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He might still believe that dreams are very well expressed through slow motion” (What Is Cinema In Inception purchase temovate 15g with mastercard, the Bazinian opposition of a stylized dream reality versus a “realist” dream reality is neither possible nor necessary because the question of if the reality of the dream is “really” slow or if it’s only slow due to discount temovate 15g otc the director’s decision to discount temovate 15g with mastercard use slow motion as a sign announcing “attention: dream order temovate 15g online,” has become irrelevant. In Inception, slow motion has become a matter of cognition because the lm doesn’t produce or reproduce a reality. Nothing could be clearer than Cobb’s explanation: “When you dream, your mind functions more quickly, so time seems to pass more slowly. Most recently, Daniel Frampton has insisted, in his book Filmosophy, that lm does not narrate or show things, characters, or actions, it thinks them: when watching a lm we observe a thinking process. Frampton attempts to grasp the cinematic thinking process with the help of newly coined concepts such as ‘ lm-thinking’ and ‘ lmind’ and assigns to ‘ lmosophy’ the task of “conceptualizing all lm as an organic intelligence” (p. Film-thinking isn’t a metaphorical way of arranging reality: “The lmind has its own particular film-phenomenology, its own way of attending to its world” (p. So far, thinkers have forced themselves to perceive moments of thought in lm, but with Inception, lm has (for almost the first time) been designed as a thinking machine from the outset. Inception provides an organic aspect in the most consistent fashion as its focus is on the systematic aspect of a lm reality that has been designed like a thinking machine. The idea of lm as a thinking machine able to produce a reality that is di erent though still logically structured has been most clearly expressed by the early French avant-garde lmmaker and theorist Jean Epstein (1897–1953). For Epstein, lm isn’t a text or a writing, but a machine able to produce a dreamlike reality by overcoming human reason and by unhinging the most basic rules of time. Comparing lm with the microscope, Epstein anticipates contemporary computer reality or virtual reality. Epstein observes how cinema stretches and condenses time letting us feel its variable and relative nature. The conclusion is that cinema does not present but think time, that it’s a “partial mechanical brain” able to develop a “rich philosophy full of surprises” (p. Epstein sketches the history of cinema in the following way: the beginnings of cinematographic art were clearly “anti-philosophical” as the inventors of cinema believed they had created a recording machine. They had no idea that lm could also be a machine able to “think” attributes, categories, relations between space and time, or series of causa-tions, in the same way in which they are thought by humans. However, equally anti-philosophical is the attitude that classi es cinematic reality as unreal and insubstantial for the simple reason that it’s imagined. Epstein explains how, during its further development, cinema would undergo the same stances that other sciences had undergone much earlier. Cinema had to learn how to split reality into parts and to recompose those parts afterwards. Epstein shows that throughout history (starting with the pre-Socratic philosopher Democritus who held that matter is made of atoms), human thinking has increasingly contested primitive visions of a continuous reality and formulated atomistic theories able to interpret reality as constituted of particles. This is why, in the end, cinema would also become able to see “reality as the sum of irrealities” and would attempt to present such an overall time composed of countless “ultra-particular times” as a new cinematic reality. In cinema there is no “time as such” but time and space “are constituted through variable relationships between successive or simultaneous appearances” (p. Film as a “Machine to Think Time” “stretches or condenses duration, which shows the real nature of time” (p. Cinema shows that reality isn’t an elementary continuity, but “a collection of grains of reality” (p. Second Life and Third World Inception follows Epstein’s predictions most clearly, but why does this happen right now in 2010 One reason is that the dream as a machine that can be hacked into has become a reality. Scientists have announced that the technology able to electronically visualize brain activity has been invented and that “dream reading” might be possible one day (Pallab Ghosh, “Dream Recording Device ‘Possible’ Researcher Claims”). Another reason why Inception presents cinematic dreams in such a mechanical way instead of working with well established phenomenological or stylistic devices, is that our approach towards reality (and therefore also towards dreams) has changed. Today, instead of blurred images and fades, the dream experience is much more likely to be conveyed by entering into labyrinthine structures that appear as constantly moving and changing virtual worlds. The formal structure of Inception is reminiscent of that of an interactive hypertext: it follows the process of non sequential electronic reading and writing, which has become most useful for websites such as Wikipedia. In a hypertext the reader clicks on a word and a new text opens up in which she will nd other words to click on: “As one moves through a hypertext, one has the sensation that there’s an almost inexhaustible reservoir of half-hidden story material waiting to be explored. That isn’t unlike the feeling one has in dreams,” writes cyber-theorist Christine Boyer. Another reason why the journey through dreams takes on the form it does in Inception is that in the contemporary world “traveling” has acquired extremely experiential connotations. For the contemporary consumer, tourism is supposed to open up a new set of sensory experiences with adventures lurking around every corner. The presentation of dreams in lm has to take these expectations into account: tourism is conceived of as a sensorial and liberating encounter with a dreamscape that includes changing ambiances as well as different psychological conditions. As Matthew Brophy shows in Chapter 14, the entire concept of Inception is reminiscent of the worlds of computer games, most speci cally Second Life, a virtual world in which players can interact with each other through avatars. In the lm, the possibility of entering dreams is said to have been developed as a training program for the military “where soldiers could strangle, stab, and shoot each other,” and “then wake up. Epstein saw that “science pretends to possess the extroverted mode of knowledge par excellence but, contrary to its pretensions, it evolves in the direction of abstraction, that is, of increasing introversion. Through rationalization, it becomes a mathematical dream, whose relationship with human reality. Today the introverted dreams, still results of the Democritic atomization of the world, are “thought” by a computer and cinema attempts to follow this model.

Syndromes

  • Use of medicines that weaken the immune system, including chemotherapy
  • Family history of early coronary heart disease -- a close relative such as a sibling or parent had heart disease before age 55 (in a man) or before age 65 (in a woman)
  • Osteoblastoma
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  • Did the skin appear abnormal at birth, or did this develop over time?
  • Percutaneous transhepatic cholangiogram (PTC)
  • Anxiety, stress, and tension
  • Have a bowel movement (especially if you are straining)

Multicored Plaques Show Merger of Plaques over Time Detailed analysis of high resolution pictures revealed an interesting class of plaques that were named ‘multicore plaques’ buy 15g temovate free shipping. These plaques are characterised by multiple temovate 15g with amex, separate Methoxy-X04 cores within a larger plaque stained with the anti-A antibody 3552 (Figure 27) generic temovate 15g mastercard. Multicore plaques were evident after just 1 day (Figure 27 a-c) as well as in the 1 month (Figure 27 d-e) and 4 months (Figure 27 g-i) incubation time discount 15g temovate free shipping. This characteristic staining strongly implies that these plaques were originally two separate plaques (in the Methoxy-X04 63 staining), but then merged over time to ultimately form one, larger plaque (in the anti-A antibody staining). Multicored plaques were found after 1 day (c), 1 month (f) and 4 months (i) of incubation time. The occurrence of these multicored plaques were quantified and the number of multicored plaques increased significantly with increasing post-Methoxy-X04-injection incubation time (Figure 28 a), showing that multicored plaques were more numerous with more advanced pathology. The size of multicored plaques was also examined and, interestingly, the size of multicored plaques was correlated with the number of cores the multicored plaque contained (Figure 28 b); a larger multicore plaque had more precursor plaques. Multicore plaques 64 2 appear to be a very consistent phenomenon as they contribute ~13% of all large (>300 µm) plaques, regardless of incubation time (Figure 28 c). The number of cores per multicored plaque is positively correlated to the size of 2 the plaque (b). The 2 proportion of large (>300µm) plaques that were multicored plaques was fairly constant over incubation time (c). To examine the fate of the cores of these multicored plaques, brain sections were stained with Thiazin Red, a post mortem stain for dense-cored plaques. Thus, the core at day 0 was stained with Methoxy-X04, but how the dense material looked at the end of the incubation time was shown with the Thiazin Red staining. A triple staining method allowed for the initial dense core state to be labelled with Methoxy-X04, the ultimate dense core state to be labelled with Thiazin Red and the ultimate diffuse state labelled with anti-A antibody 3552 (Figure 29). Comparison of these three stainings revealed two fates for the dense cores of multicored plaques as defined by multiple Methoxy-X04 positive cores within an anti-A antibody positive plaque. Firstly, the multiple cores can merge together over time to create a single, dense cored plaque (Figure 29 e-h), showing that dense core material can fuse over time. Secondly, the multiple cores can remain separate within the antibody labelled material Figure 29 a-d), despite the cores being very close together. Approximately 25% Figure 29 i) of all multicored plaques cores fused over the 4 month incubation period. The rest, 75%, still had multiple Thiazin Red positive cores, showing that they had remained multicored over this period. In (a-d), the cores remain separate (white arrows) within the anti-A antibody 3552 (A) staining and the plaque is still multicored at the 4 month time point. When these triple stained images were examined for examples of newly emerging multicored plaques, plaques were found that would not be classified as multicored from the Methoxy X04, day 0 staining, but that would be 4 month later by the Thiazin Red staining (Figure 30). These plaques had developed into multicore plaques over the 4 month incubation time showing that a new close plaque had developed over the 4 months. This phenomenon demonstrates that the multiple dense cores of multicored plaques can form sequentially. A single plaque (a) is joined by a newly formed dense cored plaque (b, white arrowhead) within the anti-A antibody positive halo (c, d). This study has identified three interesting plaque categories of plaques: flower plaques, clusters of plaques and merging plaques. In a control experiment, the post-mortem Methoxy X04 images were re-examined to find examples of these categories to rule out any confounding effect of the multiple staining techniques. Indeed, examples of all three plaque categories could be found in these images: flower plaques (Figure 31a), plaque clusters (Figure 31b) and merging plaques (Figure 31c). A flower plaque (a, white arrowheads are ‘petal’ plaques), a plaque cluster (b) and merging plaques (c, white arrows). This study, using a two-stage plaque staining technique, examined plaques over time and generated two important conclusions: 1) New plaques are more likely to form in the vicinity of a pre-existing plaque thereby forming clusters of plaques 2) Large plaques can have grown from several precursors showing that plaque clusters can fuse over time Together, these results built a new hypothesis of plaque development to compliment the uniform growth theory, namely the clustering hypothesis of plaque development. This new hypothesis, as illustrated by the schematic in Figure 32 explains how large plaques arise from clusters of multiple smaller plaques. The presented data support three different scenarios whereby this could happen and these are illustrated in Figure 32. In the first scenario, a new plaque deposits in the vicinity of the initial plaque and these two plaques grow and merge together over time, eventually forming a large plaque with a single core. Alternatively, those two neighbouring plaque cores can remain separate and the diffuse material grows around to create a large plaque with multiple, separate cores. In a third scenario, the initial plaque develops multiple neighbouring plaques (a flower plaque) and then, hypothetically, grows a diffuse halo and ultimately becomes a multicored plaque. By this, the presented data provide evidence for a clustering hypothesis of large plaque development. The clustering hypothesis is an alternative theory of how plaques can grow, and complements the uniform growth theory of plaque development (Figure 12 a). These two plaques fuse over time (c) to produce a larger plaque with a single core (d) or remain separate (e) and grow to be a large, multicored plaque (g). Alternatively, the initial plaque (a) can be joined by multiple new neighbour plaques (f) and grow to be a large, multicored plaque (g). Solid arrows represent events supported by the presented data; the dashed arrow represents hypothetical plaque development. This could be because of one of two reasons: either the microenvironment in which the first plaque appeared is conducive to plaque development, hence subsequent plaques also appear there, or, the first plaque itself somehow induces further plaques to develop in the vicinity. As mentioned in the introduction, the precise origin of A for plaque development is currently under debate and many factors may influence the location of plaque formation.

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There are online information and phone applications to generic temovate 15g mastercard help managing epilepsy (Health Navigator New Zealand effective 15g temovate, 2018) cheap temovate 15g fast delivery. As health care resources are limited trusted temovate 15g, the utilisation of technologies needs to be increased in future for epilepsy care to be delivered more efficiently to a wider population. Healthcare providers need to be creative and bring new ideas to improving epilepsy care. Summary of chapter two the first section of this chapter presented an updated classification of epilepsy which is important for treatment options and standardisation of epilepsy care. The next section of the chapter focused on the patients’ and families’ experience with epilepsy. This part highlighted discordance between patients and healthcare providers, and complexity of epilepsy. Third part of the chapter was about epilepsy nursing guidelines, efficacy, and integration of the care. The fourth part described specific epilepsy care to certain populations: adolescents, elderly and women at childbearing age. In the last section of this chapter, ideas for future epilepsy care are presented. By the literature review, there is clearly a lack of studies of epilepsy care and the nurses’ role within the care in New Zealand. It includes a description of grounded theory method and the rationale for its choice, details of data analysis process and each step of the research method, are addressed. Theoretical underpinning Emerge of the research question Before going through the details of the research methodology, it is important to revisit how the research question emerged. Despite these concerns, it is not grounded in facts and research in this area is needed. Therefore, a developing theory ‘Adult epilepsy care in New Zealand has problems’ is developed. The purpose of this study is to explore epilepsy nursing care in New Zealand to see what issues there are, how they developed and what we can do to address them. The environment where health professionals work is incredibly complex with constantly advancing treatment, increasing specialities, involvement of multi-disciplinary providers, and the focus on individual needs. To understand the social phenomenon surrounding epilepsy care, a systematic approach was required. In order to study the whole complex environment, the research question needs to be as broad as possible. Hence, my research became a qualitative study to explore the nurses’ role and care they provide for adult with epilepsy. A lack of integration in epilepsy care Developing theory Adult epilepsy care in New Zealand has problems what are the problems why the problems occurred how we can solve the problems An exploration of the nurses’ role and care they provide for adults with epilepsy What is qualitative research Qualitative research is a general broad term covering several different methodologies that have many similarities (Barroso, 2010). Qualitative research aims to develop concepts of social phenomena in natural settings, the setting people live in every day, not in experimental settings (Pope & Mays, 1995) and it helps us to see the world through the eyes of other (Barroso, 2010). Qualitative research begins by recognising and accepting there is a variety of different ways of making sense of the world. In nursing research, qualitative methods focus on the whole of human experience and aim to understand health beyond traditional quantitative measures of isolated concepts (Barroso, 2010). Qualitative research is looking for the meanings seen by individuals living in the experience, accepting their view of the world rather than that of researchers (Jones, 1995). Among the multiple different qualitative study methods, I chose the grounded theory method. By the 1960’s quantitative methods dominated with beliefs in scientific logic, objectivity and truth. Nurse scholars moved on from using quantitative research which did not answer research questions, to conducting qualitative studies to obtain the best answers to their research question (Barroso, 2010). At that time, quantitative research theory led by the logic-deductive model of research has rarely lead to new theory construction (Charmaz, 1996). Glaser and Strauss challenged and articulated explicit analytic procedures, and changed the tradition by setting clear guidelines for conducting qualitative research (Charmaz, 1996). Through influence from Blumer and Park at the University of Chicago, Strauss further adopted both the realistic philosophical practice with emphasis on studying procedure, action and meaning, and Chicago’s traditional ethnographic research (Charmaz, 2008). Nowadays, grounded theory methods have been widely adopted in many sectors including nursing. Rationale for using grounded theory method One of the main characteristics of grounded theory in this study is that in this method, theories and concepts emerge not only from the data but also systematic interpretation occurs during the course of the research (Charmaz, 2008; Strauss & Corbin, 1994). Analysis simultaneously starts with data collection procedures and the data includes the whole research environment (Charmaz, 1996). The concerns that I had at the beginning of this research were ‘guiding interests’ and that was already a part of data to develop concepts through the research process. The hallmark of grounded theory method is that the researcher develops analytic categories directly from the data and this makes the researcher stay closely connected to what is happening in the empirical world grounded in the study (Charmaz, 1996). Rich data from grounded theory research provides a thorough knowledge of the empirical world and helped me to discern what participants really mean and how they express their experience. Data collection and data analysis for grounded theory Theoretical sampling and data collection Theoretical sampling is the process of identifying who and what data should be collected. In grounded theory, who become participants and what data needs to be collected should be emerge from the developing theory (Skeat, 2011).

As you get excites the mental afection called the emotion 15g temovate with amex, and closer temovate 15g line, you catch a glimpse of a tpically Australian sign that this later state of mind gives rise to buy temovate 15g low cost the bodily next to generic 15g temovate with visa the river’s edge: “Watch out for crocs. Tink of these categories instead as a fame here to be defended says that this order of sequence is work that we can use in our scientifc investigations of incorrect, that the one mental state is not immediately emotion. No single approach is correct all of the time, induced by the other, that the bodily manifestations so we must not get drawn into an either-or debate. It is must frst be interposed beten, and that the more essential, though, to understand how emotion is defned, rational statement is that we fel. Without the bodily Theories of Emotion Generation | 435 states following on the perception, the later would be purely cognitive in form, pale, colourless, destitute of fast emotional warmth. We might then se the bear, and cortex (interpretation: A A A scared judge it best to run. A similar proposition was slower suggested by a contemporary of James, Carl Lange, and hypothalamus A emotional reaction the theory was dubbed the James–Lange theory. For instance, Paul Ekman showed action (adrenaline released causing increased heart that at least some emotional responses (anger, fear, and and respiratory rates, sweating, and fght-or-fight disgust) can be diferentiated by autonomic activit. T us James and Lange believed that with emotion there Appraisal Theory is a specifc physiological reaction and that people Appraisal theory is a group of theories in which emotional could not fel an emotion without frst having a bodily processing is dependent on an interaction bet n the reaction. The theo ries difer about what is appraised and the criteria used for this appraisal. Since appraisal is a subjective step, Cannon–Bard Theory it can account for the diferences in how people react. A counter Richard Lazarus proposed a version of appraisal theory proposal was ofered several years later by a pair of in which emotions are a response to the reckoning of the physiologists fom Harvard, Walter Cannon and Philip ratio of harm versus beneft in a person’s encounter with Bard. In this appraisal step, each of us considers not distinct enough to distinguish among fear, anger, personal and environmental variables when deciding and sexual atraction, for example. Tus, also believed that the neuronal and hormonal fed the cause of the emotion is both the stimulus and its back processes are too slow to precede and account signifcance. This appraisal step may be describe the fght-or-fight response) thought that the automatic and unconscious. Cannon found that when he severed the cortex He sees the bear A cognition (A quick risk–beneft fom the brainstem above the hypothalamus and thala appraisal is made: A dangerous wild animal is mus, cats still had an emotional reaction when provoked. Tese researchers proposed that an emotion al stimulus was processed by the thalamus and sent si multaneously to the neocortex and to the hypothalamus that produced the peripheral response. Tus the neocor Singer–Schachter Theory: tex generated the emotional feling while the periphery Cognitive Interpretation of Arousal carried out the slower emotional reaction. The Evolutionary Psychology Approach control group was told that they would experience the symptoms associated with adrenaline, such as a racing Evolutionary psychologists Leda Cosmides and John heart. The other group was told they had ben injected Tooby proposed that emotions are conductors of with vitamins and should not experience any side an orchestra of cognitive programs that ned to be efects. Each of the participants was then placed with a coordinated to produce successful behavior (Cosmides confederate, who was acting in either a euphoric or an & Tooby, 2000). When later asked how they felt and why, overarching program that directs the cognitive subpro the participants who knowingly received an adrenaline grams and their interactions. The theory tion also involves instructions for other mechanisms is a blend of the James–Lange and appraisal theories. They see the bear A possible stalking and ambush situation is detected (a common scenario of evolu tionary signifcance) and automatically activates a So they see the bear A physiological reaction hardwired program (that has evolved thanks to being (arousal: heart races, ready to run) A cognition successful in these types of situations) that directs (What’s going on Response: Perception and attention shift auto matically; goal and motivations change from a picnic in the woods to stayin’ alive; information-gathering mechanisms are redirected and a change in con Constructivist Theories cepts takes place: looking for the tree as shade for a picnic becomes looking for a tall tree for escape; Constructivist theories suggest that emotion emerges memory comes on board; communication changes; fom cognition as molded by our culture and language. If the answer is no, the people automatically conceptual act model, proposed by Lisa Barret. In this adopt freeze behavior; if it is yes, they scamper); theory, emotions are human-made concepts that emerge learning systems go on (they may develop a condi as we make meaning out of sensory input fom the body tioned response to this trail in the future); physiology and fom the world. First we form a mental representa changes; behavior decision rules are activated tion of the bodily changes that have ben called core (which may be automatic or involuntary) A they run afect (Russell, 2003). Barret suggests that these categories vary with a per son’s experience and culture, so there are no empirical criteria for judging an emotion (Barret, 2006b). LeDoux’s High Road and Low Road Joseph LeDoux of New York Universit has proposed that humans have to emotion systems operating Sensory input (she sees the bear) A physiologic in parallel. One is a neural system for our emotional response (her heart races, she feels aroused in a responses that is separate fom a system that gener negative way) A her brain calculates all previous bear encounters, episodes of racing heart, degree of ates the conscious feling of emotion. This emotion arousal, valence, and you name it A categorizes the response system is hardwired by evolution to produce current reaction in reference to all the past ones and fast responses that increase our chances of survival ones suggested by her culture and language A ah, and reproduction. The Amygdala | 437 Researchers do not agree on how emotions are fast hardwired fght-or-fight response generated, and many theories exist. His research on the role of the amyg Each amygdala is an intriguing and complex structure dala in fear has shown that the amygdala plays a major that in primates is a collection of 13 nuclei. The largest area is the basolateral nuclear complex, consisting of the lateral, baal, and accessory baal Emotions are made up of three psychological components—a physiological response, a behavioral nuclei. The baal nucleus is the gatekeper of the response, and a subjective feeling—that have evolved amygdala input, receiving inputs fom all the sensory to allow humans to respond to signifcant stimuli. The multifaceted basal nucleus is important underlying mechanisms and timing of the components for mediating instrumental behavior, such as running are disputed. It lies deep within the medial temporal lobe adjacent to the anterior aspect of the hippocampus.

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