Government of Nepal

Ministry of Communications and Information Technology

Minimum Wages Fixation Committee


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By: M. Kent, M.B. B.CH. B.A.O., M.B.B.Ch., Ph.D.

Program Director, Noorda College of Osteopathic Medicine

The simplest way to understand the British mistake in Northern Ireland is to picture a classroom treatment for strep throat purchase generic baycip on line. The classroom was videotaped as part of a project at the Curry School of Education at the University of Virginia medicine ball generic baycip 500 mg online, and there is more than enough footage to provide a good sense of the kind of teacher Stella is and the kind of classroom she has treatment under eye bags cheap 500mg baycip with visa. Some of the students have actually turned themselves entirely around symptoms 7 days after embryo transfer purchase baycip on line, so that they have their backs to Stella. Maybe she teaches in a school in a poor neighborhood and her students come from troubled families. Maybe her students come to school without any real respect for authority or learning. When the class begins, they are perfectly well behaved and attentive, eager and ready to learn. They only start to misbehave well into the lesson, and only in response to the way Stella is behaving. Stella had the girl from the class reading alongside her as a way of engaging the rest of the students. But the pacing of the back-and-forth between the two of them was excruciatingly slow and wooden. Their view of the book was completely blocked by the little girl standing in front of Stella. We often think of authority as a response to disobedience: a child acts up, so a teacher cracks down. If the teacher is actually doing something interesting, these kids are quite capable of being engaged. Each student was given a copy of the assignment, and the teacher and the class read the instructions aloud together. It is like a waiter in a restaurant giving you the menu and then proceeding to read every item to you just as it appears on the page. A boy sitting next to the teacher raises his hand midway through the reading, and without looking at him, the teacher reaches out, grabs his wrist, and pushes his hand back down. Another child starts to actually do the assignment-an entirely logical action, given the pointlessness of what the teacher is doing. If you were to watch that moment with the sound turned off, you would think of it as Leites and Wolf perfectly applied. If that little boy became defiant, it was because his teacher made him that way, just as Stella turned an eager and attentive student into someone who did cartwheels across the floor. When people in authority want the rest of us to behave, it matters-first and foremost-how they behave. This is called the "principle of legitimacy," and legitimacy is based on three things. First of all, the people who are asked to obey authority have to feel like they have a voice-that if they speak up, they will be heard. There has to be a reasonable expectation that the rules tomorrow are going to be roughly the same as the rules today. Anyone who has ever sat in a classroom knows that it is important for teachers to earn the respect of their students. What is harder to understand, however, is the importance of these same principles when it comes to law and order. We know our parents and our teachers, so it makes sense that legitimacy should matter a lot inside the home or the school. It involves an experiment that has been going on for the past few years in the New York City neighborhood of Brownsville. Brownsville is home to just over a hundred thousand people, and it lies in the eastern part of Brooklyn, past the elegant brownstones of Park Slope and the synagogues of Crown Heights. There are eighteen public housing projects in Brownsville, more than in any other part of the city, and they dominate the skyline: block upon block of bleak, featureless brick-and-concrete developments.

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Even then medications prescribed for depression buy 500mg baycip, substantial reduction in the size and significance of the drug economy will take several decades symptoms enlarged prostate order 500mg baycip amex. What lessons can be drawn from the case of Afghanistan for the involvement of international peacekeeping forces in tackling illicit economies? And how do efforts against illicit economies symptoms 4 dpo baycip 500 mg on-line, such as the drug trade medicine for stomach pain proven 500mg baycip, interact with state-building efforts? Such involvement will antagonize the rural population, which is the center of gravity of counterinsurgency, and inhibit intelligence gathering. For success against illicit economies, it is essential to address corruption and poor governance. Indeed, strengthening good governance is a requisite for counterinsurgency and stabilization as well as economic reconstruction and counternarcotics efforts themselves. At the core of most of these efforts lies a process of building positive linkages between the population and the state. Thus, for example, efforts against illicit economies such as the drug trade should be left only to specialized, constantly-vetted, and closely-monitored law enforcement units. To avoid the temptations of corruption, attacks on police by organized crime and militants, and alienation of the broader population from the police, regular police should be removed from counternarcotics efforts, including interdiction. Instead, broad police reform should be geared toward building trust so the population can see official law enforcement as a legitimate state representative delivering essential security, order, and justice. Embracing policies against illicit economies without paying close attention to their complex and multiple political effects can lead to counterproductive entanglement in local disputes, especially in places where the complexity and intensity of tribal, ethnic, and regional tensions and other local cleavages overlay the illicit economy. Illicit economies are deeply embedded in local social and political arrangements, especially where legal economies, official political arrangements, law enforcement capacity, and overall state presence are weak. Without recognizing this social embeddedness, policies to tackle illicit economies easily turn counterproductive and generate negative externalities and unanticipated second and third order effects that can negatively reverberate in other domains and within other networks. Nonetheless, peacekeeping and counterinsurgency forces do have a large and, indeed, fundamental role in reducing illicit economies-delivering security. No matter what counternarcotics efforts will be undertaken, be they iron-fisted eradication or alternative livelihood, they will not be effective in reducing the illicit economy unless firm security throughout the entire territory has been established. The state needs to be strengthened and conflict must be ended before efforts against illicit economies, such as large-scale eradication of illicit crops, can be achieved. International peacekeeping forces need to understand that the more the legal economy in the theater of intervention is destroyed, the more robust and deeply ensconced the illicit economy will be. Expanding the mission of international peacekeeping forces beyond the provision of security to direct efforts to reduce illicit economies and corruption demands that the international peacekeeping forces have a very detailed understanding of the intricacies of the local illicit networks and economy and their nexus to violent conflict, to the political and socioeconomic structures in the country, and to peace. Accordingly, enlargement of the traditional, more limited role of peacekeeping forces requires that the mission has a continual and robust information-gathering component that constantly monitors the effects of the policies against illicit economies on the political and economic distribution of power and on stability and development. It is therefore important to provide the peacekeeping forces with a robust analytical support component that would include economic, agricultural, and anthropology experts. But it is also important to recognize that the staying power of the international peacekeeping forces will always be inherently limited and that efforts to suppress illicit economies will only be sustainable if the population and its political representatives have the economic and political incentives to support such policies. Regarding nonmilitary operations, such as economic reconstruction, it is vital that the international community scale down its expectations of how rapidly legal economies can replace illicit ones. Even when the basic economic infrastructure is present and intact, the growth of the legal economies may well coincide with the continuing flourishing of the illegal enterprises. Moreover, a seeming success in suppressing an illicit economy in a particular region can easily lead to its transformation into a differently-organized illicit economy, which could be no less dangerous to the state and possibly the larger international community than the original economy. Nonetheless, efforts to boost licit livelihoods represent the only available source-country option to reduce illicit economies without resorting to substantial, lasting, and costly repression. Counternarcotics efforts are indeed a key component of stabilization and reconstruction in Afghanistan and in any country where licit livelihoods have been decimated and an illicit narcotics economy thrives and intermingles with violent conflict. However, premature and inappropriate efforts against such an illicit economy, be it drugs or other commodities, greatly complicate counterterrorism, counterinsurgency, and stabilization objectives. Hence, they ultimately also jeopardize economic reconstruction and political consolidation. Weighs Role in Heroin War in Afghanistan," Boston Globe, October 20, 2004; and Michael E.

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Dermatitis Skin inflammation from a variety of etiologies (both known and unknown) has been treated in the past by using low dose treatment wrist tendonitis buy discount baycip 500 mg line, very superficial radiation or Grenz rays medicine keri hilson lyrics purchase genuine baycip. The use of radiation for this purpose is reserved for cases refractory to non-radiation measures treatment 8th february discount baycip 500 mg with visa. Policy: Cases require medical review to confirm alternative approaches have been exhausted treatment abbreviation discount 500mg baycip amex. Desmoid Tumor Also known as aggressive fibromatosis or deep musculoapeuronotic fibromatosis, a desmoid tumor is a histologically benign connective tissue tumor with a high recurrence rate after resection. Most common sites are trunk, extremity, abdominal wall, and intra-abdominal sites, including bowel and mesentery. Surgical resection with negative surgical microscopic margins in the treatment of choice for most. Radiation therapy is indicated for inoperable cases, and may be used in conjunction with surgery and chemotherapy. Fractionated radiation therapy in excess of 50 Gy is needed for control, which may preclude its use in those of intra-abdominal location. Radiation therapy is useful, especially in the earlier stages of development, and has been demonstrated in prospective clinical trials. Typical treatment is with photon beam therapy using, at most, complex treatment planning, or with electron beam therapy in ten or fewer fractions. Eczema There is little support in the recent American literature for the use of ionizing radiation in the treatment of eczema. Eosinophilic granuloma (see Langerhans cell histiocytosis) © 2019 eviCore healthcare. The follow-up of treated patients has been shorter than necessary to establish fully long-term efficacy and safety. Policy: Cases will require medical review, including documentation that medical management has been exhausted and unsatisfactory. Erythroplasia of Queyrat this in situ form of epidermoid carcinoma involves the mucosal or mucoepidermoid areas of the prepuce or glans penis. While radiation treatments were used in the past, as Erythroplasia of Queyrat is non-invasive, its treatment can be managed with a non-radiotherapeutic approach using topical agents. The entity is discussed in the non-cancer policy due to historical references to its being a benign condition. Radiation therapy is necessary in those cases in which medical management is ineffective or otherwise contraindicated. Fibrosclerosis (sclerosing disorders) Unifocal and multifocal episodes of sclerosis have been treated in the past using radiation therapy. Sites reported include retroperitoneum, mediastinum, bile ducts, thyroid, meninges, orbits and others. While anecdotal reports of improvement have been reported, radiation therapy is generally regarded as ineffective and should not be used. Fungal infections (see Infections, fungal) In the 1940s and 1950s xrays were not infrequently used to treat tinea capitis and other skin fungal infections. In the modern era of available pharmacologic agents for the treatment of fungal infections, the benefit of use of radiation therapy is outweighed by the risk of carcinogenesis. Gas gangrene Before the discovery of antibiotics, radiation therapy was used to treat open wounds to prevent infections, and reports exist that this was of benefit. Giant cell tumor of bone (osteoclastoma) Once thought to be a benign disorder, these tumors are best regarded as malignant with a potential for metastasis. Surgery is the initial treatment of choice, but many osteoclastomas arise in bones (spine and pelvis) in which surgical resection would be unnecessarily debilitating. Local control with radiation is reported in the 75% to 85% range and can be administered safely using modern era equipment. Gorham-Stout Syndrome (disappearing bone syndrome) Also known as phantom bone, this entity is characterized by a destructive proliferation of endothelial-lined sinusoidal or capillary proliferation that may or may not be progressive, causing bone destruction most commonly in the pelvis or shoulder girdle that results in a functional deformity. Carefully selected cases that do not respond to medical measures may be improved with the use of carefully administered conformal radiation. Gynecomastia In the older era of orchiectomy or the use of diethylstilbestrol for the treatment of metastatic or locally advanced prostate cancer, it was commonplace to irradiate © 2019 eviCore healthcare. In the modern era of chemical androgen deprivation for the treatment of prostate cancer, the use of modest doses of radiation to the breasts may arrest or prevent the resultant gynecomastia and is medically appropriate.

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