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Associate Professor, Lewis Katz School of Medicine, Temple University
A comparative study of the historical documents and modern findings concerning pitches and string tensile strength on harpsichords and clavichords medicine 93 generic zofran 8mg visa, with focus on Swedish sources and keyboard instruments medicine grace potter cheap 4 mg zofran with mastercard. An authoritative and detailed study of wire used on 17th- and 18th-century harpsichords treatment 20 initiative discount zofran 8 mg mastercard. Topics discussed include alloy composition medications covered by medi cal buy discount zofran line, gauge measurements, and tensile strength. Published in the second volume of a monograph series in honor of Frank Hubbard (1920 1976). An extensive study of string measurements, materials, densities, and tensions on 130 keyboard instruments from the period. Appendices offer formulas for string tension and diameter calculations, as well as wire data sheet templates. Presents the original French text and an English translation of Chapter Twenty-One on stringing, leading to a discussion on the stringing, scaling, and pitch in 18th-century French harpsichords. The graph on safety margins of the Dumont/Taskin harpsichord (1789) in Figure 9 (p. A scientific analysis of the elements of harpsichord design, with particular attention to 120 string behavior, soundboard bebavior, string-soundboard coupling, soundboard, strings, and plucking point. Concerns the techniques of cleaning the wood and the water-soluble paintings on two harpsichords built and rebuilt by Taskin in the Russell Collection in Edinburgh, with discussion on the early decorative work done on the instruments and the challenge of restoring of painted soundboards. Using a descriptive approach, this article discusses the basic theories concerning harpsichord physicis and acoustics, with coverage on the strings, soundboard, as well as case and body resonance. Reports on a large-scale experiment on the response curves and modes of vibration of nineteen original and several modern harpsichords. A solenoid-operated machine that can "play" the harpsichord by remote control was designed for and being used in this project. The data obtained from the Italian harpsichords is different from the Northern ones. An excellent survey on the Italian, Flemish, French, German, and English schools of 121 harpsichord decoration. Discusses the cultural and intellectural ideas reflected in mottoes and mythological paintings on original harpsichords. Includes a checklist of harpsichord mottoes found on 16th- through 18th-century instruments or their depictions in contemporary paintings. Discusses the "intellectual backgraound and context" of mottoes inscribed on harpsichords in the Renaissance and Baroque periods. Includes a selective checklist of seventy-four Latin mottoes that appear on keyboards from the 16th through 18th centuries. Discusses the technique of laying and decorating papers as well as painting mottoes on modern instruments made in the style of the Ruckers family. Gives detailed, practical instructions on painting and marbling new and renovated harpsichord cases. Published in the fourth volume of a monograph series in honor of Frank Hubbard (19201976). Contains findings and identification of wood samples taken from different parts of several 17th- and 18th-century keyboard instruments. Fellowship of Makers and Restorers of Historical Instruments Quarterly 6 (1977): 1826; 7 (1977): 1624. Discusses the evidence of medieval tradition in the practice of transpositions to the fourth or fifth in 16th- and early 17th-century keyboard instruments. Patents for Inventions: Abridgements of Specifications Relating to Music and Musical 123 Instruments A. Entries related to harpsichord include: action and construction, jacks, keyboards, plectra, stops, and wrest pins. Discusses several systems of stop mechanisms found on 18th-century two-manual harpsichords, including the English machine stop, the lid swell and the Venetian swell, as well as the knee-lever mechanism. Discusses the use of C short octave in Italian plucked string keyboard instruments. The earliest evidence of this device can be found in a 1523 virginal and in harpsichords built in the 1530s. An overview of the factors involved in harpsichord acoustics, including strings, bridge, soundboard, air, and the interaction of these components.
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And 268 Prevention Of Myopia: Method Teat Succeeded yet practically all of these cases could be cured and the development of new ones prevented by the daily reading of the Snellen test card medicine in motion purchase 8mg zofran with visa. Why should our children be compelled to suffer and wear glasses for want of this simple measure of relief? In fact medications known to cause hair loss zofran 4 mg free shipping, it would not be necessary medicine yoga generic zofran 4 mg, in some cases treatment west nile virus discount zofran 4 mg amex, as in the schools of New York City, even to purchase the Snellen test cards, as they are already being used to test the eyes of the children. Not only does it place practically no additional burden upon the teachers, but, by improving the eyesight, health, disposition and mentality of their pupils, it greatly lightens their labors. If there is still thought to be need for further investigation and discussion, we can investigate and discuss just as well after the children get the cards as before, and by adopting that course we shall not run the risk of needlessly condemning another generation to that curse which heretofore has always dogged the footsteps of civilization, namely, defective eyesight. I appeal to all who read these lines to use whatever influence they possess toward the attainment of this end. This takes no appreciable amount of time, and is sufficient to improve the sight of all children in one week and to cure all errors of refraction after some months, a year, or longer. Children with markedly defective vision should be encouraged to read the card more frequently. Children wearing glasses should not be interfered with, as they are supposed to be under the care of a physician, and the practice will do them little or no good while the glasses are worn. While not essential, it is a great advantage to have records made of the vision of each pupil at the time when the method is introduced, and thereafter at convenient intervals- annually or more frequently. The records should include the name and age of the pupils, the vision of each eye tested at twenty feet, and the date. At least once a year some one who understands the method should visit each classroom for the purpose of answering questions, encouraging the teachers to continue the use of the method, and making some kind of a report to the proper authorities. At a social gathering one evening, a lady told me that she had met a number of my patients; but when she mentioned their names, 1 found that I did not remember any of them and said so. They made a kind of game of the treatment, and the progress of each school case was watched with the most intense interest by all the children. On a bright day, when the patients saw well, there was great rejoicing, and on a dark day there was corresponding depression. One girl cured twenty-six children in six months; another cured twelve in three months; a third 270 Apparent Blindness Cured 271 developed quite a varied ophthalmological practice, and did things of which older and more experienced practitioners might well have been proud. Going to the school which she attended one day, I asked this girl about her sight, which had been very imperfect. The next day she had moved it a little farther away, and so on, until the patient was able to read it from the back of the room, just as the other children did. Emily now told her to cover the right eye and read the card with her left, and both girls were considerably upset to find that the uncovered eye was apparently blind. She told the patient to cover her good eye and go up close to the card, and at a distance of a foot or less it was found that she could read even the small letters. The little practitioner then proceeded confidently as with the other eye, and after many months of practice the patient became the happy possessor of normal vision in both eyes. The case had, in fact, been simply one of high myopia, and the school doctor, not being a specialist, had not detected the difference between this condition and blindness. The school doctor had said that there was no help for this eye except through operation, and as the sight of the other eye was pretty good, he fortunately did not think it necessary to urge such a course. She had the patient stand close to the card, where, with the good eye covered, she was unable to see even the big C. Emily now held the card between the patient and the light, and moved it back and forth. At a distance of three or four feet this movement could be observed indistinctly by the patient. The card was then moved farther away, until the patient became able to see it move at ten feet and to see some of the larger letters indistinctly at a less distance. Finally; after six months, she became able to read the card with the bad eye as well as with the good one. After testing her sight and finding it normal in both eyes, I said to Emily: "You are a splendid doctor. Finding that the sight of the crossed eye was very poor, so much so, indeed, that poor An Astonishing Record 273 Mamie could see practically nothing with it, the obvious course of action seemed to her to be the restoration of its sight; and, never having read any medical literature, she did not know that this was impossible. She had Mamie cover her good eye and practice the bad one at home and at school, until at last the sight became normal and the eye straight. The school doctor had wanted to have the eye operated upon, I was told, but, fortunately, Mamie was "scared" and would not consent.
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Administrative choices in setting Medicaid eligibility standards and enrollment arrangements Studies suggest that individuals and families place great value in the Medicaid program (Stuber et al treatment variable buy zofran 8mg line. At the same time symptoms of depression 4mg zofran mastercard, research also suggests that the manner in which states administer their programs creates serious problems of stigma medications voltaren order zofran mastercard. The stigma perceived by families can be traced to how they are treated by two distinct groups: the individuals who enroll them in the program (and the settings in which they work) and healthcare providers (discussed below) symptoms 2dpo zofran 8 mg discount. Although Medicaid contains a number of specific requirements related to program administration, states also have broad latitude in how 27 Indeed, in discussing specialist referrals with physicians in practice at federally funded community health centers, the author has heard on innumerable occasions about the difficulties these physicians have in locating specialists who will accept and aggressively manage their referrals as a result of financial and other considerations. A state can extend Medicaid to the entire lowincome population regardless of disability, age, work status, or the presence of dependent children. Federal financial participation is available for all low-income individuals other than non-elderly, non-disabled adults without children. In other words, with the exception of childless, working-age adults, federal financial participation can be claimed for all lowand moderate-income children and adults, thereby removing the perception that Medicaid is only for welfare recipients and families that choose not to work (Rosenbaum and Rousseau, 2000; Schneider et al. Applications can be extremely short in any state that elects to determine eligibility on the basis of income alone. Other than proof of legal status or citizenship, program rules require virtually no written verification or documentation of eligibility factors. Enrollment periods can be set to last for a duration of 12 months, with full federal financial participation available for children regardless of any change in eligibility status during the 12-month period. Redeterminations of eligibility can be accomplished completely by mail, using "passive" procedures that automatically renew coverage in the absence of evidence to the contrary. In short, a state can design its program to virtually eliminate all of the stigma-producing events that arise from the eligibility, eligibility determination, and enrollment process itself. Furthermore, the federal government in recent years has been relatively generous about granting states the authority to conduct federally funded demonstrations that de-categorize program eligibility (Rosenbaum et al. The leader in this effort to transform Medicaid from a "welfare piggyback" program to a true public insurance program has been Medicaid, whose program now serves individuals without access to employer coverage, as well as persons who need subsidization in order to secure benefits available through their employers. States that have taken active steps designed to produce destigmatizing program structures that move Medicaid away from welfare and toward a more neutral public insurance stance are Oregon, Tennessee, Arizona, and Rhode Island. At the same time, many states retain a dated version of Medicaid, strictly limiting coverage and enrollment options and forcing the program to run like welfare. This choice helps perpetuate attitudes and beliefs on the part of provid- Copyright National Academy of Sciences. Administrative choices in payment of Medicaid providers It is perhaps safe to say that the best-known problem plaguing the Medicaid program is its notoriously low payment rates. First, low rates make it impossible for any provider but those that are heavily dependent on Medicaid revenues. The loss of revenues as a result of steep contractual allowances is simply so steep that any significant level of participation becomes economically out of the question for other than small classes of providers. This excuse is particularly available to urban healthcare providers who are plentiful in number to the point of saturation in more affluent communities. As Table 2 illustrates, because of the high concentration of minority individuals in the poorest large city neighborhoods, this refusal to participate also has its greatest adverse impact on minority beneficiaries who ultimately are starved for access in the midst of plenty. Table 2 shows the marked racial and ethnic patterns of urban poverty in the largest cities. While the concentration of urban poverty increased for all races between 1970 and 1990, by 1990, 83% of all urban AfricanAmerican poor persons resided in census tracts that could be labeled as poor, while nearly 42% resided in high-poverty census tracts. Latino poverty concentrations were somewhat less pronounced but decidedly elevated above overall rates. The failure of Medicaid programs to include capital payments in their compensation rates to safety net providers that so frequently anchor poor communities seriously limits their ability to engage in the level of renovation, facility and practice improvement, and overall technical upkeep that is essential to maintaining a safe and good quality healthcare environment. Building space essential to the expansion of capacity (along with greater employment opportunities in poorer neighborhoods) cannot be added. And finally, the recruitment of personnel and health professionals becomes even more difficult because of the depressed working conditions.
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