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It follows the course of the deep cervical artery and vertebral artery to arrive at the brachiocephalic vein weight loss journal app buy cheap orlistat 120 mg online, which it joins. The vertebral vein, which also originates from the occipital vein and suboccipital plexus, envelops the vertebral artery like a net and accompanies it through the foramina transversaria of the cervical vertebrae, collecting blood along the way from the cervical spinal cord, meninges, and deep neck muscles through the vertebral venous plexus, and finally joining the brachiocephalic vein. Cerebral Circulation 20 Cranial Veins the facial vein drains the venous blood from the face and anterior portion of the scalp. It begins at the inner canthus as the angular vein and communicates with the cavernous sinus via the superior ophthalmic vein. Below the angle of the mandible, it merges with the retromandibular vein and branches of the superior thyroid and superior laryngeal veins. The veins of the temporal region, external ear, temporomandibular joint, and lateral aspect of the face join in front of the ear to form the retromandibular vein, which either joins the facial vein or drains directly into the internal jugular vein. Its upper portion gives off a prominent dorsocaudal branch that joins the posterior auricular vein over the sternocleidomastoid muscle to communicate with the external jugular vein. Lymph vessels joining to form thoracic duct Extracranial veins Transverse cervical v. Argo light Argo Spinal Circulation omy is variable, to the anterior and posterior spinal veins, which form a reticulated network in the pia mater around the circumference of the cord and down its length. The anterior spinal vein drains the anterior two-thirds of the gray matter, while the posterior and lateral spinal veins drain the rest of the spinal cord. These vessels empty by way of the radicular veins into the external and internal vertebral venous plexuses, groups of valveless veins that extend from the coccyx to the base of the skull and communicate with the dural venous sinuses via the suboccipital veins. Venous blood from the cervical spine drains by way of the vertebral and deep cervical veins into the superior vena cava; from the thoracic and lumbar spine, by way of the posterior intercostal and lumbar veins into the azygos and hemiazygos veins; from the sacrum, by way of the median and lateral sacral veins into the common iliac vein. Arteries Most of the blood supply of the spinal cord is supplied by the segmental spinal arteries, while relatively little comes from the vertebral arteries via the anterior and posterior spinal arteries. The vertebral, ascending cervical, and deep cervical arteries give off cervical segmental branches; the thoracic and abdominal aorta give off thoracolumbar segmental branches via the posterior intercostal and lumbar arteries. The segmental arteries give off radicular branches that enter the intervertebral foramen and supply the anterior and posterior roots and spinal ganglion of the corresponding level. The spinal cord itself is supplied by unpaired medullary arteries that originate from segmental arteries. The anatomy of these medullary arteries is variable; they usually have 5 to 8 larger ventral and dorsal branches that join up with the anterior and posterior spinal arteries. Often there is a single large radicular branch on one side, the great radicular artery (of Adamkiewicz), that supplies the entire lower twothirds of the spinal cord. The spinal arteries run longitudinally down the spinal cord and arise from the vertebral artery (p. The unpaired anterior spinal artery lies in the anterior median fissure of the spinal cord and supplies blood to the anterior two-thirds of the cord. The two posterior spinal arteries supply the dorsal columns and all but the base of the dorsal horns bilaterally. Numerous anastomoses of the spinal arteries produce a vasocorona around the spinal cord. The depth of the spinal cord is supplied by these arteries penetrating it from its outer surface and by branches of the anterior spinal artery penetrating it from the anterior median fissure (sulcocommissural arteries). Spinal Circulation Watershed Zones Because blood can flow either upward or downward in the anterior and posterior spinal arteries, the tissue at greatest risk of hypoperfusion is that located at a border zone between the distributions of two adjacent supplying arteries ("watershed zone"). Such vulnerable zones are found in the cervical, upper thoracic, and lower thoracic regions (ca. Argo light Argo Anatomical and Functional Organization ments with the left hand (left hemiapraxia). Anterior callosal lesions cause alien hand syndrome (diagonistic apraxia), in which the patient cannot coordinate the movements of the two hands. Disconnection syndromes are usually not seen in persons with congenital absence (agenesis) of the corpus callosum.

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Only 8 (12%) of patients felt that telehealth made them feel uncomfortable and 4 (6%) worried about confidentiality related to telehealth usage weight loss exercise trusted orlistat 60 mg. Overall, 65 (92%) of patients were satisfied with the telehealth services they received and 64 (89%) would recommend these services to people with similar health conditions. Twenty-five (35%) felt that telehealth can be a replacement for their normal health care and 67 (93%) reported it could be a good addition to their care. Fifty-four (76%) would be interested in participating in telehealth visits in the future. Although most patients do not feel that this is a suitable replacement for their in person care, they expressed that it was certainly a good addition to their care. A large majority of patients expressed interest in continuing to participate in telehealth visits in the future. Telehealth services should be carefully adapted as a long term addition to the in person clinical care of patients with cancer. These services should be utilized to optimize patient satisfaction, save time and increase access to care, especially among high risk patients. Targeted Axillary Dissection appears to be most accurate to evaluate axillary treatment-response, but evidence to support this is limited. Preliminary analysis shows a false negative rate of approximately 5% and a negative predictive value of approximately 91%. Conclusions: this is a comprehensive analysis of germline mutation spectrum in a large Chinese patient cohort with breast cancer. Collectively, a substantial proportion of patients with breast cancer had hereditary risk factors. Distinct distribution of pathogenic mutations in breast cancer subtypes and differential associations between mutation status and clinical features were further observed. All these findings will advance our understanding regarding the pathologies and heterogeneity of breast cancer. Ruddy2, Lidia Schapira3, Steven Come4, Virginia Borges5, Tamara Cadet6, Peter Maramaldi6 and Ann H. In general, younger caregivers have been found to havegreater unmet needs and higher levels of distress compared to those who are older. To date,there is little known about the unmet needs and experiences of partners who care for youngwomen with breast cancer during active treatment. Trial Design: Cross-sectional survey of partners of young women with breast cancer. Specific Aims: To explore the experience of partners of women in active treatment or havingvery recently completed treatment for breast cancer. Statistical Methods: We employed descriptive statistics to present sample characteristics,including means or medians for continuous variables and proportions for categorical variables. Results: All partners were male (25/25; 100%), and most were white (n=23/25; 92%), workingfull-time (n=21/25; 91%); and college educated (n=19/25; 86%). Eighteen partners (n=18/25;72%) were parenting children <18 years old and 40% (n=10/25) were partnered with womenwith Stage 4 breast cancer. At the time of the survey, the median age of partners was 44 years(range, 28-69) and of patients was 38 years (range, 25-40). Additionally, 39%reported not being sexually active; 41% reported maladaptive coping; 30% reported financialstrain;30% reported relationship strain. Parenting concerns scores were generally low indicating less concern, with arange of 12-35, and mean of 20. Common responses included feeling a lack of support, need for tailored and titrated information,and desire to connect with other men who faced similar experiences. Discussion: A subset of partners of young women in active treatment for breast cancerexpressed concerns related to relationship strain, sexuality, need for support, and finances. Future work designed to meet the needs of partners of breast cancer patients includinginformational and psychosocial supports may benefit them and the patients as they manage theprocess of ongoing treatment and challenges about the future. Komen for the Cure Research Program, the Hope Foundation for Cancer Research, Breast Cancer Research Foundation, and Genomic Health, Inc. The protocol specified that interaction between treatment and the stratification variables was to be tested and, if significant, separate analyses performed by stratum.

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The most common causes of obstruction are prostatic hypertrophy weight loss kansas city generic orlistat 120mg amex, cancer of the prostate or cervix, or retroperitoneal disorders. In addition, kidney stones, blood, fungal infection, and bladder malignancy may result in obstruction. The clinician should become familiar with the most common causes, in order to prevent avoidable worsening of the course of chronic kidney disease. Further limiting the comparability of the results across the studies is the wide variation in the selection of analytic techniques and presentation of data. A major limitation of this guideline is its failure to provide a semi-quantitative assessment of the relationships between the factors assessed and the outcomes of rate of progression or risk for kidney failure. This review of these studies does not provide a conclusive answer to the causes underlying the more rapid rate of progression or increased risk for kidney failure. Stratification 229 There is a broad range of factors that are associated with more rapid decline in kidney function, some of which are amenable to interventions. Certain patient groups, defined by either type of kidney disease, clinical, gender, racial, or age characteristics, are at greater risk for progression of kidney disease-this denotes the need to increase awareness among patients and providers about proper care and the need to institute interventions to attempt to slow progression. It is thus critical to educate patients and providers regarding the risk factors and to facilitate providing aggressive interventions where indicated. This may require changing the policies of care providers and payers regarding frequency of follow-up and payment for medications. However, there are certain factors whose impact has not been conclusively determined, such as dietary protein intake, hyperlipidemia, and anemia and their treatment. Many of the conclusions regarding the impact of factors unrelated to intervention, such as age, gender, race, and cause of kidney disease, come from ``small' interventional trials. Similarly, in the case of the impact of blood pressure control, conclusions largely come from the observations that patients with lower blood pressures have improved outcomes. Alternatively, a sufficiently large prospective interventional trial could achieve a similar goal. In the kidney, these changes may lead to increased trafficking of plasma proteins across the glomerular membrane and to the appearance of protein in the urine. The presence of urinary protein not only heralds the onset of diabetic kidney disease, but it may contribute to the glomerular and tubulointerstitial damage that ultimately leads to diabetic glomerulosclerosis. It highlights the strong relationship between progressive diabetic kidney disease and the development of other diabetic complications and emphasizes the importance of monitoring and treating diabetic chronic kidney disease patients for these other complications. Microalbuminuria is present when the albumin excretion rate is 30 to 300 mg/24 hours (20 to 200 g/min) or the albumin-to-creatinine ratio is 30 to 300 mg/ g. Thus, macroalbuminuria and proteinuria may be relatively equivalent measures of urinary protein excretion (see Guideline 5). Nevertheless, differences in methods of measurement and the lack of standardized definitions or terminology often make comparisons between studies difficult. Definitions of Diabetic Complications Other Than Chronic Kidney Disease Cardiovascular disease. Cardiovascular disease is not a specific complication of diabetes per se, since it occurs frequently in nondiabetic individuals. Stratification 231 lar disease in diabetic patients and may accelerate the process of atherosclerosis. For the purposes of this guideline, cardiovascular disease refers to coronary heart disease, cerebrovascular disease, peripheral vascular disease, congestive heart failure, and left ventricular hypertrophy. The American Diabetes Association provides clinical practice recommendations for screening and treatment of cardiovascular disease in diabetes526 which are available on the Internet ( On the other hand, cardiovascular disease itself may increase the level of urinary albumin/protein. Thus, the extent to which chronic diabetic glomerulosclerosis is an independent risk factor for the development of cardiovascular disease may be difficult to determine with certainty, especially in congestive heart failure, without demonstrating diabetic kidney damage at the tissue level. The earliest change of diabetic retinopathy that can be seen with the ophthalmoscope is the retinal microaneurysm. Growth of abnormal blood vessels and fibrous tissue that extends from the retinal surface or optic nerve characterizes the proliferative stage of diabetic retinopathy. With experience, these changes can be identified readily by direct ophthalmoscopy, preferably through dilated pupils. Stereoscopic fundus photographs, however, produce a more reliable and reproducible assessment of diabetic retinopathy.

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Garkavi and co-authors could not explain the mechanisms providing non-fatal transition of the organism from one floor (range) of adaptation to a higher one weight loss jewelry buy orlistat line, after the reaction of primary and persistent activation and further enhancement of the effect above the sub-extreme, stress and higher levels. Purpose and objectives of the study: Adaptive responses of the organism under regular exposure to a sub-extreme stimulus. Responsive adaptive reactions of the organism under regular influence of the external factor of the average to sub-extreme strength were studied by L. This indicates failure of the current level of physiology to explain the mechanisms providing the body transition from one adaptation range to a higher one. Also, according to the dialectical principle of the mutual transition of qualitative changes to quantitative ones, accumulation of these changes should lead to qualitative and quantitative changes in the neuroendocrine system which is responsible for the adaptation of the whole organism. Ukolova (1977) - "it is possible to investigate separately the changes in any one system or at any one level, for example, molecular. But this is only a part of the changes in the overall complex reaction of the body. Pyatnitskaya (1988): "Integral functional reactions to the intoxication of physiological systems are known to be no less important in maintaining homeostasis than biochemical protection" [5, p. Hypertrophy and hyperfunction of the endocrine system are histological and biochemical evidence. The response of the body to any change in the internal environment depends primarily on the functional state of the neuroendcrine system. It is good health, physical activity, increased protective capacities of the body to various hazards - hypothermia, etc. After all, in such a situation, the body must experience stress with exhaustion and death! This can only be explained by the transcendental functioning of the neuroendocrine system, which can be possible only due to its adaptive hypertrophy, in response to the regular exposure to the external factor. Functional activity is the leading factor causing adaptive reactions in the body up to the development of morphological changes. Morphological changes occur in organs or systems stimulated by a flow of stimuli more regularly. Ru showed that due to "trophic stimulation" in the working organ, the assimilation process begins to dominate over the dissimilation process, and morphological changes occur at the physiological level. But one should remember that the hypermetabolic state develops in the "metabolic boiler" - at the level of tissue adaptation mechanisms [2, p. Perhaps in the higher adaptation mechanisms the neuroendocrine system - despite their tension, there are no hypermetabolization processes, which contributes to the accumulation of reserves leading to morphological changes in the neuroendocrine system in the form of hypertrophy, are there Garkavi and coauthors indirectly proves possible accumulation of Year 2020 Validation of Psychoactive Substance Dependence reserves in the neuroendocrine system during the activation reaction; "Although the metabolism is highly active during the activation reaction, it is characterized by an equilibrium" [4, p. But this is possible only when the functional adequacy of the neuroendocrine system grows in direct proportion to the strength of the external factor, which is possible only with hypertrophic neuroendocrine system and, as a consequence, its hyperproductivity. Hypertrophy of neuroendocrine system is evolutionally provided by the functional mechanism contributing to the accumulation of reserves - "advanced excitation" described in the 1930s by P. As early as in 1930s, it was found that chronic morphinization causes hypertrophy of the cortical layer of the adrenal glands in rats, which produces the "adaptation hormones" -glucocorticoids (hydrocortisone, cortisone and corticosterone), increasing the resistance of the organism to intensive stimuli [3, p. There is no doubt in the Adrenal cortex hypertrophy starts even in the activation reaction, since the process of adrenal hypertrophy is not spasmodic. There is no doubt that due to the mechanism of "advanced excitation", other internal secretion glands "takes a break" for trophic recovery processes, which leads to their hypertrophy and hyperfunctionality. And the hypertrophy of the neuroendocrine system that has developed to this moment, does not allow development of the final stage of stress - exhaustion. It is more correct to call such a process a state of not chronic, but regular, unfinished stress. Stress without the exhaustion stage, no matter how regular it is, cannot be considered as a disease. Thus, the adaptive possibilities grow in direct proportion to the increase in the dose.

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About the Security Industries Authority Staff

The Security Industies Authority is headed by a Registrar as the CEO and has thirteen (13) other staff members from all four (4) regions of the country working under him. These includes the Manager Finance and Administration, Manager Licensing and Compliance and four (4) Regional inspectors(MOMASE, Islands, Highland and Southern).

The Inspectors job are very challenging because they are at the front line of enforcement to ensure that private security companies are compliant with the provisions of the Security Protection Act to operate a security company. Most of them are former officers of the Royal PNG Constabulary. Apart from them we also have a efficient staff made up of the Executive Secretary, Accounts Officer, HR Officer , I.T Officer & an Office Janitor in Head Office Port Moresby while Admin Assistance/ Driver and an Office Admin/ Reception in Lae Momase & Highlands Region branch office.

Staff Profiles


Mr. Paul Kingston Isari

Registrar & CEO of PNG Security Industries Authority


Mr. Philip Gene, BAC, CPA PNG

Manager Finance & Administration


Mr. Spencer Gelo

Manager Licencing & Compliance

POM Office Staff

Front left – right Ms Margaret Biskum- Security Inspector New Guinea Islands, Ms Alicia Nana – Executive Secretary & Mrs Mackey Kembi Office Janitor

Back left – right Mr. Rinson Ngale – Security Inspector NCD/Southern Region, Mr. Emmanuel Tumbe HR Officer, Mr. Elijah Fave – Accounts Officer, Mr. Andrew Kaiap – I.T Officer


Lae Office Staff

Front left – right Ms Nelison Roberts – Office Secretary / Reception , Mr. Elvis Otare – Office Admin Assistance / Driver & Acting Momase Region Inspector

Back left – right Vacant – Office Manager & Security Inspector Momase Region, Mr. Pius Moi – Acting Office Manager Security Inspector Highlands Region

Security Industries Authority organizational chart


Vacancies for Council Representatives from the Security
Industry to sit in the Council

The Security Industries Authority currently does not have any vacant Council Representative position. There in total six (6) nominated representative from Security Industries in the council.(see SIA Council)

Qualified candidates will be made known here if there is a vacant in Council Representative positions.

Security Industries Authority Position Vacancies

SIA Currently has no vacancy positions available. Public will be notified for any positions available in the future.

Criteria for appointment to the Security Industries Council

  1. The candidates must have a sound knowledge in the operations of private security companies and are quite versed with the Security Protection Act 2004.
  2. The candidates shall not be currently employed in any licensed security companies that are currently registered with the Security Industries Authority or were not previously employed by any licensed security companies.
  3. The candidates shall not be a current owner or a shareholder of a licensed security company currently registered with the Security Industries Authority and the IPA (Investment promotion Authority).
  4. The candidates shall not be a previous owner or a shareholder of a licensed security company registered with the Security Industries Authority or with the IPA. (Investment promotion Authority).
  5. Interested persons may submit their application with a CV with three (3) references named and attached with their latest passport size photos.
  6. Both male and females are encouraged to participate.
  7. Only registered security companies and permitted security guards will participate in the nominations.
  8. All candidates shall be subjected to a fit and proper persons test before they are formally appointed for 3 years term by the Minister for Police & Internal Security.

For enquiries on this matter

Visit us at the Top floor of the Former Fraud Squad blue building, Gorobe Street, Badili, 2 Mile, Port Moresby NCD or Lae at Post Office Building, second street, top floor, suite # 14, Lae Morobe Province or write to the Chairman Security Industries Council PO BOX 80 Port Moresby National capital District. You can also contact Manager Licensing & Compliance – Mr. Spencer Gelo on telephone 3239851 / 3257930, or email executivesecretary@sia.gov.pg

Invitation to the Stake Holders and the Industry to make a submission on the amendments to current security Protection Act

The Registrar now invites all the registered security companies, service receivers and interested stake holders for their written submission to amend the current Security Protection Act to cover many grey areas of the law.

The submissions should clearly state what provisions of the current Security Protection Act 2004 and the Security Protection regulation 2012 are to be amended to enhance the growth of the industry. This is necessary in light of numerous complaints from the security companies and interested stake holders of the short falls in the current Act which is said to be hindering the growth of the industry.

All submissions must be dropped at The Authority Head Office: Former Fraud Squad Office, Top Floor, Gorobe Street, 2 Mile Drive, Badili,Boroko NCD in Port Moresby. They can also be posted or emailed using the address on the last page. Copies of the current Security Protection Act 2004 can be obtained at the Security Industries Authority office for K35 to use as a guide to prepare the submissions.

Appointment to the Board of Complaints

The Security Industries Authority in compliance with section 57 of the Security Protection Act 2004 has already advertised in the media in early February 2013 seeking for two (2) interested persons to sit on the Board of Complaints.

The purposes of the Board of Complaints is to hear allegations made against licensed security companies by the general public and to award appropriate disciplinary penalties to protect the integrity of the security industry. Several applications have already been received and the short listed candidates will be advised in writing by the chairman shortly before a final selection is made for their three (3) yeas appointments by the Minister for Police and Internal Security.