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In this regard menstruation 1800s purchase nolvadex without prescription, distance and remoteness can be thought of as indicators that cultural penetration by the central state is lacking" menstruation young age cheap nolvadex 20mg free shipping. Agents originating from outside of the borderland are also attracted to these cross-border micro-regions pregnancy upper back pain order 20 mg nolvadex amex. As borderlands are often strategically situated within wider spheres of regional political and military state dynamics women's health issues endometriosis cheapest nolvadex, they can provide opportunities for neighbouring states to further certain political agendas. At a very basic level, this includes governments acting according to different standards and practices in neighbouring borderlands than their own, as well as often not hesitating to intervene in such zones to secure their own borders. Indeed, the borderland represents a space where outside states can fund, strategically support, or even create, nonstate proxies to act on their behalf, carrying-out activities that would be deemed unpalatable and unacceptable by their own population or wider international community. This coastal borderland is part of a wider politically interconnected migration system that involves various sub-Saharan states (notably Nigeria, Central African Republic, South Sudan, Ethiopia, Eritrea, and Somalia), North African states (notably Morocco, Algeria, Tunisia, Libya, and Egypt), the Mediterranean Sea, and numerous southern European states (notably Spain, Malta, and Italy). Fuelled by harsh living conditions, persecution, and the attraction of opportunities in Europe, thousands of African migrants are increasingly attempting to make the perilous journey from North African points of exit to southern European points of entry. The cultural heterogeneity of these micro-regions, the constant flux of groups migrating in and out of them, and the often tense ethnic environment, can all abet violence under the right conditions. These situations tend to be exacerbated by the lack of security measures and personnel at African borders. As Anderson says, "African states lack the trained personnel, the technology and the financial resources to prevent the unauthorised movement of persons and goods across their frontiers. Movements from one state to another of starving people, ethnic groups threatened with massacre, migrant workers, guerrilla fighters, diamond smugglers, drugs and weapons dealers can threaten the interests of a neighbouring state. Borderlands also tend to draw ex-militants, both those that have been demobilised and those that have not. In essence, their loyalties are fluid and liminal, and as such, they represent an easy and cheap mobilisation force for rebel groups. Additionally, it is often the case that borderland societies have to take the law into their own hands, owing to the lack of state judicial services and absence of official routes through which to pursue justice. Porter, writing on the marginalised northern Ugandan area, "On the periphery, social harmony is not protected and ensured by an efficient formal judicial system with moral authority. In some cases, the pursuit of social harmony manifests as mob violence, organised revenge, collective killing, or summary execution". Porter, "Justice and Rape on the Periphery: the Supremacy of Social Harmony in the Space Between Local Solutions and Formal Judicial Systems in Northern Uganda," Journal of Eastern African Studies 6 (1) (2012): 85. Modern borders: condition, performance, management ed and service provision low, it is not surprising that local solutions would be used if not preferred to other more formal systems of justice". Not only can borderlands be sites of interesting political and cultural conflict dynamics, but they can also serve as the space in which transborder trading practices become oriented towards the war economies that sustain insurgencies. Indeed, the powder keg tendency of some borderlands has a strong economic dimension, and it could perhaps be said that this starts with the distinctive profit opportunities available to borderlanders. Due to issues of proximity to the border and connections to those on the other side, borderlanders tend to have a closer relationship with transnational commerce than heartlanders. The Mandingo community of West Africa, for instance, is an example of a group that fundamentally revolves around participation in regional, if not international, trade. Their position is greatly aided by the trump card held in local knowledge of the area in and around the state line, allowing them to economically navigate the cross-border micro-region to a degree unmatched by others. As Gregor Dobler and Wolfgang Zeller note, "state interventions in borderlands are often not very successful. As David Coplan explains, "smuggling, which often enough takes on an open and festive atmosphere at African borders, is after all only a crime against 298 Porter, "Justice and Rape on the Periphery," 86. Gregor Dobler and Wolfgang Zeller, "Marginal Hotspots: African Border Boom Towns" (paper presented at the African Borderlands Research Network, Johannesburg, 2009), 5. Parallel to how the specific social environment of borderlands can be luring for violent-prone actors, the economic environment can be attractive to commercial actors who prefer relatively ungoverned and lawless operating environments. Conflict entrepreneurs in borderlands are skilled at spotting such edge effects and adjusting their activities so as to best extrapolate the benefits. And they have been helped along in this regard by inadequate responses by national and international actors.

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Carbon monoxide; cyanogen breast cancer vs testicular cancer purchase nolvadex australia, hydrogen cyanide; nitrites; arsine; aniline pregnancy facts discount nolvadex 20 mg without a prescription, dimethyl aniline pregnancy kick counts purchase nolvadex 20 mg mastercard, toluidine; nitrobenzene; hydrogen sulphide (causes respiratory paralysis by impairment of oxygen utilization in the central nervous system) women's health clinic fort hood order generic nolvadex. Anaesthetics and narcotics Exert principal effects as simple anaesthesia, by a depressant action on the central nervous system. Acetylene Olefins Ether Paraffins Aliphatic ketones Aliphatic alcohols Esters Visceral organs in general Haematopoletic. Carbon disulphide; methanol; phenol; n-hexane; methyl n-butyl ketone; organophosphorus compounds; tetra-alkyl lead compounds. Lead, manganese, cadmium, antimony, beryllium, mercury; arsenic; phosphorus; selenium and sulphur compounds, fluorides. Free crystalline silica, (quartz, tridymite, cristobalite), asbestos (chrysotile, amosite, crocidolite etc. Skin Respiratory Bladder/urinary tract Liver Nasal Bone marrow Coal tar pitch dust; crude anthracene dust; mineral oil mist; arsenic. Asbestos; polycyclic aromatic hydrocarbons; nickel ore; arsenic; bis-(chloromethyl) ether; mustard gas. Carcinogens Cancer-producing agents Inerts Gases Simple asphyxiants Argon; methane; hydrogen; nitrogen; helium. For example, sulphur dioxide is highly water soluble and tends to be absorbed in the airways above the larynx. However, in the presence of particulate catalysts and sunlight, conversion to sulphur trioxide occurs and the irritant response is much more severe. Other parts of the body are also vulnerable: the skin and eyes from direct contact/rubbing or from exposure to airborne material including splashes; the mouth and pharynx by ingestion of solid or liquid chemicals. One effect of direct contact of liquid or solid, and less often vapour, with the skin is a contact irritant dermatitis. Thus whilst acute irritation is a local and reversible response, corrosion is irreversible cell destruction at the site of the contact. The outcome is influenced by the nature of the compound, the concentration, duration of exposure, the pH (see Figure 5. Thus dilute mineral acids may be irritant whereas at higher concentrations they may cause corrosion. Phenolics can result in local anaesthesia so that the pain will be absent for a time, i. Thus on the skin hydrofluoric acid produces an effect which varies, depending on concentration and duration of exposure, from mild erythema to severe burns and intense pain, sometimes delayed by several hours after the initial exposure. A tough white lump forms over the area of skin damage under which progressive destruction of cell tissue continues. Burns under the finger nails are notable in this respect because of the difficulties of treatment. Similarly, inhalation of the vapour can cause corrosion of the respiratory system and pulmonary oedema. If hydrofluoric acid is swallowed, burns to the mouth and pharynx can occur with vomiting and ultimate collapse. Generally there is no mathematical relationship between the degree of exposure and the extent of the response. Sensitization to a compound is usually highly specific and normally occurs within about 10 days, although there have been cases of workers using a chemical for years without untoward effects before developing an allergic dermatitis. With such sensitizers, complete cessation of contact is often followed by rapid recovery but no further exposure is generally permitted. Chrysoidine Crystal and methyl violet Erio black Hydron blue Indanthrene violet, R. Systemic poisons Systemic poisons attack organs other than the initial site of contact.

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As a rule women's health clinic lloydminster buy line nolvadex, both transitional levels indicate emerging and/or potential regions with their content and boundaries not defined yet womens health care center purchase genuine nolvadex on-line. Logic and mechanisms for the formation of transborder regions 144 the growing interest in state-to-state interactions limited by the boundaries of individual regions is directly related to the European integration experiments of the late 1940s and early 1950s menstruation urinalysis purchase nolvadex 10mg mastercard. Those experiments have provoked a great many similar initiatives encompassing the whole globe women's health clinic topeka ks cheap nolvadex 10mg with visa. Beginning from the latter half of the 1980s, active development of state-to-state cooperation at a regional level has given rise to declarations regarding the advent of an era of "new regionalism", one surpassing previous regional experiments in its scope and dynamism. Today, regionalism and regionalization reveal themselves in various ways, even in areas where they had been represented quite modestly before. Along with the expansion of their spatial scale and the boundaries of their distribution, regional interaction demonstrates indepth organizational diversification and an expansion in the diversity of patterns with which they reveal themselves. An important role among the specific features of "new" regionalism is played by the trend towards the expansion and invigoration of cooperative interaction at the lowest level, within the transborder aggregations differing in their format and content. In its most general sense, the notion "trans-border interaction" implies any possible form and variety of contacts involving, to a greater or lesser degree, contiguous parts of territories (their populations, resources, infrastructure, etc. In their content, they can be conflicting (varying from border disputes to local armed clashes) or cooperative (varying from sporadic unorganized trade to formal integration agreements). Both interaction types reveal themselves as more intensive in areas where political and administrative borders of states cut across a natural or historically existing unity of geographic, cultural, civilizational, economic, or other spaces. An objective basis for the stimulation of the emergence and expansion of transborder interaction may be both similarities, in the economic and living conditions, ethnic origin and language, religion and culture, and differences, in available natural and labor resources, economic development models and rates, living standards, and so on, of neighboring territories. Trans-border interaction may also be encouraged by some other factors resulting from the internal specifics of states bordering Chapter 2. Such factors may be, for instance, the remoteness (and separation) of peripheral border areas from the rest of the territory and especially from the economic and administrative centers, due to specifics of the geographic position, organization of the national economy or political and administrative structures. All these factors may to an equal degree be barriers to the development of trans-border interaction and drivers for local conflicts between states. Borders become areas of inter-connecting cooperation if the advantages arising in such areas due to the joint use of economic and cultural resources prevail over advantages arising from existence of borders16. It is hard to term trans-border cooperation, as a variety of trans-border interaction, as a new or exclusively contemporary phenomenon. Trans-border cooperative processes come into existence together with appearance of borders. However, due to their limited nature and underdeveloped condition, they do not necessarily develop beyond rather simple interactional patterns in territories immediately adjacent to borders. This was because all these interactions were largely related with trans-border communication and transborder cooperation. Currently, such interactional patterns activated as components in contemporary regional dynamics acquire new degrees of scope and quality. The replacement of former definitions of trans-border cooperation with a new notion of trans-border cooperation, wider in sense and content, reflects this new quality17. It is important in this connection that, as Perkmann and Sum believe, the construction of trans-border regions has become a more or less explicit strategic goal to be implemented by various public forces within and outside border regions18. Therefore, transborder cooperation is implemented in the form of associations and groupings which are limited in the number of their participants and in the scope of the tasks being undertaken. Perkmann and N Sum, "Globalization, regionalization and crossborder regions: scales, discourses and governance," in Globalization, regionalization, and cross-border regions, ed. Concepts and problems of border studies ernmental institutions and/or local administrative structures. At the same time, it is necessary to distinguish two types of trans-border cooperative interaction: cross-border cooperation and trans-border territorial cooperation19. Specific features of the former type are: (a) inclusion in cooperative interaction of territories immediately adjacent to the border (individual parts of intra-state administrative units); (b) participation in such cooperation of primarily local (non-governmental) actors; (c) instability, sporadic nature and limited effect of such interaction at a local territorial level only. On the other hand, trans-border cooperation normally (a) encompasses considerable portions (whole administrative units) of territories of neighboring states larger than immediate crossborder areas; (b) is coordinated by local authorities under the control and with the support of central governments; (c) results in larger-scale, steady and long-term effects. Initial stages in the formation of trans-border regions are normally characterized by the dominance of simple and locally limited interaction patterns in the form of trans-border trade exchanges.

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In areas with low concentration of food facilities/people menopause jokes humor order nolvadex 10mg with visa, logistical obstacles such as driving time or distance between involved locations may present additional challenges menstruation normal buy nolvadex 10mg with amex. The multiplication factors used to gear up from a single point introduction incident to a multiple (national) site introduction assumes resource requirements to increase proportionately with the number of introductions women's health zumba discount generic nolvadex canada. In estimating national resource requirements womens health recipes discount nolvadex 20mg overnight delivery, it was assumed the scenario would affect 25 States directly, but all 50 States would have increased workload. The time to resolve the scenario would vary depending on number of site introductions and multiple different food items contaminated. This scenario is very limited in scope and only lists a food commodity regulated by the U. Assume all response personnel in key positions are able to respond to their respective response positions after the contaminant has been introduced and they respond as expected. Assume that sector partners are connected to an information sharing and analysis or fusion system concept where preventative and protective measure information is proactively being shared. For example, if the roads are non-passable due to a natural disaster, this will affect the ability to get to the affected area and ensure the safety and security of the food supply. Assume that Multi-Agency Coordination is adequately being addressed at the State, Federal and local levels and the agencies are coordinating as expected. The following information is needed to effectively detect/respond to/recover from to an event: Quantity of product affected. Ability to determine the food item associated with illness or to rule out certain food items. Appropriate decontamination of food facility or other locations where food was available for purchase. Capable of managing the response within each State, assuming surge staffing numbers. Local Emergency Capable of responding to a local incident, Target Capabilities List 153 Resource Organization Operations Centers Human Disease Surveillance Team Estimated Capacity typically with 5 - 20 staff. One team per state Food Investigation Team Each team is capable of providing coordinated Federal/State/local response to food facilities, conduct investigations, and collect samples at 40 food facilities within a State Each team consists of 4 people per food facility for 2 days. Teams may be split in order to cover a larger number of facilities Initially all 50 states will be on heightened alert and will be investigating food facilities in each State Assume 1000 food facilities per State are potentially contaminated 1000 facilities = = 25 teams per state (4 people per team) = 100 people per state = 5000 staff nationally Food Facility Decontamination Team One field team of 4 people capable of providing coordinated response at 10 affected food facilities Assume that decontamination takes 2 days per facility Assume 25-state incident Assume 100 food facilities per State are contaminated 10 teams per state (4 people per team) For 25 States = 1000 staff nationally Food Facility Decontamination Team Supervisors 1 supervisor can manage every per 10 team staff employees. Manual of Protective Action Guides and Protective Actions for Nuclear Incidents, 400-R-92-0001. It includes exposure and disease (both deliberate release and naturally occurring) detection, rapid implementation of active surveillance, maintenance of ongoing surveillance activities, epidemiological investigation, analysis, and communication with the public and providers about case definitions, disease risk and mitigation, and recommendation for the implementation of control measures. Outcome Potential exposure to disease is identified rapidly by determining exposure and mode of transmission and agent; interrupting transmission to contain the spread of the event; and reducing number of cases. Suspected cases are investigated promptly, reported to relevant public health authorities, and accurately confirmed to ensure appropriate preventive or curative countermeasures are implemented. An outbreak is defined and characterized; new suspect cases are identified and characterized based on case definitions on an ongoing basis; relevant clinical specimens are obtained and transported for confirmatory laboratory testing; the source of exposure is tracked; methods of transmission identified; and effective mitigation measures are communicated to the public, providers, and relevant agencies, as appropriate. Epidemiological emergency response plans include steps for evaluating therapeutic outcome Epidemiological emergency response plans include steps for monitoring adverse reactions to public health interventions Epidemiological emergency response plans include communication requirements. Epidemiological Surveillance and Investigation and Emergency Operations Center Management both contribute to situation reports. Epidemiological Surveillance and Investigation and Medical Surge both provide situation reports. Epidemiological Surveillance and Investigation receives lab results from Laboratory Testing. Epidemiological Surveillance and Investigation provides outbreak notification to Mass Prophylaxis. Epidemiological Surveillance and Investigation provides investigation results to Isolation and Quarantine, while Isolation and Quarantine provides containment updates to Epidemiological Surveillance and Investigation. The team is led by a local health department, but staff may be drawn from local, State, and/or Federal resources.

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