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Functional abdominal pain syndrome

Functional abdominal pain syndrome (FAPS), chronic functional abdominal pain (CFAP), or centrally mediated abdominal pain syndrome (CMAP) is a pain syndrome of the abdomen, that has been present for at least six months, is not well connected to gastrointestinal function, and is accompanied by some loss of everyday activities. The discomfort is persistent, near-constant, or regularly reoccurring. The absence of symptom association with food intake or defecation distinguishes functional abdominal pain syndrome from other functional gastrointestinal illnesses, such as irritable bowel syndrome (IBS) and functional dyspepsia.

Functional abdominal pain syndrome is a functional gastrointestinal disorder meaning that it is not associated with any organic or structural pathology. Theories on the mechanisms behind functional abdominal pain syndrome include changes in descending modulation, central sensitization of the spinal dorsal horn, peripheral enhancement of the visceral pain afferent signal, and, central amplification.

The diagnosis of functional abdominal pain syndrome is made based on clinical features and diagnostic criteria. A thorough clinical history musty be taken to accurately diagnose functional abdominal pain syndrome. Diagnostic testing to rule out organic disorders should only be done when alarm features are present. Differential diagnosis of functional abdominal pain syndrome includes a variety of other functional gastrointestinal disorders.

There is no well established treatment for functional abdominal pain syndrome. General measures such as a positive physician-patient relationship are beneficial. Antidepressants are often used to treat other functional gastrointestinal disorders and may be helpful in treating functional abdominal pain syndrome. Psychological interventions including various forms of therapy can also be helpful.

While the exact presence of functional abdominal pain syndrome is unknown studies show that it affects between 0.5% and 2% of North Americans. Functional abdominal pain syndrome is more common in women than men and usually occurs in the fourth decade of life.

Signs and symptoms
Functional abdominal pain syndrome is characterized by frequent or chronic stomach pain and a reduction in everyday activity. The pain is persistent, near-constant, or regularly reoccurring. The pain is not related to food intake or defecation. Functional abdominal pain is usually periumbilical and is not accompanied by weight loss, vomiting, diarrhea, nocturnal symptoms, or slowed growth. Typically, the level of abdominal pain in functional abdominal pain syndrome seldom varies, with maximum pain being felt the majority of the time. functional abdominal pain syndrome is frequently coupled with a proclivity to experience and report additional somatic symptoms of discomfort, such as chronic pain believed to be connected to the gynecological or urinary systems.

Causes
Functional abdominal pain syndrome is a functional gastrointestinal disorder. Functional gastrointestinal disorders (FGD) are common medical conditions characterized by recurrent and persistent gastrointestinal symptoms caused by improper functioning of the enteric system in the absence of any identifiable organic or structural pathology, such as ulcers, inflammation, tumors or masses.

Mechanism
The pain from functional abdominal pain syndrome is thought to be caused by changes in descending modulation, central sensitization of the spinal dorsal horn, peripheral enhancement of the visceral pain afferent signal, and, lastly, central amplification.

Peripheral sensitization, also known as elevated ascending visceral afferent signaling, can happen following GI tract inflammation or damage. For example, about one-third of individuals with IBS report that their symptoms started after an acute infection episode; this is a phenomena known as postinfectious IBS (PI-IBS). PI-IBS has consistently been linked to the existence of a low-grade inflammatory infiltrate. According to theory, this inflammatory infiltration results in increased sensitivity and field of peripheral receptors, the latter of which causes hyperalgesia by recruiting and activating nociceptors that were previously silent. Furthermore, it was discovered that the best indicators of who would develop PI-IBS were stress, as measured by traumatic life events, and a neurotic personality features. These convergent lines of data support the hypothesis that inflammation and/or injury in a psychologically predisposed person may cause visceral afferents to become peripherally sensitized, increasing the amount of nociceptive information that ascends to the spinal dorsal horn.

Peripheral nociceptors become more sensitive, which increases the amount of impulses that reach the spinal dorsal horn. Central sensitization may result from an increase in the frequency and amplitude of peripheral signals that reach the spinal dorsal horn. An increase in presynaptic glutamate release causes central sensitization by removing the magnesium ion block of the N-methyl-d-aspartate (NMDA) receptor. The end result is an overall increase in dorsal horn neuron responsiveness, which frequently lasts longer than the initial shock when combined with activation of other important enzymes.

The anterior cingulate cortex is home to the majority of the central descending modulatory systems. These modulatory systems allow afferent signals from the periphery to be gated, which allows for the amplification or even restriction of the signal. They interface with the spinal dorsal horn. The pro-nociceptive condition that characterizes many chronic visceral pain syndromes is thought to be mostly caused by anomalies in the descending pain modulatory system.

Diagnosis
Since pain is the primary symptom of functional abdominal pain syndrome, obtaining a complete medical history and conducting a comprehensive physical examination continue to be essential components of the diagnosing process. The functional abdominal pain syndrome patient should be asked to provide a thorough history that thoroughly examines the timeline of pain occurrences, especially in connection with surgery, infection, or traumatic life events.

In a patient with functional abdominal pain syndrome, the clinical examination should be normal by definition. Nonetheless, as a starting point, it is important to look closely for the existence of abdominal scars from prior operations or investigations. Similarly, Carnett's sign, which involves palpating a sore spot both before and after the patient tenses their abdominal wall, could be helpful.

Diagnostic testing to rule out organic disease should not be done frequently in the absence of alarm signs, similar to other functional GI problems (ie, unexplained weight loss, bloody bowel movements, abdominal mass, anorexia). If the physical examination yields negative results, no more diagnostic testing is necessary.

The Rome IV diagnostic criteria for functional abdominal pain syndrome is as follows:

 * 1) Constant or almost constant abdominal pain.
 * 2) There is either no correlation or a very weak one between pain and physiological processes (e.g., eating, feces or menses).
 * 3) Some aspects of daily functioning are limited by pain.
 * 4) Pain is not feigned.
 * 5) No other medical illness or structural or functional gastrointestinal issue may account for the pain.

To fit the Rome IV diagnostic criteria for functional abdominal pain syndrome the patient must fit all of the above criteria and the criteria must be met over the past three months, with the onset of symptoms occurring at least six months before diagnosis.

When diagnosing functional abdominal pain syndrome, a number of other functional GI illnesses should be taken into account initially. IBS may be taken into consideration if the pain is accompanied by changes in bowel motions (frequent, loose stools or harder, infrequent stools). Functional gall bladder disease or sphincter of Oddi dysfunction should be considered if the pain is significant, occurs at different intervals (not daily), and is located in the right upper quadrant or epigastrium. Consider functional dyspepsia if the discomfort is in the epigastrium and does not meet the criteria for functional gall bladder disease.

Treatment
There is no definite agreement on how to best manage functional abdominal pain syndrome in adults. As a result, the majority of currently employed therapies are founded on data and firsthand knowledge from other functional bowel diseases and chronic pain syndromes. It is helpful to categorize therapy modalities into three groups: psychological interventions, pharmaceutical therapies, and general measures.

The doctor-patient interaction is essential to the management of a patient with functional abdominal pain syndrome and to a successful outcome. A crucial component of treatment is, in particular, validating a patient's symptoms in a caring, interdisciplinary setting. In the framework of routine outpatient reviews, the patient and the doctor should also decide on and establish realistic treatment goals.

Antidepressants, especially low-dose tricyclic antidepressants (TCAs), have been shown to be beneficial in the treatment of functional gastrointestinal disorders and chronic pain. They may also be helpful in the treatment of functional abdominal pain syndrome due to their dual effects of direct pain management and antidepressant properties.

Trials utilizing tricyclic antidepressants have generally outperformed those using selective serotonin-reuptake inhibitors in other chronic pain disorders. Venlafaxine and duloxetine are two examples of more recent medications with combined serotonin and norepinephrine reuptake inhibitors (SNRIs), which have been shown to reduce pain in some somatic pain disorders and may be helpful in functional abdominal pain syndrome. Patients with co-occurring anxiety and depression may benefit from both SNRIs and selective serotonin-reuptake inhibitors (SSRIs). The majority of analgesics, such as aspirin and nonsteroidal anti-inflammatory medications, don't really help much, maybe because they mostly have peripheral effects. Because of the risk of addiction and narcotic bowel syndrome, narcotic analgesics should be avoided.

There hasn't been a study explicitly looking at adult functional abdominal pain syndrome and psychological therapy. Studies on non-gastrointestinal pain diseases and other painful functional gastrointestinal illnesses, however, point to the potential benefit of psychological therapies. Stress management, hypnosis, dynamic or interpersonal psychotherapy, and cognitive behavioral therapy are among the interventions that may prove advantageous. The most effective way to manage impairment resulting from refractory chronic pain may be to refer patients to pain treatment clinics for multidisciplinary treatment programs. While the previously discussed psychological treatments have demonstrated improvements in mood, coping, quality of life, and health care costs, their effect on specific visceral or somatic symptoms is less clear, indicating that their most effective application may be in conjunction with symptomatic treatment.

Epidemiology
Due to a lack of data and methodological challenges in distinguishing functional abdominal pain syndrome from other more prevalent functional gastrointestinal diseases like IBS and functional dyspepsia, the epidemiology of the disease is not fully understood. Nonetheless, compared to functional dyspepsia or IBS, functional abdominal pain syndrome is generally thought to be a less frequent. The stated prevalence rates in North America are between 0.5% and 2%, and they are consistent with reports from other nations. The condition affects women more frequently than men (3:2), with a peak in prevalence occurring in the fourth decade of life.

title: Functional abdominal pain syndrome


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Mikhail Petrovich Bestuzhev-Ryumin

Count Mikhail Petrovich Bestuzhev-Ryumin (Михаи́л Петро́вич Бесту́жев-Рю́мин; September 1688 – 1760) was a Russian diplomat. He was the son of Pyotr Bestuzhev-Ryumin and elder brother of the more famous Aleksey Bestuzhev.

Mikhail Bestuzhev was brought up with his brother in Berlin. In 1705, Peter the Great commanded him to join the Russian embassy in Copenhagen. Fifteen years later, he became the Russian resident in England, which — despite an earlier obligation to the contrary — presently entered an alliance with Sweden. As the Great Northern War between Russia and Sweden was still going on, Bestuzhev attempted to interfere but was ordered by the English government to leave the country.

He then settled in The Hague, until the Treaty of Nystad concluded the war in 1721. Thereupon he was appointed Minister Plenipotentiary in Stockholm, a position which he filled with notable success. During his tenure, Sweden recognized Russia as an empire and concluded a defensive alliance with her for 12 years. Catherine I of Russia, however, ordered him to move to Warsaw in 1726, while Empress Anna removed him to Berlin before having him returned to Stockholm in 1732. Although the alliance with Sweden was prolonged, Bestuzhev was exposed to street violence more than once and was briefly taken into custody when the new Russo-Swedish War erupted in 1741.

Upon his release, Bestuzhev proceeded to Hanover to confer with George II of Great Britain. At this time, Empress Elizabeth usurped the throne and appointed Bestuzhev her agent in Warsaw. In 1743, he married Golovkin's daughter, Anna Bestuzheva, who was soon involved into the Lopukhina Affair, which resulted in her tongue being torn out. During the investigation of his wife's behaviour, Bestuzhev was held under house arrest. When he was finally allowed to go abroad, his powerful brother procured for him a series of lucrative appointments. He successively served as the Russian ambassador in Berlin, Warsaw, Vienna, and Paris, where he died.

license: Creative Commons - Attribution Share-Alike - https://creativecommons.org/licenses/by-sa/4.0/

title: Mikhail Petrovich Bestuzhev-Ryumin


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Unknown

Unknown or The Unknown may refer to:

Film and television

 * The Unknown (1915 comedy film), Australian silent film
 * The Unknown (1915 drama film), American silent drama film
 * The Unknown (1927 film), a silent horror film starring Lon Chaney
 * The Unknown (1936 film), a German drama film
 * The Unknown (1946 film), a mystery film
 * The Unknown (1964 film), a Polish war film
 * Anjaane: The Unknown, a 2005 Bollywood horror movie
 * The Unknown, a 2005 action/thriller starring Miles O'Keeffe
 * Unknown (2006 film), a thriller starring James Caviezel
 * Unknown (2011 film), a thriller starring Liam Neeson
 * Het Onbekende (Dutch for: The Unknown), Dutch television show
 * Unknown, a 2024 web series starring Chris Chiu
 * "The Unknown" (Star Wars: The Clone Wars)

Literature

 * Unknown (magazine), an American pulp fantasy fiction magazine published from 1939 to 1943
 * The Unknown, a 1998 book in the Animorphs series by K. A. Applegate
 * The Unknown (hypertext novel), a 1999 web-based hypertext novel written by William Gillespie, Scott Rettberg and Dirk Stratton with Frank Marquardt
 * The Unknown (1963 anthology), an anthology of fantasy fiction short stories edited by D. R. Bensen and illustrated by Edd Cartier
 * The Unknown, a comic book mini-series by Mark Waid

Music

 * The Unknown (Madeline Juno album) (2014)
 * Unknown (Rasputina album) (2015)
 * The Unknown (The Vision Bleak album) (2016)
 * The Unknown, a 2014 album by Dillon
 * "The Unknown" (song), by 10 Years, 2019
 * "The Unknown", a song by Crossfade from Crossfade, 2004
 * "The Unknown (Strength)", a song by In Hearts Wake from Divination, 2012
 * "The Unknown", a song by Imagine Dragons from the deluxe edition of Smoke + Mirrors, 2015
 * "The Unknown", a song by Shadows Fall from Fire from the Sky, 2012
 * "Unknown", a song by Reks from The Greatest X, 2016

Science and mathematics

 * Unknown (mathematics), a variable that appears in an equation for which a solution is sought
 * Unknown, the ongoing answer to an open problem

Video games

 * Unknown (video game) or Amnesia: The Dark Descent, a 2010 video game
 * Unknown (Tekken), a character in Tekken

Other uses

 * "The Unknown" (Over the Garden Wall), an episode of Over the Garden Wall
 * The Unknown, a location in Over the Garden Wall
 * The Unknown, a character in Willy's Chocolate Experience
 * The Unknown, a sculpture by Kenny Hunter
 * Unknown, a Unicode script
 * The Unknowns, a self-proclaimed ethical hacking group

People

 * Unknown Hinson (born 1954), musician and performer
 * The Unknown Comic (born 1945), Canadian actor and comedian
 * The Unknown DJ, American disc jockey and record producer
 * Unknown T (born 1998), British rapper

title: Unknown


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North Carolina Council of State

The North Carolina Council of State is the collective body of ten elective executive offices in the state government of North Carolina, all of which are established by the state constitution. The Council of State includes the Governor, Lieutenant Governor, Secretary of State, State Auditor, Treasurer, Superintendent of Public Instruction, Attorney General, Commissioner of Agriculture, Commissioner of Labor, and Commissioner of Insurance. Together with the North Carolina Cabinet and several independent agencies, the Council of State offices constitute the executive branch of North Carolina's state government.

The body has its origin in the colonial government of the Province of North Carolina. Under North Carolina's first constitution as a state of the United States, the Council of State comprised seven persons elected by the North Carolina General Assembly to advise the governor. The 1868 constitution redefined the Council of State as the secretary of state, state treasurer, state auditor, superintendent of public works, and superintendent of public instruction. The superintendent of public works was soon abolished, additional elective offices were later added, and the governor was made a formal member of the council. The Council of State usually meets monthly and is responsible for approving various transactions concerning state real property and finances.

History
As a British colony, the Province of North Carolina was under the leadership of a royal governor. A Governor's Council was created to advise the governor, and it comprised residents of the colony appointed by the lords proprietors and eventually the British Crown. The body also served as the upper house of the colonial legislature when it was in session. One member served as president of the council, and could take charge of the colony if the governor or their deputy were unable to exercise their duties. The president, in their legislative capacity, also signed all laws passed by the legislature. Vacancies on the council were filled by the governor's interim appointment until the lords or the Crown made a new appointment. In practice, many councilors held other government offices and often competed with the governor and the lower house of the legislature for authority. As a body, the council held great influence over the content of executive decrees, the dispensation of patronage, and the awarding of land grants.

North Carolina declared independence from Great Britain in 1776. Its first constitution, ratified in December, provided for a Council of State to "advise the Governor in the execution of his office". The council consisted of seven persons selected by both houses of the North Carolina General Assembly in a joint vote for a one-year term. The councilors were barred from holding legislative office. Vacancies on the council could only be filled by the General Assembly. In practice, the Council of State limited the governor's executive authority, as sometimes the governor was required to get their approval before taking a course of action. The council itself could not take action without the governor. The first council was elected by the constitutional convention in December 1776 and took office the following year, serving until they were replaced by the General Assembly's choices.

A new constitution was adopted in 1868, and provided that the Council of State should consist of six popularly-elected executive officials serving ex officio: the secretary of state, state auditor, state treasurer, superintendent of public works, and superintendent of public instruction. Under the constitution, the governor called and presided over the council's meetings and the attorney general served as its legal advisor, but neither were formally members of it. The office of superintendent of public works was abolished via constitutional amendment in 1873. The popularly-elected offices of the commissioner of agriculture, commissioner of labor, and commissioner of insurance were elevated to constitutional status in 1944 and added to the council. Constitutional revisions which took effect in 1971 made the governor, lieutenant governor, and attorney general all ex officio members of the council. The revisions also eliminated the responsibility of the council to "advise the Governor in the execution of his office". In 1987, Governor James G. Martin sued the other members of the Council of State during a dispute over securing a leasing agreement for government office space. The North Carolina Supreme Court ruled that the Council of State could block decisions of the governor, but it could not take positive action on its own accord.

Most Council of State members have historically been white men. Ralph Campbell Jr., who assumed the office of state auditor in 1993, was the first black person to serve on the Council of State. Janice H. Faulkner was the first woman to serve on the council, having been appointed secretary of state to fill a vacancy in 1996. Elaine Marshall, who became Secretary of State in January 1997, was the first woman elected to a Council of State office. Jessica Holmes was the first black woman to serve on the council, having been appointed state auditor to fill a vacancy in 2023.

Structure
The Council of State comprises the holders of the ten offices established by Article III of the Constitution of North Carolina: governor, lieutenant governor, secretary of state, state auditor, state treasurer, superintendent of public instruction, attorney general, commissioner of agriculture, commissioner of labor, and commissioner of insurance. All serve as the chief executive of their respective departments. They are elected to four-year terms and, aside from the governor and lieutenant governor, without term limits. Contested elections for any of these offices are resolved by a majority vote of the General Assembly. In the event of a vacancy in any of the offices aside from that of the governor and lieutenant governor, the governor can appoint an interim official until the next biennial state election. The office of governor is subject to its own line of succession. Council of State officers can be impeached and removed from office for malfeasance by the General Assembly. The officers' salaries are fixed by the General Assembly and cannot be reduced during their terms of office. Together with the North Carolina Cabinet and several independent agencies, the Council of State offices constitute the executive branch of North Carolina's state government.

The governor serves as the chairman of the Council of State. The body routinely meets the first or second Tuesday of every month in sessions subject to the state's open meeting law which the public can attend. The governor also sometimes consults the rest of the council over email during emergencies or otherwise unanticipated situations. The council retains a staff, which records the minutes of each meeting and supplies them to the council members. The secretary of state maintains the schedule and agenda of council meetings. The 2022 state budget includes plans for the construction of a permanent meeting place for the council to begin in 2023.

Powers and duties
The Constitution of North Carolina assigns minimal duties to the Council of State; per Article III, Section 3, it may call the General Assembly into an extraordinary session to consider the governor's mental capacity, and, per Article III, Section 5, the governor must consult it before they call the assembly into an extraordinary session. The council's most significant responsibilities have been assigned by statute, most dealing with real property and financial transactions. This includes approving the governor's acquisitions and disposals of state property, approving property allocations, authorizing taking on debt in anticipation of tax revenue, authorizing the state treasurer to borrow money in times of crisis, creating emergency funds, approving bond issues, and advising the governor and treasurer on assurance investments, approving of banks in which state funds can be deposited, and approving securities in which state funds may be invested. If the governor exercises a power or authority which requires the concurrence of the council, they are required by law to secure the body's approval within 48 hours of exercising said power.

title: North Carolina Council of State


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John Taylor (Taylor Ham)

John Taylor (October 6, 1836 – February 10, 1909) was an American businessman and politician who served in the New Jersey Senate. He created pork roll in 1856 and formed Taylor Provisions Company in 1888, establishing the brand "Taylor's Prepared Ham", sometimes called Taylor Ham. He also founded the Taylor Opera House in Trenton, New Jersey. Taylor Street in Trenton is also named for him.

Taylor was born in Hamilton Square, New Jersey, in 1836. His father James F. Taylor, owner of a brick yard, died when John was fourteen. Taylor entered the grocery business as a store clerk at seventeen. He quickly earned an interest with his company but left after a year to form his own partnership with James Ronan, which lasted for two years before Taylor bought Ronan's share. From 1860 through 1870, he worked in the wholesale grocery business in association with D.P. Forst. Shortly thereafter, Taylor began working in the pork and cattle packaging industry. This enterprise was organized into the Taylor Provision Company in 1888.

Taylor was a Republican active in Trenton's City Council, where he served as chairman of the finance committee. He was elected to the New Jersey Senate for Mercer County, serving from 1880 to 1883. He declined a second term. He helped to abolish the street markets of New Jersey, and organized the Inter-State Fair in 1888.

In 1860, he married Catherine Rowley who later bore him two sons: Harry C., born in September 1864, and William T., October 1869. He is buried in Riverview Cemetery in Trenton.

title: John Taylor (Taylor Ham)


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Taylor Opera House

Taylor Opera House was an opera house in Trenton, New Jersey. It was the city's first theater, and was founded by John Taylor, creator of Pork Roll and one of Trenton's leading citizens. The building first opened March 18, 1867 at 18 S. Broad Street. A historical marker was placed on the site after its demolition.

The theater presented the major speakers and performers of the day, including Mark Twain, Ethel Barrymore, and George M. Cohan, and played host to political conventions, Bible conferences, musical revues and local meetings and events. It hosted the inaugurations of Governor George B. McClellan in 1877, and Woodrow Wilson in 1910, James F. Fielder in 1914 and Walter Evans Edge in 1917.

In 1921, it was converted into a movie and vaudeville palace known as Keith's Capitol Theatre; after later sales it was renamed the RKO International.

The theater was razed by its next door neighbor (the Trenton Saving Fund Society) to create a parking lot in 1969.

A mural that was originally displayed at the opera house was rediscovered after a search began in 2021. Painted by George Matthews Harding in 1921 titled, "Washington Crossing the Delaware", the 16x10 foot painting was lost after it was put into storage having been deemed too large to display at another museum.

title: Taylor Opera House


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Horseless carriage

Horseless carriage is an early name for the motor car or automobile. Prior to the invention of the motor car, carriages were usually pulled by animals, typically horses. The term can be compared to other transitional terms, such as wireless phone. These are cases in which a new technology is compared to an older one by describing what the new one does not have.

Most horseless carriages are notable for their similarity to existing horse-drawn carriages, but with some type of mechanical propulsion. Features of the first horseless carriages include tiller steering, an engine under the floorboards, and a high center of gravity.

In the 19th century, steam engines became the primary source of power for railway locomotives and ships, and for powering processes in fixed installations such as factories. In 1803, what is said to have been the first horseless carriage was a steam-driven vehicle demonstrated in London, England, by Richard Trevithick. In the 1820s, Goldsworthy Gurney built steam-powered road vehicles. One has survived to be on display at Glasgow Museum of Transport. In the United States, a four-wheel steam carriage was made by Sylvester H. Roper in 1863.

The 1896 Armstrong horseless carriage is notable as an early hybrid vehicle, which combined an electric motor with battery and gasoline-fueled internal-combustion engine.

In 1893, Frank Duryea is reported to have made the first horseless carriage trip on U.S. roads, in Springfield, Massachusetts, traveling approximately 600 yd before engine problems forced him to stop and make repairs. He went on to found the first U.S. car company, the Duryea Motor Wagon Company, with his brother.

In April 2016, horseless carriages from the turn of 19th and the early 20th centuries were featured in a re-creation of the first London Motor Show in 1896.

title: Horseless carriage


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Vasily Lukich Dolgorukov

Prince Vasiliy Lukich Dolgorukov (Василий Лукич Долгоруков; 1672 – 8 November 1739) was a Russian diplomat and minister who was the most powerful man in the country in the later years of Peter II's reign.

A male-line descendant of the legendary prince Rurik, Dolgorukov was one of the first batch of young Russians whom Peter the Great sent abroad to be educated. From 1687 to 1700 he resided in Paris, where he learned thoroughly the principal European languages, acquired the superficial elegance of the court of Versailles, and associated with the Jesuits, whose moral system he is said to have appropriated. He began his diplomatic career as his uncle Yakov Fyodorovich's aide. He also accompanied another uncle Grigory Fyodorovich on a mission to Poland.

On his return home he entered the diplomatic service. From 1706 to 1707 he represented Russia in Poland; and from 1707 to 1720 he was appointed minister in Copenhagen. There, he succeeded in persuading King Frederick IV to join the second coalition against Charles XII in the Treaty of Copenhagen (1709). At the end of 1720 he was transferred to Versailles, in order to seek the mediation of France in the projected negotiations with Sweden and obtain the recognition of Peter's imperial title by the French court. In 1724 he represented Russia in Warsaw and in 1726 in Stockholm, the object of the latter mission being to detach Sweden from the Hanoverian alliance, in which he did not succeed.

During the reign of Peter II, Dolgorukov was appointed a member of the Supreme Privy Council. After procuring the banishment of Menshikov he drew up a letter purporting to be the last will of the emperor, appointing Catherine Dolgorukova his successor, but shortly afterwards abandoned the nefarious scheme as impracticable, and was one of the first to support the election of Anne of Courland to the throne on condition that she first signed nine "articles of limitation", which left the supreme power in the hands of the Russian council.

Anne, who repudiated the "articles" on the first opportunity, never forgave Dolgorukov for this. He was deprived of all his offices and dignities on April 17, 1730, and banished first to his country seat and then to the Solovetsky Monastery. Nine years later the charge of forging the will of Peter II was revived against him, and he was tortured and then beheaded in Novgorod on November 8, 1739.

title: Vasily Lukich Dolgorukov


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Oldenburg in Holstein

Oldenburg in Holstein  is a German town at the southwestern shore of the Baltic Sea. The nearest city is Lübeck. The town belongs to the (historical) region of Holstein, today in the German state of Schleswig-Holstein.

Oldenburg was the chief town of the Wagrians, one of the Slavic peoples that migrated as far west as the river Elbe in or after the 6th century (see Völkerwanderung), also known as Wends and Obotrites. They arrived about A.D. 700 and the Pomeranian/Kashubian (Slavic) name was Starigard or Stargard, meaning "Old Settlement", "Old Castle", "Old City/Town"; the German name Oldenburg is of Low German origin and carries the same meaning. The Obotrites were allies of Charlemagne. Emperor Otto I established the bishopric of Oldenburg under Adaldag, archbishop of Hamburg.

To the Northern Germanic Vikings, the city was known as Brandehuse, i.e. "the burned houses", indicating the bellicose times.

For centuries, Starigard/Oldenburg remained the Slavic competitor of Hedeby on the Baltic trade, until the counts Adolph I and Adolph II of Schauenburg and Holstein, supported by Henry the Lion, finally defeated the Wends during the first half of the 12th century.

The modern town has a partnership with Bergen auf Rügen in Mecklenburg-Vorpommern.

Twin towns – sister cities
Oldenburg in Holstein is twinned with:
 * 🇩🇪 Bergen auf Rügen, Germany (1990)
 * 🇱🇹 Palanga, Lithuania (2016)
 * 🇫🇷 Blain, France (2017)

Notable natives of Oldenburg in Holstein

 * Johann Liss (c.1590-c.1630) Baroque painter, active mainly in Venice

title: Oldenburg in Holstein


text:
User:Dpbsmith/prescription

Under construction

This article describes the optics of an ordinary eyeglass prescription, which is used to correct small refractive errors in the optical system of the eye. The effect of these errors is to create a blurred image. By correcting these errors, the eyeglass lens removes the blur.

Abbreviations

 * Rx means prescription and is derived from the abbreviation "rx" from the Latin word recipire, "to take." Literally, Rx is an instruction to the patient "to take" what is specified in the prescription. See Medical prescription.

 * O.D. is an abbreviation for oculus dexter, Latin for "right eye." (Some eyeglass prescriptions simply say "left" and "right" instead of "O.S." and "O.D.") Oculus means "eye." An eye doctor is sometimes called an "oculist" (although eye doctors themselves usually prefer to use either the term ophthalmogist or optometrist). The Latin word dexter means "right" (as opposed to "left"). The words "dexterity" and "dextrous" derive from this root, because the right hand is usually more skillful than the left.

 * O.S. is an abbreviation for oculus sinister, Latin for "left eye." The Latin word "sinister" means "left," which was once associated with the idea of evil. The "bar sinister" in a medieval heraldry meant that the bearer was of illegitimate descent.

 * Note: The word ophthalmologist has an "h" after the "p". The first syllable is pronounced "aahf," like the "oph" in "sophomore." It comes from the Greek root "ophthalmos-" meaning "eye;" ophthalmology literally means "the science of eyes." The word optometrist comes from a different Greek root, "opto-," meaning "vision." An optometrist literally means "one who measures vision." In the United States, these are specific terms referring to specific state licensing and courses of professional study. There is considerable overlap in the scope of the two specialties. Optometrists undergo four years of training and have received a doctor of optometry (OD) degree. They are doctors, though not medical doctors, and are licensed to detect, treat, manage, and refer cases of eye disease. Ophthalmologists are medical doctors (MD) who have typically performed an additional three to five years of residency in ophthalmology, and received board certification. The American Academy of Ophthalmology emphasizes the distinction by promoting the phrase "Eye MD" to refer to ophthalmologists. The American Optometric Association characterizes optometrists as "primary eye care providers." Very broadly, ophthalmogists tend to be oriented toward the treatment of eye disease, and optometrists toward the maintenance of optimum vision in healthy eyes.

 * D.V. and N.V. stand for "distant vision" and "near vision" and refer to the different corrections in the upper and lower portions of a bifocal lens. The "N.V." portion of a "single vision" lens prescription will be blank.

 * Spherical, Cylindrical, and Axis will be explained further below. Most eyeglass prescriptions will contain values here. The "spherical" and "cylindrical" columns contain lens strengths in diopters (see below); "axis" contains the direction of the cylinder axis in degrees.

 * Prism and Base are usually blank; they are refer to corrections for errors in eye orientation, such as strabismus.

Lenses
Depending on the optical setup, lenses can act as magnifiers, lenses can introduce blur, and lenses can correct blur. Many people first encounter lenses in the form of magnifying glasses, and think of lenses as magnifiers. Eyeglasses may, in fact, have a small magnifying or reducing effect, but that is an unintentional (and undesirable) side effect. Eyeglasses do not improve vision by magnifying images; they improve vision by reducing blur.

Lens strength
The values given in the "sphere" and "cylinder" columns of an eyeglass prescription are lens strengths in diopters, abbreviated D. The higher the number of diopters, the stronger the lens.

A +10 diopter lens would make a good magnifying glass. Eyeglass lenses are usually much weaker, because eyeglasses do not work by magnifying; they work by correcting focus.

Lenses come in positive (plus) and negative (minus) strengths. You can usually tell whether a lens is positive or negative by looking through it. Positive lenses tend to enlarge things when you look through them; negative lenses tend to diminish the size of things when you look through them. Because eyeglass lenses are usually weak, they don't enlarge or diminish very much.

Positive eyeglass lenses can concentrate sunlight, like a burning glass. Usually, however, they are much too weak to set fire to anything.

This series of pictures show the shadow cast by a pair of 1 diopter drugstore "reading glasses" outdoors in sunlight as we hold it farther and farther away from a wall. As the distance from the wall increases, the shadow of the frame seems to thicken and the bright area in the center gets smaller and brighter. It slowly changes from being "eyeglass-shaped" to circular.

Negative lenses spread sunlight instead of concentrating it.

In science textbooks, positive lenses are usually diagrammed as convex on both sides; negative lenses are usually diagrammed as concave on both sizes. In a real optical system, you usually get the best optical quality when most rays of light are roughly normal to the lens surface. In the case of an eyeglass lens, this means that the lens should be roughly shaped like a cup with the hollow side toward the eye. So most eyeglass lenses are meniscus in shape.

Spherical lenses and spherical correction
Usually:
 * the "spherical" component is the main correction
 * the "cylindrical" component is "fine tuning."

Depending on the optical setup is, lenses can act as magnifiers, lenses can introduce blur, and lenses can correct blur.

Whatever the setup, spherical lenses act equally in all directions; it magnifies, blur or corrects blur the same amount in every direction.

Cylindrical lenses and cylindrical correction
When an eye doctor measures your eye—a procedure known as refraction—usually he or she begins by finding the best spherical correction. If there is astigmatism, the next step is to remove it by adding the right amount of cylindrical correction.

Axis
Axis

Spherical lenses just have a strength, such as +1.0D, or -2.5D.

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Crisis

A crisis (: crises; adjectival form: critical) is any event or period that will lead to an unstable and dangerous situation affecting an individual, group, or all of society. Crises are negative changes in the human or environmental affairs, especially when they occur abruptly, with little or no warning. More loosely, a crisis is a testing time for an emergency.

Etymology
The English word crisis was borrowed from the Latin, which in turn was borrowed from the Greek κρίσις krisis 'discrimination, decision, crisis'. The noun is derived from the verb κρίνω krinō, which means 'distinguish, choose, decide'.

In English, crisis was first used in a medical context, for the time in the development of a disease when a change indicates either recovery or death, that is, a turning-point. It was also used for a major change in the development of a disease. By the mid-seventeenth century, it took on the figurative meaning of a "vitally important or decisive stage in the progress of anything", especially a period of uncertainty or difficulty, without necessarily having the implication of a decision-point.

Definition
A crisis is often linked to the concept of psychological stress and used to suggest a frightening or fraught experience. In general, crisis is the situation of a "complex system" when the system functions poorly (the system still functions, but does not break down), an immediate decision is necessary to stop the further disintegration of the system, but the causes of the dysfunction are not immediately identified (the causes are so many, or unknown, that it is impossible to take a rational, informed decision to reverse the situation). By "complex system" we mean something like a family, economy, or society; simple systems do not enter crises. We can speak about a crisis of moral values, an economical or political crisis, but not a motor crisis.

The crisis has several defining characteristics. Seeger, Sellnow, and Ulmer say that crises have four defining characteristics that are "specific, unexpected, and non-routine events or series of events that [create] high levels of uncertainty and threat or perceived threat to an organization's high priority goals." Thus the first three characteristics are that the event is
 * 1. unexpected (i.e., a surprise)
 * 2. creates uncertainty
 * 3. is seen as a threat to important goals
 * Venette argues that "crisis is a process of transformation where the old system can no longer be maintained." Therefore the fourth defining quality is the need for change. If change is not needed, the event could more accurately be described as a failure.

Apart from natural crises that are inherently unpredictable (volcanic eruptions, tsunamis, etc.) most of the crises that we face are created by man. Hence the requirements of their being 'unexpected' depend upon man failing to note the onset of crisis conditions. Some of our inability to recognize crises before they become dangerous is due to denial and other psychological responses that provide succor and protection for our emotions.

A different set of reasons for failing to notice the onset of crises is that we allow ourselves to be 'tricked' into believing that we are doing something for reasons that are false. In other words, we are doing the wrong things for the right reasons. For example, we might believe that we are solving the threats of climate change by engaging in economic trading activity that has no real impact on the climate. Mitroff and Silvers posit two reasons for these mistakes, which they classify as Type 3 (inadvertent) and Type 4 (deliberate) errors.

The effect of our inability to attend to the likely results of our actions can result in a crisis.

From this perspective, we might usefully learn that failing to understand the real causes of our difficulties is likely to lead to repeated downstream 'blowback'. Where states are concerned, Michael Brecher, based on case studies of the International Crisis Behavior (ICB) project, suggested a different way of defining crisis as conditions are perceptions held by the highest level decision-makers of the actor concerned: 1. threat to basic values, with a simultaneous or subsequent 2. high probability of involvement in military hostilities, and the awareness of 3. finite time for response to the external value threat.

Chinese word for "crisis"
It is frequently said in Western motivational speaking that the Chinese word for "crisis" is composed of two Chinese characters signifying "danger" and "opportunity" respectively. This is, however, considered by linguists to be a misperception.

Economic
An economic crisis is a sharp transition to a recession. See for example 1994 economic crisis in Mexico, Argentine economic crisis (1999–2002), South American economic crisis of 2002, Economic crisis of Cameroon. Crisis theory is a central achievement in the conclusions of Karl Marx's critique of Capital.

A financial crisis may be a banking crisis or currency crisis.

Environmental
Crises pertaining to the environment include:

Environmental disaster
An environmental disaster is a disaster that is due to human activity and should not be confused with natural disasters (see below). In this case, the impact of humans' alteration of the ecosystem has led to widespread and/or long-lasting consequences. It can include the deaths of animals (including humans) and plant systems, or severe disruption of human life, possibly requiring migration.

Natural disaster
A natural disaster is the consequence of a natural hazard (e.g. volcanic eruption, earthquake, landslide) which moves from potential in to an active phase, and as a result affects human activities. Human vulnerability, exacerbated by the lack of planning or lack of appropriate emergency management, leads to financial, structural, and human losses. The resulting loss depends on the capacity of the population to support or resist the disaster, their resilience. This understanding is concentrated in the formulation: "disasters occur when hazards meet vulnerability". A natural hazard will hence never result in a natural disaster in areas without vulnerability, e.g. strong earthquakes in uninhabited areas.

For lists of natural disasters, see the list of disasters or the list of deadliest natural disasters.

Endangered species
An endangered species is a population of an organism which is at risk of becoming extinct because it is either few in number, or threatened by changing environmental or predation parameters. An endangered species is usually a taxonomic species, but may be another evolutionary significant unit. The World Conservation Union (IUCN) has classified 38 percent of the 44,837 species assessed by 2008 as threatened.

International
For information about crises in the field of study in international relations, see crisis management and international crisis. In this context, a crisis can be loosely defined as a situation where there is a perception of threat, heightened anxiety, expectation of possible violence and the belief that any actions will have far-reaching consequences (Lebow, 7–10).

Personal
A personal crisis occurs when an individual can no longer cope with a situation. This is preceded by events of an extraordinary nature triggering extreme tension and stress within an individual, i.e., the crisis, which then requires major decisions or actions to resolve. Crises can be triggered by a wide range of situations including, but not limited to, extreme weather conditions, sudden change in employment/financial state, medical emergencies, long-term illness, and social or familial turmoil. Crises are simply a change in the events that comprise the day-to-day life of a person and those in their close circle, such as the loss of a job, extreme financial hardship, substance addiction/abuse, and other situations that are life-altering and require action that is outside the "normal" daily routine. A person going through a crisis experiences a state of mental disequilibrium, in which the ego struggles to balance both internal and external demands. In this case, said person resorts to coping mechanisms to deal with the stress. Various coping mechanisms include:
 * High emotions (crying, physical withdrawal)
 * Defence mechanisms (denial, repression)
 * Making rash decisions
 * Acting out
 * Putting things on hold

In some cases, it is difficult for an individual undergoing a crisis to adapt to the situation. As it is outside of their normal range of functioning, it is common that one endures a struggle to control emotions. This lack of control can lead to suicidal tendencies, substance abuse, trouble with the law and general avoidance of resources available for help. One such resource used to aid an individual in crisis is their social support system, which can come in the form of family, friends, coworkers, or health professionals. It is important that a support system consists of people that the individual trusts. Although these support systems play a crucial role in aiding an individual through a crisis, they are also the underlying cause of two thirds of mental health crises. The aforementioned mental health crises can include marital issues, abandonment, parental conflict and family struggles.

In order to aid someone in a crisis, it is crucial to be able to identify the signs that indicate they are undergoing an internal conflict. These signs, as well as the aforementioned coping mechanisms, include:
 * Irrational and/or narrow thinking
 * Lowered attention span
 * Unclear motives
 * Disorganized approach to problem-solving
 * Resistance to communication
 * Inability to differentiate between large and small issues
 * Change/alteration to social networks

Ways to manage a crisis
As aforementioned, a crisis to this day can be overcome by implementing mechanisms such as: sleep, rejection, physical exercise, meditation and thinking. To assist individuals in regaining emotional equilibrium, intervention can be used. The overall goal of crisis intervention is to get the individual back to a pre-crisis level of functioning or higher with the help of a social support group. As said by Judith Swan, there's a strong correlation between the client's emotional balance and the trust in their support system in helping them throughout their crisis. The steps of crisis intervention are: to assess the situation based on behavior patterns of the individual, decide what type of help is needed (make a plan of action), and finally to take action/intervention, based on the individual's skills to regain equilibrium. In the context of natural disasters and other climate change-related crises, emotional activation is common. Collective processing of emotional experiences is an important part of enabling individuals to increase in their resilience, leading to greater community engagement and a sense of belongingness. When appropriate support for emotional experiences is provided, climate change-induced emotions are adaptive.

The Registered Nurses’ Association of Ontario proposed the ABC model for dealing with client's interventions in crises:

Benefits of listening in a crisis
Moreover, another method for helping individuals who are suffering in a crisis is active listening; it is defined as seeing circumstances from another perspective and letting the other person know that the negotiator (the helper) understands their perspective. Through this, they establish trust and rapport by demonstrating empathy, understanding, and objectivity in a non-judgmental way. It is important for the negotiator to listen to verbal and non-verbal reactions of the person in need, in order to be able to label the emotion that the individual is showing. Thus, this demonstrates that the helper is tuned in emotionally. Furthermore, there are other techniques that can be used to demonstrate active listening such as paraphrasing, silence, and reflecting or mirroring. The goal in active listening is to keep the person talking about their situation.

In chaos theory
When the control parameter of a chaotic system is modified, the chaotic attractor touches an unstable periodic orbit inside the basin of attraction inducing a sudden expansion in the attractor. This phenomenon is termed as interior crisis in a chaotic system.

title: Crisis