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A program can also exist on a piece of paper treatment ulcerative colitis discount seroquel american express, if I invented it myself medications look up buy seroquel 100 mg without prescription, or in a manual, if it is a standard program; in these cases, it is not "in" the computer but can be put "in" at any time. But a program can be even more tenuous than that; it can exist only in my head, if I have never written it down, or if I have used it once and erased it. On the other hand, the software is more "real" in the sense that you can smash the hardware back to dust ("kill" the computer) and the software still exists, and can "materialize" or "manifest" again in a different computer. Imprints (software frozen into hardware) are the nonnegotiable aspects of our individuality. Out of the infinity of possible programs existing as potential software, the imprint establishes the limits, parameters, perimeters within which all subsequent conditioning and learning occurs. In speaking of the human brain as an electro-colloidal biocomputer, we all know where the hardware is: it is inside the human skull. For instance, the software "in" my brain also exists outside my brain in such forms as, say, a book I read twenty years ago, which was an English translation of various signals transmitted by Plato 2400 years ago. Other parts of my software are made up of the software of Confucius, James Joyce, my second-grade teacher, the Three Stooges, Beethoven, my mother and father, Richard Nixon, my various dogs and cats, Dr. Carl Sagan, and anybody and (to some extent) any-thing that has ever impacted upon my brain. Of course, if consciousness consisted of nothing but this undifferentiated tapioca of timeless, spaceless software, we would have no individuality, no center, no Self. We want to know, then, how out of this universal software ocean a specific person emerges. Because the human brain, like other animal brains, acts as an electro-colloidal computer, not a solid-state computer, it follows the same laws as other animal brains. That is, the programs get into the brain, as electro-chemical bonds, in discrete quantum stages. These are more-or-less hard wired programs which the brain is genetically designed to accept only at certain points in its development. In general, the primordial imprint can always over-rule any subsequent conditioning or learning. Before the first imprint, the consciousness of the infant is "formless and void"-like the universe at the beginning of Genesis, or the descriptions of unconditioned ("enlightened" i. But every sensitive reader knows that Brown is also talking about a process we have all passed through in creating, out of an infinite ocean of signals, those particular constructs we call "myself and "my world. Each successive imprint complicates the software which programs our experience and which we experience as "reality. It is what our Thinker thinks, and our Prover mechanically fits all incoming signals to the limitations of this map. Timothy Leary (with a few modifications) we shall divide this brain hardware into eight circuits for convenience. I assume it will be replaced by a better map within 10 or 15 years; and in any case, the map is not the territory. This is imprinted by the mother or the first mothering object and conditioned by subsequent nourishment or threat. It retreats mechanically from the noxious or predatory-or from anything associated (by imprinting or conditioning) with the noxious or predatory. This is imprinted in the "Toddling" stage when the infant rises up, walks about and begins to struggle for power within the family structure. This mostly mammalian circuit processes territorial rules, emotional games, or cons, pecking order and rituals of domination or submission. It "handles" and "packages" the environment, classifying everything according to the local reality tunnel. Invention, calculation, prediction and transmitting signals across generations are its functions. This is imprinted by the first orgasm-mating experiences at puberty and is conditioned by tribal taboos. It processes sexual pleasure, local definitions of "right" and "wrong," reproduction, adultparental personality (sex role) and nurture of the young.

Our minds medications major depression buy 300 mg seroquel with amex, he says-by which he means our software- contain the universe medicine - buy seroquel 50mg line, by the act of comprehending it. The seventh, meta-programming circuit is the most recent in evolutionary time and seems to be located in the frontal lobes. That is why the traditional Hindu exercise to activate it is to fix the consciousness in the front of the forehead and hold it there, hour after hour, day after day, year after year, until the metaprogrammer awakes and you begin to perceivecreate infinite realities where before there was only one static jail-cell "reality" in which you were trapped. As said above, this circuit is the "soul" of the Gnostics, as distinct from the self. The self seems to be fixed and firm, but is not; that is, whatever circuit you are operating on at the moment is your "self at that moment. If I point a gun at you, you go to Circuit I consciousness at once, and that is your "self at that instant. Most of the preliminary exercises in Sufi and Gurdjieff schools consist in making you aware that the "self is not constant but shifts back and forth between the imprints on the various circuits. It plays all the roles you play- oral dependent, emotional tyrant, cool rationalist, romantic seducer, neurosomatic healer, neurogenetic Evolutionary Visionary- but it is none of them. As Lewis Morgan notes, in books on linguistics there always comes a point at which the prose itself becomes wildly incomprehensible, disintegrating into nonsense. It happens in both linguistics and mathematics, because it happens in consciousness itself, language and math are just models of consciousness. Or as Alan Watts liked to say, because the tongue ultimately cannot taste the tongue. Ideas about ideas-mathematics about mathematics (Godel) -language about language-consciousness of consciousness- the whole seventh circuit brings us into what Hofstadter calls Strange Loops. Like the legendary koko bird, we follow our own tail around in ever-narrowing circles, but unlike that mythic bird we never complete the process by flying up our own rectums and disappearing. We are merely confronting infinity where we least expected to encounter it-in our own lonely selves. Physics joined linguistics, mathematics and psychology in this mete programming hall of mirrors when Schrodinger demonstrated that quantum events are not "objective" in the Newtonian sense. For fifty years since then, physicists have been struggling to build a system that will get them out of this Strange Loop. For instance, Niels Bohr proposed the Copenhagen Interpretation, which merely says, in the manner of Godel, that our equations do not describe the universe really. They describe the mental processes we have to put ourselves through to describe the universe. True enough-and this whole book is a Copenhagen Interpretation of psychology and owes everything to Dr. Simply accept that the universe is so structured that it can see itself, and that this selfreflexive arc is built into our frontal lobes, so that consciousness contains an infinite regress, and all we can do is make models of ourselves making models. You are still in life, or life is in you, but since there are infinite aspects to everything, especially to the "you" who is observing/creating all these muddles and models, there are no limits. The only sensible goal, then, is to try to build a realitytunnel for next week that is bigger, funnier, sexier, more optimistic and generally less boring than any previous reality-tunnel. And once you have built that bigger, funnier, happier universe of thought, build a bigger and better one, for next month. If all you can know is your own brain programs operating, the whole universe you experience is inside your head. All that we "know" is what registers on our brains, so what you perceive (your individual reality-tunnel) is made up of nothing but thoughts-as Sir Humphrey Davy noted when selfexperimenting with nitrous oxide in 1819, and as Buddha noticed by sitting alone until all his social imprints atrophied and dropped away. The Copernican Revolution in astronomy, the Darwinian revolution in biology, the Relativity and Quantum revolutions in physics, have all been as shocking to those who lived through them as the Immortalist Revolution is today. You can live in the reality-tunnel imprinted upon you by environmental accident or you can choose your own. You can go through brain changes as radically bad as those of Patty Hearst and Rusty Galley, as transcendentally beautiful as those of Buddha and Jesus, as epistomologically revolutionary as those of Darwin and Einstein. You can join those who have already entered the Immortalist Reality Tunnel, the Scientologist Reality-Tunnel or the Communist Reality-Tunnel. Evolutionary acceleration is forcing us to the point where each will have to take responsibility for which reality we accept. This is demonstrated by the well-known optical diagram encountered in every high-school physics class: 1 Presumably the input (software) or the brain (hardware).

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Aerospace Medical Disposition the following is a table that lists the most common conditions of aeromedical significance medicine 360 cheap seroquel 200 mg line, and course of action that should be taken by the examiner as defined by the protocol and disposition in the table medicine zanaflex buy 300mg seroquel mastercard. Note if there are any motion restrictions of the involved extremity Submit a current status report and all pertinent medical reports. The Examiner should specifically inquire concerning a history of weakness or paralysis, disturbance of sensation, loss of coordination, or loss of bowel or bladder control. Certain laboratory studies, such as scans and imaging procedures of the head or spine, electroencephalograms, or spinal paracentesis may suggest significant medical history. The Examiner should note conditions identified in Item 60 on the application with facts, such as dates, frequency, and severity of occurrence. Some require only temporary disqualification during periods when the headaches are likely to occur or require treatment. Other types of headaches may preclude certification by the Examiner and require special evaluation and consideration. Likewise, the orthostatic faint associated with moderate anemia is no threat to aviation safety as long as the individual is temporarily disqualified until the anemia is corrected. An unexplained disturbance of consciousness is disqualifying under the medical standards. Because a disturbance of consciousness may be expected to be totally incapacitating, individuals with such histories pose a high risk to safety and must be denied or deferred by the Examiner. If the cause of the disturbance is explained and a loss of consciousness is not likely to recur, then medical certification may be possible. The basic neurological examination consists of an examination of the 12 cranial nerves, motor strength, superficial reflexes, deep tendon reflexes, sensation, coordination, mental status, and includes the Babinski reflex and Romberg sign. The Examiner should be aware of any asymmetry in responses because this may be evidence of mild or early abnormalities. The Examiner should evaluate the visual field by direct confrontation or, preferably, by one of the perimetry procedures, especially if there is a suggestion of neurological deficiency. Aerospace Medical Disposition A history or the presence of any neurological condition or disease that potentially may incapacitate an individual should be regarded as initially disqualifying. Issuance of a medical certificate to an applicant in such cases should be denied or defer, pending further evaluation. Processing such applications can be expedited by including hospital records, consultation reports, and appropriate laboratory and imaging studies, if available. Symptoms or disturbances that are secondary to the underlying condition and that may be acutely incapacitating include pain, weakness, vertigo or in coordination, seizures or a disturbance of consciousness, visual disturbance, or mental confusion. Chronic conditions may be incompatible with safety in aircraft operation because of long-term unpredictability, severe neurologic deficit, or psychological impairment. Potential neurologic deficits include weakness, loss of sensation, ataxia, visual deficit, or mental impairment. Recurrent symptomatology may interfere with flight performance through mechanisms such as seizure, headaches, vertigo, visual disturbances, or confusion. A history or diagnosis of an intracranial tumor necessitates a complete neurological evaluation with appropriate laboratory and imaging studies before a determination of eligibility for medical certification can be established. A neurological and/or general medical consultation will be necessary in most instances. A complete neurological evaluation with appropriate laboratory and imaging studies, including information regarding the specific neurological condition, will be necessary for determination of eligibility for medical certification. The Examiner may issue a medical certificate to an applicant with a long-standing history of headaches if mild, seldom requiring more than simple analgesics, occur infrequently, are not incapacitating, and are not associated with neurological stigmata. Applicants for first- or second- class must provide this information annually; applicants for third-class must provide the information with each required exam. An applicant who has a history of epilepsy, a disturbance of consciousness without satisfactory medical explanation of the cause, or a transient loss of control of nervous system function(s) without satisfactory medical explanation of the cause must be denied or deferred by the Examiner. Factors that would be considered in determining eligibility in such cases would be age at onset, nature and frequency of seizures, precipitating causes, and duration of stability without medication. If the seizures occurred when the airman was a child, a parent or guardian familiar with the episodes should complete this form. Section 1 - Big Seizures Have you ever had a grand mal seizure or a big seizure where you lost consciousness or your whole body shook and stiffened? Behave in unusual ways such as smacking your lips, touching your clothes, or doing any other unusual things without intending to? Of the grand mal or big seizures that you had while awake, did they usually occur shortly after waking up?

They will likely need significant intravenous fluid resuscitation and antibiotics treatment lyme disease order 100 mg seroquel amex. Pain assessment for children should be conducted using a validated pediatric pain scale symptoms 8 weeks effective seroquel 50mg. Of all the patients who present to the emergency department, infants may be the most difficult for the triage nurse to evaluate. Parental concerns about signs and symptoms, even those not witnessed by the triage nurse, must be taken seriously. When assessing an infant, the triage nurse must pay close attention to the history offered by the parents as this may be the only real clue to the problem. Infants must be unwrapped and undressed for a hands-on assessment of perfusion and respiratory effort, remembering that they can rapidly lose body heat in a cool environment and should be rewrapped as soon as possible. Specific practices for the evaluation of febrile older infants may differ from institution to institution. However, it is universally accepted that neonates (< 28 days of age) with a rectal temperature of 38°C (100. These patients require a physician and a nurse at the bedside to provide lifesaving critical care interventions. One reason for this is that some conditions require different numbers of resources in children than in adults. However, some pediatric patients may require sedation for a laceration repair, particularly if they are below school age or appear to be especially agitated or uncooperative. Therefore, it is important to be aware of the circumstances underlying the current psychological event. In addition to establishing the reason for the exhibited behavior, it is important to capture the type, severity, frequency, and focus (is the behavior directed toward something or someone) of the behavior. In some cases, it may be beneficial to interview older children and adolescents alone. They may be more likely to offer information on sensitive subjects such as risky behaviors, abusive relationships, and drug or alcohol use without the presence of their parents. Resources will be somewhat different for the pediatric mental health patient than for the pediatric medical patient and are likely to include things such as psychiatric and social work consults. Trauma Trauma patients can be challenging to triage, especially if they have suffered internal injuries without visible external signs of injury. Pediatric trauma patients may be difficult to assess due to compensatory mechanisms that produce vital signs with the appearance of stability. The nurse must be proactive when providing care to the pediatric trauma patient to prevent deterioration and rapid decompensation. Children with Comorbid Conditions Research has found that children with comorbid conditions are both over-triaged and undertriaged (Travers et al. At the same time, children should not be automatically triaged at a higher level due to a comorbid condition. For example, the child with a known seizure disorder who presents with breakthrough seizures needs to be triaged at a higher level than the same child who presents for a medication refill. The febrile 10-year-old with a ventriculoperitoneal shunt is going to need more extensive evaluation than the otherwise healthy and non-toxic appearing 10-year-old with an isolated fever. However, a child with a sprained ankle likely does not need a higher acuity level simply because the child has a history of congenital heart disease. Psychiatric Psychiatric emergencies among children present a unique challenge for the triage nurse, who will be required to make a complex clinical decision as to the degree of danger the patient may pose to themselves or others. The Mental Health Triage Scale can be used in the assessment of the pediatric psychiatric patient (Smart, Pollard, & Walpole, 1999). Pediatric case studies are included in Chapter 9, "Practice Cases" and Chapter 10, "Competency Cases" of this handbook. Summary Assessing the pediatric patient can be a daunting task for both the novice and the experienced triage nurse. A 14-year-old female is brought in by ambulance after diving into the pool and hitting her head. There are several bottles of liquor and a number of unidentified empty pill bottles next to bed. A 16-year-old male brought in by parents who report patient was out of control, screaming obscenities, and threatening to kill the family.