Gregorian Calender Essay Example for Free

Gregorian Calender EssayIn everyday life, individuals function with a calendar. Calendars help organize daily events, special events, upcoming events, holiold age, seasons, etc. Today in the United States the recent and common calendar that is used is cognize as the Gregorian Calendar. Previous to the Gregorian calendar, the Julian Calendar was used. Both calendars are similar in some ways as well as different in others, along with sharing some advantage and disadvantages to make one calendar more useful in todays modern world. Gregorian CalendarThe Gregorian Calendar is currently the most internationally accepted calendar, (TimeandDate, 2013). Other cognise names for the calendar stern be known as Western Calendar and Christian Calendar. Pope Gregory XIII first introduced his findings of this new calendar in February of 1582, which the calendar was then named after him. The days of the calendar were put together strictly from a solar plan. The calendar has 365 days in the y ear that make up the 12 different months. distributively of the 12 months is irregular in the identification number of days that each contain.Seven of the months hold 31 days, five of the other months soak up 30 days, and the month of February has the to the lowest degree amount of days being 28. Although the month of February composes of 28 days, every 4 years Leap Year occurs adding an extra day to the year making February have 29 days in the month. Every third months of the calendar the seasons change of the 20th day of the month. This calendar is the most constant and stable calendar at the moment. Julian Calendar Before the Gregorian Calendar was the Julian Calendar which also replaced the Roman Calendar.One of the reasons it has been known that the Roman Calendar was replaced was callable to how complicated it was. Previous to the Julian Calendar the Roman Calendar was known to be complicated with how to figure when the seasons should begin and what days should be kept o r added. To help fix the problem, Julius Caesar worked with an astronomer by the name of Sosigenes to put together a calendar based more on the Sun and Earth. This calendar became known as the Julian Calendar which is rather similar to the calendar that is accepted and used today.It has the commonly used 365 days of the year that are also divided into the 12 different months. Every four years, leap year occurred in one of the months just like it does in todays calendar. Advantages and Disadvantages Between some(prenominal) calendars there are some advantages and disadvantages to how the calendars work. A disadvantage that others feel from the calendar is the days holidays may land on. Some holidays such as Christmas or blessing cannot be changed which can lead to them landing in the middle of the work week.Holidays falling on days like this can prevent individuals from making plans to be around loved ones due to work or school schedules. Another disadvantage is the irregular days of the month. Not every month has the same number of days and sometimes it can interfere with a budget or the cost of life. However, an advantage is the way the calendar is setup. Seasons are always every three months no matter what and the holidays never change. This type of stuff is always guaranteed and cannot be changed. Most Useful in Modern Society Both calendars are really close in similarity.In a way both calendars actually could be used in modern day society since individuals are so familiar with how both calendars work. However, since people are just more familiar with the term Gregorian Calendar and since this calendar is currently more up to date, the Gregorian Calendar would most likely be more useful in todays culture. Although there are many other types of calendars used in the world that can be compared to the Gregorian Calendar, this calendar has been found to be the most internationally accepted civil calendar of today, (TimeandDate, 2013).

How dependent are Americans on foreign oil Essay Example for Free

How dependent are Ameri can buoys on contrasted inunct Essay1.0 IntroductionWe start out a serious problem. America is addicted to vegetable oil. George scrub made this assertion in his 2006 State of the Union address. By 2025 the United States willing increase its daily consumption of oil to 28.3 million barrels per day. These estimates by the Energy Information Administration (EIA) show that by then, the US will depend on alien countries for 70% of its oil needs. The United States of America (USA) depends on hostile nations for 66% of the oil it consumes. According to the EIA, currently the US consumes almost 21 million barrels of oil a day. Unfortunately, this amount of oil is non produced locally so the US has to depend on foreign nations for its consumption of oil.The dependency on oil by the US has a number of do which include impact on the nations delivery determines US foreign policy shapes national security and influences the relationship between the US and otherwise nations (Ebe 2). The aforementioned offspring which dependance on foreign oil has cause takes problems for the US. One of the major problems is the fact that the US is dependent on other nations for its vim supplies. Since the US is dependent on these nations for oil, the events in these oil producing nations determine to a large extent, what happens in the US. There is need for the US to resolve this energy office staff, because dependance on other nations for oil rids the US of its sovereignty as an independent nation.1.1 Statement of problemOil is a very useful resource as it used by many industries. Many industrialized nations of the world, like the US, need large amounts of oil to keep their economies going. Over time, the US has become dependent on foreign nations for its oil needs- while local oil production has plummeted, demand is on the rise. Since the US is so dependent on foreign oil, what are the implications of this dependency?1.2 dependence on foreign oil an effects analysisThe dependence on foreign oil by the US has a lot of implications. The effect of this situation makes an impact on the economy, foreign policy, national security and international relations. These four perspectives are explored in further detail below.Effects on the US economy. dependency on foreign oil supplies has had a profound effect on the US economy. One major evidence of this fact is the constant fluctuation of prices of fellate due to changes in prices of oil. In other words, once the price of oil changes, then the price of gas in the US shifts accordingly. This has a profound effect on companies and other businesses that use gas. In the past year, oil prices have soared due to a number of factors in the world. Once these prices climb, it means that the consumer in the US has to pay more for goods and services that are related in one way or other to oil. Changes in the prices of oil in the world create shocks which are felt when prices of goods and services increase. However, the US economy would not have had to deal with these shocks if there wasnt a high dependence on foreign oil. Furthermore, the constant increase in the price of naked oil in global markets leads to the transfer of huge amounts of money to other countries in foreign trade.US foreign policy. Concerns about US dependence on oil have had an influence on its foreign policy. Various governments are aware of US dependence on foreign oil and have taken moves to protect the integrity of the US. Most people around the world believe that the US meddles in the personal business of other countries especially those in the snapper East because of the oil reserves in these places. If there is instability in the Middle East, it will drastically go the supply of oil to the US. Thus, in order to protect its and stop the constant flow of foreign oil (upon which the US is dependent), the US government takes measures to ensure peace and rule of law in these places. Haley ( 9-10) echoes the voice of critics who contend that the U is keen on maintaining stability in the Middle East because of the implication which crisis will cause the US since it relies so heavily on foreign oil. This is evident in the Gulf war and the recent invasion of Iraq. These actions by the US have created hatred in the hearts of people in the Middle East towards the US.Impact on national security. The dependence on foreign oil by the US has an impact on its national security as well. It can be argued that the dependence on foreign oil by the US has take it get involved in the affairs of other nations of the world. For example, the Middle East is a region which the US does not ignore and it is in this region that the largest reserves of crude oil abound. The US cannot afford to ignore this region because it needs the oil that is produced from these areas. Sadly, many of these countries are places where there is a lot of unrest and autocratic governments and the US gets a share of violent attacks because it relates with these nations. This situation has brewed hatred in the hearts of many and motivated attacks against the US both home and abroad. With the terror attacks on September 11 2001, the US is aware of the threat to national security and the lives of its citizens at home and abroad. Terrorist groups are aware that oil is the centre of the US economy and when they target this sector, they will inadvertently cripple the US economy and bring it to her knees.Relations with other nations. The relationship between the US and other nations is also abnormal to some extent by the dependence on foreign oil by the US. Apart from the US, other countries in the world have vested interests in oil because they too depend to a large extent on oil. With the collapse of the Soviet Union and other iron curtain countries, China has risen as an industrial giant. These industries are largely fuelled by oil and in order to achieve its aim and remain in the lead, China has improved relations with many oil producing countries and opposes restrictions imposed on these places by the US at the United Nations general assembly. These relationships between the US and other nations are founded upon dependence on oil. The dependence on foreign oil by the US has led to complex relationships between the US and other nations. At close observation, the root cause of these relationships is a great deal not noticeable, but exploring deeper brings out the dependence on oil by the US. On the other hand it is important to look at this issue in another perspective. Most of the countries which produce oil are undemocratic. Infact, some of them have oppressive rulers and since the US depends on foreign oil, these governments become prominent. The fact that they are producers of oil propels them to lime light because the US needs this foreign oil so badly.1.3 Relevant statisticsCertain statistics are important in order to understand the dependence on foreign oil by th e US. There was a time in the past when the US was the worlds largest producer of crude oil. just now all that has changed now. According to the EIA, Saudi Arabia is the worlds largest exporter of crude oil and will remain so for a while because it holds 24% of the worlds oil reserves. Conversely, the Middle East holds 66% of the worlds oil reserve and supplies 30% of oil in the world. The dependence on foreign oil by the US has been worrisome to past administrations. According to Randall, President Richard Nixon established Project Independence to stop Americas dependence on foreign nations for oil. Furthermore, President Gerald intersection approved the regulation of petroleum prices, established the Strategic Petroleum Reserve and sign(a) the Energy Policy and Conservation Act. On his part, President Jimmy Carter signed the national Energy Act to encourage the development of local sources of energy.1.4 Probable solutionsThere is growing need to decrease Americas dependence on foreign oil due to the many problems which the phenomenon poses. It is imperative to develop alternate sources of energy in the US so that dependence on oil can gradually be lifted. Dependence on foreign oil may not be lifted totally but a gradual lifting of this dependence is important. Apart from oil, there are alternate sources of energy which should be explored in the US with the backing of the government and private sector so that these initiatives can be widely adopted. In the first place transportation is a major consumer of gasoline, so cars should be made to run on other sources of reason much(prenominal) as electricity which is cleaner and will lower carbon emissions in to the atmosphere. Apart from electricity, wind energy too can be harnessed to power industries.Furthermore, dams built on rivers can generate vast amounts of electricity. Biological fuels too are important and these too need to be developed and used to decrease Americas dependence on oil. The current eco nomic crisis in the world is an indicator to many people to cut costs. However, with the rising cost of crude oil, cost cutting will mean learning to do without crude oil and using other alternate sources of energy. Most of the alternate source of energy mentioned here are not harmful to the environment and the other benefit about them is that they are renewable as well. It does not matter how vast a countrys oil reserves are. There will come a time when these reserves will deplete. If the US continues to depend on foreign oil, what will be done when these countries no longer have oil to sell? The situation is best imagined.1.5 ConclusionObviously, the US needs to look else where to gather her energy needs. The riff from oil to alternative sources of energy may take a while but the journey of a thousand miles begins with a step. This switch has become all the more important considering the amount of hatred which is shown to everything American, especially by terrorists from the Mi ddle East. Much of the world knows that the US economy is affected by oil supplies- cripple this and you bring the world greatest nation to its knees.

Management of Childhood Psoriasis with Acitretin

Man come onment of childishness Psoriasis with AcitretinAbstractPsoriasis is a inveterate inflammatory complaint of the disrobe which cigarette occur at all age-group. Psoriasis in childhood is non un ordinary and has genetic susceptibility but usually an environmental trigger such as infection is survey to initiate the complaint process. Childhood psoriasis has profound effects on both physical and psychosocial health of the patient. Treatment of mild psoriasis can be done with local therapies but those which do not resolve to topical therapies can be treated with phototherapy and systemic therapies. The engage of systemic therapies in childhood is mainly establish on the published data, fictional character series, expert opinion and the experience as there is lack of controlled trials in the age group. Based on the experience retinoid ar probably the back up line medicates for the manipulation of childhood psoriasis which do not respond to topical therapies and phot otherapy. Using acitretin in a execrable window pane and with right physical examinations and research lab investigations will reduce the hazard of potential serious adverse events. This article gives the review of use of acitretin in the childhood psoriasis.INTRODUCTIONPsoriasis is the chronic inflammatory disease of the skin having the world wide prevalence of 1-3% and is clinically characterized by erythematous papules and plaques covered with silvery scales(1, 2). Psoriasis can occur at any(prenominal) age. Psoriasis in pediatric population is not uncommon and exerts a major impact on physical and psycho-social health of a child. In about tercet of the psoriatic population, the onset of disease is seen during the pediatric age(3). In a study of 419 patients from Northern India, the age of onset of psoriasis ranged from 4 mean solar days to 14 years(4). The presence of positive family narrative was found to be 23% and 34.3% in two different studies(5, 6). paediatric psori asis has the genetic susceptibility but the environmental factors often trigger the initiation of the disease process. The almost common triggering factors include respiratory infection, sore throat, stress and trauma. There are different variants of psoriasis in children exchangeable plaque, guttate, napkin, erythrodermic, pustular and nail psoriasis(2). Plaque psoriasis is the most common subtype and the pustular psoriasis is the least common subtype(7). Psoriasis in childhood and adolescence require proper management. Both the patient and the parents must be given the knowledge about the disease and its nature. Psoriasis in childhood affects the health-related quality of life. It is found that, the run a risk of mental illness like depression and anxiety is increased in children with psoriasis than those without psoriasis(8). collectible to the presence of visible skin lesions the children with psoriasis suffer from the low self-esteem(9).Fortunately, childhood psoriasis is usually mild and can be treated with topical therapies. Systemic treatment is required only if the disease do-not respond to topical therapies, phototherapy and if the disease is significantly impairing the psychosocial aspect of the child health. Systemic therapies for psoriasis in children are not approved by FDA. Due to the lack of controlled trials use of systemic therapies are based on case reports, published data and expert opinion. On the basis of published data and experience retinoids appear to be the second-line drug of choice for children(10).ACITRETINRetinoids encompasses all the compounds either natural or synthetic, which possess the biological activity like vitamin A(11). Synthetic Retinoids are classified into three generations. Acitretin and etretinate are the second generation synthetic retinoids and are also know as aromatic retinoids(12, 13). Acitretin is the free and active metabolite of etretinate. Etretinate is strongly lipophilic and tends to accumulate more in the adipose tissue and thus has a longer elimination half-life, in contrast acitretin is less lipophilic and thus clears rapidly from the body and has the shorter elimination half-life(14).Intake with food increases the immersion of acitretin so, the bioavailability of acitretin is more when taken with food than on the empty stomach(15). Due to the longer elimination half-life of etretinate it has been largely re come outd by acitretin. However, it is found that re-esterification of acitretin to etretinate can take place with the concomitant intake of inebriant. So, the female patient especially of childbearing age should be strictly instructed to not take alcohol during the plosive of treatment with and 2 months subsequently the completion of treatment (16).USE IN PEDIATRIC PSORIASISPediatric psoriasis is usually mild and topical therapies are the first choice of treatment. Systemic therapy is not the first choice in childhood psoriasis. It is employ in the treatment of rec alcitrant psoriasis which do not respond to topical therapy, phototherapy and if it is significantly impairing the psychosocial aspects of the child health. Due to the lack of controlled trials, the use of acitretin is based on the published data, case reports and the expert opinion. However, the significant risk benefit of the treatment should always be weighed with the risk of disease without treatment. Long circumstance use of acitretin in children with inherited disorder of keratinization supports the refuge of acitretin in children, but the monitoring is always required(17). Acitretin is used effectively in the treatment of generalized pustular psoriasis, erythrodermic psoriasis, palmoplantar psoriasis and severe recalcitrant plaque psoriasis but acitretin is not effective in psoriatic arthropathy(12, 18). Acitretin is used as either monotherapy or in confederacy with topical agents and narrowband ultraviolet phototherapy.In a multicenter cohort study by Ergun et al. 61 pati ents among 289 patients were treated with acitretin at a dose of 0.3-0.5 mg/kg/day with the mean duration of treatment being 9.16+-9.06 months. 47.5% of the patient achieved at least PASI- 75 receipt. 70.7% of the patient well tolerated the treatment with no side effects. 25.9% experienced the muco epidermal side-effects, 1.7% had hyperlipidemia and 1.7% had nausea(19).In a multicenter retrospective analysis by Lernia et al. including 18 children with plaque psoriasis ,8(44.4%) patient achieved a PASI-response 75 at 16 weeks. The starting dose of acitretin was 0.2-0.5mg/kg/day but the dose was increased to 0.6mg/kg/day in two patients after(prenominal) 8 weeks. Three out of eight patients achieving PASI-75 response stopped therapy for the interval of 2-6 months but had to restart the treatment after relapse and the treatment was effective even after re-introduction. 9 patient give up treatment due to lack of efficacy and 1 patient discontinued treatment due to arthralgia. All pa tients had the mucocutaneous side-effects like chelitis, dry lips, dry mouth and pruritus. The science lab value of the patients were within the baseline during the treatment(20).Ergin et al. report a case of infantile pustular psoriasis treated with acitretin with the initial dose of 0.5mg/kg/day which was later increased to 0.7mg/kg/day. The skin lesion was cleared in the end of 4 months and then the acitretin was tapered to 0.3mg/kg/day for three months and then discontinued. Oral prednisolone was used initially then it was tapered and discontinued. Slight increase in serum triglyceride was observed but it returned to normal after the dose was tapered. No other adverse events were observed(21).Salleras et al. reported a case of 4-year-old girl with congenital erythrodermic psoriasis treated with acitretin at a dose of 0.5mg/kg/day and the complete remission achieved in three months. The discontinuation of the drug led to relapse so the patient was maintained in 0.5-0.75mg/kg/day of acitretin during the aggravation of the disease. The patient was followed till 7 years of age and no other secondary effects were observed(22).A case of annular pustular psoriasis in a 14-month old girl reported by Haug et al. was treated with acitretin in the dose of 0.9mg/kg/day and the patient achieved complete remission after 4 months. The dose of acitretin was reduced and tapered at 0.1mg/kg/day and discontinued after 10 months with no relapse in the following three years. The patient experienced mild side effects like chelitis, reversible hypercholesterinemia and bloom of alkaline phosphatase(23).Acitretin is aa excellent option in a child with palmo-plantar psoriasis. A 14-year-old boy with palmo-plantar psoriasis treated with acitretin at a dose of 10mg/day had a best response with improvement within 6 weeks. At 3-month follow-up the patient had almost lesion free. The patient had experienced adverse events like mild chelitis and xerosis but the laboratory values remai n unchanged. Later the patient was maintained on acitretin 10mg all other day to use upher with the topical combination of 15% liquor carbonis detergens intensify in triamcinolone 0.1% ointment applied every darkness(24).Combination with other therapiesAcitretin has been used in combination with NB-UVB phototherapy, methotrexate and cyclosporine A(24, 25). The effect of acitretin together with NB-UVB is found to be synergistic.A case of 3.5-year-old boy with severe pustular psoriasis (von Zumbusch type) reported by kopp et al. was started on acitretin 1mg/kg/day with the short-term use of systemic methylprednisolone for controlling the acute stage. However, any attempt to reduce or discontinue the steroid led to exacerbation of the disease. Then the patient was given NB-UVB phototherapy three times per week. Later, after five exposures the corticosteroid was tapered and discontinued. The patient was then maintained on NB-UVB phototherapy two times weekly together with acitretin 0 .3mg/kg/day. Disease was well controlled with this combination regimen. The laboratory values remained unchanged during the acitretin treatment(26).A 9-year-old boy with generalized pustular psoriasis was treated with acitretin 10mg/day and was maintained at 10mg three times week for a year. Later he actual skin pain and localized area of pustules which led to increase in the dose of acitretin 20mg/day during the flare but later tapered to 10mg/day for the following year. But the patient eventually required the addition of NB-UVB phototherapy to maintain the remission. The patient is well maintained by this combination(24).Adverse events of acitretinAcitretin in known to exert a number of adverse events. Most of the adverse events are dose dependent and reverse back to normal after decreasing the dose or after discontinuation of therapy. However, it is usual to have the minor side-effects on the long term treatment with acitretin.The most common adverse events of acitretin is the muco-cutaneous adverse events. Dry lips being the most common one and be treated with the use of emollients. Others include dry dry mouth, cheilitis, stomatitis and gingivitis and taste disturbances. Acitretin causes dryness with inflammation of mucous membrane and transitional epithelia which occasionally leads to epistaxis, rhinitis, photophobia, conjunctivitis and xeropthalmia. Alopecia, nail-fragility and paronychia have also been observed(27). Rarely patients may have the photosensitivity reactions. Retinoid dermatitis which resembles unstable psoriasis can develop 25% of the patients receiving high dose of acitretin therapy(28). Muco cutaneous side effects can be treated symptomatically, and if severe effects occur the dose reduction can be tried before the discontinuation of the drug.Acitretin causes transient circus tent of liver enzymes. The elevation is dose dependent and usually reverse back to normal after reducing the dose or after discontinuation of the therapy. Seve re hepatotoxic reactions resulting from retinoids are rare. In a data of 1877 patients receiving oral acitretin only 0.26% of the patients showed overt chemical hepatitis(29). However, the hepato-toxic reactions in children are rare because the cofactors like diabetes, alcoholism, and obesity are less likely in children(12).Acitretin also exerts the effects on lipid profile which is reverse back to normal within 8 weeks after the discontinuation of the drug(30). Retinoids are seen to cause the elevation of triglyceride and cholesterol and decrease in the high density lipoprotein. In a study it is seen that 35% of the patients had the elevation in serum triglyceride above 300mg/dl and about 15% of the patients had the elevation of cholesterol level(31). The decrease in the high density lipoprotein is also observed(29).Retinoids have been known to cause the drawn abnormalities especially in children. The long term treatment with etretinate is also associated with the extraspinal tend on and the calcification of ligament. However, the study including 19 children and young adults, treated with etretinate for continuous 5 years do not show any skeletal abnormality(32). No cases of diffuse idiopathic skeletal hyperostosis was seen in a retrospective study on long term use of acitretin in a low dose(33). No significant radiologic abnormalities associated with retinoids was detected in a patient of severe pustular psoriasis treated with low dose of acitretin for 9 years(34). It is usually not recommended to use oral retinoids for the treatment of psoriasis in children due to the report of occasional bone changes like premature epiphyseal closure, skeletal hyperostosis and extra-osseous calcification observed in the children on the long term treatment with etretinate(35, 36). If acitretin is to be used in a child, the child should be observed cautiously for any abnormalities of growth and bone development. Routine radiography is not recommended because of the radiation hazards, but the atypical musculoskeletal pain must be investigated with x-rays. Growth chart of the child on acitretin should be maintained (27). Arthralgia, arthritis, myalgia may also occur during the treatment with acitretin. A few case of vasculitis, Wegener granulomatosis and erythema nodosum are also observed.Retinoids are teratogenic drugs. The defect due to retinoids is termed as retinoic acid embryopathy. The malformations seen in the fetus include microtia/anotia, micrognathia, cleft-palate, conotruncal heart disease and aortic arch abnormalities, thymic defects, retinal or opthalmic nerve abnormalities and central nervous system malformations(37). Even though only one report of human teratogenicity due to acitretin has been published(27), acitretin should be cautiously used as acitretin is converted to etretinate which has a longer elimination half-life. The female patient of child-bearing should strictly be instructed for the use of two effective contraceptive method stating 1-month prior of treatment, during the period of treatment and 3 years after the discontinuation of treatment(38). However, the risk of teratogenicity by use of acitretin in children is less because of the least chance of a child to get pregnant.The concomitant use of retinoid with tetracycline and minocycline has led to pseudo-tumour cerebri(29). Pseudo-tumor cerebri was reported in a case of 14-year-old boy treated with isotretinoin and tetracycline(39). Retinoids also causes blurring of vision, headache and reduced night vision. Patient with severe headache, vomiting and visual disturbances should stop acitretin immediately and consult the doctor(27).The concomitant use of vitamin A with acitretin must be restricted.MONITORING GUDELINESBefore starting the treatment with acitretin, proper history taking and careful physical examination should be performed. Laboratory investigations including complete blood count, lipid profile, liver enzymes and blood chou in diabetics s hould be done. Monitoring of the liver enzymes and fasting serum cholesterol and triglyceride must be done every 2-4 weeks of therapy for the first two months and then every three months(27). Children on acitretin therapy must have their growth charted. Female of child bearing age and their parents should be counselled about the teratogenic effect of the drug and use of contraception during and after the treatment. The pregnancy should be ruled out before the initiation of acitretin therapy with two negative pregnancy tests.CONCLUSIONAcitretin is a non-immunosuppressive drug that can be effective in the treatment of childhood psoriasis. It is seen that acitretin is more effective in pustular and erythrodermic psoriasis and moderately effective in the plaque type psoriasis in children. Acitretin is used both as monotherapy and as combination therapy. As the use of acitretin in children lack sufficient data and evidence, its use in children should always be weighed with risk benefit o f treatment and risk if the disease is left untreated. The side effects are mostly dose dependent so it can be minimize by using the lowest possible dose. The dose of 0.5-1mg/kg/day was seen to be effective. It should be used cautiously in the female patient. Long term treatment with acitretin require proper clinical and laboratory evaluation.REFERENCES1.Griffiths CE, Barker JN. Pathogenesis and clinical features of psoriasis. Lancet (London, England). 2007370(9583)263-71.2.Al-Mutairi N. Childhood Psoriasis Springer International Publishing 2016.3.Raychaudhuri SP, Gross J. A comparative study of pediatric onset psoriasis with adult onset psoriasis. Pediatric Dermatology. 200017(3)174.4.Kumar B, Jain R, Sandhu K, Kaur I, Handa S. Epidemiology of childhood psoriasis a study of 419 patients from northern India. Digest of the World Core aesculapian ledgers. 200443(9)654-8.5.Seyhan M, Cokun BK, Salam H, Ozcan H, Karincaolu Y. Psoriasis in childhood and adolescence evaluation of demogr aphic and clinical features. Pediatrics International Official Journal of the Japan Pediatric Society. 200648(6)525-30.6.Fan X, Xiao FL, Yang S, Liu JB, Yan KL, Liang YH, et al. Childhood psoriasis a study of 277 patients from China. Journal of the European Academy of Dermatology Venereology. 200721(6)762.7.de Moll EH, Chang MW, Strober B. Psoriasis in adults and children Kids are not just little people. Clinics in Dermatology. 201634(6)717.8.Kimball AB, Wu EQ, Guerin A, Yu AP, Tsaneva M, Gupta SR, et al. Risks of developing psychiatric disorders in pediatric patients with psoriasis. Journal of the American Academy of Dermatology. 201267(4)651-7.e1-2.9.Fox FE, Rumsey N, Morris M. Ur skin is the thing that everyone sees and you cant change it exploring the appearance-related concerns of young people with psoriasis. Developmental neurorehabilitation. 200710(2)133-41.10.Burden AD. Management of psoriasis in childhood. Clinical and data-based dermatology. 199924(5)341-5.11.Orfanos CE, Stadler R, Gollnick H, Tsambaos D. Current developments of oral retinoid therapy with three generations of drugs. Non-aromatic, monoaromatic and polyaromatic retinoids (arotinoids). Current problems in dermatology. 19851333-49.12.Gautam M, Tahiliani H, Nadkarni N, Patil S, Godse K. Acitretin in pediatric dermatoses. 201617(2)87.13.Brecher AR, Orlow SJ. Oral retinoid therapy for dermatologic conditions in children and adolescents Journal of the American Academy of Dermatology. Journal of the American Academy of Dermatology. 200349(2)171-82.14.Wiegand UW, Chou RC. Pharmacokinetics of acitretin and etretinate. Journal of the American Academy of Dermatology. 199839(2 Pt 3)S25-33.15.McNamara PJ, Jewell RC, Jensen BK, Brindley CJ. Food increases the bioavailability of acitretin. Journal of clinical pharmacology. 198828(11)1051-5.16.Grnhj Larsen F, Steinkjer B, Jakobsen P, Hjorter A, Brockhoff PB, NielsenKudsk F. Acitretin is converted to etretinate only during concomitant alcohol intake. British Journal of Dermatology. 2000143(6)1164-9.17.Lacour M, Mehta-Nikhar B, Atherton DJ, Harper JI. An appraisal of acitretin therapy in children with inherited disorders of keratinization. The British journal of dermatology. 1996134(6)1023-9.18.Cordoro KM. Systemic and light therapies for the management of childhood psoriasis part II. Skin Therapy Letter. 200813(4)1-3.19.Ergun T, Seckin Gencosmanoglu D, Alpsoy E, Bulbul-Baskan E, Saricam MH, Salman A, et al. Efficacy, safety and drug survival of conventional agents in pediatric psoriasis A multicenter, cohort study. J Dermatol. 2016.20.Di LV, Bonamonte D, Lasagni C, Belloni FA, Cambiaghi S, Corazza M, et al. Effectiveness and Safety of Acitretin in Children with Plaque Psoriasis A Multicenter Retrospective Analysis. Pediatric Dermatology. 201633(5)530-5.21.Ergin S, Ersoy-Evans S, Sahin S, Ozkaya O. Acitretin is a safe treatment option for infantile pustular psoriasis. Journal of Dermatological Treatment. 200919(6)341-3.22.Saller as M, Sanchez-Regaa M, Umbert P. Congenital Erythrodermic Psoriasis Case Report and Literature Review. Pediatric Dermatology. 199512(3)231-4.23.Haug V, Benoit S, Wohlleben M, Hamm H. Annular pustular psoriasis in a 14-month-old girl a therapeutic challenge. The Journal of dermatological treatment. 20171-6.24.Marqueling AL, Cordoro KM. Systemic treatments for severe pediatric psoriasis a practical approach. Dermatologic clinics. 201331(2)267-88.25.de Oliveira ST, Maragno L, Arnone M, Fonseca Takahashi MD, Romiti R. Generalized pustular psoriasis in childhood. Pediatr Dermatol. 201027(4)349-54.26.Kopp T, Karlhofer F, Szpfalusi Z, Schneeberger A, Stingl G, Tanew A. palmy use of acitretin in conjunction with narrowband ultraviolet B phototherapy in a child with severe pustular psoriasis, von Zumbusch type. Digest of the World Core Medical Journals. 2005151(4)912-6.27.Ormerod AD, Campalani E, Goodfield MJ. British fellowship of Dermatologists guidelines on the efficacy and use of acitr etin in dermatology. British Journal of Dermatology. 2010162(5)952-63.28.Kragballe K, Jansen CT, Geiger JM, Bjerke JR, Falk ES, Gip L, et al. A double-blind comparison of acitretin and etretinate in the treatment of severe psoriasis. Results of a Nordic multicentre study. Acta dermato-venereologica. 198969(1)35-40.29.Katz HI, Waalen J, Leach EE. Acitretin in psoriasis an overview of adverse effects. Journal of the American Academy of Dermatology. 199941(3 Pt 2)S7-s12.30.Vahlquist C, Selinus I, Vessby B. Serum lipid changes during acitretin (etretin) treatment of psoriasis and palmo-plantar pustulosis. Acta dermato-venereologica. 198868(4)300-5.31.Gupta AK, Goldfarb MT, Ellis CN, Voorhees JJ. Side-effect profile of acitretin therapy in psoriasis. Journal of the American Academy of Dermatology. 198920(6)1088-93.32.Glover MT, Peters AM, Atherton DJ. Surveillance for skeletal toxicity of children treated with etretinate. The British journal of dermatology. 1987116(5)609-14.33.Lee E, Koo J. Single-center retrospective study of long-term use of low-dose acitretin (Soriatane) for psoriasis. The Journal of dermatological treatment. 200415(1)8-13.34.Halverstam CP, Zeichner J, Lebwohl M. Lack of significant skeletal changes after long-term, low-dose retinoid therapy case report and review of the literature. Journal of cutaneous medicine and surgery. 200610(6)291-9.35.Prendiville J, Bingham EA, Burrows D. Premature epiphyseal closurea complication of etretinate therapy in children. Journal of the American Academy of Dermatology. 198615(6)1259-62.36.Halkier-Sorensen L, Laurberg G, Andresen J. Bone changes in children on long-term treatment with etretinate. Journal of the American Academy of Dermatology. 198716(5 Pt 1)999-1006.37.Lammer EJ, Chen DT, Hoar RM, Agnish ND, Benke PJ, Braun JT, et al. Retinoic acid embryopathy. The New England journal of medicine. 1985313(14)837-41.38.Sarkar R, Chugh S, Garg VK. Acitretin in dermatology. Indian journal of dermatology, venereolog y and leprology. 201379(6)759-71.39.Lee AG. Pseudotumor cerebri after treatment with tetracycline and isotretinoin for acne. Cutis. 199555(3)165-8.

Task-Centred Anti-Discriminatory Practice in Social Work

Task-Centred Anti-Discriminatory Practice in sociable exitDemonstrate your cause of the main principles of business CENTRED PRACTICE. Consider the strengths and weaknesses of the theory in its application to anti discriminatory workout.IntroductionThe International Federation of Social Work states thatThe companionable survey profession promotes mixer change, problem solving in humanrelationships and the empowerment and liberation of citizenry to enhance well-being.Utilising theories of human behaviour and fond systems, tender work intervenes at thepoints where people interact with their environments. Principles of human rights and genial vindicatoryice be fundamental to social work1.The best kind of social work is that which places the lymph node or help user at the centre of everything it does. This is a core principle of occupation base social work, rather than working with a set of preconceived ideas the social player has to negotiate the legal material within which she/he is obliged to operate in order to hand the best results for the service user. Task based social work is therefore first and foremost ethical and anti-oppressive social work which takes as its foundation the Human Rights Act of 1998 that each person should be dealt with in terms of the concept of the inherent worth of the individual.This assignment ordain first give some definition of the role and responsibilities of the social worker. From within this manikin it will then look at the main principles of task centred practice and will use imaginary scenarios to consider the strengths and weaknesses of the theory and its application to anti-discriminatory practice.Social WorkPeople looking for a c beer as a social worker usually have more luck if they have had some develop of dealing with individuals in the community of interests. This could involve work placements or being convolute with voluntary work, both of which seen as good practice and background to engage in social work practice. Prior community involvement is seen as a valuable asset for anyone wishing to become a social worker. Social service is set against a background of voluntary charity work in the late nineteenth century and people who get involved in community work are seen to have the right kind of spirit, or an interest in social justice that is a valuable part of social work (Moore, 2002).Tasks and Roles Within the Legal FrameworkThe social workers role is outlined by what was the personal social services. The overall aim of social workers is a concern with individuals and the care they may need. Under Government legislation and the Code of Practice, social workers have to act in accordance with the 1998 Human Rights Act, the 1990 NHS and Care in the Community Act (a result of the 1988 Griffiths Report), the Chronically Sick and Disabled Persons Act of 1970 and the 1995 Disability Discrimination Act. More recently social workers are legally required to be involved in partner ship working with different agencies (ref) and this has been extended to include the service user/service provider relationship. in that respect is, arguably, some truth in the fact that this takes what is at heart a charitable search for social justice and puts it on a par with businesses and at the mercy of market forces.The primary work behind task centred practice is the identification of social systems, what they might be and what they do. Thus the properly qualified social worker necessitate a good deal of sociological knowledge with regard to things like class, gender, race and religion. He/she would also need to be witting of Parsons work on social systems and socialisation because this gives an insight into the boundaries from which a service user may be operating (Payne, 1991). Once social workers are aware of social systems and how they operate then it is possible to be able to define any imbalances within a working relationship (Payne ibid). This outlast is a necess ary part of anti-oppressive and anti-discriminatory practice, however, we shall see that task centred practice can be a two edged sword for the social worker.Paynes (1991) systems summary is essential to task centred practice because it provides the social worker with a conceptual basis to start breaking a problem and its solution into manageable pieces.Task centred practice is based on the idea that people learn by doing and that when they have a success this then improves their performance (Hanvey, 1994). Task centred theory is upgrade premised on the view that tasks are a series of steps that a professional would take in order to help a service user achieve a goal. This goal would need to take into account the rights and responsibilities of others as well as those of the service user.There are three key parts of task centred practice the first part of this process focuses on the problem or situation that the social worker is faced with, for use a young flummox who has been ho spitalised with mental health problems and now wishes to look after her child herself. In this situation the social worker would have to break the problem down for example what might the risks to the child be if it was left unsupervised with a sustain from a difficult client group? The social worker would begin by looking at the whole picture and then focus on particular aspects of the situation that could be problematic. Added to this as the social worker investigates the problem further he/she may find the shape and scope of the problem changing (Hanvey, ibid). Thus the social worker has to establish certain parameters e.g. the urgency of the problem and the chances of distress or success as well as any support the service user may have. In the graphic symbol of a young mother with mental health issues for example the following problem might occurIf the social worker needs to make a visit and the service user refuses to allow entry this could cause problems with regards to any future assessment, something which is required by the legal framework. According to the terms of the Community Care Act of 1990 (circular LAC (92) 12, any needs assessment would have to take into account that persons current living situation, any help or support from friends and relatives and what she herself hopes to gain from the assessment. Because of mental health needs this client would be entitled to a specific type of assessment.2A task centred undertake involves looking at what the service user wants (in this case to have agnatic rights and control of her child), what the problems might be. If an earlier assessment has shown that family and friends would be able to offer little in the way of help and a young child is involved then the social worker has a duty to search for alternatives. If the mothers care of the child is erratic and she is posing a problem for other people around then it would be the social workers duty to call in the medical officer of health who then ha s to confine an order from the magistrates court. This would allow the social worker to gain entry and to assess the situation and the needs of the child, however, this could bring the social worker into a value skirmish situation (this, I think is one of the problems with the task centred plan of attack).Task centred social work means that once the social worker has defined the problem and the hoped for outcome, he/she then has to decide whether the outcome is really attainable and what the consequences might be if it were achieved. With the imagined scenario used here achieving what the client wants could involve the social worker in a variety of problematic situations.Ethically speaking the interests of the service user should take priority. However the social worker has a duty to bear in read/write head the BASW guidelines on ethical practice, Boulton (2003) has said of thisIn exceptional circumstances where the priority of the service users interest is outweighed by the nee d to protect others or by legal requirements, make service users aware that their interests may be overridden (Boulton, 2003 p.10).3Where it has been estimated that a child may be at risk then a social worker has a duty of care under the 1989 Childrens Act. At the same time there is a requirement to act within a framework that is informed by the Human Rights Act of 1998 and the rights of the mother have to be taken into consideration. There is a dilemma here for the social worker because a wrong decision could result in harm occasioned either to the child or to the mother as a result of her own actions. In such circumstances a social worker is bound to make an assessment of risk, and also probable harm. If harm is occasioned then the social worker could be held to account.The (system we are in now is almost ready to treat every death as chargeable to someones account, every accident as caused by someones criminal negligence, every sickness a threatened prosecution. Whose fault? Is the first question (Douglas, 199215-16).4Clearly this situation needs a multi-agency approach including the social worker, his/her immediate superior, someone from the child protection scheme, the mothers GP, the health visitor and the mother. Putting the child on the child protection interpret with regular reviews may help alleviate the situation and is in line with the requirements of the 1989 Childrens Act. This could therefore become a case where the service users rights will be overridden because the primary duty is to the child. This is where a social worker would be faced with a conflict of ethics and values which may depart to a practice situation where, as a practitioner, the social worker cannot be right. The final part of a task centred approach is to define just how long a social worker can give to a particular case and this is almost impossible to define, particularly in the imagined scenario above. A case like this could go on for years with different levels of profe ssional involvement.ConclusionTask centred theory, I believe is a good starting point for social workers as it provides some sort of framework for dealing with some of the problems service users may present. While the theory is meant to support anti-oppressive and anti-discriminatory practice, this relies on a thorough understanding of social systems and how they operate. On the other hand there are some situations where a social worker has to weigh the needs of one person against some other and this can result in apparent oppression and neglect of a service users human rights. The fact of the matter is that there will always be cases where someone is the loser and this is a sad fact of social work experience.Bibliographyhttp//www.gscc.org.uk/NR/rdonlyres/30BC32F2-20B2-4D90-ABAB-3666D5BB44EB/0/Rolesandtasksconsultationpaper.pdf accessed 31st March 2007Boulton, J 2003 Code of morality for Social Work available at http//www.basw.co.uk/articles.php?articleId=2page=14Hanvey, C and Phi lpot, T. 1994 Practicing Social Work New York, RoutledgeKemshall, 2002 Kemshall, H. 2002. Risk, Social Policy and Welfare Buckingham, Open University Press p.9Payne, M. 1991 moderne Social Work Theory. A Critical Introduction, London Macmillan.The Care Programme Approach Policy towards integrated care programme approach and care steering (2000) South London and Maudsley NHS Trust11 http//www.gscc.org.uk/NR/rdonlyres/30BC32F2-20B2-4D90-ABAB-3666D5BB44EB/0/Rolesandtasksconsultationpaper.pdf accessed 31st March 20072 The Care Programme Approach Policy towards integrated care programme approach and care management (2000) South London and Maudsley NHS Trust3 Boulton, J 2003 Code of Ethics for Social Work available at http//www.basw.co.uk/articles.php?articleId=2page=144 Quoted in Kemshall, 2002 Kemshall, H. 2002. Risk, Social Policy and Welfare Buckingham, Open University Press p.9

Displacement Reaction :: Papers

Displacement Reaction The aim of my experiment is to find out what happens to the raise up of the atomic number 30 and copper sulphate solution when one of the variables is pitchd. Key variables amount of copper sulphate solution amount of zinc I am personnel casualty to investigate what happens to the temperature of the zinc and copper sulphate solution as the amount of zinc is increased. The equation to show this reaction is Zn + CuSO4 ZnSO4 + Cu The enthalpy change for the reaction is H = -217kJ mole This means that if 1 mole of solution is used of each substance, the heat given off will be 217,000 Joules. weapon 1 test tube 20ml of copper sulphate solution for each experiment Zinc Rubber bung Thermometer Prediction I think that as the amount of zinc is increased, the temperature of the solution will also increase. I pay back used the following formula to predict some results of this experiment. q = Q mc where q = temperature rise, Q = quantity of heat, m = mass of solution (20g) and c = the specific heat capacity of water which = 4.18Jg K . 65g Zinc 217000 joules 1g Zinc 217000 = 3338 joules 65 Therefore for 1g of zinc 3338 =39c rise 20x4.18 I can now use this formula proportionately to predict results for my investigation. For 0.3g of zinc 0.3 x 39 = 12c rise For 0.5g of zinc 0.5 x 39 = 19.5c rise For 0.7g of zinc 0.7 x 39 = 27.3c rise For 0.9g of zinc 0.9 x 39 = 35.1c rise I have used this information in order to predict the results of the temperature rise I expect to see as the amount of zinc is increased. I have also used this information to plan my experiment.

Critical Response to David Gutersons Snow Falling on Cedars Essay

Critical Response to David Gutersons century travel on CedarsDavid Gutersons novel Snow Falling on Cedars undoubtedly holds high acclaim in its reputable attempt to show the prejudice amidst the Americans and Japanese later on World war II and to a greater extent importantly the prejudice that is unavoidably apart of human nature. The author of the criticism recognizes and brings to light the things done by Guterson throughout the novel. He refers to the indignation between people brought virtually by differences, the unwillingness to accept change, and also states that things end in a moral and justified manner.The author refers to old passions, prejudices, and grudges come up throughout the novel taking place off the Washington coast. In referring to old passions the although beings up a valid point of the passion that exists between outcast and Hatsue, although it is not necessarily old as Ishmael is still vibrantly in love with Hatsue throughout the novel up until the ve ry end. Their so called passion begins in the cedar tree where they spend their childhood escaping from the prejudices of society, but form a passionate connection that cannot be broken. Referring to the prejudices and grudges the author is most evidently talking about the resentment between the Heine and Miyamato families regarding the purchase of Ole Jugersons kingdom. The grudge aroused because the land rightfully belongs to the Miyamatos as they had it land leased but when the Japanese were sent to internment camps after the bombing of Pearl Harbor there became confusion. Out of this confusion the land ended up in the hands of Carle Heine. If the land dispute would have been between two similarly colored people it would not have been as significant. Being between the Japanese and American protagonists it becomes an issue of prejudice rather than will power as Karl, the ideal white male, keeps land from the hard-working Japanese who fought for a countries freedom in which he is not even viewed as equal. The simplistic idea of land ownership boils down to a much more complicated issue of the impurities of American democracy. The author also refers to Gutersons courtroom, where the entire novel takes place, as being vigorously constructed. In doing so he alludes to the imagery portrayed through the novel by Guterson, which gives life to the seemingly standard courtroom making it a consume repr... ...as a possible motive, points to Kabuo as the murderer. Meanwhile, Hatsue Miyamoto, Kabuos wife, is the undying passion of Ishmael Chambers, the publisher and editor of the town newspaper. Ishmael, who returned from the war minus an arm, cant shake his obsession for Hatsue any more than he can ignore the ghost pains in his nonexistent arm. As a thick snowstorm whirls outside the courtroom, the story is unburied. The same incidents be recounted a number of times, with each telling revealing new facts. In the end, justice and morality are proven to be intim ately woven with beauty--the flesh of awe and wonder that children feel for the world. But Guterson communicates these truths through detail, not philosophical argument Readers will come away with a surprising store of cognition regarding gill-netting boats and other specifics of life in the Pacific Northwest. Packed with lovely moments and as compact as haiku--at the same time, a page-turner full of twists.Works CitedGuterson, David. Snow Falling on Cedars. New York Vintage Books, 1994. 75-428. Snow Falling on Cedars. Kirkus Reviews. 24 Mar. 2005 < . Snow Falling on Cedars. Sparknotes. 24 Mar. 2005 .

Reintroducing the Wolf to Yellowstone Essay examples -- Wolves Park An

Reintroducing the Wolf to YellowstoneWolves have always been a symbol of the wild, free in spirit and roamers of the land. These animals atomic number 18 considered majestic and protectors of the wilderness. They have always roamed the western join States, although their macrocosm has fluctuated over time. Over the past 10 years wildcat well reintroduction into Yellowstone National Park has been a debatable topic to those of the United States. As of 1995, wolves have been reintroduced into the park. This has come with some strong opposition and yet has prevailed. The future of the wolf in Yellowstone park is instantaneously spirit bright, although not certain since there still are those who want them banished again.HistoryMany hundreds of years ago wolves roamed the entire northernmost the Statesn guileless with no barriers and very few predators. As settlers moved into the United States, wolves became more and more scarce in the wild of America. As the wilderness areas of the United States declined, so did the population of the wolf, until there were only a few spots in the wild where wolves could still be found. Wolves used to thrive in the western United States. in that location was ample game to hunt and plenty of places to live and wander. Until people moved in, wolves were settled. As European settlement expanded to the west, it began to take its toll on the wolves and their habitat. clarification of the forests came first, which was then accompanied by significant over-hunting in this area (Noceker). Slowly wolves became concentrated into smaller and smaller areas in the west. Finally, they were assumed to be bothers to the ranchers and farmers and perhaps a threat to those people who lived in the area. As the United States matured, people realized that ... ...h. History and current status of the Yellowstone wolf restoration. September 19, 1999. http//www.poky.srv.net/jjmrm/wpages/yell-o.htmMaughan, Ralph. Overview and history of the pri meval Idaho wolf reintroduction. September 25, 1999. visted October 4, 1999. http//www.poky.srv.net/jjmrm/wpages/idaho-o.htmMoody, Joan. Historic Reintroduction Continues Despite Budget Cuts Defenders Helps Fly Wolves to Yellowstone. January 22, 1996. Visited October 20, 1999. http//www.defenders.org/pr012296.htmlNoceker, Robert J. Congressional Research Service Report for Congress Reintroduction of Wolves. August 1, 1997. Visited October 17, 1999. http//www.cnie.org/nle/biodv-13.htmlThe Abundant Wildlife Society of North America (AWSNA), An Argument against Wolf Reintroduction in Colorado. visited October 17, 1999. http//www.firstrax.com/antipro.htm Reintroducing the Wolf to Yellowstone Essay examples -- Wolves Park AnReintroducing the Wolf to YellowstoneWolves have always been a symbol of the wild, free in spirit and roamers of the land. These animals are considered majestic and protectors of the wilderness. They have always roamed the western United States, altho ugh their population has fluctuated over time. Over the past 10 years wolf reintroduction into Yellowstone National Park has been a controversial topic to those of the United States. As of 1995, wolves have been reintroduced into the park. This has come with some strong opposition and yet has prevailed. The future of the wolf in Yellowstone park is now looking bright, although not certain since there still are those who want them banished again.HistoryMany hundreds of years ago wolves roamed the entire North American continent with no barriers and very few predators. As settlers moved into the United States, wolves became more and more scarce in the wild of America. As the wilderness areas of the United States declined, so did the population of the wolf, until there were only a few spots in the wild where wolves could still be found. Wolves used to thrive in the western United States. There was ample game to hunt and plenty of places to live and wander. Until people moved in, wolve s were settled. As European settlement expanded to the west, it began to take its toll on the wolves and their habitat. Clearing of the forests came first, which was then accompanied by significant over-hunting in this area (Noceker). Slowly wolves became concentrated into smaller and smaller areas in the west. Finally, they were assumed to be bothers to the ranchers and farmers and maybe a threat to those people who lived in the area. As the United States matured, people realized that ... ...h. History and current status of the Yellowstone wolf restoration. September 19, 1999. http//www.poky.srv.net/jjmrm/wpages/yell-o.htmMaughan, Ralph. Overview and history of the central Idaho wolf reintroduction. September 25, 1999. visted October 4, 1999. http//www.poky.srv.net/jjmrm/wpages/idaho-o.htmMoody, Joan. Historic Reintroduction Continues Despite Budget Cuts Defenders Helps Fly Wolves to Yellowstone. January 22, 1996. Visited October 20, 1999. http//www.defenders.org/pr012296.htmlNoc eker, Robert J. Congressional Research Service Report for Congress Reintroduction of Wolves. August 1, 1997. Visited October 17, 1999. http//www.cnie.org/nle/biodv-13.htmlThe Abundant Wildlife Society of North America (AWSNA), An Argument against Wolf Reintroduction in Colorado. visited October 17, 1999. http//www.firstrax.com/antipro.htm