This issue covers important topics to any primary care physician such as: Immunology for the primary care physician, Routine pediatric immunization, special cases in pediatrics, Routine adult immunization, special cases in adult vaccination, Foreign born individuals, Travel medicine, Immunoglobulins, Pandemic illness/flu , Future vaccine development, clinical trials, immunization and cancer prevention/treatment, Ethics of vaccination refusal, Vaccine administration: Rules and regulations, and Keeping current with vaccine recommendations
Images from the Wards: Diagnosis and Treatment is an exciting visual resource for in-training and practicing physicians. James Studdiford, Marc Altshuler, Brooke Salzman, and Amber Tully present this comprehensive, focused image-based reference and review for diagnosis and treatment with compelling images—selected from a large bank of medical pictures in a teaching database at Jefferson Medical College—that underscore important teaching points. These 517 high-yield images represent what you might see during clinical rotations and encounter on a certification exam. The book provides self-assessment and Board-style multiple choice questions and clinical correlations to prepare you for USMLE Steps 2 and 3. This is the most effective clinical resource and review tool for licensure or re-certification. - Presents the most common and important clinical images of cases that you will encounter in a hospital or on a licensure or certification exam through 517 illustrations. - Features self-assessment and Board-style multiple choice questions based on clinical vignettes to support the learning and review process. - Provides concise but detailed clinical correlations to serve as an effective daily clinical resource and review for USMLE Steps 2 and 3, certification exams, or recertification. - Covers the staging and variations of each disease through images that clarify the entire process. - Captures each disease process in a consistent format for quick and effective reference and review.
Twenty-four years ago, Hellmut Fritzsche came to our laboratory to evaluate our work in amorphous materials. He came many times, sometimes bringing his violin to play with our youngest son, to talk, to help, to discover, and to teach. The times with him were always exciting and rewarding. There was a camaraderie in the early years that has continued and a friendship that has deepened among Iris and me and Hellmut, Sybille and their children. The vision that Hellmut Fritzsche shared with me, the many important contributions he made, the science that he helped so firmly to establish, the courage he showed in the time of our adversity, and the potential that he recognized put all of us in the amorphous field, not only his close friends and collaborators, in his debt. He helped make a science out of intuition, and played an important role not only in the experimental field but also in the basic theoretical aspects. It has been an honor to work with Hellmut through the years.
Anyone hoping to improve teamwork, performance, and budgeting, training, and evaluation programs in their organization should look no further. Completely revised, Public Productivity Handbook, Second Edition defines the role of leadership, dimensions of employee commitment, and multiple employee-organization based relationships for effective internal and external connections. It's coverage of new and systematic management approaches and well-defined measurement systems provides guidance on correct utilization of human resources that ensure improvements in productivity and performance. The authors discuss such topics as citizen-driven government and performance, public sector values and productivity, privatization, and productivity barriers in the public sector.
An essential account of how the media devices we use today inherit the management practices governing factory labor This book argues that management is enabled by media forms, just as media gives life to management. Media technologies central to management have included the stopwatch, the punch card, the calculator, and the camera, while management theories are taught in printed and virtual textbooks and online through TED talks. In each stage of the evolving relationship between workers and employers, management innovations are learned through media, with media formats producing fresh opportunities for management. Drawing on rich historical and ethnographic case studies, this book approaches key instances of the industrial and service economy—the legacy of Toyotism in today’s software industry, labor mediators in electronics manufacturing in Central and Eastern Europe, and app-based food-delivery platforms in China—to push media and management studies in new directions. Media and Management offers a provocative insight on the future of labor and media that inevitably cross geographical boundaries.
This book is the first comprehensive examination of the psychological development of deaf children. Because the majority of young deaf children (especially those with non-signing parents) are reared in language-impoverished environments, their social and cognitive development may differ markedly from hearing children. The author here details those potential differences, giving special attention to how the psychological development of deaf children is affected by their interpersonal communication with parents, peers, and teachers. This careful and balanced consideration of existing evidence and research provides a new psychological perspective on deaf children and deafness while debunking a number of popular notions about the hearing impaired. In light of recent findings concerning manual communication, parent-child interactions, and intellectual and academic assessments of hearing-impaired children, the author has forged an integrated understanding of social, language, and cognitive development as they are affected by childhood deafness. Empirical evaluations of deaf children's intellectual and academic abilities are stressed throughout. The Psychological Development of Deaf Children will be of great interest to students, teachers, and researchers studying deafness and how it relates to speech and hearing; developmental, social, and cognitive psychology; social work; and medicine.
This volume presents one of the clinical foundations of vasculopathies: the biological markers and risk factors associated with cardiovascular disease. A detailed biological and clinical framework is provided as a prerequisite for adequate modeling. Chapter 1 presents cardiovascular risk factors and markers, where the search for new criteria is aimed at improving early detection of chronic diseases. The subsequent chapters focus on hypertension, which involves the kidney among other organs as well as many agents, hyperglycemia and diabetes, hyperlipidemias and obesity, and behavior. The last of these risk factors includes altered circadian rhythm, tobacco and alcohol consumption, physical inactivity, and diet. The volumes in this series present all of the data needed at various length scales for a multidisciplinary approach to modeling and simulation of flows in the cardiovascular and ventilatory systems, especially multiscale modeling and coupled simulations. The cardiovascular and respiratory systems are tightly coupled, as their primary function is to supply oxygen to and remove carbon dioxide from the body's cells. Because physiological conduits have deformable and reactive walls, macroscopic flow behavior and prediction must be coupled to nano- and microscopic events in a corrector scheme of regulated mechanisms. Therefore, investigation of flows of blood and air in anatomical conduits requires an understanding of the biology, chemistry, and physics of these systems together with the mathematical tools to describe their functioning in quantitative terms.
From the President of the Research Society on Alcoholism The sixteenth volume of Recent Developments in Alcoholism contains the latest information on the field of alcoholism treatment research. This scholarly volume includes comprehensive reviews of the methodologies available to evaluate treatment outcome, state-of-the art psychosocial interventions, and recent advances in pharmacological adjuncts to treatment that are currently available and those on the brink of application. Other sections of the book address special issues in the treatment of alcohol dependence, including the treatment of the adolescents and other unique populations, the management of tobacco dependence, and the role of spirituality in recovery, among others. The clinician will find these reviews an important resource for learning about e- dence based treatments for alcoholism, and the researcher will find the synt- sis of recent developments informative and forward looking. The research agenda for the future rests soundly on the progress to date and additional advances in the treatment of alcoholism can be predicted in the near future. Stephanie O'Malley, Ph. D. President, Research Society on Alcoholism xi Preface From the President of the American Society of Addiction Medicine This excellent volume presents investigations covering a wide spectrum of scientific issues. It is also evident that many of these articles have clinical s- nificance, ranging from assessments of disorder, monitoring clinical progress, and behavioral and pharmacological interventions.
Physiological Systems in Insects, Fourth Edition explores why insects have become the dominant animals on the planet. Sections describe the historical investigations that have led us to our current understanding of insect systems. Integrated within a basic physiological framework are modern molecular approaches that provide a glimpse of the genetic and evolutionary frameworks that testify to the unity of life on earth. This updated edition describes advances that have occurred in our understanding of hormone action, metamorphosis, and reproduction, along with new sections on the role of microbiomes, insecticide action and its metabolism, and a chapter on genetics, genomics and epigenetic systems. The book represents a collaborative effort by two internationally known insect physiologists who have instructed graduate courses in insect physiology. As such, it is the ideal resource for entomologists and those in other fields who may require knowledge of insect systems. - Presents updated information on key physiological principles - Covers detailed and instructive figures for visual enhancement - Provides flowing text without the interruption of citations - Includes evolutionary considerations throughout, also providing a discussion on the implications of molecular techniques and discoveries - Encourages further reading with a complete bibliography at end of each chapter
Consistently lauded for its comprehensiveness and full-color color presentation, the latest edition of Rheumatology by Marc C. Hochberg, MD, MPH et al. continues the tradition of excellence of previous editions. Designed to meet the needs of the practicing clinician, it provides extensive, authoritative coverage of rheumatic disease from basic scientific principles to practical points of clinical management in a lucid, logical, user-friendly manner. Find the critical answers you need quickly and easily thanks to a consistent, highly user-friendly format covering all major disorders of the musculoskeletal system in complete, self-contained chapters. Get trusted perspectives and insights from chapters co-authored by internationally renowned leaders in the field, 25% of whom are new to this edition. Track disease progression and treat patients more effectively with the most current information, including 22 new chapters on genetic findings, imaging outcomes, and cell and biologic therapies as well as rheumatoid arthritis and SLE. Incorporate the latest findings about pathogenesis of disease; imaging outcomes for specific diseases like RA, osteoarthritis, and spondyloarthropathies; cell and biologic therapies; and other timely topics.
The recent introduction of the “nano” dimension to pyrotechnics has made it possible to develop a new family of highly reactive substances: nanothermites. These have a chemical composition that is comparable to that of thermites at submillimeter or micrometric granulometry, but with a morphology having a much increased degree of homogeneity. This book discusses the methods of preparation of these energetic nanomaterials, their specific properties, and the different safety aspects inherent in their manipulation.
The mental well-being of children and adults is shockingly poor. Marc Brackett, author of Permission to Feel, knows why. And he knows what we can do. "We have a crisis on our hands, and its victims are our children." Marc Brackett is a professor in Yale University’s Child Study Center and founding director of the Yale Center for Emotional Intelligence. In his 25 years as an emotion scientist, he has developed a remarkably effective plan to improve the lives of children and adults – a blueprint for understanding our emotions and using them wisely so that they help, rather than hinder, our success and well-being. The core of his approach is a legacy from his childhood, from an astute uncle who gave him permission to feel. He was the first adult who managed to see Marc, listen to him, and recognize the suffering, bullying, and abuse he’d endured. And that was the beginning of Marc’s awareness that what he was going through was temporary. He wasn’t alone, he wasn’t stuck on a timeline, and he wasn’t “wrong” to feel scared, isolated, and angry. Now, best of all, he could do something about it. In the decades since, Marc has led large research teams and raised tens of millions of dollars to investigate the roots of emotional well-being. His prescription for healthy children (and their parents, teachers, and schools) is a system called RULER, a high-impact and fast-effect approach to understanding and mastering emotions that has already transformed the thousands of schools that have adopted it. RULER has been proven to reduce stress and burnout, improve school climate, and enhance academic achievement. This book is the culmination of Marc’s development of RULER and his way to share the strategies and skills with readers around the world. It is tested, and it works. This book combines rigor, science, passion and inspiration in equal parts. Too many children and adults are suffering; they are ashamed of their feelings and emotionally unskilled, but they don’t have to be. Marc Brackett’s life mission is to reverse this course, and this book can show you how.
Highlights Jewish participation in the civil rights movement Black Power, Jewish Politics charts the transformation of American Jewish political culture from the Cold War liberal consensus of the early postwar years to the rise and influence of Black Power-inspired ethnic nationalism. It shows how, in a period best known for the rise of antisemitism in some parts of the Black community and the breakdown of the alliance between white Jews and Black Americans, Black Power activists enabled Jewish activists to devise a new Judeo-centered political agenda—including the emancipation of Soviet Jews, the rise of Jewish Day Schools, the revitalization of worship services with gender-inclusive liturgy, and the birth of a new form of American Zionism. Undermining widely held beliefs about the civil rights movement, Black Power, racism, Soviet Jewry, American Zionism, and the religious revival of the 1970s, Black Power, Jewish Politics describes a new political consensus based on identity politics that drew Black and Jewish Americans together and altered the course of American liberalism. In the midst of national reckoning on race, this revised edition extends the book’s thesis to the contemporary period, investigating the limits of white Jewish liberalism, the ways in which scholars have and have not addressed racial privilege in their work, and the dynamics around these themes in a much more diverse American Jewish community.
Many elderly patients suffer from psychiatric conditions that result from--or are made worse by--existing medical conditions. This new edition integrates clinical expertise needed to evaluate and treat psychiatric, medical and neurologic disorders in the older patient. Both scientific foundations of and clinical approaches to psychiatric disease are discussed by a range of experts who rely on evidence-based clinical guidelines and outcomes data. Most chapters include case studies that illuminate the approaches to diagnosis and treatment. The book's five sections include basic principles of evaluation and treatment for specific disorders; appendices offer further insight into pharmacotherapy and neuroanatomic foundation of psychiatric diseases.
The volumes in this authoritative series present a multidisciplinary approach to modeling and simulation of flows in the cardiovascular and ventilatory systems, especially multiscale modeling and coupled simulations. Volume 5 is devoted to cells, tissues, and organs of the cardiovascular and ventilatory systems with an emphasis on mechanotransduction-based regulation of flow. The blood vessel wall is a living tissue that quickly reacts to loads applied on it by the flowing blood. In any segment of a blood vessel, the endothelial and smooth muscle cells can sense unusual time variations in small-magnitude wall shear stress and large-amplitude wall stretch generated by abnormal hemodynamic stresses. These cells respond with a short-time scale (from seconds to hours) to adapt the vessel caliber. Since such adaptive cell activities can be described using mathematical models, a key objective of this volume is to identify the mesoscopic agents and nanoscopic mediators required to derive adequate mathematical models. The resulting biomathematical models and corresponding simulation software can be incorporated into platforms developed in virtual physiology for improved understanding and training.
The last in a series of three volumes edited by Marc Lee Raphael surveying some of the major rabbinic and lay personalities who have shaped Judaism in America for the past two centuries, this work focuses on Orthodox Judaism. Along with a basic description of the achievements of some of the most notable leaders, a bibliography of their writings and sources for further study is included as well as an essay on Orthodox rabbinic organizations and a survey of American Orthodox periodicals. Of interest to scholars, students, and lay persons alike, this volume will inform readers about the earliest communities of Jews who settled in America as they developed the institutions of Orthodox Jewish life and set a public standard of compliance with Jewish law. These early American Jews followed a Spanish-Dutch version of Sephardic customs and rites. Their synagogues used traditional prayer books, promoted the celebration of Jewish holidays, established mikvahs, acquired Passover provisions, and arranged for cemetery land and burial services. While many of these Sephardic immigrants did not maintain halakha in their daily regimen as did their European counterparts, they set a public standard of compliance with Jewish law, thus honoring Jewish tradition. Further immigration of thousands of Jews from Western and Central Europe in the middle of the 19th century brought a world of traditional piety and extensive Jewish learning to America, exemplified by Rabbi Abraham Rice, who served in Baltimore, and Yissachar Dov (Bernard) Illowy, who served communities from Philadelphia to New Orleans. Such men marked the beginning of a learned and scholarly rabbinate in America. This volume provides valuable biographical insights regarding some of the most notable religious leaders in American Orthodoxy.
The second edition of this guide offers a readable, comprehensive summary of everything a parent or teacher would want to know about raising and educating a deaf child. It covers topics ranging from what it means to be deaf to the many ways that the environments of home and school can influence a deaf child's chances for success in academic and social circles. The new edition provides expanded coverage of cochlear implants, spoken language, mental health, and educational issues relating to deaf children enrolled in integrated and separate settings. Marschark makes sense of the most current educational and scientific literature, and also talks to deaf children, their parents, and deaf adults about what is important to them. Raising and Educating a Deaf Child is not a "how to" book or one with all the "right" answers for raising a deaf child; rather, it is a guide through the conflicting suggestions and programs for raising deaf children, as well as the likely implications of taking one direction or the other.
Practical guide to use of laser light technology to treat skin conditions. Covers medical and cosmetic procedures. Extensive US author and editor team.
This book covers the most common areas of concern in women's health. It provides a truly integrative approach, showing when, how, and for whom complementary/integrative therapies can benefit women in continuity with their regular medical care. This is an evidence-based, clinically-oriented book that presents the background and range of complementary and alternative therapies related to common medical conditions and functional complaints and disorders. It summarizes and analyzes scientific studies on the safety and efficacy of these therapies for various women's health conditions. Each chapter includes a description of commonly used treatments, discussions of safety issues (including adverse effects and drug interactions), a comprehensive summary and methodological assessment of clinical trials on the subject (with animal and in vitro data included as appropriate), and advice on counseling patients. - Provides a clear review of the scientific evidence relating complementary and integrative medicine to the care of women. - Offers a roadmap to the options in the treatment of women with complementary and integrative medicine - expanding the clinician's practice, whatever their specialty, with realistic possibilities. - Features comprehensive coverage of safety issues. - Written by leading experts in the field. - Sidebars within each chapter provide at-a-glance advice for patients and practitioners. - Includes key coverage of non-gynecologic issues such as nutrition, headache, depression, cancer, and heart disease. - Offers comprehensive coverage of commonly used treatments and related safety issues, such as possible adverse effects and drug interactions, plus a helpful appendix on Botanical Products. - A focused table of contents makes it easy to find the right treatment for each patient based on their condition. - Features advice on talking with patients about self-treatments they may have read about in books or on the Internet.
Pamela Nadell's biographical dictionary and sourcebook is a landmark contribution to American, Jewish, and religious history. For the first time, a great American Jewish religious movement is portrayed with amplitude, authority, and personality. In the most revolutionary era in two millenia of Jewish history, this surely is an important volumn. Moses Rischin, Professor of History, San Francisco State University Conservative Judaism in America: A Biographical Dictionary and Sourcebook is the first extensive effort to document the lives and careers of the most important leaders in Conservatism's first century and to provide a brief history of the movement and its central institutions. It includes essays on the history of the movement and on the evolution of its major institutions: The Jewish Theological Seminary of America, The Rabbinical Assembly, and The United Synagogue of America. It also contains 135 biographical entries on the leading figures of Conservative Judaism, appendices, and a complete bibliography on sources of study.
The complete guide to Cisco® IWAN: features, benefits, planning, and deployment Using Cisco Intelligent WAN (IWAN), businesses can deliver an uncompromised experience, security, and reliability to branch offices over any connection. Cisco IWAN simplifies WAN design, improves network responsiveness, and accelerates deployment of new services. Now, there’s an authoritative single-source guide to Cisco IWAN: all you need to understand it, design it, and deploy it for maximum value. In Cisco Intelligent WAN (IWAN), leading Cisco experts cover all key IWAN technologies and components, addressing issues ranging from visibility and provisioning to troubleshooting and optimization. They offer extensive practical guidance on migrating to IWAN from your existing WAN infrastructure. This guide will be indispensable for all experienced network professionals who support WANs, are deploying Cisco IWAN solutions, or use related technologies such as DMVPN or PfR. Deploy Hybrid WAN connectivity to increase WAN capacity and improve application performance Overlay DMVPN on WAN transport to simplify operations, gain transport independence, and improve VPN scalability Secure DMVPN tunnels and IWAN routers Use Application Recognition to support QoS, Performance Routing (PfR), and application visibility Improve application delivery and WAN efficiency via PfR Monitor hub, transit, and branch sites, traffic classes, and channels Add application-level visibility and per-application monitoring to IWAN routers Overcome latency and bandwidth inefficiencies that limit application performance Use Cisco WAAS to customize each location’s optimizations, application accelerations, and virtualization Smoothly integrate Cisco WAAS into branch office network infrastructure Ensure appropriate WAN application responsiveness and experience Improve SaaS application performance with Direct Internet Access (DIA) Perform pre-migration tasks, and prepare your current WAN for IWAN Migrate current point-to-point and multipoint technologies to IWAN
Mark Schuckit’s Drug and Alcohol Abuse has been a clinical mainstay for over a quarter century. Now the author’s trusted expertise is available in a new Sixth Edition, thoroughly revised for content, updated references, and streamlined for increased usefulness. Schuckit combines his experience as practitioner, researcher, and teacher to give professionals and students across the health and mental health disciplines a working knowledge of drug-related pathology, beginning with pharmacology, drug mechanisms, and genetic factors. And the Sixth Edition is as accessible as its predecessors, striking the right comfort level for the classroom or the emergency room. -Clinical/emergency orientation suited to both chronic misuse and acute situations -Coverage reflects current trends in alcohol, drug, and multidrug use, abuse, and dependence -Concise chapters for quick reference -Updated bibliography—approximately 80% of citations are post-2000 -Diagnostic information reflects upcoming changes to the DSM -Latest strategies in treatment (psychological and pharmacological) and rehabilitation All material is organized for ease of use, whether the reader needs fast answers in a crisis, seeks new ideas for helping long-term patients or clients, or is just becoming familiar with the different drug classifications. This new edition offers expanded knowledge of a wide-ranging problem and a growing and clinically important population, and authoritative suggestions for effective care.
A new, hopeful pathway to understanding children’s trauma and providing effective interventions to build healthier communities Each year at least a billion children around the world are victims of adverse childhood experiences (ACEs) that range from physical abuse to racial discrimination to neglect and food deprivation. The brain plasticity of our most vulnerable makes the adverse effects of trauma only that much more damaging to mental and physical development. Those dealt a hand of ACEs are more likely to drop out of school, have a shorter life, abuse substances, and suffer from myriad mental health and behavioral issues. The crucial question is: How do we intervene to offer these children a more hopeful future? Neurobiologist and educator Dr. Marc Hauser provides a novel, research-based framework to understand a child’s unique response to ACEs that goes beyond our current understanding and is centered around the five Ts—the timing during development when the trauma began, its type, tenure, toxicity, and how much turbulence it has caused in a child’s life. Using this lens, adults can start to help children build resilience and recover—and even benefit—from their adversity through targeted community and school interventions, emotional regulation tools, as well as a new frontier of therapies focused on direct brain stimulation, including neurofeedback and psychedelics. While human suffering experienced by children is the most devastating, it also presents the most promise for recovery; the plasticity of young people’s brains makes them vulnerable, but it also makes them apt to take back the joy, wonder, innocence, and curiosity of childhood when given the right support. Vulnerable Minds is a call to action for parents, policymakers, educators, and doctors to reclaim what’s been lost and commit ourselves to our collective responsibility to all children.
Learn how to perform basic and advanced skin surgery with this combination text and atlas Written in clear, concise language, and backed by thel atest evidence, Procedural Dermatology is a practical guide for performing all types of skin procedures for both medical and cosmetic problems. Procedural Dermatology opens with a section on Surgical Principles, that discusses essentials such as headand neck anatomy, preoperative evaluation, anesthesia, aseptic technique, antibiotics, wound healing, and postoperative care. The next four sections (Surgical Skills, Skin Tumors, Aesthetic & Laser Procedures, and Aesthetic Problems) cover the different types of surgical procedures, describing them in step-by-step fashion, with each step illustrated with line drawings and photographs. Procedural Dermatology compiles current, state-of-the-art information valuable to all practitioners of dermatologic surgery, from the trainees to seasoned surgeons wishing to refine their skills.
Images from the Wards: Diagnosis and Treatment is an exciting visual resource for in-training and practicing physicians. James Studdiford, Marc Altshuler, Brooke Salzman, and Amber Tully present this comprehensive, focused image-based reference and review for diagnosis and treatment with compelling images—selected from a large bank of medical pictures in a teaching database at Jefferson Medical College—that underscore important teaching points. These 517 high-yield images represent what you might see during clinical rotations and encounter on a certification exam. The book provides self-assessment and Board-style multiple choice questions and clinical correlations to prepare you for USMLE Steps 2 and 3. This is the most effective clinical resource and review tool for licensure or re-certification. - Presents the most common and important clinical images of cases that you will encounter in a hospital or on a licensure or certification exam through 517 illustrations. - Features self-assessment and Board-style multiple choice questions based on clinical vignettes to support the learning and review process. - Provides concise but detailed clinical correlations to serve as an effective daily clinical resource and review for USMLE Steps 2 and 3, certification exams, or recertification. - Covers the staging and variations of each disease through images that clarify the entire process. - Captures each disease process in a consistent format for quick and effective reference and review.
This issue covers important topics to any primary care physician such as: Immunology for the primary care physician, Routine pediatric immunization, special cases in pediatrics, Routine adult immunization, special cases in adult vaccination, Foreign born individuals, Travel medicine, Immunoglobulins, Pandemic illness/flu , Future vaccine development, clinical trials, immunization and cancer prevention/treatment, Ethics of vaccination refusal, Vaccine administration: Rules and regulations, and Keeping current with vaccine recommendations
About the Author Marc E. King is the author of Changing Your Mind, A Theory of Space without Time, and Fifth Dimension, The Light to See. Based on new scientific understanding of hydrocarbon chemistry-of-life, he has also published The Modern Health Guide You Cannot Live Without. He is an accomplished writer who has presented technical works in an equally non-technical manner for all to enjoy. His book Changing Your Mind is a publisher's best-seller. His technical manuscript "A Mathematical Transformation of Variables Defining Space-Time and the Constant h" defines the relationship t=cB, the spatial frame width b meters, and the spatial energy per unit mass-volume EB. He is a solid state semiconductor device physicist by education and has more than 30 years experience in Silicon Valley, CA as a pioneer of high speed semiconductor technology for the applications of super computers, personal computers, programmable logic, and smart cell phones. He is married and the father of two daughters who both live and work in Silicon Valley.
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