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Robinson noted: “The general tradition of the murder of Christian children by Jews is much more ancient than this particular story generic 40mg deltasone visa allergy medicine for asthma, beginning at the time of the Church historian Socrates (5th century) generic deltasone 40 mg otc allergy shots tallahassee, and is still alive” (1957 purchase deltasone 10mg online allergy symptoms and nausea, 734) 40 mg deltasone free shipping allergy johns hopkins. Benson (1987) deals more directly with the problem of the anti-Semitism of the tale for readers and critics. The most famous is Shylock in Shakespeare’s the Merchant of Venice (1596–1597), but equally significant is Barabbas in Christopher Marlowe’s earlier play, the Jew of Malta (1589). Shylock is an origi nal and sympathetic study of the Jew as alien and victim, called impersonally “Jew” or “the Jew” throughout, using language full of Old Testament references to Jewish custom. When Shylock agrees to make the loan, Antonio expresses mock surprise, saying “gentle Jew” (punning on gentile), adding (after Shylock has exited) the ironic comment: “This Hebrew will turn Christian: he grows kind” (I iii 178–79). While Shylock provokes mixed feelings, Barabbas is a melodramatic version of the ruthless Machiavellian intriguer and a continuation of the figure of Herod, presented on the Elizabethan stage as arrogant and bizarre. Marlowe defiantly names his protagonist after one of the thieves crucified with Christ, while the title, the Jew of Malta, clearly demarcates him as an outsider in an alien multicultural context. The Prologue is spoken by Machievel, a figure obviously derived from the Italian political philosopher Niccolo Machiavelli (1469–1527), stereotyped in England as an atheistic opportunist. In the same scene, the speech beginning “Sometimes I go about and poison wells” is a catalogue of all the anti-Semitic stereotypes. He steadfastly refuses to convert, acknowledging the ruin ous financial consequences and asks mockingly of the Christians: “Is theft the ground of your religion As his stratagems catch up with him he retains a haughty defiance: “Devils, do your worst! Whereas Shylock leaves the play destroyed, with a bitterly ironic “I am content,” Barabbas dies with a final curse: “Damned Christian dogs! Equally significant to the popular conception of the Jew was the controversial figure of Dr. Lopez (1517–1594), a Spanish Jew who in 1581 became Queen Elizabeth’s physician and a political adviser. He was accused by the Earl of Essex of conspiracy to murder the queen by poisoning and was denounced by the attorney general Sir Edward Coke: “That. At his public hanging at Tyburn on June 7, 1594, the crowd had a simple denunciation: “He is Jew! The evil outsider stereotype is con tinued most famously in Fagin, the sinister “godfather” of a gang of juvenile thieves in Charles Dickens’s Oliver Twist (1837–1839). Generally called simply “the Jew,” Fagin is introduced in chapter viii as a crude caricature, “a very old shrivelled Jew, whose villainous looking and repulsive face was obscured by a quantity of matted red hair. A new development, that of the positive sympathetic stereotype, is found in Riah in Our Mutual Friend (1864–1865), Dickens’s last complete novel, and in Daniel Deronda, the eponymous hero of George Eliot’s novel (1876). The most famous Jew in Victorian public life, Benjamin Disraeli (1804–1881) was also a notable novel ist, creating in his political novel Coningsby (1844) an impressive Jewish character, Sidonia. On the wider political front there emerged a seminal anti-Semitic document, the Protocols of the Elders of Zion, privately printed in 1897 and published in various European languages from 1905 with savage propagandist caricatures. It was ostensibly a record of a secret Zion ist Congress at Basel to plan world domination. However, after an expose by the London Times in 1921, a judicial inquiry in 1934 revealed that “the supposed minutes were highly sophisticated forgeries made in the Paris office of the Russian Political Police (the Okhrana) probably for use by the Czarist regime against the Russian liberals” (Maser 1970, 165). Bizarrely, sections had been copied from two novels, Biarritz (1868), by Hermann Goedsche, and Dialogues in Hell (1864), by Maurice Joly. But since the content perfectly fitted the ste reotype of a Jewish conspiracy, it was highly effective as propaganda and was widely dis seminated, notably by Adolf Hitler and the Nazis, and by Henry Ford in the United States. The Word-Field the word-field of hostile terms starts relatively late in the Elizabethan period with the senses of the noun Jew (ca. Manning Chipman in the Dictionary of American English in 1870 observes that to jew “is used all over the U. The sense that the Jews were “different” or “alien” is shown in the considerable number of compounds such as Jew-butcher, Jew-physician, Jew-pedlar, and Jew-fencer (buyer or seller, gener ally of stolen goods).

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There is a large differential diagnosis for chorea including other inherited conditions buy deltasone 5mg with visa allergy forecast berkeley, autoimmune order 20mg deltasone with mastercard allergy symptoms yahoo, metabolic generic 10 mg deltasone otc allergy forecast dallas fort worth, and drug or toxin induced buy deltasone 5 mg on-line allergy medicine dry eyes. Another form of chorea is Sydenham chorea, which is an acute, usually self-limited disorder of early life, usually between ages 5 and 15, or during pregnancy, and closely linked with rheumatic fever. It is characterized by involuntary movements that gradually become severe, affecting all motor activities including gait, arm move ments, and speech. Management Currently, there are no drugs that appear to affect the course of Huntington dis ease. Although experiments on transgenic mice with the huntingtin gene have suggested certain compounds exerting a neuroprotective effect, this remains to be confirmed in human beings with Huntington disease. Chorea is typically improved with drugs that interfere with dopamin ergic function. These do carry the risk of tardive dyskinesia, and this has rarely been reported in this condition. Tetrabenazine is a dopamine depleting agent that is awaiting approval in the United States and has not been associated with tardive dyskinesia. As Huntington disease progresses, bradykinesia is a problem and is exacerbated by neuroleptics. Which of the following is most likely to be helpful for the chor eiform movements Judicious use of dopamine-blocking agents are effective in many patients with chorea. These need to monitored for side effects, particu larly parkinsonism and tardive dyskinesia. Levodopa can worsen chorea, although in Huntington disease patients with significant bradykinesia, this can be helpful. Onset of Huntington disease in childhood (~5% of patients) is more severe and can be of the Westphal variant, which looks more like parkinsonism with bradykinesia and rigidity. Dystonia, myoclonus, and seizures are additional clinical features that may occur. History of genetic disease: the molecular genetics of Huntington disease—a history. Predictive testing for Huntington disease: interpretation and significance of intermediate alleles. He was doing well until the age of 8 when he developed problems with supination of the left arm. He later developed tremor of the left hand, abnor mal sustained movements of the left leg; in particular, inversion of the left foot, and back spasms such that he could not walk. He writes and operates a computer keyboard exclusively with his right hand because of the rhythmic spasms on the left. He has been tried on trihexyphenidyl, car bidopa/levodopa, carbamazepine, and diazepam with very modest improvement. His examination was remarkable for abnormal involuntary movements of his upper extremities, left more than right, consisting of a rhythmic, tremor with arm sustention, associated with wrist flexion/extension as well as a pinching motion of the thumb and index finger. In addition, there are rhythmic, rostral trunk movements associated with his movements, and his voice is affected by signifi cant tremor. The patient also has rapid, nonstereotyped movements of distal and proximal muscles that suggest multifocal myoclonus in combination with sus tained, stereotypic muscle contractions of the left wrist, arm extensors, and fin ger flexors. His head assumes opisthotonic postures with walking but is extended to the right during much of the examination. His mental status exam, sensation, tendon reflexes, muscle bulk, and strength is normal. His abnormal movements are complex, involving dystonia, myoclonus, and tremor that limit his posture, gait, and extremity use. Describe the diagnostic modalities that are useful in the evaluation of patients with dystonia. Be aware of the therapeutic modalities that are useful in the treatment of patients with dystonia.

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However buy generic deltasone 20 mg on-line allergy treatment hay fever, these economic e ects have been super seded by the e ects of Israeli security policies in the West Bank and Gaza that were taken in response to order 40mg deltasone otc allergy testing waco tx the intifadas order deltasone 5mg online allergy treatment worms. Restrictions on the movement of goods and people buy discount deltasone 20 mg allergy testing zones, the destruction of capital, and the construction of a road network restricted to Israeli access have had devastating e ects on the economy of the West Bank and Gaza. Major Challenges and Issues The Palestinian economy holds promise because of its substantial human capital, as suming that the international community is willing to invest in reconstruction. Second, the Palestinian authorities will have to create conditions for employing a large and rapidly growing labor force. Tird, the West Bank and Gaza have little in the way of developed economic sectors: Many industries would need to be developed from scratch. Fourth, the Arab world provides a logical market for Palestinian products, but the West Bank and Gaza have weak economic relations with their Arab neighbors. Fifth, rapid population growth, the possible immigration by a large number of Palestinian refugees to the West Bank and Gaza, the destruction of physical infrastructure related to the intifada, and a poor initial infrastructure base will require substantial investments in roads, water, electric power, and other infrastructure. Finally, Palestinian governing institutions have yet to show signs that they can create a business environment conducive to rapid economic growth. Strategic choices made by policymakers at the outset of the new state will mark edly a ect the path of its economic development. Decisions about the de gree of economic integration with Israel in terms of trade and the mobility of Palestinian labor will shape the Palestinian economy, the rate of economic growth, and prospects for employment. Economic Scenarios and Implications The future Palestinian state can be considered within the framework of four scenarios, determined by decisions about geographic contiguity and economic integration. We analyze these scenarios for the 2005–2019 time frame, quantifying what each scenario implies for economic growth and identifying the level of investment needed to achieve sustained economic growth and improved living standards. But achieving this income growth would require signi cant investment in Palestinian capital stock: Between 2005 and 2019, the Palestinian private and public sectors and the international community would have to invest around $50 billion under each scenario, averaging about $3. Regardless of the scenario, domestic private employment would have to grow at1 a substantial pace (perhaps at an annual average of 15 to 18 percent) between 2005 and 2009 to reach rates of employment last seen around the summer of 2000. Tese employ ment rates should be possible once Palestinian businesses are able to operate in a relatively unrestricted environment and are fully able to utilize available resources. Policy Options We discuss best-practice economic policy options for Palestine that would help to support its economic development, regardless of the scenario in which it found itself. Partnering with its neighbors to develop speci c economic sectors and to leverage infrastructure 3. Investing in infrastructure for transportation, water and power, and communica tions 4. Facilitating Palestinian employment in Israel by implementing appropriate secu rity measures that make employment feasible 5. Expanding access to capital through a program of industrial estates/economic development zones, reformed domestic banking policies, and an international insurance fund 6. Improving the business climate through increased transparency and accountabil ity of Palestinian governance 8. Introduction: Overview of the Palestinian Economy The economy of an independent Palestinian state will be the engine of opportunity for its citizens. To foster an economy that can provide sustained growth in per-capita incomes, Palestine needs a dynamic private sector that grows rapidly enough to employ the current and future labor force. The economy must also be diverse and resilient 1 All dollar amounts in this chapter are 2003 U. In this chapter, we explore the issues surrounding how a Palestinian state can achieve such sustained economic growth over its rst 15 years. We rst examine the current state of the economy in the West Bank and Gaza, including development since 1967. Second, we describe the major challenges and issues confronting the genera tion of sustainable economic growth. Tird, because the details of a Palestinian state have not yet been determined, we consider how di erent initial conditions are likely to in uence the path and ultimate success of economic development. Fourth, we ana lyze the implications of these scenarios, with an eye to quantifying the amount of in vestment needed from the private sector and the international community to achieve sustained growth in per-capita incomes. Finally, we discuss a number of best-practice economic policies for Palestine that can help stimulate economic growth regardless of its initial conditions. Snapshot of Palestinian Economy in 1999 The economy of the West Bank and Gaza is small. The resulting per-capita income of nearly $1,800 a year placed the Palestinian economy in the group of lower middle-income countries (World Bank, 2002c, p.

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Gerstmann Syndrome the Gerstmann syndrome cheap deltasone 5mg overnight delivery allergy shots list, or angular gyrus syndrome buy deltasone 10 mg overnight delivery allergy medicine you can take with alcohol, consists of acalculia discount deltasone 10 mg with amex allergy relief juice, agraphia (of central type) discount 40 mg deltasone otc allergy symptoms cough, nger agnosia, and right–left disorientation; there may in addition be alexia and dif culty spelling words but these are not necessary parts of the syndrome. Gerstmann syndrome occurs with lesions of the angular gyrus and supra marginal gyrus in the posterior parietotemporal region of the dominant (usually left) hemisphere, for example, infarction in the territory of the middle cerebral artery. Hence this may be an example of a 158 Girdle Sensation G disconnection syndrome. Nonetheless the Gerstmann syndrome remains useful for the purposes of clinical localization. The enigma of Gerstmann’s syndrome: a telling tale of the vicissitudes of neuropsychology. Annals of Neurology 2009; 66: 654–662 [Erratum: Annals of Neurology 2009; 66: 869]. Cross References Acalculia; Agraphia; Alexia; Finger agnosia; Right–left disorientation Geste Antagoniste Geste antagoniste is a sensory ‘trick’ which alleviates, and is characteristic of, dystonia. Geste antagoniste consists of a tactile or proprioceptive stimulus, which is learned by the patient, which reduces or eliminates the dystonic posture. For example, touching the chin, face, or neck may overcome cervical dystonia (torti collis), and singing may inhibit blepharospasm. They are almost ubiquitous in sufferers of cervical dystonia and have remarkable ef cacy. The mechanism is unknown: although afferent feedback from the periphery may be relevant, it is also possible that concurrent motor output to generate the trick movement may be the key element, in which case the term ‘sensory trick’ is a misnomer. The phe nomenology of the geste antagoniste in primary blepharospasm and cervical dystonia. Cross References Dystonia; Reverse sensory geste; Torticollis Gibbus Angulation of the spine due to vertebral collapse may be due to osteoporosis, metastatic disease, or spinal tuberculosis. Cross References Camptocormia; Myelopathy Girdle Sensation Compressive lower cervical or upper thoracic myelopathy may produce spastic paraparesis with a false-localizing midthoracic sensory level or ‘girdle sensation’ (cf. The pathophysiology is uncertain, but ischaemia of the thoracic 159 G ‘Give-Way’ Weakness watershed zone of the anterior spinal artery from compression at the cervical level has been suggested. Clinical features of the localized girdle sensation of mid-trunk (false localizing sign) appeared [sic] in cervical compressive myelopathy patients. Usually, re exive blinking in response to tapping habituates quickly, but in extrapyramidal disorders it may not do so. This sign was once thought useful for the diagnosis of idiopathic Parkinson’s disease but in fact it is fairly non-speci c, occurring in many akinetic-rigid disorders. Cross References Blink re ex; Parkinsonism Glossolalia Glossolalia, or speaking in tongues, may be considered a normal phenomenon in certain Christian denominations, as divinely inspired, since it is mentioned in the Bible (1 Corinthians, 14:27–33, although St Paul speaks of the importance of an interpreter, since ‘God is not the author of confusion’), but it is not con ned to Christianity or even overtly religious environments. Others conceptualize glosso lalia as a form of automatic speech, usually of a pseudolanguage which may be mistaken for a foreign tongue. Such happenings may occur in trance-like states or in pathological states such as schizophrenia. As with Chaddock’s sign and Oppenheim’s sign, this re ects an expansion of the receptive eld of the re ex. Cross References Babinski’s sign (1); Plantar response Gowers’ Manoeuvre, Gowers’ Sign Gowers’ sign is a characteristic manoeuvre used by patients with proximal lower limb and trunk weakness to rise from the ground. From the lying position, the patient rolls to the kneeling position, pushes on the ground with extended fore arms to lift the hips and straighten the legs, so forming a triangle with the hips at the apex with hands and feet on the oor forming the base (known in North America as the ‘butt rst manoeuvre’). Then the hands are used to push on the knees and so lift up the trunk (‘climbing up oneself’). This sign was originally described by Gowers in the context of Duchenne muscular dystrophy but may be seen in other causes of proximal leg and trunk weakness. Gowers was not the rst to describe the sign; Bell had reported it almost 50 years before Gowers’ account. Gowers’ name is also associated with a manoeuvre to stretch the sciatic nerve and hence exacerbate sciatic symptoms. Graphaesthesia Graphaesthesia is the ability to identify numbers or letters written or traced on the skin, rst described by Head in 1920. Loss of this ability (agraphaesthesia, 161 G Graphanaesthesia dysgraphaesthesia, or graphanaesthesia; sometimes referred to as agraphog nosia) is typically observed with parietal lobe lesions, for example, in conditions such as corticobasal degeneration.

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References:

  • https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/Downloads/highlights.pdf
  • https://www2.deloitte.com/content/dam/Deloitte/ch/Documents/life-sciences-health-care/ch_Studie_Pharmaceutical_China_05052014.pdf
  • https://www.ifpma.org/wp-content/uploads/2016/02/IIHI_Report_Pharma_Value.pdf