An Incident That Changed My Life Essay

I admire a lot of people but the person I admire the most is my sister Rufaro .She has come to be the most important person in my life. There is no reason for me to live without her by my side. Rufaro is a nurse. She loves to help other because she says it was always her dream ever since she was a child. She works hard and she likes to learn something new every day. She leads a wonderful family life; she is always cheerful and happy. My sister has now been married for about 5 years and is a great mother to all her three children .She takes care of her family and still manages to find time for us. I just do not know where she gets that strength from. I admire her because she is very intelligent, ambitious and she has many goals in her life. My sister has a great enthusiasm about life that it becomes infectious when she is around other people .She also is a wonderful counselor and friend, very patient, sensitive and warm-hearted. She knows answers to almost every question, even those very silly ones. She is wise, patient and, sensible; she even helps others to solve their problems. She is also great fun to be with as she has a great sense of humor. Believe me; everybody who knows her says that about her. Even though Rufaro is younger than me in age, she is very important to me, because she teaches me to be a better person every day. She is an example to me and I love her for many more reasons. She always wants the best for our family .I wish everybody could have a person like Rufaro in their lives. Read more:Â  Essay About A Book That Changed My Life

The Benefits of Preschool for Your Toddler

How Beneficial is preschool for your toddler? Jane M. Rentas Barry University Author Note This paper was prepared for English 202 taught by Dr. Louise Rogers How beneficial is preschool for your toddler? Preschool is an early childhood program in which children combine learning with playing in a program run by professionally trained adults. Children are most commonly enrolled in preschool between the ages of two through five years old..Preschools are different from your traditional daycare in that their emphasis is learning and development rather than enabling parents to work or pursue other activities. In addition to being called preschool, these programs are known by other names, including child care, day care, and nursery school. They vary widely in their setting, format, and educational requirements. Preschools may meet all-day or half-day, either every day or just a few days per week. They could be sponsored by a church, operate as an independent non-profit, or run for profit.Th ey may be part of the public school system or part of the Federal Head Start program. Before 1960, the education of young children was the responsibility of families within the home. As of 2004, most young children in the United States spend some of their days apart from their parents. Most children attended some sort program like Headstart, Daycare or VPK prior to kindergarten. The enrollment rate for four-year-olds in 2001 was almost the same as the enrollment rate for five-year-olds in 1970. There are several factors that influence this dramatic change.One factor being a rise in the numbers of mothers working outside of the home, a decline in the size of families which leads more parents to turn to preschools as a social outlet for their children, and a desire to give children a head start academically. The higher the income and educational level of the parents, it is more likely that their child will attend preschool. As the years go by, we will see an increase of children atten ding preschool because of the substantial increase of governmental support for programs targeting children in low-income households.According to the National Institute for Early Education Research, the types of teaching activities and classroom emphases that contribute to a high-quality early education for children include the opportunities to learn persistence when working at tasks, direction following, and good listening skills, focus on language and literacy skills, as well as interactive book reading, emphasis on teaching children problem-solving skills and opportunities for preschoolers to engage in music and art. The greatest academic and social progress seen in preschools is in children from deprived backgrounds.Most children in preschool are not disadvantaged, and some researchers believe the same gains of attending preschool can be done at home by providing them educational toys, games, movies and books for the child. In some preschools, the ability of groups might mean tha t children will not receive the one on one attention they require. This is a major risk if the preschool does not follow the National Association for the Education of Young Children's recommended teacher-to-child ratio of no more than ten preschoolers per staff member.One-on-one instruction is an advantage parents will not likely find in any preschool. There are other opportunities for playing with other children that exist in churches, clubs, and other sports, where the child can learn social skills. Some believe that what children need most is lots of playing and free time and close interaction with their parents something that may be affected if the child is away from home for long periods of time. Another disadvantage is that some children experience acute separation anxiety, which indicates that they are not yet ready to make the transition to the environment of preschool.Many programs also expect the child to be toilet-trained , which is a milestone that not all children have at the preschool age. Parents considering sending their child to preschool should investigate several different ones and consider many factors before choosing one. Parents should also realize that in spite of the potential advantages that preschool may have, preschool may not be for every child. Parents can also find and research alternative ways of introducing their child to early academic skills and social activities.

Individual Constructions of PA-Related Reality Assignment Essay

Individual Constructions of PA-Related Reality Assignment - Essay Example A weak leader would always want to get ahead. He does not care whether or not he steps on anyone as long as it serves his ulterior motives. He is not able to motivate and neglects his responsibilities. A good administrator carefully oversees the work of his subordinates. He is able to adequately shade them yet not go so far as to overshadow them. This also means that he recognizes the work that everyone has done and does not claim all the credit for his own. As opposed to a good administrator, a bad one takes control of all situations. He is usually narrow-minded in his decisions and doesn’t allow for input other than his own. Much like this picture, the atmosphere between him and other members of the organization is gloomy. It is quite apparent that the garbage problem is one of the most difficult to solve. Every year the population continues to increase and these problems grows along with it. There may be visible remedies to this but is obvious that they are mere band aid solutions. This would have to be recycling. There are still many households who do not follow proper garbage disposal protocol. This may not be an ominous problem at face value but it has a great impact on life as we know it. The most pressing problem of the nation is quite perceptibly the collapse of the economy. Because of this many are affected and the continuous effort of the government must be kept at a solid pace. Only time can tell the effectiveness of the measures being undertaken. The most pressing problem of the world is how we respond to the imminent dangers of global warning. This is the dawn of what could be a pivotal point in our history. How we react to nature as human beings is something that is of the utmost import. Like a lighthouse, an activist shows the light to guide the people to the right way. Their convictions are not without merit which accounts for their intensity to fight. They give a different

Current U.S and Indonesian Economics Essay Example | Topics and Well Written Essays - 500 words

Current U.S and Indonesian Economics - Essay Example which lowered their money reserves making it more expensive to gain access to capital because the rating agencies downgrade bonds issued by countries in the Indonesians region. Dependency theory is the economic explanation of a nation in terms of cultural, economic, and political factors. These affect the economic polities the government implements. Cultures respect historical results and in economic unstable countries that the phenomenon last for a long time the people rebel against the state. Civil war is not accepted in the United Nations and they must intervene to end these types of conflicts immediately. Participatory development produces more quality food at a lower price than in the past due to developments in research and developments and genetic engineering agricultural. A difference between these two philosophies is control. Conditionality is associated with the economic policies established by the International Monetary Fund also often referred too as the World Bank. Some emerging economies believe that the economic policies of the World Bank are unfair and that they give preferential treatment to developed countries. The loans are given out, but conditionality is included so that the loans are used for a specific purpose. Community development often fails due to conflict and discrepancies in expectations. Sometimes the demands of certain interest groups are not unreasonable and the government cannot accommodate their demands due to economic constraints. Other reasons why community development programs fail is due to a lack of money. It takes money to pay for rent of community centers and to provide other types of services. 6) Some people are saying that recent and on-going demonstration called "occupy Wall Street" has become a "social movement" similar to some in the "Arab Spring" social movements of this past year. What do you think of this claim? Occupy Wall Street is a movement that supports of the country with New York and All Street being the

An Examination of the Varieties of Capitalism and its Application in Essay

An Examination of the Varieties of Capitalism and its Application in USA, Sweden and Germany - Essay Example â€Å"Where social democracy is strong, the public firm was unstable and weak, and unable to dominate without difficulty; where social democracy is weak, ownership diffusion of the large firms could reign if other economic and institutional conditions prevailed...† (Roe, [Political] 21) In this definition, Roe seem to identify that nations that have strong traditions of social democracy like Germany have inefficiencies in their public institutions and structures. This include bureaucracy and some elements of inefficiency which plagues nations with strong public sector issues. However, in traditional capitalist states, dominant economic institutions and powerful corporate entities emerge to fill the gap and determine the distribution of wealth in the economy. Roe goes on to illustrate this point by examining the American model of capitalism into detail (Capital para1). He begins by recognizing that America differs from all socialist states because there is less intervention by the government. This leaves a strong vacuum for some kind of a 'moderator' to determine the distribution of income in the economy. Roe (Capital para 3) identifies that the American economy is strongly influenced by corporate entities. He goes on to state that America's laws put more power in the hands of the managers and directors of these corporate entities. This means that shareholders do not have a strong reason to push for capital oriented decisions that will solely be in the interest of their stocks and investments. This means that the people charged with governance are the actual controllers of power in America. The state's intervention is weak whilst the shareholders, who have the true capitalist interest are also kept in check by corporate governance laws which favor the managers and directors. Employees do not have much rights because these managers can hire and fire. Elsewhere in Northern Europe and Central Europe, the strength of the state is boosted because many state in stitutions act as moderators in the corporate world (Soskice 51). This means that the state has some kind of power to intervene in the distribution of wealth. Secondly, the states in these European nations have established strong negotiation systems that ensure that stakeholders like workers and shareholders negotiate to come to a consensus. This is very pronounced in Sweden. It is also quite dominant in Germany. However, what is common to all these capitalist systems is that there is debate and consensus building in all these jurisdictions. The parties involved in these debates determine the differences. On a further analysis of the American system, Roe (Capital 75) states that â€Å"for capital markets to function, political institutions must support capitalism in general and capitalism of financial markets in particular†. This means that the state must moderate in the various debates and interests of the capital markets and some elements of the society. He states that poli tical economy shapes the capital markets by economic, political and legal institutions. This creates a mechanism where the corporate entities shape policy and policy shapes the corporate entities. In a practical analysis of what happens in America, Roe (Political 104) states that capitalism in America is made up of interest groups that converge in the form of corporate entities. Thus, the Republicans and Democrats make promises based on what

Statistics for Managers Class Discussion wk5 Essay

Statistics for Managers Class Discussion wk5 - Essay Example In business the population mean can be applied on a study using a focus group as a parameter of the whole population. He focus group can be used to sample new products and get reactions from the consumers. The population mean represents the true opinion of the entire population. During elections most opinion poll the voters predict the winning candidate this has been done for the major media houses to make consumers glued to their channels during heated campaign periods. Thus during the period the media houses make their money on adverts as the candidates use the polls advertise themselves on the weaker area of electorate. Most drug and pharmaceuticals company test their drugs on a certain focus group to test the curative and side effects of vaccine, cure drugs and cosmetics. Most recently GlaxoSmithKline and NewLinkGenetics were conducting focus group trials on Ebola virus; as a result of outbreak in West Africa (Daniel Flynn, 2014). Most consumer goods have a warranty, the risk of return of the product is calculated from the margin of error of producing a defective product. Daniel Flynn, R.-J. B. (2014, November 14). Exclusive: MSF should have called for Ebola vaccine earlier. Retrieved from Reuters:

Portfolio Part 3 Company Research Essay Example | Topics and Well Written Essays - 1250 words

Portfolio Part 3 Company Research - Essay Example It is the consumer banking division of multinational City group. The main location of this bank is at New York in United States. It has almost 983 North American branches which are concentrated in major metropolitan areas in US and these areas are New York, Chicago, San Francisco, Washington D.C., Boston, Philadelphia, Los Angeles etc. Again the bank has spread its business activities in more than 36 countries. City bank has occupied 3, 777 branch locations across the globe. It is the largest bank in United States by total assets and this bank is followed by Bank of America and JPMorgan Chase. More than 2, 00, 000 employees are involved in this organization. The offered products of this company are investment banking, corporate banking, wealth management, credit cards, consumer banking, financial analysis, private equity etc. Again the bank also offers mortgage and loan facilities to its customers. Major competitors of this organization in US are JPMorgan Chase and Bank of America. Generally middle and high income groups are the target customers of City Bank. Again the bank has plenty institutional clients and major percentage of revenue is earned from this segment. The bank has two major segments for conducting its operational work. These segments are global consumer banking and institutional clients group. Global consumer banking segment generally provides retail banking services to more than 100 million people in 40 countries of the world. 50 % of total revenue of this organization is generated from this retail banking segment and deposit of this segment consists 40 % of total deposits (Citigroup, 2013). As per the statistical report, this can be said that the organization is going to achieve 5.6 % growth rate in the upcoming year. Again this can be said that as it is the largest bank in US so it has gained the maximum market share i.e. 35 % of total market

The t Statistic Essay Example | Topics and Well Written Essays - 1000 words

The t Statistic - Essay Example The null hypothesis is based on the claim of the sales manager that the annual average sale of the company/ purchases done by the customers is greater than $14,000. The null and alternate hypotheses would be as follows, The t-test conducted with the above mentioned descriptive statistics reveals that t(ÃŽ ±/2,19) = 0.38 is less than the critical value of t = -2.093, therefore the null hypothesis is not rejected and the sales manager’s claim is considered as true. The data shown in Table 2.0 is taken from the case study named HH Industries (Levin et al., 2009, p.49). The data comprises of total number of orders per day for the first and last quarters. The null hypothesis is based on the claim of the sales manager that the sales figures are steady throughout from first quarter to last. The data selected is from the first and last quarters. The null hypothesis in this case would be that the average total number of orders per day for the first and last quarters is equal. The null and alternate hypotheses would be as follows, The t-test was conducted on two samples of number of orders from first and last quarters. Observing the t-value = - 6.9, it is concluded that the H0 is rejected. The  µ1 ≠   µ2. There is a significant difference between the average number of orders booked per day for first and last

Analysis on an Operation Research Paper Example | Topics and Well Written Essays - 1750 words

Analysis on an Operation - Research Paper Example The activities of the operation management mainly range from the strategic, tactical to operational levels. Tactical issues involve the layout of the plant and structure, the selection of equipment and replacement, and the methods of the project management. On the other hand, the operational issues involves the handling of traffic and materials, the equipment maintenance, the quality inspection and control, the inventory management and production scheduling and control. Operation management therefore focuses on the effectiveness and efficiency of the processes. The nature in which it is carried out in an organization depends on the nature of the products or services in the company such as wholesale, retail or manufacture. Shipper manufacturing company has various operational processes that enable efficient production of its products. The operation process entails the type of product or product design, the product process flow, management of quality, supply chain management, project m anagement or operation scheduling, forecasting and the inventory management. Good management of the operation processes contributes to the well performance of the company. It also helps the company to maintain its production supply and increases The Company’s development as a whole. ... The divisions include the material division (MD), Electrical Products Division (EPD), and the Advanced Product Division (APD). These divisions are located in Faribault. Minnesota. The company holds a good position in sales because of the high efficiency levels. In addition, the company has improved growth and is in a good position on productivity. Analysis of the product and product design Shipper manufacturing company manufactures various products. Some of the products manufactured include electrical products, laminated materials and specialty products. Advanced product division (APD), is a division in the company that manufactures the specialty products. Initially, APD manufactured custom products in very low volumes for the consumers. The consumers got very little products that could not satisfy their desires. However, the division plans to increase the volume of production for the multiple customers. Â  The company therefore would require increasing its operational management in order to maintain its competition in the new environment. APD produces specialty products mainly for the custom orders such as helicopter blade liners, and mine stoppers. In addition, shipper manufacturing company produces many aerostats per year which are sold to different communication companies. Furthermore, they are also sold to some foreign countries and the U.S. government mainly for communication purposes. The operation process flow analysis The production flow involves the movement of various items through the production process. Â  The flow structure or the process flow used in production purposes has various impacts on the operation layout, technological decisions, recourses and the methods used in doing the work. The process flow is a very important aspect in Shipper

Comparison between the Decolonization of Algeria and India Research Paper

Comparison between the Decolonization of Algeria and India - Research Paper Example This essay analyzes similarities and differences in patterns when looking at the decolonization of India and Algeria. In both cases, the revolutionary movements began after the Second World War. This compromised European countries since they had for decades benefitted from the resources in their colonies. Similarly, the rising nationalism in India and Algeria played a major part in the decolonization process. In the process, both countries were split along ethnic and religious lines due to the disagreements that ensued. After World War II, colonial powers of Europe which included France in the case of Algeria and Britain in the case of India became weaker. This was a result of the war which had greatly affected their economies: they had no funds to run bureaucracies in the colonies. As a result this, they had to subdue their colonies even more to gain ground and make use of the immediate available resources which could be used to revamp their frugalities once more. The European natio ns used force and abuse to gain control of the local elites. The war had caused them a major blow. After this, they could not pay Africans and Asian workers decent wages, and they opted for forced labour and other ways of discriminations. This did not go well with the locals; lacking food, clothing, medical care, water, shelter and even working for long hours was painful enough. Millions of Africans and Asians had gone to Europe to help with the war. Upon arriving home, they organized strong revolutions which enabled India to gain Independence in 1947. Algeria, like most African states, gained its independence in 1962. Therefore, there is similarity in what led to the decolonization: gaining experience in the world war and later coming home to fight the colonial masters. This independence was very difficult to achieve without the support of external parties like the United Nations Decolonization Committee which was formed much later. While different historians look at the history of colonisation in two opposing views, one thing remains constant, the death toll that trailed the struggle for independence for most former colonies. It’s well documented by the time India gained independence in 1947; conflicts between Indians and Muslims had grown and became so intense that Muslims broke off to form their own nation the present-day Pakistan while Hindus formed India. The remaining alienated communities in those nations respectively instigated the genocide of Muslims and Hindus in both countries. Regardless of the various historic recordings of how countries received their independence, it is clear that the struggle for independence was the same for all former colonies. A good example of this can be seen by comparing India, which has gone down in history as the only colony to have gained independence without war, and Algeria, where war and violence were reported in its struggle for inde

Sound Pollution Essay Example for Free

Sound Pollution Essay It focuses not on the cliched environmental problems such as Global warming, but on an issue that is quite exceptional in nature- Noise Pollution. Its name quite clearly outlines its aim and purpose of existence*- ‘Awaaz’ is a Hindi word that means- Voice. Sometimes, in everyday language, it is also used in reference to noise. Voice, noise. Perfect. Its aim is to counter noise pollution. It may sound weird, but noise pollution is one of the most prominent environmental pollutants in India. It is quite exclusive to the metropolitan cities in India-Delhi, Mumbai, Calcutta, Chennai, Bengaluru etc. Literally: Noise pollution is encountered almost every day in such places, whereas in the rural areas, it occurs periodically- noise pollution peaks during festivals- the beating of drums, trumpets, loud speakers, fire crackers, bombs etc add to the high-decibel noise made by the people during the harvest festivals and other religious festivities. In the cities and other urban sites, we can note that noise pollution is higher than usual during election times- the politicians about a hundred from each political party, which itself count up to seven hundred fifty from all over the nation, use loudspeakers that cross the maximum noise limit approved by the Supreme Court of India. The maximum decibel limit ranges between 125 and 145 db (db- Decibel; unit to measure the noise level) Especially during Diwali- a famous festival of light celebrated all over India by Hindus- involves bursting of firecrackers and bombs. These explosions and lights are mainly incorporated into these festivals to express joy and festivity. However, when a test to check the noise pollution caused by the firecrackers, was performed by the Maharashtra Pollution Control Board (MPCB) and Awaaz Foundation before Diwali, it was found that at least 8 crackers crossed the decibel limits by considerable amount. Following many such incidents, the Awaaz Foundation has been quite active in spreading awareness of the ill effects of noise pollution by helping to shape up the government policies on the same. It has also organized two seminars: The first on the pollutant – Loudspeaker on October 2004 and the next concentrates on noise pollution caused by traffic and construction sites- the latter was conducted on February 2006. To talk about the actual effect that Awaaz has managed to create in the lives of the Mumbai citizens a) Several strategies and policies suggested by the Awaaz Foundation were accepted the Government of Mumbai and were implemented such as: Incorporation of noise parameters in the construction sites of the Mumbai- Nhava Trans Harbor Sea Link. Also it has agreed to be a Silence Zone after completion of the construction. Silence zone: region around a noise-producing source in which the noise is not audible. b) Under the foundations influence, a ‘No Horn’ day has also come into practice. c) Noise Barriers have been introduced in the roads of Mumbai. d) Under its efforts, many other places have been declared Silence Zones. e) Monitoring of sound levels, especially during festivals and Political rallies have led to considerable decrease in noise pollution in Mumbai.Other activities undertaken by this foundation to gradually improve the environment of Mumbai are: Banning of Sand Mining in several Beaches, organizing a Workshop that discusses alternative methods on building and construction that do not use sand and participation in the Mumbai Tree Association are also its other initiatives. However these are not that prominent compared to their role in preventing Noise Pollution. Reference http://www.indianexpress.com/news/decible-levels/703669/

Fetal Alcohol Synodrome Essay Example for Free

Fetal Alcohol Synodrome Essay Introduction It sounds simple: women who drink excessively while pregnant are at high risk for giving birth to children with birth defects. Therefore, to prevent these defects, women should stop drinking alcohol during all phases of pregnancy. Alternatively, women who drink alcohol should not become pregnant unless and until they can control their drinking. More than 20 years ago, when fetal alcohol syndrome (FAS) was first described in the published medical literature, there were high hopes for its prevention. In fact, this has not been simple, and the biomedical and public health communities are still struggling to eliminate a birth defect that should be absolutely preventable. HISTORY Although references to the effects of prenatal exposure to alcohol can be found in classical and biblical literature, fetal alcohol syndrome was first described in the medical literature in France by Lemoine et al. in 1968. Researchers in the United States soon also published a landmark report describing a constellation of birth defects in children born to alcoholic women (Jones and Smith, 1973). FAS has since been described in most countries of the world. Briefly, FAS refers to a constellation of physical abnormalities, most obvious in the features of the face (see Figure 1-1) and in the reduced size of the newborn, and problems of behavior and cognition. These latter features lead to the most concern. The degree of abnormality in any one measure can vary greatly between individuals and can change with time in the same individual. For example, people diagnosed with FAS can have IQs from well within the normal range to the severely mentally retarded range. The physical anomalies can be slight or quite striking. Some people with FAS live fairly normal lives if given adequate and structured support throughout their lives, whereas others are severely impaired. The defects may or may not be apparent or easily diagnosed at birth. Although the manifestations of the damage might change with age, FAS never completely disappears and, as with many developmental disabilities, there is no cure, although there might be some amelioration in some individuals. FAS does not refer to signs of acute alcohol exposure or withdrawal at birth. Newborns can have blood alcohol levels high enough to affect acutely their central nervous system function and not have FAS. Newborns can also have no alcohol in their bloodstream at time of delivery but still have FAS. FAS is not a drunk baby. The costs of FAS and related conditions can be quite high—for the individual, for the family, and for society. Three groups have tried to estimate these costs, and these estimates vary greatly (Bloss, 1994). These estimates are problematic, because of uncertainties regarding the incidence and prevalence of FAS and uncertainties related to the full extent of health (and other) problems experienced throughout the lifetime of people with FAS. Estimates of the occurrence of FAS in North American communities range from 0 per 1,000 (incidence; Abel and Sokol, 1987, 1991) to 120 per 1,000 (prevalence; Robinson et al. , 1987), although rates in several of the most complete studies are similar—on the order of 0. 5 to 3 cases per 1,000 births. Assuming an annual birth cohort of approximately 4 million, this translates into 2 to 12 thousand FAS births per year in this country. As described in the report, there is a lack of longitudinal data on the extent of possible problems of adults with FAS. Therefore, cost estimates for the United States range from $75 million (Abel and Sokol, 1991) to $9. 7 billion (Harwood and Napolitano, 1985). The total lifetime cost per typical case of FAS for a child born in 1980 was estimated to be $596,000 undiscounted1 (Harwood and Napolitano, 1985). These incidence and cost figures are offered not as established facts but they are intended to emphasize that regardless of the details, or any one specific estimate, the costs of FAS to the individual and society are high. FIGURE 1-1 Photographs of children with fetal alcohol syndrome. SOURCES: Figures 4C and 4D: Reprinted with permission from Jones et al. (1973). Copyright 1973 by the Lancet Ltd. Figure 4B: Reprinted with permission from Clarren and Smith (1978). Copyright 1978 by the New England Journal of Medicine, Massachusetts Medical Society. Since publication of the papers by Lemoine and by Jones and Smith, the biomedical, public health, research, and public policy communities have devoted much time and energy to a fascinating problem of teratology (the study of the effects of chemical exposure on the developing fetus), neurobiology, disease prevention, and social disarray. The U. S. Public Health Service has spent millions of dollars in research, public education, and service programs related to the topic. Important concepts have been established through research. For example, well-controlled research studies on rats, mice, and nonhuman primates have demonstrated that alcohol exposure causes FAS. However, while alcohol is the necessary teratogen, it alone may not be sufficient to produce FAS in humans or birth defects in animals. As with most teratogens, not every fetus exposed to significant amounts of alcohol is affected. The outcomes might be modulated by numerous biologic and environmental factors, such as nutrition, threshold, timing, genetic susceptibility, pattern of alcohol exposure, or fetal resilience. Further research is needed to fully elucidate the factors that influence the expression of alcohol teratogenesis. Public education campaigns have taught many women and their partners, as well as the medical community and society at large, that excessive alcohol consumption is dangerous during pregnancy. Reduction in the occurrence of substance abuse during pregnancy, reduction in the incidence of FAS, and an increase in the questioning of patients by health care providers about alcohol and other drug use are goals of the Public Health Services Healthy People 2000 initiative (U. S. Department of Health and Human Services, 1991). See Table 1-1. Prevention of birth defects as a salient public health goal presents some exemplary success stories. A good example is the advocacy for and impact of rubella immunizations for children and women of childbearing age with no history of natural rubella or rubella immunization. An outbreak in the United States in the mid-1960s resulted in an estimated 20,000 children born with congenital rubella syndrome (CRS). CRS occurs in 20 to 25 percent of babies born to mothers who get rubella in the first trimester of pregnancy and results in congenital heart disease, deafness, mental retardation, and other fetal abnormalities. An estimate of the lifetime cost of CRS is about $330,000 per case. With widespread introduction of rubella vaccines in the late 1960s and the requirement for rubella immunization prior to school entry, the number of reported cases of CRS in the United States hit a low of 225 in 1988. As another example, new findings that folic acid deficiency during pregnancy can result in neural tube defects have led to recommendations that grain be fortified with folic acid to prevent these birth defects. Availability of effective prevention strategies led to public policy debates and recommendations for action. The emergence of crack cocaine as a major medical and public health problem in the 1980s led to worries about a generation of crack babies who would cost the medical care system, primarily neonatal intensive care wards, huge amounts of money and who would overburden the education and social service systems with problems attributable to prenatal exposure to cocaine. Further research has shown that crack cocaine can lead to serious obstetrical complications and that some of the exposed newborns do have problems. TABLE 1-1 Examples of Healthy People 2000 Goals Relevant to Fetal Alcohol Syndrome (FAS) Objective 1987 Baseline. Target 2000 Incidence of FAS (per 1,000 live births) 0. 22 0. 12 Abstinence from alcohol during pregnancy 79% Increase by 20% Screening by obstetrician/gynecologist for alcohol use 34% 75% Referrals by obstetrician/gynecologist for alcohol treatment 24% 75% Screening by obstetrician/gynecologist for drug use 32% 75% Referrals by obstetrician/gynecologist for drug treatment 28% 75% Cocaine-exposed children have not been followed as extensively or for as long a time as alcohol-exposed children; what data have been published show some effects of prenatal cocaine exposure at three years of age, but the problems do not seem to be nearly as devastating as predicted, nor as severe as the long-term problems associated with alcohol exposure. In fact, some of the long-term effects associated with prenatal cocaine exposure may be due in part to the concurrent use of alcohol during pregnancy. The federal government invested millions of dollars in demonstration projects for services for substance-abusing women. Some of these programs included services for women who abuse alcohol, but the emphasis was usually on drugs, particularly illegal ones, other than alcohol, or on polydrug use. The attention to crack cocaine and its effects on the fetus is curious given that the percentage of pregnant women who drink (approximately 20 percent) far exceeds the percentage who use cocaine (approximately 1 percent; National Institute on Drug Abuse, 1994). At the time, however, the cocaine epidemic and its potential risks to unborn children led to heated public policy debates. Policies of mandatory urine testing in delivery wards, and subsequent removal of a child from the care of a mother who tested positive for illegal substances, were instituted in many places (Blume, in press; Chavkin, 1990). The unintended negative consequences of these actions have led to a reconsideration and reversal of these policies more recently. THE FEDERAL RESPONSIBILITY FOR FAS RESEARCH As will be described in many parts of this report, FAS is a complicated health and social problem, involving many different sectors of the government. The U. S. Public Health Service (USPHS) contains the agencies with primary responsibility for research in the area. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) of the National Institutes of Health (NIH) has the lead role in research on FAS. However, NIAAA is a relatively small institute of NIH. The NIAAA appropriation in 1993 was $177 million, compared with more than $400 million for the National Institute on Drug Abuse (NIDA) and slightly less than $2 billion for the National Cancer Institute (U. S. Department of Health and Human Services, 1993). NIAAA programs related to FAS include very basic animal research, which has been the mainstay of research in this area; clinical and epidemiologic research on the effects of low to moderate alcohol use by pregnant women; and prevention research. The alcohol and pregnancy program at NIAAA included $9. 8 million to $13. 5 million for approximately 70 grants in each of fiscal years 1990-1994. Most of these research grants were RO1, investigator-initiated awards. NIAAA funds one fetal alcohol research center. In addition, many research programs sponsored by NIAAA have ancillary importance to FAS, for example, the research it funds on the epidemiology of drinking by women or on general approaches to the prevention and treatment of alcohol abuse. As an example of the level of commitment by NIAAA to this issue, the prevention research program at NIAAA has ranged from $15 million to $19. 8 million annually in recent years. As the lead research agency on alcohol, the institute and the USPHS can serve as a bully pulpit for the prevention of FAS and other alcohol-related problems. In fact, this has been the case. The U. S. Surgeon General first issued a warning against the dangers of alcohol during pregnancy in 1981. In addition to funding and conducting research, NIAAA publishes information for the public on FAS, sponsors research workshops on FAS, and has its staff speak at public meetings. Other NIH institutes fund research relevant to, but not directly about, FAS. For example, NIDA funded a $4 million National Pregnancy and Health Survey on substance abuse, including alcohol, during pregnancy. The data on alcohol were a small part of the entire project. In addition, NIDA funds epidemiologic and clinical research on the effects of substance abuse during pregnancy, and alcohol is frequently one of the substances used by these populations. A rather large study funded by NIDA was the Perinatal 20 demonstration project assessing prevention of substance abuse during pregnancy. Although the major purpose was to look at the abuse of illegal substances, some data were collected on alcohol use, as well. Another key USPHS agency involved in FAS work is the Centers for Disease Control and Prevention (CDC). The FAS Prevention Section is housed in CDCs National Center for Environmental Health, Division of Birth Defects and Developmental Disabilities. CDCs role is to collect data to define the scope of the problem; support the development and evaluation of FAS prevention projects; and build state capacity for coordinated, state-based FAS surveillance and prevention programs (CDC submission to IOM committee). The CDC maintains and analyzes surveillance programs that include FAS, such as the Birth Defects Monitoring Program. In addition, CDC sponsors and supports efforts to prevent FAS. The CDC currently has FAS prevention and surveillance projects supported through states and universities. As with NIAAA, CDC has ancillary programs related to maternal and child health, alcohol abuse, and epidemiologic surveillance that can support and inform FAS programs. Other agencies in the USPHS maintain important programs related to FAS, but these programs have much less emphasis on research. The Indian Health Service, the Health Resources and Services Administration (HRSA), and the Substance Abuse and Mental Health Services Administration (SAMHSA) fund services or demonstration projects directly or indirectly related to FAS. At this time, no agency has been able to support research on the clinical aspects of FAS, on the medical treatment of children with FAS, or on the education and remediation of these children. A notable USPHS program is the Pregnant and Postpartum Women and Their Infants (PPWI) initiative. This program was authorized by the Anti-Drug Abuse Act, passed by Congress in 1988. The demonstration grant program focuses on the development of innovative, community-based models of drug prevention, education, and treatment, targeting pregnant and postpartum women and their infants (National Center for Education in Maternal and Child Health, 1993). The program is funded jointly by the Center for Substance Abuse Prevention (CSAP) of SAMHSA and the Maternal and Child Health Bureau of HRSA. It has funded 147 demonstration projects. The most common drug addressed was cocaine, followed by alcohol and polydrug use. Because demonstration projects are rigorously evaluated only infrequently, the nature, utility, and transferability of their findings are difficult to assess. The Center for Substance Abuse Treatment (CSAT), a part of SAMHSA, was charged by Congress to support grants for residential and outpatient substance abuse treatment for pregnant and postpartum women and their infants (information provided to the committee). CSAT funded 31 residential projects in 20 states in the PPWI program and 34 projects in 24 states in its Residential Treatment for Women and Their Children program. The five treatment programs that serve Native American women include comprehensive services specific to FAS. In addition, CSAT has other activities, such as its Treatment Improvement Protocols, relevant to FAS, but the abuse substance of focus is usually cocaine or opiates, not alcohol. CONGRESSIONAL INTEREST In recognition of the seriousness of this problem, which affects both the health and the societal functioning of many Americans, several times in the past few years, members of Congress have introduced legislation related to FAS (see Table 1-2). The bills have focused largely on creating an interagency task force on FAS and increasing resources for prevention programs and prevention research. These bills, with one exception, have never been passed. The U. S. Congress mandated in Section 705 of Public Law 102-321, the ADAMHA Reorganization Act, that the Institute of Medicine (IOM) of the National Academy of Sciences conduct a study of FAS and related birth defects. TABLE 1-2 Congressional Bills Related to Fetal Alcohol Syndrome (FAS) or Women and Alcohol Bill No. and Date Introduced Bill Name Major Sponsor Overview H. R. 1322 3/7/91. Comprehensive Indian Fetal Alcohol Syndrome Prevention and Treatment Act Campbell (D-CO) Authorize services for the prevention, intervention, treatment and aftercare of American Indian and Alaskan Native children and their families at risk for FAS and fetal alcohol effect (FAE). Authorization of grants to Native American tribes for training, prevention, and intervention programs. Convening of FAS/FAE task force including federal representation and representation from Native American tribes. Would have authorized $10 million annually for FY 1993-1995 and $15 million annually for FY 1996-2000. S. 923 5/7/93 Comprehensive Fetal Alcohol Syndrome Prevention Act Daschle (D-SD) Expand resources for basic and applied epidemiological research related to FAS/FAE. Establish programs to coordinate and support national, state, and community-based public awareness, prevention, and educational programs on FAS/FAE. Establish and facilitate a national surveillance program to monitor the incidence of FAS/FAE and the effectiveness of prevention programs. Establish a task force to foster coordination among federal agencies that conduct FAS/FAE research, prevention, and treatment. H. R. 3569 11/19/93 Women and Alcohol Research Equity Act of 1993 Morella (R-MD) Provide for an increase in the amount of federal funds expended to conduct research on alcohol abuse and alcoholism among women. Would have authorized up to $23,250,000 to enable NIAAA to increase such research. H. R. 3783 2/2/94 Comprehensive Fetal Alcohol Syndrome Prevention Act Richardson (D-NM) Establish a comprehensive program to help prevent FAS and FAE and to coordinate federal efforts to prevent FAS and FAE. CDC to coordinate and support applied epidemiologic research on FAS and FAE. NIAAA to conduct and support basic research targeted to developing data to improve prevention and treatment of FAS and FAE. Develop a plan to disseminate diagnostic criteria to health care and social services providers. Establish an interagency task force on FAS and FAE. SAMHSA to support, conduct, and evaluate training programs for professionals; and prevention and education programs for the public. S 170 1/5/95 Comprehensive Fetal Alcohol Syndrome Prevention Act Daschle (D-SD) Establish interagency task force on FAS and FAE. Organize a program of basic research on services and effective prevention, treatment and intervention for pregnant alcohol-dependent women and those with FAS or FAE [Originally introduced as S. 1821 in previous session but died in committee. ] H. R. 1649 5/16/95 Comprehensive Fetal Alcohol Syndrome Prevention Act Richardson (D-SD) Establish a program for the conduct and support of research and training and the dissemination of health information about the cause, diagnosis, prevention and treatment of FAS and related conditions. Establish an. Interagency Coordinating Committee on Fetal Alcohol Syndrome. Develop uniform criteria for the collection and reporting of data on FAS and related conditions. NOTE: CDC = Centers for Disease Control and Prevention; NIAAA = National Institute on Alcohol Abuse and Alcoholism; and SAMHSA = Substance Abuse and Mental Health Services Administration. The National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health funded the project. This report is in response to that mandate. The Committee to Study Fetal Alcohol Syndrome was convened in mid-1994. Committee expertise included pediatrics, developmental psychology and neurology, obstetrics, nosology, teratology, epidemiology, sociology, substance abuse prevention and treatment, and psychiatry. The charge to the committee was to improve the understanding of available research knowledge and experience on: †¢ tools and approaches for diagnosing FAS and related disorders, †¢ the prevalence of FAS and related disorders in the general population of the United States, †¢ the effectiveness of surveillance systems, and †¢ the availability and effectiveness of prevention and treatment programs for these conditions. As part of its work, the committee assessed and reviewed U. S. Department of Health and Human Services agency research on the topic and provided guidance for the future. SOME IMPORTANT DEFINITIONS Before going further, some clarification of terms is warranted. Several terms are used in this report to refer to drinking patterns and problems. The terms used here are intended to be consistent in spirit with an earlier IOM report Broadening the Base of Treatment for Alcohol Problems (IOM, 1990), particularly in their emphasis on the heterogeneity of alcohol problems, the course of alcohol use disorders, patterns of consumption, and etiology. In this schema, alcohol consumption is seen as ranging from none to light to moderate to heavy. Alcohol-related problems (e. g. , medical, legal, social, psychological) also range from none to mild to moderate to severe. Research has pointed to a positive correlation between level of alcohol consumption and level of alcohol problems, with the most severe problems generally seen at the highest levels of drinking. This relationship is, however, variable across individuals; that is, in some cases, severe problems can be seen at comparatively moderate levels of drinking. The fourth edition of the American Psychiatric Associations Diagnostic and Statistical Manual (DSM-IV; 1994) defines alcohol use disorders as alcohol dependence and alcohol abuse. In general, these terms refer to maladaptive patterns of drinking and consequences which constitute a syndrome, usually associated with moderate to heavy alcohol consumption and moderate to severe alcohol-related problems (Edwards et al. , 1981; IOM, 1990). In DSM-IV, alcohol dependence is diagnosed when the individual meets three or more of the following seven criteria in a 12-month period: (1) tolerance; (2) withdrawal; (3) drinking in larger amounts or over a longer period than intended; (4) persistent desire or unsuccessful efforts to cut down on drinking; (5) a great deal of time spent drinking or recovering from alcohol effects; (6) declining involvement in social, occupational, or recreational activities because of alcohol use; and (7) use of alcohol despite knowledge of a persistent or recurrent physical or psychological problem caused or exacerbated by that use. Alcohol abuse is a less severe syndrome characterized by significant adverse consequences associated with alcohol use and is diagnosed when at least one of the following four criteria is met recurrently during a 12-month period: (1) failure to fulfill major role obligations because of alcohol use; (2) recurrent alcohol use in situations when it is physically hazardous; (3) recurrent alcohol-related legal problems; or (4) continued use despite social or interpersonal problems. In addition, the symptoms have never met the criteria for alcohol dependence (American Psychiatric Association, 1994). Alcohol abuse and alcohol dependence have fairly specific meaning in DSM-IV. However, these terms are frequently used as umbrella terms for maladaptive patterns of alcohol use. In this report on FAS, the committee has chosen to use alcohol abuse as an umbrella term to indicate heavy drinking, including binge drinking, that is risky for the given individual circumstances. If it is clear that a strict DSM-IV diagnosis is intended, it will be so noted. Similar conventions will be used for substance abuse, which is treated very similarly in DSM-IV (American Psychiatric Association, 1994). DSM-IV does not define the term alcoholic, but the National Council on Alcoholism and Drug Dependence does (Morse et al. , 1992). Alcoholism, too, is used but only occasionally in this report. It should be noted that there are no specific levels of consumption associated with alcohol abuse, either as used in DSM-IV or as an umbrella term in this report. Survey data from 1992 show that approximately 4 percent of all women and approximately 4 percent of women between the ages of 30 and 44 years of age could be considered to satisfy the DSM-IV criteria for alcohol abuse and alcohol dependence (Grant et al., 1994). As described in the report, the relation between levels and patterns of drinking during pregnancy and the risk of delivering an infant with FAS is complex. In this report, terms such as heavy drinking and heavier drinking are used to refer to levels of drinking associated with the highest risk for delivering an infant with FAS. Binge drinking is used to refer to a pattern of episodic heavy drinking, which is also associated with higher risk for FAS. Terms such as risk drinking, or moderate drinking are used to indicate lower levels of drinking, usually not associated with FAS, but which may be associated with alcohol-related effects in infants. It is important to note that definitions of these terms have varied across studies, settings, and samples. In particular, operational definitions of terms used to describe the level and pattern of drinking in studies of pregnant women frequently have not corresponded to definitions for women in general, which in turn often do not correspond to definitions for men. For example, a prospective study of the effects of prenatal alcohol exposure defines heavy drinking as an average of one or more drinks per day (Day et al. , 1989); a seminal FAS prevention intervention project defined heavy drinking as five or six drinks on some occasions and at least 45 drinks per month (Rosett et al. , 1981); large-scale surveys of drinking in women usually define heavy drinking as two or more standard drinks per day, where a standard drink contains approximately 0. 5 ounce of absolute alcohol); some clinical research projects define heavy drinking in women as four or more drinks per day (Wilsnack et al. , 1994), which differs from parallel definitions of heavy drinking in men (six or more standard drinks per day). The lack of consistency in terms regarding level of alcohol consumption across studies has led to confusion regarding the relationship between specific levels of drinking and risk for fetal alcohol syndrome and alcohol-related effects (see Abel and Kruger, 1995 for a review of this problem). The committee defines the relevant history for diagnosis of FAS (see Chapter 4) as one of a pattern of excessive intake characterized by substantial, regular intake or heavy episodic drinking. Evidence of this pattern may include: frequent episodes of intoxication, development of tolerance or withdrawal, social problems related to drinking, legal problems related to drinking, engaging in physically hazardous behavior while drinking, or alcohol-related medical problems such as hepatic disease. REFERENCES Abel EL, Kruger ML. Hon v. Stroh Brewery Co. : What do we mean by moderate and heavy drinking? Alcoholism: Clinical and Experimental Research 1995; 19:1024-31. Abel EL, Sokol RJ. Incidence of fetal alcohol syndrome and economic impact of FAS-related anomalies. Drug and Alcohol Dependence 1987; 19:51-70. Abel EL, Sokol RJ. A revised conservative estimate of the incidence of FAS and its economic impact. Alcoholism: Clinical and Experimental Research 1991; 15:514-524. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: 4th Edition. Washington, DC: American Psychiatric Association, 1994. Bloss G. The economic cost of FAS. Alcohol Health Research World 1994; 18:53-54. Blume SB. Women and Alcohol: Issues in Social Policy in Alcohol and Gender. R. W. Wilsnack and S. C. Wilsnack (eds. ). New Brunswick, New Jersey: Rutgers University Center of Alcohol Studies, in press. Chavkin W. Drug Addition and Pregnancy: Policy crossroads. American Journal of Public Health 1990; 80:483-487. Clarren SK, Smith DW. The fetal alcohol syndrome. New England Journal of Medicine 1978; 298; 1063-1067. Day NL, Jasperse D, Richardson G, Robles N, Sambamoorthis U, Taylor P et al. Prenatal exposure to alcohol: Effect on infant growth and morphologic characteristics. Pediatrics 1989; 84:536-541. Day NL, Robles N, Richardson G, Geva D, Taylor P, Scher M et al. The effects of prenatal alcohol use in the growth of children at three years of age. Alcoholism: Clinical and Experimental Research 1991; 15:67-71. Edwards G, Arif A, Hodgson R. Nomenclature and classification of drug- and alcohol-related problems: A WHO memorandum. Bulletin of the World Health Organization 1981; 59:225-242. Grant BF, Harford RC, Dawson DA, Chou P, Dufour M, Pickering R. Epidemiologic Bulletin No. 35: Prevalence of DSM-IV alcohol abuse and dependence: United States, 1992. Alcohol Health Research World 1994; 18:243-248. Alcohol (wine, beer, or liquor) is the leading known preventable cause of developmental and physical birth defects in the United States. When a woman drinks alcohol during pregnancy, she risks giving birth to a child who will pay the price — in mental and physical deficiencies — for his or her entire life. Yet many pregnant women do drink alcohol. Its estimated that each year in the United States, 1 in every 750 infants is born with a pattern of physical, developmental, and functional problems referred to as fetal alcohol syndrome (FAS), while another 40,000 are born with fetal alcohol effects (FAE). Fetal alcohol syndrome (FAS) is a condition that results from alcohol exposure during pregnancy. Problems that may be caused by fetal alcohol syndrome include physical deformities, mental retardation, learning disorders, vision difficulties and behavioral problems. The problems caused by fetal alcohol syndrome vary from child to child, but defects caused by fetal alcohol syndrome are irreversible. There is no amount of alcohol thats known to be safe to consume during pregnancy. Early diagnosis may reduce the risk of problems, including learning difficulties and substance abuse. Signs and Symptoms Fetal alcohol syndrome isnt a single birth defect. Its a cluster of related problems and the most severe of a group of consequences of prenatal alcohol exposure. Collectively, the range of disorders is known as fetal alcohol spectrum disorders (FASDs). Fetal alcohol syndrome is a common — yet preventable — cause of mental retardation. The severity of mental problems varies, with some children experiencing them to a far greater degree than others. Signs of fetal alcohol syndrome may include: Distinctive facial features, including small eyes, an exceptionally thin upper lip, a short, upturned nose, and a smooth skin surface between the nose and upper lip Deformities of joints, limbs and fingers Slow physical growth before and after birth Vision difficulties or hearing problems Small head circumference and brain size (microcephaly) Poor coordination Mental retardation and delayed development Learning disorders Abnormal behavior, such as a short attention span, hyperactivity, poor impulse control, extreme nervousness and anxiety Heart defects low birth weight failure to thrive developmental delay organ dysfunction facial abnormalities, including smaller eye openings, flattened cheekbones, and indistinct philtrum (an underdeveloped groove between the nose and the upper lip) . Epilepsy poor coordination/fine motor skills poor socialization skills, such as difficulty building and maintaining friendships and relating to groups lack of imagination or curiosity learning difficulties, including poor memory, inability to understand concepts such as time and money, poor language comprehension, poor problem-solving skills behavioral problems, including hyperactivity, inability to concentrate, social withdrawal, stubbornness, impulsiveness, and anxiety. The facial features seen with fetal alcohol syndrome may also occur in normal, healthy children. Distinguishing normal facial features from those of fetal alcohol syndrome requires expertise. Doctors may use other terms to describe some of the signs of fetal alcohol syndrome. An alcohol-related neurodevel.

Accutane for Acne: An Analysis

Accutane for Acne: An Analysis Before the iron curtain fell any Information about acne was rare. But with growing advances in dermatology and medicine now understanding the cause of acne and its accurate treatment is available worldwide. Acne is one of the most common skin conditions in the world. Although it’s common but accurate information about acne can be scare. This makes it difficult to get clearer skin. Therefore the information in this document can help you understand acne and how to treat/ prevent it successfully. [1]Overview of acne: Acne, or acne vulgaris, is askinproblem that starts when oil and dead skin cells clog up your pores. Some people call it blackheads, blemishes, whiteheads, pimples, or zits. When you have just a few red spots, or pimples, you have a mild form of acne. Severe acne can mean hundreds of pimples that can cover the face, neck, chest, and back. Or it can be bigger, solid, red lumps that are painful (cysts). Acne is very common amongteens. It usually gets better after the teen years. Some women who never had acne growing up will have it as an adult, often right before their menstrual periods. How you feel about your acne may not be related to how bad it is. Some people who have severe acne are not bothered by it. Others are embarrassed or upset even though they have only a few pimples. Acne starts whenoil and dead skin cells clog the skins pores. If germs get into the pores, the result can be swelling, redness, and pus. Causes of Acne Acne can be caused or exacerbated by a number of different things, including: Changes in hormone levels (such as during puberty or menstruation) Cosmetics or hair or skin products Having a family history of acne Some medications Something rubbing on the skin (like a hat or helmet) Vigorous scrubbing of the skin Stress For most people, acne starts during the teen years. This is because hormone changes make the skin oilier afterpubertystarts. Using oil-based skin products or cosmetics can make acne worse. Use skin products that dont clog your pores. They will say noncomedogenic on the label. Acne can run in families. If one of your parents had severe acne, you are more likely to have it. Symptoms of acne : Acne commonly appears on the face and shoulders. It may also occur on the trunk, arms, legs, and buttocks. Other symptoms include: Crusting of skin bumps Cysts Papules (small red bumps) Pustules Redness around the skin eruptions Scarring of the skin Whiteheads Blackheads The good news is that there are many good treatments that can help you get acne under control. What is Accutane[2] [3]Accutane’s chemical composition resembles that of retinoic acid, a compound derived from Vitamin A. The primary application for Accutane is for nodular acne in patients that do not respond to topical applications (such as benzoyl peroxide) and standard antibiotic treatments.it is administered orally in pill form. It reduces the amount of oil released by oil glands in your skin, and helps your skin renew itself more quickly. People with severe cases of nodular acne can display red, tender and swollen bumps under the skin. These bumps can have a diameter of a quarter-inch or larger. Left untreated, these bumps can lead to permanent facial scarring and disfigurement. Accutane treats these bumps by slowing the rate of chemical production that leads to skin breakouts. It was originally recommended for people with severe acne that did not respond to other treatments,but has gained in popularity in the past 25 years and is prescribed more and more frequently for less severe acne How Accutane works Exactly how Accutane works on a cellular level is unknown but we do know that it affects all four ways that acne develops. 1. It dramatically reduces the size of the skinsoil glands(35%-58%) and even more dramatically reduces the amount of oil these glands produce (around 80%). 2. Acnebacteria(P. acnes) live in skin oil. Since oil is dramatically reduced, so is the amount of acne bacteria in the skin. 3. It slows down how fast the skin producesskin cellsinside the pore, which helps pores from becoming clogged in the first place. 4. It hasanti-inflammatoryproperties. Researchers have published several studies attempting to gauge whether people with mild to moderate acne can achieve long term remission of acne with lower dosages of Accutane. Initial data is showing that people with mild to moderate acne may be able to achieve long term remission with significantly lower dosages, and thus suffer fewer side effects, including lower incidence of scarring. Relapse rates with lower dosages do not seem to increase, leading some researchers to posit that it is not cumulative dose that brings about permanent clearing as much as it is the length of time that the oil glands are suppressed. Intermittent dosing (taking Accutane only 1 week of every month) appears to work less well, producing significantly poorer outcomes for more than half of the patients studied. Why is Accutane better Only solution for severe acne Effective than antibiotics Quick results as compared to other remedies Easier to consume and continue , just an oral pill Long term results Lesser scares left after complete course Dosage:[4] Accutane should not be consumed unless prescribed by your physician, and its dosage should be as prescribed by the physician. Please refer the table below to get a glimpse of the approximate dosage of Accutane. [5]Precautions: Before starting Accutane treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.). Do not take vitamin A supplements. Vitamin A in high doses has many of the same side effects as accutane. Taking both together may increase your chance of getting side effects. Do not receive any kind of immunization or vaccination without your doctors approval while taking accutane. Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category X (accutane may cause fetal harm when given to a pregnant woman. This drug must not be given to a pregnant woman or a woman who intends to become pregnant. If a woman becomes pregnant while taking accutane, the medication must be stopped immediately and the woman given appropriate counseling). Because of the extremely high risk that a deformed infant can result if pregnancy occurs while taking accutane in any amount even for short periods of time, for both men and women: Do not conceive a child (get pregnant) while taking accutane. Two methods of effective contraception are recommended for women of childbearing potential, unless absolute abstinence is the chosen method. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy. Do not breast feed while taking this medication Side effects of Accutane: [6] Doctors prescribe Accutane when other acne treatments fail. Because serious cases of acne can be such a physical and social burden, patients may be willing to tolerate some of the common side effects that come with Accutane use, including dry skin, headaches and cold-like symptoms. A less-common side effect of the drug is pseudotumor cerebri – benign intercranial hypertension. This is a condition in which the brain acts as though there is a tumor when there is not. It can lead to blindness. Early signs of pseudotumor cerebri include headache, nausea, vomiting and visual disturbances. About half of Accutane users are women of childbearing age, making birth defects associated with Accutane use a significant concern. Unfortunately,Accutaneis linked to a series of serious side effects, including bowel diseases like Crohn’s disease, liver damage, depression, and miscarriage and birth defects if taken during pregnancy. Apart from these excessive dose of Accutane can lead to hypertension, suicidal tendencies, depression , liver damage, gastrointestinal problems , hearing impairment etc, there for as a matter of fact it is higly recommended to consume Accutane under medical supervision only. [1] American Academy of Dermatology (2007). Guidelines of care for acne vulgaris management. Journal of the American Academy of Dermatology, 56(4): 651–663. Also available online: http://www.aad.org/education-and-quality-care/clinical-guidelines/current-and-upcoming-guidelines. [2] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1349820/ [3] http://www.drugbank.ca/drugs/DB00982 [4] http://www.drugbank.ca/drugs/DB00982 [5] http://en.wikipedia.org/wiki/Isotretinoin [6] http://www.drugwatch.com/accutane/side-effects.php The Fall Of Rome | Essay The Fall Of Rome | Essay The debate about the fall of Rome and the way it happened is a centuries-old one and its vitality has been undiminished over the years. The traditional theory has the Roman Empire being violently overturned by barbarian Germanic tribes who started invading en masse during the last years of the fourth century. That wasn’t the first time that the Empire had to deal with pressure on its borders, but this time it eventually collapsed because it had already declined as a civilization due to internal problems. The first scholar to support this line of thought was Gibbon in the late eighteenth century. His great, multi-volume, work goes by the title ‘The Decline and fall of the Roman Empire’, which speaks for itself as for its writer’s thoughts (?). He argued that the most important cause which brought about the end of the Roman Empire was the expansion and gradual predominance of Christianity. First, the new religion and the structures that came with it (such as the church and the monasteries) interfered with the distribution of wealth inside the Empire, by accumulating it in institutions that were inaccessible by the state. Second, its pacifist ideology reduced the army’s will to fight and its theology corrupted the classical ideals through the spread of superstition. Another scholar arguing along the same lines was Rostovtzeff. He states the Late Empire was in retrogradation?, a sad and decadent remnant of its former self, partly because of the increase in absolutism during the reigns of Diocletian and Constantine and the emperors who succeeded them. Together with Gibbon, his arguments form the core of the ‘traditional’ theory, which puts stress especially on the issue of ‘decline’ as the main reason which made the disintegration of the empire, as a political entity, eventually inevitable. Due to the work of these two scholars, the ‘Fall of Rome’ has ended up being seen as something like the platonic idea of decline. Along with the traditional theory, we should consider the work of a more recent scholar. Following the same methodological path as Rostovtzeff, Jones credited the barbarians with the destabilization and collapse of the Roman Empire. Their invasions, he argues, should be seen as a destructive agent which placed strain on the Roman administration. At the same time, in a well-known passage, he speaks of a large part of the population that was consuming without producing anything, such as senators, soldiers and the clergy. These ‘idle mouths’, as he calls them, partly a result of barbarian pressure again, at least as far as the army was concerned, was the main reason for the economic waning of the Late Empire. Jones’ contribution was twofold. To begin with, he proposed a new chronological period, extending further than 476, the date traditionally considered as signaling the moment of death of the Roman Empire. His ending date was 602, the year of the emperor Maurice’s death as he strongly believed that the Roman Empire continued its existence, albeit geographically diminished, in the East, at least until the advent of the Slavic tribes in the Balkans at the end of the sixth century. This way, he managed to provide a connection between late- and post-Roman societies, hinting that there might have been a causal relation between the two. Secondly, he breathed new life in a period that was all but put aside by his contemporaries as of not much particular interest and after him scholars gradually started to perceive the Late Roman Empire in its own right. This was countered by ‘traditionalists’ in 2005 with the publication of a book under the title ‘The fall of Rome and the end of civilization’. In this book, the author Bryan Ward-Perkins is arguing fervently that the fall of Rome was a violent experience for the people involved, which involved much bloodshed and catastrophe. It was centered more on radical change than gradual transformation and was characterized by decline and resulted in a decline in civilized values which actually that a number of Roman cultural achievements were lost. Although this view has its merits and should not be discredited without consideration, it needs to be examined carefully because it conceals the danger of oversimplification. First, it can be argued that the author has gone too far with his emphasis on violence and catastrophe. Violence, no matter how hard on a society, is not by principle an agent of radical change which rules out any chance of transformation. Human history is full of violence and it would be surprising if the fourth and fifth centuries did not involve any at all. Despite Ward-Perkins vivid depictions, much of what was considered Roman did not disappear with the Empire. Roman qualities, such as a literate culture, can be shown to have survived as late as the seventh century, proving that the devastating barbaric invasions did not actually have such a devastating effect after all. Stemming from that, we should examine if there was a specific moment in time when Rome actually ‘fell’. If we cannot point out such an instance, then we should regard it as a more gradual process. Italy, for example, shows that society was able to maintain its order in the face of much devastation. And if, as Ward-Perkins himself admits, ‘there was no single moment, not even a single century of collapse’, then we should discard catastrophist theories as inadequate and try more. We should also keep in mind that the author comes from an archaeological milieu and, as a result, most of his proof comes from the study of material evidence. Archaeologists of the period tend to be advocates of the notion of decline more often than historians, mainly because such a decline is much more evident in the material remains of the Late Roman era. In addition to that we have to be careful with the origin the evidence. In the case of Ward-Perkins, he doesn’t hesitate to support his theory on data from Britain, but Brittania (i.e. the part of Britain which was conquered by the Romans) had never been the archetypal Roman province. So Britain is far from being the typical example of what happened after the Romans had left the island, particularly given the fact that we can find other provinces of the Roman Empire, which shared a completely different fate, such as Egypt and Syria. When talking strictly about the west, one has to be extremely cautious when trying to combin e both the archaeological data with historical sources that might give the impression of continuity. One way approaches, such as the one only just discussed, will not do. Late Antiquity With good reason one might ask what the need of such a dramatic reassertion of the traditional view on the fall of the Roman Empire. The word traditional itself implies the existence of an opposite, neoteric theory. In 1971, Peter Brown published a book which defied all the assumptions of the traditionalist school. His book ‘The world of Late Antiquity: from Marcus Aurelius to Muhammad’ argues about continuity, transformation, cultural and religious renewal. The enthusiasm that the book was met with in academic circles, especially in the United States, resulted in the banishment of terms as catastrophe, change, crisis and decline. Brown was influenced by the views of an earlier scholar, Henri-Irà ©nà ©e Marrou, who argued that late antique art had not deteriorated and that it should be looked at in its own terms. Brown was influenced by the work of Henri Pirenne. In his works the Belgian scholar supported that there was continuity to be found in terms of long-distance trade in the Mediterranean which was not affected by the barbarian invasions but collapsed with the great Arabic conquests of the seventh century. Brown placed a new stress on the period resulted in a recent rethinking of Pirenne’s views through the prism of the newly proposed notion of continuity. Finally, Brown could also be considered an influence because, as we saw earlier, he was the first to propose a causal connection between the Late Roman Empire and the post-Roman era. Thus, given the entailed predominance of continuity which was easily detected in themes such as art and religious belief, a new historical period has been founded with its own characteristics, that of Late Antiquity, in which â€Å"some of the basics of classical civilization still survived†. Its boundaries stress from the third to the eighth century, but they are still unfixed, with every writer proposing different dates, according to the issues they deal with. Brown relied heavily on the methods of historical psychology and psychoanalysis. This methodological innovation is a general trend among scholars of Late Antiquity, particularly those in the United States. They have more or less identified themselves with the kind of history that falls outside the scope of socio-economic history. For example, the history of Christianity has proven very fertile for studying Late Antiquity, especially the effects it has had on different aspects of human life, such as death, sexuality and the family. Thus, this school of thought has made astonishing contributions in such fields as gender and culture history, the history of mentalities and of popular belief. Such methods, however, often tend to function with no respect to periodization and as such they lead to fragmentation. Indeed, the work of these scholars shows more emphasis towards individuals and their perspectives than to the society they live in. As a consequence, post-modernist theories concerning source analysis have relied heavily on the works of scholars after Brown, while, in the meantime, the old philological approach has been largely abandoned. Ancient texts are dealt with not so much for their narrative value, but as agents the mentality of their authors. Of course, works exclusively focused on different authors have a lot to offer to the ongoing discussion of the period, but dogged commitment to them might create a handicap for our understanding of the period as a whole. Furthermore, partly as a response to the traditional view of catastrophe, scholars of Late Antiquity have been particularly keen on seeing continuity and transformation. But this attitude can be harmful in two ways. First, the notion of continuity seems to have an overshadowing effect on the particularity of issues in a certain period. If everything is proven to carry on from the past not changed in the least, then historical periods will automatically lose their individual tone, by which it is defined. Simultaneously, by relying to heavily historical sources (as they provide ampler evidence for continuity) we may be overturned by the findings of archaeological research (in the way Ward-Perkins was). Second, emphasis on continuity and transformation is the expulsion of their opposites from contemporary history books. Terms such as â€Å"crisis† and â€Å"decline† seem to have been anathematized in modern research and this has started to raise objections, even by scholars who are not polemicists of continuity itself. Powerful words like these falling into disuse can only be detrimental for historiography. These terms are usually avoided because of their moral implications, and it is somehow assumed that if there is decline someone needs to be charged with it. But we always have to bear in mind that history is a science and historians should concentrate purely on the facts of their research. Nevertheless, Late Antiquity’s impact shouldn’t be confined within strict scientific limits. Continuity along with transformation, apart from being objects of historiographical debate, is also too powerful of terms to be overlooked by contemporary politicians. From 1993 to 1998 a large research project, funded by the European Science Foundation (ESF), brought together scholars from across Europe. Its title was â€Å"Transformation of the Roman World† and its aim was to provide a widely accepted interpretation of the fall of Rome, along the lines of a smooth passage to what was to become today’s Europe. Two thousand years after Augustus history is being repeated: the European Union is commissioning its â€Å"poets† to create its own foundation myth. Late Antiquity is a new period that has had to carve its way bravely into powerful, deep-rooted views of modern historiography, much like the barbarians who had to carve their kingdoms fighting against the mighty Roman Empire. But unlike the former, somewhere along the way it had to make sacrifices which rendered it less effective as a means of interpretation and more limited in its scope. Also, it came to associate itself with â€Å"allies† with political agendas, who might have promoted it, but in the long term damaged somewhat its credibility in terms of objectivity. After all that, it is not surprising that Avril Cameron, a great advocate of the Brown school, herself admits â€Å"‘Late Antiquity’ is in danger of having become an exotic territory†, just before suggesting that it should be tested also in the fields of economic and administrative history. Pekepersonal thekerkerethoughts-synthesis/LA+med west Thus far, we’ve witnessed in brief a powerful debate: Ward-Perkin’s book came as a vivid reaction to a whole school of thought formed around Brown’s work, which itself was another dramatic response to an older tradition. But extremism is inherent in violent reactions, because only through opposition one side can define itself and stand out in relation to its adversaries. Naturally, the existence of opposition itself should not lead us to believe that one side is absolutely right, while the other is absolutely wrong (and in most cases they are not). Rather, it should direct us towards an evaluation of the new conclusions that emerged from the conflict and setting the problem on a new base. However, it should be noted that both books have something in common: they are heavily focused on different geographical areas, where their conclusions seem to be more frequently affirmed. This way, Brown was able to find plenty of continuity in the eastern part of the Empire, while Ward-Perkins discovered a great deal of catastrophe in its former western provinces. As Jones had underlined long before those two, historians often tend to forget that only a part of the Roman Empire actually fell to the barbarians. So, nothing would be amiss if things were so well defined, but they are not. And although it seems that Late Antiquity is better suited for early Byzantine history, there are also those medieval scholars who deem it rewarding to try their hand at the concepts that this new approach brought with it. Late Antiquity and early medieval history One of these was jean claude van dam (‘the muscles from brussels’) mouahahhahahaha Late Antiquity and the barbarians The exclusion of notions of violence and catastrophe from the debates concerning the fourth and fifth centuries, which Late Antiquity scholars promoted, created a historiographical vacuum and a way had to be found for depicting the relations between the Roman Empire and the new arrivals. If violence could not be used to describe them, then the sources had to be searched for a different sort of evidence. The subsequent reexamination of the sources gave birth to the notion of accommodation. The first scholar to do that was Walter Goffart. In a well-known book, published in 1980, he described in detail the way that the barbarians were settled on Roman lands. According to Goffart a fairly straightforward arrangement between the late Roman administration and the barbarian tribes can be derived from the sources. The critical feature of this arrangement was that the Empire relinquished its rights on the taxation of the region in which a group of barbarians were settled and instead those taxes would be collected by the barbarians. However, according to this theory, there was no expropriation of land, no partition of it to smaller units to be apportioned and no need for extra money from the tax payers. The only one who had something to lose in the process would be the central administration and this definitely helps explain the fact that there is no sign of any noteworthy resistance from the local population in the regions where the barbarians were settled in this way. The aforementioned theory was further elaborated by Durliat. After analyzing the sources rigorously, he managed to take Goffart’s theory one step further. He argued that land tax in the Late Roman Empire amounted to no more than 20% of the harvest and it was collected and administered by the curiales. They split it in three and kept one third for their city’s expenses. The other two thirds were then sent to Rome to be used for the needs of the army and the central administration. With the advent of the barbarians, this system was very conveniently transformed to accommodate them: the curiales no longer sent anything to Rome but instead conferred the appropriate amount to the barbarian group that happened settle in their city’s administrative region. Furthermore, he argued that this modus operandi continued unaffected after the fall of the western Roman Empire, in the different successor-states, until the collapse of the Carolingian Empire. This theoretical synthesis was attractive to scholars, not only due to its clarifying simplicity and astonishing applicability, but also because it served to explain the lack of any negative sentiment in the sources. The importance of it becomes clearer, if we take under consideration that actually there were complaints on the part of the sources, wherever the barbarians had not settled peacefully but by force. As we saw earlier, the curiales were unconcerned if two thirds of the land tax changed recipients, as long as they were still obtaining their part undiminished. One can easily imagine the effect that this argument had on the debate on continuity, especially since it was centered on Western Europe. Of course, this theory didn’t fail to raise some eyebrows. Liebeschà ¼tz criticized Durliat’s arguments on a twofold basis. First, he doubts that late Roman cities actually collected for themselves any part of the imperial taxes and second, he argues quite convincingly that such an agreement would eventually provide little actual security to the settling barbarians, as security is usually better ensured through direct property of the land, than through any fiscal rights. Whats more, it seems perfectly reasonable to assume that it was exactly this security that the barbarians were looking for and of course, their position of power during the last centuries of the Roman Empire made sure that they were not likely to settle for anything less. Moreover, Durliat’s theory was commented on further in an article in 1998. There, Wickham analysis Durliat’s arguments and dismisses them one by one. Initially, he disagrees that the strict fiscal meaning which the latter ascribes to terms such as possessors and fundus is actually the one intended by the legislators of the fourth and the fifth century and in so doing he undermines the theory from the beginning. But he goes on to challenge other aspects such as the idea that Church constituted a part of the state administration in the post-Roman kingdoms (and thus church property consisted only of fiscal lands) and the view that servus is the term used to suggest a free landowner. By providing hard evidence following the chronological order (Late Empire, Romano-Germanic Kingdoms, Carolingian Empire), Wickham manages to discredit convincingly the arguments about fiscal continuity throughout this period. But, it should be noted that in the end of his article, where he dis cusses briefly the issue of continuity, he states that while he is not averse to it himself, it should not be considered tantamount to complete absence of change. However, the predominance of continuity does not sit well with terms like ‘barbarian invasions’ and ‘Germanic immigration’. So, historians had to find ways to circumvent this problem; they started by looking at the ethnic identities of the Germanic peoples, because it could be argued for example that there was no clear-cut sense of common identity between barbarian groups, such as the Goths, or some common characteristics that defined ‘Germanic’ then it would be possible to downplay the importance of the aforementioned terms. This way, Late Antiquity affected another heated debate (and in the meantime was affected by it); that of European national identities. The contribution of Walter Goffart has been essential at this point. Apart from fiscal continuity, in his Barbarians and Romans, he was also arguing about against the existence of definite ethnic identities among the barbarians. Another centuries-old historiographic tradition before him interpreted the movements of the Germanic tribes according to contemporary political ideas. For example, before the Second World War, Kossina had argued that there was a separate, identifiable culture to be associated with every Germanic tribe we come across in the sources and in 1961 Wenskus had maintained that there was a core of tradition carried by the elite of each barbarian group, according to which the whole mass of the tribe was defined. But, according to Goffart ‘migrations have served as the factual underpinnings of early Germanic unity’. Thus, if he could prove that no such unity actually existed, the migration and invasion theories would lose all sense. Indeed, he argues for a ‘short history’ of these peoples oblivion was a result of translocation. The common past of these peoples at any point stressed as back as the time before their last migration. He refuses to use sources of the sixth century such as Jordanes because, in his opinion, they only reflect the ideas of their own times and cannot be trusted for their evidence of the distant past. Finally, after taking under consideration also the deductions of archaeological research, he thinks that, if one wanted to look at the discontinuity provoked by the advent of the barbarians, he should definitely put the emphasis on Rome and its security. It was the appeal that the Empire had on the barbarians and not their own expansionist agendas that brought about the fall, in an ‘imaginative experiment that got a little out of hand’. It is therefore clear that Late Antiquity has given historiography of ethnic identities new areas of research to explore. This process gets even more complicated with the interference of modern international politics and historians of the Early Middle Ages recently find themselves and their research at the center of contemporary political debates. One can discern a pseudo-history in the making, which serves political and nationalistic purposes in the sense that it tries to define distinct nations that were created centuries ago once and for all. Another assumption is that by right these nations should form separate political entities, according to their defined ethnicity and territory. To sum up, the search for continuity of the Late Antique scholars might not have been successful in the field of fiscal policies and accommodation but it ascertained the fact that we cannot presume long histories and ethnic identities of the Germanic peoples. This certainly confirmed transformation instead of catastrophe and crisis for some aspects of the fourth and fifth centuries but it surely proved that there was much discontinuity and heterogeneity concerning the notion of identity. And since the Early Middle Ages are of such a great importance in the international political stage, scholars of the period should benefit from the results of research in this field in order to prevent their academic field from becoming a plaything in the hands of international politics. (†¦Projecting their own experiences on another period of time (as historians often do) Bibliography A = Heather, P., The fall of the Roman Empire: a new history of Rome and the barbarians (London and Oxford, 2005) B = Ward-Perkins, B., The fall of Rome and the end of civilization (Oxford, 2005) C = Cameron, A., The Mediterranean world in Late Antiquity 395-600 (London, 1993) D = Marcone, A., â€Å"A long Late Antiquity? Consideration on a controversial periodization† Journal of Late Antiquity, 1 (2008), 4-19. E = Jones, A.H.M., The Later Roman Empire, 284-602 a social, economic and administrative survey (Oxford, 1964). F = G = Wickham, C., The inheritance of Rome: A history of Europe from 400 to 1000 (London, 2009). H = Innes, M., An introduction to Early Medieval Western Europe, 300-900 (London, 2007). I = Brown, P., The world of Late Antiquity: from Marcus Aurelius to Muhammad (London, 1971). J = Liebeschà ¼tz, W., â€Å"Cities, taxes and the accommodation of barbarians. The theories of Durliat and Goffart† in Noble, T. F. X. (ed.), From roman provinces to medieval kingdoms (New York, 2006), 309-323. K = Wickham, C., â€Å"The fall of Rome will not take place† in Rosenwein, B. H., Little, L. K. (eds.), Debating the Middle Ages (Oxford, 1998), 45-58. L = Goffart, W. A., Barbarians and Romans A.D. 418-584: the techniques of accommodation (Princeton, 1980) M = Goffart, W. A., â€Å"The barbarians in Late Antiquity and how they were accommodated in the West† in Noble, T. F. X. (ed.), From roman provinces to medieval kingdoms (New York, 2006), 235-261. N = Wood, I., â€Å"Barbarians, historians and the construction of national identities† Journal of Late Antiquity, 1 (2008), 61-81. O = Heather, P., â€Å"Late Antiquity and the Early Medieval West† in Bentley, M. (ed.), Companion to historiography (London, 1995), 69-87. P = Noble, T. F. X., â€Å"Romans, barbarians and the transformation of the Roman Empire† in Noble, T. F. X. (ed.), From roman provinces to medieval kingdoms (New York, 2006), 1-27. B, 40. A, 14. C, 3. D, 7. E, 1027. Also in other instances, such as 1039 and 1067. E, 1045-47. E, 1026. H, 6. C, 4. B, 13-14. B, 182-3. G, 8. H, 126. B, 123. B, 3. For example, in Chapter V, he is arguing for a drop in living standards mainly by looking at the quality and distribution of ceramics, B, 87-121. B, 87, G, 9. Especially in Chapters V and VI, B, 87-137. G, 9. Brown, P., The world of Late Antiquity: from Marcus Aurelius to Muhammad (London, 1971). B, 3-4.

Scabies Essay -- essays research papers

Scabies While sitting around your house, watching television, you notice that you have been scratching your arm and in between your fingers for a little while. After taking a closer look you notice something that you assume is a rash and just ignore it. The next day however you notice that the rash has spread and that you think you see burrows in your skin. Then it hits you, the weekend that you spent away on vacation in that not so expensive hotel to save a couple of dollars has now cost you more money in the long run. You must go see your doctor to be treated for scabies! Scabies mites are distributed worldwide, affecting all races, ages and socioeconomic classes in all climates. Sarcoptes scabei, human itch, or mange mites, are in the arthropod class Arachnida, subclass Acari, family Sarcoptidae. These mites burrow under the skin, living in linear burrows. Other races of scabies may cause infestations in other mammals such as domestic cats, dogs, pigs, and horses. It should be noted that races of mites found on other animals could not establish infestations in humans. They may cause temporary itching due to dermatitis but they do not tunnel into the skin. The mode of transmission is primarily person-to-person contact. Newly emerged impregnated females will crawl onto the uninfected person. The mite will hold onto the skin using suckers attached to the two most anterior pairs of legs. They will then burrow into the skin. Transmission may also occur via fomites (e.g., bedd...

Ancient World :: History

Ancient World In the beginning of this chapter it discusses how the pyramids were built, what purpose they served, the three pyramids at Giza, some messages found on the stones that were used to build pyramids, and what a mastabas is. Pyramids are tombs built for Egypt's pharaohs. Pyramids are large structures with four sides that are the shape of a triangle, that meet at the top to form a point. The ancient Egyptians used the pyramids as tombs for the pharaohs and temples for their gods. The pyramids have one or two little temples attached to them, which holds their relatives and servants. A few pyramids still stand today, and are great attractions for tourists. The pyramids were built by taking blocks of granite to the workshop, measuring the blocks down to size, shaping the blocks, and placing the blocks into the body of the pyramid. The core of the structure is now completed. Then, you place the limestone blocks on the top of the structure (they started putting the blocks on top and then worked their way down). They left two empty rooms to place the pharaoh and his belongings in. They sealed the pyramids so well, it took four hundred years for two robbers to figure out how to get in. Free citizens, drafted for public work, not by slaves of any sort, built the pyramids. Four thousand expert stone sculptors built the pyramids all year round. An extra work group of about ninety-five thousand men worked on the pyramids during the four-month period of the inundation (the time of enforced idleness for farmers, since the field were covered with the Nile water flood). The p yramids were built between the year 1600 B.C. and the year 2700. Many scholars believe that the reason why the pyramids were built in a triangular form is because it has a religious meaning to the Egyptians. The slanting side might have reminded the Egyptians of the slanting rays of the sun, that the pharaoh's soul could climb to the sky and join the gods. In the pyramids they buried the pharaoh's body. There was a chamber for the body. There was also a chamber for treasures of gold and other priceless items for the pharaoh's afterlife. Sometimes a boat is placed inside so the pharaoh would have a way to transport himself into his afterlife. In Pharaoh Cheopses pyramid, there was his mummy, caskets full of jewels, furniture inlaid with ivory and gold, silver and alabaster bowls and vessels, chests filled with clothing and precious ornaments, and jars filled full of food and wine.