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AEI currently utilizes a RIEGL VZ400 Terrestrial Laser Scanner on various job sites.  This proecss utilizes a high accuracy 3D terrestrial LiDAR unit.  The data collected will be brought into a feature extraction software, TopoDOT.  TopoDOT utilizes a variety of tools to identify adn quickly extrapolate features within pointcloud data.  All features can then be imported into an AutoCAD drawing file.  AEI can provide an accurate 3D pointcloud of terrain plus any existing building or structures.  The pointcloud can also be converted for Building Information Models.

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Allen Engineering is involved with the civil design and surveying for the new park in Palm Bay, Flordia.  This Regional Park will feature 150 full service campsite hookups and is scheduled to break ground in 2018.  We are extremely proud to be involved in this project.

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Allen Engineering is beginning its 21st year associated with the Space Coast Post of the Society of American Military Engineers (SAME).  During our 21 years, we have helped raise over $350,000 in scholarships and endowments.  We are extremely proud to be associated with SAME and its continued commitment to offer opportunities for students pursuing careers in the engineering field.


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Worldwide epidemiology of atrial fibrillation: a Global Burden of Disease 2010 Study birth control pills 40 generic alesse 0.18mg visa. Estimates of current and future incidence and prevalence of atrial fibrillation in the U birth control pills uti cheap alesse 0.18mg mastercard. Prevalence birth control pills cause depression purchase alesse 0.18mg line, incidence and lifetime risk of atrial fibrillation: the Rotterdam study birth control for women of faith purchase 0.18mg alesse amex. Projections on the number of individuals with atrial fibrillation in the European Union, from 2000 to 2060. Atrial fibrillation, stroke risk, and warfarin therapy revisited: a population-based study. Prospective national study of the prevalence, incidence, management and outcome of a large contemporary cohort of patients with incident non-valvular atrial fibrillation. Atrial fibrillation: profile and burden of an evolving epidemic in the 21st century. Prevalence, incidence, prognosis, and predisposing conditions for atrial fibrillation: population-based estimates. Review of epidemiology and management of atrial fibrillation in developing countries. Distribution and risk profile of paroxysmal, persistent, and permanent atrial fibrillation in routine clinical practice: insight from the reallife global survey evaluating patients with atrial fibrillation international registry. Temporal relations of atrial fibrillation and congestive heart failure and their joint influence on mortality: the Framingham Heart Study. Detection of atrial fibrillation after ischemic stroke or transient ischemic attack: a systematic review and meta-analysis. A population-based study of the longterm risks associated with atrial fibrillation: 20-year follow-up of the Renfrew/ Paisley study. Causes of death and influencing factors in patients with atrial fibrillation: a competing-risk analysis from the randomized evaluation of long-term anticoagulant therapy study. Atrial fibrillation as risk factor for cardiovascular disease and death in women compared with men: systematic review and meta-analysis of cohort studies. Atrial fibrillation in women: epidemiology, pathophysiology, presentation, and prognosis. Gender-related differences in risk of cardiovascular morbidity and all-cause mortality in patients hospitalized with incident atrial fibrillation without concomitant diseases: A nationwide cohort study of 9519 patients. Meta-analysis of gender differences in residual stroke risk and major bleeding in patients with nonvalvular atrial fibrillation treated with oral anticoagulants. Gender-related differences in presentation, treatment and long-term outcome in patients with first-diagnosed atrial fibrillation and structurally normal heart: the Belgrade atrial fibrillation study. Risk factors for anticoagulation-related bleeding complications in patients with atrial fibrillation: a systematic review. Gender differences in patients referred for atrial fibrillation management to a tertiary center. Are there gender differences in outcomes after the Cox-Maze procedure for atrial fibrillation? Parental atrial fibrillation as a risk factor for atrial fibrillation in offspring. Integrating genetic, transcriptional, and functional analyses to identify 5 novel genes for atrial fibrillation. Novel genetic markers associate with atrial fibrillation risk in Europeans and Japanese. Lemmens R, Buysschaert I, Geelen V, Fernandez-Cadenas I, Montaner J, Schmidt H, Schmidt R, Attia J, Maguire J, Levi C, Jood K, Blomstrand C, Jern C, Wnuk M, Slowik A, Lambrechts D, Thijs V, International Stroke Genetics Consortium. The association of the 4q25 susceptibility variant for atrial fibrillation with stroke is limited to stroke of cardioembolic etiology. Twelve-single nucleotide polymorphism genetic risk score identifies individuals at increased risk for future atrial fibrillation and stroke. Pitx2 prevents susceptibility to atrial arrhythmias by inhibiting left-sided pacemaker specification. Modulation of conductive elements by Pitx2 and their impact on atrial arrhythmogenesis. Chromosome 4q25 variants and atrial fibrillation recurrence after catheter ablation. Common genetic polymorphism at 4q25 locus predicts atrial fibrillation recurrence after successful cardioversion. Common atrial fibrillation risk alleles at 4q25 predict recurrence after catheter-based atrial fibrillation ablation. Parvez B, Vaglio J, Rowan S, Muhammad R, Kucera G, Stubblefield T, Carter S, Roden D, Darbar D. Symptomatic response to antiarrhythmic drug therapy is modulated by a common single nucleotide polymorphism in atrial fibrillation. Amyloid deposition as a cause of atrial remodelling in persistent valvular atrial fibrillation. Cellular and molecular mechanisms of atrial arrhythmogenesis in patients with paroxysmal atrial fibrillation. Enhanced sarcoplasmic reticulum Ca2+ leak and increased Na+-Ca2+ exchanger function underlie delayed afterdepolarizations in patients with chronic atrial fibrillation. Effects of chronic atrial fibrillation on gap junction distribution in human and rat atria.

The analyzed agencies are all present somehow in this online platform birth control for women xx generic alesse 0.18 mg fast delivery, be it through an individual description sheet (history birth control pills in green case cheap alesse 0.18mg fast delivery, vision birth control pills hair loss generic alesse 0.18mg without prescription, services offered) or just mentions in articles written by others birth control for women like me 0.18 mg alesse for sale. The content in these articles is related to awards, successful stories for their own clients, predictions about future developments, philosophies and approaches in advertising, trends and opinions about their industry. The last objective of our study refers to type of value proposition used by digital agencies, and, as it can be observed in Table 1, there are two approaches: · the first one is about an objective value proposition, that states very clearly what the agency is offering in terms of services, highlighting the experience and the cost efficiency; · the second one is about an affective value proposition, in which agencies are showing the end-value of working together, rather than what they can do for their clients. We offer our clients integrated strategies of digital marketing that efficiently combine the online marketing tactics with the off-line ones. The expertise of the tribal team worldwide covers the entire spectrum of skills in digital marketing services: concepts of campaigns and integrated campaigns, e-commerce platforms and platforms dedicated to the mobile environment, communication in social networks and strategies that creatively implement new technologies. We are a strong full-service digital agency that bridges that gap between marketing, advertising and technology by offering a vertically integrated "one-stop-shop" solution for all your strategy, creative and digital evolution. We are offering you the best possible media plan, with an excellent report between price/views/sites, in order for the client and also the agency to be happy with the collaboration and to desire a long-term relationship. We create exceptional digital user experiences that solve business problems and make lives easier. We make brands more valuable to people, and people more valuable to brands, while bringing digital to the core of communication. Ans also, multiple online platforms can be used to create a strong presence on the market and, also, to differentiate from other competitors on the market. These results can be considered the first steps towards defining and discovering better and better the market of digital agencies. Nonetheless, since the digital world is constantly changing and evolving, so is the market for digital agencies is likely to evolve and expand to new virgin territories as well. In this context, research is crucial to keep on expanding in order to get into the depth of this industry. A framework for digital marketing research: investigating the four cultural eras of digital marketing. A marketing communications approach for the digital era: managerial guidelines for social media integration. The digital marketing skills gap: developing a digital marketer model for the communication industries. Strategic and organisational challenges in the integrated marketing communication paradigm shift: a holistic vision. Meaning that sustainable development can really co-exist with current economic patterns of growth. Empirical analysis is based on panel cointegration analysis for the set of 44 countries, mostly developed and developing ones. Results are consistent with general features of standard growth models with the dual characteristic of the relationship between economic openness and green growth. This reductionism in mainstream economic theory and in practical manifestation of economic policies sometimes bypasses the question of oblivion towards the destruction of socio-economic systems. Thus, when this point is crossed, further economic growth can deteriorate the quality of life due to the costs associated with an increasing income inequality, loss of leisure time and natural resource depletion. So, the question of co-existence of equitable and sustainable development and current patterns of economic growth comes into foreplay. One concept stands out more strongly from the crowd of definitions that are trying to incorporate different aspects of wellbeing in aforementioned conceptual confrontation. Empirical analysis is based on panel cointegration analysis for the period 2008-2016 on set of 44 countries, ranging from developed and developing ones. Our results confirm general features of standard growth models with the dual characteristic of the relationship between economic openness and green growth. Theoretical background Green growth logic is based on making growth process resource efficient, cleaner and more resilient without necessarily slowing them (Hallegatte et. Considering traditional economic growth theories that identify sources of economic growth, which are paralysed with assumptions about substitution, rate on returns and technical change, it is not easy to evaluate direct or indirect contributions of environmental protection to economic growth, and vice versa. Growth theory can help in explaining green growth if we can find a nexus between environmental policies and environmental degradation on the hand, and sources of economic growth and the rates of return to the investments and innovations in the green economy, on the other hand (Smulders, Toman and Withagen, 2014). It is very hard to identify channels that are theoretically able to make green policies contribute to economic growth having in mind that human and capital stock, as well as environmental stock can change over time. If we expand scientific horizon into global economic system, we can track additional variables that influence economic growth. For example, a number of studies have reported on the positive aspects of open trade regimes, thereof that export expansion raises the rate of economic growth by the way of its impact on total factor productivity, as of negative aspects by linking greater openness to deterioration of social and environmental conditions. In theory, for example, modern exogenous growth models provide direct links between growth and endogenously chosen policy options such as freer trade regimes (Talberth and Bohara, 2006). Empirical background There is a vast number of papers dealing with different domains of economic growth theory, but we found two papers that follow the line of our inquiry. Their results, in fact, provided empirical support for researches that associate greater openness with environmental degradation, income inequality and an increase in economic activity, for that is self cancelling from a welfare perspective. This research will be a cornerstone for our study, as it was for the paper from Wang (2011). In addition, openness had an inverted U shape effect, meaning it increases sustainable development at the beginning and decreases sustainable development after a threshold point. Methodology Cointegration analysis with panel data is similar to cointegration usually employed in time series analysis and consists of unit root tests, cointegration tests and the estimation of long-run (and short-run) relationship.

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Oral propafenone for rapid conversion of recent onset atrial fibrillation-A review birth control for women quotes generic alesse 0.18 mg otc. Transthoracic cardioversion of atrial fibrillation: comparison of rectilinear biphasic versus damped sine wave monophasic shocks birth control pills that stop periods generic alesse 0.18 mg on line. Anterior-posterior versus anteriorlateral electrode positions for external cardioversion of atrial fibrillation: a randomised trial birth control otc discount 0.18 mg alesse. Facilitating transthoracic cardioversion of atrial fibrillation with ibutilide pretreatment birth control pills 2015 generic 0.18mg alesse mastercard. Vernakalantfacilitated electrical cardioversion: comparison of intravenous vernakalant and 592. Is rhythmcontrol superior to rate-control in patients with atrial fibrillation and diastolic heart failure? Rate and rhythm control have comparable effects on mortality and stroke in atrial fibrillation but better data are needed. Oral loading single dose flecainide for pharmacological cardioversion of recent-onset atrial fibrillation. Amiodarone versus placebo and class Ic drugs for cardioversion of recent-onset atrial fibrillation: a meta-analysis. Effectiveness of amiodarone for conversion of atrial fibrillation to sinus rhythm: a meta-analysis. Rapid loading of sotalol or amiodarone for management of recent onset symptomatic atrial fibrillation: a randomized, digoxin-controlled trial. A randomized trial of prophylactic antiarrhythmic agents (amiodarone and sotalol) in patients with atrial fibrillation for whom direct current cardioversion is planned. Vernakalant hydrochloride for rapid conversion of atrial fibrillation: a phase 3, randomized, placebocontrolled trial. Vernakalant hydrochloride for the rapid conversion of atrial fibrillation after cardiac surgery: a randomized, double-blind, placebo-controlled trial. A randomized active-controlled study comparing the efficacy and safety of vernakalant to amiodarone in recent-onset atrial fibrillation. Systematic review and meta-analysis of the efficacy of cardioversion by vernakalant and comparators in patients with atrial fibrillation. Treatment of stable atrial fibrillation in the emergency department: a population-based comparison of electrical direct-current versus pharmacological cardioversion or conservative management. Comparison of pharmacological and electrical cardioversion in permanent atrial fibrillation after prosthetic cardiac valve replacement: a prospective randomized trial. Cardioversion of acute atrial fibrillation in the short observation unit: comparison of a protocol focused on electrical cardioversion with simple antiarrhythmic treatment. Bellone A, Etteri M, Vettorello M, Bonetti C, Clerici D, Gini G, Maino C, Mariani M, Natalizi A, Nessi I, Rampoldi A, Colombo L. Cardioversion of acute atrial fibrillation in the emergency department: a prospective randomised trial. Effects of oral propafenone administration before electrical cardioversion of chronic atrial fibrillation: a placebo-controlled study. Verapamil versus digoxin and acute versus routine serial cardioversion for the improvement of rhythm control for persistent atrial fibrillation. Effects of diltiazem pretreatment on direct-current cardioversion in patients with persistent atrial fibrillation: a single-blind, randomized, controlled study. Pretreatment with verapamil in patients with persistent or chronic atrial fibrillation who underwent electrical cardioversion. Double-blind placebo-controlled trial of aprindine and digoxin for the prevention of symptomatic atrial fibrillation. Thromboembolic risk in 16 274 atrial fibrillation patients undergoing direct current cardioversion with and without oral anticoagulant therapy. Economic evaluation of enoxaparin for anticoagulation in early cardioversion of persisting nonvalvular atrial fibrillation: a statutory health insurance perspective from Germany. Quality of anticoagulation with unfractionated heparin plus phenprocoumon for the prevention of thromboembolic complications in cardioversion for non-valvular atrial fibrillation. Time to cardioversion for acute atrial fibrillation and thromboembolic complications. Use of transesophageal echocardiography to guide cardioversion in patients with atrial fibrillation. Amiodarone in patients with congestive heart failure and asymptomatic ventricular arrhythmia. Continuous vs episodic prophylactic treatment with amiodarone for the prevention of atrial fibrillation: a randomized trial. Preliminary report: effect of encainide and flecainide on mortality in a randomized trial of arrhythmia suppression after myocardial infarction. Mixed treatment comparison of dronedarone, amiodarone, sotalol, flecainide, and propafenone, for the management of atrial fibrillation. Multicenter study of the efficacy and safety of disopyramide in obstructive hypertrophic cardiomyopathy. Treatment of obstructive hypertrophic cardiomyopathy symptoms and gradient resistant to first-line therapy with beta-blockade or verapamil. Effect of d-sotalol on mortality in patients with left ventricular dysfunction after recent and remote myocardial infarction. Efficacy of dofetilide in the treatment of atrial fibrillation-flutter in patients with reduced left ventricular function: a Danish investigations of arrhythmia and mortality on dofetilide (diamond) substudy.

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In this context birth control 99 percent effective cheap alesse 0.18 mg without a prescription, recently was adopted a fundamental instrument on this subject birth control for women in menopause alesse 0.18mg line, namely the Convention of Istanbul (Convention on preventing and combating violence against women and domestic violence2) birth control pills kinds order 0.18 mg alesse mastercard, adopted by the Council of Europe and opened for signature in May 2011 3 birth control wikipedia cheap alesse 0.18 mg visa. Under this Convention, States must involve all relevant actors in the implementation of the Istanbul Convention, including national parliaments and institutions and non-governmental and civil society organizations. In fact, the Istanbul Convention is the outcome of a long process that has raised increasing awareness of the problem of violence against women in Europe, and, more generally, at the 2 3 Available at. On the several sources of international human rights law on Female Genital Mutilation. Even when committed by private parties, within domestic walls, instances of violence against women constitute a violation of human rights, and States bear due diligence obligations in effectively preventing and combating these crimes. The private-public distinction, which previously prevented States from interfering in the individual sphere, has been disrupted thanks to the provisions included in international legal instruments, the work of international and regional tribunals, and feminist theories (de Vido, 2017:72-73). The Convention, recognising, with grave concern, that women and girls are often exposed to serious forms of violence such as domestic violence, sexual harassment, rape, forced marriage, crimes committed in the name of socalled "honour" and genital mutilation, which constitute a serious violation of the human rights of women and girls and a major obstacle to the achievement of equality between women and men, establishes in its art. This imposition of criminalization aims at harmonising core values under criminal law protection, promoting, in this case, the liberty and security of women (and children) even against cultural motivated practices. This definition is, indeed, a "positive outcome, which fills a normative gap existing in Europe" (de Vido, 2017:75). In the case of the Istanbul Convention, it is paramount to note that, although urging States towards criminalization, it is about the protection of a core value. In another perspective, recognizing said value did not have enough protection9, the global response was to assure said protection through criminal law. If not for the adoption of an assertive response, that would mean that a (globally) relevant core value would be left, if not unprotected, at least not sufficiently protected. Here it is not a case of international instruments aiming at safeguarding liberty, rather a set of international instruments aiming at ensuring security. Defining terrorism is undoubtedly a seemingly impossible task, if one takes into account the different variations and elements of this phenomena. These elements can be summarized as follows: the terrorist purpose, the terrorist action, the terrorist target, the terrorist method and the terrorist agent (Hodgson/Tadros, 2013:499). Nonetheless, there is some consensus that terrorism is an attack on fundamental core values of the States, reason why it enables triggering of special State power in fighting it. Equally difficult is a legal definition of terrorism (Greene, 2017; Hodgson/Tadros, 2013; Weinberg et al. Considering the first difficulty above mentioned, the principle of legality demands such a legal definition of the phenomena. This Directive only defines "terrorist group" as "a structured group of more than two persons, established for a period of time and acting in concert to commit terrorist offences" (art. The Directive expressly considers the "cross-border nature of terrorism", requiring "the global character of terrorism (. Even if there is a legal definition of terrorist groups or terrorist acts, the problem remains the maintenance of the guarantistic nature of criminal law. In other words, if suspected terrorists are to be afforded the same rights as other criminal suspects. This Directive has to be implemented in accordance with those rights and principles taking also into account the European Convention for the Protection of Human Rights and Fundamental Freedoms, the International Covenant on Civil and Political Rights, and other human rights obligations under international law. Recital 39 adds that: · the implementation of criminal law measures adopted under this Directive should be proportional to the nature and circumstances of the offence, with respect to the legitimate aims pursued and to their necessity in a democratic society, and should exclude any form of arbitrariness, racism or discrimination. The fight against terrorism increases the securitary possibilities of criminal law. Ensuring the minimal guarantee standard offered by the principle of legality in criminal law, one can ask if such minimal guarantee is enough for the safeguard of the most important human rights, such as liberty. The principle of legality is a milestone of criminal law, but does not, by itself, ensure the protection of other core human 11 In the wider context of the Council of Europe there is also to consider the Council of Europe Convention on the Prevention of Terrorism (2005). Thereto it is also fundamental to respect the ultima ratio maxim of criminal law and not transform criminal law into the first ratio. Regarding the two referential points taken in consideration ­ and having under regard the international instruments thereon ­ the first impression seems to be that there is more repressive than preventive concern. It is clear that the scope of this paper does not allow for a certainty and can only point at a tendential direction of the pendulum. Nonetheless, if this repressive trend is correct, one can only call upon the risks of such a trend, which can be a peril for the safeguard of important human rights. In a global world, we are all global citizens and only a liberty directed pendulum in criminal law can truly serve (global criminal) justice. Terrorism and criminal law: the dream of prevention, the nightmare of the rule-of-law, New Criminal Law Review, Vol. However, such situation refers mostly to external macro market problems dealing with desirable and involuntary turnover but does not fully explain internal organizational problems with voluntary turnover. Namely, voluntary intentional turnover is not mainly caused by external factors but the range of internal organizational factors where causes vary depending on the industry, organizational structure and culture, and especially on Human Resources Management. This review paper describes different types of employee turnover, employee turnover rates, as well as negative consequences of undesirable employee turnover that include visible and invisible costs. Special emphasis is paid to turnover trends in Croatia where employee turnover rates are very low compared with other European countries. Nevertheless, this is not an indicator of favorable position while Croatian employees are not mobile, labor market is not dynamic and organizations are not flexible.

Hawton and Catalan (1987) classified self-injury (other than overdose) into superficial self-cutting (usually wrist or forearm - little or no association with suicidal intent) birth control for women zombies purchase alesse 0.18mg overnight delivery, serious self-injury birth control for women 90s fashion discount alesse 0.18mg on-line. Van der Kolk ea (1991) found that cutters had a history of childhood trauma birth control pills hormone imbalance generic alesse 0.18mg with mastercard, neglect and abandonment birth control 97 effective 0.18mg alesse. In most cases, self-inflicted injury is only part of a long history of psychogenic illness. Life circumstances may play an important part in determining whether remissions occur in the future. In general, the main associations with selfinjury are intellectual disability, psychosis, being in prison, and having a disorder of personality. Joyce ea (2010) conducted a family study on the molecular genetics of depression and personality in which a proband had been treated for depression. They concluded that self-mutilation and attempted suicide overlapped only partially although both phenomena could be predicted by mood disorder diagnosis and harm avoidance. They found that self-mutilation had a strong association with bipolar affective disorder and they urged readers to consider the latter rather than borderline personality disorder when assessing selfmutilation. It seems to this author that one should consider both conditions in practice and these findings (Joyce ea, 2010) will need further research to see if they apply more generally to self-mutilators. Research on stress in the medical profession is strongly associated with FirthCozens, a clinical psychologist in Leeds. It has been argued that doctors may enter medicine because of some early noxious life experiences and that, when medicine fails to help them resolve such conflicts, they become disillusioned and distressed. According to Firth-Cozens,(2003) 28% of doctors and 18% of the general working population suffer from excessive stress levels. Predictors of a more positive work milieu include high self esteem, satisfactory support with work-related problems, lower perceived workload, a positive view of leadership, low work-related exhaustion, and having a sense of participation in the organisation. Lack of influence on workplace decisions ­ managers plan and consultant input negated Compromising professional standards ­ inability to tailor interventions to individual patients ­ possibly related to catchment area/sectorisation Mental illness is common in doctors, especially alcoholism, drug dependence, and affective disorders. It may be the characteristics of the empathic doctor that make him prone to breakdown. Sources of stress include diagnostics and therapeutics, the death of children, domestic problems due to work, premorbid factors including personality variables, job insecurity, frequent moves, poor intercollegiate relations, demanding relatives of patients, administrators, being asked to be administrators instead of clinicians,(Stranjalis, 1993) rapid changes in job structure, long hours, over involvement with patients, and living in unfamiliar cultures. This was a small, brief study with a 50% response rate and a low number of errors. The higher rate of suicide among doctors may partly be explained by more successful attempts at suicide. Young male doctors are the most likely medical practitioners to be assaulted, especially if they are in psychiatry, and particularly if they are in training as psychotherapists. The idea that doctors must show persistence, ability to delay gratification, love of hard work and self-sacrifice, and an unwillingness to express career doubts can be dangerous. Job stress increases as the demands of work increase and decreases with increased feelings of control over the job and improvements of social support. Kumar (2007) suggested that burnout is particularly common among psychiatrists, which is debatable. The argument is that psychiatry is a stigmatised branch of Medicine, that psychiatrists are always struggling for resources, and that complex judgments are part of the job. Lucey (2009) has reviewed the concept of burnout, a phenomenon that is not unique to Medicine but one that afflicts about one-fifth of doctors. Leaving out people who are totally unsuited to the practice of Medicine, work overload, feeling poorly managed or poorly resourced, direct involvement in the suffering of others, high patient expectation levels, home-work interference, domestic interruptions, administrative load, and personal characteristics (committed, high-functioning, external locus of control, avoidant, obsessional/perfectionist, a tendency to feel rather think, low stress tolerance, and low self esteem) are risk factors. Working for an organisation that appears to lack values or is cynical is unhelpful, as is lone practice. Victims complain of physical and emotional exhaustion, diminished personal accomplishments in previously high-functioning individuals, cynicism, and reduced ability to care. Many issues need to be addressed, such as sense of control over work, part-time work/flexi-time, child-care, holiday leave/cross-cover/locums, career breaks/change, sabbaticals, and modulation of the workplace/home interface. Other important matters to be addressed are building a vision and trust in the mission, reasonable rewards, fairness, and consistency. Training in breakaway and induction seemed good but 72% felt threatened and 16% had been physically assaulted. The Englishman, Thomas Addison (1793-1860), of anaemia and adrenal fame, suffered from severe bouts of depression and ended his life by jumping from a window in Brighton. Some other examples are given in the table: Name Year of death Detail Method 464 stress, anxiety and depression have been found among senior doctors and managers in the British National Health Service. Availability and knowledge of pharmacology and therapeutics are important factors in suicide within the medical profession. Extra stresses on female doctors include lack of senior female role models, conflicts between career and family, prejudice and attitudes of male colleagues, and loneliness. Accident and emergency departments carry certain stresses for juniors: intense workload, diagnostic uncertainty, unsociable hours, and fatigue. Some are afraid to seek advice in case this might have adverse career implications. The only difference between the two groups was that alcohol abuse was more common among business students than among medical students. About 6% of students reported suicidal thinking in the last month and such thinking was more likely in the presence of stressful life events and absence of social support. In the first postgraduate year, one-quarter to one-third of interns suffer from clinical depression, but this figure tends to decline with the passage of time. Long hours, lack of sleep, poor diet, poor social supports, large bank loans, feelings of inadequacy, and separation from home may be important factors here, as are the abuse of alcohol, and the use of drugs for physical illness or for recreation. Junior doctors, especially if female or foreign, often perceive that they are subject to bullying.

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  • https://intelligencepharma.files.wordpress.com/2019/05/global-oncology-trends-2019-report.pdf
  • http://www.ajnr.org/content/9/1/23.full.pdf
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