The only set parameters indicated by hospital policy are to decrease the drip when respirations are less than twelve breaths per minute. Mr. V has requested that the drip be increased several times during my shift. Even though he does not appear to be in any discomfort, I increase the drip. On my final round of the shift, Mr. V requests that the drip be increased again, stating that the pain is increasing. I note that his respirations remain stable at 12 breaths per minute.
This man is dying of liver cancer. For a while, morphine will control his severe pain. However, it may further reduce respiration. As a medical professional, I feel responsible to give this patient enough morphine to ease his suffering without causing him harm. However, I must consider the legal and ethical issues at hand.
On one hand, if I continue to increase his pain medication, I may be accused of overprescribing narcotics or hastening death. On the other hand, my patient has a right to proper pain management. For most terminally ill patients, pain can be controlled and, as a hospice worker, I am responsible to provide pain control.
In the past, many nurses did not fully understand pain control. As a result, many terminally ill patients were denied enough medication to relieve their pain because nurses were afraid of addicting patients or of killing them.
The medical industry and the public believed many untrue statements about the use of strong narcotic drugs, such as morphine. People were afraid that morphine would lead to problems with drug addiction and that drugs would lose their effectiveness after a long period of time.
Today, however, medical professionals know a lot more about pain control. The American Nurses Association's (ANA) Position Statement on Promotion of Comfort and Relief of Pain in Dying Patients completely supports the use of full and effective doses of pain medication for dying patients.
We now know that the pain control process involves using a "baby steps" approach. This approach uses small doses of analgesics, such as aspirin, then using stronger drugs, such as morphine, to maintain pain control. Medical standards dictate that pain medications should be given at regular intervals and in large enough doses to maintain a patient's comfort level and pain control.
Hospices and oncology services report that respiratory depression is uncommon in patients who are receiving opioids for the control of pain. Pain is itself a respiratory stimulant, and the opioid effect on the respiratory center diminishes rapidly with chronic use. If the patient is terminally ill and the dose of opioid required to produce comfort does happen to depress respiration, it is still reasonable to allow the undesired effect (respiratory depression) in order to achieve the desired effect"
In addition, according to the ANA, increasing a dying patient's dose of medication to achieve adequate symptom control is ethical, even if it causes the person to die sooner.
Mr. V is in a hospice, where he is expected to die. The main goal of the hospice is to make the quality of the patient's life the best possible during his final days.


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The Domain Name System is a hierarchical, distributed naming system for computers, services, or any other resource connected to the internet or a private network. Whenever you need your browser to locate and connect to a computer service or device, the DNS works behind the scenes to translate an easily-memorized domain name into the numerical Internet Protocol (IP) address for that resource. You could think of the DNS as the internet's phone book: It was created to enable people to easily identify by name all devices and services connected to the internet.
The DNS terminology
A domain name is a user-friendly name associated with an internet source. For example. www.f5.com is a domain name, and the URL is associated with the servers owned by F5.
The subdivision of a domain is known as a subdomain. For example, support.f5.com is the subdomain for support on F5.com. A subdomain is anything to the left of the domain name, followed by a dot.
DNS lookup is a process through which a client (such as a web browser) queries a DNS server for a particular domain. The DNS server then replies back with an IP address, which then leads the client to the desired destination.
Domain Name Space
Domain Name Space defines the overall naming structure of the internet. It is a tree-like structure of domain names, with a root domain name at the top. From that root domain, major domains such as .com, .net, .org, and other domains branch out.
A name space tree is subdivided into zones. It defines the resources available under a specific domain.
Name Servers
Name servers store information about a zone. There are two types of name servers: Primary and Secondary. Every zone has its data stored on both Primary and Secondary name servers.
DNS Resolvers
A DNS resolver is the client side of the DNS. It is responsible for initiating and sequencing the queries that ultimately lead to translation of a domain name into an IP address.
How does DNS Work?
The short version is that a domain name typed by a user in a browser (such as www.f5.com) is translated by a DNS server into an IP address (104.219.105.148). This allows the device to find the resource you are looking for on the internet—in this case, the F5 home page.
Let's look at this process in more detail:
Say a user types the domain name www.f5.com in a browser. Because the browser has no clue where www.F5.com is, it sends a request to the Local DNS Server (LDNS) asking if it has the record for the website. If the LDNS has no record for that particular site, it starts a recursive search of the internet domains to find out who owns www.F5.com .
First, the LDNS goes to one of the root servers, which directs it to the .com DNS server. The .com server then determines the owner of www.F5.com and notifies the LDNS with a name server (NS) record for F5.com.
The LDNS then queries the F5.com DNS server NS record. The f5.com DNS server looks up the name www.F5.com . If it finds the name, it returns an Address (A) record to the LDNS. This A record contains the request name, the IP address assigned to that name in the LDNS, and the Time to Live (or TTL) for the name. The TTL tells the LDNS how long to maintain the A record before it asks the F5.com DNS server again.
When the LDNS receives the A record, it caches the IP address information for the time specified in the TTL; if any other client needs the same information, the LDNS will answer the query from its own cache of names before sending it out. Because it can hold on to the info locally, it doesn't need to keep asking the f5.com DNS server, making future connections to that resource faster.
The browser then uses the IP address to open a connection to www.F5.com :80 and sends a GET /…. which then leads to the web server returning the web page response.
Now, in practice, DNS is a lot more complicated than what the example above shows—but it should give you a fair idea of how it works.
DNS Records and Its Common Types
DNS records are mapping files which tell the DNS server which IP address is associated with which domain name. It also tells the DNS server how to handle those requests. There are various types of DNS records, but all DNS records for a specific domain are contained in something called a DNS Zone. Think of the DNS Zone as a container which allows the internet to look up the IP address for one, and only one, particular domain.
The common DNS record types are as follows:
A and AAAA Records
Address or A records (also known as host records) are the central records of the DNS. These records link a domain to an IP Address. AAAA record is same as A record—but instead of a 32-bit IPv4 IP address, it returns a 128-bit IPv6 address.
NS Record
Name Server (NS) records determine which servers communicate DNS information for a domain. Generally, you will have primary and secondary name server records for your domain.
MX Record
Mail Exchange records direct email messages to the servers for a particular domain. Multiple MX records can be defined for a domain, each with a different priority. The lowest number is the highest priority. If mail can't be delivered using the first priority record, the second priority record is used, and so on.
TXT Record
Text or TXT records may contain arbitrary text, but can also be used to define machine readable text.
Canonical NAME or CNAME records link an alias name to another canonical domain name. For instance, alias.example.com might link to example.com.
DNS Importance and Limitations
The DNS is one of the primary technology enabling the internet. It is also a vital component in the networking infrastructure. Because having an available, intelligent, secure and scalable DNS infrastructure is critical, DNS doesn't simply deliver content and applications: it manages a distributed and redundant architecture, ensuring high availability and quality user response time. If DNS fails, most web applications will fail to function properly. This not only makes DNS critical, but also a prime target for attacks. If you don't have a proper DNS infrastructure, customers won't be able to reach your applications or content—which might lead to them turning elsewhere for their needs.
However, there are certain limitations to the standard DNS services. First, even though DNS makes your application/website/content available, DNS doesn't really care whether it's up and running, or even exists.
In addition, DNS has no real ability to distribute load. It will continue to use all the IP addresses, even if the application supported by that IP is overloaded or down.
DNS also has no concept of stateful application: it cannot guarantee that a user goes back to the same IP address. For example, if you go to a particular data center and build a shopping cart that is maintained in that data center, there is no guarantee that next time you resolve the name, you will get the same IP.
Finally, standard DNS servers can only answer a limited number of DNS queries per second, making them vulnerable to distributed denial-of-service (DDoS) attacks.
DNS is the backbone of the internet, but it is also one of the most vulnerable points in your network—which makes it a high-value target. DDoS attacks can flood your DNS servers to the point of hijack or failure, leading to redirecting the requests to a malicious server. To prevent this, a high performing, distributed, secure, architecture must be integrated into the network. Companies should also add more DNS servers during DNS surges and DDoS attacks.
Even though DNS servers and cloud services can handle varying amounts of requests per second, with costs increasing as the queries increase, this solution often requires manual intervention when changes are needed. And since new vulnerabilities keep coming, traditional DNS servers require frequent maintenance and patching, making it even more costly.
The Role of Application Delivery Controllers in DNS Infrastructure
Now that we've established that DNS is prone to serious attacks, let's talk about how Application Delivery Controllers (ADCs) help shield the DNS infrastructure. ADCs can balance the loads of multiple DNS servers and cache responses, providing scale and enabling DNS servers to handle large amounts of traffic and massive attacks. This functionality enables customers to deploy many DNS servers at the same time, which lets them maximize application availability, provide greater speed, and improve performance. ADCs also quickly detect DDoS attacks and route those connections away from servers – or reject them completely. ADCs support DNSSEC, and allow organizations to defend against threats such as cache poisoning and man-in-the-middle attacks. Because of all this, ADCs reduce customers' total cost of ownership by reducing the need for extra DNS servers to be provisioned as backups in case of overload, or attack.
In short, a high-performance ADC can not only protect DNS servers from various attacks but can also provide scale, improve performance, and reduce TCO, while enabling DNS servers to handle heavy traffic loads.
With the growth of mobile apps and newer technologies such as Internet of Things (IoT) devices, DNS is also growing. In addition, the number of applications is increasing rapidly, as is the volume of traffic accessing those applications. In the last 5 years, the volume of DNS queries has doubled for .com and other addresses. More than 10 million domain names were added to the internet in 2016; and as more and more cloud, mobile and IoT implementations are deployed, the DNS is expected to grow at an even faster rate. Some recent studies done on global internet traffic show that the number of internet users will rise to 4.1 billion by the end of 2020. Because DNS servers are so critical to the internet, without a well-functioning DNS, the internet would be practically useless.
Just like IoT, the popularity of cloud services has increased immensely over the past several years. As a result, it is more important than ever to think about your DNS infrastructure, and the benefits and threats associated with it. On one hand, cloud-based authoritative DNS offers better performance, high availability, security, and scalability. On the other, it is also vulnerable to threats such as DNS infrastructure and DDoS attacks.
These threats have the potential to significantly disrupt access to websites, applications, cloud services, and other resources. Planning and managing your IT infrastructure effectively is absolutely vital to keep these attacks at bay, and continue giving your employees and customers access to the resources they need, whenever and wherever they need them.

redpajama_set_name: RedPajamaCommonCrawl


This collection embodies for me a feeling of being centered and whole, while also carrying a consciousness of my surroundings. It is in experiencing this balance that we, as individuals, can be dissolved into the most genuine feelings that lie at the core of our being—love, tranquility, and connectedness to the universe that houses us.
I created this series with a sense of wholeness and clarity in my heart, and I feel that the works carry this impression in their subtle, flowing details.


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Campaigners targeting women on tube with cards saying: 'You are a fat, ugly human'
Monday 30 November 2015, 4:35pm
Credit: Kara Florish/Twitter
Shocked commuters are reportedly being handed cards while travelling on the Tube, telling them they are a "fat, ugly human".
According to the cards, those responsible for the campaign call themselves 'Overweight Haters Ltd', an organisation that claims to "hate and resent fat people".
Kara Florish, 30, from Southend-on-Sea, was handed a card at Warren Street station by a "ordinary-looking middle-aged man" who then scuttled off.
She told Stylist magazine: "When I first read the card I thought it was a joke so put it on the seat next to me.
"I'm a size 12/14, what people call curvy but I don't consider myself fat.
"I'm active, go to the gym at least twice a week, don't smoke, hardly drink and don't do drugs. I have no health issues that I know of, have never been seriously ill or in hospital so don't consider myself a drain on the NHS. In fact, I'm currently employed by them."
Commuter Sean Thomas Knox says he saw a woman being handed a card, who then broke down into tears when she read it.
The card goes on: "We object to the enormous amount of food resources you consume while half the world starves.
"We disapprove of your wasting NHS money to treat your selfish greed. And we do not understand why you fail to grasp that by eating less you will be better off, slimmer, happy and find a partner who is not a perverted chubby-lover, or even find a partner at all."
The leaflets are being handed out at tube stations. Credit: PA
The man handing out the leaflets is reportedly described as being an "ordinary-looking middle-aged man".
Transport for London is urging people to report any such instances to station staff or police.
A spokesman said: "All of our customers have the right to travel with confidence, and this sad and unpleasant form of anti-social behaviour will not be tolerated."


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Die historische Eisenbahnbrücke Wesel an der Bahnstrecke Haltern–Venlo wurde in den Jahren 1872 bis 1874 von der Cöln-Mindener Eisenbahn-Gesellschaft (CME) als Teil der Hamburg-Venloer Bahn erbaut und war zeit ihres Bestehens die nördlichste Rheinbrücke in Deutschland. Ab 1917 existierte in der Nähe der Eisenbahnbrücke eine zusätzliche Straßenbrücke, bis beide Brücken gegen Ende des Zweiten Weltkriegs zerstört wurden. Nur die Straßenbrücke wurde daraufhin wiedererrichtet.

Baugeschichte

Anlass für die Überbrückung des unteren Niederrheins in Wesel war der Bau der Hamburg-Venloer Bahn von Hamburg über Bremen, Münster und Haltern nach Venlo. Die ursprünglich von einem ausländischen Konsortium geplante Linienführung durch das dicht besiedelte Ruhrgebiet mit einer Rheinbrücke bei Duisburg verhinderte der preußische Staat, welcher eine Streckenführung über die damalige preußische Festung Wesel forderte und der CME die erforderliche Konzession für die gesamte Strecke bis Hamburg erteilte. Dadurch konnten die in der Festung Wesel stationierten Soldaten die Brücke im Kriegsfall gegen einen Rheinübergang verteidigen bzw. sie als Basis für den Aufmarsch nach Westen nutzen. Schon in der Planung wurde dafür ein Teil des Oberbaues mit Bohlen vorgesehen, sodass die Brücke auch von anderen Fahrzeugen befahren werden konnte.

Auf beiden Seiten waren der eigentlichen Strombrücke aus hart gebrannten Ziegelsteinen gemauerte Vorlandbrücken vorgelagert, linksrheinisch 65 mit insgesamt 770 Metern Länge, rechtsrheinisch 32 ebenfalls gemauerte und 6 Stahlbrücken mit zusammen 766 Metern. Dazwischen wurde der Rhein bei Kilometer 815 mit einer Strombrücke, bestehend aus vier stählernen Einzelteilen von je 104 Metern Länge überspannt. Zur Bauzeit war damit das Bauwerk mit seinen 1950 Metern die längste errichtete Rheinbrücke. Die Ziegelsteine wurden während des Baus an Ort und Stelle aus dem bei den Ausschachtungen der Pfeiler gewonnenen Lehm gebrannt. Die außergewöhnliche Dimension des Bauwerks war nicht nur der häufigen Hochwassergefahr wegen gewählt worden, sondern auch deshalb, weil das Militär keinen Bahndamm duldete und freie Sicht für die Festung haben wollte.

Am Beginn und Ende der Strombrücke erhielt die Brücke, wie damals bei Rheinbrücken üblich, sogenannte Tambourwerke zur Verteidigung. Auch im Vorland wurden weitere Befestigungsanlagen errichtet. Linksrheinisch entstand hinter dem Deich neben den Gleisen auf Kosten der Cöln-Mindener Eisenbahn das Fort I. Es ist noch vollständig erhalten und befindet sich in Privatbesitz. Rechtsrheinisch lagen an den Weseler Bahnlinien weitere Forts, die die Festung Wesel schützen sollten. Von diesen Festungswerken sind keine Spuren erhalten.

Die Cöln-Mindener Eisenbahngesellschaft stellte die Pläne der noch im Bau befindlichen Rheinbrücke und der Elbbrücken in Hamburg auf der Weltausstellung 1873 in Wien aus und erhielt dafür ein Ehrendiplom der Section III (für Straßen-, Brücken- und Eisenbahnbau).

Beiderseits des Rheins errichtete man im Ersten Weltkrieg zur Verteidigung des Brückenkopfes Wesel Betonbunker. Sie wurden 1921 auf Anordnung der Alliierten gesprengt.

Gegen Ende des Zweiten Weltkriegs 1945 war die Brücke die letzte Rückzugslinie der zurückweichenden Wehrmacht während der Eroberung des linken Niederrheins durch englische, kanadische und amerikanische Truppen (von Norden Operation Varsity, von Süden Operation Grenade). Am Morgen des 10. März 1945 sprengten deutsche Pioniere auf Befehl von General Alfred Schlemm die Weseler Eisenbahnbrücke – drei Tage nach Eroberung der Ludendorff-Brücke bei Remagen durch US-Truppen. Die Brücke wurde nach dem Krieg nicht wiederaufgebaut; sie war zuletzt nur noch von zwei Nebenbahnen befahren worden.

Erst 1968 wurden die Reste der beiden Strompfeiler, die die Rheinschifffahrt behinderten, beseitigt. Die Brücke ist ein Teil der Route der Industriekultur.

Eisenbahngeschichte
Am 1. März 1874 wurde die Teilstrecke Wesel – Haltern der Paris-Hamburger Bahn eröffnet; zu Silvester 1874 fuhr ohne größere Feierlichkeiten der erste Zug über die neue Brücke. Vom 1. Juli 1878 an wurde sie auch von der Boxteler Bahn mitbenutzt, die in Büderich in die Venloer Strecke mündete. Die Hoffnungen der Erbauer in die Nutzung der Bahnstrecke Haltern–Venlo erfüllten sich aber nicht und es blieb bei einem nebenbahnähnlichen Betrieb. Nur die internationalen Schnellzüge der Boxteler Bahn frequentierten die Brücke bis zum Ersten Weltkrieg stark. Wegen der hohen Baukosten und der geringen Streckennutzung berechnete die Cöln-Mindener Eisenbahn und nach deren Verstaatlichung auch die Preußische Staatseisenbahn für jeden Fahrschein der Brückennutzer einen Aufschlag in Höhe von 11,25 Kilometern. 1926 und 1927 wurde die Brücke auf den alten Strompfeilern erneuert und dabei den gestiegenen Zuggewichten angepasst.

Bildergalerie – Bau der Eisenbahnbrücke

Bildergalerie

Siehe auch
 Liste der Rheinbrücken
 Liste historischer Rheinbrücken

Literatur
 Krabbe: Die Erneuerung der eisernen Überbauten der Eisenbahnbrücke über den Rhein bei Wesel. In: Die Bautechnik, 5. Jahrgang 1927.
 Ernst: Die Brückenbauten der Deutschen Reichsbahn. In: Reichsbahn, 4. Jahrgang 1928, Heft 22.
 Hans-P. Höpfner: Eisenbahnen. Ihre Geschichte am Niederrhein. Duisburg 1986.
 Jutta Prieur: Geschichte der Stadt Wesel. Band 1, Düsseldorf 1991 / Band 2, Düsseldorf 1992.
 Ulrich Dinkelaker: Brückenkopf Wesel. Lünen 1993.
 Alexander Berkel: Krieg vor der eigenen Haustür. Rheinübergang und Luftlandung am Niederrhein 1945. Wesel 1994.
 Vincent Freriks: Die Bahnstrecke Venlo – Wesel – Haltern. In: Eisenbahnen am Niederrhein. (hrsg. im Auftrag der Stadt Wesel) Wesel 2005.
 Hans Schlieper, Vincent Freriks: Die Boxteler Bahn. Die Nord-Brabant-Deutsche Eisenbahn-Gesellschaft und die internationale Vlissinger Postroute. Deutsche Gesellschaft für Eisenbahngeschichte e.V., Werl 2014, ISBN 978-3-937189-79-6.

Quellen
 Geschäftsberichte der Cöln-Mindener Eisenbahn 1865–1876
 Auszüge aus den Verhandlungen der General-Versammlungen der Aktionäre der Cöln-Mindener Eisenbahn 1869–1879

Weblinks

Einzelnachweise

Eisenbahnbrücke in Nordrhein-Westfalen
Ruine in Nordrhein-Westfalen
Wesel, Eisenbahnbrucke
Festung in Europa
Brücke in Europa
Erbaut in den 1870er Jahren
Bogenbrücke
Steinbrücke
Rheinbrücke
Route der Industriekultur (Kreis Wesel)
Verkehrsbauwerk im Kreis Wesel
Verkehrsbauwerk in Wesel
Baudenkmal in Wesel

redpajama_set_name: RedPajamaWikipedia


70 or 80 feet to the base of the Mississippi River gorge.
Here in the upper reaches of the great river, the water has, over the last 12-14,000 years, incised the earth's crust, laying bare strata of ancient sedimentary stone. How did these layers form? What was happening around here back then?
I've always believed such geologic records, like a tree's rings or layers of glacier ice, bear chronological evidence of changing seasons and climate trends, floods, fires and volcanic events. So is that the case here with what I think I've identified as Platteville limestone?
Could that possibly explain the wide range of thickness in these layers—from five or six inches, to a phyllo-like eighth-inch, and back again? Was there really that much difference between the amount of sediment or water flow from one year (or whatever the cycle was) to the next?
now Minnesota lay along the equator.
In reading up on the subject, I've learned that, instead of looking at this in terms of yearly cycles, I should be thinking much, much longer-term. This Platteville limestone formed between 488 and 436 million years ago—a period of some fifty million years.
So what is the answer to the wide variance in these layers' thickness? It turns out that this is actual not all the same rock. According to geologists, the thick, topmost layers are indeed Platteville limestone, a chemically-affected, calcium-carbonate, sedimentary rock comprising mostly-pulverized marine fossil remains.
The much thinner middle-layer strata, seen about three-fourths of the way down my photo, are Glenwood shale, another sedimentary rock made up of much finer particles of mostly mineral-based mud.
Some folks might ask me why I'd be interested in how rocks formed half a billion years ago. If you believe in your soul, as I do, that everything—animals, plants, microorganisms and, indeed, the earth—are connected, you might understand.
If you're susceptible to awe—like the kind you might experience observing details of the moon's surface through a powerful telescope, or getting close enough to touch the plate some passenger was eating from when the Titanic struck that iceberg—then you most certainly get it.
I thought I was going down to the river for a walk. I ended up witnessing—no, actually touching—something that happened hundreds of millions of years before human beings' earliest ancestors existed. The awesomeness of that is still sinking in. To me, that was a good day.
I totally get it, Jeff, and wish I could go on that walk with you----maybe take Robin Easton with us :).
Oh yes, wouldn't that be something! With that trio, we'd be so present we'd implode!


The first mega-bestseller of 1995! Detective Alex Cross is back in a coast-to-coast thriller that's even scarier and more suspenseful than Along Came A Spider.
Two depraved serial killers are on the loose. "Casanova" is abducting young women from colleges in the Southwest.
The "Gentleman Caller" is terrorizing Los Angeles.
The worst part is, the FBI thinks they're talking to each other. They seem to be competing. And they may even be working together. But at least one of them has made a serious miscalculation.
The favorite niece of Washington D. C., police detective Alex Cross has been kidnapped. Burned out after his last case, Cross is in no mood to take on another killer. But now he has no choice. This time it's personal.
As always, Alex Cross never fails to entertain me.
It sure seemed like this is a good story. However, I think this abridged version is a bit too abridged. There are many points at which the scene changes very abruptly. Some major points were revealed in a few lines and it certainly felt like there was way too much left out. I usually don't get abridged versions, but since the full length was not available I gave it a shot. I was sorry I did.
I could not even get through the first CD. It is going back in the mail this afternoon.
This was my first Alex Cross novel and I really enjoyed it. I will read more of the same for sure. The plot was captivating and the killers were the night-marish type. Good book!!
Another Alex Cross success. I would rather had a longer, unabridged version but this one was good anyway.
It was very interesting and exciting. Made a long trip in the car very much shorter. I am a fan of Alex Cross.
This Alex Cross book was awesome and fast paced. I prefer the books read by Peter Fernandez, but Chris Noth and Robert G. did an good job.
Kiss the Girls and Honeymoon are Patterson's best novels. I highly recommend them. Edge of seat, nail-biting thriller.


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10Words from Wiechers: Perception of Reality or Reality of Perception?
Although cellulite is not considered a disease, it is a significant cosmetic problem for many post-adolescent women. Recent studies using new diagnostic techniques such as ultrasound imaging can define the cellulite-reducing efficacy of cosmetics. However, there is still a need to standardize and objectify the testing procedures and to find parameters to measure anti-cellulite efficacy.
Personal care efficacy tests are known to test the physical effects or toxicity of products, often omitting more abstract and possibly equally as important factors such as well-being.
Nowadays, however, personal care has evolved even further to encompass the root of human being-ethics and morals, where the purchase of a personal care item relates to one's concern about the environment and animal welfare. But the involvement of ethics does not just apply to the consumers using the products; it applies to scientists conducting safety studies.
It remains the responsibility of the manufacturer to substantiate the safety of both ingredients and finished cosmetic products prior to their being marketed.
In 2001, Japanese researchers reported that after the age of 40, some individuals develop a malodor known as "aging odor," attributed to the presence of unsaturated C9, 2-nonenal. George Preti, PhD, a member of Monell Chemical Senses Center and an adjunct professor of dermatology at the University of Pennsylvania School of Medicine, was interested by this report and began to conduct research of his own.
This work evaluates the impact of temperature on test substrate surfaces during the application, spreading and drying steps of the in vitro method to measure ultraviolet (UV) transmission. The authors work in a range between 20°C and 35°C, and demonstrate that controlling temperature is a key test parameter that should be strictly controlled to ensure reliability.
This study describes methods used in a Korean study to calculate consumer exposure to lipstick and face creams. The average amount applied daily was estimated and compared with data collected by weighing containers before and after use. The data collected was 1.8 to 1.6 times greater than the estimate, so although the survey represented real use patterns, the actual data was more accurate.
Jun 25, 2013 | Kathleen A. Martin, PhD, McCrone Associates Inc.
Particulate contamination and discoloration may occur in products due to foreign materials introduced via raw materials or during the manufacturing process. Agglomeration or reactions between ingredients and packaging components also are possible sources. The identification of contaminants and their origin, described here, is therefore critical so that future incidents can be prevented and safety or regulatory concerns can be addressed.
The present study uses an evaporimeter to measure the degree of water loss from in vitro skin samples covered by occlusive and semi-occlusive wound dressings to serve as a model for determining the effectiveness of occlusive cosmetic formulations. The purpose of this work was to develop a model for determining the effectiveness of occlusive cosmetic formulations.
To support finished product or raw material claims these two in vitro methods—the Affymetrix microarray and the Taqman Real Time Polymerase Chain Reaction (PCR)—measure the up-regulation or down-regulation of genes.
The present study utilized an in vitro model to compare the decontamination capacity of three model decontaminant solutions: tap water, isotonic saline and hypertonic saline. Human cadaver skin samples were dosed with radio-labeled [14C]-formaldehyde and the surface skin of each sample was washed after each exposure with one of the three model decontaminant solutions.
Noninvasive subcutaneous skin imaging is a tool sought for use by the medical, pharmaceutical and personal care industries, but techniques have been lacking due to resolution and speed constraints.


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Women seen through eyes of women
In Arts & Culture January 9, 2002 Leave a Comment
Exhibit looks at women's representation in art, responding to male visions of the female nude
By Jonathan Colford
A touch of the macabre, a mosaic and a distorted naked body are among the interpretations of the female form in a new exhibit at the Ryerson Gallery.
Fourth-year Ryerson photography student Alison Skyrme, Natasha Lan, and Judy Ditner titled their exhibit of self-portraits Surface Tension. Skyrme says the title expresses the tension in the work, which examines the ways women have been portrayed by male artists.
"We were dealing with the assumptions people make when looking at images," adds Lan. "There are things at the surface, things underneath, missing pieces, fragments almost."
The three photographers did their work individually but decided to exhibit it together since it carried a similar theme.
Lan's six photos, all self-portraits, distort the image of the subject. She says they were shot through a glass block, a technique inspired by early twentieth-century photographer André Kertész, who shot reflections of women through circus mirrors. Those photos achieved a similar distortion effect, Lan says.
In Skyrme's sequence of nine black and white pictures, a blindfolded figure, clad in white, walks tentatively in a night screen filled with dead leaves and branches.
She says her shots are designed to give the impression of a woman being led off to her execution.
"I wanted them to have the resonance of a nightmare," she says.
Skyrme's works are photographic prints. Some were shot in a studio, others outdoors.
They're motivated by her experience of being stalked by a man for many years. "You keep yourself a prisoner of your fear in the way you live your life," she says.
Skyrme used a flashlight to light her pictures. She exposed them for three to five minutes while her assistant moved the flashlight around — unusual since a flashlight is usually used to add highlights, but Skyrme used it to light the entire photo. She says her use of this technique was inspired by photographer Diana Thornycroft.
Ditner is exhibiting distorted images of five paintings of female nudes and three shots of herself in a bathtub. The three bathtub shots are made up of smaller square tiles, pieced together like a mosaic.
Ditner says her work explores a new way of seeing the human figure, including representations of the female nude in the history of art.
"The images of the figure are deconstructed and reassembled using parts of the whole, asking one to use one's mind to fill in the blanks," Ditner said in an e-mail.
Photo: Judy Ditner
Photo: Natasha Lan
Photo : Alison Skyrme


Here's everything you need to know before you see "Captain Marvel," including if it has any end-credits scenes, what comics it's based on and more.
We're 21 films and more than a decade into the culture-defining Marvel Cinematic Universe, and the saga's titular hero is making her debut on the big screen.
"Captain Marvel" opens in theaters on Friday, March 8.
Felecia Wellington Radel and Alex Biese, co-hosts of the USA TODAY NETWORK and Asbury Park Press' "Fan Theory," have seen the movie and spoke with one of the defining creative minds behind the character.
Now we are ready to bring you a spoiler-free "Captain Marvel" primer before the character finally takes to the skies.
This is a hard question to answer, because directors Anna Boden and Ryan Fleck get plenty of dramatic mileage in "Captain Marvel" from having the character and the audience put together the pieces of her backstory together.
But we can say this: Carol Danvers, a member of the United States Air Force, was introduced to Marvel Comics readers back in 1968.
Carol has donned various superhero mantles over the years, and she became the latest hero to accept the title of Captain Marvel in 2012.
She's played on the big screen by Brie Larson, an Academy Award winner for the 2015 drama "Room."
This entry in the Marvel Cinematic Universe is set in 1995, way before all the Infinity Stone stuff and back when two-eyed Nick Fury (Samuel L. Jackson) was just a S.H.I.E.L.D. agent with his newbie partner Phil Coulson (Clark Gregg).
Carol Danvers, who has been living and training with the Kree, a powerful and proud alien race perpetually at war with the shape-shifting, manipulative Skrulls, crash lands on Earth, partners up with Fury and a cat, Goose, and starts to unravel her foggy memories and forgotten identity while fighting off a Skrull leader, Talos (played by a fairly hilarious Ben Mendelsohn).
From the Blockbuster seen in the trailer to all the pagers and payphone to the soundtrack choices, the movie taps into 1990s nostalgia for sure. No spoilers here, but let's just say be on the lookout for a meta, super specific 1995 blink-and-you-missed-it Kevin Smith reference that's sure to delight if you catch it.
"There's this nostalgia for everything '90s," said Marvel Studios head Kevin Feige in the film's press notes, "and it (was) felt that it would be fun to also tap into that period stylistically and cinematically with the '90s action films."
The film also stars Jude Law as Yon-Rogg, a Starforce leader and Danvers' Kree mentor, Lashana Lynch as Maria Rambeau, Danvers' best friend and a former test pilot, and Annette Bening as Supreme Intelligence.
Nothing. You can go into this one cold and still understand everything.
If you're subscribed to the MCU Subscription Plan (as in, you've seen every single one of the movies), you know that there's a reference to this movie in the singular end-credits scene for "Avengers: Infinity War." But you don't really even need to know that, as it's more a tease for the upcoming "Avengers: Endgame."
If you want some extra credit though, re-watch "Guardians of the Galaxy" (2014) and, if you've really got the time, "Marvel's The Avengers" (2012).
"Captain Marvel" is chiefly based on the comic book run by writer Kelly Sue DeConnick.
She has a cameo in the movie, and she spoke with us about her experience on set.
Listen up: Hear our full interview with comic book writer Kelly Sue DeConnick on the Fan Theory podcast. The podcast episode contains spoilers.
DeConnick, whose father was in the Air Force and who grew up on base, said one of her inspirations for Carol Danvers/Captain Marvel was Chuck Yeager, the U.S. Air Force officer and test pilot who was confirmed to have exceeded the speed of sound in level flight.
In the comics, Carol Danvers aka Captain Marvel (Earth's Mightiest Hero!) is an Avenger who frequently teams with Iron Man, Falcon and the Guardians of the Galaxy.
The tagline "Higher, Faster, Further" that was used in some of the posters and marketing for the film is taken from first issue and volume in the run, "Higher, Further, Faster, More," by DeConnick and artist David Lopez.
"For me, and hopefully many others who see the film, she will not just be a female superhero; she will be looked upon as simply a superhero," DeConnick said.
Fun fact: The original Captain Marvel was the favorite character of Jude Law's father, according to the film's press notes.
5. Is there an end-credits scene?
Yes, there are two, so plan to stick around. There is a mid-credits scene and a post-credits scene.
6. Is it ok for kids?
Not really. It's lighthearted, sure, but maybe a bit much for younger children. Probably better suited for preteen and up, hence the PG-13 rating.
7. What's next in the Marvel Cinematic Universe?
Following "Captain Marvel," the MCU continues with the follow-up to "Avengers: Infinity War" with the April 26 release of "Avengers: Endgame."
Following "Endgame" the future of the MCU remains somewhat murky Tom Holland's Peter Parker returns in "Spider-Man: Far From Home" on July 5, 2019.
Feige recently told ComicBook.com that the studio won't be announcing any plans for subsequent films until after the release of "Far From Home."
Note: No grandmas were hurt in the making of this movie.
To get the latest on upcoming movies, TV and more, including behind-the-scenes photos and exclusive interviews with cast and creators of your favorite entertainment, be sure to download the Asbury Park Press app and sign up for push notifications. Consider subscribing to APP.com so you don't miss any entertainment news.


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Der Bahnhof Châtelet - Les Halles ist ein 1977 eröffneter Tunnelbahnhof im Zentrum der französischen Hauptstadt Paris. Er wird von den Linien A, B und D des S-Bahn-ähnlichen Réseau express régional (RER) bedient und bietet zudem Umsteigemöglichkeiten zu fünf Métrolinien. Mit sieben parallelen Bahnsteiggleisen gehört er zu den größten unterirdischen Bahnhöfen der Welt. Der Bahnhof wird täglich von etwa 750.000 Fahrgästen genutzt.

Lage

Der Bahnhof befindet sich in der nördlichen Stadthälfte Rive droite im Quartier des Halles des 1. Arrondissements. Er liegt unter dem Einkaufszentrum Forum des Halles zwischen der Rue Rambuteau und der Rue Sainte-Honoré. Im Süden grenzt er an den Umsteigebahnhof Châtelet der Métro, am nördlichen Ende unterquert er deren Station Les Halles.

Name
Aus den beiden angrenzenden Métrostationen, mit denen er für Umsteiger direkt verbunden ist, ergibt sich der zusammengesetzte Name.

Namengebend für den U-Bahnhof der Métrolinien 1, 4, 7, 11 und 14 ist die Place du Châtelet. Die 1130 an der Stelle errichtete Kastellburg Grand Châtelet sicherte die Brücke Grand Pont (heute: Pont au Change), den Flussübergang vom nördlichen Seineufer zur Île de la Cité. Nach dem Bau der Stadtmauer wurde das Gebäude im 13. Jahrhundert zum Amtssitz des Prévôt de Paris und diente u. a. als Gericht und Gefängnis. 1802 wurde es auf Befehl Napoleon Bonapartes abgerissen.

Die ehemaligen Markthallen Halles de Paris gaben den Namen für die Station Les Halles der Métrolinie 4. Als öffentlicher Marktplatz wurde die Örtlichkeit im Jahr 1135 geschaffen, 1183 kamen feste Gebäude hinzu. Von 1850 bis 1856 entstanden zehn Hallen in Stahlbauweise, die zwischen 1971 und 1974, nach der Verlagerung des Großmarkts nach Rungis, abgerissen wurden.

Geschichte

Für die Anfänge des RER-Netzes zeichnet der Betreiber der Métro, die Régie autonome des transports Parisiens (RATP) verantwortlich, erst mit dessen späterer Erweiterung stieß die Staatsbahn SNCF hinzu. Abweichend von der Métro wird der Verkehr mit elektrischen Triebzügen durchgeführt, die ihren Strom aus einer Oberleitung beziehen. Der Bahnhof Châtelet-Les Halles ist mit einer Gleichspannung von 1500 V elektrifiziert.

Am 12. Dezember 1969 ging der erste Abschnitt der RER-Linie A im Osten der Stadt in Betrieb, am 20. Februar 1970 ein weiterer im Pariser Westen. Der Lückenschluss unter der Innenstadt, und damit die Eröffnung der Station Châtelet-Les Halles, erfolgte am 9. Dezember 1977. Zeitgleich wurde der erste Abschnitt der Linie B, mit Châtelet-Les Halles als zunächst nördlichem Endpunkt, in Betrieb genommen. 1981 wurde die Linie B zum Fernbahnhof Gare du Nord verlängert.

Die RER-Linie D sollte gemäß der ursprünglichen Planung vom Gare du Nord bis Châtelet-Les Halles die Gleise der Linie B mitnutzen und von dort in Richtung Gare de Lyon auf jene der Linie A wechseln. Der Betrieb über die B-Strecke bis Châtelet-Les Halles wurde am 27. September 1987 aufgenommen und besteht nach wie vor. Die Weiterführung über die A-Strecke wurde jedoch verworfen, da jene bereits vollständig ausgelastet war. Seit dem 24. September 1995 befährt die Linie D daher einen separaten Tunnel zum Gare de Lyon, damit wurde Châtelet-Les Halles auch für sie zum Durchgangsbahnhof.

Beschreibung

Die unterirdische Bahnhofshalle liegt auf der Ebene −5, sie ist 325 m lang, 80 m breit und weist sieben Gleise an vier Bahnsteigen auf. Darüber befindet sich auf der Ebene −4 das Verteilergeschoss, von dem aus, zum Teil über Fahrsteige, die Stationen der Métro erreicht werden können.

Anders als die Métro verkehren die Züge des RER im Linksverkehr. Die Bezeichnungen für die Gleise lauten von Ost nach West 1A, 1B, 3, Z, 4, 2B, 2A, die der Bahnsteige 1, 3, 4, 2. Die Bahnsteige 1 und 2 werden im Richtungsbetrieb angefahren, dort kann zwischen den Linien A und B auf derselben Ebene umgestiegen werden. Die Züge der Linie D hielten bis 2013 auf den Gleisen 3 und 4 an den Außenkanten der mittleren Bahnsteige 3 und 4. Zwischen jenen liegt das Gleis Z, das zunächst zum Wenden von Zügen der Linie D (z. B. auch von 2008 bis 2013) genutzt wurde. Mittlerweile wird es als Gleis 4Z im Regelverkehr dieser Linie in Süd-Nord-Richtung mit dem Vorteil des schnelleren Fahrgastwechsels ("Spanische Lösung") angefahren. In der Gegenrichtung halten die D-Züge weiter auf dem Gleis 3.

Fahrgastaufkommen
Im Jahr 2009 nutzten rund 750.000 Fahrgäste pro Tag den Umsteigekomplex, davon 493.000 für die Linien des RER. Dies macht ihn zu einem der bedeutendsten Umsteigebahnhöfe der Welt.

Zukunft
Das für Touristen und Pariser gleichermaßen verwirrende und unübersichtliche Gewirr des Bahnhofskomplexes sorgt schon seit seiner Errichtung für Diskussionsstoff. Durch den Neubau von Rolltreppen und die Verbesserung der Beleuchtung soll hier kurzfristig Abhilfe geschaffen werden. Der zukünftige Ausgang Sainte-Honoré soll einen direkten Zugang zu den RER-Zügen von der Rue des Halles und der Rue de Rivoli aus ermöglichen.

Weblinks

 Plan und Querschnitt des Umsteigekomplexes Châtelet-Les Halles

Einzelnachweise

RER-Bahnhof in Paris
Bahnhof in Europa


Staff Reporter Windhoek Ethiopian Airlines, the largest Aviation Group in Africa and SKYTRAX certified Four Star Global Airline, has launched three new flights to Kisangani and Mbuji Mayi in the Democratic Republic of the Congo (DRC) and Nosy-Be in Madagascar as of yesterday, March 27, 2018. The launch of the flights was announced by Group CEO of Ethiopian Airlines, Tewolde GebreMariam, at an inaugural ceremony attended by Prof Alain Tehindrazanarivelo, Ambassador of the Republic of Madagascar, Victor Mwania, First Secretary of the Democratic Republic of Congo and other invited dignitaries. "We are very happy and proud to be a very strong instrument in connecting Africa in line with our motto of the last 70 years: Bringing Africa together and closer to the rest of the world. When we open these three destinations, we may look at only the direct services we are going to operate between Addis and these destinations. But what is more important and may not be visible is that we are connecting these destinations with more than 100 destinations all over the world. Kisangani and Mbuji Mayi will be two additional points to the already three points we fly in the DRC; so we are now flying to Kinshasa, Goma, Mbuji Mayi, Kisangani and Lubumbashi," said GebreMariam. "The beautiful island of Nosy-Be is a popular tourist destination for Europeans, and since we announced that we are going to connect it with our network in a direct service, the Madagascar Embassy in Addis has been overwhelmed by visa requests. This shows that the trend is changing; nowadays Africans are visiting African friends for tourism which is very encouraging development," he added. With the launch of the new flights, Ethiopian now serves 58 destinations in Africa and more than 100 destinations globally, solidifying its stature as a veteran Pan-African airline with the largest number of destinations in the continent. Ethiopian Airlines continues to be the fastest growing airline in Africa. In its seventy plus years of operation, Ethiopian has become one of the continent's leading carriers, unrivalled in efficiency and operational success.


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Working with victims of crime: A manual applying research to clinical practice (Second Edition)
3.0 Common Reactions to Crime
It is useful to know the common reactions that victims may experience when trying to cope with the crime. Keep in mind that each victim will have his or her own unique path towards recovery, but being aware of common reactions can help workers better help victims recover. Research indicates that about 25% of victims of violent crime reported extreme levels of distress, including depression, hostility, and anxiety (Norris et al. 1997). Another 22% to 27% reported moderate to severe problems. This means that around 50% of victims of violent crime report moderate to extreme distress. Table 1 shows the reactions that researchers and theoreticians have observed in crime victims. Workers may also recognize these reactions in the victim's friends and family, since crime affects family and friends, school, work and the broader community (Burlingame and Layne 2001).
The issue of anger as a reaction is notably more complicated than one might at first assume. Researchers often link anger to property crime and fear to violent crime (Greenberg and Ruback 1992). However, anger is basically a reaction wherein people feel cheated out of something they feel they deserved. In the case of criminal victimization, they have been cheated out of their feelings of safety and fairness and belief in a just world, etc. Thus, anger can be a reasonable reaction to any type of crime. In life, anger can act as a motivator to change. Greenberg and Ruback (1992) point out that many victims create internal fantasies about getting revenge or justice. If these fantasies have positive outcomes (e.g. the perpetrator is caught), they may increase the chance the victim will take action. Thus, so-called righteous anger can help the person move forward, feel energized, to deal with the criminal justice system or get help. On the other hand, researchers have examined post-traumatic stress disorder and anger/revenge/retaliation fantasies in victims of violent crimes (Orth et al. 2008; Orth et al. 2006). They concluded that anger and revenge fantasies may initially make victims feel better, but may cause problems if the person continues to think about the crime and cannot move forward. Under this view, the timing and content of anger management programs may be very important in helping victims become healthy.
Table 1: Common reactions to crime victimization
Mood/Emotions
Fear/phobias 1, 3, 4, 5, 8, 9, 10, 16, 17, 18, 19, 21, 25, 28, 13, 14, 31
Anger/hostility 1, 2, 3, 4, 7, 18, 19, 20, 24, 28, 31
Embarrassment 1
Anxiety 2, 5, 7, 13, 27
Depression 2, 4, 6, 16, 18, 19, 20, 22, 13, 27
Grief 1, 2, 4, 21, 24, 26, 13, 14
Guilt, shame 4, 5, 6, 11, 12, 15, 29, 30
Difficulty controlling emotions 4
Apathy/numbness 5, 13
Lower self-esteem 7, 15, 17, 19, 23
Changes in relating to people 2, 6, 19, 28, 13, 14
Avoidance 5, 7, 13
Alienation 5, 17
Thinking/ Memories
Intrusive memories 2
Lower self-efficacy 2, 28
Vigilance 2, 13
Flashbacks 5, 13
Confusion/poor concentration 4, 5, 13
Dissociation 4, 31, 13
Questioning spiritual beliefs 13
Nausea 1, 13
Stomach problems 1, 13, 21
Muscle tension 1
Sleep problems 2, 13
Weight loss 17, 19
Headaches 17, 19
Faintness or dizziness 13
Hot or cold bodily sensations 13
1. Casarez-Levison (1992)
2. Everly et al. (2000)
3. Greenberg and Ruback (1992)
4. Leahy et al. (2003)
5. Mezy (1988)
6. Nishith et al. (2002)
7. Norris et al. (1997)
Updated references:
8. Amstadter et al. (2007)
9. Boccellari et al. (2007)
10. Boeckmann and Turpin-Petrosino (2002)
11. Courtois (2004)
12. Danieli et al. (2004)
13. Daniels et al. (2007)
14. DeValve (2005)
15. Dunbar (2006)
16. Gabriel et al. (2007)
17. Garnetts et al. (1990)
18. Herek et al. (1997)
19. Janoff (2005)
20. Lebel and Ronel (2005)
21. Manktelow (2007)
22. Miller and Heldring (2004)
23. Mock (1995)
24. Nordanger (2007)
25. Orth et al. (2008)
26. Pivar and Prigerson (2004)
27. Spataro et al. (2004)
28. Staub (1996)
29. Thielman 2004
30. Wertheimer (1990)
31. Young et al. (2007)
That said, workers need to be careful of confusing anger with empowerment. If not handled properly, chronic anger can be very harmful to the victim. Workers may want to focus on anger issues if they see the anger as becoming longstanding and interfering with the person's healing process. Each victim must be treated as an individual. Workers should help the victim learn to manage all emotions in a way that helps in coping with challenges while remaining healthy. This will help the victim move forward and rebuild his or her life. Anger can be a challenging emotion to face, even for the most skilled clinicians. All workers, regardless of training, should reflect on whether they are able to help victims in this area. If not, they need to refer clients to other professionals.
3.1 Severity of Reaction
Severe reactions can be overwhelming to workers. As reactions become less severe, they do not necessarily become easier for victims. This mismatch poses a challenge both to workers and to victims. Research indicates that violence during the crime increases the severity of the response; victims of non-violent crime, however, also fear for their safety, and can have increased psychological symptoms (Green and Pomeroy 2007b; Norris et al. 1997). Crime-related characteristics may also affect the severity of the reaction. (Steel et al. 2004) found that the number of offenders and the duration of childhood sexual abuse were directly related to psychological distress in both male and female victims. Workers need to pay attention to what the victim reports and use that information to help inform assessments of severity.
Although there is no overall pattern based on victim type, all victims of crime experience distress. The general finding that the more violent the crime, the more severe the reaction offers workers insight into what to expect about client reactions. Thus, a victim of a violent crime who reports that he or she feels no distress may need closer monitoring. The report may be valid, but should be examined in relation to coping skills, current behaviour, and life experience. Workers need to work with clients to help them understand distress levels, how the crime has affected their lives, and what they can do to move forward.
Victims are the best source of information about what is happening in their own lives. Recent Canadian data indicates that 21% of crime victims say that their life was not affected much by the crime (AuCoin and Beauchamp 2007). This same survey looked at victims of violent crime and found that approximately 60% of women and 70% of men reported that their daily activities were not disrupted. Workers should be aware that many victims do not report higher levels of distress (remember: be aware of trauma bias; Nelson et al. 2002). Research on female sexual assault victims found that they experience more severe reactions and take longer to heal than non-sexual assault victims (Gilboa-Schechtman and Foa 2001). Both groups had similar levels of post-traumatic stress disorder (PTSD) and anxiety, but the sexual assault group showed higher levels of depression.
Gilboa-Schechtman and Foa (2001) also examined "peak reactions" which may be of interest to workers. Peak reactions refer to the point at which the victim experiences the strongest symptoms. They found that the longer a woman took to have her peak reaction, the more symptoms she experienced. In other words, those who experienced the strongest symptoms shortly after the assault had lower levels of depression and PTSD. Thus, workers should watch a victim's symptoms closely and pay particular attention to victims who are having intense symptoms long after the crime. These clients may benefit from more intensive treatment from mental health professionals.
What workers need to take away from this research is that the unique experience of some people makes one-to-one attention an extremely important part of treatment. Thus, even in a group setting, workers should work to monitor and check in with all clients, not just those who seem to be experiencing problems during a particular session.
Fortunately, group interventions can be helpful, since all victims will have some reaction to dealing with the crime and its effects. However, workers need to be wary of mixing those with highly severe reactions to those with less severe reactions. Social comparison could negatively affect either group (Greenberg and Ruback 1992). Those with more severe reactions may feel that they should be "stronger," and those with less severe reactions could fear that they will get worse. It may not be possible to have groups for different levels of severity. Workers need to be aware of this challenge and make sure that victims understand that reaction to victimization is very much an individual path. It is important for group work to emphasize that victims can learn something from each other.
A final point on severity: in a large-scale study, Pimlott-Kubiak and Cortina (2003) examined assault history and gender. In grouping their sample of 16,000 people (8,000 women and 8,000 men), they found that most men and women reported little or no victimization. Of those who reported victimization, two groups were over 90% female: those reporting primarily sexual assault; and those reporting repeated violence that included sexual violence. Both of these groups would likely experience severe reactions. This research probably reinforces workers' experience of seeing mostly female victims in daily practice. Men were more likely to be in the group who described physical abuse in childhood (67% male) and repeated violence that did not include sexual violence (66% male) (Pimlott-Kubiak and Cortina 2003). Although any good assessment needs to ask about a wide variety of issues, workers working with women need to ask about sexual assault either as a single event, or as part of several violent assaults. When working with men, we need to be more aware of a history of physical abuse in childhood and repeated violence. These results remind us that we need to go beyond the specific crime and ask about trauma history and to use this in our interventions.
Client matching
A major reason for looking at severity of reaction is to develop ideas of how to best help victims rebuild their lives. Some victims may benefit the most from relatively minor interventions, for example, sharing information. Others with more severe reactions might require more intensive support that might be provided in a peer group. Finally, there are those clients experiencing severe reactions that may require a referral to mental health counselling or even hospitalization. It would not make sense to only give information to someone experiencing severe distress, nor would it make sense to require a person coping well to enter therapy. Table 2 describes a model to help workers think about these issues. The key element to understand is that crime victims are a diverse group with diverse needs. This diversity requires workers to adapt to the victim in providing those services that best meet the victim's needs. It may be helpful for offices to review their programs and materials to see if there are any gaps in services that relate to the various need levels (e.g. clear strategies for low- and high-need clients, but fewer for moderate-need clients).
Secondary victimization
Secondary victimization is related to severity as it can worsen an already difficult situation. Basically this happens when the victim comes into contact with professionals and paraprofessionals and is further traumatized by their response. This can happen through retelling the victim's story, being treated unfairly or experiencing other behaviours that make him or her feel as though people aren't listening or don't believe the story. It is noteworthy that victims who described police as "helpful" felt more connected to others (Norris et al. 1997). However, negative experiences with professionals increased post-traumatic stress symptoms (Campbell et al. 1999) and decreased the likelihood of reporting (Monroe et al. 2005). It is fortunate that those victims who received mental health services after having a negative experience with the system showed decreased distress (Campbell et al. 1999). Some have called for increased training for first-responders (police, emergency room staff) who are likely to encounter victims of crime (Cederborg and Lamb 2008; Hamberger and Phelan 2006).
Table 2: Severity by Service type: A proposed model
Needs Level
Possible service options
They are coping well with few symptoms, easily managed through natural coping skills and social support. They may not have experienced a severe crime and/or may have many ways to cope. Minimal services: information sharing – provide written material, brochures of available supports, and education about signs of deeper problems. These services would also be useful for those who do not feel they have any problems, but are trying to hide their suffering. These same written materials might be given to people in the victim's support system.
Experiencing some symptoms and need to expand coping skills or need a place to deal with overwhelming emotions. Generally, they cope well but are overwhelmed by being victimized. Peer-run support groups, paraprofessional and volunteer support. Some professional support may be needed, but only on a short-term basis.
Experiencing many symptoms or problems and displaying poor coping behaviours. Overwhelmed by being victimized and with few effective supports. Severe trauma may have occurred. Likely evidence of multiple problems and multiple victimizations. Need for professional treatment. This may include long-term individual or group therapy or even hospitalization to help the person stabilize.
3.2 Previous Victimization
Researchers have found that some people become victimized again and again throughout their lives (Byrne et al. 1999; Messman and Long 1996; Norris et al. 1997; Nishith et al. 2000; Peleikis et al. 2004). The relationships between trauma incidents are quite complex: new victimization interferes with the person's ability to cope with past trauma; and previous victimization affects how he or she will cope with the new trauma. In effect, the repeated victimizations interrupt the person's normal healing process, especially if the revictimization occurs in a relatively short period after initial victimization (Winkel et al. 2003).
Norris et al. (1997) noted that crime victimization challenges peoples' views of themselves or their worlds. Several studies report that previous victimization is a very strong, and possibly the strongest, predictor of further victimization (Byrne et al. 1999; Messman and Long 1996; Norris et al. 1997; Nishith et al. 2000). Research examining women in violent relationships found that many had been victims of childhood victimization and that the specific type of abuse or neglect increased the chances of different problems in adulthood: sexual abuse increased anxiety, whereas emotional neglect increased dissociation and depression (Lang et al. 2004). Female survivors of childhood sexual abuse are at increased risk of later sexual assault (Peleikis et al. 2004). Furthermore, previous victimization seems to affect the victim's reaction to new victimization, and reduce their willingness to report the crime to authorities (Buzawa et al. 2007). Researchers have theorized that low self-esteem, learned helplessness, poor relationship skills and choices, difficulty reading risky situations, or poverty may affect the choices made by the revictimized person (Byrne et al. 1999; Messman and Long 1996; Nishith et al. 2000).
Furthermore, those victims who had a very bad reaction to previous trauma are likely to have a bad reaction to new trauma (Brunet et al. 2001). Basically, revictimization gets in the way of the their ability to rebuild themselves and their lives. Workers need to ask about previous traumas (both crime-related and otherwise) and focus on details that might give clues on how best to help victims meet their needs. In addition, following-up with questions about how the victim normally handles stressful situations should also help workers to better predict how their client will react to the current trauma.
3.3 Diagnoses Commonly Applied to Crime Victims
Workers can benefit from having a basic understanding of diagnostic terms that they may encounter in files or in speaking to mental health professionals. Diagnoses commonly linked to being a crime victim include anxiety and post-traumatic stress disorder (PTSD) and depression (definitions in Figures 2 and 3).[4] Researchers have noted that these problems can appear in victims of workplace violence (Rogers and Kelloway 2000), stalking (Löbmann et al. 2003; Pimlott-Kubiak and Cortina 2003), sexual assault (Byrne et al. 1999), childhood sexual abuse (Hembree et al. 2004; McDonagh et al. 2005; Merrill, Thomsen, Sinclair, Gold and Milner 2001; Peleikis et al. 2004), childhood physical abuse (Hembree et al. 2004), violent crime (Byrne et al. 1999), gang-related violence (Ovaert, Cashel and Sewell 2003), and family violence (Chemtob and Calson 2004; Hembree et al. 2004; Wolkenstein and Sterman 1998). PTSD is often discussed as related to victimization, especially when violence occurs (Byrne et al. 1999). Several researchers have noted success in reducing PTSD symptoms through treatment. Successful treatments often include opportunities for the victim to share the trauma story while applying new skills to manage feelings and thoughts (Amstadter et al. 2007; Bryant et al. 2003; Hembree and Foa 2003; Nishith et al. 2002).
Figure 2: Anxiety and Post-Traumatic Stress Disorder (PTSD)
It must be emphasized that PTSD is a specific type of anxiety. Anxiety and fear can appear as intense fear of specific situations or public places, panic attacks, general fear and anxiety and PTSD.
Most anxiety disorders include symptoms such as:
fear, distress or worry;
physical problems (e.g. sweating, shaking, difficulty breathing, nausea, chest pain, dizziness);
behaviour change (e.g. avoidance, rituals); and
behaviours aimed at reducing distress (American Psychiatric Association 1994).
PTSD occurs after a traumatic event and symptoms may include such anxiety symptoms as:
fear;
helplessness;
intrusive and recurrent recollections;
distressing dreams;
reliving of the event;
intense distress;
physiological reactions;
avoidance or suppression of thoughts or feelings; and
specific symptoms such as sleep problems, irritability, angry outbursts, poor concentration, hypervigilance, and exaggerated startle response (American Psychiatric Association 1994).
Figure 3: Depression
Depressive symptoms may include:
low mood;
low appetite or weight loss;
sleep problems;
energy changes;
self-blame or feelings of guilt;
feelings of worthlessness or hopelessness;
difficulty concentrating; and
thoughts of death.
(American Psychiatric Association 1994)
Furthermore, many crime victims will be dealing with grief, especially those whose loved ones were victim of homicide (Miller 1998). Grief is a normal reaction to loss; however, the normal healthy grieving process can be complicated by many issues, including victimization. Miller (1998) indicates that along with the feelings of sadness, anxiety, and guilt often seen in grief, survivors of homicide victims can also experience fear and an extreme need to keep themselves and other loved ones safe. Within mental health circles, one may speak of grief or complicated grief. Pivar and Prigerson (2004) describe complicated grief as having symptoms that do not decrease in intensity or frequency, are longer in duration (from two to six months) and interfere with the person's work, school, social or home life (Pivar and Prigerson 2004). In people who have lost a loved one, workers should watch for a) loneliness, b) intruding thoughts about the person, c) yearning for the person, and d) searching for the person. Other symptoms that should tip workers to refer to mental health professionals are:
purposelessness or feelings of futility about the future;
feeling numb or detached;
difficulty acknowledging the death;
feeling that life is empty or without meaning;
feeling that part of oneself has died;
having a shattered world view (loss of sense of security, trust, control);
assuming symptoms or harmful behaviours of the deceased person; and
excessive irritability, bitterness, or anger related to the death. (Pivar and Prigerson 2004, 279).
It is important to recognize that you cannot directly compare one loss to another. Workers should also be aware of the cultural norms of the victim to understand the difference between normal and complicated grief (American Psychiatric Association 1994; Nordanger 2007; Pivar and Prigerson 2004). An easy guideline when dealing with this issue is to use the person's own definition of whether he or she is overwhelmed by grief and needs help. It can also be helpful for workers to consult with experienced colleagues or ask members of the culture about what is normal in their group. You might also rely on these sources to recommend culturally relevant rituals or support people (Nordanger 2007). In these consultation situations, you should always work to protect the confidentiality of your client.
Researchers have found that criminal violence and negative coping predict PTSD, anxiety and depression to varying degrees (Dempsey 2002; Green and Pomeroy 2007b). Daley et al. (2000) found that more chronic stressors, such as the stress experienced by a victim of family violence, are more likely to wear down the victim, whereas an acute stress, such as single-episode assault by a stranger, may deepen feelings of depression. In a study of adolescents who were victims of violence, Kilpatrick et al. (2003) found that almost 75% of adolescents who had PTSD also had either substance abuse problems or depression. Some researchers recommend that treatment efforts in these cases should target the substance use and PTSD at the same time to increase the chances of success (Amstadter et al. 2007). Gilboa-Schechtman and Foa (2001) noted that victims of sexual assault, versus non-sexual assault, were more likely to experience depression. They theorized that anxiety and PTSD are common to all traumas, but that depression is related to certain types of trauma, such as sexual assault (Gilboa-Schechtman and Foa 2001).
One question that is often raised when examining PTSD is "Why does one person develop the disorder while others do not?" Research has linked the following to increased chances of developing PTSD or interfering with recovery:
Crime- or trauma-related factors (e.g. trauma severity related to sexual assault) (Brewin, et al. 2000; Gilboa-Schechtman and Foa 2001; Ozer et al. 2003)
Perpetrator being known to the victim (Gutner et al. 2006) or a relative (Ullman et al. 2006)[5]
Lack of social support (Brewin et al. 2000; Gutner et al. 2006; Ozer et al. 2003) or poor reaction from supports (Mueller et al. 2008)
Additional life stress (Brewin et al. 2000; Ozer et al. 2003)
Previous PTSD (Brunet et al. 2001; Ozer et al. 2003)
Dissociation during or immediately following the crime (Ozer et al. 2003)
Report of childhood abuse (Brewin et al. 2000; Hembree et al. 2004; Peleikis et al. 2004)
Researchers have noted a lesser link between the following and PTSD:
Previous trauma (Brewin et al. 2000; Ozer et al. 2003; Scarpa et al. 2006)
Personal psychiatric history (Brewin et al. 2000; Ozer et al. 2003), depression in particular (Ozer et al. 2003)
Family psychiatric history (Brewin et al. 2000; Ozer et al. 2003)
Education (Brewin et al. 2000)
General childhood adversity (Brewin et al. 2000)
Gender (Brewin et al. 2000)
Age at time of trauma (Brewin et al. 2000)
Race (Brewin et al. 2000)
Fortunately, mental health professionals can help clients with these disorders. Both medical and psychological treatments can be effective. Researchers collaborate with clinicians to develop the best treatment possible. For example, effective PTSD treatment often includes an exposure element wherein the person needs to psychologically face the fear and anxiety by discussing or talking about the crime and crime-related reminders (Bryant et al. 2003; Hembree and Foa 2003; Kamphuis and Emmelkamp 2005; Kubany et al. 2004; McDonagh et al. 2005; Nishith et al. 2002). Workers not trained in these issues need to keep in mind the importance of consultation and making appropriate referrals to mental health professionals. This is especially important because many victims may have a combination of disorders (PTSD, other anxiety disorders, depression, substance abuse, personality disorders, etc.) that may affect how they respond to interventions (Amstadter et al. 2007; Chemtob and Calson 2004; Clarke et al. 2008).
A relatively recent treatment approach for trauma that workers may have heard discussed is called Eye-Movement Desensitization and Reprocessing or EMDR (Shapiro 1995). Although it is beyond the scope of this manual to detail any one treatment, EMDR is gaining in popularity and workers may have some clients undergoing this treatment. Briefly, in EMDR the therapist asks the client to focus on the traumatic event (images, thoughts, etc.), evaluate the negative qualities, and change his or her thinking about the trauma or his reaction during the trauma. While this is happening, the therapist gets the client to visually track a finger rapidly waved back and forth in front of the face (Shapiro 1995). There is much debate in the literature about what makes EMDR work, but outcome studies with victims of crime show reduced PTSD symptoms when compared to wait-list controls and similar results to other PTSD treatments (Hembree and Foa 2003).
Workers will also want to consult with healthcare professionals when working with families or children who were criminally victimized. Children will often have similar reactions to crime victimization as adults (Cohen et al. 2003). However, there can be important developmental issues that experts in child development will be able to assess (Pine et al. 2005). Despite these issues, workers may find that the treatments professionals provide children are similar to those adults receive (Cohen et al. 2003).
3.4 When to Refer to Mental Health Professionals
With respect to seeking help, Norris et al. (1997) found that about 12% of victims sought mental health services. Most of these were victims of violent crime. They found that violence and depression were the biggest predictors of seeking help. It is worth noting that they also found that professional help was only effective if the help was prompt and ongoing (Norris et al. 1997). Most Canadian victim services agencies (81%) indicate that they are able to help victims with mental health difficulties, mostly by partnering with mental health services (Brzozowski 2007).
Mental health workers can provide support for more-challenging clients. Although many victims can benefit from traditional services, some may need the more intensive treatment that professionals trained to deal with mental health issues can provide. These include victims who may have a mental illness, intense stress reactions, complicated grief, complex life histories or other problems. As Lawson (2001) noted, most professionals are trained to understand different types of abuse, can help clients process emotions, can teach skills and help with planning/problem solving. Professionals can also help victims identify and use social support systems, and act as an additional support to the natural supports. Basically, professionals can work with the client to help them cope (Gorman 2001).
Understanding your limits is an important part of being an effective worker. You need to use consultation from both your supervisors and co-workers to understand your limits. Thus, there are no set rules as to when to refer your client to more professional services. However, there are some issues that should make you think about whether bringing someone else in may be in your client's best interest. Obviously, the resources and supports available in your area will also affect what other supports you and the victim can access. This does not mean that you cannot support the client but, rather, that you should consider a referral to mental health professionals when you feel you need help. The following list identifies situations that might require a referral:
You suspect the person has depression, anxiety, post-traumatic stress disorder, continued dissociation or other mental health problems (especially if substance misuse is also present).
There are complicated grief issues that interfere with moving forward.
Suicide or self-harm is a concern.
Retaliation, or harming others, is a concern (which may require contacting the police or other authorities as well).
Intense emotions (anger, sadness, grief) are beyond your skills or resources.
The person seems to be unmotivated and stuck.
The person does not seem to get as much from group, self-help, or other interventions.
The person does not seem to be getting better even though apparently motivated and working hard.
The person has a long, complicated history of victimization or abuse.
The person has a long history of mental health or substance-abuse problems.
Those working in more isolated areas should contact their local health care professionals for help in solving problems about how to best meet the needs of victims in general. These partnerships can be invaluable in providing new information and professional support. Isolated workers might also use strategies such as telehealth consultation (using phone, e-mail or video-conferencing) to get guidance or receive consultation or supervision. Telehealth systems can also be used to deliver therapy, with the local supports working with the victim and possibly participating in therapy with a professional in another area. Other possibilities include bringing in professionals to conduct workshops, crisis treatment or supervision sessions. It is important for workers to be cautious about digging deeply into complex victims issues without backup. Sometimes this cannot be avoided, since the victim may be ready to deal with these issues. It is important for workers to ensure that they consult with others when outside their areas of expertise. Acting ethically and being respectful of your clients includes being aware of your own limits.
3.5 The Basics
As people deal with having been victimized, workers can identify common reactions. These reactions are normal, but may still mean that the victim requires help to deal with being overwhelmed. Table 1 lists some common reactions discussed in research.
Anger is a difficult emotion for the victim and also for the supports and workers. Much care is needed to make sure that it is handled properly (Greenberg and Ruback 1992). Workers should understand that anger is a natural reaction to victimization, but that it can also interfere with getting better. Thus, there is no easy answer to how to handle anger; training, judgment and empathy are your best tools for deciding how to help victims showing anger. Supervision/consultation will be key in dealing with your reaction to anger and other emotions.
Severity of Reaction
All victims of crime experience some distress (Norris et al. 1997). Research indicates that violence during the crime increases the severity of the reaction and about 50% of victims of violent crime report moderate to severe reactions (Norris et al. 1997).
Victims of sexual assault reported more severe reactions and took longer to heal than victims of non-sexual assault (Gilboa-Schechtman and Foa 2001).
Workers need to be careful of groups that mix victims who have severe reactions with those that have less severe reactions. Social comparison (feeling better off or worse off) with other group members may interfere with treatment if not handled properly (Greenberg and Ruback 1992). Workers should think about how to best match client needs to service level for their clients' benefit (see Table 2).
Women may be at risk for more severe reactions since they are more likely than men to experience sexual assault or repeated victimizations (including sexual assault) (Pimlott-Kubiak and Cortina 2003).
Professionals need to be careful of causing the victim even more distress (secondary victimization) by not being sensitive to the victim's state of mind (Campbell et al. 1999).
Previous Victimization
Researchers have found that previous victimization is a very strong predictor of further victimization (Byrne et al. 1999; Messman and Long 1996; Norris et al. 1997; Nishith et al. 2000). Victims who have had a bad reaction to previous trauma are likely to have a bad reaction to new trauma (Brunet et al. 2001).
Previous victimization tends to affect the victim's reaction to new victimization, perhaps through low self-esteem, habits of learned helplessness, poor relationship skills or choices, difficulty in reading risky situations, or poverty (Byrne et al. 1999; Messman and Long 1996; Nishith et al. 2000). These results remind us that we need to go beyond the specific crime and ask about trauma history and to use this information in our interventions.
Common Diagnoses of Victims of Crime
Diagnoses commonly linked to being a crime victim include depression, anxiety, and post-traumatic stress disorder (PTSD).
Depression symptoms can include low mood, low appetite or weight loss, sleep problems, energy changes, self-blame or feelings of guilt, feelings of worthlessness or hopelessness, difficulty concentrating, and thoughts of death (American Psychiatric Association 1994).
Anxiety symptoms can include fear, distress, and worry or physical symptoms (e.g. sweating, shaking, difficulty breathing, nausea, chest pain, dizziness), behaviour change (e.g. avoidance, rituals) and behaviours that try to reduce distress (American Psychiatric Association 1994).
PTSD is a form of anxiety disorder that is linked to a specific incident, such as a crime, natural disaster, or accident (American Psychiatric Association 1994). PTSD may include such symptoms as fear, helplessness, intrusive and recurrent memories, nightmares, reliving the event, intense distress, being jumpy, avoidance or suppression of thoughts or feelings, and specific symptoms such as sleep problems, irritability, angry outbursts, poor concentration, hypervigilance and exaggerated startle response (American Psychiatric Association 1994).
Complicated grief, or intense grief that goes on for a long time, can be a problem for some victims and their survivors.
Risk factors for developing PTSD include crime- or trauma-related factors (Brewin et al. 2000; Gilboa-Schechtman and Foa 2001; Ozer et al. 2003); a lack of social support (Brewin et al. 2000; Ozer et al. 2003); additional life stress (Brewin et al. 2000; Ozer et al. 2003); previous PTSD (Brunet et al. 2001; Ozer et al. 2003); and dissociation during or immediately after the crime (Ozer et al. 2003).
When to Refer to Mental Health Professionals
Workers should carefully consider when to refer clients to mental health professionals.
If they are not trained in mental health issues, workers should consult and make appropriate referrals to professionals. Partnerships with healthcare and telehealth, consultation, and visiting professionals are possible solutions for workers in isolated areas.
[4] Workers may also encounter the term acute stress disorder,which has similar symptoms as PTSD but lasts less than a month (Brewin et al. 2003).
[5] Ullman et al. (2006) also found that victims of perpetrators who were strangers showed increased PTSD symptoms.


text:
One cannot really separate Provence from images of purple lavender fields, the heavenly lavender scent in the air and the distinctive taste of lavender infused dishes. Lavender is an herb rich in history and culture. Long prized for its scent and healing properties, it is also one of the most beloved plants in the garden. Ranging in colors from vivid sun-soaked indigo to a subtle violet-white, it evokes within a sense of calming and rest through its heady and unmistakable aroma. Lavender is rich in aromatic molecules called esters, which are antispasmodic, pacifying, and non toxic, while other molecules give it its antiviral, antibacterial, and anti-inflammatory powers. One of the most consistent of the many therapeutic attributes of lavender oil is respiratory relief.
With its magnificent hues and beguiling aromatic perfume, lavender has had its place in the hearts of men and women almost since the beginning of time. In ancient Rome lavender was recognized for its healing and antiseptic qualities, its ability to deter insects, and for washing. The name of lavender comes from the Latin word "lavare" meaning "to wash", and was used as a ritual bathing herb in ancient Rome. Biblical references and folklore have mingled together over the years, and it was believed that Adam and Eve took lavender with them when they were banished from the Garden of Eden. As that legend goes, lavender later received its perfume distinction when Mary laid the baby Jesus' clothes upon a bush of it to dry. Lavender was later used to ward off evil and in medieval times a cross made of lavender hung over the door provided a safeguard against disease and all evil. During the 17th century in London, it was believed that a bunch of lavender tied around the wrist protected one from the Plague. That belief might have been partially true, as the Plague was spread by flies who are repelled by lavender.
Lavender has always been associated with love. In Tudor times, a maiden wanting to know the identity of her true love would sip a brew of lavender on St. Luke's day while murmuring: "St. Luke, St. Luke, be kind to me; In my dreams, let my true love see me". Alpine girls tucked lavender under the pillows of their lovers in hopes of turning their thoughts toward love and romance. Once married, newlyweds would put bunches of lavender under their mattress to ensure the marital passion.
Today, lavender still is associated with love and healing. In the First World War when modern antiseptics were depleted, the public was asked to gather up garden lavender so the oil could be used to dress war wounds. Lavender is an antiseptic, as well as an herbal remedy. Wrapped in cushions, dried flowers can help to induce sleep and ease stress or depression. It can be brewed into a tea and used to relieve headaches, sinus congestion, hangovers, tiredness, exhaustion, and tension. True romantics still know the value of lavender, and many have been swayed by the gift of this wonderful plant.
Lavender is a relative of mint and native to the Canary Islands, North and East Africa, the Mediterranean, Arabia, and India. Lavender flowers yield abundant nectar, which yields a high quality honey. They can be candied and are used as cake decoration or to flavor sugar, called "lavender sugar". French chefs in Provence have been incorporating lavender into their cuisine for many centuries. It lends a floral, slightly sweet and elegant flavor to many dishes, from ice cream to roast chicken.
Lavender's aroma is rich and camphoric sweet, with an herbaceous floral note. It is a truly magical plant and those who have ever been enticed and seduced by its sweet heady perfume become enamored for life. A walk through a field of blooming lavender is a stroll that is never forgotten.
France - Paris and Provence