I am also going to emphasize the Crown (the chrysanthemum) and the army (the star in the title of my paper) erectile dysfunction is often associated with order 200 mg red viagra with amex, not the navy (the anchor) erectile dysfunction 19 year old male generic 200mg red viagra overnight delivery. The End of the Samurai as a Caste Armed forces erectile dysfunction testosterone order red viagra 200mg with visa, De Gaulle once said erectile dysfunction treatment brisbane order red viagra 200mg otc, constitute the "most complete expression of the spirit of a society hypogonadism erectile dysfunction and type 2 diabetes mellitus buy red viagra 200mg low cost. I t would not d o for the samurai to know the martial and civil virtues without manifesting them erectile dysfunction caverject injection red viagra 200 mg fast delivery. As a Japanese police official reported on the landings, "[We] knew we could not control these people. Once the last Shogun gladly surrendered his secular powers to the boy emperor in 1867, there ensued the vital phase known as Meiji Z. T h e motto of the nation-makers and rapid-fire modernizers was Fukoku kvohei-Military Strength and Prosperity, the latter clearly presupposing the former. T h e first order of business was to centralize and solidify the political system by demolishing the system of the fiefs and replacing them with prefectures-a dangerous business when the government could rely upon an Imperial Guard made up of no more than 8,000 loyal clansmen, in an ocean of perhaps 400,000 dispossessed samurai. During the delicate process of this revolution from the top, the exclusive military class and the vestiges of feudalistic prestige-ranking were extirpated systematically and "order was brought out of confusion. While the warriors were being transformed from a leisure class to a productive class, the commoners were granted new rights. They were allowed (and eventually ordered) to take family names for the first time, to travel on horseback on public highways, to manage their own farms, t o intermarry with nobility, and to wear garb hitherto reserved for the warrior^. If we were t o select the best of them, provide them easy-to-use weapons and equipment, and give them group training, they would d o well against foreign enemies. G But when the French-tinged conscription law of 1873 was promulgated, opposition raged on several sides. Certainly obligatory national service would undermine o r at least prove incompatible with the legacy of elitist R i d d o. Many of the proud samurai had expected that national defense would rest on their shoulders, even under the new system. To these arrogant, self-interested warriors and to not a few government officials, i t seemed ridiculous, naive, and blasphemous to entrust vital military duties to "lowly clods" of dubious loyalty, bravery, and ability. As one Japanese said, "It was as if dogs and cats were to become the equal of h ~ m a n s. Those who could afford it took advantage of a monetary provision for lifetime exemption from service. Others used the loopholes, such as study in professional schools at home or abroad, service as an official, or exemption a s an eldest or only son o r head of household. A favorite ploy among students was to develop a sham cardiac condition by imbibing bottles of soy sauce on the morning of the draft physical. By 1889, it is estimated, 35,600 men were running away per year, or about 10% of the draft-eligible males. Pamphlets appeared on the subject of draft evasion, and it is said that some individuals began to pray t o gods who possessed the supposed capability of "saving" them from military service. Rumors that unmarried women would also be subject to the draft caused a large-scale rush into marriage. When one elite artillery 40 battalion evinced "spiritual weakness" during the serious Takebashi mutiny of 1878, 53 soldiers were executed and 210 were jailed, flogged, caned, or banished. In part because "the movement for popular [rights] is spreading," the army in 188 1 organized a military police force (kempei) to keep service thought under administrative surveillance. The power to enforce controls on criticism of the government and to combat "highsounding ideas and empty theories" was transferred from the Education Ministry to the Ministry of Home Affairs, with a strong civil police force organized along paramilitary lines. These organs were buttressed by the issuance of Admonitions to the Armed Forces (1878) and of the famous Imperial Precepts of 1882. This is because it achieves elevation of the national prosperity and paves the way for firmness of character. We believe that any person in charge of training cultivates good soldiers; also he makes good citizens. The Emperor Meiji was easily prevailed on to go out into the country, widely and often, for what we would call "P. Meiji was the first reigning monarch to travel personally from one end of the realm to the other. In 1882, the old exemption rules were abolished, and neither official duty nor monetary payments were accepted in lieu of service. Despite several changes, the basic draft laws of 1872-73, institutionalized by the constitution of 1889, remained the law of the land until the overhaul of 1927. The governors were directed to cxplain the "object and import" of conscription, but unhappiness lingered among draft eligibles and their families, especially among those lads who would have to interrupt an apprenticeship or leave an undermanned farm, or who were trying to pass the entrance exams for secondary school or the university. It is said that a certain college in the Tokyo area became a sanctuary for far more students than its capacity, if only the young men paid the tuition and enrolled as applicants in the prep school, preferably without attending any classes. At first, conscription was restricted to the Tokyo area; in 1874, the draft was extended to Osaka and Nagoya. The 9mallness of the original army (about 32,000 men in a standing force 41 of six garrisons by 1876) would prevent most of the samurai (who but they, indeed But while, from the outset, it was asserted that the officer corps was open to all men of ability, this was long as much a principle as a practice. Certainly ex-samurai, with their tradition of learning, were not excluded from officering the new army. Clansmen from Choshu and Satsuma (the most important ancient provinces) and from Tosa and Hizen (next in importance) staffed the highest military positions, rather carefully balanced in the early days. Nor should it be forgotten that Yamagata Aritomo was the key personage in the Meiji military, while Ito Hirobumi was the leading figure in the civil government. Both came from Choshu, and it was unthinkable that, whatever their differences in opinion, they would allow the army to break away from its cooperation with the government. We know that, during a cabinet crisis in 1891, when Ito (who was not disinterested) was asked about finding successors for the service ministers who had resigned, he refused, thus preventing the possibility of civilian ministers for the armed forces. Building on the military advice provided by the French and later the Prussians, the reorganized national army proceeded to win enormous successes over foreign foes: Imperial China (1 894-95), the Boxers (1900), and Tsarist Russia (1904-05). All of these remarkable victories occurred only 40 to 50 years after Perry landed in Kanagawa. The New Military and the Soldiery The: burden of conscription was borne, in practice, mainly by impoverished farmers and the urban poor-10,000 men of the 300,000 or 400,000 who reached draft age each year. As Takata has said, the provisions for deferment and exemption became almost empty words, so far as the destitute were concerned. But the Meiji leadership insisted that success in the army, as in other national pursuits, would depend solely on ability and effort, regardless of social origin. Thus the offspring of middle-class farmers might rise to become high school principals or general officers, by means of government-subsidized normal schools or military academies. To the founders of conscription, military service was regarded as "an integral part of the national educational process": ". I6 There can be no doubt that military service exerted remarkable effects on the Japanese recruit, especially the peasant introduced suddenly to the urbanized garrison town. The first national soldiers were dressed in narrow-sleeve kimonos and loose trousers, wore the topknot, and carried swords in their sashes. Some of the early recruits regarded the barracks stoves as gods of fire, and bowed to them each morning. A goodly number from rural areas were bewildered by such Western accoutrements as army cots, chairs, desks, toothbrushes, forks, and knives. By 1907, the army was eating about 18 times as much meat as did the civil population. A poll of recruits conducted in 1892 disclosed that 70% called army food better than what they were accustomed to at home. In 1909, at a hospital for disabled soldiers, the weekly menu consisted of eggs (8 times), beef (3 times), pork and pork cutlets (once each), and fish (8 times), in addition to liberal helpings of rice and vegetables. Hokkaido whale meat was also canned, with the added inducement that it was reputedly good in combating lung troubles. The huge needs of the Russo-Japanese War stimulated the development of the canning industry, which was by now processing fruit, vegetables, milk, and seafood, salmon and trout being the most popular fish fare. Of a recruit sample polled in 1892, 8 % smoked and 12% drank when they entered service; but, from the same group, 9 0 % drank and 80% smoked when they left the army. Soldiers also stimulated a taste for beer, although the majority of the populace had found the drink to be bitter. A local breakthrough was achieved during the army maneuvers of 1892 at Utsunomiya, when a brewery from Yokohama "rushed to the spot with its wears [sic]," in the words of a chronicler, "and reputedly made a killing. Although the soldiery were allegedly affected adversely by the "unwholesome" and "extravagant" life in the cities, a few somehow managed to save money in postal accounts. Still, it was probably the first monthly pay- 43 ment the inen had received in their lives. I n appraising the early impact of the Merji military upon society, it may be straining matters in a quest for significance to speculate, as one Japanese historian has done, that "the walking habits of soldiers very likely caused many ordinary people to walk i n a more orderly fashion. For example, knit socks had to be imported in huge numbers and at great expense until Japanese makers could produce them. Eventually, Japanese cotton spinncrs ousted Indian cotton yarn from external Asian markets as well, and the Japanese spinning industry became the most prosperous in the world. It has, in fact, been said of modern Japan that, without exaggeration, "all factory industry was built with a military significance. While these influences cannot be denied, study of Japanese sources reveals internal ramifications profoundly affecting Japanese society. T h e first point to be made is that the tightened military conscription law had wiped out the traditional safeguards of the family system. Patriotic duty was understandable, in defense of the principle of Chi/ (Imperial loyalty); but something had to yield in case of conflict between allegiances. Some Japanese scholars believe that interest in the country was shaken by individualistic thinking which stemmed from this period. Impersonal military service was marked by iron discipline and cruel physical punishments for the smallest infractions, especially on the part of new soldiers and "misfits" such as physically and psychologically weak intellectuals. Critics spoke of the "mechanical, isolated life of the army," which stifled originality, ruined initiative, and was characterized by unreality and nonsense. According t o the Niroku newspaper Y R 19 10, the reported military suicides per year had increased from 75 in 1900 to 92 in 1907. The number of army suicides had now reached 10% of deaths from illness; the cause was usually given as "mental derangement. According to one newspaper in Aomori, figures for thc Hirosaki Division in 1905 revealed that 1,521 soldiers had fled in the homeland, and 170 overseas. Not only were individual desertions on the rise, but there were also cases of mass flights. In March 1908, 32 men of the 1st Division, resenting "excessively hard training" by an acting company commander, brazenly marched out the barracks gate, saluted by unsuspecting sentries. T h e government, not cntirely incorrectly, saw the hand of socialists behind the waves of antimilitarism and draft dodging. But there is no doubt that the worst antagonisms developed after the Russo-Japanese War, between the civilian populace and the "returning (3. Rough and brutalized, many of these veterans were disliked and feared by the townsfolk and villagers as "disturbers of thc peace. Certainly this must have been the most cnlightcned period in the history of the modern Japanese army. T h e rapport between Throne and services contributed greatly to the strengthening of the Imperial system of government, as did the insulation of the army from activist ideologies. A number of devices were contrived whereby the government and the high command could bind the military to the patriarchal monarch, as "His army":2F 1. Membership in the Imperial Family was made prerequisite to certain high appointments, such as Chief of General Staff (1 8 8 6). Through economies in the Imperial Household, special Imperial grants were made to the armed forces, even to the extent of assisting the navy with warship construction when the Diet would not allocate the desired funds to the navy (1887, 1893). T h e basic Imperial Precepts to Soldiers and Sailors was issued in 1882, interpreted to mean that the military were Imperial favorites. Our relations with you will be most intimate when We rely upon you as Our limbs and you look up to Us as your head. Inferiors should regard the orders of their superiors as issuing directly from Us. T h e Emperor, as Generalissimo, was by law the locus of the Supreme Command Prerogative, placing him perwnally at the apex of the chain of cornmand, parallel to but outside of the civilian hierarchy. According to the Meiji Constitution, the "sacred and inviolable" Emperor determined the organization and peacetime standing of the armed forces, and possessed cole power to declare war, make peace, and consummate treaties. T h e armed forces were especially pleased by the fact that the Emperor rcviewed the troops, attended all field maneuvers (in the worst of weather), often visited military schools and installations, and awarded prizes to honor graduates. Yamagata instituted the system whereby Imperial operational orders were not countercigned as were civil cabinet orders. Therefore military orders from the Palace were regarded as absolute and personal instructions from the sovereign in his capacity as Commander-in-Chief. All of this inculcation of the mystical piety that the armed forces were a private army of the Crown, entailing blind, religious obedience to the Son of Heaven was an extremely important tool in the hands of military leaders who regarded themselves as outside the control of party organs. Fukushima aptly suggests that "it was a case of a monarchy which could not fit into the system of constitutional government, and armed forces which could not modernize themselves, existing in a relation of mutual d e p e n d e n ~. Consequently, Japan did not produce d o y e n s able to bear the burden of political responcibility i n a modern n a t i o n - ~ t a t. What was useful to the armed forces was retained and expanded; what was restrictive was ignored or discarded. I n consequence the Emperor not only lost his charisma as an absolute monarch but was steadily divestcd of the role o f constitutional monarch who is close to the pcoplc. In particular, the Supreme Command Prerogative proved to be one of the strongest forces exploding military interests away from the civilian government embodied in the cabinet system. The National Association of Chambers of Commerce, for one, criticized the scale of military budgets and tamed the armed forces a nonproductive element in society. In the Diet interpellations of December 19 1 1, a Representative plied the government with 17 detailed and critical questions ranging from the need for military secrets to the strategic plans of the armed forces.
Vitamin D can be obtained through dietary supplementation and through direct cutaneous synthesis from exposure to sunlight erectile dysfunction drugs in homeopathy cheap red viagra 200mg on-line. Breast fed Infants For exclusively breastfed or partially breastfed infants: Breastmilk is not typically sufficient in vitamin D erectile dysfunction medicine from dabur red viagra 200mg overnight delivery. Because most formula-fed infants ingest nearly 1 L (approximately 30 ounces) of formula per day after the first month of life erectile dysfunction treatment doctors in hyderabad generic red viagra 200mg with mastercard, they will achieve an adequate vitamin D intake each day erectile dysfunction treatment after radical prostatectomy 200 mg red viagra visa. Supplementation should be continued until the infant is taking 1L per day of infant formula or is weaned after 12 months to vitamin D fortified whole milk impotence young male discount 200mg red viagra amex. Iron deficiency may result in cognitive and behavioral problems impotence tumblr order red viagra 200 mg without a prescription, some of which may be irreversible. Infants born prematurely or to mothers with a history of diabetes, hypertension or anemia may have lower than normal iron stores. The recommendation for iron supplementation in exclusively breastfed infants is controversial. Breastmilk remains the ideal nutrition for infants for the first 6 months of life. In addition, iron in breastmilk is more bioavailable than that in iron-fortified formula. Because of this, most exclusively breastfed babies do not need any additional nutrient or iron supplementation until 6 months of age. By 6 months, infants should be introduced to iron fortified foods (cereal or meat) or an iron containing multivitamin. If the infant was premature or born to a mother with a history of diabetes, hypertension or anemia, they may need supplementation by 4 months. In partially breastfed infants who receive more than one-half of their daily feedings as breastmilk, they should also receive 1 mg/kg per day of supplemental iron if they are not receiving iron-containing complementary foods. For formula-fed infants, their iron needs can be met by their formula which contains about 12 mg of iron per liter and the introduction of iron-containing complementary foods at 4 to 6 months of age. P a g e 249 Complementary foods that are a good source of iron include iron-fortified single grains cereals (such as rice, oatmeal, barley) and pureed meats. Suggestions for Learning Activities: Students can role play giving anticipatory guidance about this topic. Students can be asked to go to local pharmacy or retail baby supply store to look at different options of supplements that parents have to choose from. Students can be given scenarios after discussion to determine what supplements infants should be given. American Academy of Pediatrics, Section on Breastfeeding and Committee on Nutrition. A five-year-old boy is now at the 95th percentile for weight and 50th percentile for height whereas previously he had been at the 50th percentile for both height and weight. Striae- Areas of linear skin thinning and erythema associated with rapid skin stretching. Non-alcoholic fatty liver disease- Deposition of fat into the liver and elevation of liver enzymes, generally associated with being overweight. Review of Important Concepts: Historical Points Children should be their thinnest from about 4-6 years of age as they tend to gain more height than weight during this time. It is normal for a child to look skinny and for parents to be able to count ribs in this age group. Many parents feel that their normal child is too thin or fail to recognize that their "normal" looking child is actually obese. Families with parental obesity may show more concern about weight gain, or conversely may be more likely to try to normalize the excess weight. Dietary history should assess food choices at meals and snacks, fluid types and amounts, and portion sizes. Consider asking about: excess thirst/urination as a screen for Type 2 diabetes, night breathing difficulties as a screen for obstructive sleep apnea, limp as a screen for slipped capital femoral epiphysis, and signs and symptoms of depression. Knowing the trend on the growth chart is more important than knowing the actual numbers. It is frequently difficult to identify a child who is overweight or mildly obese just by looking at the child. In a child whose development is otherwise normal and linear growth is not delayed, it is unnecessary to screen for causes of obesity other than excess caloric intake. Obese children are more likely to suffer from depression and other mood disorders, have obstructive sleep apnea, develop insulin resistance or even Type 2 diabetes in childhood, and have non-alcoholic fatty liver disease. Obesity in children, as with adults, is a complex and difficult condition to treat and should be considered a chronic condition. We can manage side effects but obtaining long term stable weight loss is difficult. The most effective programs engage the entire family in behavior change by having family meals, healthier food choices in the home, engaging in physical activity together and monitoring more frequently than once a year. In children who are obese but still growing taller, the goal would be decreased weight velocity or weight maintenance to help them "grow into" their weight. If the child was significantly overweight or had complications, then gradual weight loss would be recommended. Adolescents who are no longer gaining height can work on gradual weight loss, up to 2 pounds per week if they are experiencing complications from their obesity. Given that he has maintained his linear growth at the 50th % it is unlikely that he has some other disease process causing his weight gain. Suggestions for Learning Activities: Review how to plot height/weight on a growth chart and interpret the results. Review the medical complications of obesity that can be seen in children and how they persist or progress in adulthood. Discuss any state or local initiatives related to childhood obesity in your area (school lunch changes, limits on sugary beverages/snacks in schools, etc). Review some simple tools for giving anticipatory guidance related to maintaining a healthy weight. For example 5-2-1-0: Each day get 5 servings of fruits and vegetables, 2 or fewer hours of screen time, 1 or more hours of physical activity, 0 servings of sugary beverages. The health conscious parents of a healthy, non-obese 15-month-old ask if they can switch her to nonfat milk, as they are concerned about obesity and heart disease. Definitions for Specific Terms: Full fat dairy- Dairy products which have not had fat removed from them during processing. Reduced fat milk- Milk with only 2% fat Low fat milk- Milk with only 1% fat Review of Important Concepts: 1. The second year of life is one of rapid physical and neurologic growth needing myelination of brain cells, requiring relatively large amounts of calories per kg of body weight compared to adults. Full fat dairy allows toddlers to get more calories in smaller volumes, important as they can be scattered and low volume eaters. Dairy fat restriction could be considered for a child who is overweight or has a very strong family history of obesity as these would be risk factors for hyperlipidemia later in life. Historical Points Ask the parents to elaborate on their concerns and review family history for significant obesity, heart disease or hyperlipidemia. Toddlers can have "food jags" either of quantity or content They will eat very small amounts of food for a time then eat large amounts, or eat one food excessively for a while then refuse to eat it. Review developmental milestones Toddlers become ambulatory and begin to burn more calories through activity (but less through growth) than in the first year. Important to review the growth charts (weight, height, and head circumference) and which percentiles the child is following. She is not currently obese but has she been having rapid weight gain compared to length Basic neurologic exam looking for any developmental delay that might impact caloric needs. Children who are less active due to hypotonia or delayed gross motor skills may have lower caloric needs. In young children, obesity rather than dietary composition alone seems to be a stronger risk factor for atherosclerotic changes at a young age. When should you check lipid levels on this child if the parents are worried about heart disease There are no recommendations to routinely check children less than 2 years of age. If there was a strong family history of a genetically mediated hyperlipidemia syndrome with premature death then it might be reasonable to check a child this young. There is some evidence that lipid levels can be volatile and a single elevated number may not consistently remain elevated in an untreated child as it would in an adult. Child should remain on whole fat dairy until 2 years of age to support caloric needs for growth and development. Suggestions for Learning Activities: How might your counseling change if the toddler was at the 90th % for weight and 10th % for length Discuss that full fat dairy is not a hard and fast rule and there are times when it is reasonable to have a toddler on low fat dairy. Review growth charts for children 0-36 months showing that while growth slows compared to the first year of life it is still occurring at a much faster rate than later in childhood. Discuss dietary sources of fat: when it is recommended that 12-23 month old children not have a fat restricted diet that does not mean they should eat foods with lots of added fat (fried foods for example) but rather eat foods where natural fats have not been removed P a g e 255 Other Resources: Pediatric Nutrition Handbook, American Academy of Pediatrics (Chapter 32 reviews issues of dietary fat in toddlers) Factors affecting the stability of blood lipid and lipoprotein levels from youth to adulthood: evidence from the Childhood Determinants of Adult Health Study. A three-year-old child presents to the Emergency Department with acute onset of stridor and tachypnea. Discuss your approach to this patient including important aspects of the history and physical exam, the differential diagnosis and management principles. Stridor is a short, medium- to high-pitched sound heard during inspiration that is consistent with upper airway obstruction. Narrowing of the upper airway space causes resistance to airflow through the airway. Negative pressure during inspiration leads to further narrowing of that space with partial obstruction, leading to inspiratory stridor. Respiratory rate is generally higher in infants and gradually decreases until adolescence. Review of Important Concepts: Historical Points Acute onset: the differential diagnosis varies between patients with acute onset of respiratory distress and a more gradual onset. The history of an acute onset of distress leads one to think about one precipitating event, such as aspiration of a foreign body or exposure to an allergen leading to anaphylaxis and respiratory distress. More gradual onset and other associated symptoms such as fever or rhinorrhea leads one to put infectious causes such as croup, epiglottitis or bacterial tracheitis higher on your differential diagnosis. Events immediately preceding onset of symptoms: Asking about preceding symptoms or events is very important in these patients. Other associated symptoms: Associated symptoms such as fever, rhinorrhea and sick contacts may help you narrow your differential. If the patient has urticaria, you may move allergic reaction/anaphylaxis higher on your differential. Immunization status: Underimmunized patients with stridor, fever and a toxic-appearance may have epiglottits secondary to Haemophilus influenza type B. Tachypnea, subcostal and intercostal retractions, nasal flaring, head-bobbing, tripoding, cyanosis, and altered mental status are all signs of respiratory distress. Cyanosis and altered mental status are late findings and immediate intervention is needed. Patients may be significantly hypoxemic before appearing cyanotic; therefore, an accurate pulse oximetry reading in addition to visual inspection can be helpful during assessments of patients with respiratory distress. Wheezing: It is important to differentiate stridor from wheezing on physical exam, as stridor is typically associated with upper respiratory tract obstruction and wheezing is associated with lower respiratory tract obstruction. Wheezing is a noise heard over the lung fields on expiration and usually requires a stethoscope to auscultate. Given the acute onset, age of the child and lack of other symptoms, foreign body aspiration with partial upper airway obstruction is most likely. Partial obstruction in the upper airway will result in inspiratory stridor, whereas lower airway obstruction will cause wheezing and/or diminished breath sounds on the side with the foreign body. Patients with a foreign body in their airway require rigid bronchoscopy to remove them. How can you differentiate between a foreign body aspiration and an infectious cause of stridor Epiglottitis is a serious infection that can cause rapid deterioration and airway occlusion, it is a medical emergency. Croup is caused by a viral infection and patients may have some fever or upper respiratory symptoms in addition to the stridor. On chest auscultation of a patient with foreign body aspiration, you will likely hear diminished breath sounds on the side with the foreign body. Suggestions for Learning Activities: Ask the student to develop a differential diagnosis and list supporting findings for each diagnosis. Review chest and lateral neck radiographs of patients with croup, epiglottits, retropharyngeal abscess, foreign body aspiration and foreign body ingestion. Review appropriate anticipatory guidance for toddlers, specifically discussing injury prevention. Develop a simulated patient scenario with a high-fidelity mannequin for students to work through this case, including emergency care and recognizing the diagnosis and ultimate management. Definitions for Specific Terms: Petechiae- Tiny 1-2 mm red or purple non-blanching flat lesions caused by hemorrhage of small blood vessels.
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Any required upgrades erectile dysfunction inventory of treatment satisfaction edits generic red viagra 200mg free shipping, replacements or repairs to this computer or printer shall be the responsibility of the Contracior impotence ginseng generic red viagra 200mg without prescription. The Contractor shall be responsible for all travel and lodging expenses for maintenance staff operations what causes erectile dysfunction in 30s discount 200 mg red viagra mastercard. The Contractor shall have the authority erectile dysfunction cpt code order red viagra 200 mg visa, with prior written approval by the Department impotence unani treatment in india order 200 mg red viagra with visa, to remodel the Facility or make substitutions erectile dysfunction medication shots red viagra 200mg without a prescription, alterations, additions, modifications and improvements to the Facility. The cost of such remodeling, substitutions, alterations, additions, modifications and improvements shall be paid by the Contractor, unless the Department has agreed in writing to reimburse the Contractor for those costs. Such remodeling, substitutions, alterations, additions, modifications and improvements shall become part of the Facility. Where required by the Department, the design and construction of remodeling, substitutions, alterations, additions, modifications and improvements shall be accomplished in accordance with the Texas Engineering Practice Act and the Texas Board of Architectural Examiners. Promptly after the occurrence the continued operation of such Facility, the Contractor shall notify the Department writing of such loss or damage. The Department and the Contractor shall jointly assess the nature and extent of such damage or loss and, as soon as practicable thereafter, determine whether it is practicable and desirable to rebuild, repair or restore such damage or loss. All such machinery, equipment, and other personal property, other than any StateOwned Equipment, shall remain the sole property of the Contractor. The Contractor shall identify to the Department and keep separately inventoried all machinery and equipment that is ancillary to or supplemental to , but not an integral part of State-Owned Equipment, which is purchased by the Contractor. All State-Owned Equipment shall remain part of the Facility and may not be removed from the Facility without prior written approval from the Department. The Department shall be entitled to conduct periodic inventories of State-Owned Equipment throughout the Contract Term. The Contractor shall cooperate with the Department in its conducting of all inventories of State-Owned Equipment. Actions such as submitting a purchase order, requesting purchase approval from corporate headquarters or the addition to a budget request for subsequent purchase, etc. The Contractor is required to correct all deficiencies identified by the Department and to obtain acceptance of the work by the Department. The Department shall be notified in writing each time that an item of State-Owned Equipment. Department Policy shall be followed in reporting State-Owned Equipment that has been lost, stolen or destroyed. The replacement equipment shall have Equipment that is inoperable beyond repair with a replacement cost over $25,000. Such infrastructure items include but are not limited to State-Owned Equipment such as water heaters, electrical panels, commodes, individual surveillance cameras, door locks, fire alarm, computer network, etc. The Contractor shall be responsible for all repairs and/or replacement costs for equipment that result from improper preventative maintenance or lack of corrective maintenance as determinefd by the Department. The Contractor shall report, verbally, followed by email notification, serious and/or E. The Contractor shall be responsible for all utility arrangements and estimating the cost for electricity, natural gas, water, etc. Consumption and cost information shall be shared with the Department as an ongoing operational program as required. The Contractor shall adequately secure buildings and provide other security equipment necessary to maintain control of assigned Offenders. Department in the event of escape(s) or other extraordinary events at the Facility or from any location where. The Contractor shall provide reimbursement to the Department for costs incurred by the 1. Costs related to the use of authorized personnel from the Office of the lnspector General; Costs for the handlers of tracking dogs; or All necessary and related expenses to support the staff authorized to be on the scene and to protect public safety. The Contractor shall ensure all areas adjacent to the perimeter are visible under all conditions or monitored on a regular basis by perimeter patrol. The Contractor shall provide a comprehensive Building Schedule, which includes recreation, in accordance with Department Policy. The Department shall have the sole right to make all final decisions for award and forfeiture of good time. Copies of the Facility selfmonitoring reports shall be retained on the Facility and available, upon request, to Department staff. The Contractor shall also provide a description of reporting procedures for quarterly Facility self-monitoring corporate designees. The Contractor shall parlicipate in or establish Community Work Projects and/or Public Service Programs in compliance with Department Policy. All community work and public service projects, regardless of duration, require C. The expenditure of and accounting for all Facility Generated lncome to include, but not limited to , commissaries and telephones shall be in accordance with Department Policy. The Contractor shall not have access to revenue generated from the vending machines. The Department reserves the right to utilize Facility Generated lncome for the benefit of the Facility. The Contractoremployee identification card shall incorporate security features that cannot readily be replicated in the program or commercially. Force may be used to achieve the compliance of an Offender or to maintain a safe and B. The Contract Monitor shall be a full time employee of the Department and the Contractor will exercise no control over the Monitor. Offender records shall be labeled in a manner satisfactory to the Department as well as organized and retained in the original folder. Department reserves the right to supervise the records preservation, boxing, labeling and movement to a secure, separately keyed and locked area on the Facility until the management transition is complete. The Department and other Government regulatory agencies have the right to inspect and test all Services called for by this Contract, to the extent practicable at alltimes and places during the Contract Term. The Contractor shall furnish, and shall require subcontractors to furnish, at no increase in the Contract price, all reasonable facilities and assistance for the safe and convenient performance of these duties to limitations provided by law with respect to rights of privacy, have the right to reasonably prompt access and to examine all records of the Contractor related specifically to the Facility, including financial records, maintenance records, employee records including time and attendance records, and Offender records generated by the Contractor and its subcontractors in connection with performance of this Contract. The response must include supporting documentation which verifies execution of corrective action(s) taken. The Contractor shall provide and maintain an inspection system acceptable to the Department covering the Facilities and work called for by this Contract. Such monitoring by the Department shall not relieve the Contractor of any of its obligations under this Contract. The Contract Monitor and other Department staff shall provide written findings regarding non-compliant conditions, processes, procedures or operations implemented at the Facility, and observations that could, if not addressed by the Contractor, become an item of noncompliance as described in Section E. The Contractor shall ensure that this clause concerning the authority to audit funds. Audits or inspections may include allegations or complaints involving program operations or the Contractor and its employees (including consultants, independent contractors and their employees and agents and volunteer workers). At any time, any party may designate any Person as its Authorized Representative delivering to the other party a written designation signed, if on behalf of the Contractor, by its President or any Vice President, or if on behalf of the Department, by the Executive Director. Such designations shall remain effective until new written instruments are filed with or such notice is given to the other party that such designations have been revoked. The Contract Specialist is responsible for general administration of this Contract, negotiation of any changes and final issuance of written changes/modifications to this Contract. The Facility Administrator or a designated representative shall meet with the Contract Monitor to discuss problems as they occur. The Contractor may offer prompt payment discount, for example, one percent (1o/o), 15 Days (refer to page 1, block 7 of the of the Solicitation, Offer and Award form) if the Contractor desires expedited Payment. Name of business, remittance address, and invoice date; Contract number; Descriptions, price, and quantity of Services rendered; Daily census; and 2. The Payment schedule shall be based on occupancy level determined by current Offender accounting procedures (Midnight Strength Report). Box 4018 Huntsville, Texas 7 7 342-401 8 lf the Contractor has previously submitted a completed Vendor Maintenance Direct Deposit and Substitute W-9 Form to the Department for another separate contract, another form is not required to be submitted. The Department recognizes that the Contractor has entered into this Contract and has offered to furnish the Services hereunder based upon the Department Policies in effect as of the date of this Contract. The parties shall make a good faith effort to mutually agree on the cost adjustment prior to the implementation of the new policy at the Facility, unless implementation of new policy is required immediately due to security or public safety issues. The Department may elect to deduct from its Monthly Contractor Payment as specified in Section G. Contractor shall be responsible to pay the invoiced amount within thirty (30) Days of receipt unless the Contractor and Department mutually agree on an alternative payment method. The Department shall have the right to withhold the Monthly Contractor Payment untilthe failures described below have been corrected. Failure to correct identified areas of non-compliance to the satisfaction of the Department within twenty (20) Days upon receipt of written notification. The Contractor agrees that the Department shall not pay interest to the Contractor for monies so withheld. The Contractor shall comply with the rules adopted by the Department under Texas Government Code, Sections 403. Upon request, the Department shall be entitled to receive without expense, copies of the policies and all endorsements. Copies and changes to the initial insurance policies, including extensions, renewals, cancellations and revisions shall be submitted to the Contract Specialist within thirty (30) Days of the effective date. By accident, $2,000,000 per each accident; and By disease, $2,000,000 per employee with a per policy aggregate of $1,000,000 Commercial Automobile Liability lnsurance covering owned, hired, and non-owned vehicles, with a minimum combined bodily injury (including death) and property damage limit of $1,000,000 per occurrence. Commercial General Liability lnsurance including, but not limited Premises/Operations, Personal & Advertising lnjury, Products/Completed Operations, independent contractors and Contractual Liability with minimum combined bodily injury (including death) and property damage limits of $2,000,000 per occurrence, $1,000,000 products/completed operations aggregate and $5,000,000 general aggregate. Liability coverage shall include coverage for damage to property and injury to Persons caused by boiler and other equipment malfunction. The policy shall contain an endorsement to include coverage for the property of third parties. Professional Liability (including Errors and Omissions) including coverage for the rendering of, or failure to render, professional services with minimum limits of $1,000,000 per occurrence, $2,000,000 annual aggregate. Name the Department and its officers, employees and elected representatives as additional insured to all applicable coverages. Waive subrogation against the Department, its officers, employees and elected representatives, for bodily injury (including death), property damage or any other loss, to all applicable coverages. Provide that all provisions of this Contract concerning liability, duty and standard of care, together with the indemnification provision, shall be underwritten by contractual liability coverage sufficient to include such obligations within applicable policies. Ensure that all certificates of insurance identify the Service or product being provided and the name of responsible party. The Contractor through an insurance agent licensed by the State of Texas shall obtain all insurance coverage and an insurance company licensed to issue such coverage in this state shall provide such coverage. All policies shall include a provision requiring a written notice of cancellation to the Department. All insurance coverage obtained by the Contractor shall continue in full force and effect during the Contract Term. Proof of insurance policies must be delivered prior to the Service Commencement Date. The Contractor may choose the amount of deductible for any other insurance coverage required (above) to be obtained by the Contractor. The deductible may exceed five percent (5%) of the required yearly aggregate limit of coverage for each occurrence. The Contractor is responsible for the first (1st) dollars to be paid for any such claim. The Contractor may subcontract for the performance of any of its responsibilities provide Services pursuant to this Contract. No subcontract may be entered into unless the Department provides prior written approval, which approval may not be unreasonably withheld. A subcontractor may not work directly with the Department in any manner and shall not be included in Contract negotiations, renewals, audits or any other discussions except at the request of the Department. L Unless waived in writing by the Department, the subcontract shall contain the following 1. An acknowledgement that the subcontract is subject to the Contract between the Department and the Contractor (the "Master Contract"). The subcontract shall contain the required Authority to Audit clause referenced in Section 8. The Contractor shall provide notice to all subcontractors of their selection as subcontractor for this Contract. A copy of the notice shall be provided to the Contract Specialist no later than ten (10) working days after this Contract is awarded. The Contractor shall submit to the Contract Specialist on a monthly basis (by the fifth (sth) Day of the following month) the Prime Contractor Progress Assessment Report, which is included in Exhibit J. During this transition period, the Contractor shall transfer all Offender records to the Department if requested to do so by the Department. Provided, however, that this Section shall not prevent the Contractor from making recommendations to the Department with respect to any of the above without the prior written decision of the Department. Upon request by the Department, Contractor shall provide the name of the employee and location of transfer, all pending investigations and disciplinary actions, and previous disciplinary actions. Services under this Contract, the Contractor shall purchase products and materials produced in the State of Texas when they are available at a price and time comparable to products and materials produced outside of Texas. Criminal history information means information collected about a Person by a criminaljustice agency that consists of identifiable descriptions and notations of arrests, detentions, indictments, information and other formal criminal charges and their dispositions. The term does not include information as to convictions, fingerprint information, and driving records.
Ministers of Modernization: Elite Mobility in the Meiji Restoration impotence herbs buy 200mg red viagra with visa, 1868-1873 (Tucson erectile dysfunction neurological causes effective red viagra 200 mg, 1964) erectile dysfunction homeopathic safe red viagra 200mg. Colonel Interview Location Tokyo Tokyo and Tsu Tokyo Tokyo Nagano Commentary William H impotence meaning in english purchase 200mg red viagra with mastercard. McNeill the Uiti~ersifyof Chicago I have a difficult task this afternoon commenting on the two fine papers that we have just heard which impotence pills cheap red viagra 200mg free shipping. I think therefore that I will separate my remarks on the two papers rather than trying to cross over erectile dysfunction causes tiredness order 200mg red viagra with amex. He suggests that these regimes may offer the dominant, easiest, and most obvious way to go from a condition lacking viable political traditions to some unforeseen, and as yet unforeseeable, "modern" form of government. It is certainly true that the prerequisites of effective government in our age are now legion and they are not all well understood. Even the most probing inquiry soon runs up against various arcana irnperii, "secrets of empire," that permit some men to command and others to obey. I n any society without such patterns effective government or government of any kind of course quickly becomes impossible. But we really d o not know what makes such coherence voluntary in some times and places and what sometimes breaks the consensus so that civil war o r some less drastic breakdown of public peace ensues. This is a standing problem for historians and social scientists for which we really d o not have a satisfactory answer. And until men know or can manipulate such things with assurance (and I am not entirely sure I wish t o live to see that age) the secret of what allows effective democratic or effective authoritarian government to arise in some places and not t o arise in others continues to escape even the best-meaning social engineers and developmental reformers. That is, whether military regimes will turn out to be bridges toward some modernized and civilian forms of government o r whether they may not prolong their hold on power for indefinite periods into the future, or until existing patterns of state sovereignty and territorial jurisdiction are somehow radically altered. I am impressed by the fact that through most of human history governments have been the heirs of military cliques, ruling initially by conquest. But the assumption that civilian government is somehow normal, as Professor Black was at pains to say, is a bias of the western world. To assume civilian government;I normal everywhere and always is, perhaps, a mistake. There is nothing which requires military regimes in Africa or in a country like Greece or any other part of the world to fade away and turn into civilian governments necessarily. I n any consideration of the role in developing lands of military and civilian components, careful consideration and study of military education and training patterns therefore assumes the greatest importance. Such patterns had much to do with shaping the governmental regimes that exist and are likely to exist for some time into the future in Africa, Latin America, and elsewhere. I would draw the practical conclusion (and I think this i s not differing with Professor Black at all) that military courses available to foreigners ought to be broadened, if they have not been already, to take serious account of administrative, legal, economic, sociological, and even historical topics. I know this exists for our own military men and is very important for our common affairs at home. For all I know such courses may exist for foreign military as well, but in the recent past at least I know that it was possible for officers traincd in this country to take a series of courses and achieve high technical expertise while still retaining exceedingly naive sociopolitical ideas. This is truc for example of the present head of the Creek government who was highly trained in communications, a fact which in n o way affected the attitudes and expectations which he derived from a provincial childhood in a remote part of Greece. Thinking more generally of what Professor Black said to us I have some reservation about the bi-polar typology of military regimes which he proposed. The distinction between law and order regimes and developmental regimes seems a little bit fuzzy to me. In his paper, on page 17, he says that you must have an ideology relevant to development t o effectively be a developmental regime. Now some of the most powerful radical regimes of the historical past have been efforts to go back to what 63 was believed to be a purer o r better state in the past. Such a mixture, such discrepancy between professed goals and actual achievements, far from being exceptional, se3ms to me quite the rule in public life. Consequently, the effort to niche a tidy division of military regimes into those attempting to defend what exists, and those attempting to alter inherited conditions is probably not as straightforward o r simple to apply in practice as the listing that Mr. In general I think that the peculiarities of the Greek case (which was the only case amongst those with which Professor Black deals that I have any personal acquaintance with or can speak with any sense of security about) are probably paralleled elsewhere. If so, the effort to apply a general scheme of interpretation to particular military regimes becomes very difficult indeed. As I turn to the second paper, with its description and analysis of the particular case of Japan, it seems to me this expectation of individual idiosyncrasy is very much confirmed. What could be more remarkable, more unique, more idiosyncratic than the Japanese path to modernity I found particularly novel and interesting the manner in which h e pointed out the early manifestations s anti-militarism in Japanese life. T h e story that Professor Coox presented t o us leaves me with reinforced, vivid appreciation of the extraordinary polarity built into Japanese society and Japanese psychology. T h e polar opposition between harsh and overbearing militarism on the one hand, and extreme and passionate anti-militarism on the other, seems to alternate throughout recent decades of Japanese history; and shifts from one to the other attitude have occurred more than once, and with a suddenness that is amazing. Other facets of Japanese history also exhibit similar changeability and very rapid fluctuations from one extreme to another. F o r example, the imitation of Chinese culture as against the imitation of western models; o r the rebellion of student generations as against the conformity of young business executives and professionals once they launch upon a career. T h e prevalence of ruthless assertiveness and thc prevalence of self-deprecatory politeness, these and many other polarities can be detected everywhere. They impress a stranger very strongly on first coming into contact with Japanese society. Now I am not going to try to psychoanalyze the Japanese nation; and I am not going to try to explain, being too ignorant. But I do observe 64 that the fluctuations in behavior traced for us in this interesting paper must represent attitudes and capabilities peculiar to Japan. This makes the successful modernization of that nation less a practicable model for others to follow than an extreme and exceptionally interesting case of rapid and extraordinary social change. I think, too, the same could be said of Turkey from the time of Ataturk, or even earlier than that time. That is to say, the effort Ataturk made to establish civilian government was rooted in the experience that he had in his own generation, and that Turks like him, modernized and modernizing army officers like him, had had in their repeated collisions with the western powers during the previous century. Therefore I wonder whether the affiliation or the professed affiliation between say Nasser and the Ataturk experience, o r between the Reza Khan and the Turkish revolutionary movements of the 1920s means much more than a verbal acknowledgement of a sense of solidarity. I d o not know what transfer really is possible from the peculiar conditions of Anatolian Turkey to Iran or to Egypt o r to any other part of the world. This tends to leave me then in reaction to both papers with what may seem like a negative view, saying that every case being unique can not really be understood except in its own particular terms. I rather distrust typologies and generalizations that fuzz over local and what arc essentially historical differences. Yet I am prepared to believe and I wish also to defend the proposition that the historical importance of military regimes as they exist in the world today arises from what they do have in common, and what that may be is a result I think of the superior transferability of military command structures and of military technologies and military psychological attitudes from westernized communities to others. An inquiry directed to these sorts of transfers might, I think, be richly rewarding. Russia modernized by remodeling its armed establishment along western lines not only in the days of Peter the Great, but before that in the days of Ivan the Terrible, and before that even in the days of thc grand duke Ivan 111. T h e Turks began a process of military modernization in the 18th century, and T suspect that collisions along other civilized frontiers may have led, for example, barbarians along the Chinese frontier to have learned to match Chinese military equipment and organization before they learned much else about Chinese civilization. I would suspect-in fact 1 do suspect very keenly-that such may have been the secret of the meteoric carcer of Genghis Khan in the 13th century. Now this is the direction in which T would like to go: t o seek t o try to understand the role of the military in modernization, looking for the paths, perhaps mainly educational and through formal educational institutions, by which army and navy and air force personnel acquire familiarity with modernity (whatever we take modernity to m e a n), and to look to thc features and the facets of military organization, custom, and life style that make it possible for men who come from very narrow and infinitely diverse rural backgrounds to become effective army officers 65 and commanders, or as enlisted men to live in barracks and conform t o military discipline. Because it is this capacity to take raw peasant boys, raw boys off the farm, and turn them into officers or turn them into enlisted men, that gives the military its point of leverage within backward societies. I t seems clear at least t o me that there are facts about military life and custom and habit that d o make it relatively easy for such institutions to take root among the most diverse and mutually alien types of society, whereas civilian institutions and attitudes seldom can effectively be transferred; or if they can be transferred, it takes a much longer time, and the process of transferrence is far less certain of achieving results that are comparable to the model upon which the process is predicated. My role is not to offer a paper of my own, but t o comment upon those we have heard and start your minds working toward the question period which is now upon us. Discussion A 40-minute discussion period followed the papers of Professors Coox and Black and the commentary of Professor McNeill. Professor Berenice Carroll then queried Professor Coox about the nature of his sourdes, a question whose answer is now evident in his footnotes. Colonel John Napier of the Air War College then questioned Professor Black about his omission from his paper of any extended comment on civic action programs. Professor Black replied at length, citing instances from Turkey, Russia, and the United States, concluding that military or militarist regimes have no special claim to engaging or not engaging in military civic action programs. Professor Coox contributed data concerning the work of the Japanese Army in railroad building. In return for funding and materials provided by the civil government and private companies, the military acquired large-scale practical experience. Marine Corps Education Center, Ouantico, questioned the application of some of Professor Black`s generalizations to the experience in Senegal. Professor Black acknowledged his point, adding only that "even given some such exceptions, generalization is still possible and often fruitful. Professor McNeill suggested tentatively that the transfer of Western military techniques in the past may simply have resulted from non-western perceptions of Western success. Professor Black joined the discussion, suggesting that the question of transfer is perhaps a function of the number of people who must become involved in the effects of the transfer. Transferring a civilian airline system, with assistance, can be done in a much shorter time, perhaps only a decade or two. The armies of most underdeveloped countries are quite small, numbering in toto perhaps a smaller group than the Cadet Wing enrolled here; hence change can occur much more rapidly. Also, with military organization and the kind of control such organization makes possible, it takes a relatively small number of people to exert control and thus impose change. I would cite the Civil War as one specific example, and of course cite the Confederate States as an underdeveloped or backward nation. Americans have had many examples of involvement with military and civil governnicnt, as well as mixtures of the two. T h e question of transferring institutions might be examined by looking more closely a t our career in Cuba, at our career in Ihe Philippines and round about in the Gulf, in Central America. One of the institutional methods that was used was the creation of the Burmu of Tnsular Affairs, which is in itself a fascinating governmental agency worthy of attention. I think out of all this mixture of experience in civil-military relationships, if you will, you might come up with one generalization: that as we went forward into new areas and set up military-civil government, we achieved two things with relentless purpose: suffrage and sanitation! This is something Professor Coox talked about (and Professor Black was concerned with as well). Have these episodcs of defeat, disastrous defeat, or more or less disastrous defeat, permanently altered the balance of suspicion between a democratic people and its military institutions Does o u r democratic system now see the military as even more of an anachronism, more of a fading embarrassment, than it did before Vietnam Or is there in the clamor for an all volunteer army some planting of seeds for another quasi-autonomous military clique suggested by Professor Weigley this morning Clark Good evcning Ladies and Gentlemen: Over the years it has become almost a tradition to invite a distinguished former military officer to deliver the banquet address for the Military History Symposium. Tonight we are privileged to have as our speaker a man who not o n l y served the United States Air Force with great distinction, but one whose contributions to both the theory and employment of air forces have cnrncd for him a distinct place in the history of our service. By the late 1930s he had become an instructor in the Bombardment Aviation Section of the Air Corps Tactical School. In that position he was among those who formulated the theories of Air Force employment that wcre to be applied so successfully in World War 11. I n fact, o n the eve of war, he was called to Washington t o join the team of men in the Air War Plans Division who put together the plan for the strategic bombardment of Gcrniany that was adoptcci by the Joint Chiefs a n d the President. When the Eighth Air Force went to war, General Hansell went along, moving up t o command first a Bombardment Wing and then a Division. Although retired For disability in 1946, the Chief of Staff of the Air Force called on his talents once ayain with the outbreak of war in Korea. Since his second retirement in 1955, (kneral Hansell has remained very active in military affairs and has been especially helpful t o us with our History Program hcrc at thc Academy and in the various programs of the Air University at Maxwell Field. Pltrri 7 l w r Defecrtecl Hitler, an account of the development of the stratcgic bombing concept. First, because I feel honored to appear before this prestigious gathering of professional historians and professional military officers. Second, because General Clark has kindly permitted me to limit my remarks to the narrow field of my own experience. I am acutely aware that this room is filled with professional historians, and I know that they are far better informed than I. So, it is with relief that I address myself to observations based on my own experience. They cover the past 40 years, iricluding active participation in the military scene and continued interest as an inactive observer. It provides a wealth of interest for the historian, and a rich field for examination by the military analyst and the military strategist. Air warfare tested and proved the precept which was proposed by von Clausewitz and specified by Liddell Hart that the "will of the people" is the fundamental objective in conflict between nations. In World War I1 air power brought the people of Europe and Japan directly into the combat zone throughout the length and breadth of the land. Nuclear missiles and the high-speed bomber have multiplied that power ai thousand fold, and have brought the threat to the people of America as well. For a part of this 40-year period America was safe at home and needed only offensive forces. But we continued to concern ourselves entirely with the offense, and to neglect our defenses, long after the situation had changed.
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