This title is filled with useful and practical language learning strategies designed to help doctors, nurses and other healthcare workers (who do not speak an indigenous language) to learn an African language through their daily contact with patients. More than this, it gives advice on ways to reach some understanding of the culture, health beliefs and world views of the patient in a medical consultation. Although English/Zulu and the Zulu medical culture are used as the examples, the underlying themes are applicable to any culture. The book has retained the humour and wit of its predecessor, Learning Language and Culture in the Medical Consultation, but it has been considerable revised and expanded to include more material on the cross-cultural consultation, the Aids pandemic, as well as appendices of vocabulary and 'survival phrases' designed to facilitate communication and understanding in a medical context.

Get an in-depth look at pediatric primary care through the eyes of a Nurse Practitioner! Pediatric Primary Care, 6th Edition guides readers through the process of assessing, managing, and preventing health problems in infants, children, and adolescents. Key topics include developmental theory, issues of daily living, the health status of children today, and diversity and cultural considerations. This sixth edition also features a wealth of new content and updates - such as a new chapter on pediatric pharmacology, full-color design and illustrations, new QSEN integration, updated coverage of the impact of the Affordable Care Act, a refocused chapter on practice management, and more - to keep readers up to date on the latest issues affecting practice today. Comprehensive content provides a complete foundation in the primary care of children from the unique perspective of the Nurse Practitioner and covers the full spectrum of health conditions seen in the primary care of children, emphasizing both prevention and management. In-depth guidance on assessing and managing pediatric health problems covers patients from infancy through adolescence. Four-part organization includes 1) an introductory unit on the foundations of global pediatric health, child and family health assessment, and cultural perspectives for pediatric primary care; 2) a unit on managing child development; 3) a unit on health promotion and management; and 4) a unit on disease management. Content devoted to issues of daily living covers issues that are a part of every child's growth - such as nutrition and toilet training - that could lead to health problems unless appropriate education and guidance are given. Algorithms are used throughout the book to provide a concise overview of the evaluation and management of common disorders. Resources for providers and families are also included throughout the text for further information. Expert editor team well is well-versed in the scope of practice and knowledge base of Pediatric Nurse Practitioners (PNPs) and Family Nurse Practitioners (FNPs). NEW! Updated content throughout reflects the latest developments in our understanding of disease processes, disease management in children, and current trends in pediatric healthcare. NEW! Chapter on prescribing pediatric medications emphasizes the unique needs of children in pharmacotherapy. NEW! Practice Alerts highlight situations that may require urgent action, consultation, or referral for additional treatment outside the primary care setting. NEW! Full-color design and illustrations improve usability and learning. NEW! Graduate-level QSEN integration: Quality and Safety Education for Nurses (QSEN) is now introduced in the Preface. The QSEN Safety competency is now emphasized via the new Practice Alert highlights and integration of National Patient Safety Goals and Core Measures. The Informatics competency is addressed with new informatics content in a refocused Strategies for Managing a Pediatric Health Care Practice chapter. The Teamwork and Collaboration competency is addressed by new content on the trending topic of interprofessional collaboration, also in the Strategies for Managing a Pediatric Health Care Practice chapter. The Evidence-Based Practice competency is integrated through icons that reference evidence-based guidelines. Reorganized application of Gordon's Functional Health Patterns provides a more conceptually consistent flow with Gordon's model. Expanded integration of Healthy People 2020 goes beyond the emphasis on physical activity in the previous edition. Expanded coverage of health literacy includes application of health literacy principles - the ability to obtain, read, understand, and use healthcare information to make appropriate health decisions and follow instructions for treatment - in relevant chapters. Additional coverage of growth and development includes a thorough revision of the chapter on developmental management in pediatric primary care along with inclusion of developmental milestones in appropriate chapters. Expanded coverage of assessment, genetics and epigenetics, mental health issues, the Children with Special Health Care Needs (CSHCN) Services Program, and global health reflect the growing impact of these trends on pediatric primary care. Updated coverage of the Affordable Care Act includes a focus on the impact of the Affordable Care Act (including Medicaid expansion) and its implications for access to pediatric healthcare. Updated coverage of the Bright Futures guidelines goes beyond the previous edition's focus on mental health and sexual development. NEW! Focus on diversity (vs culture) offers a greater emphasis on diversity in its many dimensions rather than on culture alone. Refocused practice management chapter has been retitled Strategies for Managing a Pediatric Health Care Practice and eliminates general practice management content that is already covered in other parts of the curriculum to focus on content more specific to pediatric practice management - including the various settings for pediatric primary care, informatics, and other essential topics influenced by the Affordable Care Act, National Patient Safety Goals, and the growing trend of interprofessional collaboration.

What does it mean to help save someone's life? How does it feel to nearly kill a patient? Can we keep our patients safe at night? In the face of overwhelming pressures, can we thrive or only survive? And is a happy life as a doctor still possible? In the early months and years of work, it is these kinds of questions, rather than any technical or knowledge-based queries, which preoccupy many new doctors. This elusive, hidden curriculum is pervasive within departments, around hospitals and across health systems, but is rarely, if ever, explicitly examined and discussed. At its core is the issue that should matter above all others - how we can keep our patients as safe as possible. The Bleep Test combines gripping and startlingly vulnerable recollections of early experiences on the wards with an array of research findings, from psychology and human biology to anthropology, business and behavioural economics. Acknowledging that the truly complex challenges facing new doctors lie far beyond the realms of the traditional medical sciences in which they were trained, the book explains that the shift to being a doctor depends on first understanding how we think, reason and behave as someone we have been all our lives - a human amongst humans. Focused on the experiences of, and the issues facing, recently qualified medics, The Bleep Test is not only for young doctors, but also for anyone who manages them, works with them, cares for them or may, one day, depend on them.

The Poetry of Loss: Romantic and Contemporary Elegies presents a renewed look at elegy as a long-standing tradition in the literature of loss, exploring recent shifts in the continuum of these memorial poems. This volume investigates the tensions arising in elegiac formulations of grief through detailed analyses of seminal poets, including Wordsworth, Keats, and Plath, using psychoanalytic precepts to reconceptualize consolation through poetic strategies of inner representation and what it might mean for personal and collective experiences of loss. Tracing the development of elegy beyond extant readings, this volume addresses contemporary constructs of mourning and their attendant polemics within the wider culture as extensions of elegiac longings and the tendency to refuse consolation and cede to the endlessness of grief. Furthermore, this book concludes that contemporary elegies break with conventions of poetic structure and expression; rather than the poets seeking resolution to grief through compensation, they often find themselves dwelling within the loss rather than externalizing and transcending it. The Poetry of Loss: Romantic and Contemporary Elegies examines these developing psychoanalytic concepts pertaining to a poetics of loss, providing readers with a new appreciation of mourning culture and contemporary attitudes towards grief.

Utilizing longitudinal research, the authors have identified the mediational nature of the process of how traumatic events in childhood lead to increased HIV risk as adults. The book approaches the outcomes of childhood maltreatment systematically; demonstrates for the first time the need to examine the mediators of abuse, the indirect paths from childhood experiences to adult behaviors; offers useful measures of HIV risk based on risky behaviors; presents a feminist analysis of cultural norms that support HIV risk in women. The research presented clarifies present conceptualizations of interpersonal power, and gender's impact on the process and negotiation of, and desire to engage in, safer sexual practices. Knowing the importance of mediators will enable counselors and therapists to intervene on these variables at an early stage, thereby helping to reduce the incidence of subsequent risky behavior.

In the Shadow of Our Steeples: Pastoral Presence for Families Coping with Mental Illness helps you and other experts and quasi-experts in the field of religious and family counseling to give sound direction and guidance to family members who are caring for a loved one who suffers from mental illness. You'll find many avenues of care and counseling that will greatly enhance your ability to lend support and encouragement in situations where the burden of care seems too great for only a few individuals to lift. In reading it, you'll find your options increase tenfold, and you'll become a better symbol and resource of faith for these unique families.Inside In the Shadow of Our Steeples, you'll discover how to cure the obsession with success that too often goes along with counseling situations that involve mental illness. You'll also discover a greater, more enduring strain of Christian love, full of surprising joys, caring, and hope. Geared toward moving parishes away from public stigmas and toward a collective ministry of presence, this book beckons to those clergy who know and believe that a far more understanding and far-reaching form of counseling exists. Specifically, you'll learn about these and other long-sought-after aids: establishing theological foundations and goal-setting in the area of pastoral care countering the stigmas of mental illness using biblical studies and models using a "ministry of presence" to analyze chronic illness and promote "rehabilitation in the absence of cure" bringing clergy and mental health professionals into a collaborative arena of care improving the relationship of professional chaplains to clergy in ordinary parish settingsOverall, In the Shadow of Our Steeples helps bring together the sufferer, the family, the civil servant, and the religious counselor into one synergistic group of rehabilitative influence. This sound guide's specific examples and proven strategies will help turn your despair into hope, even in the face of chronic mental illness.

Contents:
Preface. Section 1. Ambulatory Services: Clinical, Administrative, and Training Issues. Administration of Ambulatory Services for Children and Adolescents: Historical View, Present Issues, Challenges, and Solutions. The Specialty Clinic: A Bridge Between Research and Clinical Practice. Child and Adolescent Services in a Community Mental Health Center: Transition, Organization, and Staffing Issues. Training in Ambulatory Settings. Section 2. Assessment. Psychiatric Assessment of Infants and Parent-Child Interaction. Psychiatric Evaluation of School Age Children. Psychiatric Assessment of Adolescents and their Families. The Process of Psychological Assessment. Speech and Language Evaluation. Forensic Community Child and Adolescent Psychiatry. Section 3. Common Disorders of Childhood and Adolescence. Affective Disorders in Children and Adolescents. Obsessive Compulsive Disorder, Tics and Tourette's Syndrome and Separation Anxiety Disorder. Attention Deficit/Hyperactivity Disorder. Conduct and Oppositional Defiant Disorder. Alcohol and Substance Abuse in Children and Adolescents. Pervasive Developmental Disorders and Learning Disorders. Section 4. Therapeutic Interventions. Pharmacotherapy in Children and Adolescents. Cognitive-Behavioral Therapy with Children and Adolescents. Individual Psychotherapy and Use of Play with Children. Individual Psychotherapy with Adolescents. Behavioral Interventions with Children and Adolescents. Group Psychotherapy with Children and Adolescents: Key Issues. 5. Day Treatment for Children and Adolescents. Day Hospital: Planning, Staffing and Administration. Therapeutic Milieu in a Day Hospital for Children and Adolescents. Day School for Emotionally and Behaviorally Disturbed, and Learning Disabled Children and Adolescents. 6. Other Community Based Programs. Mental health Services in Schools: Expanding Opportunities. Finding Our Way Home: Home and Community Based Care. Therapeutic Nursery. Foster Care.

This book is dedicated to anyone who is a patient, who has been a patient or who may become a patient. In fiction stories and characters are created by man, but patients are God's creations. To those waiting in doctor's rooms with pimples and painful wounds, sniffing and sneezing to mommies with new born babies and grannies who tell bedroom stories to little children. To the sick, lame and lazy, to those with tics and those who are maimed or crazy, I share these memories in the hope and belief, that they will give you an understanding of a family practitioner's life in small town South Africa. Share a family's tears and fears during house calls, alone, when everyone else is fast asleep. Enjoy the laughs and joys of operative procedures, and see the sadness of death- slowly, suddenly, unexplained, unfair- and then the miracle of a new-born baby. These memories are dedicated to all those inquisitive people who want to share a humanistic, holistic approach to life's problems and pleasures through the eyes of a general practitioner. To young doctors, may it open your eyes and enrich your soul, and to older doctors, may you remember that is, after all, God's greatest gift. To patient who disliked me, here you can enjoy my humiliations and tribulations, and all those who liked me may share my joys and jubilations. To the fellowship of those that help and heal, I hope you'll share these memories. I hope you enjoy reading them as much as I enjoyed the experiences. Most of the names of patients and doctors were changed to protect the people involved. In some cases, as requested, the original names stayed. Thanks to you all, for being part of my journey.

The Doctor of Hiroshimais the extraordinary true story of Dr Michihiko Hachiya, whose hospital was less than a mile from the centre of the atomic bomb that hit on that warm August day. In immense shock and pain, he and his wife Yaeko dragged themselves to the devastated hospital building and what colleagues they could find.

In time, they begin to heal, and start to treat the impossible numbers of patients - a small girl covered in burns, an elderly man with pneumonia, a young boy and his little sister looking for their parents. They also began to investigate the strange unexplainable symptoms afflicting his patients - things he never dreamed he would see...

Told simply and poignantly in Dr Hachiya's own words, The Doctor of Hiroshima is a unique and deeply moving human story of survival about a small, committed band of hospital staff in the face of unthinkable destruction and loss.

This text seeks to enable medical sociology to establish a voice in key debates in the social sciences. These debates concern modernity, postmodernity, structuralism and poststructuralism as they relate to medical sociology. Topics include: disease and medicine in postmodern times; gender, health and the feminist debate; the sociology of health and ageing; medicine and complementary medicine; and death in postmodernity.

PREFACE TO THE SECOND EDITION
The need for a thorough understanding of medical terminology has not diminished in the least for pharmacists and other health care practitioners in the five years between the publication of the first edition of this book and this second edition. If anything, it has become greater. The pharmacy profession has further solidified its clinical role in patient care, and pharmacists are more entrenched than ever before in the role of counselor and advisor to both patients and practitioners alike. For more than a few pharmacists, what not long ago was an occasional question from a physician about appropriate drug therapy has become regular consultation concerning the interaction of drugs with the patient, his life, and the many other therapies he may be facing. Pharmacy chains, which not long ago installed glass walls to separate the pharmacist from customers, have asked technicians to count pills while pharmacists are in continuous contact with the patient.
Such practice changes have increased the demand for clinical knowledge among pharmacists, including a knowledge of medical terminology, and those demands have been passed on to the authors in preparation of the second edition of this book. While the role of the text is still to help pharmacists be more effective interpreters and counselors, some changes have been made in response to reader requests.

Many people agree that prayer is a central feature of spiritual life. But what is prayer? Scientific and Pastoral Perspectives on Intercessory Prayer: An Exchange Between Larry Dossey, MD, and Health Care Chaplains explores common questions and concerns about intercessory prayer, or the act of praying for the benefit of others, from several different points of view. Chaplains, priests, ministers, and clergy in the health care profession will learn how prayer is examined from sources other than traditional Christian views, such as parapsychology. From Scientific and Pastoral Perspectives on Intercessory Prayer, you will learn what prayer means to some chaplains and to their ministry and how prayer can make drastic changes in the lives of your parishioners, patients, and their families.Written by eight chaplains, the articles in this text are in response to an essay by Larry Dossey, a nationally known physician who speaks and writes about prayer. The contributors to Scientific and Pastoral Perspectives on Intercessory Prayer discuss his points of view on intercessory prayer, which are based on quantum physics. You will learn if this area of physics can make a difference in how you practice your faith, how you worship, and what you think about or expect from prayer. Scientific and Pastoral Perspectives on Intercessory Prayer examines several other topics related to prayer, including: discovering whether or not intercessory prayer is truly different from other methods of meditation exploring the relationship between intercessory prayer and meditative or praise prayer linking prayers and their results to the expectations or intentions of those who engage in them differentiating between an intercession and a wish deciding for yourself what constitutes evidence or proof when discussing the aspects of prayer how our opinion of prayer relates to how we think about the universe and about God Since Scientific and Pastoral Perspectives on Intercessory Prayer focuses on the cooperation between science and theology, you will discover that, in many instances, people believe that the power of prayer should be taken seriously. This text also shows you how the questions and functions of prayer are shared by everyone, despite religious differences or methods of praying. Encompassing research and personal experiences, Scientific and Pastoral Perspectives on Intercessory Prayer will help you answer questions about religion and its role in the lives of parishioners, patients, and clergy, as well as provide you with evidence to the positive and healing power of prayer.

Many people agree that prayer is a central feature of spiritual life. But what is prayer? Scientific and Pastoral Perspectives on Intercessory Prayer: An Exchange Between Larry Dossey, MD, and Health Care Chaplains explores common questions and concerns about intercessory prayer, or the act of praying for the benefit of others, from several different points of view. Chaplains, priests, ministers, and clergy in the health care profession will learn how prayer is examined from sources other than traditional Christian views, such as parapsychology. From Scientific and Pastoral Perspectives on Intercessory Prayer, you will learn what prayer means to some chaplains and to their ministry and how prayer can make drastic changes in the lives of your parishioners, patients, and their families.Written by eight chaplains, the articles in this text are in response to an essay by Larry Dossey, a nationally known physician who speaks and writes about prayer. The contributors to Scientific and Pastoral Perspectives on Intercessory Prayer discuss his points of view on intercessory prayer, which are based on quantum physics. You will learn if this area of physics can make a difference in how you practice your faith, how you worship, and what you think about or expect from prayer. Scientific and Pastoral Perspectives on Intercessory Prayer examines several other topics related to prayer, including: discovering whether or not intercessory prayer is truly different from other methods of meditation exploring the relationship between intercessory prayer and meditative or praise prayer linking prayers and their results to the expectations or intentions of those who engage in them differentiating between an intercession and a wish deciding for yourself what constitutes evidence or proof when discussing the aspects of prayer how our opinion of prayer relates to how we think about the universe and about God Since Scientific and Pastoral Perspectives on Intercessory Prayer focuses on the cooperation between science and theology, you will discover that, in many instances, people believe that the power of prayer should be taken seriously. This text also shows you how the questions and functions of prayer are shared by everyone, despite religious differences or methods of praying. Encompassing research and personal experiences, Scientific and Pastoral Perspectives on Intercessory Prayer will help you answer questions about religion and its role in the lives of parishioners, patients, and clergy, as well as provide you with evidence to the positive and healing power of prayer.

Das Paediatric Handbook des Royal Children's Hospital Melbourne ist ein bewahrter Leitfaden fur das Management haufiger und ernster Erkrankungen und Stoerungen im Kindesalter. Dieser Bestseller vermittelt Studenten und Fachexperten im medizinischen Bereich, in der Pflege und verwandten Disziplinen aus dem Gesundheitssektor relevante und aktuelle Informationen zu einer Fulle von Themen aus der Padiatrie, um die richtigen Entscheidungen in der Praxis zu treffen. Dieses Handbuch, jetzt in der 10. Auflage, liefert uberzeugende Illustrationen und evidenzbasierte Diagnose- und Management-Algorithmen, u. a. zu Wiederbelebungsmassnahmen und medizinischen Notfallen, Medikamentengabe und Therapien, medizinische und chirurgische Eingriffe u.v.m. - Bietet zugangliche Zusammenfassungen haufiger und ernsthafter Erkrankungen und Stoerungen im Kindesalter. - Greift auf die jungsten klinischen Leitlinien zuruck. - Enthalt unzahlige Farbfotos, Illustrationen, Diagramme und klinische Aufnahmen. - Mit praxisorientierten Leitlinien zur beruflichen Ethik und Kommunikation in der padiatrischen Sprechstunde. - Liefert aktuelle Informationen zur Gesundheit von Gefluchteten, Transgender-Personen und Personen mit unterschiedlichen Geschlechteridentitaten. Das Paediatric Handbook ist ein unverzichtbares Referenzwerk fur Mediziner, Pflegekrafte und Fachpersonal verwandter Gesundheitsberufe, Studenten und Trainees.

Originally published in 1961 this book is divided into two parts. In the first Laing critiques the Kleinian view of unconsciou phantasy, as developed by Susan Sutherland Isaacs. He emphasizes the overwhelming presence of social phantasy systems. In Part 2, Laing discusses the extent to which an individual is or is not invested in their own actions, using ideas drawn from Martin Buber and Sartre

Post Normal Accident revisits Perrow's classic Normal Accident published in 1984 and provides additional insights to our sociological view of safety-critical organisations. The operating landscape of high-risk systems has indeed profoundly changed in the past 20 to 30 years but the core sociological models of safety remain associated with classics of the 1980s and 1990s. This book examines the conceptual and empirical evolutions of the past two to three decades to explore their implications for safety management based on several strands of works in various research traditions in safety (e.g. cognitive engineering and system safety, high-reliability organisation, sociology of safety, regulatory studies) and other interdisciplinary fields (e.g. international business, globalisation studies, strategy management, ecology). It offers a new and insightful interpretation to the challenges of today. It investigates how globalisation has reconfigured the operating landscape of high-risk systems and emphasises the importance of thinking safety through a strategic angle. This book serves as an ideal resource for the safety professionals and safety researchers from any established disciplines such as sociology, engineering, psychology, political science or management. Features: Introduces an original analysis of popular safety writings, including Normal Accident, by Perrow Identifies the importance of thinking safety from a sociological angle with the help of key writers Stresses the need for greater sensitivity to strategy and "errors from the top" when it comes to the safety of high-risk systems Explains how globalisation has reconfigured the operating landscape of high-risk systems Renews our understanding of the current safety management challenges in an increasingly global risk picture

This collection of brief essays by thought-leaders, scholars, activists, psychologists, and social scientists imagines new workplace structures and policies that promote decent and fair work for all members of society, especially those who are most vulnerable. The world of work has been deteriorating for decades and the very institution of work needs to be systematically understood, critiqued, reimagined, and rebuilt. This book offers thoughtful suggestions for new work arrangements, individual strategies for enhancing one's work life, and recommendations for innovative systemic and institutional reforms. The collection offers critical analyses in conjunction with constructive solutions on rebuilding work, providing direction and context for ongoing debates and policy discussions about work. The book will be of interest to activists, policy makers, management and leaders, scholars, professionals, students, and general readers interested work-based reform efforts and social change.

Based on a newly developed, practical and relatable ‘Pressure Cooker Model’ which bridges the gap between theoretical models of FND with non-FND specific CBT models. Psychology-led and firmly rooted in psychological principles: written and created by a psychologist who is passionate about psychology treatment for FND. Places a larger emphasis on the active formulation and treatment of social and environmental processes in FND to actively increase awareness of FND and help improve recovery and reduce stigma. Model has wide-spread applicability for different populations with FND, different professionals involved in FND and different therapy formats. Accompanied by an appendix of resources and templates for clinicians

This book theorizes the role of optimism in anthropological thinking, research, writing, and practice. It sets out to explore optimism's origins and implications, its conceptual and practical value, and its capacity to contribute to contemporary anthropological aims. In an era of extensive ecological disruption and social distress, this volume contemplates how an optimistic anthropology can energize the discipline while also contributing to bettering the lives, communities, and environments of those we study. It brings together scholars diverse in background, career stage, and theoretical approach in a collective attempt to comprehend the myriad intersections of anthropology and optimism. The challenges of the COVID-19 pandemic have recently underscored the larger, longer-term catastrophes of climate change, ecosystemic collapse, social injustice, and antipathy towards scientific knowledge and those who produce it. In this context, exceedingly few anthropologists feel comfortable observing and documenting passively while their research communities face unrelenting waves of (un)natural disasters. We need to act. But we also need to hope. Discontent with the state of the world and cultural anthropology's turn to increasingly positive, future-oriented, and engaged work have converged to unleash a courageously optimistic anthropology. This book is a timely springboard for this impactful and emergent approach.

Since it was first published in 1995, "The Wounded Storyteller" has occupied a unique place in the body of work on illness. Both the collective portrait of a "remission society" of those who suffer from some type of illness or disability and a cogent analysis of their stories within a larger framework of narrative theory, Arthur W. Frank's book has reached a large and diverse readership, including the ill, medical professionals, and scholars of literary theory. Drawing on the work of authors such as Oliver Sacks, Anatole Broyard, Norman Cousins, and Audre Lorde, as well as the people he met during the years he spent among different illness groups, Frank recounts a stirring collection of illness stories, ranging from the well-known - Gilda Radner's battle with ovarian cancer - to the private testimonials of people with cancer, chronic fatigue syndrome, and disabilities. Their stories are more than accounts of personal suffering: they abound with moral choices and point to a social ethic. In this new edition Frank adds a preface describing the personal and cultural times when the first edition was written. His new afterword extends the book's argument significantly, writing about storytelling and experience, other modes of illness narration, and a version of hope that is both realistic and aspirational. Reflecting on both his own life during the creation of the first edition and the conclusions of the book itself, Frank reminds us of the power of storytelling as way of understanding our own suffering.

Hearing is a prerequisite for the evolution of language and thus the development of human societies. It is the only major sense whose evolution can be traced back to vertebrates, starting with sarcopterygians. The book explores the evolution of auditory development that has remained largely unexplored in contemporary theories of neurosensory brain evolution, including the telencephalon. It describes how sensory epithelia from the basilar papilla evolved in the ear and connected dedicated cochlear neurons to neuronal centers in the brain, and deals with how sound is converted through sound modulations into reliably decoded messages. The loss of hearing with age is expected to reach 2.6 billion people by 2050. As such, the book explains and reviews hearing loss at the molecular level to the behavioral level, and provides suggestions to manage the loss.