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The evaluator would not count the last court day as the "index" and the earlier ones as "priors pulse pressure points diagram effective lasix 100 mg. Eventually demi lovato heart attack mp3 purchase generic lasix pills, after two or more crimes heart attack zippo generic lasix 40mg, the offender is detected, charged, and goes to court. For Example: An offender commits a rape, is apprehended, charged, and released on bail. Very shortly after his release, he commits another rape, is apprehended and charged. Because the offender was apprehended and charged between crimes this does not qualify as a crime "spree" ­ these charges and possible eventual convictions would be considered separate crimes (even if the offender is subsequently convicted for both on the same day). In a slight variation of this, consider what would happen if the offender were caught and charged in August for just one of the offences (perhaps the one from March). Perhaps the following year he was subsequently caught and convicted for the January and July offences, and then the year after that he was convicted for the May offence. In this example, they would still all count as one cluster, even though there are separate convictions in three different years, because the offender never reoffended after being caught for the first time. This occurs most commonly with sex offenders when public notoriety or media publicity surrounding their trial or release leads other victims of past offences to come forward and lay new charges. Because the offender has not been charged or consequenced for these misbehaviours previously, they have not been officially detected and then chosen to reoffend. Jones had never been detected for these offences, they were not on his record when he was convicted in 2012. Offences for which the offender has never been detected that come to light once the offender is in the judicial process are considered pseudo-recidivism and are counted as part of the index cluster. In this case, both the 2012 convictions and 2015 charges form part of the index cluster, even though they are several years apart. The basic concept in order to disentangle clusters or sentencing occasions is that the offender has to be officially detected for previous misbehaviours and then "choose" to ignore that sanction and reoffend anyway. If he chooses to reoffend after being officially detected then he creates a new offence and this offence is considered part of the record, usually a new index offence. If historical offences come to light, for which the offender has never been detected, once the offender is in the system for another sex offence, these offences "come forward" and join the index offence to form an index cluster. Further complications in historical cases (when a series of offences occur in between the index behaviour and the detection for the index) are described on page 41, under the section of "Prior Offences. Technical violations after conviction for an index sex offence are also not considered anywhere in Static-99R scoring. Events occurring after that point in time may be relevant for risk management and supervision, but they would be considered as separate from the Static-99R assessment. For Example, Post-Index Sex Offences: Consider a case where an offender commits a sex offence, is apprehended, charged, and released on bail. You are assigned to evaluate this offender but before you can complete your evaluation he commits another sex offence, is apprehended, and charged. Because the offender was apprehended, charged, and released this does not qualify as a crime "spree. These new charges and possible eventual convictions would be considered a separate crime. In a situation of this nature the new charges would create a new sex offence and become the new index offence. This violent offence would not be scored on either Item #3 (Index Non-Sexual Violence convictions) or Item #4 (Prior Non-Sexual Violence convictions) but would be referred to separately, as an "external risk factor," outside the context of the Static-99R assessment, in any subsequent report on the offender. Prior Offence(s) An offence (sexual, non-sexual violent, or non-violent) would be counted as a prior offence if the offender committed a new offence after being detected for the offence in question, but prior to the detection for the index sex offence (or the latest index sex offence detection in a cluster). Generally for something to count as a new offence, the offender must reoffend after detection for a previous offence. If the offender was aware that they were under some form of legal restraint and then goes out and sexually reoffends in spite of this restriction, the new offence(s) would create a new index offence.

No deaths were attributed to arteria renal purchase lasix 40mg free shipping vaccination blood pressure exercise program purchase 100mg lasix with amex, and the number of cases of Guillain-Barrй syndrome were within the range expected by chance alone hypertension young age safe 100mg lasix. Syncope is noted among United States adolescents after vaccination, phlebotomy or other invasive procedures. One case report of brachial plexus neuritis following quadrivalent vaccination has been published in Europe. Other adverse reactions were experienced by five females aged 16­26 years who presented with either multifocal or atypical demyelinating syndromes within 21 days of receipt of quadrivalent vaccine. Four were ultimately diagnosed with multiple sclerosis, and three had neurological dysfunction before vaccination. The diagnosing physicians concluded that no definite conclusions could be made about the causes of these events because this age group has about twice the risk of developing multiple sclerosis than Australian females overall. In Australia, seven confirmed cases of anaphylactic reactions were reported during passive postmarketing surveillance following school-based vaccination with the quadrivalent vaccine. Reported anaphylaxis rates were significantly higher than reported anaphylaxis rates for other vaccines delivered in schools. In trials, anaphylactic reactions were not more common in vaccinees than placebo recipients (Brotherton et al. Coadministration was well-tolerated and no vaccine-related serious adverse events were reported (Schwarz et al. Co-administration was well-tolerated and no vaccinerelated averse events were reported (Protocol 024 Investigators, 2008). These models assume vaccination of girls with three doses before age 13 and hypothetical costs per vaccinated female that include vaccine, wastage and delivery costs. Some of these hypothetical costs may be affordable for a given country but require vaccine prices that are about 100-fold lower than current costs in most high-income countries. Several models have estimated the impact and cost-effectiveness of vaccination with or without screening methods suitable for low-income countries. It can be misleading to directly compare quantitative results of models due to differences in model type, assumptions and uncertainty in parameters. However, most models predict that in low and middle-income countries with either no or limited screening, vaccination alone with at least 70% coverage will avert more cases of cervical cancer than will screening alone one to three times per lifetime. Vaccination plus screening two to three times per lifetime is more effective than vaccination alone, but more costly. Less complex, less data-intensive population-level models that capture the main dimensions of more complex research models, use accessible epidemiological data from countries or regions, and spreadsheet-based analysis have been developed (Sue Goldie, Harvard University, pers. Countries can use such simple population-level models to estimate avertable disease burden and costeffectiveness of vaccination strategies, and inform decisions around vaccine introduction (Lee & Irwin, 2008). At a cost per vaccinated girl of International (I)$ 50 (assuming a per-dose cost of I$ 12. In Thailand, a cost­benefit analysis found that vaccination was not cost effective compared to the current strategy of screening women aged 35­60 years with cytology every 5 years. Most preventable deaths would occur in countries with moderate cancer incidence and large populations. At a cost per vaccinated girl of I$ 10 (I$ 2 per dose), vaccination is cost-saving in 26 of 33 countries. Seventy percent vaccination coverage of five birth cohorts would avert about 300 000 deaths. Such a 5-year programme would cost about I$ 811 million assuming a per-dose vaccine cost of I$ 12. A hypothetical ten-year vaccination campaign in these 33 countries would prevent an estimated 27 cases of cervical cancer and 16 deaths per 1000 vaccinated girls. This projection compares to 3­4 deaths per 1000 children vaccinated for rotavirus and 6. It concluded that vaccine introduction should be considered at such prices (Gutierrez-Delgado et al.

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Substances of Abuse Among Adults in Rural Drug Courts 80% 70% 60% 50% 40% 30% 20% 10% 0% ar m a s ti ceut mu ica l an l ts ac s e d e u t ic a t i al ve s ace u op tical ioid s i ne oh r oi an i ne A lc Co r i ju Ma he t am He Substances of Abuse in Urban Juvenile Drug Courts Primary substances of abuse among urban juvenile drug court participants are depicted in the dark green bars in Figure 11 arteria spinalis anterior buy 40 mg lasix fast delivery. For most of these jurisdictions blood pressure chart newborn lasix 100mg sale, primary blood pressure ranges uk buy generic lasix canada, secondary, and tertiary substances of abuse included marijuana (92% of respondents), alcohol (79%), methamphetamine (33%), heroin (21%), cocaine (13%), pharmaceutical opioids (13%), pharmaceutical stimulants (8%), and other drugs (25%). Me Primary substance of abuse Secondary or tertiary substance of abuse t ha ar m in Figure 12. For most of these jurisdictions, primary, secondary, and tertiary substances of abuse included marijuana (94% of respondents), alcohol (81%), methamphetamine (38%), cocaine (13%), heroin (13%), pharmaceutical sedatives (13%), pharmaceutical stimulants (6%), pharmaceutical opioids (6%), and other drugs (13%). Substances of Abuse in Urban Juvenile Drug Courts 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% ar m a s ti ceut mu ica l an l ts ac s e d e u t ic a t i al ve s ace u op tical ioid s i ne oh r oi an i ne A lc Co r i ju Ma he t am He Figure 12. For most of these jurisdictions, primary, secondary, and tertiary substances of abuse included marijuana (95% of respondents), alcohol (90%), methamphetamine (35%), heroin (15%), pharmaceutical opioids (10%), pharmaceutical sedatives (5%), pharmaceutical stimulants (5%), and other drugs (25%). Me Primary substance of abuse Secondary or tertiary substance of abuse t ha ar m Drug Court Costs Respondents were asked to provide the average cost per drug court participant in their state or territory in 2014. Less than half of states and territories (48%, n = 26) provided statewide or territorial data to answer this question. Presumably, the large variation in costs reflects regional differences in the cost of living, as well as more favorable economies of scale for programs serving larger numbers of participants. It may also reflect differences in the types of drug court models being implemented. Finally, jurisdictions employ different accounting methods for estimating drug court costs. Some jurisdictions have had extensive cost analyses completed on their programs, whereas others use far simpler and potentially less accurate methods for calculating costs. Given the wide variation in costs, it is not possible to characterize an average cost per participant in a typical drug court. Variations in state and territorial laws and practices dictate whether such legislation is necessary for drug court implementation. Some states or territories have legislation defining what drug courts are and specifying the critical components of the programs. Typically, these statutes incorporate or reference the 10 Key Components of Drug Courts, Adult Drug Court Best Practice Standards, or similar documents. Other states have passed more detailed legislation or regulations creating funding mechanisms, credentialing requirements, and conditions for staff training and program evaluation. However, many states with thriving drug court operations have not seen a need to pass legislation specifically authorizing drug courts. Just over half of respondents (51%, n = 27) reported having appropriation legislation for drug courts. In this context, appropriations do not include local governmental or private funding, federally funded discretionary or formula awards, block grants, participant fees, or in-kind use of existing resources. Moreover, appropriations do not include funds used for drug courts that come from other state agency budgets, such as corrections, substance use disorder treatment, or court administration. In a difficult economic environment, the continued increase in federal funding for drug courts is a testament to their life-saving, crime-reducing, and budget-controlling contributions. Drug-Free Babies in Drug Courts the cost to deliver a drug-dependent baby is approximately $62,000, compared to an average cost of $4,700 to deliver a healthy infant (DuBois & Gonzalez, 2014). For babies requiring pharmacological treatment for neonatal abstinence syndrome, increases in hospital costs typically exceed $40,000 per infant per hospital stay (Roussos-Ross et al. This figure does not include drug-free babies fathered by male drug court participants, born to female participants after they graduated or were discharged from drug court, or born in 33 states and territories that did not have data to report. Therefore, the number of drug-free babies born as a result of the services provided in drug courts is likely to have been considerably higher. Federal Appropriations for Drug Courts Federal appropriations for drug courts in 2014 increased by more than 47% over the previous five years. In 2014, 55 Painting the Current Picture: A National Report on Drug Courts and Other Problem-Solving Courts in the United States Figure 14. This figure does not include drugfree babies born after participants were discharged from drug court, fathered by male drug court participants, or born in 33 states and territories that did not have data to report.

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All the data are based on self-reports prehypertension and anxiety discount lasix online visa, and was confirmed only by looking for congruity between the partners in separate interviews blood pressure bottom number high buy discount lasix. I also did an informal check of the self-reports against my personal observations at club meetings and play parties and found no discrepancies pulse pressure high order lasix visa. This group of researchers has either discounted paraphilic relationships (Krafft-Ebing, 1886) or has described such relationships as pathological (Freud, 1938; Money, 1986). I can find no descriptions of relationship dynamics from either group of academic researchers. The duration of the relationship in question ranged from six months to 18 years, with an average of 5. That is, it did not include alternative gender orientations including gay, lesbian, transsexual, or intersexual individuals. Within that sample I used a snowball technique, where in several cases respondent couples reported to their friends their interview experiences and recommended participation in the study to other qualified couples. Prime Role Initial Study Current Study Top 47% 76% Bottom 23% 12% Switch 30% 12% Women Top 21% 18% Bottom 58% 71% Switch 21% 12% Figure 1. Thus a difference in the gender/orientation mix between the original study and the current study is understandable. I further explained that each member of the couple would be interviewed separately, followed potentially by an interview with the two members of the couple together. If there was a positive response, I exchanged contact information or scheduled interviews. At the initial meeting, the research was explained, including the possible risks and benefits of participating and the potential for emotional damage or discomfort. If both members of the couple continued to wish to participate, each partner was asked to sign an informed consent form (Appendix A). Initially the couples selected to be interviewed were to be all genders and gender orientations. I chose to restrict the pool of respondents to fit the convenient base of respondents. It was initially expected that some individuals would be more comfortable answering questions directly to Nadine as a submissive woman. Nadine took parallel notes and interjected questions or asked for clarification as she saw opportunities that I had missed. Her questions, although sparse, were highly significant and made a real contribution to this study. This process turned out to be unwieldy, both in the interview and, more prevalently, in the transcription process. While the taping was presented as optional to the respondents, none declined to be taped. The tapes were transcribed over the course of the study, the transcribed answers were spot checked against the field notes, and the verbiage was used as part of the analysis. The interviews with each individual were conducted using a variation of the form developed by Kinsey and his associates (Pomeroy, 1982). This format allowed for consistency in the questions asked and facilitated rapid recording of field notes so that I could maximize my focus on the answers and any nuances. This approach worked well, and as experience in interviewing was accumulated, it was apparent that a few of the questions did not produce results or needed further elaboration. I then went back to previous respondents and performed a follow-up interview to fill in potential gaps in the data. The interviews started with simple questions such as age and occupation, then moved into lifestyle identification. This provided a forum for 12 the respondent to discuss areas of the relationship that were particularly satisfying, thus ending the interviews on an upbeat note. Initially, after completing the individual interviews, a joint interview of the couple was conducted. I saw little new data from these joint interviews and the joint interviews were abandoned. Upon completion and acceptance of this dissertation and any follow-on studies, the code identifiers will be destroyed by shredding. During the interview process, I watched to see if I could detect any reluctance regarding the taping process.

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