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After another year of private schooling in New York generic suhagra 100mg with visa, he entered Yale University in 1870 cheap 100mg suhagra free shipping. A good athlete discount 100 mg suhagra otc, he was captain of the first official football team fielded by the school order suhagra 100mg otc. This school discount 100mg suhagra with visa, like the other seven medical schools in New York at that time, was 123 Who’s Who in Orthopedics President of the American Association for the Surgery of Trauma in 1962. As the Director of the Trauma Division of the American College of Surgeons, he had a signifi- cant role in trauma education and the develop- ment of programs for emergency trauma care throughout the United States. Born and educated in Nashville, Tennessee, he graduated from Vanderbilt Univer- sity and the University of Tennessee School of Medicine. His interest in surgery of the extremities led him to limit his 1911–1980 practice to orthopedics. Hampton rose to prominence during World Paul Randall Harrington was educated in the War II as the orthopedic consultant for the North Kansas City school system and graduated in African and Mediterranean Theaters. The experi- 1930, having been named one of the State of ence gained in this role led to the publication of Kansas’ 15 most outstanding high school gradu- two books, “Wounds of the Extremities in Military ates. He was also an outstanding basketball player Surgery,” and “Orthopedic Surgery in the in high school. He retired with the rank of the university he played on their basketball team, Brigadier General. Although his initial plan was to of the clinical faculty of Washington University. In 1936, he He was Chairman of the Committee on Trauma tried out for the national Olympic team and won of the American College of Surgeons and was the championship of his region in the javelin 124 Who’s Who in Orthopedics throw, but he was unable to attend the finals in Antonio, Texas. Harrington did his internship and first year surgical technique, and during this time many of surgical residency at Roper Hospital, lifelong friendships were formed. No one could Charleston, South Carolina, after which he associate with Paul for any great length of time returned to St. Luke’s Hospital in Kansas City, without realizing the unique individual he was. He joined the United States tributed more than 30 publications and he gave an Army Medical Corps and was assigned to the instructional course on the treatment of scoliosis 77th Evacuation Hospital, serving from May at the annual American Academy of Orthopedic 1942 to November 1945 as chief of the orthope- Surgeons’ meeting for 11 consecutive years. He undertook with great zeal Paul was one of those unusual persons with the position of caring for the post-poliomyelitic boundless energy. Initially when most of his time was consumed by the there were very few patients, but in the late 1940s development of the Harrington instruments and the patient load increased dramatically as a result his theories concerning the treatment of the scol- of the poliomyelitis epidemics. During the same period he also National Infantile Paralysis Association was became an expert on photography and high- established, the first such organization in the fidelity systems. Harrington became well recognized for his ested in scoliosis, having realized that the current accomplishments as recipient of the Most Distin- methods for treating scoliosis were inappropriate guished Alumnus Award in 1975 from the for the patient who was severely paralyzed after Medical Alumni Association at the University of poliomyelitis. He also received the Cora and Webb resulting from poliomyelitis was manual correc- Mading Medal from the Institute for Rehabilita- tion of the scoliotic deformity at the time of tion and Research and Baylor College of Medi- surgery, and internal fixation of each facet. This cine in 1973, and the Nicolas Andry Award from worked well initially, but the fixation did not hold. In the Paul Randall Harrington died on November 29, beginning, he would fashion the instruments the 1980, ending a life of accomplishment that began night before surgery. After surgery the next day, in Kansas City, Kansas, on September 27, 1911. Once the basic design was devel- for his straightforward frankness, his bow ties, his oped, he had it tested extensively by the Engi- par golf, his smile, his trumpet, and above all for neering Department at Rice University in being a nice person. Houston, Texas, and at a commercial testing company in Chicago, Illinois. He then allowed the instruments to be sold, but initially only to those who personally had seen his technique performed. Harrington belonged to many medical asso- ciations, and was one of the founding members of the Scoliosis Research Society. Harrington was orthopedic consultant to the United States Air Force and to the United States Army in San 125 Who’s Who in Orthopedics Hospital in Weston for the treatment of this disease in civilians. His interest in tuberculosis never left him and he held weekly clinics for 35 years—his last clinic being held just before he left for Banff. Gallie was extremely anxious, when he was appointed Professor of Surgery at the University of Toronto, to have a surgeon of Dr.

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Both before and after its 1997 election victory suhagra 100 mg with amex, New Labour adopted the issue of health inequalities as one of its major themes cheap suhagra 100 mg fast delivery, a preoccupation that is reflected in its public health policy documents order suhagra 100mg without a prescription. At first inspection cheap 100mg suhagra amex, the extent of medical and political concern with health inequalities appears puzzling cheap suhagra 100mg without a prescription. Though, as we have seen, class differentials have persisted, in real terms the health of even the poorest sections of society is better than at any time in history: indeed the health of the poorest today is comparable with that of the richest only twenty years ago (see Chapter One). Furthermore, it appears that the preoccupation with social class in the sphere of health (as indicated by the scale of academic publications) has grown in inverse proportion to the salience of class in society in general. After the emergence of the modern working class following the industrial revolution in the mid-nineteenth century, the question of class and its potential for causing social conflict and, for some, social transformation, dominated political life. It appears that after this era finally came to an end with the collapse of the Eastern bloc and the Soviet Union in 1989–90, and the political and social institutions organised around class polarisation lost their purpose, the subject suddenly became of much greater medical and academic interest. No longer subversive, class had acquired a new significance in relation to the social anxieties of the 1990s. A closer examination of recent debates about issues of class and health reveals some of the concerns underlying the discussion of health inequalities. Whereas in the past the working class was regarded as the major source of instability in society, that menace has now receded, to be replaced by a perception of a more diffuse threat arising from trends towards social disintegration. The government’s focus on issues such as crime and drugs, anti-social behaviour, teenage pregnancy and child poverty reflects its preoccupation with problems that appear to be the consequence of the breakdown of the family and of traditional communities and mechanisms for holding society together. All these concerns come together in the concept of ‘social exclusion’ which emerged in parallel with increasing concerns about health inequalities. At the launch of the Social Exclusion Unit, a key New Labour innovation, in December 1997, Tony Blair summed up the significance of the concept for New Labour: ‘It is a very modern problem, and one that is more harmful to the individual, more damaging to self-esteem, more corrosive for society as a whole, more likely to be passed down from generation to generation, than material poverty’ (The Times, 9 91 THE POLITICS OF HEALTH PROMOTION December 1997). The term social exclusion appears to be less pejorative and stigmatising than more familiar notions such as ‘the poor’ or ‘the underclass’. Social exclusion also implies a process rather than a state: people are being squeezed out of society, not just existing in conditions of poverty. It expresses a novel sense of guilt over the failures of society as well as the familiar condescen-sion towards the poor. Above all it expresses anxiety about the consequences of social breakdown as well as fear of crime and delinquency. The concepts of equality and inequality have also undergone a significant re-interpretation. This began with the Commission on Social Justice, a think-tank set up in 1992 in the inter-regnum between Neil Kinnock and Tony Blair, when John Smith was Labour leader; it reported in 1994 after his sudden death (Commission on Social Justice 1994). After Labour’s fourth and most bitter election defeat, this body accelerated the process of ridding the party of its social democratic heritage that had begun under Kinnock and was completed under Blair. It shifted Labour’s goal from social equality to social justice, which it defined as recognition of the ‘equal worth’ of all citizens (CSJ 1994:18). In place of the traditional view of inequality as a question of the distribution of the material resources of society, the commission explained it in cultural and psychological terms. Thus it emphasised that ‘self respect and equal citizenship demand more than the meeting of basic needs; they demand opportunities and life chances’. It concluded that ‘we must recognise that although not all inequalities are unjust…unjust inequalities should be reduced and where possible eliminated’. Once Labour had accepted Mrs Thatcher’s famous dictum ‘Tina’—‘there is no alternative’ to the market— then it had also to accept the inevitability of inequality. Its traditional clarion call to the cause of equality gave way to feeble pleas for fair play. In his emotional speech to Labour’s centenary conference in September 1999, Tony Blair reaffirmed the government’s commitment to tackling inequalities in British society and pledged to ‘end child poverty within a generation’. While this went down well with party traditionalists, Blair was careful to put the distinctive New Labour spin on the concept of equality. Thus he reaffirmed that, for New Labour, ‘true equality’ meant ‘equal worth’, not primarily a question of income, more one of parity of esteem. As Gordon Brown put it, poverty was ‘not just a simple problem of money, to be solved by cash alone’, but a state of wider deprivation, expressed above all in ‘poverty of expectations’.

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The vertical scale order 100 mg suhagra amex, which is the same in all four panels suhagra 100 mg on-line, is greatly exaggerated (as in Figure 9 100mg suhagra mastercard. The motion of the basilar membrane has a peak that is localised along the length of the cochlea discount 100mg suhagra otc. At this position buy discount suhagra 100mg on-line, the maximum displacement occurs beneath the outer hair cells, and there is a slight inflexion point at the outer edge of the outer pillar cell. The maximum displacment of the basilar membrane is now much lower, indicating a profound loss of sensitivity. A person with no outer hair cell force generation would suffer a profound hearing loss. Experiments on isolated cells have shown that such stimulation increases the Exploring human organs with computers 167 development of structurally complex biological systems. Rather than attempting to replicate the existing organ of Corti, we could use finite- element models to predict the degree of mechanical amplification that could occur in regenerated hair-cell-based sensory epithelia, whose struc- ture and properties are quite different from those of the normal organ of Corti. Biological, carbon-based implementations of the simplified organ could be constructed using genetic techniques, both by manipulating the function of individual cells and controlling the way in which the develop- ing cells form the structure. The development process itself is amenable to finite-element analysis since it is driven mainly by local effects. The replacement organ could be constructed from cells obtained from the even- tual organ recipient, bypassing the problems associated with tissue rejec- tion during transplantation. Conversely, silicon-based implementations of the simplified model could be used in signal processing applications. For example, a silicon cochlea could form the front-end of a speech recognition system with a performance superior to any designed by an electrical engineer. It is highly likely that by the second decade of the new millennium silicon-based computing will have reached fundamental technological or physical limits. Computers will therefore be based on substrates that exhibit superior performance characteristics. Optoelectronic devices, which use substrates such as gallium arse- nide, permit the interconversion of electrons and photons. Hybrid comput- ers, which may already be available commercially by 2010, would use silicon for computation and photons for data transfer. The coherent mod- ulation of very-high-frequency light beams enables many high-capacity amount of force generation. But in the model, increased force generation leads to less basilar membrane motion. This paradoxical observation is the first that is consistent with the experimental observations that an increased amount of brain stimulation causes a decrease in cochlear amplification. The model behaviour is the direct result of the inflexion point at the outer edge of the outer pillar cell becoming much more pronounced. There are two motion peaks at the position of stimulation, one beneath the outer hair cells and the other at the outer edge of the outer pillar cell. This model response is consistent with experiments in which the cochlea is electrically stimulated, and comparison with Figure 9. KOLSTON signals to be combined onto a single beam, taking up little space and not interfering with cooling air. In, say, 20 years a fully optical computer would integrate lasers with optical modulators and photodetectors, and could be 1000 times faster than today’s computers. Carbon shares silicon’s electron valency, making it a viable semiconductor. But carbon’s real potential lies in its unrivalled ability to form compounds of very high molecular weight, which has made it suitable for the encoding and processing of the huge amount of informa- tion required to construct a human being. It is a logical step to consider uti- lizing DNA code and associated enzymes, which have been developed and refined over billions of years of evolution, to construct a carbon-based com- puter. Such a device could exist in a test-tube, into which DNA-like mole- cules would be placed containing the input data, and recombinant DNA techniques used to perform the processing function. A carbon-based computer would have several attractive characteristics: • Fast: trillions of strands of DNA would be processed in a single bio- chemical operation, so that a computation that would currently take one year to perform could be completed in one second. Taken together, these performance levels represent a million-fold improve- ment over present-day computers. This means that the current rate of exponential growth in computing power will be sustained for another half century if carbon-based computers were to become commodity items by 2050. It may then be feasible to implement a finite-element model of a complete human at a cellular level. The potential power of distributed computing is well demonstrated at the website www.

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