By: John Hunter Peel Alexander, MD
As the entry for Pygmalion shows quality 40/60 mg levitra with dapoxetine erectile dysfunction doctors austin texas, George Bernard Shaw’s provocative use of the term in his comedy in 1914 provoked a scandal in London, but had no impact in New York. Bloody now has very different currencies and severity of impact in global varieties of English. It continues to have only limited use in the United States, being unlisted in most dictionaries of slang. In British and South African English it is now a mild and somewhat passe intensifier. These modes can be highly developed in what were traditionally called “primitive” cultures. Thus the ritualistic action of pointing the finger among the Australian aborigines can in itself have fatal consequences for the victim, the equivalent of the curse. It is a viable speculation that in the remote stages of a culture, gesture increasingly accompanies and even replaces language (see Sapir 1921, 21 and Barber 1964, 24–34). Consequently, a historical survey shows that various modes of body language continue to thrive up to modern times, some of them sufficiently provocative to lead to legal consequences. The most unambiguous and wounding gesture of personal contempt, short of actually laying hands on someone, is to spit at them, notably recorded in the humiliation of Christ in the Gospels (Mark 10:34 and Matthew 26:67). One of the last references recorded in the Oxford English Dictionary is from Uncle Tom’s Cabin (1852), chapter xxxviii. Offensive body language, or what Ashley Montagu calls “gesticulatory swearing” (1973, 344), has become the focus of considerable discussion in modern times, often carrying the misleading implication that it is a modern phenomenon. Although little evidence exists in the surviving Anglo-Saxon and Middle English literature, there are highly developed in stances in the Renaissance. Absurdly and tantalizingly, the signs are described in detail, but their meaning is not. The famous exchanges of coded provocation between the servants of the Capulets and the Montagus in Romeo and Juliet (1594) provide a notable early example. Since the actions are derived from Continental practices, they need to be explained in the text to the English audience: Sampson: I will bite my thumb at them; which is a disgrace to them, if they do bear it. Their actions are explained in Randle Cotgrave’s Dictionarie of the French and English Tongues (1611) under the entry for nique: “To threaten or defie by putting the thumbe naile into the mouth and with a jerke (of the upper teeth) make it to knack [make a cracking sound]. Johnson defined fico in 1755 in both linguistic and physical terms as “An act of contempt done with the fingers expressing ‘a fig for you. Other continental idioms, such as French faire la figue and Spanish dar la higa, denote the same action.
However generic levitra with dapoxetine 40/60mg online erectile dysfunction low libido, in Palestine’s case, there is little sense in carving out selected areas in which government procedures are expedited. Palestine is so small, geographically (the 148 Building a Successful Palestinian State size of the San Francisco metropolitan area) and economically, that the Palestinian government would be well advised to eliminate tari s and simplify business registra tion and other procedures for the entire country, not just special zones. Governments that create simple, low-cost, transparent procedures for registering and regulating busi nesses have had some remarkable successes in terms of economic development: Wit ness Hong Kong, Estonia, and Singapore. Such a step would signal to the international investor community that the Palestinian government seriously wishes to attract foreign investment and support the private sector. Regardless of whether the Palestinian government simpli es regulations for the entire state or just selected zones, regulations should have the following characteristics: They should be designed to help facilitate the movement of people to their jobs and the movement of goods between port facilities and industrial or agricultural centers. Such rules would provide safeguards to foreign investors and address investor concerns about the rule of law and transparency. Investing in Human Capital Tere is currently a mismatch between the skills of the Palestinian labor force and those most needed in the sectors of the economy most likely to expand. Most university stu dents study liberal arts subjects rather than engineering or sciences, majors that have been more marketable but less popular. We do suggest, however, that businesses should be shielded from excessive regulation, which is a concern given the relative inexperi ence of Palestinian governing bodies. High dropout rates may stem from the poor quality of vocational training: Students question the bene t for future employment of poorly designed training courses. As the Palestinian economy develops and modernizes, it will require a skilled workforce ready to participate in a competitive, global environment. Ensuring that the Palestinian workforce is adequately prepared will require signi cant investments in human capital. Although we discuss reforms of the education system in more detail in Chapter Eight, we note several areas in which reforms would give Palestinian students more-marketable skills: • Foreign donors should provide tuition assistance and subsidies to encourage en rollments in the sciences and engineering. Conclusions In this chapter, we examined possible economic development trajectories in an indepen dent Palestinian state during the 2005 to 2019 time frame. We focused on Palestine’s prospects for sustaining growth in per-capita incomes over time. In exploring this issue, we discussed the major challenges that will confront the Palestinian economy, as well as the four critical issues—transaction costs, resources, the Palestinian trade regime, and the access of Palestinian labor to employment in Israel—that will determine the condi tions under which the Palestinian economy will function. Using a growth accounting model, we then examined how the four scenarios resulting from di erent levels of con tiguity and integration a ect per-capita income. The scenario with the highest resulting per-capita income after ten years (high contiguity and high integration) saw incomes 24 percent higher than incomes in the scenario with the lowest resulting per-capita income (low contiguity and low integration). We also discussed best-practice policy options that could aid the Palestinian economy under any conditions. Decisionmakers should nd our framework and analysis useful in two important respects. First, they provide a rough approximation of the magnitude of investments needed to generate rapid recovery and then growth in per-capita incomes in Palestine.
Although dhat syndrome is most commonly identified with young men from lower socioeconomic backgrounds order levitra with dapoxetine 40/60mg amex erectile dysfunction and pump, mid dle-aged men may also be affected. Comparable concerns about white vaginal discharge (leu korrhea) have been associated with a variant of the concept for women. Khyal cap "Khyal attacks" (khyal cap), or "wind attacks," is a syndrome found among Cambodians in the United States and Cambodia. Common symptoms include those of panic attacks, such as dizziness, palpitations, shortness of breath, and cold extremities, as well as other symp toms of anxiety and autonomic arousal. Khyal attacks in clude catastrophic cognitions centered on the concern that khyal (a windlike substance) may rise in the body—along with blood—and cause a range of serious effects. Khyal attacks may occur with out warning, but are frequently brought about by triggers such as worrisome thoughts, standing up. Khyal attacks usually meet panic attack criteria and may shape the experience of other anxiety and trauma and stressor related disorders. Related conditions in other cultural contexts: Laos (pen lom), Tibet (srog rlunggi nad), Sri Lanka (vata), and Korea (hwa byung). Kufungisisa Kufungisisa ("thinking too much" in Shona) is an idiom of distress and a cultural explana tion among the Shona of Zimbabwe. As an explanation, it is considered to be causative of anxiety, depression, and somatic problems. As an idiom of psychosocial distress, it is indicative of interpersonal and social difficulties. Kufungisisa is associated with a range of psychopathology, including anxiety symp toms, excessive worry, panic attacks, depressive symptoms, and irritability. In a study of a random community sample, two-thirds of the cases identified by a general psychopathol ogy measure were of this complaint. In many cultures, "thinking too much" is considered to be damaging to the mind and body and to cause specific symptoms like headache and dizziness. In the case of brain fag, "thinking too much" is primarily attributed to excessive study, which is considered to damage the brain in particular, with symptoms including feelings of heat or crawling sensations in the head. It has been described in Africa, the Caribbean and Latin America, and among East Asian and Native American groups. Maladi moun Maladi moun (literally "humanly caused illness," also referred to as "sent sickness") is a cultural explanation in Haitian communities for diverse medical and psychiatric disor ders. In this explanatory model, interpersonal envy and malice cause people to harm their enemies by sending illnesses such as psychosis, depression, social or academic failure, and inability to perform activities of daily living.
Somatic: False belief involving body functions such the belief that the brain is rotting or melting cheap 40/60mg levitra with dapoxetine visa erectile dysfunction treatment fruits. Infidelity: False belief associated with pathological jealousy about a person‘s lover being unfaithful. There are overvalued ideas which refer to unusual thoughts of a bizarre nature but they are not as rigid as delusions. For example, a man who believes that his credit card number should end with the digit 6 and refuses to accept a new credit card with a different last number. Magical thinking involves seeing a connection between two events which would seem unrelated to most people. For example, a woman may believe that every time she buys things from a particular shop her husband loses a contract. Overvalued ideas and magical thinking do not indicate that the person has a mental disorder but suggests some psychological decline. Violent thoughts such suicidal ideas or thoughts of harming or killing another person also need to be assessed. For example, speaking to person with Schizophrenia or other forms of psychosis can be 19 difficult because their language may be illogical. Examples of thought disorder: Incoherence: the speech is not clear and understandable. For example, Suma is nice person but there is lot of poverty in the world and I am going to cut my hair tomorrow. Circumstantiality: Indirect speech that is delayed in reaching the point by bringing in lot of irrelevant details. Tangentiality: Going off on a different point without coming to the original idea. For example, when one is not very sure if he has had breakfast and is asked what he had eaten, he may give an elaborate account of a typical breakfast. Flight of ideas: Rapid, continuous shifting from one idea to another in which ideas tend to be connected. Pressure of speech: Rapid speech as if the person feels forced to speak continuously. Perseveration: Continuing with a response to a previous question or stimulus after a new question or stimulus is presented. While assessing the affect, the clinician checks if it is appropriate (condition in which 20 emotional tone is in harmony with the accompanying idea) or inappropriate (disharmony between the feeling tone and the thought or idea accompanying it). The affect is described as blunted affect when there is a severe reduction in the intensity of externalised feeling tone and as flat affect when signs of affective expression are absent or nearly absent, the face is immobile and voice is monotonous. On the other hand, exaggerated or heightened or overdramatic affect is reported when the emotional expression is very strong. The range of affect in terms of the variety of emotional expressions noted is also taken into account.
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