Both sides of free trade Research Paper Example | Topics and Well Written Essays - 1750 words

Both sides of free trade - Research Paper Example ironmental sustainability, the citification mechanism of producers in exporting countries and certification of products in importing countries and creating awareness of such products among consumers of the developed world (Singh, 2001). On the other hand free trade is a global effort to carry out international trade free of negative protectionist practices such as higher tariffs on imports, subsidies to domestic producers, foreign exchange restrictions, dumping cheaper goods abroad, imposing dubious standards on imports and import substitution by propping up unwieldy domestic industries. Theoretically free trade is based on neoliberal economic principles dating back to Ricardo’s argument on the principle of comparative advantage. Free trade and fair trade aren’t necessarily the same though some of the ultimate outcomes would converge. In fact divergences between the two are many and if free trade were practiced with full force indeed, fair trade would take a back seat. Globalization has been the catch word used by many who advocate free trade. Such people vehemently support all and everything in the name of free trade. On the other hand fair trade is a distant cousin of free trade. An inevitable aspect of this relationship between the two is that the former is marginalized while the latter is well placed at the center of the global market. Fair trade is essentially replete with intricate nuances ranging from market access facilitation processes to marginalized producers to sustainability efforts. Such noble principles need some theoretical and conceptual frameworks to support them though. Free trade theories are many while the principle of comparative advantage is the most predominant among them. The basis on which free trade is advocated by its supporters is determined by a series of arguments which in turn are associated with neoliberal perspectives. In the first place globalization is the logical premise used by supporters of international free trade to

The Media Effect: Male Body Image

The Media Effect: Male Body Image Many men and women are in the midst of a fight for that perfect body depicted by the media. In the UK the average man is 5ft 9ins tall and weighs 13.2st while the average woman is 5ft 3Â ½ins tall and weighs 11st (Whitlock, 2009). Researchers investigated the perception of ideal body weight in both men and women and found 38.3% of normal weight women thought they were overweight, while for men 32.8% who were overweight thought they were about the right weight or underweight. (Christakis, 2003) Men tend to see themselves as being thinner than they actually are and have a desire to become bigger (Mintz, 1986). A study of around 1000 men found that over 50% were unhappy with their bodies. They were asked to draw their ideal body and researchers found that the body ideal was so muscular it could only be achieved by using steroids. (Croft, 2009). Some Psychologists speculated that media influences shaped peoples idea of body size by presenting thinner women and bulkier men than average. (McCreary Sadava, Vol 2(2), Jul 2001). Studies by The Eating Disorders Association shows that around 1.15 million men and women in the UK suffer from an eating disorder with 61% of women feeling fat compared to the medias image of beautiful women. (National eating disorders Association). Another worrying thought is that most fashion models are thinner than 98% of American women (Smolak, 1996).As women are constantly surrounded by such models in TV adverts, magazines, news articles amongst other things; its not surprising that they find this level of thinness the ideal. Wiseman et al conducted a study on Cultural expectations of thinness in women. They found that the body measurements of playboy models for 1979 1988 were up to 19% below the average body weight for their age group. These findings were compared to an early study between 1959 and 1978 and found that body measurements had decreased while there was a significant increase in diet and exercise articles during this period suggesting that there is a link between to the two. (Wiseman, 2006) In studies on media and body image, most of the research is directed towards women. This means that men are often forgotten. As men are increasingly characterised by their body, I aim to highlight the effect of media on them. (Henwood, 2002), says that the media presents ideals for men as well as women. patterns of consumption, life style choices and media representation of men now often focus on mens appearance and the male bodymedia advertising routinely depicts in positive ways youthful toned muscular male bodies. Psychology Today readers completed questionnaires on body image in 1993 and found The muscle-bound body build was highly rated by men, while women preferred a medium, lightly muscled build in their ideal males. (Neimark, 2009) It seems that men are influenced by the media and not by real women. The use of men in media may have a substantial effect on the way males view themselves. A muscular toned body is being used in much the same way as the thinness ideal for women. Mens Health magazine is spilt into 6 subsections compromising of Fitness, Health, Weight loss, women, nutrition and grooming. This shows that males are being made to think that their weight is not ideal and to bulk up to look like the men portrayed in the magazines. On the mens health website, there are links to a new way to sculpt your abs and build the body you want on a back ground of a super toned males torso. (Moore, 2010) Attitude is the best selling gay magazine in Britain and is also distributed worldwide. (Gilmour, 2008) In the latest issue of the magazine, Gareth Thomas, a gay rugby player, is the front cover. He has huge leg muscles, a big chest, and muscular arms, making it seem that this is what men like, and so the readers will strive to become like this. (Attitude Homepage, 2010) It has been proposed that males have become more muscular and toned in an attempt to be more masculine. Soft and rounded is traditionally seen as the female ideal, while males are the opposite. So by working abdominal muscles to achieve the much desired six pack is an attempt to hold this masculine ideal. (Henwood, 2002) Studies into male body image have begun to show that men have as much displeasure with their shape as do women. This is not just found in the UK but all over the world. Pope el al (2000) found that men from France, US and Austria chose an ideal body shape that was heavier and more muscular than them. They also believed women preferred that body shape too. Women are willing to settle for their own mates appearance, accepting extra weight, even though their ideal male is different. Males are not as worried about being overweight as women, but more troubled by muscle mass, showing our cultural ideals of men. The muscly body build was preferred by men, while women liked a medium, lightly muscled build in their ideal males. (Neimark, 2009) The old ideal of maleness has been replaced. The New York Times writer Natalie Angier says that boys of school age are now being diagnosed of hyperactivity and having learning problems just by being a typical male. So as the behavioural ideal has changed so has the ideal male body. It is more muscular but also in contradiction, quite feminine. Schwartz conducts studies in America on gay men he says that the male body clean skinnedNo longer stiff and upright but sinuous representing the feminine side. (Blashill Vander Wala, 2009) Men are now exercising more than ever with around 8.5 million having a gym membership. The American Sports Data company found that those men with memberships spend a mean of 90.8 days a year in a gym. This could be linked to males trying to become what they believe women want, judging by how the average male is portrayed in the media. The gender gap in the way the media present the body has closed. The unattainable female bodies shown now have a male equivalent, the V shaped physiques of male models everywhere in todays media. George Gerbner the founder of the Cultivation Theory, which looks at whether the media has a long term effect on audiences, such as body image, said that what we see on TV and in magazines eventually becomes our standard of reality and desire. (Seed, 2006) Schooler and Ward measured the male real body discomfort due to media consumption. They found that by watching television it made men feel uncomfortable with their bodies. People see the same images over and over and start to believe its a version of reality, if those bodies are real and thats possible, but you cant attain it, how can you not feel bad about your own body? Mens bodies are being used more often to sell products. Dolce and Gabbanas (shttp://amandagore.files.wordpress.com/2009/01/dg-ad.jpg) ad contains 4 males with the V shaped body that has become so popular today. The male modelling for Jean Paul Gaultier in the advert for aftershave has a body most men are striving to achieve. He has very muscular figure and is topless in the picture. (http://www.mimifroufrou.com/scentedsalamander/images/Le-Male-2009-Billboard-B.jpg). Men are spending more time and money on fragrances, facial creams and hair products. By presenting males in the media this way to sell products, males may believe if they take more care with their skin and buy all this products they will achieve the look of the airbrushed models. In this sense the media is endangering mens health by promoting these images, but will not stop willingly as the beauty industry has such high revenue. The big question is whether the media and our culture are truly to blame. Jeffrey Yang from Harvard University looked at the differences in body image in men from the west (Europe and America) against men from Asian countries. He found that men in Taiwan were satisfied with their bodies and had a lower use of steroids compared to men in the West. Also, unlike in the west, there were no Taiwanese magazines for fitness or bodybuilding. (Cromie, 2005) This seems to suggest that the media are to blame as there were no pictures of super fit males in magazines promoting exercise, and fewer men used drugs to achieve the figure desired. If someone has a poor body image, they might take steps to change their body, even if it taking potentially harmful substances. Anabolic Steroids are described as being any of a group of synthetic steroids or hormones used to stimulate muscle and bone growth; sometimes used illicitly by athletes to increase their strength by steroid.com (http://www.steroid.com/drugprof.php) Anabolic steroid abuse has been associated with a lot of side effects. Examples include acne, and breast development in males, which although unsightly are not severe. However other consequences of taking steroids can be life threatening such as heart attacks due to high cholesterol levels and liver cancer (National Institute on Drug Abuse, 2006). Those who inject the drug also risk getting HIV ( InfoFacts: Steroids (Anabolic-Androgenic), 2008). Is taking steroids to get a hench body worth it? The U.S. Census Bureau says there is a total population of around 301 million people. The National Centre for Education Statistics believes that of this 301 million, 16.5 million are school children between 9th and 12th grade. The Centre for Disease Control and Preventions (CDC) says the percentage of students who admit to a lifetime steroid use was 4%. This means theres an estimated 660,000 students (14 to 17 years of age) whove admitted to steroid use. (ASA) Not to mention those unreported. This is a huge figure. Although this doesnt make a direct link with steroid abuse and the media, it can be inferred that these teenagers are taking steroids to get the body of the media male. Boys and men who are not happy with their body have been found to try and put weight in the form of muscle. (McReary Sasse, 2000) And steroids do this. The medias depiction of what is normal keeps getting for women and more muscular for men. Female models 25 years ago weighed only 8% less than average; currently the figures stand at around 23%. Male models are seeing similar things. In the past 25 years the media male has lost 12lb of fat but put on 27lb of muscle. (Body Image Website) With these ideal bodies represented in the media, its not surprising that males and females are turning to extreme measures to deal with their bodies. According to the ladies room, only 5% of women have the right genes to ever attain the Barbie shape. The body ideal for men is also almost unachievable, without illegal steroids and there is a limit to how much muscle a man can get naturally. (Tart, 2009) Although there is not a direct link between males body image and the media, it is implicated in many previous studies. Further research would be beneficial.

the patriot Essay -- essays research papers

THE PATRIOT   Ã‚  Ã‚  Ã‚  Ã‚  The Patriot, directed by Roland Emmerich has to be one of the most patriotic films I have ever seen. This film focuses on merit, and how people of all backgrounds worked together for one cause: freedom.   Ã‚  Ã‚  Ã‚  Ã‚  The movie for the most part is accurate, even though most commentators have a different standpoint. Many of us are aware of the revolution and other important historical events. But, what we have to put into perspective is they the way all of these historical events have been perceived.   Ã‚  Ã‚  Ã‚  Ã‚  The movie's protagonist is Mel Gibson playing the role of Benjamin Martin. Benjamin Martin is a South Carolina planter who is still haunted by his notoriously brutal past as a soldier in the French and Indian War. When the American Revolution comes, he chooses not to fight for the Continental Army because he wants to protect his family. But when the British Colonel Tavington threatens their welfare and kills one of his sons, he chooses to enlist. Martin becomes the leader of a makeshift militia, which consists of peasants, slaves, a minister, and other irregulars. During the war Martin and his men discover that they will pay a steep personal price for their rebellion, but are still willing and will go in with it. Thanks to their courage and bravery since July of 1776 through the Declaration of Independence every American is granted rights that must be enforced.   Ã‚  Ã‚  Ã‚  &nbs...

Carl Robbins Case Study Essay

Carl Robins is a new campus recruiter who is on the fast track to success. However, as a new employee, he is not fully informed on processes of the company. From my analysis, I conclude that Carl Robbins is not organized and did not assemble training plan for the new recruits. New employees can acquire a situation too deep and too fast. It takes at least six months to a year for someone in a new position to understand his or her role within a company. Carl Robins is doing too much too fast. A plan needs to be in place and reviewed before any new trainees were hired. Background  Carl Robins, a new recruiter with ABC, Inc., has a dilemma. Because a training plan was not put in place and the proper research was not done, Carl runs the risk of an unsuccessful orientation. Carl’s position has the role of coordinating tasks and gathering information for new people coming to the company. If the process is unsuccessful, it will leave a bad impression with not only Monica Carrolls, Operations Supervisor, but the new trainees as well. As the coordinator, Carl has not put in the research required to obtain the information needed for the trainees. Key Problems  Several problems exist for Carl Robins. The first issue is that he is six months into his position and is not aware of certain policies and procedures within ABC, Inc. The next issue is that a training plan does not exist for Carl to follow to make sure trainees meet the requirements. Last, being new to his position Carl did not do the research or ask questions on what needed to be done. He just assumed. An action plan or schedule should be active before the new trainees were hired. Carl did not prepare for the orientation; he runs the risk of not possessing the space or materials to conduct the orientation. Alternatives  Preparing a group of people in a new environment to do a job takes time and planning. In my analysis I have found several alternatives to solve Carl’s problem. First Carl needs to confront his supervisor and explain that he is not prepared and what went wrong. At that time, Monica and he can work together to get the manuals and booklets prepares, drug tests and physicals scheduled, and talk to technology services to work out an agreement for access to the training room. Carl will have to work diligently to contact the trainees and update them on the new information. If all goes well, the orientation will be successful. The second route would be to create a list of tasks that need to be completed for the training in order of importance and due dates. The next step would be to meet with the operations supervisor to get her input, and ask any questions he may not know the answers to. Asking questions and staying organized leaves little room for error. Once Carl has met with his supervisor, he should keep track of what tasks are complete and when completed. Carl should also keep the trainees informed of any issues and forecast any problems that arise. Reccomendations  Carl Robins is a new employee eager to prove himself. Carl has a great deal of confidence but he let it get in the way of his responsibilities. I would recommend my second alternative, which requires Carl Robins to make a list of all tasks that need to be completed and keep his supervisor involved throughout the process. This way Carl can get insight to policies and procedures of the company. The supervisor may also be able to forecast any problems that may arise with his training plan from her experiences. I would also recommend that Carl practice time management and communication skills to help him learn how to approach situations such as the current one. In any organization there are individuals who like Carl, are just starting out and believe they can conquer the world. Some people let their confidence level get in the way of success. Carl Robbins has a responsibility to the new trainees to prepare them to do a job. Because this is his first recruitment effort, Carl is already not meeting expectations. Anyone in a recruiter position should be knowledgeable and have an action plan. If my recommendations are put into action, Carl Robins will lead a successful orientation.

Chapter 2 Thesis Enrolment System

Notes on Philippine pre-colonial literature Notes and anecdotes on Philippine pre-colonial literature, mostly taken from my Filipino 14 class under Mr. Popa. The pre-colonial period in the Philippines is the longest chapter in the country's history. Yet it is also the darkest chapter in history, with very few records extant. The lack of knowledge concerning the period stems from the lack of resources concerning this era, brought on by the perishability of the items produced during those times.Having a strong affinity with nature, the early Filipino communities produced items molded from the raw materials in the region, mostly from plants and trees. Another reason was the Spanish colonization of the Philippines. The Catholic friars who were tasked with converting the â€Å"uncivilized† natives demonized the pre-colonial culture, seeing the beliefs of that era as a threat to their mission to spread Christianity in the land. Only a few manuscripts still survive to this day, mostl y done by Spanish priests who had immersed themselves in the community in an attempt to decipher their ways.One of the most important was the Vocabulario de la Lengua Tagala by Fr. Juan de Noceda and Fr. Pedro San Lucar (1734), an anthology of early oral lore that preserved many examples of pre-colonial literature. However, despite the Spanish teachings, Philippine pre-colonial culture was not as barbaric as it had been made out to be. The presence of a bustling trade economy with Chinese and Muslim merchants existed long before the landing of the Spaniards. The oral literature in existence during that time also displayed a sense of sophistication beyond that of simple barbaric cultures.Anitism, a term coined by Stephen Hislop, refers to the religion prevalent in the religion at that time. The early Filipinos believed in the presence of  anitos, primordial forces of nature that could accompany or possess people. Filipinos also held the principle of  loob  with great importance . Loosely translated,  loobmeans inside. Loob  is also a vague reference to the soul. An attempt to explain  loob  may proceed as follows. The concept of  loob  can, first and foremost, be related to the concept of a soul. It is something that resides within the person.However, it is not corporeal, or as specific as a soul; it is a vital part of the person but not the person in his/her entirety. Loobis also related to space and trust; with the phrase  malapit ang loob ko sa iyo  (malapitmeaning near) referring to a person's high trust level with the other. Loob  is also a personal space, something sacred to the person that belongs to him alone. The Filipinos were also well-endowed in the area of literature. A long-standing oral tradition that still survives in remnants to this day traces its roots to the pre-colonial period. Philippine literature employed everyday language, and was a communal activity.As such, the social relevance of literature during that time was very important. Themes included the daily routines of the community, living in accordance with nature and living within the community. Literature was the primary expression of the community's experiences, beliefs and emotions. Filipino pre-colonial literature followed certain conventions. Due to its oral nature, most stories had a formulaic method of construction. This was reinforced by the duty of literature as a reflection of the communal belief and experience; the repetition of themes highlighted the prevalent qualities of the region's culture, and identity was thus embodied.The oral tradition also refined the structure of pre-colonial literature, employing the use of rhythm and rhyme to great effect. Rhythm and rhyme distinguished literary pieces from normal conversation while employing the familiar everyday language that everyone in the community understood. These devices also made the pieces easier to remember and retell, while allowing the storyteller to associate the rise a nd fall of tone with the appropriate portions of the story.Philippine literature possesses a deep level of sophistication, seen in the organic unity of language, theme and relevance within each piece. The use of common language did not prevent the pieces from obtaining a touch of elegance that set it apart, a testament to the literary ability of the pre-colonial culture. Literature was a vital tool for community cohesiveness, rooted in the foundations of language as a tool for survival. Banding together to overcome the dangers of the wild, literature took on communal themes that promoted a sense of togetherness throughout the locals.Literature also reflected the affinity of pre-colonial Fipinos with nature, with the use of colorful metaphors and vivid backgrounds to enhance the story and express their appreciation of nature itself. Literature is such an integral part of pre-colonial Philippine culture that it was one of the methods employed by the Spanish in order to convert the Fil ipinos towards Christianity. However, the Filipinos were intensely critical of these Spanish pieces, largely due to their inability to relate them to their communal beliefs.

Free Essays on Philosophy

Can Descartes be certain that he is thinking? How? Can he be certain that he exists? How? (And who is he?) Descartes’ statement â€Å"I think therefore I exist† raises questions about the meaning of thought, the meaning of existence but most fundamentally, in what sense he can be certain. The difficulty in establishing the certainty of â€Å"I think† and â€Å"I exist† is that the two concepts are interrelated. Thus, for example, differing interpretations of what it is to think will have a profound impact on the question of whether Descartes can achieve the certainty of his existence. The success of his attempt to achieve certainty can be analysed in relation to how far he overcomes the universal doubt he has introduced in the first meditation. It is in this sphere of meaning that â€Å"I† becomes very relevant as it is possible to argue that his use of â€Å"I† demonstrates that his own interpretation of what is certain is partially based on intrinsically held beliefs. Williams describes the statement â€Å"I think† as indubitable. This is because â€Å"if anyone believes he is thinking or that he exists then necessarily he has a true belief.† Using the Cartesian method, the statement that â€Å"I think† is unique because it is the only premise that has the property of having its truth confirmed by the act of doubting it. Descartes demonstrates that he has found a statement that is not defeated by the possibility of a ‘malicious demon’ when he says â€Å"If I am in doubt, if I am entertaining the possibility that I might be deceived, then the very fact that I am around to entertain that doubt shows that I must exist†. Thus he is already assuming that his ability to entertain doubt, or â€Å"think† is certain, which based on the premise above, is a not unreasonable conclusion. Before further examining his assertion that he is thinking, the question of what Descartes means by thinking must be defined. In the simplest form, possible d... Free Essays on Philosophy Free Essays on Philosophy Philosophy is an interesting subject in the fact that it is not based solely on science, mathematical formulas, and chemical equations, but more on the idea of ethics, morals, and values which in turn is based on perception, interpretation, education, and religion, just to mention a few. Different cultures appear to have different values compared to my own and at times I often wonder whether these different cultural values morals and ethics are good or bad? The interesting fact is that it is not my place to determine whether they are or not, but to accept the difference, and either try to understand them or disregard them. If I do choose to accept them, I have the option of incorporating them into my own beliefs. If we look at Kant’s theory of Good Will, you’ll find that if what you do or believe in is in good faith, meaning done with good intentions, that the outcome is rather irrelevant due to the fact that it was done out of good intention. I personally believe that good intention is something handed down from generation to generation based on parental belief, which could possibly come from religion in some way or form even if they are not religious. The questions posted are, why do different cultures ethics, morals, and values differ? Do I believe in Kant’s theory? And if religion were not to play a role in morals and values where would they come from? In my opinion, different cultures carry different perspectives on life, and yes I do believe in Kant’s theory, and lastly, I’m not sure morals and values cannot come from religion, at the very least, from many years before, when life was more in a barbaric stage of living. Why do different cultures ethics, morals, and values differ? I don’t think there is any one answer to this question because ethics, morals, and values are a compilation of different perspectives and interpretations of what is right and wrong. What may be right here in America, may not seem righ... Free Essays on Philosophy Aristotle Aristotle was born in 384 BC and lived until 322 BC. He was a Greek philosopher and scientist, who shares with Plato being considered the most famous of ancient philosophers. He was born at Stagira, in Macedonia, the son of a physician to the royal court. When he was 17, he went to Athens to study at Plato's Academy. He stayed for about 20 years, as a student and then as a teacher. When Plato died in 347 BC, Aristotle moved to Assos, a city in Asia Minor, where a friend of his named Hermias was the ruler. He counseled Hermias and married his niece and adopted daughter, Pythias (wierd names, huh). After Hermias was captured and executed by the Persians, Aristotle went to Pella, Macedonia's capital, and became the tutor of the king's young son Alexander, later known as Alexander the Great. In 335, when Alexander became king, Aristotle went back to Athens and established his own school, the Lyceum.Since a lot of the lessons happened when teachers and students were walking, it was nicknamed the Peripatetic school (Peripatetic means walking). When Alexander died in 323 BC, strong anti-Macedonian feeling was felt in Athens, and Aristotle went to a family estate in Euboea. He died there the following year. Aristotle, like Plato, used his dialogue in his beginning years at the Academy. Apart from a few fragments in the works of later writers, his dialogues have been wholly lost. Aristotle also wrote some short technical writings, including a dictionary of philosophic terms and a summary of the "doctrines of Pythagoras" (the guy from the Pythagorean Theorem). Of these, only a few short pieces have survived. Still in good shape, though, are Aristotle's lecture notes for carefully outlined courses treating almost every type of knowledge and art. The writings that made him famous are mostly these, which were collected by other editors. Among the writings are short informative lectures on logic, called Organon (which means "inst... Free Essays on Philosophy Can anybody ever truly think outside the box? In our subconscious mind lies everything we were taught growing up and everything we have heard, but maybe not noticed. I am no great scholar and I am barely starting school at Brazosport College in Texas. But, I have many ideas waiting to be written down on paper and I intend to start tonight, on June 16, 2004. As I was saying, today in school, we talked about Benjamin Franklin and Ralph Waldo Emerson. They were two great American writers as well as thinkers. Benjamin Franklin believed you should strive for self excellence and that greatness occurred while serving your country as well as your community. I think just a bit deeper than that. First of all, what is our country? It is many people gathered together trying to maintain stability and hopefully grow. But Why would they want to do this? Many people say that they do it for our future, and for our children’s future. I think that everybody is at some point, selfish. By helping others, these people fill an emptiness inside themselves that I believe was placed intentionally by some divine power. Everything we do has to fill some kind of emptiness inside ourselves. That’s why we help others and try to be â€Å"good† citizens. Don’t get me wrong, I am definitely not anti-government, and if I wasn’t afraid to die, I wouldn’t be writing this right now. In fact, my writing this and jotting some thoughts down is actually filling an emptiness that was placed inside of me. I have no idea why, but for some reason, it is there. I know that the greatest question that philosophers can ask is why. Why did this happen? And why did it have to happen in this way? Even still, I ask you why do we go on with our everyday lives. A typical morning for me would begin with waking up. I would then proceed to the bathroom and brush my teeth. Then, I eat, dress myself, and go to work at Buc-ees, a local convenience store... Free Essays on Philosophy Can Descartes be certain that he is thinking? How? Can he be certain that he exists? How? (And who is he?) Descartes’ statement â€Å"I think therefore I exist† raises questions about the meaning of thought, the meaning of existence but most fundamentally, in what sense he can be certain. The difficulty in establishing the certainty of â€Å"I think† and â€Å"I exist† is that the two concepts are interrelated. Thus, for example, differing interpretations of what it is to think will have a profound impact on the question of whether Descartes can achieve the certainty of his existence. The success of his attempt to achieve certainty can be analysed in relation to how far he overcomes the universal doubt he has introduced in the first meditation. It is in this sphere of meaning that â€Å"I† becomes very relevant as it is possible to argue that his use of â€Å"I† demonstrates that his own interpretation of what is certain is partially based on intrinsically held beliefs. Williams describes the statement â€Å"I think† as indubitable. This is because â€Å"if anyone believes he is thinking or that he exists then necessarily he has a true belief.† Using the Cartesian method, the statement that â€Å"I think† is unique because it is the only premise that has the property of having its truth confirmed by the act of doubting it. Descartes demonstrates that he has found a statement that is not defeated by the possibility of a ‘malicious demon’ when he says â€Å"If I am in doubt, if I am entertaining the possibility that I might be deceived, then the very fact that I am around to entertain that doubt shows that I must exist†. Thus he is already assuming that his ability to entertain doubt, or â€Å"think† is certain, which based on the premise above, is a not unreasonable conclusion. Before further examining his assertion that he is thinking, the question of what Descartes means by thinking must be defined. In the simplest form, possible d... Free Essays on Philosophy For this assignment I decided to report on the bible. I choose this book because it’s something that I’ve grown up learning about and it speaks on everything that this assignment consists of. Growing up in church, I’ve found that reading the bible helps you in everyday life. Life, death, justice, morality, power, society, reason, and divinity are all topics covered in the bible. I’ll start with life because that's where it all began. The first story that comes to mind when speaking of the bible usually is Adam and Eve. This story begins in Genesis, the first chapter, starting at verse 26. God creates man and calls him Adam, and from Adams rib he creates woman and calls her Eve. They lived in perfect peace until Eve was tempted by a serpent and ate from a forbidden tree called the tree of life. After she ate from the tree, she went and had Adam do the same. Before eating from this tree they had no knowledge of being naked, but once they had, they quickly covered themselves with leaves. I’ve always found this story to be interesting because if Eve had never eaten from that tree as she was told, things possibly wouldn’t have changed. The whole world possibly could be walking around naked in peace without knowing. One thing that the bible speaks of a lot is healing power. People often give testimonies or speak of being healed of deadly diseases. Some people have spoken of pronounced dead and they were brought back to life. These are all part of healing power. The bible speaks about Jesus being able to heal the sick and raise the dead. Scriptures like Hosea 12:3, Micah 3:8, and Matthew 9:6-8 all speak of healing power. There’s not just one type of power, besides healing power God gives the power to forgive sins. Just as he forgives us of our sins and wrong doing, he’s gives us the power to do the same. Matthew 9:6 says, â€Å"but that ye may know that the Son of man hath power on earth to forgive sins, (then saith he to ...

Global Warming Essay

Global Warming Essay There is plenty of research on Global Warming issues, however, scholar’s over the world are far from unanimity on its root causes and ways of prevention. Global warming  is a climatic process, which is related to what seems to be ‘an insignificant increase of global temperature’. At glance the  difference  seems trivial indeed – Earth’s mean surface temperature has increased by some 0.8 since the early 20th century, however, this has triggered a chain reaction and contributed to glacier melting in the Arctic and the Antarctic Penninsula. This, in turn, is leading to the increase of the ocean heat content, which spurs a whole new series of climatic changes. Most of these changes are believed to be human-induced and are most typically contributed to deforestation and carbon dioxide emissions. There is plenty of research on Global Warming issues, however, scholar’s over the world are far from unanimity on its root causes and ways of prevention. Most scientists, with a 90% probability, tend to agree, that it is a process that is directly related to human activity. To substantiate their claim, they pull out the so-called ‘hockey stick’ graph, which was first introduced by Michael Mann in 1998 and is since widely used by world’s climatologists. GLOBAL WARMING IS A  MYTH The graph reads as follows: during the last nine centuries, global temperature has remained relatively unchanged (which is likened to the shaft of the stick), while during the last century (with the advent of the industrial revolution) the graph curve escalated dramatically (the part that resembles the blade). Such arguments look quite convincing if you compare temperature fluctuations during the nine-hundred-year span to those of the last century. The hockey stick graph has also spurred debate on the validity of the datasets and their interpretation and has lead to the so-called ‘hockey stick controversy’, in which some environmental scientists questioned data and methods used by Michael Mann. Mann’s model ended up being reviewed and analyzed by the National Academic of Sciences, who supported Mann’s initial hypothesis, saying that current temperature levels were unprecedented until at least 1000 years. In years that followed, this model was tested by other scholars who used more sophisticated data sets and statistical methods, and they too confirmed that Mann’s initial model was accurate. More sophisticated data sets and improved methods of research were able to extend the ‘hockey shaft’ as far as 11000 years back, only confirming the initial hypothesis – global warming is a result of human irresponsibility. This essay is a short stub on the extensive topic called ‘Global Warming’. If you need an article written on the topic, feel free to contact us for a custom written essay on any of the global warming issues. We would be happy to find a writer with a background in climatology/ecology who will come up with a top-notch quality product on any of the ‘global warming’ subtopics.

Make Invisible Ink Using Lemon Juice

Make Invisible Ink Using Lemon Juice Use this easy recipe to make invisible ink. It only takes a few minutes to complete!  Lemon juice is acidic and weakens paper. When  paper  is heated, the remaining acid turns the writing  brown before discoloring the paper. Ingredients You only need a few simple materials to make invisible ink: Lemon or Lemon JuiceSunlight or Heat SourcePaperPaintbrush or Stick How to Make Invisible Ink Squeeze lemons to obtain their juice or obtain bottled lemon juice.Use the juice as ink by applying it to a stick or paintbrush and writing on paper.Allow the paper to dry.When you are ready to read your invisible message, hold the paper up to sunlight, a light bulb (recommended), or another heat source.The heat will cause the writing to darken to a pale brown, so your message can now be read.Another way to read the message is to put salt on the drying ink. After a minute, wipe the salt off and color over the paper with a wax crayon to reveal the message. Useful Tips Experiment with other juices. White wine, orange juice, vinegar, and apple juice all work well, too.A cotton swab makes an excellent disposable paintbrush.The writing turns brown because the weakened paper burns before the rest of the paper. Be careful not to overdo your heating and ignite the paper!

Women and Migration Essay Example | Topics and Well Written Essays - 500 words - 2

Women and Migration - Essay Example Women migrants have less access to legal protection and social services and are victimized by abuses and harsh working conditions. Female migrants usually are forced to work as domestic and sex workers and are succumbed to torture and cruel treatments. Women who migrate from poor Asian countries are also faced with racism and bias from host countries. Women also are exposed to psychological and physical pressure when travelling to camps in different host countries. Sexual exploitation of women and trafficking is a part of the life of female migrants. Many a time female women who migrate to different countries are compelled to work in unhealthy working condition without safety and security. There are no guidelines to safeguard their human rights and security and some are subjected to violence and exploitation. Even in case of remuneration, women are paid very insignificantly when compared to men. Women are at a loss on migration if they are not employed in a reputed job. Women at many times have to stay away from husband and children in order to earn for their family and in long run, their relationship is negatively affected. They cannot care for their children in the right manner which can hamper the physical and mental development of the children. They have to face lack of health care, poor living conditions, low paying jobs in host countries which are a matter of great concern. Many women undergo depression and mental health issue due to the pressure they have from work surroundings. Gender discrimination is one aspect largely encountered by female migrants in host countries and they are mostly forced to do work s which is less skilled and paid for. Women migrants who work under challenging condition should be protected from abuses on the part of human right laws. Human rights standards should be more strong and consistent pertaining to women migrant workers and should protect them from all visible exploitations and abuses.  Ã‚  

Mathematical Concepts in Registered Nursing Career Research Paper

Mathematical Concepts in Registered Nursing Career - Research Paper Example They would normally be stationed in hospitals, home healthcare service providers, physicians’ offices and in nursing care facilities. Before licensing, prospective registered nurses should have acquired relevant academic qualifications in approved nursing program ranging from diploma to bachelor’s degree. To further understand the roles played by registered nurses, it would be critical to examine their specific duties.Specific Duties of a Registered Nurse Borrowing from the registered nurses’ outlook as documented by BLS, nurses observe patients and record symptoms of patients and their medical histories. Patients’ medical histories serve to give indications of their current medical condition. By analyzing the patients’ medical histories, the nurse would in essence be considering the past statistics. The nurse would be majorly concerned with relative frequencies of past medical conditions. To effectively achieve this, these nurses would appreciate t he important role played by measures of central tendencies including the median, mode and mean as documented by Meerschaert (214), in evaluating these historical observations. To make these numerical data useful to the registered nurse, there would be need to understand the concepts in probability and statistics so as to evaluate the chance and collect, organize, analyze and describe numerical data ). These mathematical functions help organize these observations in a meaningful manner.BLS also notes that nurses operate and monitor some medical equipment. This therefore means that the nurses have the ability to perform diagnostic tests and analyze the results thereof. Probability and statistics mathematics finds key application in nursing in the diagnosis of medical conditions. To be particular, relative frequencies of observed phenomena would give crucial leads to diagnosis of existing medical conditions. As discussed by Timmons, Johnson and McCook (351), relative frequencies would show the frequency of each category, in this case the categories being the medical conditions. Higher frequencies of a particular pathogen could point out at the medical condition being a consequent of such. Probability being a study of random events helps nurses in diagnosis such that higher relative frequencies indicate a higher probability of recurrence of such medical conditions. In consultation with doctors and other available healthcare professionals, nurses set up the plans for the care of patients or advise on the existing plans. They teach the patients together with their families on ways of managing their injuries or illnesses. Since public health and home health nurses travel to the location of patients to deliver such services, they would appreciate the knowledge of statistics and probability in planning their schedule so as to effectively utilize their resources. To be specific, nurses would plan to visit their patients densely distributed in a region at a go so as to save on time and resources. In offering care, nurses also give medicines and treatments to patients as observed by BLS. The quantity and frequency of drug intake they prescribe referred to as dosage in nursing terminology would be determined by the

Role of Nuclear Medicine in the Field of Gastrointestinal Diseases Essay

Role of Nuclear Medicine in the Field of Gastrointestinal Diseases - Essay Example Through imaging the physician can advice the patients with such diseases the cure and treatment. With the help of Nuclear Medicine Imaging, the imaging of IBD may be performed with In-111Leukocytes and Tc-99m Leukocytes. Nuclear Imaging can assess the conditions and situation of the gastrointestinal tract of the patient. With detailed observation the physician can advice the patients on what medicine to take to cure the said disease. Medicine is the science and art concerned with treating diseases so with preservation of one's health. It is a branch of healing art that deals with restoration of life and curing diseases by administration of drugs. Medicine is a very wide subject but it all includes all the sciences that are under the healing art and all varieties of curative treatment. Not only is it all about treating but also about preventive and the discussion of causation (Universal Encyclopedia, 1993). The development and classification of medical science have proceeded by gradual steps from very early times. The year 1543 marks an important point in the development of modern medicine. It was Andreas Versalius who published De Humani Corposis Fabrica (The Fabric of Human Body) in that year. It was a first great achievement for in that book the real structure of human body was revealed. Versalius undermined the widespread of reverence for authority in science and prepared a way for independent observation in anatomy and medicine. After that achievement there was a lot of upgrades in the field of medicine. The works and achievement of Pasteur in the field of Microbiology, Mendel in the field Genetics, and Darwin in Evolutionary Biology has greatly influenced and advanced the field of Medicine. As Medicine has been developing into more knowledge about the art of healing researches and more studies have been done. Among to its advancements are the discovery of tissue grafting. Transplants of organs are now possible and have saved many lives already. Born with the improvement in the field of Medicine is Nuclear Medicine. This field of Medicine is a science of healing that uses radiation to provide or give information about the person's anatomy and the functioning activity of the specific organs. With the information given to the physician, the doctor can provide and recommend proper diagnosis and treatment. Examples of conditions that can be checked with this field are cancer, heart diseases, thyroid disorders, bone disorders and gastrointestinal diseases (Nuclear Imaging, 2006). This field of Medicine is actually a sect specialty with in the field of radiology. The diagnostic examination that results from the images of body anatomy and functionality is comprised in this field. Nuclear medicine is a subspecialty within the field of radiology. The images are developed based on the detection of energy emitted from a radioactive substance given to the patient, either intravenously or by mouth. Generally, radiation to the patient is similar to that resulting from standard x-ray examinations (Nuclear Medicine, 2006). The substances used in this kind of practice are radio nuclides (radiopharmaceuticals). During examinations the radioactive substances are administered to the patience and the radiation emitted is then measured. Mostly of these examinations involves the formation of an image using a gamma camera. Nuclear medicine can

Restaurant field experience report Essay Example | Topics and Well Written Essays - 500 words

Restaurant field experience report - Essay Example The beverage manager is responsible for preparing drinks orders for the entire day for dining service. I, therefore, managed beverage stock as required and ensured that they are paid for. The other major role that I had to take estimate how much beverage would be consumed on each day and place orders with the suppliers. Additionally, I had to check for fresh deliveries in order to maintain high quality. I also learned how to solve on clients complaints about the served drinks.As a receptionist, I was responsible for greeting guests, show them their tables and provide menus. I also provided customer service and deal with all inquiries in a courteous and professional manner, either via email or telephone. Additionally, providing information to guests on requests to ensure their comfort, safety and satisfaction were also a principal responsibility for me. During this period I learned to offer exquisite customer care service, to solve their inquiring and complaints made via email or tele phone. I also developed adequate communication skills and to be professional at all times while attending to guests.The efficiency of the kitchen of a restaurant rests on Expeditors. This is the person who is responsible for setting the pace and flow in the kitchen. On this post, I ensured that the orders made by guests were completed on time, according to the menu, and ensures they are in good quality for their satisfaction. I was also responsible relaying orders made to the kitchen.

Vocal nodules Essay Example | Topics and Well Written Essays - 500 words

Vocal nodules - Essay Example However in order to fully appreciate the mechanism involved in this process an understanding of speech mechanism with respect to the role of vocal fold nodules is required. This is discussed below; The larynx or the voice box has a twin infolding of mucous membranes (vocal folds) stretched across the larynx. During speech or phonation, the air flow (originating from the lungs) is modulated by these membrane vibrations. Increased air flow/air pressure in the lungs causes the folds to open and once the pressure recedes after the air flows out the fold close again. These folds vibrate when closed due to internal air pressure. (Cumming 2005) In effect, the loudness of speech or what is best termed as the pitch of the voice is determined by resonance frequency of the vocal folds and is measured in hertz. Fundamental frequency of vocal fold vibration correlates with changes in vocal fold tension and subglottal pressure and hence vocal fold mass, stiffness, and viscosityis the main predictor of the pitch of the voice (Hirano 1987). Vibrations of the vocal folds that are too forceful or prolonged result in vascular congestion. If persistent they will eventually result in hyalinization of superficial lamina propria and eventually this is likely to lead to the formation of nodules.

Psychology essay Example | Topics and Well Written Essays - 2500 words

Psychology - Essay Example Nine months after the implementation of these changes, a recent employee performance appraisal revealed that employee performance and motivation levels had decreased. This article will utilize the theory of psychological contract and the attribution theory to evaluate why the employees are experiencing the above mentioned changes. These will be followed by recommendations that the firm could apply in order to improve on this situation. A psychological contract could be defined as a set of promises and beliefs held by an individual employee about the terms of the exchange between the employee and his or her organization, or the agent of the organization (Wellin, 28). The psychological contract can be a complex concept since it is an unwritten rule that cannot be directly expressed in a tangible way. Nevertheless, there have been arguments to the effect that a breakdown of the psychological contract can result in poor performance of individual workers or of the organization as a whole (Anderson, 102). This can be caused by a reduction in levels of organization commitment, lack of motivation, absence and attendance problems and high levels of staff turnover, some of which the financial company is already experiencing. Being a psychological rather than a legal contract, a psychological contract refers to beliefs about the deal as opposed to what is contained in writing within the formal employment contract about the deal (Conway & Briner, 23). Breach is probably the most important idea in psychological contract theory since it is the main way of understanding how the psychological contact affects the feelings, attitudes and behaviours of employees. A breach of the psychological contract occurs when one party perceives that the other has failed to fulfil promised obligations. In this case, the financial organization’s freeze on pay-rises and overtime payments combined with the freeze in almost all training could

Vocal nodules Essay Example | Topics and Well Written Essays - 500 words

Vocal nodules - Essay Example However in order to fully appreciate the mechanism involved in this process an understanding of speech mechanism with respect to the role of vocal fold nodules is required. This is discussed below; The larynx or the voice box has a twin infolding of mucous membranes (vocal folds) stretched across the larynx. During speech or phonation, the air flow (originating from the lungs) is modulated by these membrane vibrations. Increased air flow/air pressure in the lungs causes the folds to open and once the pressure recedes after the air flows out the fold close again. These folds vibrate when closed due to internal air pressure. (Cumming 2005) In effect, the loudness of speech or what is best termed as the pitch of the voice is determined by resonance frequency of the vocal folds and is measured in hertz. Fundamental frequency of vocal fold vibration correlates with changes in vocal fold tension and subglottal pressure and hence vocal fold mass, stiffness, and viscosityis the main predictor of the pitch of the voice (Hirano 1987). Vibrations of the vocal folds that are too forceful or prolonged result in vascular congestion. If persistent they will eventually result in hyalinization of superficial lamina propria and eventually this is likely to lead to the formation of nodules.

The Differences Between Public and Private Accounting Research Paper

The Differences Between Public and Private Accounting - Research Paper Example According to Eisen, accounting refers to the â€Å"art of organizing, maintaining, recording, and analyzing financial activities† (1). The work of an accountant is to convert the accounting information into meaningful terms that are understandable and thus can be used by interested parties. An accounting system can use a simple check register or use the Microsoft Office Accounting which is more appropriate. Although accountants follow the same procedure as bookkeepers, an accountant can design a system that will capture all the necessary details that are needed in a business (Snyder Microsoft.com). Accounting systems are there to serve the control, management, and planning purposes of public finance administration. There are many reasons why accounting is said to be very vital. Just like the language of business, every business owner should be able to know the importance of accounting. Accounting is important as it helps in interpretation of companies operations and finances. Another reason why accounting should be considered important is the fact that it is usually considered as the guiding force to good management decisions in a particular company. No company management team can make sound decisions without knowing how the company finances are. It is important because it helps people to move to a next level in their plans for business. For example, with accounting, a business owner is able to avoid fraud that can cause the downfall of his or her businesses. 2. Differences between Private Accounting and Public Accounting There are many ways of classifying accounting and accountants but the most common method is whether it is private or public. Most college students get stranded on whether to start their career in private accounting or public accounting. Lecturers and university professors are of the opinion that public accounting is the best path to a successful accounting career. The advantage of following this route (public accounting) is there are hi gh salaries involved, more interesting and diverse work which gives an accountant the chance to get exposed to many other companies because his or her work is not limited to a particular company. For example, a public accountant performs three to four audits in different companies in one year, while the private accountant is usually stuck monitoring ledges for a year in one company (Vault Editors 91). Differences between the two types of accounting arise from the differences that exist in payments and accountants training, experience, working environment, social skills, and certification. 2.1 Payments Public accountants are paid directly for providing their services to businesses or individuals. According to Pride, Hughes and Kapoor, â€Å"a public accountant works on a fee basis for clients and may be self-employed or be the employee f an accounting firm† (446). In other words, the payment is made to the accountant himself and not via a company (Vault Editors 90). Private ac countants on the other hand are not paid directly as it happens in public accounting. Payments are made via the company a private accountant is attached to. Direct payment is not possible in this type of accounting (â€Å"What is the difference,† accountingtools.com). 2.2 Training A public accountant is trained on how to evaluate of accounting systems, gather evidence and make assessments to find out whether statements are correct (â€Å"

Audit of Syphilis Screening in Pregnancy

Audit of Syphilis Screening in Pregnancy Tables Table 1:Syphilis confirmatory test results for forty nine  pregnant woman 18 Table 2:Syphilis screening results of eleven new-borns of  positive syphilis mother 24 Table 3: Positive syphilis confirmatory test results for sixteen  pregnant woman 30 Figures Figure 1: The laboratory turnaround time of syphilis screening  for mothers 28 Figure 2: The laboratory turnaround time of syphilis screening  for new-borns 28 Tables Table 1: Syphilis confirmatory test results for forty nine pregnant woman 18 Table 2: Syphilis screening results of eleven new-borns of positive syphilis mothers 24 Table 3: Positive syphilis confirmatory test results for sixteen pregnant woman 30 Figures Figure 1: The laboratory turnaround time of syphilis screening for mothers Figure 2: The laboratory turnaround time of syphilis screening for new-borns ABSTRACT Objective: A re-audit of syphilis screening in pregnancy was carried out to ensure that the improvements in laboratory and clinical aspects of management for the antenatalof pregnant women with positive syphilis screening and their new-born babies fully met were in accordance with the UK National Guidelines on the Management of Syphilis (Kingston et al., 2008) and the Guidelines for the Management of Syphilis in Pregnancy and the Neonatal Period (Stringer et al., 2013). Methods: Patients’ data were collected via query of the three databases: Clinisys Labcentre, Telepath and EuroKing. The n the data were analysed using Microsoft Access 2013. Results: Samples from Forty nine49 pregnant woman with positive syphilis results serology were referred to a reference laboratory laboratory were sent to MRI for syphilis serological confirmatory testing. Sixteen pregnant woman with of these women were confirmed to have had had positive syphilis were identified. Ten pregnant woman were re-tested screened at least twice during their pregnancy and six pregnant woman were only screened tested once during pregnancy. Over-testing of for treponemal IgM were seen in nineteen patients[h1] with non-reactive RPR titre. Only eleven babies born to mothers with syphilis were followed-up with serial serological tests for syphilis. Only four new-borns were fully screened. Some of the new-borns were not tested with treponemal IgM due to sample insufficiency. Conclusion: There were some improvements seen since the first audit which includes the changes of the confirmatory testing schedule in MRI, lower screening false positive rate, and increased follow-up of the new-borns. There were also things to improve in the management of syphilis in pregnancy and the new-borns of positive syphilis mothers. Treponemal IgM test should be performed only when the RPR test were reactive to prevent over-testing of patients. The test algorithm for screening of syphilis in new-borns should give priority to RPR test and treponemal IgM to prevent under-testing[h2]. In-house confirmatory testing should be considered to allow reduction of test turnaround time’s thereby aiding patient management.Improvements[h3] should be made in the management of syphilis in pregnancy and the new-borns of positive syphilis mothers. Treponemal IgM test should be performed only when the RPR test were reactive to prevent over-testing of patients. The test algorithm for screening of sy philis in new-borns should give priority to RPR test and treponemal IgM to prevent under-testing[h4]. 1.0  INTRODUCTION 1.1  Syphilis Syphilis is an infectious disease caused by Treponema pallidum (T.pallidum) subspecies pallidum. The disease is transmitted from human to human, and humans are its only known natural host (Woods 2005). Epidemiologically, in the UK, cases of syphilis have increased in England since 1997 led by a series of outbreaks reported from Manchester, London and Brighton (Health Protection Agency 2009). Since 1999, diagnoses of infectious syphilis have been made in heterosexuals where the outbreaks are linked to sex work, students and young people. But, there was a changing pattern of infection between 1999 and 2008, when seventy three percent of new diagnoses of infectious syphilis were reported in men who have sex with men (Health Protection Agency 2009). The transmission is primarily by sexual activity (Zeltser Kurban 2004) (vaginal and anal intercourse) and by direct contact with active primary or secondary lesions (Lafond Lukehart 2006) for example through oral sex and kissing at or near an infectious lesion (Kent Romanelli 2008). T.pallidum may invade the host through normal mucosal membranes and also through minor abrasions in the skin (Zeltser Kurban 2004) such as from sexual trauma, causing an inflammation, ulcer and then spreading through the blood stream to other parts of the body (Goh 2005). 1.2  Syphilis in Pregnancy Mothers with untreated syphilis may seriously complicate their pregnancy. Vertical transmission of T.pallidum across the placenta (Singh Romanowski 1999) can occur at any time during pregnancy (Vaules et al., 2000; Oswal Lyons 2008), this leads to wide dissemination of the spirochete in the fetus (Woods 2005). Fetal infection resulting in spontaneous abortion, still-birth, premature delivery, non-immune hydrops fetalis and also congenital infection (Singh Romanowski 1999; Vaules et al., 2000; Ledger 2000). Vertical transmission may occur at any stage of syphilis infection. However, the transmission is more common in mothers with primary and secondary stage of syphilis (Singh Romanowski 1999; Vaules et al., 2000; Oswal Lyons 2008) as the risk of transmission depends on the levels of spirochaetemia which are higher in these stages compared to other stages (Vaules et al., 2000). Syphilis may also be transmitted during birth by contact of the new born with the mother’s genita l lesion (Ledger 2000; Berman 2004). 1.3  Congenital Syphilis Signs of infection for early congenital syphilis may appear within the first two years of the infant’s life with clinical manifestations include hepatosplenomegaly, rash, fever, and signs of neurosyphilis, especially bulging fontanel, seizures, and cranial nerve palsies (Mattei et al., 2012; De Santis et al., 2012). As for late congenital syphilis, the sign of infection may only be seen over the first two decades with clinical manifestations such as frontal bossing, nasal cartilage destruction, and dental abnormalities (Mattei et al., 2012; De Santis et al., 2012). Congenital syphilis leads to multiple organ infection because of the widespread haematogenous dissemination (De Santis et al., 2012) that will further cause death in the fetus or new born. However, the disease is almost preventable if mothers with syphilis are treated early in pregnancy (Walker Walker 2007). 1.4  Serologic Test Diagnosis of syphilis is made based on clinical signs and symptoms, microscopic examination and serologic tests (Little 2005). Two types of serologic testing were available; non-treponemal specific tests and treponemal specific tests (Clyne Jerrard 2000). Non-treponemal tests are widely used for testing and screening for syphilis as they are rapid, simple and inexpensive (Ratnam 2005). The example of  non-treponemal tests include the Venereal Disease Research Laboratory (VDRL) test and the rapid plasma reagin (RPR) test (Kent Romanelli 2008). Due to the rate of false-positive results which present in about one to two percent for these tests, the positive results have to be confirmed by sets of treponemal-specific tests such as the T.pallidum particle agglutination (TPPA) test, T.pallidum haemagglutination (TPHA) test and treponemal enzyme immunoassay (EIA) test (Kent Romanelli 2008). 1.4.1  Antenatal Screening The detection and treatment of infectious syphilis are extremely important in preventing congenital syphilis (Chakraborty Luck 2007; Simms Broutet 2008). An effective antenatal screening programme can have a huge impact in the way of managing both mother and baby. All pregnant women should be screened for syphilis at their first antenatal appointment (French et al., 2009) and the test should be repeated early in the third trimester (Goh Thornton 2007). Also, all infants born to seropositive mothers should be examined at birth and at monthly intervals for three months until it is confirmed that serological tests are and remain negative (Oswal Lyons 2008). The primary screening tests recommended (Kingston et al., 2008) are either treponemal EIA or TPPA/TPHA. If the screening test is positive, it must be confirmed by either one of the opposite tests. VDRL or RPR will be performed when the confirmatory test gives positive results (Kingston et al., 2008). 1.5  Audit on Diagnostics of Syphilis in Pregnancy The diagnosis of infectious syphilis in women in the UK increased between 1999 and 2007. The increase of syphilis cases in women has also led to the re-emergence of congenital syphilis in the UK which may suggest sub-optimal management of patients with syphilis (Health Protection Agency 2009). In 2011, an audit on diagnosis of syphilis in pregnancy was performed at the Pennine Acute NHS Trust (PAHT) to ensure the syphilis screening in pregnant women and also the serological diagnostic of their new-born babies followed the UK standard for Microbiology Investigations in Serological Diagnosis of Syphilis which were introduced by Public Health England in 2007 (Public Health England 2014b). The purpose of introducing the standard was to assure equivalence in the investigation strategies in different laboratories across the UK (Public Health England 2014b). The audit reveals the concerns about the delays in syphilis confirmations and insufficient follow-up for new-borns of positive syphilis mothers. At least eighteen percent of positive syphilis cases took more than one month for confirmation and the turnaround time for eleven percent of the syphilis screening cases out of forty five cases took more than one week. It is also found that there was inconsistency in performing treponemal IgM test where fifty three percent of cases (twenty four cases out of forty five cases) were not tested for treponemal IgM. For the management of neonates, only four new-borns were followed-up and among four new-borns, only one have been followed up according to the guidelines. Recommendations made from the audit includes the improvement of time to confirmation of specimens, changes of confirmation test by using treponemal IgM to all pregnant woman, referral of all pregnant woman with inconclusive syphilis confirmation to Genitourinary Medicine (GUM) clinic and management of new-borns where follow-up should be completed according to the guidelines provided (Vladana et al., 2011). 1.6  Re-audit of Syphilis Screening in Pregnancy A re-audit of syphilis screening in pregnancy at the PAHT was performed to discover if changes made after the first audit recommendations have led to the improvement of services. The re-audit was carried out three years after the first audit done in 2011. The re-audit aimed to ensure that the improvements in laboratory and clinical aspects of management for the antenatal women with positive syphilis screening and their new-born babies were in accordance with the UK National Guidelines on the Management of Syphilis (Kingston et al., 2008) and the Guidelines for the Management of Syphilis in Pregnancy and the Neonatal Period (Stringer et al., 2013). 2.0  METHODOLOGY 2.1  Background The PAHT comprises four major district general hospitals; North Manchester General, Fairfield General Hospital, Rochdale Infirmary and The Royal Oldham. Some 12,000 women annually present for antenatal care. Women usually attend for antenatal care at one of three antenatal clinics or one of several General Practice Clinics within the community. In the UK antenatal infectious disease screening is usually performed at three months gestation (http://www.screening.nhs.uk/). Women are offered screening for rubella immunity, hepatitis B virus infection, human immunodeficiency virus infection and T.pallidum (syphilis) infection. Among 12,000 women screened within the PAHT in the period 1st January 2013 to 31st December 2013, a series of forty nine pregnant woman with positive syphilis serology were identified. To determine whether syphilis screening and follow up care of babies born to these mothers followed the UK Guidelines of the Management of Syphilis (Kingston et al., 2008) and the Gui delines for the Management of Syphilis in Pregnancy and the Neonatal Period (Stringer et al., 2013), a retrospective study was performed. 2.2  Diagnosis of Syphilis Pathway Patients’ blood sample was collected with informed consent at the antenatal clinic and laboratory test requests were made. The patients’ information was recorded in the maternity information system database; â€Å"EuroKing† (Euroking, Chertsey, Surrey, UK). Samples were transported to The Royal Oldham Hospital (TROH) microbiology laboratory via the hospital transport system to be tested. Patient demographic information was recorded in the laboratory data system Clinisys Labcentre (Clinisys, Chertsey, Surrey, UK). If the syphilis screening test was negative, a report was generated and then posted to the antenatal clinics where the sample came from. If the syphilis screening test was positive, the sample was sent to a reference laboratory, Manchester Medical Microbiology Partnership Laboratory at Manchester Royal Infirmary (MRI) for confirmatory testing. Testing at the MRI comprises two treponemal enzyme immunoassay tests for total treponemal antibody; a T.pallidum specific assay (EIA); the T.pallidum particle agglutination assay (TPPA); the reagin precipitin assay (RPR) and where appropriate a T.pallidum specific IgM enzyme immunoassay (IgM) in accordance with national guidelines (Kingston et al., 2008). These results were recorded in the MRI laboratory database system, (Telepath; CSC Healthcare, Banbury, Oxfordshire, UK) and a printed copy of the patient test results was sent back to TROH microbiology laboratory. The reference laboratory report was transcribed onto the Clinisys Labcentre system and a printed report was generated to be to the antenatal clinics. Finally, the patients’ report received by the antenatal clinics was recorded in the patients’ notes and updated in the EuroKing system. 2.3  Data Collection Data collection for the study was accomplished via query of the three databases: the PAHT laboratory database system, Clinisys Labcentre, the MRI database system, Telepath and the maternity information system database, EuroKing. The data gathered including the patients’ hospital number, NHS number and specimen number, date of birth, the date of sample collection and report, and also the syphilis serology data which includes the patients’ treponemal EIA, TPPA, RPR and treponemal IgM results. The sample collection and sample reported data were obtained to investigate the turnaround time taken for the diagnosis within the laboratory. 2.4  Analysis of Data The laboratory system data was presented as Microsoft Excel spreadsheets (Microsoft Corporation, Seattle, USA). All the patients’ data were then imported and assembled in Microsoft Access 2013 (Microsoft Corporation, Seattle, USA). The data for the forty nine pregnant woman with positive syphilis serology were analysed using Microsoft Access 2013 (Microsoft Corporation, Seattle, USA). 2.5  Clinical Audit This was conducted under the Clinical Audit provision of the NHS National Research Ethics Committee (National Research Ethics Service 2008). The work was registered and approved as a Clinical Audit with the Clinical Audit Department of the PAHT. Data analysed was anonymised before release from the Trust to comply with Data Protection Guidelines (Caldicott Committee 1997). The clinical audit used the UK National Guidelines on the Management of Syphilis (Kingston et al., 2008) as a standard. 3.0  RESULTS Fifty positive syphilis serology results were identified from forty nine pregnant woman undergoing routine antenatal infectious disease screening at TROH microbiology laboratory. All specimens were screened with Chemiluminescent Microparticle Immunoassay test using the Abbott Architect Syphilis TP Assay (Abbott Diagnostics, Chicago, USA). The fifty specimens were also sent to the Manchester Medical Microbiology Partnership Laboratory, MRI which acts as a reference laboratory for syphilis serological confirmatory testing. 3.1  Confirmation Methods by MRI The reference laboratory confirms syphilis screening with two treponemal EIAs, a semi-quantitative TPPA, a semi-quantitative RPR, and where appropriate a T.pallidum specific EIA for IgM antibody in accordance with national guidelines (Kingston et al. 2008). The first treponemal EIA test was the same Abbott Architect Syphilis TP Assay (Abbott Diagnostics, Chicago, USA) used at TROH for syphilis serological testing; the second treponemal EIA test used the DiaSorin Liaison XL System (DiaSorin S.p.A, Saluggia, Italy), the semi-quantitative TPPA was the Serodia TPPA Assay (Fujirebio Diagnostics, Inc., Tokyo, Japan), the semi-quantitative RPR was the Abbott Syfacard – RR card test (Abbott Diagnostics, Chicago, USA), and the T.pallidum specific EIA for IgM were run using CAPTIA Syphilis-IgM Assay (Trinity Biotech, Ireland, UK). Where necessary, further testing using T.pallidum specific immunoblotting and/or T.pallidum specific polymerase chain reaction testing are also used in confir mation testing. All specimens were confirmed using treponemal EIA, TPPA and RPR but only about twenty nine specimen out of fifty specimen were tested using treponemal IgM. There were seventeen positive screening with syphilis and thirty three negative screening with syphilis. Negative screening was defined by having negative results for either one or both treponemal EIA, TPPA titres of less than 1:80 and RPR titre of less than 1:2; positive results were defined by having positive results for both treponemal EIAs, a TPPA titre of greater than or equal to 1:160, RPR titre greater than or equal to 1:2 and positive results of treponemal IgM (Table 1). Table 1: Syphilis confirmatory test results for forty nine pregnant woman. Patient numbers with symbol â€Å"*† are pregnant woman with positive syphilis results. Patient Test TEIA1 TEIA2 TPPA RPR IgM EIA InterpretationResult 1 1 Positive Negative Negative Negative Not Done Negative *2 1 Positive Positive 1:640 Negative Not Done Positive 2 Positive Positive 1:320 Negative Negative 3 1 Positive Negative Negative Negative Not Done Negative 4 1 Positive Negative Negative Negative Not Done Negative *5 1 Positive Positive 1:5120 1:64 Not Done Positive 2 Positive Positive 1:5120 1:64 Not Done 3 Positive Positive 1:2560 1:8 Not Done Patient Test TEIA1 TEIA2 TPPA RPR IgM EIA Result 6 1 Positive Negative Negative Negative Negative Negative *7 1 Positive Positive 1:640 Negative Not Done Positive *8 1 Positive Positive 1:1280 Negative Not Done Positive 2 Positive Positive 1:2560 1:1 Not Done 9 1 Negative Negative Negative Negative Not Done Negative 10 1 Positive Negative Negative Negative Negative Negative 11 1 Positive Negative Negative Negative Not Done Negative 2 Positive Negative Negative Negative Not Done *12 1 Positive Positive 1:5120 1:4 Negative Positive 2 Positive Positive 1:5120 1:4 Not Done Patient Test TEIA1 TEIA2 TPPA RPR IgM EIA Interpretation *13 1 Positive Positive 1:640 1:64 Not Done Positive 14 1 Positive Negative Negative Negative Negative Negative 15 1 Positive Negative Negative Negative Not Done Negative 16 1 Positive Negative Negative Negative Not Done Negative 17 1 Positive Negative Negative Negative Negative Negative 18 1 Positive Negative Negative Negative Not Done Negative 2 Positive Negative Negative Negative Not Done *19 1 Positive Positive 1:640 Negative Not Done Positive 2 Positive Positive 1:1280 Negative Not Done 20 1 Positive Negative Negative Negative Not Done Negative Patient Test TEIA1 TEIA2 TPPA RPR IgM EIA Result 21 1 Positive Negative Negative Negative Not Done Negative *22 1 Positive Positive 1:640 1:4 Not Done Positive 2 Positive Positive 1:1280 1:4 Not Done 23 1 Positive Negative Negative Negative Not Done Negative 24 1 Positive Negative Negative Negative Not Done

Pollution and Plunging Male Fertility :: Pollution Environment Environmental

Pollution and Plunging Male Fertility Several reliable studies have confirmed that fertility among men has decreased as a result of pollution. The average male ejaculation is about three milliliters. This amount of semen can contain between 20 million to 300 million sperm per milliliter semen. To determine the approximate number of sperm per milliliter of semen, technicians must place a drop of semen on a slide and, while looking through a microscope, they count the sperm within a certain sector. Men that have sperm counts below 20 million per milliliter are said to have reduced fertility and those whose counts fall below 5 million are considered sterile. In 1974, C. M. Kinloch-Nelson and Raymond G. Bunge at the University of Iowa, studied the semen quality of men who had fathered two or more children and were about to undergo vasectomies. Of the 386 fertile men studied, 7% of them had sperm concentrations above 100 million per millimeter and the average concentration was 48 million. When they compared their findings to similar studies done in the thirties, they found that sperm counts had been decreasing for 50 years. "They discovered that among healthy adult males who were not being treated for infertility, the average sperm count had declined by about 40 percent, from 120 million sperm cells per milliliter of semen to about 70 million" (Big Drop 36). In 1979, a professor at Florida State University, upon analyzing student semen samples discovered surprisingly low sperm counts and alarmingly high levels of toxic chemicals (including DDT and PLB's). "He suggested that environmental pollution might be causing the sperm decline" (Big Drop 36). The results of his findings triggered studies all over the world, showing counts in the range from 55 to 75 million and others showing numbers well above 100 million. Men exposed to high levels of toxic chemicals on the job were found to have semen containing pollutants. "Most scientists held to the view that changes in counting techniques were responsible for the reported dip" and . . . "after a few headlines, the sperm crisis became yesterday's news" (Big Drop 36). In 1996, Niels E. Skakkebk, a Danish pediatric endocrinologist, began studying male infertility and growth disorders among children . He had been noticing numerous boys with testicles that had not descended and malformed genitals. A study done in 1984 examining 2,000 Danish school boys showed that 7% of them had one or both testicles still inside their bodies.

Essay --

Air superiority will continue to be vital for the preservation of the U. S. Military well into future contingency operations. Airpower is one of the military’s greatest strengths providing global reach and deterrence, and will continue well into the time to come. However, the traditional air missions of air combat and bombing are being replaced by Unmanned Aerial Vehicles (UAV’s) and intelligence, surveillance, and reconnaissance (ISR) capabilities only imagined in the past. UAV’s are not only in great demand by forces deployed in Afghanistan, they are also at work in a wide range of civilian applications, from law enforcement surveillance to mundane tasks such as checking remote pipelines or monitoring livestock. 1 The demand is so high that it surpasses supply, which naturally means fast track development of new systems, to meet the needs of increasing requirements. 2 For example, Lockheed Martin is developing a football sized UAV that can fly in and out of the water. This adds to the reach of a submarine by having its own fleet of small flying UAV’s that can search a grid the ...

The Role of Inflammation in the Advancement of Chronic Obstructive

The Role of inflammation in the advancement of Chronic Obstructive Pulmonary disease. Introduction Chronic obstructive pulmonary disease (COPD) is the collective term used for respiratory disease, including chronic bronchitis and emphysema. The disease develops slowly and is often not diagnosed until it is advanced and irreparable damage is evident (Global Initiative for Chronic Obstructive Lung Disease, 2011). The disease is characterised by airflow obstruction and lung parenchyma.Parenchyma, associated with emphysema, is the permanent enlargement of the air spaces distal to the terminal bronchioles, accompanied by airway wall destruction, without obvious fibrosis (Demirjian and Kamangar, 2011; Atsuyasu et al. , 2007). Airflow limitation results from loss of elastic recoil and reduced airway tethering. Chronic bronchitis leads to narrowing of airway calibre, increasing airway resistance. Patients may display signs of one or both of these diseases as they frequently occur in associat ion with each other.Common symptoms are wheezing, coughing, shortness of breath on exertion, production of sputum and recurrent respiratory infections (Global Initiative for Chronic Obstructive Lung Disease, 2011). There are a host of triggers that exacerbates symptoms including smoking and environmental pollutants, resulting in chronic inflammation (Kazuhiro and Barnes, 2009; Manuel et al. , 2002). â€Å"Inflammation is defined as the presence of redness, swelling and pain, caused by the presence of edema fluid and the infiltration of tissues by leukocytes† (Nairn & Helbert, 2002, pp15).Inflammation is a key biological response to eliminate harmful pathogens, but there is increasing evidence to suggest that chronic inflammatory responses are accountable for the advancement of this disease and other chronic diseases including coronary artery disease, cancer, rheumatoid arthritis and multiple sclerosis. This review explores the correlation between COPD and inflammation and the subsequent effects on the systemic systems and the link with coronary heart disease (Mantovini et. al. , 2008; Mohr & Pelletier, 2005; Sattar et. al. , 2003; Powells et. al. , 2001; Danesh et. al. 2000; Murdoch & Finn, 2000). Methods Search engines used were Google Scholar and Pub Med using the keywords COPD, inflammation, disease, apoptosis, interleukin 8, cytokines, coronary heart disease and COPD. Searches were restricted to dates between 1999 and 2012. The majority of the included papers were obtained from the reference lists of other research papers. COPD risk factors: COPD is strongly linked with repeated exposure to noxious particles or gases and cigarette smoke has been acknowledged as a prime risk factor (Fabri et. al. , 2006; Lindberg et al. , 2005; Pauwels and Rabe. 2004, Association for Respiratory Technology & Physiology, 2000). Smokers have an increased prevalence of respiratory and lung function abnormalities, a greater rate of decline in FEV1 and a higher mortality rate than non-smokers (World health organisation, 2012). However, only a third of smokers develop COPD which implies that other factors such as genetics and environment are involved (Agusti, 2003). Exposure to air pollution caused by heating and cooking with bio-mass fuels in poorly ventilated housing are major risk factors for COPD, especially in developing countries (Pauwels & Rabe, 2004).The most documented COPD genetic risk factor is the deficiency of Alpha -1-antitrypsin, a polymorphic glycoprotein which offers anti-protease protection against the serine proteinease, neutrophil elastase (Abboud & Vimalanathan, 2008; Devereux, 2006; Siafakas & Tzortzaki, 2002; Fabbri et al. , 2006). Research studies (in vitro) indicated that Alpha – 1 – antitrypsin also possesses anti-inflammatory capabilities that extend beyond its anti-protease role, including regulation of CD14 expression (Nita, Serapinas & Janciauskiene, 2007), inhibition of TNF-? ene upregulation (Subramaniyam , 2007) and inhibition of lipopolysaccharide activation of monocytes and neutrophil migration (Janciauskiene et al. , 2004). Deficiency of Alpha -1-antitrypsin is associated with COPD progression in both smokers and non-smokers, although far greater in smokers (Bergen et al. , 2010; Fabbri et al. , 2006; Siafakas and Tzortzaki. , 2002; Foos et al. , 2002). Studies have suggested that smoking with this genetic disposition will substantially increase risk of developing COPD (Kohnlein & Welte, 2008; Pauwels & Rabe, 2004; Foos et al. , 2002; Siafakas & Tzortzaki, 2002; Association forRespiratory Technology and Physiology, 2000). Pathogenesis of COPD Exposure to noxious particles â€Å"†¦ triggers cytokine activation to recruit cells, which play a vital role in removing the noxious agents†¦ † (Nairn & Helbert, 2007, pp22). An infiltration of neutrophils, eosinophils and CD8+ T-lymphocytes into the airways and lungs follows (Demedts et al, 2006; Mahler et al. , 2004; Sopo ri, 2002). High concentrations of chemokines, interleukon-8 (IL8) and tumor necrosis factor-a have been found in patients with COPD which are potent activators and chemo-attractants of leukocyte subpopulations (Murdoch and Finn, 2000; Yamamoto et al. 1997). The interaction of chemo-attractants with leukocytes initiates a series of coordinated and cellular events, which includes phagocytosis, release of soluble anti-microbials and formation of reactive oxygen compounds involved in intracellular killing (Murdoch & Finn, 2000). Neutrophils and macrophages release elastase, stimulating the production of mucus to assist in ridding the airways of the irritants and subsequent waste generated by the inflammatory response (Shimizu et al. , 2000).Other processes such as neutrophil necrosis and reactive oxygen species further contribute to mucus hyper secretion (Kim and Nadel, 2004; Mizgerd, 2002). When an inflammatory response is no longer needed protease inhibitor cells dampen the response. Research suggests that the inhibiting response in COPD is not triggered and chronic inflammation presides, representing a crucial mechanism in the pathogenesis of COPD (Demedts et al. , 2006; Hodge et al 2004). Hypersecretion of mucous can inhibit the ciliated epithelium from transporting mucus from the airways.Subsequent delays in bacteria clearance results in bacterial colonisation, which stimulates further granulocytic recruitment to the airways, escalating the inflammatory response. Chronic inflammation is linked with tissue destruction, imbalance of proteolytic and anti-proteolytic activity, hyper secretion of mucus, increased apoptotic activity and oxidative stress which contribute to the progression of COPD. Long term, chronic inflammation can result in widespread airway and parenchymal cell destruction which further contributes to disease progression (Mantovini et al. 2008; Mohr and Pelletier, 2005; Sattar et al. , 2003; Sopori, 2002; Powells et al. , 2001; Danesh et al. , 2 000; Murdoch & Finn, 2000). Research suggests that macrophages express a markedly lower amount of toll like receptors in COPD suffers, resulting in a decreased recognition of microbes, facilitating damaging microbial colonisation, which may explain the increased amount of respiratory infections in COPD sufferers (Schneberger, 2011; Droemann et al. 2005). Infection initiates a biased release of inflammatory mediators which may escalate the pathogenesis of the disease (Gaschler et al. 2009, Ritter et al. , 2005; Sethi, 2000). Oxidative stress Demedts et al, 2005 found that the alveolar macrophages of COPD sufferers produced much higher levers of oxygen radicals and myeloperoxide which are important for the destruction of inter-cellular pathogens. Oxidant/anti-oxidant imbalance can result in the inactivation of anti-proteinases, airspace epithelial injury, increased sequestration of neutrophils in the pulmonary microvasculature, and gene expression of pro-inflammatory mediators, all of which exacerbate the inflammatory response (MacNee, 2000 Drost et al. 2005). Emphysema like changes have been show in the CT scans of malnourished women, suggesting that diet has an effect on lung tissue in the absence of smoking (Coxon et al. , 2004). Dietary supplementation then may be a beneficial therapeutic intervention in this condition, as antioxidants not only protect against the direct injurious effects of oxidants, but fundamentally alter the inflammatory events that play an important part in the pathogenesis of COPD (Coxon et al. , 2004; MacNee, 2000). Apoptosis and COPDResearch suggests that there is increased apoptosis of epithelial cells in smokers and COPD patients. Apoptosis persisted despite smoking cessation which suggests apoptosis may play a part in driving the inflammatory process and progression of the disease (Hodge et al. , 2003). Increased apoptotic alveolar epithelial and endothelial cells in the lungs not counterbalanced by proliferation and sufficient ph agocytic clearance results in destruction of lung tissue and development of emphysema (Demedts et al, 2006; Kazutetsu, Naoko & Atsushi, 2003; Barnes et al. 000) Apoptosis can be induced by various stimuli, including oxidative stress, elastase and infiltrating cytoxix CD8 + T cells which are all associated with inflammation (Kazutetsu, Naoko and Atsushi, 2003). Efferocytosis allows for the removal of apoptotic material with minimal inflammation and prevents the development of secondary necrosis and ongoing inflammation. Failure of this highly conserved process may contribute to disease pathogenesis by impeding both the resolution of inflammation and the maintenance of alveolar integrity (Mukaro and Hodge, 2011; Taylor et al. , 2010; Morimoto et al, 2006; Vandivier et al, 2006).Proteolytic/Anti-proteolytic activity Mukaro and Hodge, (2011) suggests that in COPD there is an imbalance between proteolytic and anti-proteolytic activity, a prominent factor in the pathogenesis of this disea se, which may contribute to lung parenchymal destruction. Research has also found that macrophages demonstrate defective phagocytic ability against common airways pathogens in COPD (Taylor et al. , 2010; Hodge et al. , 2003), The findings of Berenson et al. , (2006), supported a paradigm of defective immune responsiveness of alveolar macrophages, but found no significant differences in the blood macrophages of COPD sufferers.Taylor (2010) believes that persistence of bacteria as a consequence of defective phagocytosis may be a chronic antigenic drive for chronic inflammation. Systemic effects of COPD â€Å"Chronic inflammation is present in all disease processes, mediating all stages of disease from initiation, manifestation and maturation† (Sompayrac 2003, pp12). Compelling epidemioligical data links systemic inflammation to atherosclerosis, ischemic heart disease, strokes, and coronary deaths (Danesh, Whincup and Walker, 2000; Ridker, 1999).These observations have been stro ngly supported by experiments that show the direct effects of certain inflammatory markers, such as C-reactive protein (CRP), on the pathogenesis of plaque formation (Zwaka, Hombach and Torzewski, 2001; Lagrand, Visser & Hermens, 1999). A study by Gan, Man & Sin, 2003) found that patients with COPD were 2. 18 times more likely to have an elevated circulating c-reactive protein levels. Evidence strongly suggests that there is relationship between COPD, systemic inflammation, and cardiovascular diseases.Studies show that patients with mild-to-moderate COPD, cardiovascular disease is the leading cause of morbidity and mortality (Din and Man, 2009; Pope et al, 2003). As these diseases share similar risk factors such as smoking, increased age and inactivity, causation is unclear and is likely to be due to multiple factors, including lifestyle, environmental and genetics (Gan, 2005; Agusti et. al. 2003). Discussion Inflammation, it would appear, is a double edged sword; crucial for cleara nce of pathogens and recovery from injury; but can also contribute to life threatening chronic diseases (Smith, 1994; Sporori, 2003).COPD is a complex condition, influenced by multiple genetic and/or environmental risks. A cycle of low grade inflammation is the consequence, with destructive and damaging effects, resulting in mucus hyper-secretion, airway obstruction, increased elastase production and oxidative stress, which encourage further inflammation and destruction. COPD is associated with exposure to smoke or noxious gases, however inflammation may also be caused by irritation from coughing, wheezing, respiratory infections and mucus production. Most exacerbations of COPD are caused by bacterial or viral infection (Sanjay and Murphy, 2008; Sanjay 2008).Mucosal cells produce mucus, which irritates the airways causing airway obstruction. This subsequently reduces FEV1, and cough effectiveness, which contributes to the build up of bacterial mucus. Imbalance between proteolytic an d anti-proteolytic activity presides, creating an ideal environment for infection. Research suggests that macrophages express a markedly lower amount of toll like receptors in COPD suffers, resulting in a decreased recognition of microbes, facilitating damaging microbial colonisation, which may explain the increased amount of respiratory infections in COPD sufferers (Schneberger,2011; Droemann et al. 005). Infection initiates a biased release of inflammatory mediators which may escalate the pathogenesis of the disease (Gaschler et al. , 2009, Ritter et al. , 2005; Sethi, 2000). Researchers have found high levels of neutrophils, macrophages and CD8+ cells in ex smokers (Lappers et al. , 2006). Thus, suggesting that inflammatory changes in COPD, although initially induced by inhalation of noxious agents, are fundamental to the disease process, rather than to the initial trigger per se (Gamble et al, 2007). Studies have shown that airway epithelial and T-cell apoptosis in COPD continue s despite smoking cessation (Lappers et al. 2006). Excess apoptosis results in inappropriate destruction of host tissue, leading to atrophy and tissue necrosis, which in turn further stimulates the inflammatory response and perpetuates the situation. We have already ascertained an imbalance between the proteolytic and anti-proteolytic activity and this is another factor that contributes, resulting in failure to resolve the inflammatory reaction rapidly (Hodge et al. , 2005). Un-cleared apoptotic cells may undergo secondary necrosis with discharge of injurious cells contents resulting in tissue destruction and further inflammation.Inability to remove apoptotic cells and debris created overwhelms the normal clearance mechanisms, stimulating further inflammatory responses, further contributing to COPD pathogenesis (Sanjay and Murphy, 2008; Sanjay 2008). It has been identified that the immune system may become less responsive, the longer that chronic inflammation presides, which may lea d you to believe that this would initiate an inhibitory effect on the inflammatory process. However this is not the case and the inflammatory process persists, presenting as low level chronic inflammation.In addition a less responsive immune system is more susceptible to infection, exacerbating the inflammatory response (Sanjay and Murphy, 2008; Sanjay 2008). There appears to be strong epidemiological links between cardiovascular disease and COPD. The same inflammatory markets are evident in both suggesting a systemic link. Both diseases share similar risk factors, so it is difficult to determine initiation of the diseases. One could also argue that the debilitating effects of COPD, which include a reduced exercise capacity, dyspnoea and deconditioning increase the risk of cardiovascular disease development.In conclusion, it appears that adaptive immune is active in the disease progression of this complex pathophysiological syndrome. Particularly elaboration and production of cytoki nes, chemical mediators and auto-antibodies, which directly injure respiratory tissues. CD8+ mediates tissue destruction, whereas CD4 orchestrates inflammatory responses, which facilitates humoral immune responses (Gadgill and Duncan 2008). Conclusions made in this review are only valid within the boundaries of the research and papers used. 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