Human Natures Tragic Flaw Essay

Do you believe there is a beast within man that tempts us to do wrong and commit sin? Or is it just human nature to be sinful? In the bible, book of Genesis, it shows how God created Adam and Eve. These two beings had everything one could possibly imagine, food, water, shelter, and the protection of our heavenly father. Their only rule in The Garden Of Eden was to not eat from the forbidden fruit tree in the center of the garden, but Adam and Eve were flawed and soon fell into temptation from the serpent, and ate the fruit. They went against God’s only command and made the human species sinners. In the novel, The Lord Of The Flies, a plane crashes on an uninhabited island leaving numerous boys stranded. These boys had to learn to survive without adults to make their food and provide shelter for them. At first they all agree to a chief, Ralph, and are willing to work together to build shelters, but as the novel reaches its climax, they turn savage which soon leads to the death of three boys. The author â€Å"William Golding† portrays that it is not human nature within ourselves that makes us act out, but when times are rough, violence and sin leads us away from the path of righteousness. Symbolism is used throughout the novel to show that things put in this world tempt us to act out. The biggest illustration of symbolism in The Lord Of The Flies is in relation to â€Å"the beast†. The Beast was introduced on the very first day on the island. A little boy with a mulberry-colored birthmark on his face educated everybody of a so called Beast, which he had apparently seen on the previous night. At the time, this was overlooked by the older boys as something in his imagination. As the story advances it becomes evident that the older boys begin to believe in this Beast. One evening Simon was spotted when returning from one of his nature walks, and Jack persuaded the others that he was the Beast. Each boy began pouncing on Simon, stabbing and beating him to death. This shows that a small thing, such as the serpent in the Garden of Eden, can cause fear and tempt us to do wrong, and in this case commit murder. Another example that holds much symbolic value throughout the story is the usage of the word â€Å"scar. † When the plane crashes on the lush island, it disrupts the balance and harmony of nature untouched by man’s influence. The twisted wreckage of the plane creates an imperfection in the peacefulness of nature, and leaves the beach a â€Å"scar† of what it used to be, stunning and unharmed by man’s vicious impulse. An object which also attains much symbolic relevance as the story unfolds is the conch shell. Delicate, fragile, and white, the conch is what brings the boys together on the first day at the beach. It is used throughout the story as an object of high importance and tradition, as it calls meetings together and determines who has the right to speak, depending on who is holding it at the time. It can be seen as a representation of law and order amongst the boys, as it unites them and prevents chaos from arising. As the book progresses, however, characters like Jack and his hunters put less and less importance in the sensibility and order in the concept of the conch, and finally disregard it altogether as chaos erupts over the island. This symbolizes the struggle of civilization and savagery, as Jack’s hatred of Piggy and Ralph grows and he and his boys resort to primal urges like hunting and killing. It is shown throughout the novel that although it is man’s natural instinct to cause destruction, it is not human nature to sin. We are tempted into sin by those around us, and even our own mind sets. â€Å"William Golding† beautifully portrays that it is not human nature within ourselves that makes us act out, but when times are rough, violence and sin leads us away from the path of righteousness.

Holistic Care Nurse

The name and other identifying information about the patient included within this piece of work have been changed to protect confidentiality, as required by The Code of Professional Conduct (Nursing and Midwifery Council, 2008). For this reason, the patient included in this case study will be given the pseudonym of Sam Jones. The purpose of this assignment is to identify one client problem and provide an evidence-based plan of care for the individual. The purpose of care planning is to show a logical and systematic flow of ideas through from the initial assessment to the final evaluation (Mooney and O'Brien, 2006).The nursing model that will be incorporated in this care plan will be the Roper, Logan and Tierney's model (2000). This model was chosen because is it extremely prevalent in the United Kingdom and is the most widely used model familiar to nurses. The model of nursing specifies 12 activities of daily living which are related to basic human needs and incorporates five dimensi ons of holistic care, physiological, psychological, sociocultural, politicoeconomical and environmental (Roper, Logan and Tierney's model, 2000).Care plans are based on evidence-based practice, allowing the nurse to determine the est possible care and rationale for the chosen nursing interventions (Roper, Logan and Tierney, 2000). They take into account the psychological, biological and sociological needs of the person and therefore provide a holistic approach to care (Roper, Logan and Tierney, 2000). The main activity of living that will be affected within this care plan will be maintaining a safe environment as Mr. Jones may have a potential problem of death, due to hypovolemic and/or metabolic shock caused by ketoacidosis.Diabetic ketoacidosis (DKA) usually occurs in people with type 1 iabetes mellitus, but diabetic ketoacidosis can develop in any person with diabetes (Diabetes I-JK, 2013). DKA results from dehydration during a state of relative insulin deficiency, associated wit h high blood levels of sugar level and ketones (Diabetes I-JK, 2013). This happens because there is not enough insulin to allow glucose to enter the cells where it can be used as energy so the body begins to use stores of fat as an alternative source of energy, and this in turn produces an acidic by-product known as ketones (Diabetes I-JK, 2013).It is evident that DKA is associated with significant isturbances of the body's chemistry, which should resolve with appropriate therapy (Diabetes I-JK, 2013). Severe metabolic acidosis can lead to shock or death (Dugdale, 2011). The specific problem was chosen because there are measures that can significantly reduce the risk of metabolic and hypovolemic shock which can be caused by severe metabolic acidosis (Dugdale, ) Within the care plan relevant care interventions will be identified to prevent the possible development of shock for Mr.Jones. In practice the interventions would happen contemporaneously. The interventions involve identifyin g the potential risk factors for the development of hock by using specific assessments. This will be done by following an assessment which includes planning, assessing, implementing and evaluating the care that will be provided to Mr Jones and to evaluate its effectiveness (Mooney & O'Brien, 2006). Once the diagnosis was made, specific, achievable, measurable, realistic and time limited goals of care for Mr.Jones were made. The NHS foundation trust specific guidelines for adult diabetic ketoacidosis suggest a series of immediate actions and assessments for suspected DKA which will allow for appropriate interventions to be ade and will provide a baseline which will provide a measure of the effectiveness of the treatment (The Joint British Diabetes Societies Inpatient Care Group, [JBDS], 2012). Mr Jones will need fluid and electrolyte management to clear ketones and correct electrolyte imbalance (Nazario, 2011).

Construction Economics Assignment Example | Topics and Well Written Essays - 1750 words

Construction Economics - Assignment Example The industry provides services such as maintenance, repairs and rehabilitation of existing structures. The industry comprises of three main sectors, which include building construction, heavy and civil engineering and specialty trade contractors. The building and construction sector includes contractors who build buildings for residential, industrial and commercial purposes. Heavy and civil contractors build roads, bridges, sewers and other major projects mostly relate to state infrastructure. Specialty deals with carpentry, painting and other works that relate to all types of construction. The industry teds to enter recessions first and often the last to recover. Most economic factors, which lead to recession, affect the construction industry. Inflation is one of the major causes of recession where consumer goods become expensive resulting to a drop in customer spending. In instances when the economy is expanding, there is increased consumer spending due to better wages and high disposable income. During the economic boom individuals have disposable income, which they use to buy durable goods and assets such as apartments and homes (Samuelson & Nordhaus, 2004 p. 56). In addition, the state acquires more tax revenue, which it utilizes by developing infrastructure. All three sectors of the construction industry indicate tremendous growth during this period. ... This happens in the initial stages of economic contraction. The Federal Reserve additionally, increases the lending interest rates and mortgage rates leading to reduced loans. The monetary control and inflation affect the construction industry even when they are in the early stages of inflation. The fluctuating interest rates results to an increase in the number of defaulters since they are unable to pay (Agapiou et al, 1998, p. 56). Federal Reserve increase in interest rates and reduced money supply result to weak housing market. The increase in lending affects the housing market, which comprises of the building sector of construction industry. Those already building houses are unable to continue due to escalating prices brought by rise in energy cost and fluctuation of currencies. Economic recession heavily affects the construction industry even in the early stages due to initial reduction in customer sending that result to a decrease in the demand of housing due to oversupply. Rec ession affects the industry more when compared to transport, education and financial industries. In addition, housing prices fall leading to a rise in foreclosures. Schmalensee (1987) says that the recession results to a rise in unemployment and thus a decline in the number of construction works (132). An imbalance in supply and demands slows the construction of residential building due to increase in interest rates. For example during 2007 recession total construction in United States declined by 28% (Department of labor). During recession, the government reduces its spending since its budget is normally under strain. This results to a decline in heavy and civil sector of the construction industry, which heavily relies with government projects such as roads and

The effect of insecurity on economic growth in Mexico Research Paper

The effect of insecurity on economic growth in Mexico - Research Paper Example This reduces the GDP of the country since employees are less productive when they are under stress and trauma when they are in their working stations. Violence and insecurity in Mexico is a cause of a number of mental illnesses among the citizens of Mexico. This reduces the productivity of the Mexican population and since mentally ill people who would offer personnel are under strain. The cost of insecurity in Mexico turns detrimental with the effect it has on the levels of sales. Business hours are short in societies where there is high insecurity. The Mexican business sector thrives under strenuous conditions with intense insecurity in the country. This reduces the level of sales and profits and, consequently, the GDP. According to the World Bank Group, 2011, heightened insecurity in Mexico, there is a most likely high expenditure in internal security. The high expenditure on the internal security reduces the level of investments that the country has on infrastructure and developme nt projects. Investment in human capital equally reduces with increased expenditure on security in Mexico. The cost of health care in Mexico increases with intense insecurity situations. The cost of policing is most likely to increase with high instances of insecurity in Mexico. All these costs have detrimental effects on the economy of Mexico. ... According to Rodgers, Beall and Kanbur, 2012, the violence-insecurity nexus poses detrimental effects to the local economy of most Latin American societies, Mexico included. Crime in cities of Latin American countries is among the greatest challenges to growth of businesses. The investment confidence of most investors in Latin American societies is low because of the high level of insecurity. Domestic investors in Mexico are reluctant to take risks involved in putting up businesses. Foreign firms are cautious to put up investment in insecure societies because of the high potential impacts of insecurity. Losses to business from the high incidences of burglary in Mexico are among the most detrimental challenges to investors. The cost of paying internal security officials to protect the Mexican society from violence continues affect the economy. The cost of compensation by insurance firms is high because of spreading incidences of robbery and burglary to businesses in Mexico. The net ef fect of insecurity to the Mexican economy is the loss of the potential revenues that accrue from domestic and foreign investments in the country. Sohnen, 2012, addresses the detrimental consequences that the high rate of crime, violence and insecurity has in Mexico and most of Central American society’s economic prosperity. The consequence of insecurity on the health of Mexicans is high and has related effect on the cost of health care expenditure. According to Sohnen, cooperation among different institutions in Mexico is under great challenge from the escalating insecurity conditions. Insecurity in the country compromises the efficiency of different government institutions to coordinate and promote economic growth in the country. The economy, therefore, experiences retardation

Cargo Essay Example | Topics and Well Written Essays - 500 words

Cargo - Essay Example This report will discuss the opportunities that Etihad cargo needs to adopt in order to continue with its outstanding performance and to ensure that the cargo business is growing. It is believed that the current Etihad Cargo warehouse is worn out since it is not operating toward achieving the goal of the company. The company needs to look at various issues that are leading to this situation this is because, the cargo business is said to increase tremendously. Plans are underway to ensure that the company acquires new freighters and open new destinations so as to increase its opportunities of making more profits. New freighters will imply that the company opens up a modern warehouse with the capacity to handle large cargos. The current warehouse is small and in poor state to handle large cargoes in that it is ill equipped to an extent that it cannot sustain live animals for more than six hours. The racks in the warehouse are damaged which leads to unavailability of space. The new warehouse is required to handle cargoes that come in and out from all corners of the world. This will mean that the company has new facility which will open opportunity to present new business lines. It is vital for the company to change its managerial style since imports and exports have increased which makes products management more intricate. Warehouse management will foresee some benefits to Etihad Cargo such as enhanced order fulfillment expediency, potentiality to meet specific requirements made by customers and increase inventory accuracy. Despite the fact that warehouse management will be costly to cargo department, the benefits surpass the losses since the management will reduce errors and manage the warehouse keeping in mind that our cargo business in growing. The cargo sales department is given the responsibility of looking for business opportunities in places like Dubai and Abu Dhabi. Etihad Company ought to increase its shares in UAE

Health economics Charles e phelps,, Essay Example | Topics and Well Written Essays - 1250 words

Health economics Charles e phelps,, - Essay Example A risk premium is the average expected loss. Ua represents the utility function of an averse person showing the level of satisfaction at income level Ia. X is the risk premium. The graph above represents the levels of satisfaction of two individuals with different levels of income. Io is the expected value. From the graph, Ia is less than Io meaning that the averse person receive a low income and consequently has a utility level that is lower than the expected utility. In the expected benefit calculation, where â€Å"m† is the medical treatment, Pm is its price, f is the probability that an event will occur and C is the co-payment rate, why does it matter that M depends on C? This is because co-payment helps in the reduction of medical care consumption costs. Without copayment, an individual may not be able to access and afford medical treatment. Copayment is also important when it comes to covers relating to medical services since it helps an individual to prevent unwanted expenses. Therefore, when calculating an individual’s expected benefit, all expenses and benefits incurred or gained on medical services have to be considered. Copayment has to be considered since it covers an individual’s medical expenses and that is why M depends on C during calculation of expected benefit. This is the trend of individuals with risky lifestyles or jobs to acquire life insurance. It can make the insurance company face screening and signaling problems. Insurance is always more likely bought by individuals who are prone to higher risks than those with low risks. Insurance firms try to reduce the adverse selection problems of having those who insure big risk buying their product. They do this through adjusting prices and measuring risk. Consequently, life insurance firms need medical documents and will not give policies to individuals who have long term illness.

Written and Unwritten Constitution Essay Example | Topics and Well Written Essays - 1750 words

Written and Unwritten Constitution - Essay Example As we have already seen, the sources of the British Constitution are many and various, and may generally be grouped under four heads: This distinction between written and unwritten constitutions has led to the establishment of a far more important classification of written and unwritten constitutions. The idea of permanency is closely associated with the concept of constitution so much so that stability is considered to be one of its main attributes. Written constitutions are considered to be more permanent and, therefore, more written, because, generally speaking, they cannot be amended except by a special process or by means of special machinery. Unwritten constitutions, on the other hand, are deemed to be unwritten because they can be amended or altered by the ordinary process of legislation. It should, however, be noted that the distinction between written and unwritten constitutions does not necessarily depend on the distinction between written and unwritten constitutions. A written constitution may be as unwritten as an unwritten constitution. A typical instance is furnished by the Italian Constitution of 184 8 which, according to the generally accepted view, could be amended by the ordinary process of legislation. (Smith, 2001, 80) The distinction between written and unwritten constitutions was pointed out for the first time by Bryce, and has now become a fundamental concept of constitutional law and practice. According to Bryce, there are two types of constitutions: those which have grown organically without any pattern either in their form or in their content and which consist of a variety of laws, conventions and customs. (Bogdanor, 1997, 351) The second type is the result of systematic, exhaustive and conscious labour. The first type is derived from the same source as the ordinary laws and, consequently, may be abrogated or revised by the same organ and in the same manner as in the case of ordinary laws; and this he calls an unwritten constitution. On the other hand, a written constitution is derived from a source other than that of ordinary laws and is of a rank superior to that of ordinary laws. It can only be annulled or amended by the same organ which created it or some other organ to which its power has been delegated. In other words, a written constitution is one which demands for its amendment or revision special machinery or a special method. 1 It, therefore, occupies a privileged position and possesses a greater guarantee of permanence: a situation which French jurists have described as constitutional super-legality. In theory, therefore, inflexibility is the essence of this system. (Patterson, 1947, 135) A typic al instance of a written constitution is furnished by the United States of America. Article 7 of the Constitution prescribes two different methods of amendment: (i) either two-thirds of both Houses of the Congress may propose amendments, or legislatures of two-thirds of the States may call a convention for proposing amendments, and (ii) the

Managing and Leading Change Essay Example | Topics and Well Written Essays - 1000 words

Managing and Leading Change - Essay Example The change at the General Motors Company executed a complete reengineering of the organizational structure, which not only reduced the cost of business, but also improved the flow of communication at all levels and the pace of decision making. Organizational structure is the pattern of hierarchies of management in a company which controls the information flows as well as the reporting of relationships. The organizational structure of a company lays the basis of the operational policies. â€Å"[C]companies may find it necessary to change organizational structure to remain competitive or adapt to changes in the company, industry or marketplace† (Ingram, 2012). Organizational changes at the General Motors Company started with the forced retirement of Stempel. After Stempel’s retirement, Jack Smith was made the new CEO and Smale was made the chairman of the board. Hoagland, on the other hand, became the new president of the General Motorss Company and served as the right-ha nd man of Smith. After implementing these changes, the next target of the new top management team was to alter the chain of command of the General Motors Company. These changes were followed by flattening of the organization structure of the General Motors Company with the elimination of 50,000 hourly and 24,000 salaried jobs. This helped the top management cut down the costs and enhance the profitability of the business. Formal organizational structure is not quite important for small organizations because the flow of communication is easy, but the organization of the magnitude of the General Motors Company requires a formal organizational structure. â€Å"[I]n a larger organization decisions have to be made about the delegation of various tasks. Thus, procedures are established that assign responsibilities for various functions† (Distelzweig, 2012). As Smale became the leader of the board’s executive committee, he took the directors’ board of the General Motor s Company into confidence. Under Smale’s leadership, the board of directors instituted a revolt against the old management team of the General Motors Company. The power which the board of the General Motors Company used to oust the old management team of the company was basically their majority, realization of the company’s poor functioning with respect to profit-making, and an urge for change. The managerial strategies used by the company’s board in achieving success included but were not limited to identification of loopholes in the system, realization of the unnecessarily tall structure of the organization, and downsizing of the company. The fundamental objectives which the company’s board wanted to achieve included reduction of the corporate staff so that the decision making could be improved and simpler and change would be easier to introduce and implement. Too many managers working at different levels in the company made it difficult for any decisio n to be taken and any strategies to be implemented since any decision that was taken needed approval of many. â€Å"To make good downsizing decisions, executives need to appreciate more than just the immediate impact on human resources. And their information should be based on the collective experience of many firms† (Bruton, Keels, and Shook, 1996). The board replaced Stempel with Smith and Hoagland both of whom were very experienced in the reduction of expenses and

Females and Science GCSE'S Literature review Example | Topics and Well Written Essays - 1500 words - 1

Females and Science GCSE'S - Literature review Example our, or sex†¦Ã¢â‚¬â„¢ This was supposed to mark a fundamental shift the rights of females when it comes to education as this would basically mean both male or female student have a right to equal treatment in education. Participation and achievement of females in certain subjects and more especially science subjects was a major issue in the 1950s since schools were divided on sex basis. Single sex schools for boys and girls tough different subjects; boys were taught more academic subjects while girls were taught subjects more inclined to femininity and the home setting. â€Å"†¦the advent of free education for many girls had brought nothing more than the opportunity to learn, †¦ all those domestic skills which they could, in former times, have learnt at home.† (Deem 1978, P. 17). Male domination continued to affect every aspect of society and children were introduced to this even in the education system where the girl was seen to be just capable of learning dome stic related subject which were may be thought easy to handle. Beginning in the 1970s feminists began to query the underachievement by girls in subjects such as science and mathematics. They found out that division in the curriculum was largely to blame inequalities in the education system which led to underachievement of girls in science and technical subjects and this led to educational reforms of 1988 which granted females an equal opportunity for education as males. They were therefore able to participate just like boys in the learning of all subjects including sciences. Major changes have been observed in examinations measuring the competence of students all the genders in academics and these changes are linked to the reforms brought about by the Education Act of 1988. Government has intervened significantly to ensure provision of equal education for all, and at the same time public views on gender have also changed positively. Prior of to the reforms of England’s education system, goals were socially

Personal Statement Adjust(including) Essay Example | Topics and Well Written Essays - 1000 words - 6

Personal Statement Adjust(including) - Essay Example Specifically, UC system is a perfect program for me since it provides the opportunity to build the academic foundation I desire. I have gained my interest and need for further understanding of the socioeconomic disciplines from my experiences while living in the state of California (Gonzà ¡lez). Indeed, travelling across the United States has been fulfilling. In effect, the travels have enabled me to bring alive the information that I had previously read in books and always wanted to experience in my life. Specifically, my travels have led me to California, New York, Pennsylvania, Texas, and Nevada where I have had a chance to vacation. Consequently, I have acquired instrumental knowledge about the operations in each state that I have vacationed in, with each state and city visited having different elements that make them distinctive in their own way, which explains the differences in society and economies different states experienced. For example, New York City has the high transit utility in the United States and a successful financial market in the Wall Street. On the other hand, San Jose has a large freeway system to support the third densely populated city in California and the famous high technology companies located in the Silicon Valley region. I believe that travel has strengthened my experiences and complemented my understanding of the book knowledge on America. Further, my volunteering roles with the Salvation Army and the Second Harvest Bank have had a huge impact on my life. It was during this time that I realized and identified the difference between the society and the economy. In the course of my work with these two organizations, I collected, packed, and distributed materials on my way to becoming a professional volunteer. Notably, an experience regarding two locals arguing about the quantity of meals they received is forever etched in my mind since it highlighted the challenges experienced in such

How to Avoid Being Sleepy Essay Example for Free

How to Avoid Being Sleepy Essay Check with the doctor if you have to take medicine for your medical condition and it should not interfere with your sleep. †¢ Maintain a healthy diet. Remember to stay away from too many sweets. Eat more fresh fruits and vegetables. †¢ You can take a vitamin supplement rich in iron and B12 – check with your doctor first. †¢ Try to relax. Stress and anxiety causes you to lack of sleep at nights and this will only make you feel sleepy the following day. †¢ Feel positive. Work on your feeling of enthusiasm, so you can release positive energy in you and lessen your sleepiness. Just focus on your work and think of the good result of doing a good job out of it. If you still feel sleepy most of the time that it hampers your productivity as a person, you might as well have yourself checked by your doctor. You may have a more complicated problem about sleep, so it is best to do this at once. Source: Health Guidance| 6 Powerful Ways to Stop Being Tired by Brad Isaac on August 16, 2007 One of the more common complaints I hear from people is how tired they feel all the time. I too experience times where I am tired and fight sleepiness. Being tired obviously decreases motivation and causes you to feel like you aren’t at 100%. Being tired might even cost you money! That’s why in order to beat tiredness it’s a good idea to have a plan. Here’s my 6 point plan to beat daytime tiredness: 1. High aerobic exercise *- I’m not talking about a leisurely walk after dinner, I am saying some high intensity stuff. If you find yourself wanting to doze during the day, then you need to increase your aerobic exercise. It increases your blood flow, decreases standing heart rate. You’ll be relaxed more during the day, sleep better at night and feel more energy. John Wesley at Pickthebrain. com says he gets his exercise in the morning and it works for him all day. Personally, I find that either morning or evening works for me. Just depends on the season. So I’d recommend, in the beginning at least, to be flexible and find the right time for you. 2. Cut the sugar – Are you drinking sugar in your coffee or morning beverage? It could be making you tired. When I switched from sugar to honey, I noticed a difference in my energy level that week. Plus, an old farmer’s tip says eating honey from your local bees helps to do away with sinus allergies. Worth a try anyway. Also avoid sugar snacks during the day. Many office workers bring in treats to share with everyone like doughnuts, cakes, ice cream. Just say no. Avoid these sugar traps that zap your energy. 3. Eat a good breakfast – by â€Å"good† I don’t mean Fruit Loops or a Danish. Grab some protein, eggs, low fat toast, granola, yogurt. Skipping breakfast sets you up for a mid morning crash. Plus, you’ll be starved and eat more for lunch (see point #4) 4. Eat a light lunch – This advice comes from Benjamin Franklin. He noticed that his co-workers would gorge themselves at lunch and then have an afternoon of sleepiness. He chose instead to slowly and methodically eat a hunk of bread as he read a book. 5. Take time during lunch for you – which is the second part of Ben Franklin’s advice. While he slowly ate his bread he’d take â€Å"Ben time† by reading a book. By taking a full break from the reality of work in this way, you can come back from a â€Å"mini-vacation† refreshed and ready to take on the afternoon. 6. Cat-nap – If you have a flexible schedule you can nap when you get tired. The key with this is not to nap too long. A 1 to 2 hour nap will make you more tired. A 15 minute nap or caffeine nap will wake you up and prepare you for the rest of the day. Sometimes you can squeeze in a 15 minute cat nap during lunch. Other times you might have to wait until after work. Either way, a nap can refresh and rejuvenate you. Tips on Preventing Sleepiness Below are then few simple ways on how nurses may take to prevent sleepiness while on duty. These ways have been taught immeasurable times already, but I just felt the need to assert these as well. 1. Take a power nap. In numerous studies, taking naps have been found to increase alertness and improve performance. However, taking naps may not be allowed during breaks or meal periods among nurses. They can then take a nap before their shift starts. Naps should be short though (no more than 45 minutes) to reduce awakening from deep sleep and prevent sleep inertia. 2. Consume caffeine. Although caffeine has earned its bad reputation with regards to health, it also has been found to be an effective stimulant in increasing alertness. It just needs to be taken properly. Drinking coffee or tea must then only be done at the beginning of a shift or about an hour before an anticipated sleepiness. Additionally, caffeine must not be taken at least 3 hours before bedtime to prevent the possibility of insomnia. Most important, caffeine must only be consumed when needed, and not on a regular basis or when alert. 3. Drink plenty of water. Water helps prevent dehydration, which increases the feeling of drowsiness. Water should be taken then even when not yet thirsty, to stay energized at work. 4. Go into the light, literally. Light has been found to increase alertness. Sunlight is the most effective; however, artificial light in different levels are also found to induce alertness. Nurses on night duty may then go into well-lit areas for several hours during the shift. 5. Get enough sleep. Enough said. How To Avoid Sleep While Studying? I can still remember when I was in college, studying during exams was like hell and what used to make it worst was my falling asleep. Exams are near and to get good grades, we decide to study for long hours. We decide that the best time to study is the night time, but we cannot stop ourselves from sleeping while we are studying. (Especially in subjects like History, Science, Biology, etc. ) These subjects are too boring to keep us awake.

The Various Types Of Child Abuse Social Work Essay

The Various Types Of Child Abuse Social Work Essay Ministry of Community Development, Youth and Services (MCYS, 2005) states that, Child abuse is defined as any act of omission or commission by a parent or guardian which would endanger or impair the childs physical or emotional well-being, or that is judged by a mixture of community values and professionals to in inappropriate. Different types of abuse MCYS (2005) recognised four different types of abuse, namely physical abuse, sexual abuse, emotional abuse as well as neglect. In addition, neglect can be broken down into 4 segments; physical, medical, education and emotional (Child Welfare Information Gateway, 2006) Therefore, what actually comprises in each of the different types of abuse? Physical Abuse In accordance to Child Welfare Information Gateway (2005), physical abuse is physical injury caused by punching, beating, kicking, stabbing, burning or using a foreign object to hit the other party. The severity of injury may vary from minor bruises to fractures or death. Furthermore, physical abuse does not take into consideration if perpetrators accidentally or intentionally harm the child. Sexual Abuse Sexual abuse is known as inappropriate activities performed by the perpetrators. The Federal Child Abuse Prevention and Treatment Act (CAPTA) further defined sexual abuse as the employment, use, persuasion, inducement, enticement, or coercion of any child to engage in, or assist any other person to engage in, any sexually explicit conduct or simulation of such conduct for the purpose of producing a visual depiction of such conduct; or the rape, and in cases or caretaking or inter-familial relationships, statutory rape, molestation, prostitution, or other form of sexual exploitation of children, or incest with children. (Child Welfare Information Gateway, 2006) Emotional Abuse Child Welfare Information Gateway (2006) states, child can be emotional abused if perpetrators conduct behaviours that affects childs emotional development or sense of self-worth. However, MCYS (2005) added, emotional abuse not only affects childs emotionally development, it also weakens childs social and intellectually development. Additionally, such abuse exists with adults continual hostility, ignoring, blaming, threats, discrimination or blatant rejection of the child (MCYS, 2005). Moreover, based on research, both sources agreed that other types of abuse are also present if emotional abuse is being identified. Neglect In relation to Chan, Chow Elliot (2000), neglect was redefined as either omission or commission of any act that impairs the childs physical, psychological, intellectual or social development. As mentioned above, neglect can be categorised into 4 different segments. First, physical neglect may be the inability of providing food and shelter as well as the lack of supervision (Child Welfare Information Gateway, 2006). Second, adult may failed in the provision of essential medical care or mental health treatment which is known as medical neglect (Child Welfare Information Gateway, 2006). Next, adults may commit to education neglect if they are not capable of giving child an education as well as the lack of attention to special education needs (Child Welfare Information Gateway, 2006). Last but not least, if adults do not attend to childs emotional needs, failure to give child adequate love and care and allowing child to have easy access to alcohol and drugs, adults are at high risk in executing emotional neglect (Child Welfare Information Gateway, 2006). However, it is important for further investigations to be done if any of the neglect is present. There might be other contributing factors such as poverty or different culture practices that might surface parents are being negligent. Why is Child Abuse a topic of interest As an advocator, it is important to know that children are safe, being respected and are treated appropriately. With the raising numbers of cases of child abuse in Singapore, it shows that any children may be at risk of being a victim. According to the statistics on child abuse investigations from Year 2009 to Year 2010 (MCYS, 2011), apart from physical neglect, the rest of the types of abuse cases had increased. The numbers shown were the cases with evidence of cases. For example, the number of physical abuse cases had a jump from 82 to 133, which is about 38%. As for sexual abuse, it raised from 28 to 46 numbers of cases, which is equivalent to 39%. Emotional abuse cases had increased by 2, summing up to 6 cases in Year 2010. Although there was a drop of 4 cases for physical neglect, it may show that people may be more aware of such wrong behaviours. However, these numbers stated above only showed the reported cases with evidence. What about the other cases that had been reported but inadequate evidence were gathered? In addition, children from the United States (U.S) were victims of abuse and neglect as well. Statistics for Year 2006 shows that 54% are victims of child maltreatment of age up to 7 years. To add on, statistics reported an estimated number of 1,530 children died due to abuse or neglect. Out of 1,530 children, 78% were children under the age of 4 (Shaw Goode, 2006). This shows that children of the preschool years are very vulnerable to abuse. Maine State Dept. of Behavioral and Developmental Services (2001) mentioned that childhood abuse may lead to adult experience of shame, repeated flashbacks and nightmares may be traumatic for the victim. In addition, it may cause victim to be severely anxious over matters, depression as well as developing feelings of humiliation and unworthiness. Therefore, it is also important to educate parents about the raising numbers of child abuse cases. In addition, to create awareness that no one should deprive a child to have a healthy childhood experience. Hence, in this present paper, it will further elaborate on who may be the victims of child abuse and its impact on children, how child abuse affected parents and what happened to survivors of child abuse as they grow up. Victims of child abuse and its impact According Chan, Chow Elliot (2000), evidence from research stated that adolescents are also at high risk on physical maltreatment. On top of that, more commonly reported cases of physical child abuse cases involve the adolescents as well. Therefore, what makes a certain child be at a higher risk of child abuse? Statistics consistently showed that families that are socially and economically disadvantaged have more reports on physical abuse. Based on the research, families that falls under the low income family or annual income are below poverty level, it is more likely for the child to receive more fatal or serious injuries (Chan, Chow Elliot, 2000). Being financially unstable may cause a child to be a victim of child abuse, however this is not the main reason to place such child at risk. Pre-matured infants, intellectually disabled and any child who are developmentally disabled can be vulnerable to being abused too (Chan, Chow Elliot, 2000). The reasons behind it are such child is viewed as a source of stress and burden to the family and family might find it difficult to handle. For instance, a child was being physically abused, how did the experience affects the child negatively? In accordance to Chan, Chow Elliot (2000), it may cause impairment in childs behaviours, varied severity of physical injuries on child, child faces difficulties at school and child may have poor interpersonal skills. However, one of the limitations of this study is that research was carried out long ago and results are still limited and scarce in Singapore. Next, this study did not exactly mention the precise source where they gathered the statistics or how did they go about gathering and compiling the results. Lastly, this study focuses on two age groups which are the infants and toddlers and the adolescents. What about children from the older age group? How high is the risk for older children pertaining to child abuse? Impact on parents The term impact on parents refers to parents who were once victims of abuse or parents who had child who was being abused. Hence, how did once victimised parents got over the bad experience and started a new family? In addition, how did parents feel when their child was being abused by others? Being a parent, survivor of child abuse, and yet having a child who was assaulted, it may be very distressing especially for parents who disclose their childhood abuse experience for the first time (Grant, 2006). Furthermore, these parents may start to develop a sense of guilt as they were not incapable to protect their child despite experiencing it. Parents may also have flashbacks of those painful memories after disclosing the abuse (Grant, 2006). In addition, Grant (2006) mentioned that parents who had child being abused may begin to face many challenges. Having a child being abused, it may be hard for certain parents to accept the fact. Certain parents may be too overwhelmed and can be emotionally unstable. Parents may be in the state of confusion which in turn may impede their ability to support and provide help for their child and family throughout the investigation process (Grant, 2006). Taking for example if parents entrust their child with a caretaker and it turn out to be the caretaker who is the perpetrator, parents may be devastated and hard to believe. In addition, parents may be in great shock and developed a sense of betrayal. Therefore, after encountering such incident, how easy or possible can the parent cooperate and trust other unknown professionals? (Grant, 2006) Additionally, parents may also put the blame on themselves for allowing their child to be abused. For instance, they may question themselves, Why had not I (parents) see this situation?, Why did not I protect my child? or What type of a parent am I? (Grant, 2006) Upon accepting reality, it can be really hard on parents to handle the upcoming problems faced at home if they have more than one child. Parents may understand that they had to spend more time with the victim, trying to help the child to get over the bad encounter. On the other hand, parents have to ensure that they are capable to maintain a healthy relationship with other children at home. If the situation is not handled appropriately, other children may start to develop a sense of jealousy and resentment towards the victimised sibling as well as the parent (Grant, 2006). However, one of the limitations in this study is that there was not any statistics given. Next, this study did not mention the age of the parents. Older parents may be able to handle the situation better than younger parents. Lastly, this study did not give detailed information on the parents family background and the relationship within the family. With a supportive family, parents as well as child may be able to recover faster from the bad encounter. Survivors of child abuse when they grow up As researched by Maine State Dept. of Behavioral and Developmental Services (2001), some abused children may experience lifelong emotional harm as they grow up. For instance, some abused children may experience serious mental health problems. Research estimated that abused children are 2 to 3 times more likely to develop a serious mental illness. In addition, up to 70% of women who were treated in psychiatric setting have histories of childhood abuse (Maine State Dept. of Behavioral and Developmental Services, 2001). On top of that, some may suffer lifelong physical harm due to childhood abuse. Ranging from 3% to 6%, research shows that abused children may develop a permanent disability (Maine State Dept. of Behavioral and Developmental Services, 2001). Brain damage is an example of permanent disability and 20% to 50% of abused children suffered from brain damage but of different severity. It is further hypothesized that abused children are of higher risk of getting heart disease, cancer or even other chronic medical conditions (Maine State Dept. of Behavioral and Developmental Services, 2001). However, there is not concrete evidence to prove this hypothesis. Another negative impact on abused children is that they cause self inflict harm. Some abused children may get into a depression and others may choose to attempt suicides (Maine State Dept. of Behavioral and Developmental Services, 2001). Some abused children may even abuse the use of drugs, alcohol or nicotine in order to minimise or hide their pain. It was also reported by Maine State Dept. of Behavioral and Developmental Services (2001) that sexually abused children may be more exposed to further sexual abuse or to contract sexually-transmitted disease (STD). However, one limitation of this study is that the statistics are not up to date. Therefore, results given in this study may not be accurate enough. Findings may vary if research is done based on recent years. Apart from the depressing impacts that happened on survivors of childhood abuse, some survivors chose to seek help from professionals such as social workers, counsellors or therapists. This research was done by questionnaires and interviews were conducted based on respondents willingness. Out of 500 questionnaires mailed out, there were 384 completed questionnaires. Fifty interviews were also conducted to further supplement the data. Out of the 15 themes that were emerges based on how helpful the services were, seven common themes were mentioned in the study. Respondents felt that professional helpers were patient and they listened. In addition, professional helpers seem to be empathetic (Palmer, Brown, Rae-Grant Loughlin, 2001). Next, respondents felt that professional helpers were able to help them deal with their raging feelings and they no longer have to avoid those feelings. To add on, having nonjudgmental and understanding professional helpers benefitted survivors as they were encouraging too. Next, survivors felt empowered as the professional helpers believed in them. Professional helpers were also able to provide connections for the survivors with other survivors, letting them know that they are not alone. On top of that, professional helpers helped survivors to build their self-esteem and develop a value of self worth. Lastly, professional helpers were able to validate survivors experience giving surviv ors assurance (Palmer, Brown, Rae-Grant Loughlin, 2001). However, one of the limitations of the study is to generalise survivors experience across different types of abuse. In addition, the study only produced one side of the data. Findings may be different if these components are further addressed. Conclusion To conclude, it is important to create the awareness to parents about the raising numbers of child abuse cases in Singapore. By doing so, parents may be more aware of their own actions and not commit to any form of abuse be it accidentally or intentionally. In addition, parents are encouraged to develop an early, secure and consistent relationship with the children (Shaw Goode, 2008). On top of that, according to Shaw Goode (2008), parents need to provide the same level of attention to childs emotional and social needs, not only their cognitive skills. For future research, it would be good to research more on how one can further help victims and survivors who are really resistant to get over the bad experience. In addition, another research can be done to help children to work on their social and emotional skills after the bad encounter.

Exosome as Nanoscale Vesicles | Pancreatic Cancer Research

Exosome as Nanoscale Vesicles | Pancreatic Cancer Research Abstract Exosome are nanoscale vesicles that are released from cancer cells, playing an important role in the microenvironment of cancerous tumour cells.6,8 The exosomal vesicles (EV) contribute to the progression and growth of the tumour, and can be targeted using gold nanoparticles (GNP).1,6,7 The exosomes are isolated from the blood plasma, and with their stability in bodily fluids, they can be targeted and inhibited using GNP.   The GNP will inhibit the cancer cell, and will stop tumour growth and production.   Using proteomic and quantitative methods, the exosome EphA2, showed the highest detection of specificity and sensitivity in pancreatic cancer patients.1,2,4,8 Further tests confirmed that EphA2-EV has potential in early detection for pancreatic cancer, due to the levels specificity and sensitivity being higher in comparison to pancreatitis patients and the control patients.1 Keywords: Biomarkers, Exosome, Pancreatic cancer, Nanoparticle, Proteomics, Vesicles, Plasma, Antibody Introduction Pancreatic cancer, is vastly terminal, with a survival rate of less than 5%.   Pancreatic ductal adenocarcinoma (PDAC), is the most common form of exocrine pancreatic cancer, accounting for around 95% of pancreatic cancer cases.10 PDAC is a silent cancer, and with the lack of testing, the need for novel biomarkers to aid in early detection is imperative.   With no valid early detection methods, and no symptoms of early stage PDAC, the cancer will progress rapidly throughout the body before it is detected.   There is need to find a biomarker, aiding in the early detection PDAC, so that a treatment can be provided to stop the cancer from progressing.   The current tumour biomarker, CA19-9, is not reliable in early detection due to falsely elevated results of diseases other than PDAC.10 Recent studies suggest that exosomes, a nanovesicle, has a high potential as the future biomarker of PDAC, due to the stability and detection sensitivity in human blood plasma.1,2,4,8 Malicious exosomes, are veiled by cancer cells, screening the importance in tumour maturation and progression.7 Studies show how to optimize a method, to isolate exosomes from the blood plasma, to further assist in biomarker discovery.   In regards to analysing exosomes as a potential biomarker, exosomes need to purified and isolated with differential centrifugation paired with ultracentrifugation (UC).   Another technique used, is affinity purification of the exosomal membrane antigens using density gradient (DG) centrifugation, separating the vesicles based on their density.8 A practise needs to be conducted, to purify exosomes, from only a small volume of blood plasma. With studies being conducted on the stability in fluids of circulating exosomes, it can be confirmed that these nanovesicles have the ability of targeting to uptake to hinder or delay tumour development.   With the size of the exosomes ranging from 40 100 nm, they are distinguished for tumour microenvironment.   Exosomes, a potential biomarker, for the early detection of PDAC, are also being studied as potential nanocarriers to target cancer cells and delaying tumour growth.1,7,8 The most common nanocarrier being studied is the gold nanoparticle (GNP), due to its imaging, diagnostics, and therapy abilities.   The GNP can be easily synthesized via the citrate reduction, which is why is has potential in medical theranostics.7 Extracellular vesicles (EV), are secreted into extracellular space, they are involved in tumour initiation, progression as well as metastasis.   EVs can be used as non-invasive biomarkers, but the current studied methods are time consuming in regards to EV isolation.1,7,8 The EV membrane markers which are part of the tetraspanin family, are CD9, CD63, and CD81, respectively, and an assay demonstrates similar features.6 A nanoparticle EV assay, will be captured by an EV-specific antibody with the dual binding of EV, using 2 nanoparticle probes.   The 2 nanoparticle probes, will produce a plasmon, promoting an increase in sensitivity and specificity for the discovery of an exosomal biomarker.   Ephrin type A receptor 2 (EphA2), has recently been identified as a biomarker, of the tumour derived pancreatic cell line, and enriched on EV.1   EphA2, shows overexpression, increases in vitro invasiveness and anoikis resistance in pancreatic cancer cell lines.1 A recent study has been conducted with healthy control patients, pancreatitis patients as well as pancreatic cancer patients, with the use of nanoplasmon-enhanced scattering (nPES) assay a fast, sensitive, and specific method in biomarker detection. Convention Tumour Markers in Pancreatic Cancer Carcinoembryonic Antigen CEA CEA, is a glycoprotein, that is measured in a common blood test used for testing patients with cancer, including pancreatic cancer.   This will measure the amount of the CEA protein that is in the blood of a patient who may have cancer, and the CEA levels can be used to determine whether treatment is working or if the cancer is spreading.   A CEA level of 5 ng/mL, is considered a normal level of this protein, but there are several conditions that can alter the levels of the CEA in your blood, which is why this is not a valid biomarker in the detection of pancreatic cancer.5 CEA testing can be useful in regards to recurrent colon cancer as well seeing if treatment is successful.   Levels of CEA can be elevated due to smoking, as well as in other diseases such as Crohns disease.   Due to the unreliability of CEA levels in cancer, this blood test confirms that CEA is not a consistent biomarker for the early detection of pancreatic cancer. CEA is expected to be paired with other biomarkers, for early detection reasons.   When paired with CA19-9, there is an increase in detection for sensitivity and specificity, showing an improvement in diseases including pancreatitis as well as pancreatic pseudocyst.   Despite the improved results for pancreatic diseases, CEA is still not valid for the detection of pancreatic cancer, even when it is paired with another marker such as CA19-9.5 Carbohydrate Antigen CA19-9 Carbohydrate antigen (CA19-9) was discovered in 1981, and is considered a sialyl lewis a (sLea).9 CA19-9 is found on the surface cancer cell, expressed as a glycolipid and an O linked glycoprotein, and is related to the Lewis blood group antigens.3   Patients with Le (alpha beta +) or Le (alpha + beta -) blood group, express levels of CA19-9 in their blood, whereas approximately 5 10% of patients with Le (alpha beta -) blood group do not express CA19-9, limiting the use as a valid biomarker.9 Due to the low, and uncertain sensitivity of CA19-9, it is a poor interpreter of PDAC, therefore it is not a valued biomarker. CA19-9 is unable to differentiate between benign, precursor lesions and malignant conditions in PDAC patients, and it gives elevated results in many other gastrointestinal cancers.3   This blood test can show elevated CA19-9 levels in patients with other non-cancer diseases including pancreatitis and cirrhosis.3,9 The CA19-9 blood test can be beneficial in regards to knowing if a pancreatic tumour is secreting it, and to judge the efficiency of treatment, and look for pancreatic cancer recurrence.   A healthy patient will have a CA19-9 level of 0 37 U/mL, therefore with increasing levels of CA19-9, this could indicate tumour growth.3 For more accurate results, a PDAC marker needs to be discovered and paired with CA19-9, to increase the sensitivity and specificity in early detection.   With CA19-9 as the only marker, studies show it was only elevated in 50 75% of patients having PDAC, confirming that is not consistent as a biomarker and should not be used in diagnostic testing.3,9 Expressing elevated levels in other diseases such as benign jaundice, pancreatitis, and ovarian cancer, confirms the lack of consistency using the CA19-9 marker and that it cannot be used as an accurate indication of early pancreatic cancer detection.3 Emerging Biomarkers With the absence of reliability using the current PDAC biomarker, C19-9, it is a necessity to discover a biomarker with improved sensitivity as well specificity for the early detection of PDAC.   Recent studies suggest, that exosomes can be detected in body fluid such as blood, and they have potential as disease biomarkers.   Exosomes, found in blood plasma, need to be collected from healthy patients to obtain individual and pooled samples.   The collected blood plasma, will need to be separated, by centrifugation, to isolate the exosomes for further proteomic and quantitative studies.8 Isolation Methods Isolation of exosomes using the UC method, involves normal human plasma, and diluting it with PBS.   The sample will be differentially centrifuged, to eradicate cell debris, which is followed by UC.   The subsequent pellet, is washed in PBS, and filtered, and the filtrate was ultracentrifuged.   The resulting exosomal pellet, used for the study, will be resuspended in PBS.8 Using the EI isolation method, the plasma, is diluted in PBS and centrifuged.   The supernant is filtered, and the filtrate will be incubated using a blocking agent.   A microcolumn was placed in magnetic separators, where the column was rinsed with rinsing solution.   Beads were bound to the exosome, and were applied to the magnetic column.   The column will be washed with rinsing solution, and the immune captured exosomes were recovered by removing them from the column and placing them in a collection tube.   The exosome bound microbeads are washed to elute the exosomes, and centrifuged to obtain the exosomal pellet.   The exosomal pellet will be resuspended in PBS.8 Lastly, isolation using DG method, involved the exosomal pellet that was obtained from UC as well as normal blood plasma that was layered on iodixanol solution and centrifuged.   To the top of the tube, there were 12 fractions, with increasing densities.   The fractions are diluted with PBS and centrifuged, the resulting pellet was washed with PBS, centrifuged and resuspended in PBS.8 Western Blot and Microscopic Analyses The western blot method, shows the enrichment of the exosomal marker proteins.   Gel electrophoresis is used to separate and identify the different proteins.   The thickness of the band, indicates the amount of the protein that is present.   There is a labelled antibody, that is bound to the protein of interest.   AFM is used, to get a 3D image of the exosomal vesicle. Recent studies confirma that the exosomal markers CD9 and CD63 are enriched in exosomes purified using UC and EI methods.8 The study indicates that the UC method, had four exosomal markers whereas the EI method had only two exosomal markers, CD9 and CD63.   Transmission electron microscopy (TEM) and atomic force microscopy (AFM), were used on the isolated exomes, from the three exosomal isolation techniques.   In the DG sample, the TEM reported homogeneous vesicle, with diameter ranging from 40 100 nm, confirming the characteristics of exosomes.   The AFM produced a 3D image of the exosome, and after further analysis it was revealed that the exosomes had round membranous vesicle characteristics. LC-MS/MS Liquid chromatography mass spectrometry (LC-MS/MS), is a quantitative method used for the identification of proteins at the peptide level.   The first quadrupole is for the selection of the precursor and the second quadrupole is highly specific for detection.   In comparison to gas chromatography mass spectrometry (GC-MS), LC-MS/MS is not limited to volatile substances, it is better for the detection of molecules.   LC-MS/MS can produce many quantitative results, and has a high specificity and sensitivity. The study was carried out, using an LTQ Orbitrap Velos with a nanoelectrospray interface coupled to an Ultimate 3000 RSLC nanosystem and the LTQ Orbitrap Velos mass spectrometer operates using a nano -ESI spray.   The LC-MS/MS spectra are searched against the human protein database using MASCOT.   Equal amounts of protein from the three exosomal samples were separated, reduced, alkylated and digested with trypsin.   The DG sample had the highest number of protein identifications, followed by the UC isolation method.   Therefore, the western blotting, microscopy and MS results confirm that the DG isolation method is the most effective, in regards to isolating exosomes from blood plasma.8 Targeting with Gold Nanoparticles Malicious Exosomes The exosomes are formed from endosomal pathways, after they are fused from multivesicular bodies (MVBs) with plasma membrane.   The formation of malicious exosomes, also starts in the endosomal pathway.   The early exosome is formed from the migration from the cell periphery to the nucleus, by the formation of intraluminal vesicles (ILV).   The process interceded by exosomal complexes required for transport (ESCRT) and other proteins.   Late exosomes/ MVB, migrate to the periphery and fuse with the membrane, releasing the ILV, which are called exosomes.   The proteins, Rab GTPases, mediate the endosome migration.7 The malicious exosomes, are released from cancer cells found in the tumour microenvironment.   Exosomes play a role in variation and shaping of that tumour microenvironment.1,2,4,6,8 Malicious exosomes have potential as biomarkers, due to their stability in biological fluids including blood plasma.   There have been increased levels of circulating exosomes seen in several cancers including pancreatic cancer.1,6,7,8 Nanovesicles can be used to carry therapeutics, and have potential to limit cancer progression.1,7 The method consists of inhibiting the malicious exosomes biogenesis. Gold Nanoparticles The GNPs can be easily synthesised, as well they consist of a variety of shapes and sizes.   These nanoparticles exhibit intense light absorption and scattering, and they are deemed to be highly stable.1,7   They have potential in targeting, therapeutics as well as diagnostic capabilities. Regarding rapid tumour growth, a compressed lymphatic vessel will collapse causing lymph drainage, which will then allow for the nanosized molecule to be taken at the tumour site.7 This process will allow for passive targeting with nanosized molecules.   The cellular interest will be dependent upon the size and shape of the GNP.1,7 The tumour cells will overexpress their cell number receptors, which can be used for potential biomarkers.1,2,4,6,7,8 These cell surface receptors, will aid in the direction of the GNP to the tumour cells. Gold Nanoparticle Targeting The GNP will target malicious exosomes, by undertaking the malicious exosomes biogenesis with GNP specific targeting moieties as well as silencing moieties.7   Using antibodies to aim at the exosome for capture and selective retention.   Lateral flow immunoassay, will aid in exosome detection with CD9 and CD81 as antibodies, and CD63 with GNP.1,7 Therefore, GNP are being studied as a potential candidate for cancer therapy as well as for malicious exosome targeting.   The use of nanotheranostics to help quantify and inhibit the malicious exosomes. Sample Collection and Processing This recent study, developed a method for the purification of exosomes in blood plasma, as well as finding the EV concentrations in the plasma samples.   A three-probe EV capture was used, with a capture antibody that recognizes an EV membrane protein (anti-CD81), with antibody conjugated AuS and AuR to serve as two EV probes.   This EV capture was designed to form a plasmon, with the different GNP binding on an EV to improve sensitivity and specificity of EV detection.1   The study examined 59 pancreatic cancer patients, 48 pancreatitis patients, and 48 control patients, to see if early pancreatic cancer stage could be distinguished from pancreatitis patients and the control patients.1 Method The EV isolation consisted of cells grown in culture media, and washed with PBS.   The culture supernatants were collected and centrifuged to pellet cells, and centrifuged again to remove cell debris.   Concentrated with centrifugal filtering units, and centrifuged, the precipitates were collected and resuspended in PBS and centrifuged.   The resulting precipitates were collected and dissolved in PBS.   The ELISA assay, consisted of ninety-six well plates, which were incubated with antibody CD81.   The ELISA assay was analysed for absorbance, and the standard curve plotted the light absorbance versus the log10 EV standard concentration in pg/uL.1 The peptides were separated using Ultimate 3000 nano-LC, with an enrichment column as well as an analytical column.   The peptide fractions were analysed with Velos Dual-Pressure Linear Ion Trap mass spectrometer, and one MS scan, was followed by eight MS/MS scans. The nPES platform was constructed by filling sample wells with plasma sample or cell culture EV samples, followed by incubation and being washed three times with PBST and three times with PBS.   The sample wells were then filled with AuS and AuR PBST solution, and were incubated and washed three times each with PBST and PBS, respectively.   The sample wells were fitted with a cover slip and dark-field microscopy (DFM) was used for imaging.   The DFM images, that had image areas with brightness equal to 225 were selected, and the ratio of the image area to the whole image gave area ratios that were indicative to the nPES EV signal.1 A standard concentration curve was generated with a linear regression of nPES area ratio with log10 concentrations.1 SEM images analysed the images of GNP binding to EV, from EVs that were purified from human plasma.   The purified EVs were hybridized with anti-CD63-AuS and anti-CD9-AuR.   The SEM fields were analysed to calculate the total EVs, as well as the number of GNP-bound EVs per um2 of each assay. Proteomics and the Early Detection of PC An nPES was previously designed, for EV detection using GNP, that can scatter light at different wavelengths indicative to their shape and size.   Using both gold nanospheres (AuS) as well as gold nanorods (AuR), a plasmon is formed, increasing the scattering intensity.   With the plasmon, antibodies against CD9, CD81, and CD63 can capture and detect EV in a sample.1,7   AuS and AuR are detectable using dark field microscopy (DFM), and will form the complexes AuS-EV-AuR, AuS-EV and AuR-EV.   These complexes can be analysed using scanning electronic microscopy (SEM), examining the binding and distribution.   Following the pure preparation of EV samples, EV plasma was added to give the EV plasma standard.   The anti CD81 was incubated with the standard and two antibodies conjugated GNPs, AuS-Anti-CD63 and AuR-Anti-CD9, which exhibited ratios >0.35%.   A comparison was done with nPES and enzyme linked immunosorbent assay (ELISA), of the sensitivity and linearity of thei r EV values.   The nPES assays showed to be highly sensitive, requiring less plasma as well has exhibiting more advantages over ELISA in regards to measuring EV concentrations.1 Since CA19-9 is the only accepted pancreatic cancer marker that is not valid, pancreatic cancer derived EV marker is a more feasible biomarker due to the multiple factors that the pancreatic cancer cells express.   The nPES assay will quantitate tumour derived EV from blood samples, and one of the two EV specific GNP were replaced with one specific for the membrane protein.   LC-MS/MS proteomics, bioinformatics is used to identify trans-membrane proteins on EV PC (PANC-1 and MIAPaCa-2) and PDAC (BxPC-3).1 There were 128 membrane proteins identified, and 26 were expressed on EV.   The EphA2 showed the highest expression and is associated with cancer progression, metastasis, and prognosis.   The EphA2, was also not expressed by EV in HPNE. EphA2 was chosen as the potential marker, and CD81 and CD9 were chosen for EV capture.   The nPES was modified, using one capture antibody (anti-CD81) and two antibody-conjugated GNP probes (anti-EphA2-AuS and anti-CD9-AuR).1 The plasma EphA2-EV levels were higher in pancreatic cancer patients, in comparison to pancreatitis patients and the normal control (NC).   With the strong association between the circulating EphA2-EV and early stage pancreatic cancer, there is potential for EphA2-EV to be used as an early detection marker.1   The CA19-9 levels were increased in the pancreatic cancer patients in comparison to the pancreatitis patients and the NC, but the levels were not increased in the early stages of PC.   The receiver operating characteristic (ROC) curves, showed that the plasma EphA2-EV levels are promising in the classification of pancreatic cancer stages. The current EV analysis methods are tedious and lengthy for the isolation procedures, as will having volume requirements.   The nPES platform that has been studied, assimilates EV capture and detection with the use of the plasmon coupling effect, to have an increase in both detection sensitivity and specificity in small volume samples and fast sensitive biomarker quantification.   This EV nPES platform, can be generalizable for any disease state that has a specific EV marker.1  Ã‚   The nPES EphA2-EV blood assay shows substantial value regarding pancreatic cancer screening tests, due to being a rapid, accurate and non-invasive blood test for the early diagnosis of pancreatic cancer. Conclusions This review article explains the need to find a valid biomarker in the early detection of pancreatic cancer, as well as discussing how exosomes have potential to be that marker in the early detection process.1,2,4,6,7,8   The existing biomarkers for pancreatic cancer, are not valid markers in the early detection due to the lack of sensitivity and specificity that they exhibit when differentiating between benign and malignant stages.   The use of exosomes for the early detection of pancreatic cancer, shows potential as a biomarker, with the use of nPES platform.1 The platform allows for EV capture using plasmon coupling, which increases in detection sensitivity and specificity, which allows for the discovery of an ultrasensitive biomarker.   The nPES EphA2-EV assay could differentiate between pancreatic cancer patients (stage I and II) and pancreatitis and NC patients.1 The role of EphA2-EV, could help to improve early detection rates as well as improving patient outcome, and th is blood test is inexpensive, accurate and non-invasive.   This review involved proteomic and quantitative methods, to find a novel biomarker for the early detection of pancreatic cancer, and non-invasive nPES EphA2-EV analysis can aid in improving early pancreatic cancer detection and treatment. References Liang, K.; Liu, F.; Fan, J.; Sun, D.; Liu, C.; Lyon, C. J.; Bernard, D. W.; Li, Y.; Yokoi, K.; Katz, M. H.; Koay, E. J.; Zhao, Z.; Hu, Y. Nature Biomedical Engineering 2017, 1 (0021). Duxbury, M. S.; Ito, H.; Zinner, M. J.; Ashley, S. W.; Whang, E. E. Biochemical and Biophysical Research Communications 2004, 320 (4), 1096-1102. Jazieh, K. A.; Foote, M. B.; Diaz, L. A. Seminars in Radiation Oncology 2014, 24 (2), 67-76. Ansuini, H.; Meola, A.; Gunes, Z.; Paradisi, V.; Pezzanera, M.; Acali, S.; Santini, C.; Luzzago, A.; Mori, F.; Lazzaro, D.; Ciliberto, G.; Nicosia, A.; Monica, N. L.; Vitelli, A. Journal of Oncology 2009, 2009, 1-10. Ballehaninna, U. K.; Chamberlain, R. S. Tumor Biology 2013, 34 (6), 3279-3292. Melo, S. A.; Luecke, L. B.; Kahlert, C.; Fernandez, A. F.; Gammon, S. T.; Kaye, J.; Lebleu, V. S.; Mittendorf, E. A.; Weitz, J.; Rahbari, N.; Reissfelder, C.; Pilarsky, C.; Fraga, M. F.; Piwnica-Worms, D.; Kalluri, R. Nature 2015, 523 (7559), 177-182. Roma-Rodrigues, C.; Raposo, L.; Cabral, R.; Paradinha, F.; Baptista, P.; Fernandes, A. International Journal of Molecular Sciences 2017, 18 (1), 162. Kalra, H.; Adda, C. G.; Liem, M.; Ang, C.-S.; Mechler, A.; Simpson, R. J.; Hulett, M. D.; Mathivanan, S. Proteomics 2013, 13 (22), 3354-3364. Ballehaninna, U. K.; Chamberlain, R. S. Indian Journal of Surgical Oncology 2011, 2 (2), 88-100. Pancreatic Cancer https://www.cancer.org/cancer/pancreatic-cancer.html (accessed Mar 20, 2017). Eldorado by Edgar Allan Poe | Analysis Eldorado by Edgar Allan Poe | Analysis In the poem Eldorado, poet Edgar Allan Poe delivers a fundamental message that can be understood if carefully evaluated. Poe gives the account of a knight in search of a land called Eldorado, which holds riches and fortune. After much futile searching, the knights enthusiastic quest for treasure ends in death. The foremost theme of this poem is the desire for wealth and treasure. This theme is an influence from Poes life and the relevant Gold Rush of 1849 (Coad 60). The literary devices, symbols, relevancy, and personal experiences offer a deeper meaning to the poem than what lies on the surface. Poes skillful use of these elements helps to stress the ignorant desire humans have for wealth and fortune. The poem delivers a reflective moral issue many readers can, in some way or another, relate to. Poe uses the word shadow in each of the four stanzas of the poem, each stanza consisting of six lines. The third line in each stanza is where the use of the word shadow is introduced. Though the word occurs multiple times, it has a different meaning each time. The first shadow represents a literal shadow, a casting shadow of the sun. It could also be interpreted as happiness and sadness. The second shadow represents the shadow that has overcome the knights heart after much unsuccessful searching. The third shadow represents a live figure, possibly his or maybe an angel. And the fourth shadow figuratively refers to Valley of the Shadow (21). The fact the knight has grown old and weak, and must cross Over the Mountains Of the Moon, Down the Valley of the Shadow is seen as a symbol of the knights death, relating to the Biblical valley of death (19-21). Through Poes use of the word shadow and the period in which the poem was written, readers can understand Poes message. Poe uses the shadow in each stanza to convey his message. As the meaning of the shadow changes, so do readers emotional state. As he begins the first stanza, readers see a happy, gaily, bedighted knight who is enthusiastic about going on his search for gold. This start gives readers a sense of happiness and jolt of energy. His shadow could also be a foreshadowing of future events. However, Poe begins the second stanza with the word But. This contradictory word signals a shift between the first and second stanza and also a shift in emotion. The knight has become old, disheartened, and dismayed as the shadow is used in context to signal the emotional state of the knight. This signal causes readers to suddenly have a change in emotion; readers become sympathetic towards the knight. Poe continues to elaborate on the disappointment of the knight in stanza three. The knight encounters a live or possibly imaginative figure and asks the shadow where is Eldorado, reflecting on his hopeless jo urney in which he wasted his life. This figure could possibly be an angel providing guidance, an angel of death, or even himself. As the shadow replies to the question in stanza 4, readers are left with the idea that he has come to the end of his life and has died. With the closing of the poem, the audience can relate to the pain the knight feels. In all, the repetitive shadow becomes engraved in the readers mind, helping to sway the emotions. The life of the knight also provides a moral for people to learn. Poes moral in Eldorado is not to seek for riches on earth. The only true riches are the riches one receives after death. The knight in the poem seeks for physical riches for many years without any hope, leaving him disheartened and at the end of his life. When asked where Eldorado could be, the knight was told Down the Valley of the Shadow (21). This insinuation emphasizes the main point that true riches are found in Heaven, not earth, and any riches sought on earth leads to despair and death. As suggested by The Meaning of Poes Eldorado by the John Hopkins University Press, it can be argued Poe portrayed himself as the knight (Coad 60). Poe published his poem in 1849, the same year as his death. Like the knight, Poe had sought after an accomplished life, which he failed to do during his life. He was also unstable in the last years of his life. However, the knight most probably was a reference to the many prospectors of the California Gold Rush, which took place during the time the poem was written. The poem may have been Poes warning to the many prospectors that would experience the same hardships of the knight. Poes repetition of shadow and Eldorado and use of other symbols play an important part in his poem. It helps to further stress his main point. Other such devices Poe uses to communicate to his audience is through auditory and imagery senses. Poe uses aabccb rhyme scheme in the first three stanzas and xxabba rhyme scheme in the fourth stanza of his poem . Poes creatively written stressed and unstressed poem is one way Poe remarkably appeals to the readers auditory and imagery senses. The use of this rhyme scheme creates a thumpity, thump sound when read aloud, bringing the clattering of the horses trot to life. The symbols and rhyme scheme helps to immerse the reader into the scene of the poem and drives them to continue reading until the end. Eldorado is a poem by Edgar Allan Poe that has a stressed message to readers. It tells the story of a knight who traveled for a period of his life searching for a city of gold, Eldorado. It provides a message to all readers that true riches and happiness are only acquired through Heaven after death. If one attempts to search for wealth, in hopes happiness will follow, that person will come to the end of their life saddened and in despair. Poes use of symbols, rhyme scheme, and repetition brings life to his poem, which keeps the readers entertained and helps to convey his message. The poem brings light to the life of everyone and anyone searching for happiness and wealth on earth. Thus, Eldorado is Over the Mountains Of the Moon, Down the Valley of the Shadow, Ride, boldly ride . . . If you seek for Eldorado! (19-24).

Investigate the Effect of Moisture Content on Wheat Grain Seeds Respiration Rate :: GCSE Biology A2 A-Level Coursework

Investigate the Effect of Moisture Content on Wheat Grain Seed's Respiration Rate HYPOTHESIS: There will be a positive correlation between moisture content of wheat grains and their respiration rate. Therefore as the moisture content (independent variable) increases so will the respiration rate (dependent variable). The rationale behind the hypothesis came from studying photosynthesis in plants. During the light-dependent reactions of photosynthesis, the photolysis of water (H2O) occurs inside photosystem II. The products of photolysis combine with NADP from photosystem I, to form reduced NADP. This reduced NADP passes to the light-independent reactions of photosynthesis, where it is utilised to make triose phosphate from glycerate 3 phosphate. Without water, photolysis would not occur and therefore the light-dependent and light-independent reactions would not take place at all. Therefore I would predict that the higher moisture content of wheat grain seeds the higher the respiration rate will be, this is because the seeds will be able to utilise more water than a wheat grain seed with low moisture content. VARIABLES: The independent variable used in this experiment is going to be moisture content, and the dependent variable will be the respiration rate. The other variables; temperature, air pressure and air will be kept at fairly constant levels. Carrying out the experiment inside a fume cupboard will help achieve in keeping these variables to remain constant. However another variable sunlight cannot be controlled during this experiment, and will obviously vary during the experiment. The possibility of using a standard light bulb to keep light levels constant was considered, but was rejected due to safety fears e.g. overheating when the experiment was not being monitored during the time between readings. BACKGROUNG KNOWLEDGE: Deterioration of stored grain seeds is an important economic problem in agriculture, therefore it is important to find out the most suitable conditions for stored grain seeds to be maintained in. For this experiment wheat grain has been chosen, this is because it is widely cultivated around the world e.g. the Mediterranean and West Asia, and is used to make flour and pasta. This means wheat is a staple crop throughout the world, and its storage is essential. To store grain effectively it is important to stop germination from occurring at all. Germination is the onset of growth of the embryo in a seed, this usually happens after a period of dormancy. Dormancy is the state where germination will not occur, even if environmental conditions are favourable. This is often an advantage for seeds, as it allows germination to occur in a more favourable season. In the case of wheat seeds they need several weeks or months of prechilling before the will actually germinate.

The Opening of A Dolls House :: A Dolls House Essays

A critical analysis of the opening of the play A Dolls House. In the opening of the play "A Dolls House" ,the setting of the stage is of a house portrayed as if it were a dolls house. The items described in the house are all small therefore representing a dolls house where all items are miniature, the type of furniture owned , such as a piano, show that the family is moderately well off. There is no narrator in the play and all information and knowledge about the character is gained from listening to conversations. Ibsen has incorporated relevant information into conversations, this seems like a natural situation and makes the audience feel like they are looking onto a real house with real people. This means that the actors will have to act well so as to show audience with out seeming as if they are telling them. This means Ibsen had to write the opening of the play not only telling the audience what is going on but what has gone on. Nora is the first character introduced, and is shown entering the house on her own, the first sentence spoken in the play is said by Nora, this is to do with concealment and money. "The children mustn't see. How much is that?" This is significant to the rest of the play as these are two main themes used through the play. When Helmer (Nora Helmer's husband) enters he is then shown through out of the rest of the opening and the play, to treat Nora like a child using methods such as control and speaking to Nora in a patronising and child like manner. In the conversation between Nora and Helmer, Helmer refers to his wife as if she were inferior in the relationship using terms such as "songbird" and "squirrelkin". Nora in return replies to Helmer also using child like talk, such as referring to money as "pennies and pennies". Nora is also shown to be generous with money as she is tells the porter to "keep the change" this is an immediate indication that Nora is not worried about spending. Helmer also states that when Nora gets money it "melts in (her) hands" suggesting that she does not save .Nora's attitude towards money is also shown later in the opening when she shows no concern of borrowing money and being in debt. Nora also shows lack of feeling towards other people and there situation as long as she is ok , this shows a selfish nature as she says "why would U care if I still owed people money".

Wellness :: essays research papers

  Ã‚  Ã‚  Ã‚  Ã‚  The wellness wheel couldn’t have come at a better time because I’ve recently been trying to change my dieting and exercising habits, as well as the way in which I feel and look at myself. Knowing that my answers to some of these questions could be completely bias, I realize that the wellness wheel is how I look at myself in my perspective. Others could have different opinions about how I score myself.   Ã‚  Ã‚  Ã‚  Ã‚  I found that I did very well on section eight, scoring a perfect twenty. Now, that is just how I felt at the time I took the test. Different answers and scores could appear at different times depending on my mood. Section eight was about wellness with playing and working. I feel I did very well on this particular section because I know how to separate work from play. I know when and how to work hard; and I’m very proud of the things I do and my accomplishments. On the other hand, I know when I’ve been working too much, and personal enjoyment away from work is almost like therapy to me. I think that the way I work is what enabled me to do so well in this section. I usually enjoy work, and I always try to turn work into an enjoyable activity, instead of â€Å"work†. I feel that if you work hard, you should play hard too.   Ã‚  Ã‚  Ã‚  Ã‚  The main areas that I scored low in are the areas surrounding diet and exercise. Throughout my life, up until the past couple of years, I’ve always been extremely athletic and did some form of exercise regularly. However, now that I have more responsibilities; working full-time and going to school full-time, I’ve notice that I have slipped from exercising regularly, to not exercising at all. I’ve become a couch potato, figuring that I put so much time and effort into work, that when I get home I should sit on the sofa and plop my feet on the coffee table, eating junk food till my stomach erupts. I know this isn’t me, and I don’t want to be a couch potato for the rest of my life. However, this horrible habit that I’ve developed is a cycle that spirals downward leading me to unhealthy obesity. I’m only 170 pounds, still in shape, but on the verge of gaining an actual beer belly. I need to break the cycle and set a rou tine exercise plan for myself that will also include a relaxed diet.

Last Words Essay

Her last words will live forever with me. The night before my grandmother died we said our last good-byes in hopes that she would rest in peace knowing that we loved her. I had known her for 35 years, and in those 35 years we had become extremely close. She was not only a grandmother to me but also a friend and a confidant. I feared the day that I would have to deal with the pain and the realization of losing her. Although I knew that day was coming, I didn’t want to let her go. She passed away almost ten years ago, in October, but it still feels like yesterday that I was standing over her deathbed and telling her that I loved her for the last time. I am just now coming to grips with the pain and loss I feel when I think of her. My family and I were sitting down at home having dinner, and we received a phone call. My mother answered the phone. It was a nurse calling from â€Å"Saint Francis Medical Hospital†, where my grandmother was a patient in intensive care unit (ICU), also known as a critical care unit (CCU). The nurse said to my mother, â€Å"Fermina is not doing very well and she might not make it through the night. You and your family might want to come and say your â€Å"good-byes.† My mother’s tan face turned pale white, and tears began to fill her deep brown eyes. She looked as though someone had punched her in the gut, as a long tear came down her face and a look of fear and sadness had over taken her to a different world. After she got off the phone she was shaking like a naked child on a cold night. Through great gasps of breath she filled the family in on what was going on. My mother was very upset to drive so I had to drive to the hospital. We wanted to be by my grandmot her side. In silence we reached our destination, and I was extremely hesitant to go in because I knew what I had to face. I was afraid of death, of losing my grandmother. When I found enough courage to at least enter the hospital ICU unit, I felt emptiness inside of me that I had never felt before. I was cold and the halls were dark, almost like I had entered a dungeon. As we were walking, my family and I passed the nurse’s station. I could tell that they  recognized who we were because the heavy-set one with red hair curled in a bun atop her head began to cry, and the other nurse that look thin as a noodle with brown hair even ran toward us and gave us hugs and her condolences . Trying to fight back the tears, the nurse said to me sadly, â€Å"Your Nana loves you very much; every time she sees you she gets a twinkle in her eyes.† As we embraced I began to think about all the times that I was with my Nana and how much fun we had. I began to cry. Sobbing, I realized that time was passing by and that I had not yet seen my grandma. Not wanting to accept the fact that she was going to die, I reluctantly began to walk toward her room. My shoes made slight squeaking sounds, but all I could focus on were the rectangular square white ceiling tiles and the sadness in my heart. The hallway that led to her room was dark and dreary; it smelled slightly of urine. There was a slight draft, and I heard the other residents moaning for help. I was horrified—reliving that feeling I got the last time I was in a haunted house. It seemed like the hallway had gotten so much longer since the last time I had walked down it. As I approached the thick, brown wood door, there was a blue and white nametag on it (about the size of a Pop Tart) that said â€Å"Fermina Pellot† in large, black block letters. I was not ready to go in and see my grandmother in her death bed. However, it was time to face the music; the moment in my life that I never wanted to happen was right before me. I chose to stay outside and get my composure. I watched my father and sobbing mother go in and say their good byes, and both come out with tears streaming down their faces. â€Å"Is she talking?† I asked. â€Å"Not a word,† cried my dad, his stern, olive face now broken red with sadness. It was my turn; the thought of not even going in crossed my mind, but I knew I would regret it. Hesitantly I took one step into her room, and I saw one of my most favorite people in the world laying in the bed on the left. She just lay there with her eyes softly closed in a state of tranquility. I smiled at her, and she did not respond; at that time a sense of loneliness overcame my body. Her complexion was transparent, her body skinny and fragile and her light pink mouth was gapping open. I walked closer to the bed and she began to breathe heavier and heavier. She could sense my presence. I reached for her hand,  and it was ice cold. It was difficult for me to see her like that. There was so much that I wanted to say, but the words caught on the lump in my throat. Forcing them, I spoke loudly in hopes that she would answer, â€Å"Hi, Nana; it’s me Luis. We just came to see you, and it looks like you’re not doing very well. I brought you your favorite drink, Coca Cola.† No words came from her mouth, not even a whisper. But she gave my hand a squeeze. I leaned over the rail on the bed and gave her a hug. I pushed back her spider-web-like hair with my mouth and whispered to her â€Å"When you leave you will be taking a big piece of my heart, but you will be leaving an even bigger piece of yours.† Having not said one word all night, she looked up at me and whispered loudly, â€Å"Mijo (son), I love you so much,† as a tear trickled down her face from her right eye. Then she returned to her comatose state. I wiped the tear off of her face and said, â€Å"I love you.† Even though that was one of the worst feelings that I ever had, it was also a relief to know that she loved me. That night left me empty and sad, but when I woke up the next morning, I knew that she had passed, and I was okay with it because I knew that she was in a better place. Even though Nana is gone and it has almost been 10 years since her death, it is still hard to fathom the idea that she is no longer physically in my life. I miss her, but I know that she loves me because of her last words. She still lives on within me and her words carry enormous weight. More than we sometimes think. They often impact people for decades, providing the courage to press on or one more reason not to give up on life.

Childhood Obesity Essay Introduction Essay

Introduction fleshiness is a sound and major health complication alter to 112,000 deaths annually most of which ar preventable. corpulency is to a condition where excess avoirdupois has collected in the luggage compartment has to the train of adversely bear upon ones health. There is no general accord on the lowest explanations of obesity in adolescents and children. Therefore, most professionals accept the guidelines published on bole mass index number (BMI) to broadside cases of over charge in children and adolescents. The increase of obesity among children in 2008 increase from 5 sh be to 17 percent in the aforesaid(prenominal) year. This paper will focus to look for the causes of obesity in children and come about methods on how it heap be prevented. One is considered as orotund or overweight when his or her body mass index BMI exceeds 30 kg/m2) (Flegal, 2000).Body mass index is obtained by measuring an individuals weight in kilograms relative to his or her hei ght in meters. Presently obesity is the widest spread medical problem affecting children and teenagers in developed countries like the join States. Other measure of obesity accommodate a) Weight-to-height tables- These tables define being overweight and give ranges for a healthy weight base on the height of a teenager or child. b) Body modify percentage- fill in a percentage of body weight, is a strong indicator of obesity. Boys argon regarded corpulent when their body blubber is above 25 percent and girls over 32 percent. obesity has profound effects on the flavor of a patient by change magnitude the possibility of contracting change of illnesss. The future(a) are health consequences of obesity gibe to Center for Disease Control and legal community (CDC). Cancers (breast, endometrial and colon)Coronary heart distemperHypertensionStrokeType 2 diabetesDyslipidemiaOsteoarthritisGallbladder and liver and diseaseGynecological problems (infertility, abnormal menses)In d o-gooder to the health consequences above, obesity puke overly create social, as well as, aflame problems to an individual or patient referable to the stigma associated with one being overweight.Causes of obesityPhysical exercise and dieting are among the best ways for tr eating obesity. One can improve his or her diet gauge by reducing the intake foods generative in cipher, e.g. those high in sugars and fat and increasing the consumption of dietary fiber. Drugs much(prenominal) as anti- obesity medication drugs may be taken to write down craving or inhibit the absorption of fat. A gastric balloon may enable one lose weight if exercise, medication and diet are non effective. process may also be performed to lower stomach volume and or catgut length. This leads to earlier satiation and reduced baron to absorb nutrients from food. Below are both(prenominal) of the major causes of obesity (Ferry, 2011).Physical inactivity- The increased use of computers, video games and tv sets go by and large contri preciselyed to an inactive lifestyle for many teenagers and children in developed countries like the U.S. On average, teenagers and children in the United States of America spend tierce hours daily watching television. This form of recreation not only uses little strength but also encourages eating of snacks. whole one-third of children in the United States engage daily physical exercise instruction in school. Dietary habits- The eating habits of teenagers and children have shifted away from healthy foods such as vegetables and whole grains to enormous reliance on fast foods, sugary drinks and eating tasteful snacks. These foods tend to contain high levels of fat or calories but low in essential nutrients. Unhealthy eating habits include eating when not hungry, watching television while eating or eating while doing homework e.t.c. Genetic factors- some families tend to have obesity.Parents who are obese tend to have obese children. It is ra ttlingcrucial to note that obesity does not occur through genetics alone, but when one eats more calories than he or she uses. Socioeconomic status-Non working parents or families with low incomes are more in all probability to consume excess calories for a abandoned level of activity. Specific medical conditions can cause obesity but are rare. This includes inherited disorders of metabolism, hormone or chemic imbalances. Certain medications can alter how the body stores fat or processes food, thus resulting to weight gain. There is limited evidence to shop the fact that some multitude who are overweight eat little tho gain weight due to a slow metabolism. Obese people get hold of more energy expenditure than people who are thin due to the energy required to maintain their massive body mass. ConclusionObesity is considered a major cause of deaths worldwide with increasing preponderance in children, teenagers and adults. The American nubble crosstie has guidelines for health y children and families. It recommends that one should eat decent calories and eat a wide variety of foods to obtain adequate nutrition. It also recommends that the enumerate cholesterol taken per day should be less than 300mg. These guidelines are only applicable to children above two years of age. It is prerequisite for everyone in the family to apply these guidelines and not adept those who are obese. Schools should introduce anti bullyrag campaign to assist overweight children. The biggest responsibility falls on parents to ensure their children come up healthy eating tips.ReferencesAmerican Heart Association. Dietary Recommendations for Healthy Children. Apr. 19, 2012. . Ferry Jr., R.J., ed. forage and Health Management of Pediatric Obesity and Diabetes. New York Springer Science+ ancestry Media, 2011 416. United States. Centers for Disease Control and Prevention. puerility Overweight and Obesity. Apr. 27, 2012. .