Laurence S. Baskin, MD

• Chief of Pediatric Urology
• University of California?an Francisco
• Benioff Children? Hospital San Francisco, California

The leading papers and journals all over the country spoke in very glowing terms about the Soya Bean dishes that were exhibited dr. mike's arthritis relief etoricoxib 90 mg visa. So keen was the interest and enthusiasm evinced by the cosmopolitan public of Bombay that seats in the restaurant had to be reserved in advance arthritis medication without aspirin etoricoxib 90mg on-line. Many were ready to finance any scheme that I would propose arthritis diet management discount etoricoxib 120mg on line, but unfortunately my time was not my own as I had to attend to my duties in the State and could not take advantage of their generous offer arthritis gloves target buy etoricoxib 120 mg fast delivery. The Department of Commerce and Industry of the Government of Bombay inquired if I could furnish them with information about the machinery for the extraction of Soya-bean milk. Letters of inquiries from private individuals kept pouring in daily from all parts of India. All this has induced me to undertake the preparation and the publication of this book. The Soya Research Institute at Moscow is making researches into the nutritive, industrial and economical values of Soya Bean. In Russia, rickets and consumption are treated by Soyolk extracted out of Soya Bean. Buddhists in China use bean-curd [probably yuba], shaped in molds, to make many products that resemble animal products: fish with sauces, a whole chicken swimming in a golden chicken soup. A cartoon shows a figure of "The Versatile Soya Bean" smiling and dancing with hands on hips. This is the earliest document seen (April 2003) that mentions a meat alternative which is described as an alternative to fish or seafood. Geschichte, Anbau und Verwertung einer einzigartigen Nutzpflanze [A little soybean primer. Utilization in East Asia: Koji, miso, shoyu, soymilk, yuba, tofu (Sojakдse, like Quark), soy oil and press-cake. Utilization in Europe and America: As fertilizer and feed, as food (soy flour, roasted soybeans, soy coffee, green 113 vegetable soybeans (den jungen Sojakern. Wehrman, saw in the botanical garden of Montigny-les-Metz a plant that was unknown to him. He harvested 80 to 100 seeds, with which he continued his investigations successfully for some years" [Note: Haberlandt (1878, p. The Preface begins with an old Chinese saying: "To be born in Soo Chow, "To be clothed in Hangchow, "To be fed in Kwanchow. Some recipes call for bean sprouts, but it is not clear from what kind of beans they are sprouted; probably mung bean. Soy-related recipes: Bean curd soup (Dow foo tong, with "2 bean curds (dow foo)," p. This use of fermented black beans, with garlic and/or ginger, to make a sauce in the kitchen would, in later recipes, be given a standardized name: "black bean sauce. Beef with bean curds (Dow foo ngow yuk, with "4 bean curds " and "Ѕ 114 teaspoon black bean sauce ," p. The Chinese do not serve their cheese as a separate course at the end of the meal as Americans do, but see it as a main course. This cheese (foo yu), strictly speaking, is not a cheese at all because it contains no milk. Plain chow mein is almost the same as Chicken chow mein, but with Ѕ cup less chicken. Recipes are given for Beef chow mein, Chicken chow mein, Lobster chow mein, Shrimp chow mein. Revue Internationale des Produits Coloniaux et du Materiel Colonial 14(158):61-65. The utilization of soya in Europe: Dry seeds (whole dry soybeans), soy sauce, soymilk, yuba, tofu, soymilk casein, soy lecithin, soy flour and chocolate, soy oil. In short, Pynaert describes all the basic types of soyfoods and encourages their introduction to the Congo. Yields: "In 1915 the agronomist Mestdagh made it known that at the end of an experiment well conducted at Lusambo in the district of Sankuru [Belgian Congo], he had harvested 1,472 kg/ha of a light yellow variety of soybean, and 1,786 kg/ha of a black variety. Lejeune, who worked in the Congo for nearly 20 years, recently furnished information of great interest on the subject of the soybean cultivation which he had undertaken in the colony as well as in RwandaUrundi. This variety adapted itself remarkably well to the conditions of the Eala milieu and gave soybean yields of 1,000 to 2,000 kg/ha. At Rubona, still in Rwanda-Urundi, the following seed yields were obtained from 1931 to 1935. Lejeune; at the Agronomic Station at Yangambi, near Stanleyville, from 1937; at Nioka in Upper Ituri (Haut-Ituri; Ituri is a district in the oriental province of the Belgian Congo) where yields are 450-500 kg/ha in poor soil but 700-800 kg/ha in good soil, and even up to 1,000 kg/ha; it is concluded that indigenous crops will probably not give yields of greater than 400-500 kg/ha. This document contains the earliest date seen for soybeans in Ruanda-Urundi, or the cultivation of soybeans in Ruanda-Urundi (1927) (one of two documents). The are columns for the legume product name, moisture, total phosphorus, phytin phosphorus, and phytin phosphorus as a percentage of total phosphorus. Soy products include (with total phosphorus in mg/100 gm and phytin phosphorus in mg/100 gm): Soybean (484, 213), fresh soybean [green vegetable soybean] (835, 298), soybean curd [tofu] (623, 314), soybean curd cake [pressed tofu] (604, 431), fried soybean curd (355, 309), soybean curd sheet [pressed tofu sheets] (618, 318), soybean milk clot [yuba] (750, 342). Eng; chi] · Summary: Fifty-six kinds of local foodstuffs are analyzed for their total and available iron contents. It is estimated Tonkin cultivated about 12,000 ha of soybeans and harvested an average of 7,500 metric tons per year. The low yield of only 625 kg/ha, compared with a world average of 1,000, is explained by the fact that soybeans are generally cultivated with corn in a 1:1 mixture. Since 1933 Paul Braemer, chief of agricultural services in Hong Kong, is exerting himself to propagate more this nutritious plant. Up till now the strong flavor of the soy protein deters colonials from using soy for food and soymilk. Made experimentally at the Maurice Museum, these have not attained but a relative success in the European colony. Gujerat College of Ahmedabad, recommends warmly this economical and fortifying food. Soy is now used increasingly in industrial dining rooms and universities (he lists names). It is likely that India will acclimatize varieties rich in oil, develop extraction mills in its centers of industry, and deliver a large tonnage to the English soap makers. Soy in Africa: the French tried growing soybeans successfully in Dahomey and Togo. In North Africa trials have been taken more seriously since 1918 in Algeria, then in Tunisia and Morocco. Australia is finally cultivating soybeans since the start of the century in the southeast, and today on all the east coast (Queensland, New South Wales and Victoria). At the start of this century, when the German industry launched "Nitragine," a liquid culture of nitrogen fixing bacteria, there was much interest. The American practice, founded on the research of Norman Shaw (1910) and on the experience at the agricultural experiment stations at Michigan (1905), Wisconsin (1907, 1922). Also one of the best bibliographies; the most extensive of any European book to date on all aspects of soybeans and soyfoods. Most of the early studies on soybean diseases and enemies are analyzed in Morse (1927) "Soy Beans: Culture and Varieties. The early research on the chemical composition of the soybean plant was to determine its value as forage. The latter also studied the composition of the soybeans from Etampes, as did Giljaranski. The structure of the soybean cells was studied in France by Colin and Blondel (1888). The median oil content from Asian soybeans is not more than 17%, while that of American soybeans attains 19%. The importance of soybeans as a protein source was not pointed out by researchers for 69 years, i. Satow of Sendai, Japan for the precipitation of soymilk by a ferment or by sulfuric acid. At the start of the 20th century, soy pap was prescribed with success for diabetics in the hospitals of Algeria, as in Japan and Austria. Potatoes: 80 grams give 224 calories Soybeans: 40 grams give 188 calories Rice: 50 grams give 180 calories Bread: 45 grams give 145 Followed by 16 other foods. Durand (no citation) discussed cooking whole soybeans in water with sodium bicarbonate. At whole dry soybeans, there is considerable discussion of their use in vegetarian diets.

Unlike the closet arthritis diet sugar generic etoricoxib 90mg with amex, storage cabinets often display locks or key holes to indicate their concealed interior at the exterior surface arthritis feet numbness order etoricoxib 90mg otc. Free-standing mild arthritis in knee exercises buy etoricoxib 120 mg cheap, decorated arthritis pain killer medication buy etoricoxib 90mg fast delivery, upright objects, armoires and the like are able to suggest, if not quite imitate, the clothed human body. From about 1840 onwards, the closet offered, instead, diminished architectural expression. The closet not only concealed the things it contained but, significantly, it also promised to hide itself. In the principal story, a pantry or closets are a necessary accompaniment to the dining room or living room, but are scarcely required in connection with any of the other apartments. Bed-rooms always require at least one closet to each, and more will be found convenient. In these mid-nineteenth-century texts, as in constructed domestic space, the closet was rendered barely visible. Concealing the storage of clothes and other possessions, the closet may have served to address widespread ambivalence about material acquisition and the accumulation of excess. This ambivalence appears clearly in an 1882 lecture by Harriet Beecher: the good sense of the great majority of business men-and women-is in favour of enterprise, and of that frugality and economy which shall result in amassing property. The closet worked, along with other architectural strategies, to advance an extensive reform movement that aimed to invest the American home with signs of moral propriety. Increasingly strict codes of behaviour were given architectural form as, for instance, the stairway to second-floor bedrooms moved out of the entrance hall to a less visible part of the interior. Likewise, programmes and spaces once joined were separated into discrete rooms with distinct degrees of privacy. At a wide range of architectural scales, efforts mounted to moderate the visibility of spaces now deemed private. Windows or doors rarely appear at the rear or side of the closet, even though they might serve to admit light and air as well as passage. The room relies exclusively on its closet and the closet depends uniquely upon its room. The threshold between closet and room mediates their relation, simultaneously connecting and dissociating the two spaces. Although the closet door may take many forms (among them, sliding, pocket and hinged single or double doors), the door always shuts to conceal the interior of the closet and opens to allow access. Moreover the door is usually articulated to minimise its own visibility, often set flush or painted to match the surrounding wall. According to a domestic planning manual from the 1940s: `Closets should not interfere with main areas of activity in a house. But, despite its formidable 345 Ј Henry Urbach ў architectural strength, it fails to contain the tension exerted by contrary imperatives: storage versus display, keeping things hidden versus keeping things handy. There is always some seam, gap, hinge, knob or pull that reveals the door as a mobile element. Moreover, the door displays the presence of the closet beyond by setting parameters for decorating and furnishing the room. One does not, for example, place furniture in front of a closet door as though it were part of the wall. Holding things at the edge of the room, simultaneously concealing and revealing its interior, the closet becomes a carrier of abjection, a site of interior exclusion for that which has been deemed dirty. Rather, they are deposited just beyond the space they simultaneously soil and cleanse. This partial, incomplete elimination keeps that which is dirty present so it can constitute, by contrast, the cleanliness of the clean. Closet and room work together to keep the room clean and the closet messy, to keep the contents of the room proper and those of the closet abject. The closet door mediates imperatives of visual concealment and physical access, undermining the separation of closet and room while stabilising their difference. For at least a century, as David Miller, Eve Sedgwick, and others have demonstrated, the closet was a social and literary convention that narrated homosexuality as a spectacle of veiled disclosure. It served a larger social project committed, as Michel Foucault has shown, to establishing homo- and hetero-sexuality as distinct and unequal categories of identity. Instead of polymorphic sexual practices, there was now a taxonomy of new sexual types. Like the wall seams and door pulls that betray the closet, the absence of wedding bands and other positive assertions of heterosexuality would raise the spectre of gay identity even without forthright disclosure. One could neither be fully legible nor fully invisible; instead, dissemblance would serve to reveal a condition otherwise unstated. By contrast, heterosexuality was identified with procreation, fidelity and true love. Despite its presence throughout the early part of this century, the homosexual closet was not named as such before the 1960s. The nascent gay rights movements identified the closet as a tool of homophobic heterosexism and advanced a new battle cry: `Out of the closets! And, indeed, within a regime of (almost) compulsory heterosexuality, the personal and political value of coming out must not be underestimated. But, at the same time, its effects on the architecture of the closet should not be overstated. Where heterosexuality is presumed, coming out can never be accomplished once and for all. As Sedgwick has argued, the sustenance of gay identity (where straight identity is presumed) depends upon continuous acts of declaration. Every new acquaintance, every new situation demands a repetition of, or retreat from, disclosure. But the binary logic of the closet/room pair, the rigid opposition of in and out, does not account for the dynamic entanglement of closet and room, the ways in which they constantly separate and reattach, the ways in which one is always both in and out, neither in nor out. These are crude and brittle words, unable to capture the diachronicity and multivalence of identity as played out in social space. This is something Mikhail Bakhtin theorised in his model of language as a site of social contest. Or the practice, common among gay men during the 1970s, of displaying a coloured handkerchief in the rear jeans pocket. Appropriated from the uniform of labourers, the handkerchief served not only to display sexual orientation, but also to indicate, with considerable nuance, particular sexual interests. Extending from the inside of the pocket to the outside of the trousers, the handkerchief also recapitulated, at the scale of the body, the larger spatial relation governing the storage and display of gay identity. In recent years, gay people have learned to re-articulate other, more overtly homophobic codes of dress: (macho) tattoos, (Nazi) pink triangle, (gym teacher) hooded sweatshirt, (military) crew cut, (femme fatale) lipstick and (skinhead) Doc Martens. These gestures of dйtournement-when done well, and before they ossify into new norms-underscore the relation of homo- and hetero-sexualities without necessarily adopting the violence and inequity of their opposition. Since the closet was invented alongside homo- and hetero-sexuality over a century ago, gay people have needed to work with and against it. At the same time, however, it has also provided for other, surprisingly articulate meanings. The impressive architectural stability of the closet notwithstanding, it has not always-and need not necessarily-describe a spatiality so rigid. A wide range of spatial practices, including architectural scholarship and design, offer opportunities to redress, provoke and reconfigure the relation of closet and room. Working with and against the closure of the closet, it is possible to produce an expanded space between closet and room. Long before the built-in closet was invented, there was another kind of closet, a very different kind of space. From the late-fourteenth to the nineteenth centuries, the closet referred, in terms both architectural and social, to an inhabitable room. During the fifteenth century in England, a closet particular to royal residences emerged. Closely associated with the private apartments of the sovereign or other nobility, this closet referred to a chamber used for retreat, writing, contemplation, small receptions and religious activities. Through its various incarnations, the royal closet allowed for gathering and interaction with others.

In their book arthritis in american eskimo dogs cheap etoricoxib 120 mg with mastercard, Resilience: Why Things Bounce Back arthritis in back hips buy etoricoxib 120 mg low cost, Zolli and Healy (2012) 11 identify two key aspects to resilience as continuity can arthritis in the knee be removed order etoricoxib 60 mg online, and recovery following change arthritis rheumatology purchase etoricoxib 120mg line. The key aspects of continuity and adaptability, as discussed by Zolli and Healy, are common themes throughout resilience literature. They argue that the resilience of a system hinges on its preserving of adaptive capacity, the quality that allows a system to adapt to change without losing the ability to fulfill its core purpose. Like other systems in nature or commerce, "social resilience often rests on the adaptive capacity of a community, or its ability to sense, interdict, and intervene" (Zolli and Healy, 2012 p. Other scholars point to a key factor in resilience as the need for an adaptive system that self-corrects in response to change (Swanstrom, 2012; Reckhow and Weir, 2012). The networks present provide a reference system from which needed resources are drawn in times of stress. Zolli and Healy further state that "the fragility and resilience of most systems begins with their structure" (p. Networks within communities are fragile insofar as they are built between people, and as such, are prone to breach through a variety of external forces. Maintaining relationships, and the built-in structure they provide can be a 12 challenge for even the most resilient of communities ­ and especially so in highly mobile societies as exist in the United States. Brown and Kulig (1996) contend that community resilience is not the collective sum of resilient individuals, but examine resilience through three dimensions of the community: political-economic conditions, social networks, and ways of understanding. They maintain, "the interplay between these features within given communities leads to a net enhancement or negation of the collective capacity to be resilient" (p. Therefore, community resiliency is not merely coping (the absence of choice), but rather being 13 proactive and intervening (p. Communities can actively build resilience through the course of responding to various disruptions over time. Berkes and Ross identify specific strengths that are instrumental in building community resilience. Bajayo (2012), in discussing community resilience points to "collective efficacy," or the motivation of community members to act because they believe that their collaborative action will bring positive change. Steiner and Markantoni (2013) contend that when undertaking a study of community resilience, "local settings and socio-economic characteristics" must be taken into account (p. They view community resilience as the overlap of four areas: individual and community social resilience, and individual and community economic resilience. The literature I reviewed invariably links levels of social capital with the concept of resilience, whether that is on an individual level (Forrest-Bank et al. Through my study of starter-home communities, I found the presence or 14 absence of social capital contributed to their resilience or non-resilience. Robert Putnam, considered the leading authority on social capital, defines it as "social organization such as networks, norms and social trust that facilitate coordination and cooperation for mutual benefit" (Putnam 1995, p. Light (2004) also writes that social capital is about trust "embedded in social networks," and encourages people to work together on community problems by enabling action. This results in a high turnover rate of residents ­ both in homeowners and tenants ­ and prevents social capital from forming (Ziersch & Arthurson 2007). Light (2004) also traces the roots of social capital by situating it within other forms of capital: financial, physical, human, and cultural. Social capital stands alone, however, in that its "uniquely democratic accessibility" does not require access or privilege and can be attained by the poor or indigent. We can see examples of social capital evident in older, tight knight neighborhoods that remain strong, even though their residents may be of very modest means. The first is bonding, which are those close ties within extended families or 15 ethnic communities to which an individual is closely identified. These are strong, lasting influences that are at the deepest core of an individual. They are sometimes seen as restrictive, however, and for many these ties hinder true self-expression. Therefore, a second network is needed that reaches outside the family bonded network. The bridging network is made up of looser ties that extend across and connect different groups of people. Bridging networks form through relationships such as friends, coworkers, and community or hobby interests. Bridging promotes the "strength of weak ties," which brings new information not found in our close family bridging networks. Resilience bridging expands relationships to important connections to structure and institutions such as police, the city, banks, or code & inspection officers ­ critical to a community rebound. Bonded ties are more numerous, easier to maintain, and typically of more diverse points of view. It is the loose network of bridging that often opens doors for job opportunities, allows a new perspective on things, and promotes new experiences. He documents how civic engagement and community development activities can ultimately lead to the building of neighborhood-level social capital. It is the content dimension that impacts trust, and hence the effective use of the structural social capital. The 133home neighborhood had been built and marketed as a nearly entirely investor-owned development, and as such, the large majority of renter-occupied homes created an environment in turmoil as widespread foreclosures led to numerous evictions. This created a cycle of turnover in residents that hindered community engagement and attachment to the neighborhood. The failure to create sustained civic engagement (Stage 1) prevented the advancement through the remaining stages of creating social networks, the building of trusting relationships, collective action, and the incurrence of lasting individual or social benefits. In a similar vein, Bajayo (2012) discusses community resilience as reliant upon the networking of resources including economic development, social capital, information 17 and communication, and community competence. A community with greater pre-stressor resources can protect against and recover from losses, whereas "vulnerable groups. Without access, these groups have limited prospects for resilience and face a probable path of even greater vulnerability and marginalization" (Bajayo 2012, p. Whether or not a community will adapt is due in part to its degree of social capital, i. Starter-home neighborhoods are often home to the described vulnerable groups who lack the pre-stressor resources necessary to be resilient. With this in mind, can certain community elements be deliberately introduced to help build-in resilience? I believe so, and in fact, I believe they must and through this research, aim to identify such elements. Foster (2012) also makes this point and argues, "resilience performance can be developed through resilience capacity. Likewise, Davoudi (2012) argues I add here that being a woman is not in itself a vulnerability, but in low-income and workforce housing female-headed households with children are common. I also challenge the notion that resilience necessarily be equated with bouncing back to the pre-stressor state. This assumes that a state of equilibrium existed prior to the stressor event, as traditional market-driven economics would suppose. I am not convinced, however, that such equilibrium does indeed exist in the case of some starter-home neighborhoods. It places an emphasis on the retrofitting of buildings, prohibiting rebuilding in environmentally sensitive areas, and strengthening local codes and ordinances to standards geared toward withstanding local hazards. A community must be prepared to take ownership and management of the recovery process. All residents in disaster-impacted communities must have a way to interact and provide input on future development. Include mitigation efforts to build disaster-resilient communities and reduce risk. Sometimes disasters wipe away older, more affordable neighborhoods and after being replaced with brand new construction, they may no longer provide these options. The starter-home model presents an option for post-disaster recovery housing able to address workforce and affordable housing needs because it can be built quickly.

For example arthritis diet chart in hindi purchase etoricoxib 90 mg visa, should she find herself delayed at the other end of Paris and hungry arthritis in dogs feet generic etoricoxib 90 mg on line, she will not dare to enter into a restaurant rheumatoid arthritis pregnancy 90 mg etoricoxib amex. She would constitute an event; she would be a spectacle: All eyes would be constantly fixed on her arthritis medication pain etoricoxib 120mg without prescription, and she would overhear uncomplimentary and bold conjectures. The pressures of intensified individuality protected in public by the blasй mask of indifference, registered in the equally socially induced roles of loving husband and responsible father, led to a desire to escape the overbearing demands of masculine domestic personae. The public domain became also a realm of freedom and irresponsibilty if not immorality. For the man going out in public meant losing oneself in the crowd away from both demands of respectability. Thus a woman going out to dine at a restaurant even with her husband present was scandalous, whereas a man dining out with a mistress, even in the view of his friends, was granted a fictive invisibility. Do you imagine that I get much good from what I see, chaperoned as I am, and when, in order to go to the Louvre, I must wait for my carriage, my lady companion, my family? They became the sites for the negotiation of gendered class identities and class gender positions. The spaces of modernity are where class and gender interface in critical ways, in that they are the spaces of sexual exchange. They are, as the canonical works indicate, the marginal or interstitial spaces where the fields of the masculine and feminine intersect and structure sexuality within a classed order. Clark, the Painting of Modern Life: Paris in the Art of Manet and his Followers, New York, Knopf, and London, Thames & Hudson, 1984. Another study to undertake this work is Theodore Reff, Manet and Modern Paris, Chicago, University of Chicago Press, 1982. The tendency is the more marked in earlier drafts of material which appears in the Painting of Modern Life. Roszika Parker and Griselda Pollock, Old Mistresses: Women, Art and Ideology, London, Routledge & Kegan Paul, 1981, 38. I refer for example to Edouard Manet, Argenteuil Les Canotiers, 1874 (Tournai, Musйe des Beaux Arts) and to Edgar Degas, Mary Cassatt at the Louvre, 1879­80, etching, third of twenty states (Chicago, Art Institute of Chicago). I am grateful to Nancy Underhill of the University of Queensland for raising this issue with me. It is furthermore interesting to note that both these scenes are painted quite close to the Morisot home in the Rue Franklin. Dreyfus and Patricia Allen Dreyfus, Evanston, Illinois, Northwestern University Press, 1961. Richard Sennett, the Fall of Public Man, Cambridge, Cambridge University Press, 1977, 126. Walter Benjamin, Charles Baudelaire: Lyric Poet in the Era of High Capitalism, London, New Left Books, 1973, chap. Smith, Ladies of the Leisure Class: the Bourgeoises of Northern France in the Nineteenth Century, Princeton, Princeton University Press, 1981. In passing we can note that in a drawing for a print on the theme of omnibus travel, Mary Cassatt initially placed a man on the bench beside the woman, child and female companion (c 1891, Washington, National Gallery of Art). The Journals of Marie Bashkirtseff (1890), introduced by Rozsika Parker and Griselda Pollock, London, Virago Press, 1985, entry for 2 January 1879, 347. To begin his talk (to a seminar organized by the Australian Institute of Urban Studies), Lennen told this fable: `As Adam and Eve were leaving the Garden of Eden, Adam turned to Eve and said, "Do not be distressed, my dear, we live in times of change. So I shall take this question here as an invitation to make up answers as I go, and the essay will be the response. To a newcomer, for example, the major supermarket in an unfamiliar centre is usually more difficult to read than the spatial relations between the speciality food shops and the boutiques. Nevertheless, there are always some basic rules of contiguity and association at work to assist you to make a selection (of shops, as well as products). However, I am more interested in a study that differentiates particular shopping centres. Shopping centres do get facelifts, and change their image-increasingly so as the great classic structures in any region begin to age, fade and date. On the one hand, they seem so monolithically present-solid, monumental, rigidly and indisputably on the landscape, and in our lives. At the same time, shopping-centre management methods (and contracts) are very much directed towards organizing and unifying-at the level of administrative control, if not of achieved aesthetic effect-as much of this spectacle as possible by regulating tenant mix, signing and advertising styles, common space decor, festivities, and so on. Above all, it does not eliminate the moment of everyday discontent-of anger, frustration, sorrow, irritation, hatred, boredom, fatigue. Like effective shopping, feminist criticism includes moments of sharpened focus, narrowed gaze-of sceptical, if not paranoid, assessment. But in using them in shopping centres, I strike another difficulty: a rhetorical one this time, with resonances of interdisciplinary 171 Ј Meaghan Morris ў conflict. Of course, these are not questions that any academic, even feminist, is obliged to ask or to answer. As a feminist, I cannot and do not wish the image, or the reality, of other women away. But this particular image was originally published in an Australian government report on the Shopping Centre as a Community Leisure Resource. These details help us to imagine that we know what is happening here: a young mother is strolling in the mall, enjoying herself enormously in its ambience, and sharing her pleasure with a friend. This image of an ordinary woman, then, is not a glimpse of her reality, but a polemical declaration about reality mobilized between the authors (or better, the authority) of a governmental report and its readership. Even her thoughts and feelings about shopping at Blacktown Westpoint now, or ten years ago. Above all, I cannot try to look through this image of a woman to my imaginary Real Woman and ask of her, `What does shopping-woman want? The study of shopping centres today is necessarily involved in a history of the positioning of women as objects of knowledges, indeed as targets for the man-oeuvres of retailers, planners, developers, sociologists, market researchers and so on. For having said that the text-image relation could be my object, the gap narrows too easily to a purely professional dispute (a critique of sociological constructions, for example). Like department stores before them (and which they now usually contain), they are described as palaces of dreams, halls of mirrors, galleries of illusion. This rhetoric is closely related, of course, to the vision of shoppingtown as Eden, or paradise: the shopping centre is figured as, if not exactly Utopian, then a mirror to Utopian desire, the desire of fallen creatures nostalgic for the primal garden, yet aware that their paradise is now an illusion. The slow, evaluative, appreciatively critical relation is not enjoyed to the same extent by women who hit the carpark, grab the goods, and head on out as fast as possible. But if walking around for a long time in one centre creates engagement with and absorption in the spectacle, then one sure way at least to begin from a sharply defined sense of critical estrangement is to arrive at a drive-in centre on foot-and have to find a way to walk in. Also, there are different practices of use in one centre on any one day: some people may be there for the one and only time in their lives; there are occasional users choosing that centre rather than this on that day for particular, or quite arbitrary reasons; people may shop at one centre and go to another to socialize or hang around. The use of centres as meeting places (and sometimes for free warmth and shelter) by young people, pensioners, the unemployed and the homeless is a familiar part of their social function-often planned for, now, by centre management (distribution of benches, video games, security guards). Three years ago, one theorist imagined the future thus: `Centres will be designed specifically to meet demands of the economic shopper, the recreational shopper, or the pragmatic shopper, and so on. That said, I want to make one more point about pedestrian leisureliness and critical time. For example, the building of Indooroopilly Shoppingtown required the blitzing of a huge chunk of old residential Indooroopilly. This is also why I suggested that it can be important to write a history of particular shopping centres. It helps to denaturalize the myths of spectacular identity-in-place that centres produce in order to compete with each other, by analysing how these myths, those spectacles, are constructed for particular spaces over time. As the sociologist John Carroll reports with the cheerfulness of the true conservative, `The Promotions Manager of one of the Shopping World chains in Australia has speculated that these centres may replace Valium. Department of Environment, Housing and Community Development, the Shopping Centre as a Community Leisure Resource, Australian Government Publishing Service, Canberra 1978. See Stuart Ewen, Captains of Consciousness: Advertising and the Social Roots of the Consumer Culture, New York 1976; Stuart and Elizabeth Ewen, Channels of Desire: Mass Images and the Shaping of American Consciousness, New York 1982; Kerreen M. The Disenchantment of the Home: Modernizing the Australian Family 1880­ 1940, Oxford 1985. Victor Gruen is widely regarded as the inventor of the modern enclosed mall, and his book was influential on subsequent accounts.

They may not be reproduced without the express written consent of the author and/or publisher arthritis zargan buy etoricoxib 60mg free shipping. Their experiences arthritis diet for hands purchase 120 mg etoricoxib mastercard, insights and expertise have shaped the document into one that will provide other families arthritis medication meloxicam generic etoricoxib 90mg without a prescription, individuals and professionals with clear guidelines leading to an earlier diagnosis rheumatoid arthritis relieve home remedies purchase etoricoxib 120mg with visa. To receive appropriate diagnostic services, a child must be able to obtain a comprehensive evaluation conducted by competent and qualified personnel using a protocol of acceptable tools and procedures. It is essential then that parents, providers and educators remain vigilant in ensuring that all children, regardless of gender, race, ethnicity or socioeconomic status are appropriately diagnosed as early as possible, and provided with the individualized services that can lead to optimal outcomes. The Connecticut Guidelines for a Clinical Diagnosis of Autism Spectrum Disorder (hereafter referred to as Guidelines) are a result of collaborative efforts that were initiated under the Connecticut Act Early Project. As part of the Act Early Campaign, regional summits of state teams were held during 2008-2010, with a Connecticut team participating in the New England Act Early Summit in Providence, Rhode Island in April 2010. In order to realize this vision, the team felt that a number of service components had to be defined and adopted throughout the state. To begin the process, the Act Early Team identified a number of principles to guide the development of the guidelines. While it is out of the purview of this document, the American Academy of Pediatrics recommends general developmental screening at the 9-, 18- and 30month well child visits. See Appendix A for the American Academy of Pediatrics surveillance and screening algorithms. Everyone in Connecticut, including diverse and underrepresented groups, should have easy and equitable access to diagnostic evaluations and intervention services. A family-centered approach is the foundation of all diagnostic services and interventions, and is represented throughout the Guidelines. A medical home approach provides comprehensive primary care that is accessible, continuous, comprehensive, family-centered, coordinated, compassionate, and culturally effective. To accomplish this a multidisciplinary 12 member work group consisting of parents, autism researchers, educators, and practitioners from developmental behavioral pediatrics, early intervention, public schools/special education, developmental psychology, child psychiatry and law was enlisted to write the guidelines. The work group met monthly to draft the guidelines, using a facilitator to discuss the content and format of the guidelines. These discussions were recorded and written into a working document by one member of the group who was responsible for developing the written draft of the guidelines. Between meetings, the workgroup reviewed, edited and resolved differences on the written drafts. This larger group brought together diverse perspectives to ensure that the guidelines were relevant to the evidence on best practice in diagnostic evaluation, as well as the Connecticut service delivery system. The larger advisory group was involved in three meetings during the process in order to review and approve decisions about key components of the guidelines. Most importantly, the group provided feedback on the social validity of the guidelines to diagnosticians, families, higher education faculty, public school administrators and personnel, advocates, and others. The purpose of these Guidelines is to provide a consistent and comprehensive source of information for diagnosticians who conduct these evaluations. Kanner described 11 children who lacked the usual disposition to make social contact and had a strong resistance to change in their environment. Among restricted and repetitive behaviors, for the first time hyper- or hypo-reactivity to sensory input or unusual interests in sensory aspects of the environment was included. The specifiers are intended to provide an "opportunity to define a more homogeneous subgrouping of individuals with the disorder who share certain features. There are also specifiers for the presence of accompanying intellectual disability and/or language impairment and associations with other known medical or genetic conditions, environmental factors, other neurodevelopmental, mental, or behavioral disorders, and catatonia. The specifiers are not mutually exclusive or jointly exhaustive; thus more than one specifier can be given. However, these diagnostic criteria were recently published, and have not been utilized extensively on a large scale. Prior to age three, delays or impaired skills and functioning should be found in at least one of the three areas: social interaction; language as used in social communication; or symbolic or imaginative play. The loss of skills generally occurs over the course of several months with developmental regression occurring prior to age 10, but typically by the age of five. Children with this disorder display behaviors similar to children with autistic disorder, with impairment in social communication skills, and restricted, repetitive and stereotyped patterns of behavior. Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. The diagnostician should also consider whether co-occurring disorders exist and if genetic testing or a referral for another type of diagnostic evaluation is indicated. It is recognized that conducting a high quality and comprehensive evaluation consumes a considerable amount of time which may not be commensurate with the level of public/private insurance reimbursement. While this document does not address the issue of financial reimbursement for diagnosticians, important work remains to be completed in this area. Before describing the diagnostic process, we cannot overemphasize the importance of using a family-centered approach throughout. Therefore it is critical that diagnosticians are trained to have a family-centered approach, such that family members/ caregivers are viewed as essential and valuable partners in the process of diagnosing children (National Center for Family-Centered Care, 1989). One of the keys to providing family-centered care is to recognize that a family consists of those members the family chooses to call "family," thus diagnosticians must be inclusive when asking about and involving family members/caregivers in a diagnostic evaluation. This requires flexibility on the part of the diagnostician, in terms of scheduling, respecting social and cultural values, and building on the strengths of each child and family. Information gathered from the family when paired with observations and data gained from thorough assessments, contribute to an accurate diagnosis. Record Review the diagnostic clinician should request and obtain medical and other available records as part of the diagnostic evaluation process. This can ensure that duplicative tests and assessments will not be requested unnecessarily. The Connecticut Guidelines for a Clinical Diagnosis of Autism Spectrum Disorder - 17 - Table 4. Family history (medical, psychosocial), including any history of developmental disabilities, including autism, genetic conditions, learning problems, mental health and behavioral problems in family members. It is important to learn of family members with school problems, alcohol and substance abuse, incarceration and early deaths and those who may have had undiagnosed disorders/conditions as well as any diagnosed neurological and behavioral problems that family members may have experienced. This can be done during the family interview with focused questions about family members going back three generations. For some children, especially those under age three who may be enrolled in a home visiting or early intervention program, this may occur in the home environment. No matter where, a comfortable "child friendly" environment with developmentally appropriate toys should be created to observe the child at play during the assessment. This type of environment allows the diagnostician to get a sense of how the child typically interacts with familiar and unfamiliar people. Social communication impairments are characterized by difficulty maintaining conversations, deficits in nonverbal communicative behaviors used for social Table 5. Social interaction impairments are characterized by an inability or disinclination to share and direct attention with another person, called joint attention. Another feature of impaired social interaction is a lack of social referencing. This set of symptoms is exhibited by an apparent adherence to routine and discomfort with change, preoccupying interests, and an apparent interest in the parts of objects rather than the whole or its functional use. Rather, repetitive and restricted behaviors typically begin increasing around ages four to five years (Charman et al. When a clear clinical picture does not emerge from the evaluation, the diagnostic team or lead diagnostician should consider conducting a formal assessment using a standardized diagnostic instrument to assess autism symptoms or should refer the child and family to an appropriately trained and experienced clinician for a diagnostic evaluation. The purpose of the evaluation is to understand behaviors related to social interaction, to assess communication skills, and to ascertain whether restricted behaviors and repetitive interests are present. The selection of particular instruments is based on - 20 - Connecticut Guidelines for a Clinical Diagnosis of Autism Spectrum Disorder Table 6. Importantly, the instruments discussed in the following section are to be used only with children who have a developmental age of at least 12 months. Through a series of play based tasks, the semi-structured instrument enables trained professionals to assess communication, social interaction, play and restricted and repetitive behaviors (Lord et al. The Toddler Module does not produce a score; only ranges of concern (little-or-no, mild-to-moderate, moderate-to-severe) result from administering the assessment (Luyster et al. The instrument aids in distinguishing autism spectrum conditions from other child psychiatric conditions by identifying the presence and extent of autistic social impairment. It is administered with children as young as 30 months through adulthood and takes 15 to 20 minutes to administer.

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