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

Deputy Director, Southern California College of Osteopathic Medicine

In this Research Note muscle relaxant lorzone discount azathioprine on line, we apply a concept developed to understand learning of business organizations to recent transformations of jihadist groups muscle relaxant pregnancy order discount azathioprine on line. The question we want to shed light on using this approach is whether muscle relaxant video generic azathioprine 50 mg with amex, and in which ways spasms meaning cheap azathioprine 50mg with amex, terrorist groups are able to question not only their immediate modus operandi, but also the fundamental assumptions their struggle is built on. More specifically, we focus the inquiry on the development of the Al-Qaeda network. Despite its acknowledged penchant for learning, the ability of the jihadists to transform on a deeper level has often been denied. Keywords: Organizational learning, terrorist transformation, strategic change, jihadism, Al-Qaeda, Hayat Tahrir al-Sham Introduction Departing from earlier assertions that terrorist organizations are generally conservative and averse to experimentation and change,[1] there is a growing literature dealing with the capacity of militant actors for flexibility, learning and innovative behavior. Distinguishing this level from tactical and organizational learning, Crenshaw described such strategic innovation as "shifts that change the fundamental pattern of terrorist challenges to political authority. Not only do many researchers focus too narrowly on tactical learning, but studies in the field also often suffer from the fact that their central concept is generally undertheorized in favour of case descriptions or typological contributions, and fail to rigorously link back to the extensive literature on learning developed in other fields. We attempt to address these shortcomings by drawing on a well-established theoretical concept developed outside the context of political violence, namely the organizational learning approach created by Argyris and Schцn. Crucially, as this approach was originally developed for understanding as well as improving learning processes, it is especially suited for an analysis of learning from the point of view of violent organizations themselves. This allows to better capture the internal reasonings and reflections that determine whether and how a group is able to engage in transformational learning. Specifically, we apply the concept to a study of the Al-Qaeda network, investigating whether, and in which ways, it was able to question not only its immediate modus operandi, but also the basic assumptions its struggle is built on. For example, Hafez argues that jihadists "appear to be incapable of internalizing lessons from past failures. The Concept of Double-Loop Learning Argyris and Schцn start with the assumption that "all deliberate action ha[s] a cognitive basis, that it reflect[s] norms, strategies, and assumptions or models of the world. Argyris and Schцn call these "theories of action", which include "strategies of action, the values that govern the choice of strategies and the assumptions on which they are based. In fact, they argue that given the constant turnover of actual members, it "is this theory-in-use, an apparently abstract thing, which is most distinctively real about the [organization]. Organizational learning, in this sense, is an intentional change in the organizational theory-in-use, traceable through such descriptions as well as the observable patterns of organizational action. Consequently, they define successful learning in a narrow sense as the "detection and correction of error," i. Based on the elements of theories-of-action, Argyris and Schцn distinguish two types of learning: In single-loop learning systems, the detection and correction of error connects the outcome in a single loop only to strategies of action, whereas the governing variables remain unchanged. In double-loop learning systems, a double feedback loop "connects the detection of error not only to strategies and assumptions for effective performance, but to the very norms which define effective performance. Single-loop learning to increase the effectiveness of actions is the dominant response to error and is ingrained in routine procedures in any organization. However, especially in changing environments, single-loop learning may actually lead to long-term ineffectiveness, as well as to a reduced capacity for double-loop learning. This results in the paradoxical situation where an increase in effectiveness in relation to one goal can lead to a decrease in effectiveness in relation to another. Due to the fact that in single-loop learning systems the governing variables are not questioned, conflicting requirements remain hidden and even may become undiscussable in organizations. This can lead to dilemma situations that Argyris and Schцn term "double binds": If members expose these contradictions, they question norms that are ingrained in everyday operations. For example, while organizations often officially encourage their members to report mistakes, members often refrain from doing so for fear of being punished as the harbinger of bad news. In contrast, in double-loop learning systems, people acknowledge when there is a mismatch between intention and outcome, share awareness of organizational dilemmas, engage such conflicts through inquiry and decrease double binds. In other words, while single-loop learning focuses on improving what an organization already does, or "doing the things right," double-loop learning is concerned with what organizations ought to do, or "doing the right things. Argyris and Schцn emphasize that their description of the mechanisms of organizational learning is neutral and that "any particular example of it may prove to be [. They must become aware that they cannot correct the error by doing better what they already know how to do, but by engaging in deep organizational inquiry. In this process the focus has to shift from learning concerned with improvement in the performance of tasks to inquiry through which an organization explores the values and criteria that define what improved performance means.

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Detailed requirements already exist for pesticide applicator licensing spasms 1983 trailer order azathioprine toronto, proper pesticide use back spasms 32 weeks pregnant order generic azathioprine line, sale spasms lower left side buy cheap azathioprine on-line, storage muscle relaxant 800 mg cheap 50 mg azathioprine fast delivery, and transport. It is important to note that label directions on pesticide products are the equivalent of federal and state law and must be followed. However, state regulations can be more stringent than the pesticide label, but never less stringent (since less stringent would violate federal law). The use of certain pesticides will trigger a seven hour wait before students may re-enter the area. An example would be pesticide label directions that direct the applicator not to allow entry until the product has dried and settled. However, the new law says that if a product label does not give a specific numeric re-entry time then the re-entry time defaults to seven hours. Public school boards, trustees of charter schools, and principals or lead administrators of private schools are responsible for complying. Public, private and charter schools with grades pre-kindergarten through 12 must comply. Not covered by the law are colleges, universities, or day care centers (unless the day care center is on a school property). Record Keeping: the school must keep records of pesticide application on school property at each school for three years after the date of application and for five years after the application of a pesticide for termite control. A full discussion of what constitutes a low impact pesticide is contained on page 22. Annual Notice: the school must provide annual notification at the beginning of each school year to all staff and to the parents or guardians of the student body. After the annual notice is distributed at the beginning of the school year, new staff and parents or guardians of new students must receive this notice upon employment or enrollment, respectively. They must never be made to wait until the next school year to receive this information. Notification and Sign Posting: the school must provide prior notice and post signs before the use of any pesticide (except that notification and signs are not needed when "low impact" pesticides as defined by the law are used). The notice must be given at least 72 hours before the pesticide application to all staff and parents or guardians of students enrolled at the school. Additionally, signs must be posted at least 72 hours before the pesticide application. During holiday periods or during the summer months when school is not in session, only staff and the parents or guardians of students using the school in an authorized manner need to be notified. Communication with the pest control professional is essential for obtaining all necessary information about the planned use of pesticides. Emergency Pesticide Use: the law provides for slightly different notification requirements in the event of a "school pest emergency" that is defined as an "urgent need to mitigate or eliminate a pest that threatens the health or safety of a student or staff member. One example of an emergency would be the presence of stinging insects such as ground hornets in an athletic field where events are scheduled. If a pest emergency exists, the school may use pesticides, but the posting must be done at the time of the application, and the notice to parents and staff must be done within 24 hours (or by the next school morning, whichever is earlier) after the emergency application. The notice that goes to parents and staff must explain what the reason for the emergency was, and if possible, what can and will be done to prevent such an emergency use of pesticides in the future. Re-entry: the law requires schools and pesticide applicators to carefully time applications and strictly control when students re-enter pesticide treated areas. The following is a summary of these requirements: 21 Applications of pesticides (except for low impact pesticides) are not allowed in a school building when students are present, unless the area being treated is served by a separate ventilation system and is also separated from the untreated area by smoke or fire doors. For applications of pesticides (except for low impact pesticides) whether indoor or outdoor, students are not allowed in the treated areas prior to the time allowed for reentry on the pesticide product label. If the label gives no numeric time for re-entry, then the law mandates that seven (7) hours must pass before students can re-enter. For applications of low impact pesticides, students are not allowed to re-enter until the pesticide application has dried or settled, or if the label specifies a re-entry or ventilation time, until that time has passed. Responding to inquiries and providing information to students, staff, and parents or guardians regarding pest management, and to State and County representatives. Laws are generally written in broad terms, and regulations are designed to be more specific and carry out the intent of the law.

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Each trial site will require potential patients to undergo a Screening Visit prior to randomisation to a treatment group spasms in throat discount azathioprine 50 mg visa. Each patient will receive a unique screening number which must be entered in a screening log that must be maintained at each trial site spasms groin area purchase generic azathioprine on line. The screening number will be allocated sequentially in the order in which the patients are screened muscle relaxant norflex cheap azathioprine online visa. Under no circumstances will patients screened in the trial be permitted to be re-screened for a second time in this trial muscle relaxant glaucoma buy generic azathioprine 50 mg on-line, except who need Run-in Period to stabilize the dose of concomitant treatment per protocol. Loss to follow-up (every effort must be made to contact the patient; a certified letter must be sent or phone calls on three separate days must be made). Worsening will be defined as an increase from the last visit in Mayo rectal bleeding subscore 1, over 3 consecutive days. Correction of previous data entries and/or entering of data related to visits/procedures done prior to but made available after withdrawal of consent. The Sponsor may temporarily or permanently discontinue the trial at an investigational site at any time for safety, ethical, compliance or other reasons. If this is necessary, the Sponsor will endeavour to provide advance notification to the site. A self-adhesive tear-off label will be included and is to be affixed to the drug accountability form maintained at the trial site. For the remaining infusions, the patient will be monitored for one hour post-infusion only, since clinical experience in this field has shown that this is sufficient for patients receiving frequent infusions. The temperature in the storage compartment shall be monitored every working day with a thermometer and the values shall be documented. Deviations in storage temperature must be reported without delay, and the medicinal products must not be used until further instructions from the Sponsor are received. The randomisation list will not be available to any person involved in the conduct (Section 5. Breaking of the blind for individual patients in emergency situations is an Investigator responsibility. As far as the emergency permits, the need to break the blind will be communicated to the Sponsor. As far as the emergency permits, the need to break the blind will be agreed by the Investigator and the Sponsor. The Investigator who unblinds a treatment must record the reason and date for unblinding before the treatment code can be broken. In case of accidental unblinding, the same documentation as for emergency unblinding must be obtained. If the Sponsor needs to unblind a treatment, the reason and the date of opening should be recorded with signature, following corporate standard operational procedures for unplanned unblinding of clinical trial patients. Every attempt will be made to ensure that all other trial and site staff will remain blinded throughout the course of the trial. Information on whether the blind has been broken for any patients must be collected before the database is declared clean and is released to the statistician. All periods are associated with evaluations and procedures that must be performed at specific time points, as described in Sections 6. The Time and Events Schedule (Table 1) summarises the frequency and timing of trial events. During screening, diagnostic colonoscopy or flexible sigmoidoscopy, at the discretion of the Investigator (if no diagnostic colonoscopy with serial biopsy has been performed within one year of screening, a full colonoscopy is required, to exclude malignancy), centrally read. The screening endoscopy should be performed at Day -35 to Day -6 prior to Randomisation. The scores for stool frequency and rectal bleeding will be calculated as an average based on scores collected from the Patient daily Diary, for up to 5, but at least 3 days prior to each applicable visit. In addition, the stool frequency and rectal bleeding subscore will be considered missing for the day of all endoscopies and the day after. Includes haematology, clinical chemistry, coagulation tests, and urinalysis assessments. Clinical laboratory test should be conducted -5 to -1 days prior to Randomisation. A complete physical examination will be performed at Visits 1 (Screening) and 9 (Follow-up). Includes blood pressure (measured after the patient has been in a seated position for 3 minutes of rest), pulse, respiratory rate, and body temperature.

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In this view muscle relaxers not working discount azathioprine 50mg fast delivery, the events contributing to tumorigenic transformation muscle relaxant lyrics buy genuine azathioprine on line, such as interrupted or decreased expression of "tumor suppressor" genes muscle relaxants for tmj order azathioprine 50 mg online, loss of programmed death pathways spasms rectum order generic azathioprine on line, evasion of immune cells and macrophage surveillance mechanisms, retention of telomeres, and activation or amplification of self-renewal pathways, occur as single, rare events in the clonal progression to blast-crisis leukemia. Many methods have revealed contributing protooncogenes and lost tumor suppressors in myeloid leukemias. Translating stem and progenitor cell biology to the clinic: barriers and opportunities. A direct measurement of the radiation sensitivity of normal mouse bone marrow cells. Cytological demonstration of the clonal nature of spleen colonies derived from transplanted mouse marrow cells. Cytological evidence for a relationship between normal hematopoietic colony-forming cells and cell of the lymphoid system. The long-term repopulating subset of hematopoietic stem cells is deterministic and isolatable by phenotype. Self-renewal, differentiation or death: regulation and manipulation of hematopoietic stem cell fate. Future developments in genomics and proteomics, as well as in gene therapy, have the potential to widen the horizon for clinical application of hematopoietic stem cells even further. Modification of acute irradiation injury in mice and guinea pigs by bone marrow injection. Purification of primitive human hematopoietic cells capable of repopulating immune-deficient mice. Evidence that hematopoietic stem cells express mouse c-kit but do not depend on steel factor for their generation. Development of a human adaptive immune system in cord blood celltransplanted mice. Functional characterization of individual human hematopoietic stem cells cultured at limiting dilution on supportive marrow stromal layers. An in vitro limiting-dilution assay of long-term repopulating hematopoietic stem cell in the mouse. Purification of murine hemopoietic stem cells and committed progenitors by fluorescence activated cell sorting using wheat germ agglutinin and monoclonal antibodies. A novel fivetransmembrane hematopoietic stem cell antigen: isolation, characterization, and molecular cloning. Hematopoietic Stem Cells, Biology and Therapeutic Applications: Phenotypic and functional analysis of hematopoietic stem cells in mouse and man. Isolation and functional properties of murine hematopoietic stem cells that are replicating in vivo. Human T, B, natural killer, and dendritic cells arise from a common bone marrow progenitor cell subset. Common lymphoid progenitors rapidly engraft and protect against lethal murine cytomegalovirus infection after hematopoietic stem cell transplantation. Myeloid progenitors protect against invasive aspergillosis and Pseudomonas aeruginosa infection following hematopoietic stem cell transplantation. Isolation of primitive human hematopoietic progenitors on the basis of aldehyde dehydrogenase activity. Rhodamine123 staining in hematopoietic stem cells of young mice indicates mitochondrial activation rather than dye efflux. Phenotypic analysis of mouse hematopoietic stem cells shows a Thy-1- negative subset. Mouse strain variability in the expression of the hematopoietic stem cell antigen Ly-6A/E by bone marrow cells. Phenotypic and functional changes induced at the clonal level in hematopoietic stem cells after 5-fluorouracil treatment. Hematopoietic stem cells expand during serial transplantation in vivo without apparent exhaustion.

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