Public Interest Law Initiative


T. Asam. Argosy University.

The direction of the couple is O perpendicular to the plane created by the two parallel forces cheap 10 mg atorlip-10 otc cholesterol levels england. The resulting product is a vector that is perpendicular to both a and b: a 3 b 5 iai ibi sin u e (3 discount atorlip-10 10 mg without prescription recommended cholesterol levels nz. The sense of direction of e is deter- mined by the right-hand rule: point the fingers of the righthand in the di- rection of a, then turn the fingers toward b, and the thumb will point to the right sense of direction of e. Also, if two vectors are parallel to each other, their cross product is equal to zero. This leads to the following vector prod- ucts between the unit vectors e1, e2, and e3: e1 3 e2 5 e3 52e2 3 e1 (3. The moment Mo is a measure of the capacity of force F acting on point P to cause rotation about point O. The magnitude of Mo is the product of the magnitude of the force and the perpendicular distance of the point O from the line of action of the force. Note that in the evaluation of the moment, the position vector from O to P can be replaced with any other that connects point O with a point on the line of action of force F (Fig. Note also that, if the distance be- tween point O and the line of action of force F is zero, then this force cre- ates no moment with respect to point O. If two forces are equal in magnitude and opposite in direction, their sum is equal to zero. Nevertheless, these two forces exert a moment with respect to any point in space so long as they do not share the same line of action (Fig. The moment created by the force couple about a point in the plane of the couple can be shown to be equal to the product of the perpendicular distance d between the line of action of the opposing forces and the mag- 68 3. An athlete whose arms are 66 cm long stands with his hands at the thighs holding 10-kg dumbbells. The athlete contracts his front, middle, and rear deltoids and pulls the weights up directly to the side (Fig. He raises his arms to the full-flexed shoul- der position with the weights above the elbow joint and higher than the shoulder level. Then he slowly lowers the weight to the starting position, and repeats the exercise. Compute the moment generated by the weight of the dumbbell at the shoulder when the arm makes 0°, 45°, and 90° with the vertical axis. A workout scheme for the shoulder muscle deltoids incorporates abduction of the arms while carrying free weights (a). The position of the dumbbell with respect to the origin is then given by the following equation: rp/o 5 L sin u e 2 L cos u e (3. The force exerted by the dumb- bell on the athlete equals to the weight of the dumbbell if the exercise is done slowly. The moment this force generates with respect to the center of the shoulder is M 5 (L sin u e1 2 L cos u e2) 3 (2M ge2) 52M g L sin u e3 (3. Note that we could have computed the moment M without going through the vector product. From the definition of vector product, we know that the magnitude of r 3 F must be equal to the magnitude of F times the distance d from point O to the line of action of F. Lie on back on floor, rest- ing lower legs across bench with arms behind base of neck. Com- pute the moment created by the weight of the upper body on the pelvic joint at the beginning of the crunch where the torso is only slightly off the ground. For the athlete shown in the figure, the distance L between the pelvic joint and the center of mass of the upper body is 34 cm. Solution: We can find the answer to this question without utilizing vector mathematics. Moment of momentum of a particle i about point O, H°, is defined as Ho 5 ri/o 3 mi vi (3. The moment of momentum of a particle of mass m tracing a circle of radius r with speed v is Ho 5 m v r e (3. This equation shows that moment of momentum about point O remains constant so long as the particle traverses a circle with constant speed.

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Sir James Paget buy cheap atorlip-10 10 mg on-line cholesterol steroid, a famous London surgeon in the 19th century concluded from his thirty years of experience that the major determinant of students’ success as doctors was "the personal character discount 10 mg atorlip-10 mastercard cholesterol ratio numbers, the very nature, the will of each student". Medicine is a popular career choice for reasons perhaps both good and not so good. And who is to say whether the reasons for going in necessarily affect the quality of what comes out? Glamour is not a good reason; television "soaps" and novels paint a false picture. The routine, repetitive, and tiresome aspects do not receive the prominence they deserve. On the other hand, the privilege (even if an inconvenience) of being on the spot when needed, of possessing the skill to make a correct diagnosis, and having the satisfaction of explaining, reassuring, and giving appropriate treatment can be immensely fulfilling even if demanding. Yet others who do not get their kicks that way might prefer a quieter life, and there is nothing wrong with that. It is a matter of horses for courses or, to return to the analogy, well fitting pegs and holes. An interest in how the body works in health or in disease sometimes leads to a career in medicine. Such interest might, however, be equally well served by becoming an anatomist or physiologist and undertaking a lifetime study of the structure and function of the body. Many more people are curious about how the body works than either wish to or can become doctors. None the less, for highly able individuals medicine does, as George Eliot wrote in Middlemarch, present "the most perfect inter-change between science and art: offering the most direct alliance between intellectual conquest and the social good". Rightly or wrongly, it is not science itself which draws most people to medicine, but the amalgam of science and humanity. Accurate assessment of the outcome of a complex web of interactions of body, mind, and environment, which is the nature of much ill health, is not achieved that way. It depends on a relationship of trust, a unique passport to the minds and bodies of all kinds and conditions of men, women, and children. In return the doctor has the ethical and practical duty to work uncompromisingly for the patient’s interest. One person’s best interests may conflict with another’s or with the interests of society as a whole—for example, through competition for limited or highly expensive treatment. On the other side of the coin, what is possible may not in fact be 3 LEARNING MEDICINE in the patient’s best interest—for example, resuscitation in a hopeless situation in which the patient is unable to choose for him or herself—leading to ethical dilemmas for the doctor and perhaps conflict with relatives. Dedication to the needs of others is often given as a reason for wanting to be a doctor, but how do you either know or show you have it? Medicine has no monopoly on dedication but perhaps it is special because patients come first. As Sir Theodore Fox, for many years editor of the Lancet, put it: What is not negotiable is that our profession exists to serve the patient, whose interests come first. None but a saint could follow this principle all the time; but so many doctors have followed it so much of the time that the profession has been generally held in high regard. Whether its remedies worked or not, the public have seen medicine as a vocation, admirable because of a doctor’s dedication. A similar reason is a wish to help people, but policemen, porters, and plumbers do that too. If a more pastoral role is in mind why not become a priest, a social worker, or a school teacher? On the other hand, many are attracted by the special relationship between doctor and patient. It has been said that, "Patients have a uniquely individual relationship with their doctors not encountered in any other profession and anything which undermines patients’ confidence in that relationship will ultimately undermine the doctor’s ability to carry out his or her work". A journalist writing in the Sun wrote cynically, "In truth there is not a single reason to suppose these days that doctors can be trusted any more than you can trust British Gas, a double glazing salesman, or the man in the pub". If it is of any comfort to the Sun, a Mori poll in 1999 asked a random selection of the public which professionals could be trusted to tell the truth. The results were: doctors 91%, judges 77%, scientists 63%, business leaders 28%, politicians 23% and journalists 15%. Professionalism includes the expectation that doctors (and medical students) can be relied on to look after their own health before taking responsibility for the care of others.

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We miss all the other purposes when interpreting all acts as aimed at happiness atorlip-10 10 mg lowest price cholesterol test kit walmart, while we simultaneously dilute the meaning of "happiness" to describe all objectives cheap atorlip-10 10 mg without a prescription cholesterol chart mmol. The case is similar when all motives are reduced, as I already mentioned, to selfishness, or to "power," or "greed. Additionally, we need to understand why and how value gets assigned to certain portions of cyclical processes. Frequently, some stage in a process gets assigned a role as the foundation of value for the entire cycle. Do poetry and art have survival value or does survival have poetic and artistic potential and value? Perhaps we should not dispute endlessly about whether wholes derive value from parts or parts from wholes, but instead appreciate that values in processes and life cycles are mutually supporting and derived: from top to bottom and bottom to top in scale; from past to present to future and back in time; from every part and experience to every other part and experience in organism; from individual to group and group to individual in society. Fulfillment, or "eudaimoneia" as Aristotle conceived it cannot be "utility" as put forth in expected utility theory. The primary reason is that fulfillment is not the immediate goal of any act, but is instead the efflorescence of a balanced, lucky and well-lived life. This "human flourishing" cannot be aimed at directly, and is more in the nature of a gift of grace than a specifiable objective. We can put ourselves in the way of it, but we cannot wrest it from fate by following a system or using main force. UTILITY AND THE PAST In explaining rational choice as it is usually defined, Robyn Dawes states that one criterion of such choice is that it is based on the possible future consequences of the choice. Even when the future costs of continued involvement clearly outweigh the future benefits, we tend to enter the sunk costs into the balance as future costs of abandonment 144 CHAPTER 5 or, conversely, benefits of continuance. Jung once said that he would not divulge Sigmund Freud’s dreams, told to him in confidence, even though Freud had been dead for decades. But is it not possible that Jung might have gotten far more gratification out of telling Freud’s dreams than keeping them a secret, and yet still have remained loyal to the deceased Freud? Is it not possible that we do some things because our acts nourish our characters (souls, to use another word) and because we want integrity itself, not just good feelings about apparent integrity? To decide that anything past should be honored only if doing so makes us feel good is a large leap from the simple observation that sometimes it is a good idea to quit a losing cause. The narratives of our lives are not properly carried out only by considering their endings in isolation from what has gone before. The outcome of a piece of music is not the same as the end: it is the integrated whole. The long sweep of living reaches back, confirms, affirms, respects, regrets, justifies, embraces and rejects aspects of the past. We cannot just "put a thing behind us" as though it was disconnected from our present selves, without diminishing those selves. This is why economic talk about "sunk costs" is not sufficient to dismiss much concern about the past. I will go so far as to assert that our present and future acts and experiences actually have a sort of consequence for the past. What whole sections of the past are in terms of value, can be altered and completed in the present and future. It can be argued that the past is not final because in the qualitative sense it is not wholly over. Jung’s action affected not only himself and his contemporary world, but even Freud, although Freud was not aware of it. Actions have all sorts of "effects" on their antecedents: on how we must interpret those antecedents, and on how we remember, value and evaluate them. This means that while we can and should write off some things as "sunk costs," and while we need to let go of old convictions, hopes, plans and goals in the appro- PREFERENCE, UTILITY AND VALUE IN MEANS AND ENDS 145 priate circumstances, we cannot write off the past as a whole. BROADER REASONING ABOUT ENDS The rational use of instruments (means) just cannot be separated for most purposes from the reflective consideration of ends.

Interactive learning of sign language can be facilitated with a VE simulation system buy 10 mg atorlip-10 visa grapefruit cholesterol medication interaction. Legal signs modeled by hands attributed with DataGloves can be automatically interpreted by the computer system effective 10mg atorlip-10 cholesterol in raw eggs, and incomplete signs can be shown correctly (69). Such a system can keep track of the score of an individual user, who might ®nd this talking mirror interesting and encouraging to use. VE technology can also be used in the rehabilitation of muscles and the nervous system after surgery or accidental 48 VES IN MEDICINE; MEDICINE IN VES damage. Conventional rehabilitation sessions are often experienced as dull, and VE technology may give rehabilitation a new dimension. A patient may be motivated in therapeutic rehabilitation via interaction with a playful or even competitive VE simulation. Motor functions can be stimulated by playing with virtual objects with a minimum of energy or e¨ort. Diseases may be recognized from response times and ®nger movements of a patient wearing a DataGlove, and dysfunctions at a perceptive level can be concluded from a patient who senses a growing con¯ict of sensory input. Also the relationship between the electroencephalogram (EEG) and speci®c cognitive activities in VE can be investigated in a therapeutic session. Traditionally, the radiologist interprets 2-D x-ray images of the patient to support medical decision making. Since the introduction of CT to the ®eld of diagnostic imaging, radiologists have gained experience in interpreting 3-D x-ray, nuclear, and MR images. These 3-D im- ages, however, are often visualized on a slice-by-slice basis rather than in 3-D, although fully 3-D applications have already been introduced. VE technology may provide a whole new repertoire of applications to diag- nostic radiology. All applications should depart from scanned patient data from which computer models are extracted and represented in VE. The main advantage of moderating patient data to the physician through graphic models may be that this type of representation is closer to looking at real body organs than are gray-level images. Physicians have become familiar with screening gray-tone images for faint ¯aws in structures, symmetry, brightness, etc. These tools allow them to interactively put markers at locations of interest without wasting the original patient data. Obviously, where telecommunication is ap- plied, some kind of human±system interface is needed, of which VE should be considered. Telemedicine can be applied for remote consultation (physician± physician and patient±physician). Remote diagnosis and surgery can be carried out by a specialist giving assistance to a nonspecialist in, e. Teletriage is de®ned as a special type of teleconsulta- tion, aiming at supporting the military physician in a war or crisis situation 2. Although the military physician is examining a casualty, he or she can report the ®ndings to a remote medical expert by voice. The medical expert, or a team of experts, can respond by pro- jecting instructions through VE technology onto the eye of the military physi- cian, freeing his or her hands. The physician is able to receive being instruction from specialists without having to be a specialist himself or herself. Linking the VE triage support system to electronic triage systems (ETS) based on picture archiving and communication systems (PACS) is yet another possibility (72). The need of advanced imaging tools in combat situations has already been reported (73). Eventually, remote surgery in a combat situation will be controlled by a surgeon in one of the higher echelons through teletriage support systems. Instructions from the specialist can be sent to the consulting physician through VE. The local and remote physicians can share the same virtual space in which the patient is present. In this way, the normal and pathologic anatomy can be projected onto the eye of the consulting physician while examining the patient.

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