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Admiralty law also covers many commercial activities arthritis in neck with bone spurs purchase 7.5 mg mobic mastercard, although land based or occurring wholly on land infectious arthritis in dogs symptoms buy mobic amex, that are maritime in character arthritis in dogs forum generic mobic 15 mg without a prescription. Admiralty law is distinguished from the Law of the Sea can arthritis in the knee cause numbness generic 15 mg mobic otc, which is a body of public international law dealing with navigational rights, mineral rights, jurisdiction over coastal waters and international law governing relationships between nations 400 the source of modern day admiralty law is hidden in the ancient past. Special courts arose in the Mediterranean, Atlantic, and Baltic trading states to enforce what was accepted by these states as a form of international law arising from the longstanding customs of the sea. Of particular interest to us is the system established in England where courts set up under the cognizance of the Lord High Admiral were, in the latter part of the 14th century, given jurisdiction to hear civil cases limited to "a thing done upon the sea. Colonial courts were set up under the Vice-Admiralty in British North America and given expanded jurisdiction to hear criminal and civil matters involving colonists. Following the Revolutionary War, the newly formed United States incorporated the English judicial system. The system of separate admiralty courts with separate procedures was continued in the United States until 1966, when the courts were unified. Even though they are now unified, separate and distinct admiralty procedures are still available and the substantive law applied to decide cases, whether in state or federal court is the body of federal admiralty law. According to Wikipedia, Seaborne transport was one of the earliest channels of commerce, and rules for resolving disputes involving maritime trade were developed early in recorded history. Early historical records of these laws include the Rhodian law (Nomos Rhodion Nautikos) (of which no primary written specimen has survived, but which is alluded to in other legal texts: Roman and Byzantine legal codes) and later the customs of the Hanseatic League. In southern Italy the Ordinamenta et consuetudo maris (1063) at Trani and the Amalfian Laws were in effect from an early date. Islamic law also made major contributions to international admiralty law, departing from the previous Roman and Byzantine maritime laws in several ways. These included Muslim sailors being paid a fixed wage "in advance" with an understanding that they would owe money in the event of desertion or malfeasance, in keeping with Islamic conventions in which contracts should specify "a known fee for a known duration. The "Islamic influence on the development of an international law of the sea" can thus be discerned alongside that of the Roman influence. Admiralty law was introduced into England by Eleanor of Aquitaine while she was acting as regent for her son, King Richard the Lionheart. These courts do not use the common law of England, but are civil law courts largely based upon the Corpus Juris Civilis of Justinian. Admiralty courts were a prominent feature in the prelude to the American Revolution. For example, the phrase in the Declaration of Independence "For depriving us in many cases, of the benefits of Trial by Jury" refers to the practice of Parliament giving the Admiralty Courts jurisdiction to enforce the Stamp Act in the American Colonies. Because the Stamp Act was unpopular, a colonial jury was unlikely to convict a colonist of its violation. However, because admiralty courts did not (as is true today) grant trial by jury, a colonist accused of violating the Stamp Act could be more easily convicted by the Crown. Admiralty law became part of the law of the United States as it was gradually introduced through admiralty cases arising after the adoption of the U. Many American lawyers who were prominent in the American Revolution were admiralty and maritime lawyers in their private lives. Those included are Alexander Hamilton in New York and John Adams in Massachusetts. In 1787 Thomas Jefferson, who was then ambassador to France, wrote to James Madison proposing that the U. Constitution, then under consideration by the States, be amended to include "trial by jury in all matters of fact triable by the laws of the land [as opposed the law of admiralty] and not by the laws of Nations [i. In the more modern era, Supreme Court Justice Oliver Wendell Holmes was an admiralty lawyer before ascending to the federal bench. This interesting history of admiralty law has very real consequences to those who find themselves pressing claims within the admiralty jurisdiction. The criminal and civil law with which we are most familiar is derived from the English common law. The law of admiralty, however, having had its origin in the Mediterranean and European sea trade, more closely resembles the European civil law system than the English common law. One significant difference which proved an irritant to our colonial forefathers given the expanded jurisdiction of the British Admiralty Court in the American colonies is the lack of jury under admiralty procedures. The Flag Shows the Substantive Law Of Admiralty Maritime law is a legal body that regulates ships and shipping.
Source: Gupta et al arthritis diet apple cider vinegar mobic 7.5 mg online, 2006 Environmental change and poverty in cities the economic imperatives that drive urbanization also play a large role in determining the status of the urban environment and ecosystems arthritis lyme buy generic mobic 15mg on line, as well as the extent and depth of poverty expensive arthritis medication purchase mobic, wealth and inequality in the city rheumatoid arthritis case study buy 15mg mobic with visa. This sub-section reviews the ways in which urbanization processes generate risk by shaping the environment of the city and the growth of slums. The role of global environmental change on disaster risk in cities is also considered. I Modifying the hazard environment Consumption of natural assets (trees for fuel, groundwater, sand and gravel) and the overexploitation of natural services (water systems and air as sinks for sewerage or industrial waste) modify the environment and generate new hazards. These include deforestation and slope instability within and surrounding cities, encouraging landslides and flash flooding. Recent evidence illustrates that with increasing affluence and through the use of technology, those who produce waste and risk can avoid the consequences both in time and space. Thus, the environmental costs of over-consumption by the wealthy become burdens for the poor, who are forced to live not only in unsafe and insecure housing, but also with urban pollution and environmental degradation. High consumption by the rich and in aggregate by richer cities has contributed 80 per cent of carbon emissions that cause climate change. Yet, it is the less wealthy and the poor in cities, towns and villages who will least be able to cope with and adapt to the local impacts of climate change, either directly or collectively through government or social actions. Flood risk has been made worse in urban areas through the silting of natural water courses and the lowering of water tables, followed by salt intrusion or land subsidence. Building roads and houses makes it harder for rainwater to drain through the soil, leading to more frequent flash flooding in cities. The loss of mangrove ecosystems on urban fringes leads to coastal erosion and exposure to storm wind and waves. Similarly, deforestation on hill slopes within and surrounding settled land can create instability and lead to greater landslide hazard. Many losses to Hurricane Mitch, during 1998, in Central America were in small regional towns smothered by mudslides or flash floods caused by deforestation in adjacent agricultural areas. Inadequately built multistorey construction has been a cause of losses in many urban disasters, and skyscrapers have also been the site for devas- Inadequately built multi-storey construction has been a cause of losses in many urban disasters. Calcutta and Baroda are just two cities where the close proximity of manufacturing, hazardous materials storage and residential areas has been a cause for concern. For instance, emissions from cities in North America and Australia are often 25 to 30 times higher than those of cities in low-income countries. Climate change has far reaching consequences for the incidence and impacts of disasters in cities. Cities are particularly vulnerable to the impacts of climate change, as this is where much of the population growth over the next two decades will take place and where a large and growing proportion of those most at risk from climate change reside. Indeed, several projections have indicated that sea levels are expected to rise by 8 to 88 centimetres during the 21st century due to climate change. In sub-Saharan Africa, climate change and the consequent extreme climatic variations is a key factor which causes rural populations to migrate to urban areas, thereby fuelling rapid and often uncontrolled urban growth. While cities remain vulnerable to the effects of climate change, they are also key contributors to global warming. Cities are responsible for 80 per cent of the carbon emissions that cause climate change through energy generation, vehicles, industry and the burning of fossil fuels and Some 998 million people lived in urban slums in 2006, and if current trends continue, it is predicted that some 1. In Manila, informal settlements at risk to coastal flooding make up 35 per cent of the population; in Bogota, 60 per cent of the population live on steep slopes subject to landslides; and in Calcutta, 66 per cent of the population live in squatter settlements at risk from flooding and cyclones. At an individual and household level, vulnerability to natural and human-made hazard is shaped by the kinds of physical, economic, social and human capital assets that people can command. Capacity to increase, protect or diversify an asset profile is largely determined by cultural, administrative and legal institutions and opportunities, such as security of tenure, access to markets, customary hospitality or the effectiveness of the rule of law. Many people in slums have fewer assets and supporting institutions than those living in formalized residential areas and are consequently highly vulnerable to harm from natural and human-made hazards, as well as from other risks associated with crime, violence and insecurity of tenure. Housing provides personal security, but can also be a livelihood resource if it is the locus of home-based enterprises. During Hurricane Mitch in 1998, a disproportionate number of the victims were street children. Renters as well as those living in squatter settlements are at risk from eviction, generating uncertainty before disaster and often resulting in homelessness post-disaster due to competing higher-value land uses. It is not unusual for disasters to be followed by the redevelopment of inner-city low-income rental or squatter areas during reconstruction, often (and famously, in the case of Mexico City) with widespread protest.
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Two findings emerged as statistically significant: Females reported a higher prevalence of cyber bullying perpetration than did males (9 percent arthritis in fingers golf order cheapest mobic and mobic, compared to 6 percent for males) arthritis diet recipes discount 15 mg mobic overnight delivery, and males reported almost twice the prevalence of physical bullying perpetration as did females (38 percent arthritis herbs generic mobic 7.5 mg with visa, compared to 20 percent for females) arthritis in neck and back pain buy cheap mobic online. There was no gender variation in psychological bullying, which a third of males (33 percent) and females (32 percent) reported perpetrating. These youth are included in the total sample of surveyed youth but not in the male/female breakouts. Prevalence of Bullying Perpetration by Gender (%) Cyber bullying Physical bullying Psychological bullying Total (N=5,647) 7. Across all youth, the greatest prevalence of overlap in victimization and perpetration reports occurred with regard to physical bullying (21 percent of youth reported both types of bullying) and psychological bullying (23 percent of youth reported both types of abuse) in the prior year. These rates were similar to the shares of youth who reported only victimization experiences for each type of bullying (19 percent and 22 percent, respectively, for physical and psychological bullying victimizations) and more than twice the shares who reported only perpetration (7 percent and 10 percent, respectively, for physical and psychological bullying perpetration). Using data in the table below, we also calculated what proportion of bullying victims also perpetration and what proportion of perpetrators were also victimized. For example, we divided the percentage who both were victimized and perpetrated by the total percentage of victims (which equals the sum of victim-bully overlap and only victimization percentages), to show the portion of victims who also perpetrated. Lastly, we turn to gender variation in overlapping reports of bullying victimization and perpetration, which were statistically significant for all types of bullying. As shown in table 34 and figure 7, for all forms of bullying, female youth were significantly more likely to report only 44 the survey was not designed to disentangle offensive from defensive acts of bullying, so the primary focus here is on the overlap in victimization and perpetration regardless of who the primary "bully" may have been. With regard to victim/perpetrator overlap in bullying, the most notable differences were that females were twice as likely as males to report overlap behavior with regard to cyber bullying (7 percent, compared to 3 percent for males), while males were twice as likely as females to report overlap behavior with regard to physical bullying (28 percent, compared to 15 percent for females). Bullying Victimization and Perpetration (%) Cyber bullying Only victimization Only perpetration Both victimization and perpetration Physical bullying Only victimization Only perpetration Both victimization and perpetration Psychological bullying Only victimization Only perpetration Both victimization and perpetration Total (N=5,647) 12. Overlap in Bullying Victimization and Perpetration Experiences How female youth (N=2,904) experience bullying: How male youth (N=2,705) experience bullying: 71 this document is a research report submitted to the U. Specifically, are there differences in bullying victimization and/or perpetration rates based on sexual orientation or middle school/high school status Variation in Bullying Experiences by Sexual Orientation Tables 35 and 36 show the prevalence of bullying victimization and perpetration for youth based on whether they identified as heterosexual/straight (94 percent, 5,218 youth) or as lesbian, gay, bisexual, transgender, or questioning (6 percent, 316 youth), with a chi-squared statistic documenting the level of significance across categories. Prevalence of Bullying Victimization by Sexual Orientation (%) Cyber bullying Physical bullying Psychological bullying Total (N=5,647) 17. Prevalence of Bullying Perpetration by Sexual Orientation (%) Cyber bullying Physical bullying Psychological bullying Total (N=5,647) 7. Across all categories of bullying, high school students reported significantly higher prevalence rates of bullying victimization and perpetration than did middle school students. Prevalence of Bullying Victimization by High School or Middle School Status (%) Cyber bullying Physical bullying Psychological bullying Total (N=5,647) 17. Prevalence of Bullying Perpetration by High School or Middle School Status (%) Cyber bullying Physical bullying Psychological bullying Total (N=5,647) 7. Surveyed youth were asked, in general, whether any of the bullying victimization experiences they reported had occurred on school grounds, how often they had occurred at school, and whether they had happened during the school day. Figure 8 shows the prevalence rates for each of these questions regarding bullying victimization at school. As shown, one out of four youth said they had experienced bullying on school grounds (25 percent) and nearly the same share said it had happened during the school day (23 percent). Further, fifteen percent of youth said they had experienced at least one type of bullying victimization (cyber, physical, and/or psychological) at school once a month or more during the prior year. With regard to victimization rates for all types of bullying, youth in 10th grade reported the highest rate, followed closely by those in 11th grade. With regard to perpetration rates for all types of bullying, youth in 11th grade reported the highest rate, followed closely by those in 10th grade. Youth in 9th grade reported rates in between those of 10th/11th graders (at the high end) and 7th/8th/12th graders (at the low end). Thus, we did not find support for the presence of higher levels of bullying experiences in transitional grade years. Prevalence of Bullying Victimization on School Grounds among Teens (%) (N=5,647) Note: Valid, nonmissing data on measures in this figure were present for 84 percent of respondents.
Zoledronic acid is the only reviewed cancer medicine that falls in the dark green category for at least one indication arthritis instant relief discount mobic 7.5mg on line, whereas imatinib is not marked as dark or light green for any indication rheumatoid arthritis definition and causes purchase 15 mg mobic overnight delivery. Table 2 summarizes the review of indications for three antibiotics rheumatoid arthritis onset discount mobic express, including meropenem arthritis medication that starts with a p purchase genuine mobic on-line, which is regarded as a medicine reserved for treating serious illnesses caused by antimicrobial-resistant bacteria. In total, 27 medical indications were assessed for these antibiotics; although the medicines were assessed for several indications, none were found suitable for all the indications for which they were assessed. For example, ciprofloxacin was assessed for 22 indications, whereas cilastatin/imipenem and meropenem were assessed for only 5 and 7 indications, respectively, suggesting that ciprofloxacin is a popular antibiotic. However, for 15 indications, there was no evidence supporting clinical benefit in the guidelines. It was assessed for 11 medical indications but was found to be safe and clinically effective in only 2 of these, and there was no evidence on value for money (light green). Table 4 shows the list of indications associated with amino acid through the literature review and guidelines. Although it was assessed for 26 indications, there is no evidence available on the clinical benefit of using this medicine (orange) and none of the indications were included in the guidelines. Table 5 presents results for esomeprazole, which was assessed for six indications. For the red case, a systematic review and meta-analysis found that concomitant use of esomeprazole and antiplatelet medicines was associated with greater risk of adverse cardiovascular events. Cancer and Immunosuppressing Medicines (continued) Erlotinib Imatinib Oxaliplatin Paclitaxel Rituximab Sorafenib Zoledronic Indications Chronic immune thrombocytopenia Myasthenia gravis Systemic lupus erythematosus Relapsing-remitting multiple sclerosis Hemophilia A/B Hepatocellular carcinoma Advanced stage Before liver transplantation Recurrence c c c c Bone and Joint Osteoporosis without pathological fracture Bone problem due to bone metastatic cancer Breast cancer Renal cancer Prostate cancer Hypercalcemia of malignancy Rheumatoid arthritis Others Preventing risk of cardiovascular events *depends on dosage. Ciprofloxacin is listed in "d" for indications used based on the opinion of clinical experts in infectious diseases. Meropenem is listed in "c" for another 12 indications including bronchiectasis, community-acquired/hospital-acquired/ventilator-associated pneumonia, empyema, sepsis, biliary infection, pyogenic liver abscess, infectious acute pancreatitis, bacterial peritonitis, and immunodeficiency. It is listed in "d" for indications used based on the opinion of clinical experts in infectious diseases. Only a small proportion of patients are diagnosed with medical indications that are in dark green (8 percent across three medicines) and light green (2 percent across four medicines) categories. Only two medicines, rituximab and sorafenib, were not prescribed outside reviewed medical indications, whereas in the case of cilastatin more than 90 percent of the patients were prescribed the medicine for indications outside the reviewed indications. Notably, esomeprazole is administered to about 14 percent of patients for an unsafe (red) indication. Figure 4 shows the result of the clinical expert review of medical records of patients whose prescriptions had been deemed inappropriate according to the review, including medical indications not identified from the review (gray category in figure 3). The clinical experts confirmed, after reviewing principal diagnosis, co-morbidity, and complications, that a significant number of patients overutilize the reviewed medicines. Overall, even though experts found that 29 percent of prescriptions outside of the identified indications from the review were justifiable, they confirmed that a majority of these prescriptions (58%) were unjustifiable. For 13 percent of medical records, clinical experts were not able to determine whether the prescriptions were justifiable or unjustifiable. An appropriate indication is defined as one that was coded as either dark green and light green during the literature review process, plus the additional indications found to be justifiable by expert review. The blue-coded proportion shows the amount of expenditure for each medicine that is being currently spent on appropriate medical indications. The yellow-coded proportion shows the amount of expenditure, for each medicine, on indications with evidence showing clinical benefits but not good value for money in the country. The brown-coded portions show expenditure, for each medicine, on medical indications that have been deemed inappropriate through the literature review and are considered unjustifiable by clinical expert judgment. Ci Discussion the review found that only 22 percent of current expenditures for these medicines were for appropriate indications; the remainder were for inappropriate indications. The proportion of appropriate indications varied substantially across these medicines. Al b Am um st in in at o in ac,I id m ip en Ci e pr ofl m ox ac in Er lo Es om tin ep ib ra zo Im le M atin er op ib en O em xa lip la Pa tin cl it Ri axe tu l xi m So ab Zo ra fe le ni dr b on ic ac id Medicines this study draws five key lessons. Fourth, it is feasible to systematically conduct a document review, analyze service utilization, and incorporate expert input to develop a list of medical indications for reimbursement in resource-constrained settings.