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  • Director of Diagnostic Dermatopathology, Department of Dermato-Histopathology, St John's Institute of Dermatology, St Thomas' Hospital, London, UK

In a world in which few places are untouched by global forces and flows quinsana plus antifungal powder buy cheap ketoconazole 200mg on line, ethnographic research focusing on single sites and local experiences fungus gnats hot sauce 200 mg ketoconazole with visa, culture and roots is constrained and constraining (Gupta and Ferguson antifungal pill side effects buy cheap ketoconazole 200 mg line, 1997) fungus cerebri cheap 200 mg ketoconazole amex. While conventional single-sited research is capable of registering the impact of globalization in the local context of its research settings, it must rely on theoretical work (on world systems, globalization) to frame the experiences of local subjects and cultural impact of encounters with the global. Multisited research, on the other hand, through the study of multiple locales, extends the scope of ethnography to include not only the life world of situated subjects, but also associations and connections among sites that make up the system. While acknowledging macrotheoretical accounts of globalization, multi-sited research engages in its own empirical investigations of the relationships, discourses, infrastructures and agents that connect, constitute and construct the global (and local). Multi-sited fieldwork does not represent an entirely new conception, yet it marks a break with the norms and assumptions instituted by classical anthropology. Hannerz (2003) discusses these fieldwork norms in terms of the prescriptions of Evans-Pritchard. It represents the idea of a thorough, formative, exclusive engagement with a single field. Hannerz suggests that, while this ideal has been important for the identity of the discipline, it does not represent the full range of research practices anthropologists have engaged in. He also argues that the transnational, translocal and global themes addressed through multi-sited ethnography have appeared in anthropological studies of diffusion, acculturation, culture contact, social change and modernization throughout much of the twentieth century. Single-sited ethnography should not be identified too closely with the classical quest, however. Using rather conventional research approaches, such studies have looked at the way local cultures have resisted, accommodated or made creative use of powerful foreign cultural influences. While analysis of resistance tends to reflect the desire to preserve cultural integrity and resist external influences, the genre also acknowledges the capacity of globalization to produce new cultural forms and diversity in the local context, through creolization and hybridity. The genre does seem to maintain certain taken-for-granted notions of the local rooted in an emic perspective. Mobility, flows and relations between places are central to each of these genres and call for multi-sited approaches. We might, however, ask whether there really is a significant difference in the methodology of fieldwork in the two approaches. Although he implies that network-based fieldwork, which involves following a flow of social interaction along networks of people and things, is much less solidly anchored in a locality, he does not believe that the character of the fieldwork or the fieldworker changes fundamentally (Moeran, 2005). While the theories on culture have generated a new line of consumption and market research based on single-sited research (see Arnould and Thompson, 2005, for a selective summary), theories of globalization have not generated a similar line of multi-sited research, at least not to the same extent. Perhaps the challenges posed by multi-sited research are greater than those of single-sited research. However, if we want to understand globalization, as well as international marketing informed by theories of globalization, multi-sited ethnographical research provides a rewarding route. However, more and more research questions will emanate from the phenomena of the market that are increasingly transnational. Research strategies Following Marcus (1995), we introduce five strategies for constructing multi-site ethnographic studies. These are avenues to be pursued in order both to accomplish a generation of knowledge of transnational phenomena and to establish a transnational terrain for Multi-sited ethnographic market studies Table 39. Varying intensities and qualities of fieldwork the circulation of cultural meanings, practices, objects and identities in diffuse time­space Central themes of the research Illuminating the entire culture and social life of a people or the perspective of the subaltern. Exercise in mapping terrain, goal not holistic representation Comparative dimension is integral to study. Constructs the lifeworld of situated subjects, but also ethnographically constructs aspects of the system itself through the connections among sites Comparative perspective Comparative studies are generated for homogeneously conceived conceptual units, on the basis of separate projects of fieldwork Relies on theory of world system for contextualizing portraiture in terms of which experiences of local subjects are described and analyzed Reliance on theory of globalization (world system) studying global consumer culture. We relate these strategies to studies in marketing and consumer research which are exemplars of multi-sited research, although not necessarily explicitly framed as such. Follow the people the flow of people is a particular aspect of the global cultural system that lends itself to a multi-site approach. These studies acknowledge that market phenomena are constructed and lived transnationally. Hence one must follow the people as they move to, from and through multiple sites or their multiple local manifestations. Follow the thing Material manifestations of contemporary consumer culture are results of the output of transnational commodity chains. In order to get beyond the surface brand identities of mass consumer goods, Klein (1999) traced, for example, Nike shoes back through the chain of commodification and hence uncovered previously unknown brand meanings.

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Chapter 7 We used quantitative sensory testing to where do fungus gnats come from order ketoconazole 200 mg with amex investigate if a neurological dysfunction is a predominant mechanism of cold intolerance fungus ease buy 200 mg ketoconazole. The quantitative sensory testing is ideal to antifungal gold bond purchase 200mg ketoconazole with visa interpret in a noninvasive manner the behavior of the different types of small nerve fibers (A- antifungal for yeast infection ketoconazole 200 mg with mastercard, A- and C) abnormalities in patients with cold intolerance. In addition the possibility of the quantitative sensory testing device as a diagnostic tool for cold intolerance was evaluated. Chapter 9 the main results from the previous chapters and their implications are discussed. Conclusions are made, research questions are answered, the main objective evaluated and possibilities for future research are shared. Nylander, Cold-induced vasospasm after digital replantation does not improve with time. Dahlin, Self-reported cold sensitivity in normal subjects and in patients with traumatic hand injuries or hand-arm vibration syndrome. Lassvik, Cold sensitivity after replantation in relation to arterial circulation and vasoregulation. Tsai, Methods and results of replantation following traumatic amputation of the thumb in sixty-four patients. Nystrom, Cold intolerance is not more common or disabling after digital replantation than after other treatment of compound digital injuries. Sundkvist, Persistent postoperative complaints after whole sural nerve biopsies in diabetic and non-diabetic subjects. Dahlin, Cut-off value for self-reported abnormal cold sensitivity and predictors for abnormality and severity in hand injuries. Padnos, Comparison of heat and cold stress to assess thermoregulatory dysfunction in hypothyroid rats. Mekjavic, Cold-induced vasodilatation is not homogenous or generalizable across the hand and feet. Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, 1995. Kamiishi, Patterns of thermoregulation associated with cold intolerance after digital replantation. Veldhuijzen, Perspective on diffuse noxious inhibitory controls as a model of endogenous pain modulation in clinical pain syndromes. Dhillon Postgrad Med J 2009;85:481-488 Cold damage to the extremities: Frostbite and non-freezing cold injuries. In: Proceedings of the 11th International Conference on Environmental Ergonomics: 22-26 May 2005. Increasing the reproducibility of a cold sensitivity test for non-freezing cold injury; pp. Clinical problem Chapter 2 Prevalence and severity of cold intolerance in patients with a hand fracture E. A high prevalence of cold intolerance after nerve injury and replantation is described in literature. In this study, we evaluate the prevalence and severity of cold intolerance in patients with a hand fracture. This questionnaire assesses the severity of the cold intolerance using 6 questions. Thirty-eight percent (95 confidence interval: 24-53%) was diagnosed with pathological cold intolerance. Conclusion Cold intolerance is increasingly accepted as a serious problem for patients with trauma in their extremities. We found that 38% of our patients with hand fractures had pathological cold intolerance Prevalence and severity of cold intolerance in patients with a hand fracture 29 Introduction Cold intolerance after fracture of the hand is not well documented. Cold intolerance is defined as abnormal pain after exposure to mild or severe cold, with or without discoloration, numbness, weakness, or stiffness of the hand and fingers. Although cold intolerance is a frequent sequel of upper limb trauma, the prevalence is particularly high after nerve injury.

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The aims are to zinsser anti fungal paint discount 200mg ketoconazole teach problem solving (to help regulate emotions and tolerate distress) fungus fly 200mg ketoconazole free shipping, validation of perceptions fungus gnats kill larvae purchase 200mg ketoconazole visa, and meditation skills fungus disease purchase ketoconazole 200mg with visa. According to Melanie Klein (1882-1960), objects, for the infant, are either good or bad, not both; part is confused with whole: breast is equated with mother and is either a good or bad breast depending on the service the infant receives. An ability to see that everyone has positive and negative attributes is a normal developmental acquisition 1028 changing personality as such. The aims of therapy are to alter beliefs and to allow behaviour to become more rational. The patient learns to use skills designed to help him cope with stressful situations. Problem-solving therapies: the therapist teaches strategies that help others cope with problematic situations. Problems are identified, broken down into manageable components and skills (prioritising, brainstorming solutions, and making lists of advantages and disadvantages) to solve these are developed. These approaches have been shown to be effective in anxiety and depression in primary care and in helping people who self-harm. Mindfulness3334-based cognitive therapy: this approach (Segal ea, 2002), based on American work with patients experiencing chronic pain and somatic illness, is used to reduce the chances of relapse in recurrent depression. Minds have a will of their own and what we do or feel may be determined by streams of thoughts about what belongs to the past or future. Usually conducted over eight sessions, the patient learns meditation (practiced regularly), breathing exercises, and yoga. Behaviour therapy: this approach is based on learning theory: psychiatric disorders are seen as learned and therefore as being capable of unlearning. Punishment only produces short-term reductions in target behaviours when used alone and is more effective if combined with simultaneous reinforcement of desired behaviour. Ivan Petrovich Pavlov (1849-1936) Nobel Prize 1904 Behavioural therapies useful for Single phobias - desensitisation and flooding Obsessional problems - response prevention, audiotaped habituation3336 Sexual dysfunction - Masters and Johnson techniques 3333 3334 3335 See also Hawton. Self-control desensitisation resembles ordinary desensitisation because it employs a hierarchical presentation of fear-relevant cues but differs from it by using various strategies to reduce anxiety during exposure. Behaviourists use directive treatment methods, with clear goals, and an objective measurement of outcome. Operant conditioning employs immediate rewards following the appearance of the desired behaviour. Token economy has become less popular because of fears that its effects might not last, that it deprived people of their rights, and that changes, if any, might be due to staff attention rather than the token. Operant techniques are probably best for behavioural problems in which there is some proportion of voluntary control. The Premack3338 principle states that any frequently performed piece of behaviour can be used as a positive reinforcer of the desired behaviour. Intermittent reinforcement is more resistant to extinction than continuous reinforcement. Shaping involves providing successive approximations to the required behaviour, with contingent positive reinforcement. Behaviourists observe and concentrate on the symptoms or behaviour rather than, as in analytical approaches, looking for hidden psychic problems. Desensitisation in imagination is not as effective as in vivo3339 desensitisation as the patient may fail when he faces a real feared situation. Flooding (implosion) is rarely used today compared with the past because of the extreme stress involved and the relatively equivocal results. Behaviourist terminology Avoidance training: one learns to remove oneself from the source of a noxious stimulus before it can happen. Chaining: piecemeal addition to a behavioural chain that eventually produces a full action. For example, holding a spoon, then holding the spoon and putting it in the mouth, and so on, in an attempt to teach a child how to eat.

Katalini fungus face buy ketoconazole 200mg without prescription, Integrating Localization into a Video Game adaption of text fungus vinegar 200mg ketoconazole visa, abbreviations fungus gnats molasses cheap ketoconazole 200mg on-line, graphics and ideas that may cause misinterpretation fungus gnats damp cheap ketoconazole 200 mg with visa, physical product adaptation, shortcuts, forms, etc. Localization may require a comprehensive review of logic, visual design or presentation if translation is significantly different from the culture of origin. Localization process can also include change of design, marketing message, object or colour, or paradigm in order to adapt the product to the target culture. Localization goes beyond text structure, including also technical, cultural and marketing strategies, as it is oriented to the final product, "without taking any standpoint on the source text or the relation between the source text and the target text", as in Czech (2013). At the beginning, localization was separated from the products, while today developers create software with source files created for internationalization process. Later on, the expansion of software and documentation has asked for the process of internationalization, which precedes the localization process. In that sense, it can be said that internationalization precedes and facilitates the task of localization. Internationalization assumes the level of abstraction from the specific culture, language or the market. It is performed only once in the development process and can influence the localization process, which impacts ease of technical issues, costs and business processes. While translation is the process transferring content from one language (original language) to another language (target language) by preserving the context, localization process is more specialized and oriented to a final product in order to meet expectations of the global market, as indicated on web pages of Lionbridge. Pym (2005) defines localization as translation + factor X, where factor X includes internationalization, adaptation, controlled writing, use of translation memories, integration of machine translation, project management, i. Siaucin and Liubinien (2011) point out that "localization encompasses not only activities of traditional translation (terminology research, editing, page layout, proofreading), but also includes multilingual project management, software and online help engineering and testing, conversion of translated documentation to other formats, translation memory alignment and management, multilingual product support, and translation strategy support. In ers re n d ent the locali ization proce various experts enga ess, aged in prod duct adaptati are inion engineers. Software localization too include S ols the whole range of co e ommercial an free softw nd ware created for Window or Macws intosh pla atform. Localization also includes other types of software, such as tools to track changes on Web sites, word counting tools, currency converters, etc. Video games also do not use controlled languages (except programming language) or any scheme in the text creation phase. Moreover, game makers often employ professional writers who create a story for a particular title. The second difference between video games and technical translation is the medium. As in Mateusz (2014), video game translation is interwoven with the source code of a particular product. As presented in Siaucin and Liubinien (2011), Chroust (2007) elaborates localization as multi-layered process in the form of pyramid performed at different levels: technological infrastructure ­ as the basic level, including all technological and organizational preparation before and during the localization grammatical and semantic layer ­ as the second and third layers, including textual translation and language expressiveness graphic and iconic representation layer ­ which can be changed when localizing software, games or web sites business conventions and practice layer ­ important for. Numerous companies and associations offer their services on the market for localization, although sometimes it seems as a major and perhaps unnecessary investment, localization is today considerably important process for increased competitiveness in the global marketplace. Cooperation with the localization can start from the preparation of the software that will use localization, continuing in regular intervals in order to avoid pauses in production, also in Soh et al. Software preparation through internationalization greatly facilitates the localization team to see and test the context of use, thus increasing the ability to test the integration of localization and the quality of the translation. Quality control through communication with the localization team within the development process, and clear use of unambiguous words leads to successful localization project, as in Cem et al. Cardenosa (2006) explains three main approaches in the architecture of the internationalization process: when messages, menus and other culturally sensitive factors are contained in the source code of the application ­ for this case it is necessary to develop different version for each language, which multiplies costs and time when messages are extracted into external library, the application is generated from the common code and linked to the specific language library the third approach consisting of core application with all functionalities, culturally independent and linked dynamically to external localization resources containing all specific information. According to Erbil (2016), different game companies follow today different levels of localization, pointing out four levels of localization: the first level when localization is not performed because of cutting costs. Katalini, Integrating Localization into a Video Game Another area of relevant development are online games, which often incorporate chat among players while the game is being played. This implies a need for simultaneous translation of text chat and chat based on speech, as online games have no regard for linguistic boundaries. This raises the scope for research into the application of natural language processing systems. In addition to monetizing localization, it also enables the convergence of creativity writing to many users who can enjoy localized texts, which would not be possible if the game was released in a language they do not know.

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