselfandoppressedbythisfaultthathehasnotcommitted himself; likewise, she is a victim and a shrew in spite of herself; sometimesherevolts,hechoosescruelty,butthenhemakeshimself anaccompliceofinjustice,andthefaultreallybecomeshis;sometimes heallowshimselftobedestroyed,devoured,byhisprotestingvictim: but then he feels duped; often he settles for a compromise that both diminishes him and puts him ill at ease. A man of goodwill will be moretornbythesituationthanthewomanherself:inonesense,one isalwaysbetteroffbeingonthesideofthedefeated;butifsheisalso of goodwill, unable to be self-sufficient, unwilling to crush the man with the weight of her destiny, she struggles with herself in an inextricableconfusion. Onemeetssomanyofthesecasesindailylife forwhichtherearenosatisfactorysolutionsbecausetheyaredefined byunsatisfactoryconditions:amanwhoseeshimselfasobligatedto maintainawomanhenolongerlovesmateriallyandmorallyfeelshe is a victim; but if he abandoned without resources the one who has committedherwholelifetohim,shewouldbeavictiminanequally 855 unjustmanner. Thewrongdoesnotcomefromindividualperversity -andbadfaithariseswheneachpersonattackstheother-itcomes from a situation in the face of which all individual behavior is powerless. Aworldwheremenandwomenwouldbeequaliseasytoimagine becauseitisexactlytheonetheSovietrevolutionpromised:women raised and educated exactly like men would work under the same conditions and for the same salaries;2 erotic freedom would be acceptedbycustom,butthesexualactwouldnolongerbeconsidered aremunerable"service";womenwouldbeobligedtoprovideanother livelihood for themselves; marriage would be based on a free engagement that the spouses could break when they wanted to; motherhood would be freely chosen-that is, birth control and abortion would be allowed-and in return all mothers and their children would be given the same rights; maternity leave would be paidforbythesocietythatwouldhaveresponsibilityforthechildren, whichdoesnotmeanthattheywouldbetakenfromtheirparentsbut thattheywouldnotbeabandonedtothem. But is it enough to change laws, institutions, customs, public opinion, and the whole social context for men and women to really become peers Woman is defined neither by her hormones nor by mysterious instinctsbutbythewayshegrasps,throughforeignconsciousnesses, her body and her relation to the world; the abyss that separates adolescent girls from adolescent boys was purposely dug out from earlyinfancy;later,itwouldbeimpossibletokeepwomanfrombeing 856 whatshewasmade,andshewillalwaystrailthispastbehindher;if the weight of this past is accurately measured, it is obvious that her destiny is not fixed in eternity. One must certainly not think that modifyinghereconomicsituationisenoughtotransformwoman:this factorhasbeenandremainstheprimordialfactorofherdevelopment, butuntilitbringsaboutthemoral,social,andculturalconsequencesit heraldsandrequires,thenewwomancannotappear;asofnow,these consequences have been realized nowhere: in the U. No one teacher can today shape a "female human being"thatwouldbeanexacthomologuetothe"malehumanbeing": ifraisedlikeaboy,theyounggirlfeelssheisanexception,andthat subjectshertoanewkindofspecification. If, from the earliest age, the little girl were raised with the same demandsandhonors,thesameseverityandfreedom,asherbrothers, takingpartinthesamestudiesandgames,promisedthesamefuture, surroundedbywomenandmenwhoareunambiguouslyequaltoher, themeaningsofthe"castrationcomplex"andthe"Oedipuscomplex" would be profoundly modified. The mother would enjoy the same lastingprestigeasthefatherifsheassumedequalmaterialandmoral responsibility for the couple; the child would feel an androgynous world around her and not a masculine world; were she more affectivelyattractedtoherfather-whichisnotevencertain-herlove forhimwouldbenuancedbyawilltoemulatehimandnotafeeling ofweakness:shewouldnotturntopassivity;ifshewereallowedto prove her worth in work and sports, actively rivaling boys, the absence of a penis-compensated for by the promise of a child- wouldnotsufficetocausean"inferioritycomplex";correlatively,the boy would not have a natural "superiority complex" if it were not instilledinhimandifheheldwomeninthesameesteemasmen. I have said how much easier puberty would be if she surpassed it, like the boy, toward a free adult future; menstruation horrifies her only because it signifies a brutal descent into femininity; she would also assume her youthful eroticism more peacefully if she did not feel a frightening disgust for the rest of her destiny; a coherent sexual educationwouldgreatlyhelphertosurmountthiscrisis. Objectionstothissystemalwaysimplyrespectforsexualtaboos;but it is useless to try to inhibit curiosity and pleasure in children; this onlyresultsincreatingrepression,obsessions,andneuroses;exalted sentimentality, homosexual fervor, and the platonic passions of adolescent girls along with the whole procession of nonsense and dissipationarefarmoreharmfulthanafewchildishgamesandactual experiences. Whatwouldreallybeprofitablefortheyounggirlisthat, notseekinginthemaleademigod-butonlyapal,afriend,apartner -she not be diverted from assuming her own existence; eroticism andlovewouldbeafreesurpassingandnotaresignation;shecould experiencetheminarelationshipofequaltoequal. Ofcourse,thereis noquestionofwritingoffallthedifficultiesachildmustovercometo becomeanadult;themostintelligent,toleranteducationcouldnotfree herfromhavingherownexperiencesatherownexpense;whatone would want is that obstacles should not accumulate gratuitously on herpath. Woman is the victim of no mysterious fate; the singularities that make her different derive their importance from the meaning applied tothem;theycanbeovercomeassoonastheyaregraspedfromnew perspectives; we have seen that in her erotic experience, the woman feels-andoftendetests-maledomination:itmustnotbeconcluded that her ovaries condemn her to living on her knees eternally. Virile 858 aggressiveness is a lordly privilege only within a system where everything conspires to affirm masculine sovereignty; and woman feelssodeeplypassiveintheloveactonlybecauseshealreadythinks herself that way. Many modern women who claim their dignity as human beings still grasp their sexual lives by referring back to a tradition of slavery: so it seems humiliating to them to lie under the manandbepenetratedbyhim,andtheytenseupintofrigidity;butif reality were different, the meaning sexual gestures and postures symbolicallyexpresswouldbedifferentaswell:awomanwhopays, whodominatesherlover,can,forexample,feelproudofhersuperb inertiaandthinkthatsheisenslavingthemalewhoisactivelyexerting himself;andtodaytherearealreadymanysexuallybalancedcouples forwhomnotionsofvictoryanddefeatyieldtoanideaofexchange. Infact,manis,likewoman,aflesh,thusapassivity,theplaythingof hishormonesandthespecies,uneasypreytohisdesire;andshe,like him, in the heart of carnal fever, is consent, voluntary gift, and activity; each of them lives the strange ambiguity of existence made bodyinhisorherownway. Thefactofbeingahumanbeing is infinitely more important than all the singularities that distinguish humanbeings;itisneverthegiventhatconferssuperiority:"virtue," as the ancients called it, is defined at the level of "what depends on us. Withoutadoubt,ifacasteis maintainedinaninferiorposition,itremainsinferior:butfreedomcan break the circle; letblacksvoteandtheybecomeworthyofthevote; givewomanresponsibilitiesandsheknowshowtoassumethem;the fact is, one would not think of expecting gratuitous generosity from oppressors;buttherevoltoftheoppressedattimesandchangesinthe privilegedcasteatothertimescreatenewsituations;andthisishow men, in their own interest, have been led to partially emancipate women: women need only pursue their rise, and the success they obtainencouragesthem;itseemsmostcertainthattheywillsooneror later attain perfect economic and social equality, which will bring aboutaninnermetamorphosis. It is true that by doing away with slave markets, we destroyedthosegreatplantationslinedwithazaleasandcamellias,we dismantled the whole delicate Southern civilization; old lace was put away in the attics of time along with the pure timbres of the Sistine castrati, and there is a certain "feminine charm" that risks turning to dust as well. I grant that only a barbarian would not appreciate rare flowers,lace,thecrystalclearvoiceofaeunuch,orfemininecharm.

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If so antibiotics quiz pharmacology purchase 0.5 mg colchicine amex, both antimicrobial underwear mens discount 0.5mg colchicine, the incident and the ranking authority may be better served by allowing the lower ranking officer to maintain command antibiotic beads for osteomyelitis buy 0.5mg colchicine visa, while the higher-ranking authority assumes an advisory role herbal antibiotics for uti purchase colchicine 0.5mg with mastercard. Should the incident degrade or the Incident Commander not be in control, the higherranking individual will maintain the authority and responsibility to assume command. The first arriving officer will either establish or pass command, and if establishing command, shall remain in command until relieved by a higher authority. It does not mean that the agency gives up or loses any of its authority, responsibility, or accountability. Unified command may be applied to incidents that: Operating Procedures the same general incident command system principles are utilized for each call for service. In small-scale incidents, patrol officers shall respond to the scene and resolve the incident without the involvement of other Departmental components. During the initial response to an incident, the first officer on the scene will establish command and act as the Incident Commander until relieved by an authorized authority who assumes command. A common and frequent example of this is a call for service that evolves into a barricade situation. The first officer on the scene establishes command and acts as the Incident Commander until relieved by a supervisor who assumes command. The purpose of this plan is to facilitate cooperation among law enforcement and fire/rescue agencies in the Metropolitan area, and to ensure the maintenance of order, enforcement of law, and public safety during a state of emergency beyond the capacity of any of the signatory jurisdictions. The Chief of Police, Assistant Chief, Deputy Chiefs, and District/Division Commanders will maintain copies of the plan. Release of any information regarding a critical incident or disaster requiring implementation of the Mutual Aid Plan shall be the responsibility of the affected jurisdiction through their Public Affairs Office or Media Relations Division. The exercise may range from a tabletop to a full-scale exercise, and may be conducted in conjunction with outside agencies. Employees shall familiarize themselves with the Incident Command System through this General Order. All training conducted shall be documented through procedures established by the Training and Education Division. Criteria & Procedures for Requesting Assistance For an agency to request assistance, a State of Emergency shall exist, and the Department shall have committed or anticipate committing all available resources. The Chief of Police is authorized to request assistance from designated officials in jurisdictions from which aid is sought. Reporting Procedures Following each activation of the Incident Command System, an Inter-Office Memorandum shall be used to prepare an After-Action Report that describes actions taken, results, and suggested improvements, if any. Command & Control the jurisdiction in which an incident occurs shall retain command and control. When the jurisdiction is uncertain, two or more jurisdictions are affected, or question exists as to responsibility for command, the first unit from the affected jurisdictions to arrive on the scene shall establish command 2. The sector supervisor or commander whose units were first to arrive on the scene shall assume the role of Incident Commander, as necessary, and exercise command and control authority until relieved or replaced by an authorized authority who is assuming command. The Incident Commander heads the incident management team, and shall consult with team members in decision-making. In multi-jurisdictional incidents, senior officials from each affected jurisdiction shall be included in the incident management team. If issues related to command and control cannot be reconciled among the ranking public safety officials, the County Executive shall resolve them. Officers dealing with juvenile offenders shall use the least coercive among reasonable alternatives. Arrest & Processing of Juveniles When arresting a juvenile, the same laws of arrest apply to juveniles as adults. On-view and hot pursuit criteria are also the same regardless of the age of the offender. If officers determine that the safety of a transgender juvenile or other prisoner would be compromised by transporting the transgender juvenile in the same vehicle as other prisoners, transgender prisoners may be transported in a separate vehicle. Arrestee Transport Transporting officers shall search juveniles regardless of whether they had been previously searched.

Metabolism Estramustine is supplied as the estramustine phosphate form chest infection cheap colchicine 0.5 mg with visa, which renders it more water-soluble antibiotic not working generic colchicine 0.5mg with mastercard. Biliary and fecal excretion of alkylating and estrogenic metabolites has also been demonstrated antibiotic resistance world health organization order colchicine 0.5 mg mastercard. Contraindicated in patients with active thrombophlebitis or thromboembolic disorders ear infection 9 month old colchicine 0.5mg line. Contraindicated in patients with known hypersensitivity to estradiol or nitrogen mustard. Contraindicated in patients with peptic ulcer disease, severe liver disease, or cardiac disease. Instruct patients that milk, milk products, and calcium-rich foods may impair absorption of drug. E Toxicity 4 Cardiovascular complications are rare and include congestive heart failure, cardiac ischemia, and thromboembolism. Cross-resistant to vinca alkaloids, anthracyclines, taxanes, and other natural products. However, oral bioavailability is non-linear and decreases with higher doses of drug (. Decreased albumin levels result in a higher fraction of free drug and a potentially higher incidence of host toxicity. Metabolism Metabolized primarily by the liver via glucuronidation to hydroxy acid metabolites, which are less active than the parent compound. High-dose therapy in transplant setting for various malignancies, including breast cancer, lymphoma, and ovarian cancer. Chemotherapeutic and Biologic Drugs 191 E Baseline CrCl should be obtained, and renal status should be carefully monitored during therapy. More commonly observed during the initial infusion of therapy and probably related to the polysorbate 80 vehicle in which the drug is formulated. The drug should be immediately stopped and treatment with antihistamines, steroids, H2-blockers such as cimetidine, and pressor agents should be administered. Toxicity 5 Mucositis and diarrhea are unusual with standard doses but more often observed with high doses in transplant setting. Toxicity 10 Increased risk of secondary malignancies, especially acute myelogenous leukemia. E Metabolism Etoposide phosphate is rapidly and completely converted to etoposide in plasma, which is then metabolized primarily by the liver to hydroxyacid metabolites. Coagulation parameters need to be closely monitored and dose of warfarin may require adjustment. Baseline CrCl should be obtained and renal status should be closely monitored during therapy. Toxicity 1 Myelosuppression is dose-limiting with leukopenia more common than thrombocytopenia. Toxicity 6 Hypersensitivity reaction with chills, fever, bronchospasm, dyspnea, tachycardia, facial and tongue swelling, and hypotension. Distribution Steady-state drug concentrations are reached within 2 weeks after oncedaily dosing. Six main metabolites have been identified, including three monohydroxylated metabolites, two hydrolytic ring-opened products, and a phosphatidylcholine conjugate of everolimus. In general, these metabolites are significantly less active than the parent compound.