#Department of Social Service job circular

[shoshanews]

Apply DPSA Circular 42 of 2024 DPSA Circular 42 of 2024 The DPSA Circular 42 of 2024, published on 15 November 2024, is now available for public access. This circular provides detailed information about a wide range of job openings within South Africa's National Departments and Provincial Administrations, ensuring a variety of career opportunities for job seekers in public service. In this post, we’ll explore the key highlights of DPSA Circular 42 of 2024, offer tips on navigating government job applications, and emphasize the importance of public service careers in driving national development. Circular 42 of 2024Posting Date: 15 November 2024Full Document: Circular 42 (click here to view the full document)WhatsApp Channel: DPSA Vacancy Circular Why Consider Government Jobs in South Africa? A career in South Africa’s public sector provides more than just financial stability; it offers an opportunity to contribute to the country’s social and economic development. With the circular's diverse range of roles, candidates can find positions tailored to their skills, qualifications, and career aspirations. Government positions come with competitive benefits, professional growth opportunities, and the chance to impact lives. The circular includes vacancies across key National Departments and Provincial Administrations, allowing candidates from all regions to apply. Below is an overview of the departments and what they offer: National Departments These departments offer roles in various sectors, from education and justice to infrastructure and safety. - Basic EducationIf you’re passionate about shaping South Africa’s future, positions in Basic Education provide opportunities to work on policy development, curriculum design, and program management. - National TreasuryAre you a finance professional? Treasury vacancies include positions in economic policy, budget management, and financial oversight. - South African Police Service (SAPS)For those dedicated to public safety, SAPS offers openings in administration, forensics, and investigative roles. - Water and SanitationBe part of managing South Africa’s critical water resources and sanitation projects. Each department offers unique career opportunities with room for growth, ensuring a fulfilling career path for professionals in diverse fields. Provincial Administration Opportunities If you prefer to work closer to home, the Provincial Administrations provide opportunities within your region. Here’s a breakdown of available positions: - Gauteng ProvinceJoin one of South Africa’s economic hubs with vacancies in healthcare, education, and metropolitan governance. - KwaZulu-Natal ProvinceFind roles focused on tourism, agriculture, and rural development. - Western Cape ProvinceExplore job opportunities in one of South Africa’s most vibrant provinces, offering positions in urban planning, governance, and social services. SEE ALSO: DPSA Circular 41 of 2024 Read the full article

[7consultancyblog]

Plastic, rubber and paint industry in India gives a fair opportunity for you to build career

Plastics and rubber industries include establishments that process plastic and rubber raw materials into products. The industry has had global success mainly due to the enormous growth rate of polymer consumption, from raw materials to end-user products. Although plastics and rubber play a fundamental role in modern society, the growing concern around plastic waste makes it imperative to develop a more circular approach to their use in the future. Plastic, Rubber and Paint industry Recruitment Agency in India that provides support in Recruitment. Furthermore, the incredible versatility and diversity of plastics, from food packaging applications to underground wind turbines, makes recycling and recovery extremely challenging and expensive. Plastic is also defined as polymers of long carbon chains. Plastics always include carbon and hydrogen. While plastics may be made from just about any organic polymer, most industrial plastic is made from petrochemicals. Thermoplastics and thermosetting polymers are the two types of plastic. Thermoplastics can be heated and remolded over and over again. Some thermoplastics are amorphous, while some have a partially crystalline structure. Natural rubber is one of the most important polymers for human society. Natural rubber is an essential used in the creation of more than 40,000 products. Synthetic rubber is also used to make ‘elastic’ bands and to make ‘rubber’ gloves. Synthetic rubber is also used for making Wellington boots. The conditions needed to grow these rubber trees are very specific and only occur in certain areas in the world.

The automobile sector holds many opportunities being the largest consumer of natural rubber. In 2016, there was a reported 15 percent growth in this industry, and annual growth according to this trend is expected for t6he next few years. Growth in income and standard of living will provide major opportunities for rubber exports. Proximity to rubber plantations will give better access to the rubber trees saving time and money in transport and other logistics. The plastics industry, in truth, is a collection of niche interests and sectors – ranging from the production of food packaging and single-use goods right up to the specialist materials applications such as the engineering polymers. A broad knowledge of all processes and polymers is of help when starting a career. A successful manufacturing career in plastics is likely to include a more than basic competence and enthusiasm for modern manufacturing methods such as JIT, continuous improvement, and others. The Department of Rubber and Plastics Technology will strive to be a globally renowned department known for its academic excellence, professionalism and social responsibility. Best Plastic, Rubber and Paint industry Recruitment Agency in India that provide best services. They aim to impart high technical knowledge, practical skills, leadership qualities, ethical skills, leaders and creative entrepreneurial skills to become demand oriented solution providers in the field of rubber and plastic technology.

Recruitment is the process of activity seeking out finding and hiring candidates for a specific position or job. The recruitment definition includes the entire hiring process, from inception to the individual recruit’s integration into the company. As a company that helps place into organizations, large and small, around the world, they understand their significant responsibility to encourage diverse and inclusive hiring practices. The reality is much more complex the recruitment process involves many moving parts, and there are many forms depending on the company’s needs and resources. Large organizations, the typically employ recruiters within their HR department. In small-to medium-sized organizations, the hiring manager that will directly oversee the new employee may take on recruiting responsibilities. Many companies hire third-party staffing agencies to make hires or use recruitment process outsourcing, which brings in outside recruitment experts to serve as strategic consulting partners. The rubber industry can be place that offers a very rewarding career and they want to be able to find candidates a role in which they can thrive and reach their true potential. Contact experts with experience from the plastic processing industry, consultants who provide mould designing, product and packaging designing services.

Our understanding of such trends supplies them with more time to prepare for a better future when industries and technologies increasingly rely on their corporate social responsibility and environmental, social and governance policies. The plastic Industry contributes to almost every daily recruitment of a human being whether it is Clothing, Construction, Housing, Furniture, Automobiles, Horticulture, Medical Appliances, Packaging, Electronics and Electrical items. Rubber is a natural resource which is harvested from the bark of a tree. The rubber industry is thriving due to the demand for rubber is being used for the manufacture of various products. Also, people make use of different rubber products in their day to day life. Rubber is also used in the production of several industrial components. Thus the future of rubber industry seems to be bright in India. We are one of the Top Plastic, Rubber and Paint industry Recruitment Agency in India.

[lizseyi]

Kinstellar Appoints New Sector And Service Line Heads And Head Of German Desk

Kinstellar supports professional growth by offering a broad range of career development opportunities for our team, including the role of sector/service line head or co-head. We provide growth opportunities to all of our talented lawyers with the relevant experience and an outstanding track record.

We are delighted to announce the following appointments:

Csilla Andrékó, Partner in our Budapest office, is the Co-Head of the firm-wide Banking & Finance Service Line. Csilla is one of the founders of the Firm and the former Managing Partner of the Budapest office. Csilla also served as the head of the regional Banking & Finance and Restructuring & Insolvency Service Lines. She retired from active practice last year, but has remained close to the firm and is a valued mentor to our team. Csilla has agreed to step out of retirement to help refresh and guide our Banking & Finance service line.

Csilla has over 30 years of experience in project and acquisition finance, restructuring and insolvency matters, PPP/PFI finance, international banking and syndicated lending as well as in capital markets. She is a leading name and authority among her peers with an outstanding career, and we are confident that, under her guidance, we will continue building a strong and acknowledged service.

Magdalena Răducanu, Special Counsel in our Bucharest office, is the Co-Head of the firm-wide Banking & Finance Service Line. She has more than 22 years of experience advising leading banks, financial institutions and borrowers on banking and finance matters. Since joining the Firm and our Banking & Finance Service Line in 2021, Magdalena has advised or coordinated banking mandates totalling EUR 4 billion.

Magdalena has expertise in a broad range of banking and finance matters, having dedicated her focus exclusively to this area and to financial regulatory matters. Lately, she has focused significant efforts assisting banks on various ESG-related mandates.

Miloš Velimirović, the Managing Partner of our Belgrade office, is the Co-Head of the firm-wide Financial Institutions sector. He co-leads the sector alongside Diana Dimova, Managing Partner of our Sofia office.

With more than 15 years of experience in banking & finance, Miloš has advised companies and financial institutions on issues associated with the regulation of the financial services sector and on M&A, data protection, project financing, and other general matters. He has participated in complex financial transactions of corporate clients, government, municipalities, and state-owned entities with a total value of over EUR 2 billion. Miloš is particularly active in investment funds regulatory matters and the fintech industry.

Before joining SOG Law Firm and subsequently Kinstellar, Miloš worked as the Head of Serbia’s Public Finance Department, served as a member of the Credit Committee at Hypo Alpe-Adria Bank, and was Finance Specialist at the World Bank Competitiveness and Jobs project. His combined education in law, finance, and business, as well as his background in banking, enable him to provide clients with comprehensive advice. His experience in public offices and position with the World Bank make him well positioned to advise clients cooperating with public authorities and institutions.

Jan Lehký, Counsel in our Prague office, is the Co-Head of the firm-wide Environmental, Social and Governance (ESG) service line. He co-leads the sector alongside Olena Kuchynska, Managing Partner of our Kyiv office.

With more than 15 years of experience, Jan focuses on a range of ESG and regulatory issues with a focus on helping investors with ESG and governance strategies, including navigating ESG transparency, ESG disclosures and reporting, environmental regulation, circular economy issues, ESG litigation risk, and ESG-related obligations and risk assessments. His expertise also includes structuring real estate transactions, such as acquisitions of real estate portfolios, construction law, and the permitting process during various stages of development, as well as advising on high-value, long-term lease agreements, title insurance, litigation, and general commercial and contract law.

Lukáš Mrázik, Managing Associate in our Bratislava office and Co-Head of the firm-wide Data & Cybersecurity service line, is also Co-Head of the firm-wide Technology, Media & Telecommunications (TMT) sector. He co-leads the sector alongside Viliam Myšička, Partner in our Bratislava office.

Lukáš has over eight years of experience focusing on the Technology, Media & Telecommunications and Life Sciences & Healthcare sectors, with particular expertise in data protection, intellectual property and corporate matters. Lukáš holds CIPP/E, CIPT and CIPP/US certifications awarded by the International Association of Privacy Professionals.

Prior to joining Kinstellar, he worked in London as an Associate at a global consulting firm owned by a leading technology company, where he assisted on privacy and data protection issues and all aspects of GDPR implementation.

Iustinian Captariu, Partner in our Bucharest office, is the Head of the firm-wide Energy & Natural Resources sector and service line. 

Iustin has over 15 years of experience advising local and international clients on all aspects of energy law, including energy M&A, renewable investments and developments, upstream projects, joint-ventures, reorganisations, disputes, licensing, and all types of regulatory matters.

Lukáš Ševčík, the Managing Partner of the Prague office and the firm-wide Head of the Defence & Security sector, has been appointed to lead our German Desk.

Lukáš is a German-qualified lawyer, educated and trained in Germany and is a member of the Frankfurt Bar Association. He has 30 years of experience advising international clients on their investments and divestitures in CEE.  For further reference, please also visit our dedicated German Desk webpage (in German).

Lukáš Ševčík Managing Partner

+420 221 622 258lukas.sevcik@kinstellar.com

Miloš Velimirović Managing Partner

+381 63 555 156 milos.velimirovic@kinstellar.com

[phonebyprice]

Bangladesh all Job Circular 2023

Bangladesh is a country in South Asia that is growing rapidly, and it provides many job opportunities in different fields. Whether you want to work for non-governmental organizations (NGOs), the government, private companies, or banks, this guide will give you valuable information about the latest job circulars in Bangladesh.

NGO Jobs Circulars

NGOs are important in addressing social and economic challenges in Bangladesh. They offer jobs in areas such as education, healthcare, poverty reduction, women empowerment, and environmental conservation. Many NGOs regularly publish job circulars to find talented individuals who want to make a positive impact. You can find NGO job circulars on the websites of well-known NGOs like BRAC, Grameen Bank, CARE Bangladesh, and Save the Children.

Government Jobs Circulars

The government of Bangladesh provides various job opportunities in sectors like administration, education, healthcare, engineering, finance, and law enforcement. The Bangladesh Civil Service (BCS) examinations are highly competitive and open doors to prestigious government positions. To stay updated on government job circulars, you can regularly check the official websites of the Bangladesh Public Service Commission (BPSC), Ministry of Public Administration, and other relevant government departments.

Private Jobs Circulars

Private companies in Bangladesh, from large multinational corporations to small and medium-sized enterprises, offer diverse job opportunities in sectors like information technology, manufacturing, telecommunications, banking and finance, and hospitality. Job circulars for private companies are usually published on their official websites, job portals like Bdalljobs.net, and in newspapers. Networking, professional connections, and online job platforms can help you find private job circulars.

Bank Jobs Circulars

Bangladesh's banking sector is rapidly expanding, creating a high demand for skilled professionals. Both public and private banks regularly announce job circulars for positions like officers, executives, managers, and tellers. You can explore bank job circulars by visiting the official websites of banks like Sonali Bank, Islami Bank, Agrani Bank, Janata Bank, and renowned job portals in Bangladesh.

Conclusion

Bangladesh provides a wide range of job opportunities in NGOs, government, private companies, and banks. It is important to stay updated on the latest job circulars to secure employment. Make sure to check official websites, job portals, and newspapers regularly for recent announcements. Networking, professional connections, and online platforms can also improve your chances of finding the desired job circulars. Best of luck in your job search, and may you find success in your chosen career path in Bangladesh!

[jobscirculars]

Social Service Job Circular 2022

Social Service Job Circular 2022

Department of Social Service Job Circular 2022 has been published online by the Bangladesh Department of Social Service Social Service Job Circular 2022 authority. Also, DSS Job Circular 2022 has been published on our website, which is published on the official website http://www.dss.gov.bd. DSS Job is a Bangladesh Govt Job. Currently, the Department of social job is viral news of Bangladesh’s…

[farhadunnoor]

Department of Social Services DSS Job Circular 2021

Department of Social Services DSS Job Circular 2021

শেয়ার করে রাখুন Department of Social Services (DSS) offers a unique opportunity to gain experience and develop skills in the government sector. Department of Social Services (DSS) has issued a job circular for all job seekers and unemployed in Bangladesh. So for those who are looking for a good job for the beautiful future of themselves and their family, this job may be the desired job. The…

[bdjobinsider]

Department of Social Services Job Circular 2021 has been announced in the daily job portal by their authority to get Department of Social Services Job Circular 2021 complete information and applying process from www.bdjobsinsider.com. Apart from the general education of poor children, there are two boys in the Konabari of Gazipur district, two for boys in Rangunia of Chittagong district, and one for girls in Tungipara of Gopalganj district for proper rehabilitation through various training. The services of the Disadvantaged Children Training and Rehabilitation Center are… Raising the distressed children, nurturing them in the family environment with love and care, providing education and vocational training, providing physical, intellectual, and human excellence to the residents, rehabilitation, and self-reliance. To fill the following vacancies for PIU under the project titled “Rehabilitation of Distressed Child Training and Rehabilitation Center Konabari Gazipur” by the Department of Social Services, Ministry of Social Services Applications are invited from genuine local citizens of Bangladesh on a full temporary basis only for the duration of the project (June-2022) on the total

[joanofsnarrrk]

Fic: as iron sharpens iron - Chapter 2 (Burn Notice) - 9k+ words

SUMMARY: Somewhere along the way, at one point or another, Madeline tells them, “You need to stick together.”

And that, more or less, is what they do.

Nearly a year and a half later, here’s chapter two! I’m blaming a lethal combination of a global pandemic and grad school.

Here’s Part One. Also: both chapters can be found on AO3.

——————

He knows it's coming. Has known since the very beginning.

(You left, Michael. You had a choice to make, and you made it.)

He knows all the reasons they can't be together—has them memorized, front and back, reverse alphabetical order, ascending and descending order of importance. Hell, he could even recite them in English, Russian, and Farsi if asked. He used to mentally run them on a loop all the time, but that's—it's not enough anymore. Because the truth of the matter is that he has wavered on the subject with an alarming amount of frequency over the last year with her here in Miami, further demonstrating—in his mind—that his judgment has become too clouded to be objective anymore.

(I'll always care about you, Michael. I'll still help you with your thing, and you'll still help me with mine, but we can't be together.)

It doesn't change the fact that, no matter how prepared he is, no matter how many times he's been briefed on all the terrible consequences they could incur as a direct result of their...liaison, it's difficult to hear her say it out loud.

It doesn't truly become painful until the sound of her words echoes off the empty walls of the loft, and without so much as a glance back, she walks out the door.

—

"Fi, what do you think of these?"

She turns and takes in the floral print blouse and matching hoop earrings (with little, plastic flamingoes on them) Madeline is holding up. They're hideous.

"They're, uh—" She goes back to scanning the department store for visible security threats. There's a particularly suspicious character seated over by the food court in the adjoining mall. "—they're really something."

She tracks the food court guy until a woman and small child approach him, and the three head off toward the New York & Company at the south end of the mall. Satisfied, she glances back, then does a double-take at the deeply unamused look on Madeline's face.

"What?"

"Fiona," she says dryly, stashing the blouse and earrings onto the circular rack beside them, "I'm not an idiot. I know you're only here because Michael asked you to babysit me."

Fi looks down at her nails and swallows. "Well, I think his exact phrasing was 'protect her'..."

"You say 'tomato,' I say 'condescending eldest son.'"

Fi peruses through the clearance rack, nose wrinkling at all the tacky prints. "Michael's helping Sam protect a client—some ex-convict turned dedicated family man—from some bad men in Little Havana. He just—" She shrugs. "—wanted to keep you safe. He cares about you."

Madeline snorts at that. "Yeah? Well, he's got a funny way of showing it."

Fi somehow manages to keep her thoughts on that particular subject to herself. She comes across the tackiest shirt of all. "What about this one?"

It's a t-shirt with Hot Mama emblazoned across the front. Even by both of their style standards, it's awful.

Madeline doesn't even bat an eye. "Only," she says, pulling a shirt of her own off the rack, "if you agree to get this one."

More subtle, but no less awful, hers reads Trouble. They exchange matching grins as they swap shirts.

"You know, Fiona, honey," Madeline begins uncertainly, avoiding Fi's gaze as she holds up her shirt to make sure it's the right size, "Michael's been mum about this whole break up, but I'm sure it...well, I'm sure it hasn't been easy—"

"We were never together," she automatically corrects, ignoring the way her heart twists painfully at the denial.

Madeline's expression turns suspicious, but she keeps her opinions to herself. "Of course. I just mean, if you can't come to poker games, or come visit as frequently because seeing him is too difficult, I...I understand."

It's such a thoughtful sentiment, and one that fills her with an alarming amount of anguish, that Fi feels the need to correct her immediately. Just the idea that Madeline thinks she doesn't want to be her friend anymore because of her son's emotional incompetence is...is...

"Absolutely not." Her voice squeaks out an octave or two higher than normal, but she plays it off like she doesn't even notice. "That's a preposterous idea, Madeline, and I'll hear none of it. Now, go try that on."

The small smile that Madeline flashes her on the way to the changing room is both grateful and doting in equal measure.

—

Even in Afghanistan, the early morning brings some kind of reprieve from the heat, but Miami is its own kind of animal. Sure, it's marginally less humid, but as Michael's sneakers pound against the dirt running trail and his lungs (heavy and unmistakably saturated with the moisture in the air) swell in his chest, he forgets what an absolute hell hole this place is—an insult, probably, to Hell since it can't possibly be this humid there.

(Home sweet home.)

"Mikey—h-hold up!"

Sam's voice barely registers with him as he presses forward, ignoring each coinciding jolt that shoots up his legs and makes his teeth rattle. He deliberately tunes out the internal voice that reminds him thirteen miles was a hell of a lot easier back in his Army Ranger days, at the age of 23, than it is at the age of 41. Still...Langley never had this view—sun cresting over the ocean, streaks of muted pink and orange stretched across the early morning sky.

(Langley also didn't have frozen bank accounts and deleted job histories, that same internal voice reminds him, which...fair).

They bypass a park bench, which Michael figures is as good a spot as any to take a break, just as he gets a side cramp. Apparently, his own body has a truly wicked sense of humor. He presses his palm to just below his rib cage as he watches Sam collapse onto the other end of the bench, legs sprawled.

"Aw, c'mon, Sam," Michael says to him in between labored breaths. He attempts a smile but winces when he gets another sticker. "Don't tell me you've gone soft in retirement. I thought SEALs were supposed to have better stamina than this."

Sam's own breathing is erratic as his chest rises and falls unevenly. He wipes an arm across his forehead. "Uh, for the record: If we were in water right now, we wouldn't even be having this conversation."

"Why?" Michael looks up from the ground, hands planted on his knees. "Because you would have drowned?"

Sam's responding look says everything a rude, single-fingered gesture could. "Oh-ho! That's real funny, Mike." He lets his head rest on the back of the bench a moment, eyes jammed shut, trying to regain a steady pace of breathing again. "I'll let it slide, though, 'cause I know you're all messed up about this break up with Fiona—"

"We were never together."

"That's just the denial, brother. Veronica says it's the second stage of the grieving process, and—"

Michael lets his head fall, chin to chest, and holds out his hand. "If I buy breakfast, can we please drop this?"

Sam takes his proffered hand and uses the leverage to spring from the bench. "Throw in lunch, and I'll forget I ever met the broad."

Despite himself, Michael grins at that. When they finally make it back to the Charger—drenched and completely exhausted—Sam beats his personal best time by about a second and a half, which he claims—in addition to both meals—is worth at least two drinks of his choosing.

"It's certainly worth at least a drink and a half," Michael ultimately decides, and Sam's responding laughter is contagious.

—

The instructor is too...peppy for this early in the day. At least, that's what Maddie thinks.

All she says, however, cigarette hanging limply from the corner of her mouth is: "I hate her."

Sam rolls his eyes, careful not to lose his grip on the pool noodle she's balancing on as she does half-assed flutter kicks. The other ladies in the aquaerobics class keep covertly (and some not so covertly) shooting them dirty looks. He manages to keep them at bay with a few disarming smiles. Apparently, Sammy's still got charm to spare.

Of course, it probably helps that he's easily the youngest one in attendance, but when your best buddy asks you to keep an eye on his Ma, what can you do?

All he says to her, however, is, "Now, now, Maddie. My shrink from back in the service would say you're projecting."

"Projecting?"

"Mm-hmm. It means you're not really mad at the instructor, you're just upset because—"

"I know what it means, Sam. I'm not an idiot."

"—Fiona and Mike broke up."

"Fiona said they were never together."

Sam snorts. "Yeah, Mike said the same thing."

"Oh, please," she spits out with enough force that her cigarette drops from her mouth into the pool. "They were 'never together' in the same way you date 'age-appropriate women'."

"Hey, now," he bristles, sounding almost hurt.

Maddie doesn't apologize, but her tone doesn't carry the same kind of bite when she adds: "I suppose that's why Michael put you in charge of surveillance this morning? So the two of them don't have to spend more time together?"

He relinquishes the pool noodle to her when the instructor holds her own noodle above her head. Maddie mirrors the movement. "Or, maybe I just like scoping out all the eligible broads in Miami-Dade County who are raking in those sweet social security checks."

She barks a singular, "Ha!" over her shoulders, which of course earns them a few more disgusted looks.

Up front, the instructor begins doing some kind of modified jumping jacks. Her teeth gleam as she smiles widely and says, "Okay, ladies! Let's move with porpoise and try to have some dol-fun with this one!"

The two of them exchange looks. "I hate her," Sam finally decides, frowning.

Maddie turns back around, a self-satisfied smirk on her face. "Now who's projecting?"

—

She could flag down someone at the Cuban café down the block, but—ugh, no. Horrible idea. Untrained civilians would be more trouble than help. The cops? Not unless she wants Michael and Sam to get pinched—and as tempting as the latter may be...There!

Fi makes a hasty approach to the EMT station just down the block. This was supposed to be a two-man job (of which she had no part, thank-you-very-much) until her pedicure was interrupted by a call from Michael, who practically begged her for reinforcements. So even before her gels have a chance to set, she finds herself in Hialeah trying to find a suitable enough commotion to allow Michael and Sam the chance to escape from...well, whatever it is they've got themselves involved with.

He owes me big time, she thinks sourly before hiking her dress up just the tiniest bit and fanning air into her eyes to make them water before she makes her entrance.

"E-Excuse me? Somebody! Can-Can anybody help me?" she cries, really turning up the dramatics—truly, if anyone should be teaching an acting master class, it should be her.

There are a couple of ambulances and a group of EMTs playing cards. Or, at least they were playing cards before they all turn to look at the hysterical woman standing in their station.

One of the men—a genuine look of sincerity and concern on his face—approaches her. "What seems to be the trouble, ma'am?"

"It's my father," she tells him, voice cracking. "He's feeble, and—and the dementia? It's only getting worse. He was supposed to meet me at the jai alai court on seventh, but he never showed." She brings her hand to her mouth as if suddenly overcome with emotion rather than trying not to break at the thought of Sam being described this way. "I think—I think it might be gang-related?!"

The man places a comforting hand on her shoulder, which normally would be a bit forward, but Fi's having trouble getting upset over the whole ordeal—especially when that hand belongs to someone with such a cute face.

A very cute face.

"Don't worry, ma'am," he reassures her earnestly—it's only further endearing, "we'll send someone out to make sure he returns home safely."

He gestures behind him to two of the men playing cards, who immediately stand to attention. With his back turned, Fi quickly shoots out a text to let Michael know the cavalry's on its way. The sound of the ambulance's siren as it turns out of the garage startles her, and just as she slips her mobile back in her hip bag, the man redirects his attention back to her.

"Oh, thank you!" she gushes, making a show of dabbing at her eyes. "Thank you, Mr....?"

"Uh, Campbell. Just—Campbell."

"Thank you, Campbell. I'm—" She hesitates, only slightly, with every intention of offering up a fake name (Millicent, maybe?). But it's like she said: he's very cute. "—I'm Fiona."

Eventually, he asks for her number, blushing and backtracking at her raised eyebrows as he explains they want to make sure they have a point of contact in case Bryce and Jeff (the two guys in the ambulance) find her father.

They never do, obviously. But Fi does receive a text from an unknown number later that night inviting her to stop by the garage any time tomorrow.

...for an update on her father, of course.

(He doesn't actually ask her out until the following week, and by that point, she updates the contact listing in her phone from Cute EMT to Just Campbell).

—

Their question doesn't make sense. Especially because they're at Carlito's, and their brunch order hasn't even arrived yet.

"I like Campbell," Michael says, his smile not really all there. "He's...great."

Sam and Barry exchange glances, as if they somehow know something he doesn't. Michael hates it. He flags down the waitress for another mimosa—maybe two?

The whole thing's an ambush, all things considered.

—

"You said what?" Fi practically shrieks.

A few women on the yoga mats in front of them turn around to glare at the interruption. She offers up a hasty apology.

Sam, who is finally dressed appropriately in a baggy t-shirt and athletic shorts, looks duly chastised. Whether from her outburst or the fact that he can't seem to maintain his balance for boat pose, she's uncertain. "I told her that I've traveled all over the world, seen a lot of women, and that..." He hesitates when he catches her glaring. "...that she's one in a million?"

Fi lets out an exasperated yelp. "How did you possibly make it through SEAL training when you are clearly suffering from such advanced levels of brain damage?" she hisses, careful to keep her volume in check.

Sam falls back against his yoga mat gracelessly as they mimic the instructor's transition into corpse pose. "Hey!"

An older woman on the other side of Sam looks at him, disappointed. "Veronica has every right to be upset," she says. "You tell her she's something special and then can't even honor her with a response when she proposes?"

Sam tries to catch his breath, arms splayed at his side. He glares at her. "Uh, no offense, but you're not exactly a relationship expert here. You've only been with Anthony, what? Two weeks?"

"No, Donna's right," Fi assures him, closing her eyes to hopefully re-establish some form of equilibrium.

Another girl, Natalie—with bangs and a University of Miami t-shirt—chimes in from behind them. "Sam, my guy. It's completely understandable that you would have some reservations, or whatever, given everything that went down with Amanda. But you can't just, like, project all of your emotional baggage onto Veronica. It's not fair to her."

Sam looks between the three of them as they transition into bound angle pose. His hips creak painfully in the process. "Okay, let's assume that some—"

"—all—" Fi corrects.

"—Fine, let's assume all of that is true. What do you guys think I should do?"

"Have you called her since?" Donna wants to know.

Sam looks uncomfortable—and not just because his body hasn't moved like this since before the Soviet Union dissolved. "Well, no, not exactly, but—"

"Sam!"

This time, Fi doesn't bother watching her volume. She stands abruptly, slinging her yoga mat over her shoulder, and grabs Sam by his ear. His protests combined with her antics are enough to disturb the whole class. The instructor scowls at them both.

"Don't worry, we're leaving," she calls out, dragging a sniveling Sam behind her. He barely protests when she informs him they're driving over to Veronica's, so he can explain to her in person why he's an emotionally stunted idiot man child (her words).

—

"Now, you can hit me all you want," Sam growls at him, breathing wild and uneven, "but I'm gonna stand here 'til you get your head back in the game."

All Michael can see is red (although, some of that may be courtesy of Sam, who apparently still packs a hell of a right hook) as his options for saving the sick boy, Jack, vanish right in front of him. To him, it's just tactical reevaluation: Rachel is no longer an option, so the next logical step is Carla, who has the cash they need. But to Sam, it's apparently a breach of conscience.

It's been so long since Michael took his conscience into consideration—seared and mangled beyond repair, as it is. But Sam, apparently, views it not only as something worth saving but as something capable of being saved.

So he retreats, equal parts livid and grateful toward the guy blocking his front door.

A good friend supports you, both tactically and personally, he thinks, but an even better friend knows when to draw the line.

—

"You're lucky I like you so much," Fi says through a barely concealed yawn as they walk into Milam's. "Otherwise, you would never find me up this early on a Sunday."

Campbell smiles and pulls her into his side. "Good thing I'm so convincing then."

She has every intention of keeping up her pouting act and drawing the whole thing out a little while longer, but when she looks up at him and sees how...happy he looks, she finds it difficult to stay annoyed at him. Especially because she finally has the chance to wear the romper she snagged from the outlet mall two weeks ago for a fraction of its original cost.

(Michael would have complained about heading out to Dolphin Mall on a weekend, but Campbell was more than game. He even offered to drive—)

She cuts off that thought and instead focuses on how warm his fingers feel through the thin material of her romper. "And charming," she adds without really meaning to, but as soon as she sees his smile widen, she's glad she does. "However, I believe there were promises made regarding a homemade breakfast of some kind?"

She wiggles out of his grasp to pull a hastily made grocery list out of her pocket (half-off and pockets? Be still, her heart!). She hesitates a moment when she sees two of the cashiers looking intently in their direction (it's always the same girls who stare at her every time she's in here). They go back to busying themselves with the registers as soon as they see her looking their way.

"An egg white omelet with spinach?" Campbell suggests, then after a moment of doubt, he adds, "Right?"

It's adorable—as is everything he does. She nods in reassurance, and his shoulders sink in relief.

"Now," she says, redirecting the conversation to the task at hand, "produce is on the other side of the store, but the eggs are lumped in with poultry here, so if we hit up this side first, then make a straight shot through to—"

Campbell releases her and instead clasps one of her hands in his. "We have nowhere else to be today. Why don't we go up and down the aisles and pick up anything else we might need?"

She hesitates. Tactically, his plan is an absolute disaster—why would you divert from the objective for non-essential food items? But, a small voice reminds her, not everyone is as tactically minded as him.

Campbell frowns as her smile presumably falters, but she shakes her head like an Etch-A-Sketch and hooks her arm in his. She makes a big show of sighing and rolling her eyes as she relents. "Fine, but you owe me a yogurt now."

He plants a kiss on her head. "Blueberry, right?"

She spends the rest of the day pointedly ignoring the voice that won't stop reminding her he's not Michael.

—

Crouched behind their registers, Olivia turns to Maricruz. "Oh, my God—that's the supermodel wife slash girlfriend!"

"The one with the yogurt guy?"

She nods. "Yeah, but that's definitely not him."

Covertly, the two peer over their registers to get a better look. Not long after, Supermodel Wife Slash Girlfriend looks in their direction, and they quickly disappear again.

"Uh, excuse me, but who the heck is generically handsome white dude?" Maricruz demands, sounding almost offended.

Olivia's shoulders sink. "Do you think she's cheating on him? Poor yogurt guy."

"I mean, it could be her brother?"

"Yeah, right. He had his arm wrapped around her waist. That's, like, Boyfriend 101."

Maricruz puts her foot down. Metaphorically. "No. No way. I—"

"Excuse me." An elderly woman peers over Maricruz's conveyor belt, her mouth pressed into a hard line. "Could I please get some assistance?"

The two girls pop up from their crouched positions and brush themselves off. Maricruz offers the woman a conciliatory smile. "So sorry, ma'am. I'm happy to help you out."

After Maricruz rings up her order—a tube of Sensodyne and a bag of Werther's Originals—the elderly woman walks off in a huff. They both wave after her, wide smiles plastered on with professional ease, until Maricruz turns back to Olivia.

"No, look. I have a cousin who runs a kind of sketch auto body shop in Little Haiti, and he says yogurt guy was in just last week buying a new windshield, and supermodel wife slash girlfriend was with him."

Olivia looks somewhat impressed. "You looped your cousin into this?"

"...Yes. I'm not proud of it," Maricruz laments. "According to Diego, yogurt guy is in there a lot, always showing up with his car busted up. One time, Diego swears he saw bullet holes on the side, hand to God."

Olivia takes this in with some difficulty. "But he...he owns so many polo shirts! I just—what does that guy do?"

Maricruz crosses her fingers, nodding in Supermodel Wife Slash Girlfriend's direction. "Hopefully, not her. My money is still on super hot sister."

—

"Now, did Shawn deliver, or did he deliver?"

Michael turns just in time to see the giddy smile stretch across Sam's face as he makes his return to their seats, his arms delicately balancing chili cheese fries and plastic cups of beer. Before Sam can reclaim his seat between them, Fi makes a grab for the fries, while Michael takes one of the proffered beers. When Sam settles in, he tries to snag one of Fi's fries, but she slaps his hand away.

"Fifty-yard line, third row back," Michael recalls, unable to help the grin from spreading on his own face. "I've gotta admit—these seats are real nice, Sam."

Of the three of them, he's the only one in an orange polo shirt. The other two are decked out, head to toe, in Dolphins' colors—including jerseys (Sam, of course, in an old Marino one) and in Fi's case, an orange bandana. She even has eye black under each eye.

"Nice?" Sam demands with a hearty laugh. "Mikey, these seats are more than nice. They're phenomenal. I can practically see the whites of Ricky Williams' eyes!"

Fi sighs dramatically. "Get back to me when we're talking about real football," she says, popping a fry into her mouth.

"Real football?" Sam gestures toward the whole field. "This is as real and American as apple pie, lady."

She rolls her eyes. "Michael, can you please inform Sam that I am not an American?"

"Mikey, can you please inform Fiona that I didn't serve in the Navy for over a decade to listen to the good name of American football be besmirched?"

"Kids, kids," Michael says dryly. "Let's try not to kill each other before half time even begins."

Arms crossed, Sam and Fi glare at each other. "Fine," they spit out simultaneously.

Michael smiles from behind his sunglasses as an announcement filters in through the speaker system that they're clearing the field to honor a group of local World War II veterans. Sam springs up from his chair just as a steady stream of other people migrate toward the restrooms and concession stands.

"Those beers shot right through me," he informs them just as Fi makes a point of dramatically shuddering. "I'm gonna try to beat the lines."

As soon as he leaves, Michael is acutely aware that he and Fi are alone together for the first time since...well, a while. Without Sam as a buffer between them, she seems much closer than before. Which is...inconvenient because she said they can't be together, and she's still—well, the whole thing is still—a lot.

And...maybe she called Campbell before the start of the game, and Michael realized he hadn't been able to make her smile or laugh like that in a long time.

"I never got a chance to thank you, Michael."

He looks up at the sound of Fi's voice, but when he turns to her, she has her feet propped up on the seat below her, gaze straight ahead. He copies her stance, settles into the cheap plastic seat. "Thank me for what?"

"For taking this job and putting Felix away for good. He was a monster. Corey and Tanya deserved more than living their lives in constant fear."

Michael has a brief flash to his father, but he reflexively pushes that back. Instead, he watches as a group of elderly veterans make their way onto the field. "Well, you said you felt strongly about it."

"I did," she says, then quickly corrects, "I do. Tanya is just a kid, and when I—"

Abruptly, she cuts herself off, and it takes everything in him to keep his gaze straightforward. Fi could never stomach his pity, and he has a feeling now would be no different. There's something there, but he won't press her. Instead, he tries a different tactic. "You did good work, Fi. They were lucky to have someone who lets her emotions run the show on their side."

He feels eyes on him, and instinctually, when he turns to look at her, she's looking right back, an appreciative smile on her face. He looks away just as she makes the decision to climb over and into the seat next to him. She plucks a fry from Sam's abandoned pile and settles in before saying, "Sam will simply lose it when I tell him I submitted his name as one of these elderly veterans."

It's enough for both of them to share matching grins and clink plastic cups as the concept of colleagues who are just friends seems more attenable.

(In the spirit of colleagues who are just friends, he may need to tell Sam to stop calling Campbell "Soup" behind his back.)

—

Even from his spot behind the police line, Michael can feel the stifling heat blazing from the explosion site. He's not actually breathing in any of the smoke or the smell of charred plastic, but he may as well be, the way his chest constricts, the way bile comes up and burns his throat on its way back down.

He spends the next few hours scouring what seems like every freeway, every back road, and every alley that make up Miami-Dade County looking for her. He mentally compiles every safehouse, every evacuation measure, every weapons stockpile she has littered throughout the city. All the while he tries calling her ("This is Fi. Leave a message.") again ("This is Fi. Leave a message.") and again ("This is Fi. Leave a message.") and again ("This is Fi. Leave a message."). It's only when the rain turns into a torrential downpour, reducing his visibility to practically nonexistent, that he's forced to make the retreat back to the loft. The click that accompanies the closed door carries with it a finality that Michael refuses to—can't—accept.

But then her voice somehow filtrates through his waning adrenaline and utter exhaustion ("You have got to get a landline in here."), and suddenly, he can't focus on anything other than remembering how to breathe.

There's no Campbell, there's no job, there's no sleazy, retired ex-SEAL making not-so-subtle comments, or a well-meaning-but-intrusive mother demanding to know how he ever let a girl like her go—

There's just them.

And suddenly his chest constricts, and he's drowning for another reason entirely when she sinks into his embrace—warm, and solid, and alive.

—

Sam keeps asking, keeps pressing, keeps...being Sam about the whole thing, but she is quite adamant on the subject.

She doesn't want to talk about it.

"Are you sure?" he tries again, breathing heavy. They're outside the loft, where the Charger usually is, sparring (Michael's off with—other Sam). She can't recall who had the idea first, but she's dismayed it took this long to figure out that hitting Sam is...well, it's phenomenally cathartic.

"Because it seems like—" He ducks, narrowly avoiding being kicked in the head. When he comes back up again, he fixes her with an indignant glare. "—it kind of seems like you might wanna talk about it."

"There's nothin' to talk about." Fi's next punch lands squarely on the beat-up couch cushion he's using as a strike shield. If her native accent slips through the haze of her own outrage, then so be it.

"Nothing at all?" This time her foot connects with the cushion, but he holds his ground. For an octogenarian (she assumes, anyway), he's still surprisingly spry. "You're telling me," he continues, as she blocks his counter, "that you have absolutely nothing to say about the fact that Mike—our Mike—was once engaged?"

Fi lets out an enraged shriek before she lands a roundhouse kick that makes Sam lose his footing and stagger backward. While he recovers, Fi paces—hands on her hips, breathing erratic, head and chest pounding in tandem.

"Of course, I do!" she cries, coming to an abrupt halt. "Do you know what he said to me? What he told me that first night we were in Miami?" When Sam shakes his head, she tells him: "He said—" She swallows past the lump in her throat with some difficulty. "—He said I was the 'closest he ever got.' And then this—this Sam woman just shows up, out of the blue, and she's just like him—"

Sam stands fully and looks at her with not quite empathy—he's not nearly evolved enough to pull that one off if she's being honest (and she almost always is)—but with pity. It's positively grotesque.

"Fi..." he trails off, his expression totally lost.

She can't tell if it's said out of genuine concern, or out of embarrassment by her outrageous emotional display, and he's just too much of a gentleman to address it forthright—but either way, she decides, she has spent far too much time wallowing to be of much use to anyone. (The fact that she just compared Sam to a gentleman is merely further evidence of her fraught emotional state, as far as she's concerned).

"Sam, I'm fine." She wipes her hair out of her eyes and brings her fists back up to fighting stance. "Like I said," she reminds him, "I don't want to talk about it."

Sam takes a moment to determine if she really is fine, but she doesn't budge. Satisfied, he clears his throat and holds the couch cushion back up. "Fine by me, sister. But this time," he advises her with an annoyingly smug smirk, "try leaning your whole body into it. Your last kick was pretty weak."

Later, after Fi leaves and Sam drives over to the clinic in Coconut Grove to tell his medical buddy about the whole ordeal, Sam's buddy takes one look at his x-rays and tells him he has three cracked ribs.

—

I left her because you don't marry someone when you love somebody else.

Madeline can't see Fiona's expression from her place in Michael's bed (pretending to be asleep limits her line of sight), but she can't help the small smile that blooms on her own face at her son's admission.

She hasn't known Fi long, but she has come to think of her as...family. Like the daughter she never had (the one she miscarried all those years ago). Sometimes she thinks about it—about what would happen if her fool son would start prioritizing the people he cared about over his job and what that would look like. How he would finally decide whether Fiona was officially his girlfriend or not, and how she would finally have the big family get-togethers during the holidays with all of them (her sons, and Fiona and Sam) like she always wanted, and maybe—eventually, somewhere down the line—how she might even get grandchildren out of the deal. She snuggles down into Michael's god-awful mattress, hopeful.

Her son certainly picked the right girl, but so help her, if he thinks Fiona—coming from an Irish Catholic family like that—would ever be caught dead proposing instead of him, then he clearly inherited all of his common sense from Frank, who was—at his best—a complete idiot.

[doctorfiction]

Are there certain injuries that are more commonly seen in young women abused by their boyfriends?

You will notice that this posting consists of a single entry. I had already chosen 3 questions for this week’s posting when this appeared in my inbox. As you know, my answers are generally infused with a fair dose of whimsy.

I felt this question deserved a forum of its own undiluted by humor. Fear not, the 3 previously chosen questions will appear next week.

It is my fervent hope that the inspiration for this question is purely literary.

One of the most common misconceptions is to limit the concept of abuse to physical violence. Abuse springs from a desire to control. The perpetrator accomplishes this task through a combination of physical, emotional, social and financial gambits.

 I will answer the question with a most disheartening fictional  Emergency Room encounter.

As I am a writer, talking to other writers, I have exercised poetic license. The patient presented here is a fictitious amalgam of partner abuse injuries I have treated in the Emergency Department. My hope is that this will both answer the question and further raise awareness of this epidemic.

The post is quite long but please bear with me and read it all. I hope it will both educate and aid in the literary treatment of this epidemic issue.

Abbreviations: CC/chief complaint, HPI/ History of Present Illness, ROS/Review of Systems, PMHx/Past Medical History, CM/ current medications, PSHx/Past Surgical History, Imaging/ (X-ray, CT, MRI, Ultrasound), Dx: Diagnosis, and TX. If you are “getting all medical” in your story, the format shown below adds great credibility, allowing you to present information for discussion without appearing as an “info-dump.”

Physical examination was as follows: Pertinent POSITIVES are in bold

23 NOV 20XX

CC: L leg pain, headache and chest wall pain.

HPI: A 22-year-old female sits on the exam table. She is accompanied by her 25-year-old boyfriend. The boyfriend is bent over and whispering in her ear. She is nodding. They separate and he half smiles when I enter the room with a nurse.

The patient has swelling and yellow-brown bruising about the left eye. Although it is a hot summer evening, she is wearing a long-sleeve blouse, jeans, and socks. Her partner is wearing cut-offs, short-sleeve T-shirt and steel-toe work boots with gray socks.

She c/o Left lower leg pain, left upper arm pain, right rib pain made worse with deep breathing, abdominal pain without nausea and headache with blurred vision on left. She states that she sustained the injuries when she tripped over a rug and fell onto a “coffee table.” She denies LOC. (loss of consciousness) She also complains of left lower leg pain, worsened by weight-bearing. She c/o low abdominal pain associated with fall. Her partner interjects, stating that she can be clumsy and fell off the front porch 2 months prior sustaining arm, chest head injury. She denies ETOH (alcohol.) The nurse tells her she looks familiar. The patient responds that she was in the E.D. a couple of months ago after “falling off the front porch.” Her partner laughs and volunteers that she’s a bit clumsy. The patient is crying, appears deferential and stares at the floor during history.

 ROS: Positive for Head trauma with pain and swelling about R eye. Blurred vision R eye. A headache. Right side chest pain worse with deep breathing, and pain mid-portion L upper arm. Abdominal pain. Increased frequency of urination. Fatigue. Irregular infrequent menses. (LMP 4 months prior)

PMHx: Depression with Anxious Mood

            Second Trimester Abortion secondary to fall

            Abdominal Pain/chronic of unknown etiology

            Fracture Right Wrist after fall

 OB-GYN: G2/P0/Spontaneous AB2 (2 pregnancies, no births, 2 non-medically induced abortions)

CM: Prozac 20mg daily

PSHx:

D&C after traumatic abortion

Open Reduction and Internal Fixation Right Wrist Fracture

Social: Patient states she feels safe at home when queried.

Negative ETOH or illicit drug usage. 3 cigarettes per day

The nurse gives the patient a gown for the examination and asks the boyfriend and me to step out. He is reluctant but complies.

In the hall, the E.R. clerk hands me an EDie. report on the patient.

An EDie report is a computer-generated list of every emergency department visit to any E.R. for a given patient in a given time period.

The patient’s Edie reveals she has had nine visits in the past 12 months. Five visits have been for musculoskeletal “fall” trauma, two for abdominal pain, and one for anxiety. The clerk pulls me aside and states that the patient’s partner has had two E.D. visits in the past year, one for injuries sustained in a fight at work and another for evaluation after an arrest for driving while intoxicated.

When I question the partner regarding the patient’s repeated fall injuries, he states again that she falls a lot, becomes visibly agitated and says he has to go outside for a smoke.

Exam:

General: Patient alert and oriented x 3. No acute physical distress.

Head: Scaring of eardrums, L>R consistent with childhood ear infections vs healed traumatic rupture from blunt trauma. Questionable Left hemotympanum (blood behind the eardrum.) Obvious dental caries (tooth decay) in upper and lower molars. Chipped teeth: Right upper central incisor upper and Left lower canine.

Neck: Trachea midline, neck veins flat, Tenderness with Range of Motion. Generalized tenderness with palpation, no spinous tenderness. Blue-green fingertip bruising noted, one left, three right at the level of the trachea. (strangulation injury either “throttling or near strangulation to establish control)

Heart: Rate 102 and regular, without murmur.

Chest/Back: Lungs clear to auscultation without quiet areas. Black-blue fingertip bruising left breast. Multiple areas of bruising. Bright erythema (redness) with underlying edema noted of anterolateral aspect R ribs 5-7. Significant tenderness and crepitus (grating or crackling) over the affected area with inspiration. No tenderness or crepitus or step-off noted on spinal exam. Numerous bruises L/R chest and back. These cover the spectrum, ranging from Black-Blue-Green-Yellow and Brown.

Abdomen: Non-distended, non-tympanic with positive bowel sounds. The uterus is non -palpable. There is a large area of erythema noted in the suprapubic area with associated tenderness. A single circular 4mm burn with eschar is noted 7.5cmm inferior to the umbilicus.

Genital/Pelvic: Deferred at patient request (follow-up ob-gyn exam to be scheduled) Upper Extremities: No gross deformity. Warm and well perfused with good bilateral peripheral pulses. Fingertip erythema noted over mid-portion Left Humerus. Numerous areas of fingertip bruising. As with back and chest, these range from black to brown. Right extremity and balance of left extremity have a similar appearance. In addition, there are a total of 9 (4 right arm and 5 left arm) 5mm circular scars (cigarette burns) consistent with old healed 2nd-degree burn.

Lower Extremities: Warm and well perfused with good bilateral peripheral pulses. No gross deformity, no shortening or external rotation of leg when supine. SLR (Straight-Leg-Raise) negative left and right. Again, numerous bruises of various colors left and right over the Anterior Tibia. Abrasion and erythema with underlying edema (swelling) and tenderness left mid anterior tibia. No crepitus.

Neurological: Cranial and Spinal Nerves intact by exam. Gait not tested until post-X-ray due to painful weight-bearing.

Psyche: Cooperative, minimally conversational with direct query. Flat affect with overt signs of Depression with Anxious Mood

Labs:

1)Urine HCG (pregnancy test) negative

 2) Urinalysis 2+blood and numerous WBC (white blood cells), with numerous motile trichomonads (trichomoniasis)

3) CBC, CMP WNL (Within Normal Limits)

 Imaging:

1) Head CT w/o contrast: small 2 mm LEFT tempo-parietal subdural hematoma. No other acute pathology but there is scattered parenchymal (brain tissue) scarring consistent with old microbleeds. No facial/nasal/orbital fractures seen.

 2)Left Tibia/Fibula X-ray: No acute bony or soft tissue abnormality seen. Evidence of old, healed nondisplaced fracture anterior tibia.

 3)Left Humerus X-ray: spiral fracture mid humeral shaft with no angulation and good apposition.

 4)Chest X-ray with Right Rib detail: Acute nondisplaced fractures right ribs 3-5. Old rib fractures noted in various states of healing R ribs 3,5,6 and L ribs 4-7. No pneumothorax, no acute cardiopulmonary process.

 DX: 1) Traumatic Subdural Hematoma

       2)Abdominal Contusion

       3)Contusion Left Tibia

       4) Spiral Fracture

       5) Nondisplaced fractures R ribs 3-5

       6) Trichomoniasis

       7) Amenorrhea

       8) Acute on Chronic Depression

 *****Symptom Cluster suggestive of Domestic Abuse*****

 Consult: Social Services

              Hospital Administration on Call

              Hospital Security

 Additional History: Patient is presented with diagnosis and informed of concerns regarding potential abuse scenario. Patient denies abuse and asks to see her partner. Security is sent to the parking area to retrieve partner. When security approaches partner’s vehicle, he speeds from the parking lot.

 When the patient is informed of partner’s departure, she becomes tearful and agrees to update history.

 Patient and partner were introduced at a local bar and began dating three years prior. Both shared a common bond of having dropped out of high school. Her partner was a laborer at a local scrapyard. Patient clerked at a local department store while taking night courses to finish high school. She admits to social drinking while her partner was a moderate to heavy drinker given to occasional binging. They moved in together and shared rent until he told her he would leave unless she quit her job and high school completion courses. When the patient’s family complained, he forbid her to have personal or telephone contact with her family. Her partner was involved in a physical altercation at work and was taken to the E.R. for treatment of injuries. Employer mandated testing was positive for alcohol and cannabis, at which point he was discharged from his job. At this point, he increased his alcohol intake and began an escalating pattern of abuse. He forced her to sell her car to pay rent, utilities, and grocery expense but placed the proceeds in his checking account. At this point, the patient informed her partner that she was pregnant and he beat her violently for the first time. Punching her repeatedly in the abdomen until she passed out from pain. The patient subsequently miscarried. Patient packed clothes and was leaving with a friend. Partner blocked driveway and tearfully apologized. Over the protests of her friend, she agreed to remain with him. Partner encouraged her to take a cleaning job at a local business but confiscated her checks forcing her to bring peanut butter sandwiches to work for her lunch. He refuses to allow dental visits due to cost and forbids the use of oral contraceptives because it will encourage her to be promiscuous at work. When she returns home from work and finds him in bed with a female neighbor, he states that he did it to show her what would happen if she were unfaithful. Shortly thereafter, the patient developed a frothy malodorous vaginal discharge, itching and pain with intercourse.

 Emergency Department TX:

I.V. of normal saline @ 100ml/hr

Flagyl 500mg PO (by mouth) for Trichomonal Vaginitis

Splinting, sling left arm for Humeral Fracture

Consults: Presented patient history and physical to Hospitalist at a tertiary medical center. Documented acceptance of patient and arranged transport.

Disposition: Patient is transferred by ALS Ground (Advanced Life Support Ambulance) to tertiary care medical center where she was admitted to Neuro-Surgery for observation of her brain bleed with consults to Orthopedics, Ob-Gyn, and Social Services.

 Notification of local law enforcement regarding high index suspicion of domestic assault

The fictitious chart above is NOT an exaggeration:

 Physical Injuries:

 U.S. Department of Health and Human Services reports that domestic violence is the cause of more injuries in women ages 15 to 44 than all other injuries combined with more than 1 million women per year seeking care in the E.D. One fourth of these women will require admission, and greater than one in ten will require major medical treatment. Nearly 4 million women are beaten in their homes every year. ONE IN FOUR women will experience domestic violence in her lifetime.

 The above patient has evidence of significant physical abuse.

 Bruises: direct trauma to the skin appears first as a bright red area and over the course of a 10- day period the color of the injury progresses from black to brown as noted above. This allows the injury to be aged. Numerous bruises of different colors indicate a pattern of continuing abuse.

Fingertip bruises are a result of the very common grasp injuries used to control the abused woman.

 Burns: numerous 4mm circular injuries/scars in various states of healing indicate cigarette burns. These are commonly inflicted as punishment. Arm burns are common. Burns near the genitalia establish complete dominance and maximum humiliation.

 Head Trauma: You will recognize the epidural hematoma from a previous posting. The patient’s Head CT also showed evidence of scaring indicating a pattern of repeated blows to the head over time. The eardrum scars revealed blows forceful enough to cause rupture of the eardrum. The patient has several chipped teeth indicating repeated blows to the mouth over time.

 Fractures: The X-rays Physical exam revealed an old nasal bone and septal fracture. Multiple rib fractures both new and in various states of healing support ongoing abuse. The spiral fracture of the Humerus (upper arm bone) is a result of grasping and rotational stress and is a classic abuse fracture. The fingertip erythema (fresh injury) combined with this fracture is considered abuse until proven otherwise. The healing/healed fractures on the patient’s tibia (shin) suggest she has been struck repeatedly with a hard object (steel toe boots or a club of some kind.)

 Abdominal Injury: The blows to the abdomen represent the abuser’s attempt to terminate a perceived pregnancy due to the patient’s lack of menstrual cycle.

 Emotional Abuse:

 The effects of emotional abuse, while invisible, are no less devastating. Abused women have a markedly increased incidence of substance abuse including smoking. Low self-esteem and a feeling of hopelessness lead to loss of educational, relationship, and educational opportunities. Abused women have a fivefold increased risk of anxiety and depression.

Financial Abuse:

 The abuser generally denies the woman access to finances which restricts access to dental/health care, work-appropriate clothing and personal care items necessary to secure quality employment.

Social Abuse:

 The abuser generally restricts access to family, friends, social outings and even media information to limit the possibility of abuse exposure.

General Health Abuse:

 Abusers generally engage in behavior which can have profound negative effects on the abused woman. A preponderance of abusers lack even a high school diploma and consider an educated or trained female a threat. Even the educated abuser fears the empowerment of a woman with a marketable skill. Generally speaking, domestic abusers are substance abusers exposing the woman to the hazards of their impaired driving, the violence of their drug suppliers, and the ramifications of their frequent brushes with law enforcement. The “risk-taking” behavior of the abuser will also frequently put the woman at risk for both minor and serious sexually transmitted disease.

Women at greatest risk for injury from domestic violence include those with male partners who abuse alcohol or use drugs, are unemployed or intermittently employed, have less than a high-school education, and are former husbands, estranged husbands, or former boyfriends of the women. 

Having said this, there are lawyers who beat their Ph.D. wives, physicians who manipulate their girlfriends, college professors who take advantage of their students, and politicians, actors and director/producers who use their power to exploit women.

 I hope this response will further heighten awareness of this epidemic and as a positive side effect provide some insight in depicting these characters in your writing.

 Thank you for your indulgence. I promise next week’s trio of postings will be a return to Doctor Fiction’s usual mixture of banter, brilliance, and bullshit.

The Doctor is In. Want to ask a question? Read the guidelines first.

[jibonislam435]

DSS Job Circular 2020

DSS Job Circular 2020

DSS has been published new job circular. To get Department of Social Service (DSS) job related all information found our website: jobnewsbd24.com otherwise visit to DSS official website available: dss.gov.bd and dss.teletalk.com.bd. DSS online application start: 07-Sep-2020 and end date: 27-Sep-2020. So, get any government job search you can bookmark and note our website.

It is very popular and…

[bdcareer24-blog]

Department Of Social Service Job Circular in August 2017

Department Of Social Service Job Circular  will be published Jugantor paper wbsite and our website.Application declined 17 August 2017. vacancy in  Department Of Social Service.

Department Of Social Service Job Circular 2017

Application Published Date : 11 August 2017

Job Type : Government Jobs

Jobs Location: Any where in Bangladesh

Source : Jugantor

Official website : www.dss.gov.bd

Online…

[making-a-supperer]

#4.  The HOBNOB

277 Sheridan Rd, Racine, WI 53403 Sat, Feb 23  @5pm

hob•nob – to socialize, mix, associate, hang out (informal) mingle, consort, hang about, keep company, fraternize.

Before I headed off to Portland to spend the whole month of March with some of my grandkids, Lauren and I decided to squeeze in our fourth supper club of the year by the end of the Polar Vortex month of February.  Great decision, especially as we targeted the HOBNOB in Racine, a very popular supper club that has been high on our radar for the past couple of years.  The HOBNOB’s lakeside setting and old fashioned décor are highlighted in many of the fine WI Supper Clubs books out there.  While the rainy-foggy evening clouded the lake view, our spirits weren’t dampened on this much-anticipated evening.

The HOBNOB has always been a family-owned business. The Higgins family opened the original HOBNOB in downtown Racine in the 1930s. Higgins and his two sons started building the current HOBNOB in 1952, which took two years to complete. Michael Aletto, purchased the HOBNOB in February 1990. It was a smooth transition, as Aletto kept many of the Higgins' family recipes and included some from his family's restaurant in Illinois.  Michael’s wife and co-owner Anne Glowacki says most of the menu items are prepared in-house, including all the sauces and soups. She says they take a lot of pride in the daily preparation of the food, the dining set-ups and the bar.  This is a very unique place that accommodates special occasions with its excellent food, private rooms, live entertainment on the weekends, and of course signature ice cream drinks!

Higgins to Aletto hand-off in 1990?

Our Making-A-Supperer victims for this round were my longtime family friends Ginny and Tom, whose family grew up along mine in the NorthShore part of Milwaukee.  Soccer is a huge part of our connection as I coached their son Ian, Ginny started the Women’s Soccer Club which my ex-wife played in, and “Big Tom” and I have played with the old-timers for the past 20+ years.  They have 6 (maybe 7, hard to keep track) beautiful kids and Ginny comes from a family of 16 kids (maybe 17).   That rather large crew held the world record for largest family band, besting the Von Trapp’s from The Sound of Music fame.   I love sharing that tidbit.    It was great to catch up on Ginny and Tom’s kid’s lives during our cozy 30 minute drive from Glendale to Racine.  And like Lauren, Ginny is a gourmet cook so there’s that connection as well.  Really love these guys!

So this HOBNOB place has really cool spaces. The Belmar Room, just off to the left as you walk down the main hallway, has lavish off-white half-circle booths and tables with its own bar. This room can be booked for special events and it houses live entertainment on the weekends.   There is also the private little Moroccan Room, which fit up to 6 in cozy quarters, farther down the main hallway.  This is a must dining spot in the future. The Cocktail Lounge, AKA the main bar area, runs nearly the length of the main dining room and here’s where the full vibe of the past comes to life.  Circular leatherette booths, dim lighting, swanky music, and cocktail glasses as far as the eye can see.  Even the coat room oozes with old school charm.  Why have we never been here before?

The Belmar Room in front.  Private Party Time!

We were seated in the Terrace Room, which normally has an awesome view of Lake Michigan.  But again it was rainy-foggy so we focused our attention on the menu.  We started off with the crab stuffed mushrooms and calamari, which came highly recommended by our server Debbie.  Of course I had to badger Debbie about our Making-A-Supperer tour and I had her be the first to sign our invite post card – a new tradition.  Debbie has worked here on-and-off since ’98 and she offered a few stories about the place.   She quickly offered Lauren a replacement for her too-strong Manhattan and she did recover nicely from missing Ginny’s knife.   She was a very good sport with putting up with our goofiness and I didn’t hold it against her for never hearing of the Making-A-Murderer Netflix series.  I’m guessing the gravitational pull from Chicago is greater than from Manitowoc for “Raciners”.  Anyways, giving the HOBNOB a 4.25 service rating.    And the mushrooms and calamari were tasty but not quite spectacular.

The Cocktail Lounge area.  Bit dark and noisy - in a very good way!

Tom and I savored fine whiskey Old Fashioneds as the group ordered entrees.  Of course we had our regular little spat about a “guideline” of everyone ordering something different so we could max out our menu sampling.   Lauren is good with ordering first so she never runs afoul of this “guideline” – but she’s not a fan.  But it is just a “guideline”, so…   ☺    Lauren picked the Filet Oscar, Ginny the Lamb Shank, Tom the Whitefish, and I chose the Prime Rib.  All of the dishes were very well prepared and delicious.  But Lauren is the real foodie so I’ll let her blog post address the juicy details of the entrees.    Lauren and Tom rated their Filet Oscar and Whitefish as 5 stars, Ginny rated her lamb shank as a 4, and I gave my prime rib as a 4.5.  So a 4.5 overall food rating.    The crazy thing was we didn’t take a single picture of our entrees – we were too busy enjoying each other’s company and family stories.  Such a comfortable place that we forgot to do our job.  So Google to the rescue for an entree shot.

We did splurge a bit, even without adequate tummy room, on a few desserts.  Tom ordered the towering Banana Banshee ice cream drink, Ginny the chocolate torte, and Lauren and I shared a classic crème brulee.  Ok, we all shared everything.  It was all delicious – and way too much food for the evening.  But, when in Rome…

Big Banana Banshee dessert for Big Tom

The big hitter for the HOBNOB is certainly ambiance.  The combination of the lake views, the special rooms, the vintage décor, the outdoor neon signs, the original owners photos in the entrance, the Cocktail Lounge, and the so on and so make this quite the supper club destination.  We give it a 5.0 rating for ambiance and I can’t imagine any other remaining supper clubs on our tour exceeding this kind of package.  But surprise me.

So we’re giving the HOBNOB an overall rating of 4.75, tying it with the Five O’Clock Steakhouse for our highest ranking so far this year.   And the average cost of $63/person was much lower than the Five O’Clocks $105/person cost so that helped the HOBNOB rating.   We’ve only hit 4 of our 19 targeted clubs so far, but I wouldn’t be surprised if these 2 clubs stay at the top of our list at year’s end.  It will be interesting to see how central and northern Wisconsin fares against these early leaders.  They could get killed, in a Making-A-Supper manner.  BTW, Facebook gives the HOBNOB a 4.5 rating.

Ginny trades in Big Tom for Big Chair

Speaking of Making-A-Supperer, this supper was a bust relative to Steven Avery guilty or not discussion.  Server Debbie was guilty of Netflix ignorance and Ginny and Tom obviously have better things to do with all of their gang than watch Netflix murder documentaries.  After a painful series overview and much egging on, Tom offered a surprisingly low 7% guilty verdict, heavily influenced by his suspicions of a corrupt sheriff’s department.   Ginny finally rested at a 45% guilty verdict, which was probably influenced more by her torte than my boring series overview.   I’m hoping our next supper victims will be a little more educated on the Avery story.  I think we need to find a Manitowoc supper club next…  

[nsokaal]

DSS Result 2022 - Union Somaj Kormi Exam Result PDF Download

DSS Result 2022 – Union Somaj Kormi Exam Result PDF Download

DSS Result 2022 for some categories has been published.  The result was published today.  if you took part in the examination then this post is only for you. We will also provide the DSS job exam mcq result. So let’s start the important article for you. Department of Social Services job & exam details A few days ago a circular was published by the authority. in this circular they give the demand…

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#departmentofsocialservicesjobcircular2022 #সমাজসেবাঅধিদপ্তরনিয়োগবিজ্ঞপ্তি২০২২ #সমাজসেবাঅধিদপ্তরনিয়োগবিজ্ঞপ্তি, #সমাজসেবাঅধিদপ্তর, #সমাজসেবাঅধিদপ্তরনিয়োগ২০২২, #সমাজসেবাঅধিদপ্তরনিয়োগ #সমাজসেবাঅধিদপ্তরনিয়োগবিজ্ঞপ্তি২০২২

[jobsoresults]

Dss Somaj Kormi Exam Date

Dss Union Somaj Kormi December 24 Exams Postponed We all know the  fact that it takes a lot of time to prepare for each recruitment exam and within this time students have to prepare and participate in the exam. But those who do not realize that they will pass the exam date so early and at this time may not be able to prepare due to lack of time. So if you want to take the minimum preparation at that time, then you must take a look at the questions of last year's exam and its solution from our website.Dss Somaj Kormi Exam Date changed. Dss Somaj Kormi Exam Date Notice .pdf suspension of recruitment test for the post of Social Worker (Union) Permanent Revenue Then you will be able to get a good idea about the question paper and go to the test center and at least get some common questions. You may know that in 2018 a recruitment notice was published from the Department of Social Services for the post of Social Worker Union. This Dss circular of somaj kormi will specify around 500 persons. Since HSC pass students can apply for the position mentioned in the recruitment notice and students from all districts of Bangladesh can apply, the number of applications increases. Social Service.. Union Social Worker New Notice 202 About 10 lakh candidates from all over Bangladesh applied for 463 posts. ultimately, the exam for the stated post can be start on the 24th of December at three pm. The test can be held in the centers of the surrounding districts which include Dhaka. But there are many students who are going to take this test without any preparation just to gain experience. So, instead of going for the experience, you can prepare for the few days before the exam, if you can prepare for a few days, then you can come to the exam hall.   So if you answer the correct question without answering the wrong question in the test center and if the quantity is less then also answer the correct question. case it will speed up your studies. New date for written examination for the post of Union Social Worker So those who want to take part in the exam by preparing well before the exam and those whose level of preparation is absolutely zero should also take a look at the solution of this last year's question and take part in the test by looking at the solutions at the test center.   Recruitment of 500 people in http://www.dss.gov.bd/ Job Summary Employer Name : Bangladesh Bank Name of the Post : See recruitment. Job Location : Anywhere in Bangladesh. Number of Vacancies : 500 Job Nature : Full-time jobs. Job Type : Govt Jobs. Gender : Both males and females. Age Limitation : 18 – 30 years. Educational Qualifications : See the circular Experiences and  Requirements : See the circular image. Salary Amount : See the circular Benefits and Others : As per government employment laws and Regulations. Publish Date : See the circular Application Deadline : See the circular   Applications can be made by entering this link http://www.dss.gov.bd/   Company Information Company Name http://www.dss.gov.bd/ Company Type: Government organization Official Website: http://www.dss.gov.bd/ If you are really a job seeker and a portal explorer, then be connected with us. Visit our website regularly to get the latest job-related information. This is our NEWS section. The experts are here only for you. We dream that there will be no single unemployed person in the world in the future. To know further news follow our website Follow Read the full article