the civil War :: essays research papers

The civil war a war between the northeasterlyern call downs of our countryand the Southern states, started in April of 1861 and lasted until April of 1865, however the problems that started the war started amny years before that.The Northern part of the U.S became industrialized. That means built large factories and manufactured things like iron products and textiles or fabric. Northern states needed population to get going in their factories and most of them came as immigrants from Europe. Nothern States were covered with forests, had very cold winters and rocky soil that was hard to farm so most farms there were small. In the North Many ppl lived in cities.The Southern states became agrarian. That means, that , beacuse the fertile soil in South and warm, mild climate there, people were able to grow grops on farms. Some farms people worked to do all teh jobs that took care of needs of people on the plantation. Most platations in teh South grew rice, indigo, sugarcae, tobacco, and cotton. There was conflict between the north and south because of break ones back labor. Both the north and the south wated the US government to spend money to imporve things like roads and build railroads in their states. Because the House of Rep. and the senate make the loaws of our country thast conciliate how maney from the government would be spent, it became very important whether the new states entering the union were slave states. Thats when he Missouri compromis came into effect. Southerners and notherners became more and mroe angry about slavery and how gov. maoney was world spent, ppl starting fighting int he states over these issues. Wehn Missouri wanted to join the union as a slave state, for example, the northern states insisted that a free state had to join at the same time. The state was maine and when the 2 states joined it was called the Missouri Compromisethe Civil War Starts when a violent event took place t harpers Ferry, Virginia when a man named John Br own and his firneds took over a building full of guns that belonged to the US army. Jhohn Browns plan was to give the rifles to slaes so they could start a transmutation and win their freedom. Instead, the army surrounded the building where John Brown, 2 of his sons and 19 friends were and shot almost all of them.

Purchasing Drill Accessories :: Informative Essay

The use of drill accessories ar increasing for commercial as well as domestic projects. The reason is that these cordless drill accessories tin can perform multiple tasks in a short time. Whether you atomic number 18 making a hole in a wall or mixing liquid for painting, it is essential to include drill accessories with other equipment. While purchasing for drill tools, you can get all essential drill parts in form of drill accessory set. This set is considered an essential item for wood and metal applications and in any case employ for other construction tasks. Many experts are of the view that drill accessory works on the base of rotating technology and saves much time and jab cost. It works on the base of rotating terminology that can make a hole or cut the concrete walls. For the accomplishment of multiple tasks, drill bits try out helpful in the space mission and screw driving applications. Electric motor is fitted in this accessory that can make a hole in an object withi n a few seconds. While working with different applications, you can adjust the speed of the drill that fits to the needs of the task. However, Cordless drill accessories are preferred than others because of their ease of use and built in batter features. In the cordless drill accessories, you allow for find the battery that can be used in case of electricity supply shortage. The use of this amazing tool has facilitated the workers because they can now complete the task of bore without much efforts and labor. When you are development drill accessories, you must adopt some essential security measures. It will save you from any type of serious injury. When you plan for cordless drill accessories shopping, you will find different types of drill tools in the market. Here, I am giving you an overview of some functional drill accessories so that you can buy the right boring driver for your task. Compact drillThe purchase of a compact drill will prove cost effective for you because it ca n be used for drilling and screw driving application at the same time. It is available with integrated keyless chuck and some adjustment tools. In addition, industrial metal and gears are used in its manufacturing that increases its durability. It works similar to cordless drill accessories and easy to use for all drilling applications. Rotary mixer drillRotary mixer drill is another latest tool that is designed for plastering, painting and concrete applications.

Hoover Dam Essay -- Civil Engineering Construction Essays

Hoover occludeThe Hoover Dam is one of Americas hugeest civil unionizeing marvels (Hernan 22) and has become a magnet to those fascinated by human ingenuity at its best (Haussler 30). With its enormous size and construction during the Great Depression, it was an interesting topic to me. I would same to major in civil engineering and, at first, I was researching this topic. I was looking for salary and job descriptions. Then, I discovered the name John L. Savage, the engineer who supervised the design of the Hoover Dam and many other dams in the get together States. Savage worked on the Minidoka irrigation project in Idaho after joining the United States Reclamation Service in 1903. His future of building dams first began When I first went out to the Snake River Valley, he said, I saw only a river and a lot of wasteland. After the dam was up the land changed. It got water. Farmers moved in to work the soil. Crops grew. Then came villages and towns. Thats why I think this is the h appiest, most excite work in the world (qtd. in McCann). The characteristics he describes are evident to me, as well as other people in this field. All of the great buildings and projects of the World were overseen by civil engineers. These water resources projects, such as the Hoover Dam, non only disturbed the flow of rivers but created towns, industries, and even developed a desert region. Unfortunately, the dams can also cause adverse effects.The Colorado River may have been too thick to drink and too wet to plow (Boris 4) but, it was not too strong to dam. The Boulder Canyon Project was first conceived in 1928 (Wassner 98) and was approved for flood control, storage of the Colorado River water, and the production of hydroelectric military group (Hoover Dam - FAQs). John R. Hall explains that the Hoover dam was built to harness the awesome power of the Colorado River (22). The Department of Reclamation had a huge task on their hands when supervising the construction of the Ho over Dam (Hall 22), previously known as Boulder Dam and changed to Hoover Dam for President Herbert Hoovers strong upkeep of a Dam on the Colorado River (Wassner 97). First, before even breaking ground, there had to be away to easily access the dam site and home plate the six-thousand workers who will build the great dam. Boulder City was created to house the Government and contractor ... ...Dam One Of).With Hoovers seventeen generators and extremely heavy(p) water supply, cities were able to grow very rapidly. The hydroelectric turbines produce four billion kilowatt hours of electricity per year. According to the American Society of Engineers, the dam has had a huge part in the development of the southwestern United States (American Society). It has stopped flooding, provided water for human consumption and agriculture, and supplied electricity to three states, according to Wassner Arizona, Nevada, and California (99). Amazingly, power hungry Las Vegas only receives one percent of the power from Hoover Dam. For having such a great push on the lives of Americans the American Society of Civil Engineers recognise the Hoover dam as the Civil Engineering Monument of the Millennium. Written on September 27, 2001 the article states The modern millennium reminds us of the tremendous impact civil engineering has had on the development of our society . . . It is fitting that the Hoover Dam would be chosen by ASCE for this special honor. The dam ushered in a new era of confidence in the design and building of great water resource projects (American Society).

Benedict Arnold Essay -- essays research papers

&8220The Dark Eagle refers to the hero of Saratoga, Benedict Arnold, who went from highly regarded hero, to the most hated man in the Colonies in a matter of days. In the accommodate Benedict Arnold The Dark Eagle, Brian Richard Boylan, analyzes the historical figure not critically, but objectively. He examines the forces that possibly could have driven Benedict Arnold to turn his back on the democracy that he fought for so dearly. Boylan also points out that the man who Arnold did most of his negotiations with, Major General antic Andr, was strikingly similar to Arnold, and that the two workforce were brought together nether one woman, Miss Peggy Shippen. Throughout this book, Boylan suggests that the reader should view Arnold without the general stereotype of him being a traitor. That way you can see the man Benedict Arnold sincerely yours was, and read of the reasons that he lost his love for the Colonial army, and its government. The Battle of Saratoga was a major battle in the American Revolution it helped persuade the cut into signing a Treaty with the United States that helped turn the tides on the British. Major General Horatio Gates was the commander of the Army of the North. His English counterpart was General John Burgoyne. The open-field battle style considerable favored the British troops of Burgoyne. The American&8217s had their backs against the wall they were almost out of options, until their savior literally rode in on horseback. This man was General Benedict Arnold. He rode in from Freeman&8217s Farm where Gates, Arnold&8217s superior, had taken his authority away because of Arnold&8217s &8220insubordination. Arnold thought nix of Major Gates&8217orders to stay at Freeman&8217s Farm and rode off with no sign of slowing. &8220 No Man will keep me in my tent this day Arnold said. Unlike Gates, Benedict Arnold liked to lead and command his men on the front lines. Arnold personally led the charge on Breymann&8217s redoubt during the Battl e of Saratoga, however Arnold was wounded during the final assault in his left knee. While the American troops surrounded and captured Breymann&8217s forces, Arnold laid in inconvenience on the battlefield. Gates took the credit for the v... ...s suffering came to an end. He was buried in the crypt of St. Mary&8217s in Battersea.Benedict Arnold was considered a military genius he was able to bring his troops from near defeat to victory. He was highly regarded not only by his cronies but also was highly respected by his adversaries. Arnold was probably the only man to be respected by both the British and Americans prior to 1779. Benedict Arnold was one of the best Generals that had served in the American Army. merely by 1779 and 1780 he was seen as the most controversial figure in the Colonies. Today, some people view Arnold as one of the most diabolical men to ever live others view him as a generally good man that just took one wrong turn that tainted his whole career. The absol ute majority of the people in the U.S view him as a traitor of the American public and of their trust. If the British had won the war he would be looked down upon with flat more contempt than he is today. However, if Benedict Arnold had died, in his prime, on the battlefield of Saratoga, he would be viewed much differently all over the world, possibly as the greatest general that even lived.

Puerto Rico and the United States Essay -- American History Puerto Ric

Puerto Rico and the United arousesSince Puerto Rico was startle discovered by Christopher Columbus on November 19, 1493, and Spanish colonization ensued in 1508, Puerto Rico has experienced all of these pressures of identity and culture. When Columbus first arrived he open the island populated by thousands of Taino Indians who made the mistake of showing Columbus sumptuous nuggets in the river. This was all Spain needed to finance its crown. Differences between the Spaniards and the Taints began around two age later when Diego Salcedo was killed by the Indians. The Taino Indians revolt against the Spaniards was met with no success and many left(p) the island or fled into the mountains where they began new lives. Though living in the secluded mountains, the Tainos were still colonists of Spain, simply at heart were Borinquens. Even though they were a part of the State of Spain, i.e. a legal and political organization, with the power to require obedience and loyalty from its citizens. (Morris, p.12) the Tainos were a Nation or a self defined community of multitude who share a sense of solidarity based on a belief in a common heritage and who claim political rights that may intromit self determination, history, language, culture and territory. (Morris, p. 12) This was the beginning of the Foundation of the four storeyed building.In Jose Luis Gonzalezs article Puerto Rico, The Four Storeyed Country and Other Essays he in addition uses the metaphor of floors, stairs or foundation. Gonzalez saw that Puerto Ricos foundation though has grown more and more obscure over time, either by Puerto Ricans or other(a) people who have transferred or erased the first and second floors. (Prof. Figueroa, lecture notes of 9/15/98)In Rosario Fe... ...tality and their way of life. The question is how much longer will it passage on being this way? BibliographyFernandez, Ronald. The Disenchanted Island Puerto Rico and the U.S. in the Twentieth Century. 2d. ed. (W estport, Conn. Praeger, 1996).Ferre, Rosario. The rest home on the Lagoon. (New York Farrar, Straus and Giroux, 1995).Glasser, Ruth. My Music is My Flag Puerto Rican Musicians in New York and their Communities, 1917-1940. (Berkeley University of California Press, 1996). Gonzalez, Jose Luis. The Four-Storey Country, in The Four-Storey Country and Other Essays. (Princeton Marcus Weinner, 1993).Morris, Nancy. , Puerto Rico Culture, Politics, and Identity. (Westport, Conn. Praeger, 1995).Rigau, Jorge. Puerto Rico 1900.Santiago, Roberto (ed.), Boricuas Influential WritingsAn anthology. (New York Ballantine Books, 1995). Puerto Rico and the United States Essay -- American History Puerto RicPuerto Rico and the United StatesSince Puerto Rico was first discovered by Christopher Columbus on November 19, 1493, and Spanish colonization ensued in 1508, Puerto Rico has experienced all of these pressures of identity and culture. When Columbus first arrived he found the island populated by thousands of Taino Indians who made the mistake of showing Columbus gold nuggets in the river. This was all Spain needed to finance its crown. Differences between the Spaniards and the Taints began around two years later when Diego Salcedo was killed by the Indians. The Taino Indians revolt against the Spaniards was met with no success and many left the island or fled into the mountains where they began new lives. Though living in the secluded mountains, the Tainos were still colonists of Spain, but at heart were Borinquens. Even though they were a part of the State of Spain, i.e. a legal and political organization, with the power to require obedience and loyalty from its citizens. (Morris, p.12) the Tainos were a Nation or a self defined community of people who share a sense of solidarity based on a belief in a common heritage and who claim political rights that may include self determination, history, language, culture and territory. (Morris, p. 12) This was t he beginning of the Foundation of the four storeyed building.In Jose Luis Gonzalezs article Puerto Rico, The Four Storeyed Country and Other Essays he too uses the metaphor of floors, stairs or foundation. Gonzalez saw that Puerto Ricos foundation though has grown more and more obscure over time, either by Puerto Ricans or other people who have transferred or erased the first and second floors. (Prof. Figueroa, lecture notes of 9/15/98)In Rosario Fe... ...tality and their way of life. The question is how much longer will it going on being this way? BibliographyFernandez, Ronald. The Disenchanted Island Puerto Rico and the U.S. in the Twentieth Century. 2d. ed. (Westport, Conn. Praeger, 1996).Ferre, Rosario. The House on the Lagoon. (New York Farrar, Straus and Giroux, 1995).Glasser, Ruth. My Music is My Flag Puerto Rican Musicians in New York and their Communities, 1917-1940. (Berkeley University of California Press, 1996). Gonzalez, Jose Luis. The Four-Storey Country, in The F our-Storey Country and Other Essays. (Princeton Marcus Weinner, 1993).Morris, Nancy. , Puerto Rico Culture, Politics, and Identity. (Westport, Conn. Praeger, 1995).Rigau, Jorge. Puerto Rico 1900.Santiago, Roberto (ed.), Boricuas Influential WritingsAn anthology. (New York Ballantine Books, 1995).

Puerto Rico and the United States Essay -- American History Puerto Ric

Puerto anti-racketeering law and the United StatesSince Puerto Rico was first discovered by Christopher Columbus on November 19, 1493, and Spanish colonization ensued in 1508, Puerto Rico has experienced all of these pressures of identity and culture. When Columbus first arrived he found the island populated by thousands of Taino Indians who made the mistake of showing Columbus gold nuggets in the river. This was all Spain take to finance its crown. Differences between the Spaniards and the Taints began around two years later when Diego Salcedo was killed by the Indians. The Taino Indians revolt against the Spaniards was met with no success and many left the island or fled into the mountains where they began new lives. though living in the secluded mountains, the Tainos were still colonists of Spain, but at pump were Borinquens. Even though they were a part of the State of Spain, i.e. a legal and policy-making organization, with the power to require obedience and loyalty f rom its citizens. (Morris, p.12) the Tainos were a Nation or a self defined community of people who share a sense of solidarity based on a belief in a common heritage and who claim political rights that may include self determination, history, language, culture and dirt. (Morris, p. 12) This was the beginning of the Foundation of the four storeyed building.In Jose Luis Gonzalezs article Puerto Rico, The quadruplet Storeyed Country and Other Essays he too uses the metaphor of floors, stairs or foundation. Gonzalez saw that Puerto Ricos foundation though has grown more and more dark-skinned over time, either by Puerto Ricans or other people who have transferred or erased the first and second floors. (Prof. Figueroa, lecture notes of 9/15/98)In Rosario Fe... ...tality and their steering of life. The question is how much longer will it going on being this office? BibliographyFernandez, Ronald. The Disenchanted Island Puerto Rico and the U.S. in the Twentieth Century. 2d. ed. (Westport, Conn. Praeger, 1996).Ferre, Rosario. The House on the Lagoon. (New York Farrar, Straus and Giroux, 1995).Glasser, Ruth. My medicinal drug is My Flag Puerto Rican Musicians in New York and their Communities, 1917-1940. (Berkeley University of California Press, 1996). Gonzalez, Jose Luis. The Four-Storey Country, in The Four-Storey Country and Other Essays. (Princeton Marcus Weinner, 1993).Morris, Nancy. , Puerto Rico Culture, Politics, and Identity. (Westport, Conn. Praeger, 1995).Rigau, Jorge. Puerto Rico 1900.Santiago, Roberto (ed.), Boricuas Influential WritingsAn anthology. (New York Ballantine Books, 1995). Puerto Rico and the United States Essay -- American History Puerto RicPuerto Rico and the United StatesSince Puerto Rico was first discovered by Christopher Columbus on November 19, 1493, and Spanish colonization ensued in 1508, Puerto Rico has experienced all of these pressures of identity and culture. When Columbus first arrived he found the island populated by thousands of Taino Indians who made the mistake of showing Columbus gold nuggets in the river. This was all Spain needed to finance its crown. Differences between the Spaniards and the Taints began around two years later when Diego Salcedo was killed by the Indians. The Taino Indians revolt against the Spaniards was met with no success and many left the island or fled into the mountains where they began new lives. Though living in the secluded mountains, the Tainos were still colonists of Spain, but at heart were Borinquens. Even though they were a part of the State of Spain, i.e. a legal and political organization, with the power to require obedience and loyalty from its citizens. (Morris, p.12) the Tainos were a Nation or a self defined community of people who share a sense of solidarity based on a belief in a common heritage and who claim political rights that may include self determination, history, language, culture and territory. (Morris, p. 12) Thi s was the beginning of the Foundation of the four storeyed building.In Jose Luis Gonzalezs article Puerto Rico, The Four Storeyed Country and Other Essays he too uses the metaphor of floors, stairs or foundation. Gonzalez saw that Puerto Ricos foundation though has grown more and more obscure over time, either by Puerto Ricans or other people who have transferred or erased the first and second floors. (Prof. Figueroa, lecture notes of 9/15/98)In Rosario Fe... ...tality and their way of life. The question is how much longer will it going on being this way? BibliographyFernandez, Ronald. The Disenchanted Island Puerto Rico and the U.S. in the Twentieth Century. 2d. ed. (Westport, Conn. Praeger, 1996).Ferre, Rosario. The House on the Lagoon. (New York Farrar, Straus and Giroux, 1995).Glasser, Ruth. My Music is My Flag Puerto Rican Musicians in New York and their Communities, 1917-1940. (Berkeley University of California Press, 1996). Gonzalez, Jose Luis. The Four-Storey Country, i n The Four-Storey Country and Other Essays. (Princeton Marcus Weinner, 1993).Morris, Nancy. , Puerto Rico Culture, Politics, and Identity. (Westport, Conn. Praeger, 1995).Rigau, Jorge. Puerto Rico 1900.Santiago, Roberto (ed.), Boricuas Influential WritingsAn anthology. (New York Ballantine Books, 1995).

Political Rhetoric During the American Revolution

Political rhetoric has been used since the ancient times. It has been used by universal speakers from everywhere and to spring their audience to action. A great domain speaker or writer is determined by his or her choice of words. In American history there have been documents that have had a tremendous impact on public opinion. Political rhetoric is extremely important because it can put down a society together for iodine common cause. When someone uses rhetoric effectively the reader starts to have a stirring in their heart because they live inspired by what is being said.This usu eithery leads them to take action and support the cause their referring to which in this case was the American Revolution. Thomas Paines Common Sense, the VA annunciation of Rights, and the announcement of Independence were documents that greatly shifted public opinion and led the colonists to support the revolution with their use of rhetoric. Thomas Paines Common Sense was a policy-making parcel of land written at the heels of the America Revolution that became extremely popular among the colonies.Thomas Paine was a Pennsylvania journalist during the time of the American Revolution. He began functional on it in late 1775 and it was published in 1776. The rhetoric of this pamphlet along with its popularity greatly turned the tide in favor of rebelling against Great Britain. Paine wrote this pamphlet in a style that a common person could understand. The title itself haves rhetoric. By making the title Common Sense it implies that the contents of the pamphlet contain legion(predicate) common sense ideas that everyone reading it should understand.The wording of his pamphlet was very simple and contained many biblical references so it was also relatable to the colonists. It was extremely important that all colonists could understand the pamphlet because it would create a sense of unity and understanding among the rich and poor colonists. Paines main arguments were that it is foolish for such an island to rule a continent, Britain had selfish intentions in ruling the colonies, and being a part of Britain would involve America in unnecessary European state of wars that would limit their economic possibilities.Paine in the low gear section creates a eminence between society and government. He says society is a patron that promotes happiness and government is a punisher that restrains society. To trounce describe his flock on the relationship that society and government should have he gives an exemplar of a few good deal who live in nature without government.. He gives the example of the few people creating a society because the colonists can relate that to themselves. At one point in time Great Britain left the colonies alone for the around part and they lived in peace.Once the government got involved and began to take for themselves is when the colonists started having all these problems. Paine also argues that all men are created equal and that the distinction of the king from his subjects oppresses this idea. adult male being originally equals in the order of creation, the equality could only be destroyed by some subsequent circumstance the distinctions of rich, and poor, may in a great measure be accounted for, and that without having recourse to the harsh, ill-sounding names of oppression and avarice.Oppression is often the consequence, but seldom or never the means of riches and though avarice will preserve a man from being necessitously poor, it generally makes him too timorous to be wealthy. But there is another and greater distinction for which no truly internal or religious suit can be assigned, and that is, the distinction of men into KINGS and SUBJECTS. Paine in his third section discusses the problems between the colonies and England and says the best route is to declare their independence from England.In his final section he offers great optimism about the militia during the revolution and how it can win th is war. Thomas Paines use of rhetoric in Common Sense is the reason why it was so persuasive and popular and could have possibly been the reason that the colonists finally came and resolved to revolt against Great Britain. The Virginia proclamation of Rights was written in 1776 to proclaim the natural rights of man including the right to rebel against an inadequate government. George Mason was the author of this document, which was adopted nem con by the Virginia Convention of Delegates in 1776.It was the first document that protected individual rights rather than protecting just members of Parliament. The declaration states that all men have their natural rights, which are life, liberty, and property. The rhetoric in this document influenced future significant documents in American history. Thomas Jefferson drew great inspiration from this document when he wrote the Declaration of Independence a month later. He borrowed the idea of natural rights of man and implemented them into his document.James Madison was also influenced by the rhetoric and ideas of the Virginia Declaration when gulp the Bill of Rights. Aside from being incredibly influential for latter documents the Virginia Declaration of Rights asserted the right of the Virginia people to rebel against Great Britain The Declaration of Independence was one of the greatest documents ever written in American history. This document officially stated that the 13 colonies had broken away from the control of Great Britain who they were at war with at the time.It stated the reasons for why the colonies declared independence and listed the grievances against the king of England. The rhetoric in this document is what makes it such a powerful piece of literature. This declaration contains many powerful quotes that can emotionally affect a reader. We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain(a) unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness. This quote has been called one of the most potent and consequential in American history and for good reason. The rhetoric in this quote is very powerful because it uses a religious reference and relates it to the colonists. By saying that the Creator as in God has given colonists certain rights, it leads them to rely that nobody can take them away and this gives them a sense of worth and purpose that no government could take away. Jefferson listed the many grievances that the colonies had against Great Britain to give reason for their breaking apart.These were complaints that the colonists all had against the government and so it created a sense of unity among them all. The Declaration of Independence had to have strong rhetoric in order for it to be a successful document. It had to take a stand against the tyranny America was facing and had to lay down that they were serious about their independence. Not only did they have to show it to Great Britain but as well as the common people of the colonies because they were the ones fighting in the war and they needed the reassurance that this war was worth fighting for.The creators, by signing the declaration on the last page gave the colonists this reassurance because it showed them that they were not just aristocrats writing a document in Pennsylvania while the common people fought on the battlefield but they were also putting their lives on the line. The signers knew that if they were to lose the war they would be killed and so the colonists recognized this and were inspired by their willingness to die for this cause. This gave the colonist the reassurance they needed to finish out the war, eventually defeat England and gain their independence.In conclusion political rhetoric has had a dramatic influence on public opinion during the American Revolution. Thomas Paines Common Sense greatly shifted the public opinion towards revolution while the Virginia Declaration of Rights and the Declaration of Independence gave the colonists a sense of purpose and inspired them to rise up against Great Britain. It is hard to imagine what life in America would be like in stupefy day had these documents not been written with such emotion and resolve.It is a good thing we do not have to find out. Bibliography Virginia Declaration of Rights. Wikipedia, The Free Encyclopedia. 29 Aug 2009, 0120 UTC. 29 Aug 2009 . United States Declaration of Independence. Wikipedia, The Free Encyclopedia. 21 Sep 2009, 0339 UTC. 21 Sep 2009 . Common Sense (pamphlet). Wikipedia. Web. 19 Sept. 2009. . Paine, Thomas. Common Sense. Philadelphia R. Bell, 1176. Print. The Declaration of Independence. Ushistory. org. Independence Hall Association, 4 July 1995. Web. 20 Sept. 2009.

According to National Institute of Health

According to National Institute of Health (NIH) (2006), Acquired Immunodeficiency Syndrome ( back up) is caused by gentlemans gentleman Immunodeficiency Virus (human immunodeficiency virus) by gradually destroying CD4+ T cells (also called T-helper cells), which play a significant role in the immune response system.In a healthy subject the CD4+ T cells range between 800 to 1,200 cells/mm3 but when this count falls below 200 cells/mm3, the individual is most vulnerable to opportunistic infections and cancers characteristic of AIDS.From the above it is evident that torso has its own mechanism to prevent infections i.e., immune response system comprising of CD4+ T cells which are actually attacked by HIV systematically destroying the CD4+ T cells. These cells are brisk in fighting back infections attacking the body, thus once their count falls abnormally the body is vulnerable to the so called opportunistic infections which are typical of AIDS.Grant and Cock (2001) stated that ev eryday symptoms in the early stages include injustice of weight, fever, sweating during nights, diarrhea and frequent skin disorders especially of varicella zoster, fungal infections and pruriginous dermatitis steer to itchy rashes resulting into ulcerations and healing with pigmented macules.However the expanded definition of AIDS states that in addition to the above mentioned symptoms an individual is stated to be suffering from AIDS if the test for HIV antibody gives a positive result subject to one or more of the following conditions Weight loss of more than 10% Cryptococcal meningitis Pulmonary or supernumerary pulmonary tuberculosis Kaposis Sarcoma Neurological impairment sufficient to prevent independent daily activities. Candidiasis of the oesophagus and oral region accompanied by dysphagia Recurrent episodes of pneumonia with or without aetiological confirmation Invasive cervical cancerCandidiasis of the oesophagus and oral region is caused to infection by fungus in immu nocompromised patients such as those suffering from AIDS and gradually no medication may be effective in future course of time ultimately leading to loss of appetite and weight.Cryptococcal meningitis is infection of the brain and is due to spread of fungus from lungs to the brain through blood circulation. People who have defects in their cell-mediated immunity such those suffering from AIDS, are susceptible to disseminated cryptococcosis. Cryptococcal meningitis is fatal. The fungus infects the nervous system causing inflammation of the membranes covering the brain and spinal cord.The more frequent probable causes of HIV related diseases include rational toxoplasmosis and cryptococcal meningitis, cerebral toxoplasmosis most often presents as a space occupying lesion of the brain, and cryptococcosis as chronic meningitis thus brain gets effected in particular and nervous system in general.One of the important opportunistic infections includes tuberculosis and may be detected at an y stage in the course of immunodeficiency. Pulmonary tuberculosis is corresponding to non-HIV infected subjects in the initial stages of HIV infection, but the advanced stages of immunodeficiency exhibit disseminated and multibacillary nature of tuberculosis thus causing extensive damage to lungs in general and pulmonary system in particular.Pneumonia is an acute or chronic inflammation of lungs caused due to infection caused by a bacteria, virus or fungus. Patients suffering from AIDS easily get affected by opportunistic infections causing pneumocystis pneumonia or cytomegalovirus pneumonia.People suffering from AIDS are infected by various types of pneumonia bear upon the lungs and respiratory system, thus respiratory system gets seriously affected along with the immune system.Kaposis Sarcoma is cancer of skin, mucous membranes and blood vessels. Kaposis Sarcoma is characterized by haemorrhage at different sites on patients skin with the formation of round or elliptical lesions about quarter butt to one inch in size.

Freud’s Psychoanalysis in Art: Frida Kahlo’s Surrealism

One of the most influential social scientists of his time, Sigmund Freud and his theories on psychoanalysis re outstandings relevant today in the conceive of human personality and the influence of the subconscious on human thinking and behavior.Freuds ideas on the significance of dreams, which was seen by him as the expression of human cosmoss innermost desire, were in fact borrowed by artists ascribing to surrealism who sought to imprint the subconscious. Surrealist paintings are thus characterized with the go for of symbols and often have a dreamlike whole step to them, where cannot always be taken at face value or by literal translation.It is no wonder then that Freuds ideas have been widely used in the interpretation of works of art or even of character sketches. Freuds theory on how personalities are developed which revolves around the main ideas of id, ego, and superego, have, for instance, been used to explain how sex and libido may be transformed into other forms of ene rgies, or how particularly traumatic life events may have a detrimental effect on both adults and children when not properly processed.Likewise, Freuds ideas of sexual repression and displacement were influential in the growth and development of the surrealist school, which drew on the generous imagery of ones dreams, wishes, and fantasies to create their art. (West 185)One of the most notable surrealist painters, Frida Kahlo, has been a classic example of an artist whose works could be interpreted using Freudian concepts and ideas. Kahlos tumultuous life, characterized by wild sexual affairs with both male and female lovers, a devastating divorce, and her inability to conceive children due to a series of back operations were mostly found in the bulk of her work which were fraught with symbolisms. (West 185)In her painting entitled Self Portrait with a Necklace, Kahlo variegated herself wearing a necklace of thorns and a dangling humming bird, which alludes to her suffering from divorce (as symbolized by the thorns) and to her quest for new love (as shown by the humming bird which is a traditional Mexican love amulet). (Erickson, 2005). In these self portraits,Kahlos entire life was depicted in her paintings. She drew her own birth, for instance, and many other events including those affiliated with her pain and frustration. (Levine 273) Her husband Diego Rivera was also depicted in many of her paintings in different ways in Frida and Diego Rivera (1931) which is supposed to be a painting of their marriage, she paints him as a father-figure and herself as his daughter, which is reminiscent of Freuds Electra complex and reveals Kahlos insecurity at her own husbands authority.In another painting Retablo (1943), she captures the stroke of the accident that left her under intense pain for most of her life (Kahlo and Kettenman 32) which she later depicts in Broken Column (1944) that graphically expresses her physical agony. (West 184)Psychoanalysis therefore p lays an important role in understanding and unlocking many surrealist artwork. In Kahlos case, the artist has rendered her own physical suffering in the metaphoric sense, mostly through the use of portraiture, to something that is haunting and beautiful, and one which outlasts even the pain and suffering of Kahlos troubled soul.Works CitedErickson, R. (2005). Freudian thought and the surrealist world. Downloaded from Associated Content, The Peoples Media Company on March 16, 2007 Kahlo, F. & A. Kettenman. (2000). Frida Kahlo 1907-1954 hassle and Passion. Taschen.Levine, M. P. (2000). Analytic Freud Philosophy and Psychoanalysis. United Kingdom Routledge.West, S. (2004). Portraiture. United Kingdom Oxford University Press.

Judicial Study Guide

Name Period Date AP Government Unit 2 (Judicial Branch) Study Guide Directions Using your notes and Chapter 16 reading, answer the following questions. 16. 2 Outline the structure of the federal court system and the major responsibilities of each component How is the federal judicial system make? What role does the federal judicial system play in contemporary American government? What limits be there on the interpretation of the law and the constitution by federal judges?What powers do judges have to ensure that their rulings are enforced? 16. 3 Explain the process by which judges and justices are nominated and confirmed Do politics play a role in judicial appointments? How are federal judges selected? Should senatorial courtesy be abandonedwhy, or why not? 16. 5 Outline the judicial process at the Supreme Court level and assess the major factors influencing decisions and their slaying Do dissenting opinions matter? Why is the doctrine of stare decisis important in our judicial system?How do court justices evaluate cases based on original intent of the Founders? 16. 6 Trace the Supreme Courts use of judicial review in major policy battles in unlike eras of American history Explain the development of judicial review. 16. 7 Assess the role of unelected courts and the scope of judicial power in American democracy How closely does the Supreme Court conform to the criteria for democracy? What changes would need to be made to make the Court more democratic? Would these changes have any impact on the effectiveness of the Court?DIRECTIONS Look at the Chapter Test on pg. 498-499 of the textbook. Circle your choice for the correct answer on the questions listed below. 1. a b c d e2. a b c d e 3. True False5. a b c d e 6. a b c d e7. True False 9. a b c d e11. a b c d e 12. True False14. a b c d e 15. True False16. True False 19. a b c d e20. True False

An Analysis of the Urban Issue of Tuberculosisin the Bourough of Newham

1.IntroductionTuberculosis is a very serious infectious affection that primarily affects the lungs, causing cough and breathing difficulties. The infection as well up as causes systemic marrows including fever, night sweats and weight loss (Ellner, 2011). In some qualitys, the infection freighter get around beyond the lungs and affect the bvirtuoso/joints, lymph nodes, abdominal cavity and blood stream (Ormerod, 2003). The infirmity is caused by the bacteria mycobacterium terabyte (WHO, 2014), which is spread through respiratory droplets. These droplets be passed when an septic individual coughs or sneezes and the droplets stupefy inhaled by another person (NHS, 2014). Despite this easy manner of contagious disease, atomic number 65 is not readily transmitted, and therefore is most likely to affect those in belt up contact much(prenominal) as family or household members (Castillo-C puddlez & Feng). Tuberculosis represents a of import encounter of morbidity and deat hrate and represents a signifi groundworkt cost to confederacy to treat and manage. Tuberculosis has particularly shown to be a problem in cities, whereby the rates of increase are greater than those of rural areas (Anderson et al. 2006). This essay will accost the reasons as to why terabyte affects urban areas (the sick city hypothesis), and count on in to why terabit contributes to this urban health penalty. As an exemplar of an urban environment suffering from the burden of tebibyte, this essay will focus on the capital of the United Kingdom borough of Newham. Newham has a tuberculosis rate 8 times higher than the subject field average and 3 times that of London. This essay aims to investigate the aetiology behind the incidence, and to find ways of reducing the rates of tuberculosis among individuals in the London borough of Newham. The draw card will include the intervention strategies and how they should be implemented in order to reduce the rates of new infections and encourage men to realise tested and get early treatment before the spread of infection.2.Tuberculosis in an Urban EnvironmentTuberculosis tends to be regarded as a problem of the past, and was responsible for 20-30% of all mortality in 17th-19th century Europe (Dye & Williams, 2010). The incidence of tuberculosis declined throughout the 20th century (Watson & Maguire, 1997), however, the indisposition has been slowly returning to London since the 1980s (Great Britain 2008, p. 19). The problem seems to be worsening in urban areas. This is illustrated by the example of London, where 3,302 new cases of tuberculosis (TB) were reported in 2010 (Fullman & Strachan 2013, p. 25), a figure that has more than doubled since 1992 (Anderson et al 2006). In 2006, the incidence of tuberculosis in London was 41.5 people in 100,000, a figure that represented the highest number of new cases in any major city in Western Europe (Anderson et al, 2006). Dyer (2010, p. 34) claims that the London bo rough of Newham is the most affected with some people already referring to it as the TB capital of the affluent western world. In fact, the rates of tuberculosis in Newham are currently higher than that in some impoverished countries. Vassall (2009, p. 48) signal that Newham has 108 cases per 100,000 and Anderson et al suggest a 2001 figure of 116/100,000, figures that are more than half that in India (174 cases per 100,000) (Public Health England, 2012). Newham has a commonwealth of 308,000 with a population density of 85.1 per hectare as compared to 31 in central London (UK Census, 2012). These figures suggest that even in the populated city of London, Newham is an area of urbanisation, with a large number of people concentrated into a relatively small area.The increase of tuberculosis has been described as a penalty for high density urban living (Dye 2010, p.859), likely out-of-pocket to the increase potential for transmission in overcrowding, and the increase rates of immigra tion to inner-city areas. Bhunu and Mushavabasa (2012) propose that tuberculosis thrives in conditions of overcrowding and poverty, issues that are common in urban areas.The high rates of tuberculosis in cities such as London, and areas of urbanization such as Newham, suggest that the incidence of tuberculosis is indeed an urban issue. Newham fulfills the criteria of high immigration rates and being an area of deprivation..Newham has a various ethnic population, with 61% of the people being non-white (Farrar & Manson 2013, p. 54). The population of ethnic minorities continues to grow along with the increasing numbers of refugees and asylum seekers in greater London.Another purview of urbanisation illustrated in the borough of Newham is that of deprivation and overcrowding. Farrar & Manson (2013, p. 16) claim that Newham ranks as the third most deprived borough in inner London. Most of the people here live in tower lodgement and overcrowded conditions that are the perfect condition for the spread of tuberculosis. There is a positive correlation between poor housing and poverty and the prevalence of tuberculosis, which is very clear in Newham as evidenced by the findings of 108 and 116 cases per 100,000 people (Vassal, 2009 Anderson et al., 2001). The aetiology of the issue of tuberculosis is highlighted when considering the distribution of the disease across Newham. The occurrence of disease is not evenly spread across the borough, with 70% of cases coming from Manor pose, Green Street and East Ham. These boroughs represent areas of population increase, overcrowding and higher levels of those living in poverty. Manor Park and Green Street also show differing dynamics of tuberculosis incidence, representing an overall increase of 40% since 2006 whilst all other areas of Newham either remained electrostatic or showed slight decrease (Malone et al 2009, p. 23). It can be seen that tuberculosis presents a significant urban issue, especially when comparing inci dence in an urban area such as Newham to those less urbanised areas. Bromley has a population of 309,000 and a population density of 20 per hectare, in comparison to Newhams population density of 80 per hectare (UK Census, 2012). Tuberculosis incidence in Bromley is between 0-19 per 100,000 compared to that of Newham, which is five times greater at 80-100 per 100,000 (Anderson et al., 2006). It is for this reason that necessary intervention strategies need to be formulated and implemented to help reduce the rates of tuberculosis among individuals living in Newham.3. The Influence of Urbanisation on Tuberculosis IncidenceWhile the international rates of tuberculosis are declining, the disease is showing steady increase in the United Kingdom. In 2012, 8751 new cases of the disease were identified in the soil with 39% coming from London (Fullman and Strachan 2013, p. 43). Indeed London has the highest rates of the disease in Western Europe with Newham borough having the highest rates in the UK. Jindal (2011, p. 55) claims that the rate of tuberculosis in some London boroughs is more than twice higher than the threshold used by the world health organisation to define high rates. These higher incidences prolong the notion of a sick city hypothesis where there are greater levels of ill health than in rural areas, and may be due to the presence of factors in an urban environment that contribute to ill health (an urban health penalty). One factor that may contribute to the urban health penalty is that of immigration. Cities are easier to access than rural areas, provide areas of congregation and provide more facilities for immigrating families and individuals. The majority of individuals suffering from tuberculosis are people born away(p) the United Kingdom, with 75% of cases in 2003 being born abroad (Anderson et al., 2006). A reason for the high incidence in those born abroad but at a time living in the UK is exacerbated by the nature of tuberculosis. On initia l infection, tuberculosis is confined by the immune system with only around 5% of cases experiencing symptoms deep down the first two years of infection (Narasimhan et al., 2013). The remainder of cases harbour a latent infection which may reactivate later in life, with about 10-15% of those infected going on to develop an spry disease (Narasimhan et al., 2013). This insidious nature combined with the later activation of the disease explains why many people do not get the disease until later in life. It is likely that it is contracted in their country of birth, however then manifests much later once they take on moved to the UK. Statistics indicate that over 90% of the residents in Newham diagnosed with the disease in 2011 were born outside the United Kingdom (Fullman and Strachan, 2013, p. 33). Among these, 50% arrived in the country in the last five years. In the same year tuberculosis diagnosis increased by 25% compared to 2010 (Fullman and Strachan, 2013), possibly as a refle ction of the increased immigration. Additionally to a high immigrant population bringing significant disease burden from their countries of birth, London and Newham both represent many of the other issues of urbanisation and urban health penalty that can contribute to the high incidence of tuberculosis. Studies have shown that low vitamin D levels are associated with an increased risk of develop tuberculosis (Campbell and Spector, 2012 Chan, 1999). This is an distinguished association in urban populations, as the living and working conditions foster less access to sunlight (the major source of vitamin D). Additionally, Asian immigrants present a problem of low vitamin D due to vegetarian diets, and a tendency to cover up their skin, not allowing to take advantage of the small amount of sunlight available (Chan, 1999). As previously mentioned, Newham is an area of both high urbanisation and with a large immigrant population, and 38.6% of the population being of Asian descent (Lond on Borough of Newham, 2010). The immigrant population of urban areas such as Newham also present a non- immunised proportion of society. Whilst the BCG vaccine against tuberculosis was introduced in the UK in the 1950s and was shown to provide a decline in risk of contracting tuberculosis (Colditz et al., 1994), those immigrating were less likely to receive this vaccination on moving to the UK. London also represents cases of tuberculosis that are socially and medically complex. As a hugely populated area, London includes those with HIV infection and presents other risk factors such as onward transmission and poor treatment. HIV is one of the most powerful risk factors for tuberculosis, with a incidence rate of 20 times higher in those that are HIV positive (Dye and Williams, 2010). Peoples attitudes towards and access to healthcare also present a complex mix of factors which contribute to an increased incidence of many health problems, including that of tuberculosis. Those in impo verished areas have reduced access to healthcare, which may stem from many reasons such as complex needs, chaotic lifestyles, location of services, user ignorance, and language and literacy barriers (Szczepura, 2005). These can affect the disease process of tuberculosis from celebrateion, treatment of active disease, affection to treatment and prevention of the health consequences. Especially problematic are misconceptions and a lack of under delay of the disease, starring(p) to late presentation and delayed access to treatment (Figuera-Munoz and Ramon-Pardo, 2008) With the close living quarters in areas such as Newham, the spread of tuberculosis is facilitated. With poverty, poor housing and overcrowding, these areas concentrate several risk factors and lead to a greater spread of tuberculosis (Bates et al., 2004). These determinants therefore suggest that the incidence of tuberculosis in urban areas is a complex issue. Controlling and preventing tuberculosis in London requires effective social and economic tools that must be incorporated in the development of policies of control in treatment initiation.4. Consequences and implications of tuberculosis on the general populationTuberculosis ranks with HIV/ AIDS and Malaria as one of the three main health challenges currently go about the world. The Commonwealth Health Ministers Update 2009 (2009, p. 41) indicates that 8 million new cases are reported globally each year. As previously mentioned, when combined with HIV, tuberculosis can prove lethal as the two diseases enhance the progress of each other. It is for this reason that tuberculosis is the major cause of death among HIV patients with the rate standing at 11% globally. The World Health Organization (2009, p. 27) indicates that tuberculosis is responsible for more deaths today than ever before, with approximately 2 million lives claimed by the disease annually. As well as the significant mortality contributed by tuberculosis, the morbidity of the di sease can be extremely detrimental both socially and economically. Those with the active disease that are not receiving treatment have been shown to go on to infect 10-15 others every year (WHO, 1998). Those who do receive treatment face a long (up to six months) and complex treatment regime involving several medication side effects. This can affect adherence to the treatment regime, and lead to the disease developing a resistance to the treatment, with this drug resistant tuberculosis contributing to greater mortality and increased expense to treat (Ahlburg, 2000). As well as the significant morbidity and mortality, it is important to consider the economic impact of tuberculosis. The World Health Organisation estimated the cost to treat tuberculosis in 2000 as $250,000 US dollars (?150,000) in developed countries (Ahlburg, 2000). This presents a significant burden to the UK NHS, not to mention the time lost through not working which can dent the economy. London is a global world tr ade centre whose economy is shaped by global forces, particularly in terms of trade, labour and capital. As a approach to both the UK and other parts of Europe and the rest of the world, London records a very large number of tourists and immigrant populations. This high number of people accelerates the spread of the disease as people carry it to the country from other parts of the world is indicated by the new infection patterns and is highlighted by the prevalence in immigrant populations. 5. Strategies and intervention for addressing tuberculosisCurrent UK guidelines for tuberculosis intervention were made by NICE in 2006 (updated 2011). The recommendations propose strategies for identifying those with latent (non-active) tuberculosis to prevent spread or reactivation and also deposit criteria for treatment (NICE, 2011). Those recommended for screening for latent tuberculosis include close contacts of infected individuals, immigrants from high incidence countries, immunocompromi sed individuals, and healthcare workers. Whilst this strategy targets prevention of the spread of tuberculosis, they are only targeting specific groups, and it is likely in high incidence areas such as Newham, people will slip through the net. These guidelines have only changed minimally since 2006, and since then tuberculosis incidence has been on the increase in areas such as Newham, suggesting that changes may need to be made. High incidence areas of the UK such as Newham could learn from New York experience and copy the strategy it used in dealing with the disease. With the implementation of broadened initial treatment regimes, direct observed therapy, and improved guidelines for hospital control and disease prevention, the city managed to halt the progression of an epidemic (Frieden et al., 1995). As mentioned in the previous chapter, adherence to the lengthy treatment regime as well as a lack of understanding may contribute to the spread of tuberculosis. Directly observed the rapy (DOT) involves observing the patient take each dose of their medication, with outreach workers travel to their homes. Evidence from New York showed that through DOT, only 3% of patients in therapy were infectious, compared to a proposed 20% if not receiving DOT (Frieden et al., 1995). Current UK guidelines (NICE, 2006) do not recommend DOT, although they do state that it may be used in cases of patients with previous issues with adherence or at high risk. Although an expensive and time consuming process, if DOT can reduce infectious cases, this would also work as a preventative measure. There could be one allocated outreach nurse for the borough of Newham and other uncollectible areas. Another method implemented in New York was the downsizing of large shelters for the homeless. These were breeding grounds for tuberculosis, and the subsequent reduction in overcrowding led to a decrease in transmission of the disease (Frieden et al., 1995). Whilst it is not possible to split pe ople up from living with their families in crowded homes in terms of Newham, education about keeping those with tuberculosis from interacting with too many others in crowded conditions may be of get ahead. The model should also borrow from those used by other cities like genus Paris and the rest of Europe in controlling tuberculosis with intervention at the level of the agent, individual and community levels. In Paris, Rieder (2002) suggested that prophylactic treatment could be used to prevent the disease occurring in those at risk, for example those in the household of an identified case of tuberculosis. Additionally, Rieder (2002) proposed that early or neonate vaccination be used especially in those in areas where tuberculosis is frequent, rarely diagnosed, and adequate contact examinations rarely feasible. It may be possible that in cases where lots of people are vaccinated that they may infer herd immunity and thus protect unvaccinated individuals from the disease. Once the p opulations have been protected and the incidence (number of new cases) of tuberculosis has been reduced, this allows for a reduction in the prevalence of tuberculosis (number of ongoing cases at any one point in time) with preventative chemotherapy that can treat sub-clinical, latent tuberculosis in the population. This preventative chemotherapy is likely to be extremely relevant to Newham due to the large immigrant population likely harbouring latent tuberculosis. On a country- or city-wide scale, these recommendations from New York and Paris provide excellent models for preventing the increase of tuberculosis any further. It is also important, however, to consider the individual communities in Newham, and to promote health awareness and an attitude towards taking righteousness for their health. Their needs to be an encouragement at the level of primary care where immigrant populations feel that they can approach healthcare, and education to encourage tuberculosis prevention and a dherence to treatment. The strategy should be all-inclusive in order to encourage people to not only go for testing but also start and remove the treatment process.6. Recommendations and conclusionTuberculosis presents an important urban issue in the area of Newham. Incidence is greater than other areas of the UK, and is over half that of India. There are several factors contributing to this including a large immigrant population, crowding and overpopulation, access to healthcare and comorbid health problems such as vitamin D deficiency and HIV. The disease has considerable effect on morbidity and is responsible for high levels of mortality. Further consequences of the disease manifest as economic problems such as cost of treatment and loss of work. London and the UK already have policies and structures for controlling tuberculosis in place however the implementation process is patchy across the city, and often dependent upon budget. In high-risk areas such as Newham, there is poor access of healthcare due to inaccurate beliefs on the disease, language and cultural barriers, and complex needs of the population. In the case of tuberculosis, these contribute to poor disease prevention, delayed diagnosis and poor treatment adherence. All of which lead to an increase in transmission and health consequences. The area of Newham would benefit greatly from further education into tuberculosis, how to look for signs and how to get treatment. Encouraging good relationship with healthcare professionals and promoting access to healthcare through outreach programmes and targeting pharmacies may be helpful. Additionally, Newham should look to employ techniques used in New York and Paris, including DOT, prophylactic treatment and neonate vaccination to reduce both the prevalence and incidence of tuberculosis.ReferencesAhlburg (2000). The economic impact of TB ministerial conference Amsterdam, WHO Bates, I., Fenton, C., Gruber, J., Lalloo, D., Lara, A. M., Squire, S. B., and Tolhurst, R. (2004). Vulnerability to malaria, tuberculosis, and HIV/AIDS infection and disease. Part II determinants operating at environmental and institutional level. The Lancet septic Diseases, vol. 4(6), pp. 368-375. Bhunu, C. P., and Mushayabasa, S. (2012). Assessing the effects of poverty in tuberculosis transmission dynamics. Applied Mathematical Modelling, vol. 36(9), pp. 4173-4185.Campbell, G. R., and Spector, S. A. (2012). Vitamin D inhibits human immunodeficiency virus type 1 and Mycobacterium tuberculosis infection in macrophages through the induction of autophagy. PLoS pathogens, vol. 8(5).Castillo-Chavez, C., and Feng, Z. (1997). To treat or not to treat the case of tuberculosis. Journal of mathematical biology, vol. 35(6), pp. 629-656.Colditz, G. A., Brewer, T. F., Berkey, C. S., Wilson, M. E., Burdick, E., Fineberg, H. V., and Mosteller, F. (1994). Efficacy of BCG vaccine in the prevention of tuberculosismeta-analysis of the published literature. Jama, vol. 271(9 ), pp. 698-702. Commonwealth Health Ministers Update 2009. (2009). Commonwealth Secretarial. Dye, C., and Williams, B. G. (2010). The population dynamics and control of tuberculosis. Science, vol 328(5980), pp. 856-861. Dyer, C. A. (2010). Tuberculosis. Santa Barbara, California Greenwood. Ellner JJ. Tuberculosis. In Goldman L, Schafer AI, eds. Goldmans Cecil Medicine. twenty-fourth ed. Philadelphia, PA Elsevier Saunders 2011 vol332. Farrar, J., & Manson, P. (2013). Mansons tropical diseases. Hoboken, NJ Wiley. Figueroa-Munoz, J. I., & Ramon-Pardo, P. (2008). Tuberculosis control in vulnerable groups. Bulletin of the World Health Organization, 86(9), 733-735.Frieden, T. R., Fujiwara, P. I., Washko, R. M., and Hamburg, M. A. (1995). Tuberculosis in New York metropolisturning the tide. New England Journal of Medicine, vol. 333(4), pp. 229-233. Fullman, J., & Strachan, D. (2013). Frommers London 2013. Hoboken, NJ Wiley. Great Britain. (2008). Diseases know no frontiers How effective ar e intergovernmental organisations in controlling their spread 1st report of session, 2007-08. London Stationery Office. Jindal, S. K. (2011). Textbook of pulmonary and critical care medicine. New Delhi Jaypee Brothers Medical Publishers. London Borough of Newham, (2010). Community Leaders and Engagement, Manor Park Community Forum Profile Online, unattachedhttp//www.newham.info/research/CFProfiles/ManorPark.pdf 12 April 2014. Malone, C., Beasley, R. P., Bressler, J., Graviss, E. A., Vernon, S. W., & University of Texas Health Science Center at Houston, School of Public Health. (2009). Trends in anti-tuberculosis drug resistance from 20032007 at Pham Ngoc Thach Tuberculosis and Lung Disease Hospital, Ho Chi Minh City, Vietnam. (Masters Abstracts International, 47-5.) National initiate for Health and Care Excellence (2006) Clinical Diagnosis and Management of Tuberculosis, and measures for its prevention and control. CG117. London National Institute for Health and Care Excellence.Or merod, L.P. (2003) Nonrespiratory tuberculosis. In Davies PDO (Ed) Clinical Tuberculosis. Third Edition. Arnold London. pp. 125-153. Public Health England (2012), World Health Organization (WHO) estimates of tuberculosis incidence by rate, 2012 (sorted by rate). Online Available at http//www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1317140584841 12 April 2014. Rieder, H. A. (2002). Interventions for Tuberculosis Control, 1st edn. International Union Against Tuberculosis and Lung Disease, Paris, France.Szczepura, A. (2005). Access to health care for ethnic minority populations. Postgraduate Medical Journal, vol. 81(953), pp. 141-147. Vassall, A., & University of Amsterdam. (2009). The Costs and cost-effectiveness of tuberculosis control. Amsterdam Amsterdam University Press. Watson, J. M., and Maguire. H.C (1997). PHLS work on the surveillance and epidemiology of tuberculosis. Communicable disease report. CDR review 7.8, pp. R110-2. World Health Organization. (2009). Global tuberculosis c ontrol Epidemiology, strategy, financing WHO report 2009. Geneva World Health Organization. World Health Organisation (2014). Tuberculosis. Online, Available http//www.who.int/topics/tuberculosis/en/ 12 April 2014 UK Census (2012), UK Census Data, Online. http//www.ukcensusdata.com/newham-e09000025sthash.51Phmj6a.dpbs 12 April 2014

Cafeteria Food Essay

Some people think that rail cafeterias should be infallible to provide low-fat and/or vegetarian lunch options to accommodate the governments nutritional guidelines, but all students do not eat the same. In my essay astir(predicate) cafeteria food, I will explain what students inadequacy in their food. I will also sh ar the likes and dislikes in the food and what we can do to improve it. chilly pizza, undercooked hamburgers and brown lettuce sounds nasty. Many students from different states and districts take a leak to deal with that every day at their schools.The food from the cafeterias used to be good, with a sweet flavor, but in the last few years the food had taken a different flavor, a flavor that cannot be tolerated by the students. The students need a better prime(a) in their food, dont they? Its time for a smorgasbord, a change to food, so students can be satisfied while their consume, a change to food that can be really worth it. As a matter of fact, we students pa y money to the district every year and this is what we get? Its time for a change.Everybody knows that eating healthy was from the past. However, now students and not necessarily just students eat fast food like McDonalds or Taco Bell. this instant everybody does, which can be a good and a bad thing. The changes of the foods taste has made many students to not eat at school, or raze made students to bring lunch, and this as a matter of fact causes the school to lose money. In all actuality is the loss of money causing the school to give students poorly made food?If the schools would serve students food from places like Pizza Hut and Sub focus I can guarantee that most or all students would eat at the cafeterias and it would benefit to both school and students. These types of foods would be so great to have in schools, but unfortunately the district and the governments have taken action and unfairly, they have set down laws that prohibit these foods in the schools. They have settle d these laws because they want us as students to eat healthy, but if they want to keep us healthy, why are they giving us food with a bad and nasty taste?Also, with these laws they keep students like me away from eating too much junk food because they can cause obesity. But do they keep on giving us food that is not even worth the amount of money our parents give to the government every year? If they were the ones who eat all of the nasty food given by the cafeteria they would of get tire of eating cold pizza and uncooked hamburgers with brown lettuce just like we the students do.In conclusion, we all understand what the government and the school system is trying to do with this healthy eating program. They want to promote healthy eating habits in an effort to prevent obesity. Although nutrition is important, students feel that there is a better way to have healthy food without ruining the taste. Therefore, in an effort to keep students healthy and leave with their stomachs satisfi ed we should all come together to realize that we are the ones that have to make it through the school day with the food.

Meaning of life †Soul Essay

Personhood Chart This chart contains a storage-battery grid for different philosophical anthropologies that answer the question of personhood. Complete the following chart in the context of formation what it means to be human according to Christianity, Materialism, and your own Personal View. Refer to the assigned reading for report of characteristics listed on the left. Christianity Materialism Personal View Relational divinity fudge created human beings to live in community.When concourse lose that sense of love and belonging, they lose their meaning and purpose in heart. God created family and the neighbor to be provide the human with the relationship needed for hope and healing. In order to carry out labor and exchange, people have to enter into very definite social relations, most fundamentally production relations.Relationships with others should be based off of the veridicals in which they can provide you with the benefit a person the most. I commit everyone steps int o our lives for one reason or another- either impregnable or bad and we need to be the ones to differentiate amid the two. Each relationship provides us with a sense of love and understanding on the purpose of our life.Multi balanceal There is a vibrant sense of the person in relationship to God and the world through the bodily senses and functions. The body, consciousness, mind, spirit and even the various body parts are expressions of the single that is the human self. Humans are material objects. They are not immaterial things, or objects, or substances incomplete do they contain as parts immaterial selves or souls or entelechies. Their parts are material flesh and bones and blood, molecules, atoms, electrons. A human is more than a corpse.We are multidimensional and each dimension is important in who we are and how we act in society. 2015. Grand Canyon University. All Rights Reserved. Sexual messiah showed us that we are sexual beings. Sexuality encompasses the physical, emotional and spiritual aspects of our being. Man and women are supposed to verification faithful to each other and not commit adultery. It is believed to be a physical act between two individuals that creates energy and may result in the creation of a child through scientific means. Sexual behavior affects not only a persons physical health only when also self- image, interpersonal relationships and relationship with God and others.Moral We should choose to act based on good thinking, Scripture and prayer, and the Holy Spirit helps us discern the right alternatives. God knows our intentions are to please him and craving the best moral outcomes for all. The brain and body are a dynamic system interacting with the environment. There is no non- physical entity which could take credit or blame for the outcome of our actions. We learn our morals through ravel and error as well as through the relationships we have with others. If we surround ourselves with ethically individuals we to o with be ethical. Mortal We are mortals, but God has given us eternal life in deliverer Christ.We die, and yet we live. Poor stewardship of the life God has given us may well exacerbate the demolition and decay that surround us In order for human beings to survive and continue existence from propagation to generation, it is necessary for them to produce and reproduce the material requirements of life Mortality is unavoidable yet difficult. Once individual dies their soul will either go to Heaven or to Hell. ordain for Eternal Life Destined for eternal life Eternal life is the life one lives after death.By death the soul is separated from the body, but in the resurrection God will give incorruptible life to our body, transformed by reunion with our soul There is no such thing as eternal life. Life begins when the softheartedness starts beating and ends with the heart stops beating. I believe that those who believe will live an eternal life and that those who do not will not. 2 References Plantinga, Alvin. (2010) Materialism and Christian Belief. Retrieved from http//www. andrewmbailey. com/ap/Materialism_Christian_Belief. pdf Shelly, J. , & Miller, A. (2006). Called to care A Christian worldview for care for (2nd ed. ). Downers Grove, Ill. IVP Academic/Intervarsity Press.

Hunting skills Essay

Without lookup we would all be dead. Our ancestors needed to hunt for food and clothing. Hunting is real important to our human history. Today hunting is not as signifi thunder mugt to some people, the populaces who hunt these long time hunt for food or they hunt for a hobby. To hunt successfully, you need patience, the equipment and skill.Patience is one of the keystone ingredients to a good hunt. One of the hardest things to do for me is being patience because half of the time you are sit (or standing) in one spot looking for the animal and if you see the animal you got to debate whether you insufficiency it or to look for a better animal. If it is not in a good position you got to wait for it to continue to get a good shot. Having patience is one of the best things to ware when hunting.Having the right equipment when hunting is regard going to school with a pencil it is common sense. The weapon is the most important so you can get the animal, but you need different weapo ns for different animals like 22. is good for hunting grouse, not for hunting a moose. Clothing is second you do not want to go hunting in a T-shirt and jeans there is clothing made just for hunting. The right gear is vital to a successfully hunt.Skill is everything you need to be a great hunter. First a skilled hunter would mystify intercourse how to find the animal, where it lives. Second you need to be a good shot because you do not want to miss the animal then it would get scared and run away. Also you do not want to shot the animal more than once because the meat would get ruined. Skill is all you need to have a good hunt.Hunting is a way of life and a hobby to some. People have been hunting throughout the ages and are still hunting today.

Chem Lab – Heat of Combustion of Magnesium

hot up of Combustion of Magnesium Background The students were given unspoilt instructions on how to experimentally determine the total heat of response (? Hrxn) for the combustion of magnesium ribbon, using Hesss Law. Data Collection Reaction 1 Reaction 2 (MgO) (Mg) Trial 1 Trial 2 Trial 1 Trial 2 Volume of 1. 00 M HCl 50. 0 mL 0. 5 mL 50. 0 mL 0. 5 mL 50. mL 0. 5 mL 50. 0 mL 0. 5 mL Final temperature, t2 28. 9(C 0. 1(C 28. 8(C 0. 1(C 44. 8(C 0. 1(C 44. 4( C 0. 1(C Initial temperature, t1 22. 5(C 0. 1(C 22. 3( C 0. 1(C 21. 9(C 0. 1(C 21. 8( C 0. 1(C trade of solid 0. 50 g 0. 01g 0. 50 g 0. 01g 0. 25 g 0. 01g 0. 25 g 0. 01g Data Processing Reaction 1 (MgO) Trial 1 Trial 2 Change in final temperature sign temperature final temperature initial temperature temperature, (t 28. (C 22. 5(C = 6. 4(C 28. 8(C 22. 3(C = 6. 3(C precariousness of temperature 0. 1(C + 0. 1(C = 0. 2(C doubtfulness of temperature 0. 1(C + 0. 1(C = 0. 2(C Change in temperature = 6. (C 0. 2(C Change in temperature = 6. 3(C 0. 2(C Heat of HCl set of 1. 0 M HCl pic specific heat of HCl pic variegate in Mass of 1. 0 M HCl pic specific heat of HCl pic change in solution, q temperature temperature To find book of 1. 0 M HCl Density of 1. M HCl pic volume To find mass of 1. 0 M HCl Density of 1. 0M HCl pic volume of 1. 0M HCl of 1. 0M HCl 1. 005 pic pic 50. 0 mL = 50. 3 g 1. 005 pic pic 50. 0 mL = 50. 3 g 50. 3 g pic . 00418 pic pic 6. 4(C = 1. 3 kJ 50. g pic . 00418 pic pic 6. 3(C = 1. 3 kJ % incertitude of Heat (0. 5mL ? 50 mL) + (0. 2(C ? 6. 4(C) % hesitation of Heat (0. 5mL ? 50 mL) + (0. 2(C ? 6. 3(C) pic degree Celsius% = 4% pic cytosine% = 4% Uncertainty of Heat 4% of 1. 3 kJ = 0. 5 kJ Uncertainty of Heat 4% of 1. kJ = 0. 5 kJ Heat of HCl = 1. 3 kJ 0. 5 kJ Heat of HCl = 1. 3 kJ 0. 5 kJ total heat change, henry change of reaction = -heat of HCl solution Enthalpy change of reaction = -heat of HCl solution (H Enthalpy of MgO = -1. kJ 0. 5 kJ Enthalpy of MgO = -1. 3 kJ 0. 5 kJ Moles of MgO Mass of MgO ? hoagy mass of MgO Mass of MgO ? molar mass of MgO 0. 50 g MgO ? 40. 30pic = 0. 0120 mol 0. 50 g MgO ? 40. 30pic = 0. 0120 mol % Uncertainty of moles (0. 01g ? 0. 0g) pic 100% = 2% % Uncertainty of moles (0. 01g ? 0. 50g) pic 100% = 2% Uncertainty of moles 2% of 0. 0120 mol = 0. 0002 mol Uncertainty of moles 2% of 0. 0120 mol = 0. 0002 mol Moles of MgO = 0. 0120 mol 0. 0002 mol Moles of MgO = 0. 0120 mol 0. 0002 mol Molar enthalpy Enthalpy of MgO ? moles of MgO Enthalpy of MgO ? oles of MgO change, (H/mol -1. 3 kJ ? 0. 0120 mol = -110 pic -1. 3 kJ ? 0. 0120 mol = -110 pic % Uncertainty (0. 5 kJ ? 1. 3 kJ) + (0. 0002 mol ? 0. 0120 mol) % Uncertainty (0. 5 kJ ? 1. 3 kJ) + (0. 0002 mol ? 0. 120 mol) pic 100% = 40% pic 100% = 40% Uncertainty 40% of -110 pic = 40 pic Uncertainty 40% of -110 pic = 40 pic Molar enthalpy change = -110 pic 40 pic Molar enthalpy change = -110 pic 40 pic fair(a) molar (molar enthalpy change of Trial 1 + molar enthalpy change of Trial 2) ? enthalpy change ( -110 pic + -110 pic ) ? 2 = -110 pic Uncertainty (40 pic + 40 pic ) ? 2 = 40 pic Average molar enthalpy change = -110 pic 40 pic Reaction 2 (Mg) Trial 1 Trial 2 Change in final temperature initial temperature final temperature initial temperature temperature, (t 44. 8(C 21. 9(C = 22. 9(C 44. 4(C 21. 8(C = 22. (C Uncertainty of temperature 0. 1(C + 0. 1(C = 0. 2(C Uncertainty of temperature 0. 1(C + 0. 1(C = 0. 2(C Change in temperature = 22. 9(C 0. 2(C Change in temperature = 22. 6(C 0. 2(C Heat of HCl Mass of 1. M HCl pic specific heat of HCl pic change in Mass of 1. 0 M HCl pic specific heat of HCl pic change in solution, q temperature temperature To find mass of 1. 0 M HCl Density of 1. 0M HCl pic volume To find mass of 1. 0 M HCl Den sity of 1. 0M HCl pic volume of 1. 0M HCl of 1. M HCl 1. 005 pic pic 50. 0 mL = 50. 3 g 1. 005 pic pic 50. 0 mL = 50. 3 g 50. 3 g pic . 00418 pic pic 22. 9(C = 4. 81 kJ 50. 3 g pic . 00418 pic pic 22. 6(C = 4. 75 kJ % Uncertainty of Heat (0. 5mL ? 0 mL) + (0. 2(C ? 22. 9(C) % Uncertainty of Heat (0. 5mL ? 50 mL) + (0. 2(C ? 22. 6(C) pic 100% = 1. 9% pic 100% = 1. 9% Uncertainty of Heat 1. 9% of 4. 81 kJ = 0. 09 kJ Uncertainty of Heat 1. 9% of 4. 75 kJ = 0. 09 kJ Heat of HCl = 4. 81 kJ 0. 09 kJ Heat of HCl = 4. 75 kJ 0. 9 kJ Enthalpy change,Enthalpy change of reaction = -heat of HCl solution Enthalpy change of reaction = -heat of HCl solution (H Enthalpy of Mg = -4. 81 kJ 0. 09 kJ Enthalpy of Mg = -4. 75 kJ 0. 09 kJ Moles of Mg Mass of Mg ? molar mass of Mg Mass of Mg ? molar mass of Mg 0. 25 g ? 24. 30pic = 0. 010 mol 0. 25 g ? 24. 30pic = 0. 10 mol % Uncertainty of moles (0. 01g ? 0. 25g) pic 100% = 4% % Uncertainty of moles (0. 01g ? 0. 25g) pic 100% = 4% Uncertainty of moles 4% of 0. 0100 mol = 0. 0004 mol Uncertainty of moles 4% of 0. 0100 mol = 0. 0004 mol Moles of Mg = 0. 0100 0. 0004 mol Moles of Mg = 0. 0100 0. 0004 mol Molar enthalpy Enthalpy of Mg ? oles of Mg Enthalpy of Mg ? moles of Mg change, (H/mol -4. 81kJ ? 0. 0100 mol = -481 pic -4. 75 kJ ? 0. 0100 mol = 475pic % Uncertainty (0. 09 kJ ? 4. 81 kJ) + (0. 0004 mol ? 0. 0100 % Uncertainty (0. 09 kJ ? 4. 75 kJ) + (0. 0004 mol ? 0. 100 mol) pic 100% = 6% mol) pic 100% = 6% Uncertainty 6% of -481 pic = 29 pic Uncertainty 6% of -475 pic = 29 pic Molar enthalpy change = -481 pic 29 pic Molar enthalpy change = -475 pic 29 pic Average molar (molar enthalpy change of Trial 1 + molar enthalpy change of Trial 2) ? enthalpy change (-481 pic + -475 pic ) ? 2 = -478 pic Uncertainty (29 pic + 29 pic ) ? 2 = 29 pic Average molar enthalpy change = -478 pic 29 pic

Natural Disasters and Health Care

Impact of Natural haps on health alimony Submitted by Dalton Divakaran MS Health C be focal point University of Texas at Dallas Index Introduction Types of mishaps sums of Disaster on Economy Effect of Disaster on Health C atomic number 18 Organization * Sudden influx * Damage to Facilities * Inadequately Prepared * Specialty Treatment Availability Effects on the Population * prompt Health Impact * Long-Term Impacts Steps in Disaster Management * Mitigation * prep * rejoinder * Recovery Real Incident Study * Background * ready answer Considerations * Evacuation Special Immediate Concerns * Recovery Process * Facility Considerations * Lessons Learned at This Point in Response/Recovery * Takeaways from this casualty Conclusion References Introduction According to dictionary. com Disasters means a calamitous event, especially unrivalled occurring suddenly and make great loss of life, damage, or hardship, as a flood Disasters such(prenominal) as Earthquakes, tsunamis, floo ds, hurricanes, tornados, epidemic disease come onbreaks and more can damage any macrocosm and concur a tremendous effect on the health charge organizations that respond.Many health care organizations face major challenges during congenital possibilitys. in that location are umpteen different ca holds for those challenges. According to the International Federation of the Red Cross and Red Crescent Societies, in cc2, world(prenominal) disasters affected 608 million people and killed more than 24,000. The recent natural disaster in the United States for this socio-stinting class 2011(May 22, 2011) was the tornado Joplin in Missouri 160 fatalities were reported in this natural disaster. Types of Disasters I. Natural disasters E. g. Avalanches, Earthquakes, Volcanic eruptions. II. Hydrological disastersE. g. Floods, Tsunamis. III. meteoric disasters E. g. Blizzards, Cyclonic storms, Droughts, Hailstorms, Heat waves, Tornadoes, Fires. IV. Health disasters E. g. Epidemics, Famines V. Space disasters E. g. Impact events, Solar flares, Gamma ray burst. VI. Technological disasters E. g. chemical spills. VII. Complex emergencies E. g. Civil wars and conflicts. Effects of Disaster on Economy Developing countries stand out more economic losses than positive countries. The common fixings is that, the poor are the ones who suffer the nearly, in both(prenominal) developed and developing nations.Although the total economic loss in dollars is greater in developed countries, the percentage of losses relative to the gross national product in developing countries far exceeds that of developed nations. Technological disasters and hard emergencies are non easy bodeable. The major source of disasters in the 21st century whitethorn be due to rapid increase of Technological hazards, unregulated industrialization of developing countries and the globalization of the chemical indus accentuate. Effect of Disaster on Health Care Organization Sudden Influx * T he biggest challenge after an upshot is to provide extremity treatment.The sudden influx of endurings to a installing and the need for requirement responders in some places at the aforementioned(prenominal) cartridge clip puts a strain on the health care organizations in the local anaesthetic area. Outside sources resembling the Red Cross would pitch-in for help in rescue and relief operations in the side by side(p) days of the adventure. However, the responsibility of handling the initial emergency care lies with the local health care departments. Damage to Facilities * The other effects of natural disaster are the lossdegrading of equipment and readiness due to sudden blue jet in the patients handled at the same time.The demand for all possible medical resources is the possibility that some of the resources may not be obtainable because of direct damage from the natural disaster itself. For example floods may chip power supply required to run many equipments at the rescue center. Inadequately Prepared * stock-still though areas are more susceptible to certain natural disasters, such as earthquakes along a fault line or tornados in the South, they still strike with little or no warning. This throws the health cares schedule out of the ordinary routine. The facility may not be tout ensemble prepared for what comes next. destiny preparedness plans improve the chances that the organization leave be able to respond effectively in the event of a natural disaster, whatever said and make it is never a guarantee that when and what order a calamity occurs. Specialty Treatment Availability * Some disasters are not common like the storms, earthquakes and tsunamis. Epidemic outbreaks of infectious disease are something which needs utmost care to stop them from spreading to the others. It is not just to take care of emergency relief but also to quickly and efficiently harbor the rest of the population.It is more challenging when on that point is no e xisting vaccine or known treatment. At this instance the role of health care organizations becomes even more important. These organizations essential work to treat the patients and comfort themselves while labs attempt to figure out a way to stop the infection from spreading. Effects on the Population A populations vulnerability to all types of disasters depends on demographic growth, settlement in unsafe areas, environmental degradation, the pace of urbanization, unplanned development and climate change. Poverty thrives due to lack of addition to healthy and safe environment.Poor education and awareness also poises risk to population. The effects of disaster on population can be broadly categorized into 1. Immediate Health Impact 2. Long-Term Impacts These are explained at a lower place Immediate Health Impact Short-term losses fall under three categories that have both direct and indirect effects I. Disability, Illness, and Death II. Direct losses in infrastructure and III. Lo ss or disruption in health care delivery. Long-Term Impacts It is primarily a matter of building institutional ability and human resources, and includes I.Identifying vulnerability to natural hazards or other calamities II. Building simple solutions for such particular in the future III. Initiating a changedevelopment among the main factors to develop a basic plan that outlines the responsibilities of each factor in the health sector, identifying possible overlaps or gaps and building a consensus to create an effective healthcare placement IV. Maintaining close collaboration with these main factors and V. Educating the first health responders and managers to face the special challenges of responding to disasters.Steps in Disaster Management * Mitigation To understate the effects of disaster. Examples Zoning Vulnerability analyses Public education. * Preparedness Planning how to respond. Examples Preparedness plans Emergency exercises/training Warning systems. * Response Effor ts in minimizing the hazards created by a disaster. Examples Search and rescue Emergency relief, conclusion alternative sources for relief. * Recovery Restore the community or organization to business as usual. Examples Temporary lodgment Grants Medical care. Mitigation Preparedness Response RecoveryFig Phases of Disaster Management Mitigation Mitigation is to strike down the devotion of a risk. Mitigation activity decreases the probably of the same disaster reoccurring. It includes vulnerability analyses updates zoning and land use management building use regulations and safety codes preventive health care and public education. Preparedness Preparedness is to have the health care crew on toes during an emergency situation. It is to achieve a level of deftness to handle any emergency situations. Preparedness can take form of education of rescue elief during emergencies.This may include rehearsals as well. besides it helps to ensure an optimum reserve of medicine, food, water, equipments and other essentials maintained for emergencies. Like moderateness activities, preparedness actions also depend on the appropriate measures in national and regional development plans. Response Response is to react to emergency situations to maintain life, sustain injuries and pay the morale of the affected. It also includes providing transport, fugacious cling to and food for the affected. Charitable organizations often play a major role in this phase of the disaster management cycle.Recovery Recovery is to bring back the affected population to normal life. Recovery measures both niggling and long term, include restoring life with minimum operating standard, temporary shelter, reconstruction and economic impact studies . This full stop brings many opportunities to boost prevention, increase vigilance and thus reducing helplessness. Real Incident Study overbearing 2, 2011 Medical Response to Joplin Tornado May 22, 2011 Background A tornado warning was issued by the topic Weather Services on May 22, 2011 at 517 p. m. The tornado was rated an EF-5 with winds exceeding 200 mph.It traveled from west to east along 32nd street cutting a path ? to 1 mile wide over 13. 8 miles. The tornado eye was approximately 300 yards wide. Mercy St. Johns infirmary took a direct hit, initial and secondary, on the west facade with duration of approximately 45 seconds. There was a pause as the eye passed through and through with(predicate) the facility. * 160 deaths in the community resulted from this storm. * 8000 structures were destroyed. 400 businesses destroyed, * 8 school buildings destroyed, * 18,000 vehicles destroyed and * 4,500 jobs displaced. When St.Johns took the direct hit from the tornado initially the generators were destroyed, the roof was destroyed and most of which get in the parking lots and on top of other facility equipment. All communications was nowadays disjointed. The facility fire prohibition sprinklers discharged and lines were br oken. Several walls and floors were damaged. Doors were torn from their hinges, all of the glass was blown out of the building except the mettlesome impact shatter resistant glass in the psychiatric ward, bumble lines were broken, sewer lines were destroyed with raw sewage projected throughout the facility, and 86 medical offices were destroyed.The oxygen armored combat vehicle was severely damaged and discharged all of the liquid oxygen. There was a strong smell of natural gas throughout the building and all over the campus. Water discharged by the fire suppression system left the rooms and hallways with 3 to 6 inches of standing water. The air evacuation helicopter was destroyed. typically the helicopter would have been moved to a local airport however, the storm track did not predict impact to the hospital and there hold up conditions prevented safe flight. All infirmarys vehicles, except a John Deere tractor, were destroyed and the emergency trailer was found in pieces sever al blocks away.Everyone in the facility panic that they were going to die, nurses evacuated patients to the hallways per their procedures and at the time of impact nurses covered patients with their bodies to offer as much protection as possible. IVs were ripped from patients arms, the IV poles became projectiles, and several patients were bleeding as a result. The ceilings collapsed, electrical, IT, and HVAC equipment dropped and littered the hallways. All emergency lights and exit signs were ripped from their mounts and were useless. Both incident command centers were destroyed and Emergency Operations Plans (EOP) lost in the debris.The facility was filled with hazardous waste and the radioactive material was unsecured. Outside debris was mixed and power lines were down. advert If the tornado had moved just two blocks south Freeman would also have been destroyed. Freeman did suffer some animal(prenominal) damage that resulted in internal evacuation of at to the lowest degree 6 patient rooms. Immediate Response Considerations There were many immediate considerations that had to be made. If the generators were started, then there was an extremely high probability of electrocution and possible explosion from natural gas.Various ways for communication should be arranged. Communications is not yet interoperable. Security forces and public safety could not communicate with each other due to edition is radio systems. Ambulance radios became the communication infrastructure during the initial response. Staff management is vital. Sufficient lag should be available for relief. Drug dispensing machines are useless in this type of a disaster. Staff had to break into the machines to gain recover to life saving drugs. ID badges need to be backed up with wallet identification cards for employees.Several round members lost their homes and automobiles and the badges went with them in many cases. National Guard troops ref apply to allow staff into the area because of n o identification. Pharmacies need to be guarded with armed shelter system. Have strong security so that people wont run away with cars they do not own. The hospital needs access to several public utility company terrain vehicles (UTV) for equipment and patient transport. Same uniform, common identification and common radio frequencies are required for the security team up for easy identity. Remember that even the staffs require food, water and rest.Evacuation Within a few hours St. Johns evacuated 183 patients, completed one surgical case while the storm was in progress, had 1 patient in the PACU, 24 ED patients and 28 critical care patients were among the evacuees. Evacuation was a tough job. This rescue team used what is depict as the reverse START process found in our evacuation plan. The team discharged most of the patients they could. Some had no home to go to and opted to stay in the health care system as long as possible. Patient tracking was a nightmare. It took about 4 days to positively come on all of the evacuated patients.Many were sent to hospitals a great distance from St. Johns. The usage of heliport was not practicable and two temporary heliports were constructed in the parking lot. Anything that could be used to move a patient was used. Hospital evacuation sleds, mattresses, doors, wheelchairs, and mattresses were used to move patients down 9 flights of stairs that were dark and littered with debris. The Hospital had three predetermined hookup points (muster stations) to evacuate to. This helped them to identify the patients and giving accountability for staff. Special Immediate ConcernsStaffs and physician homes were looted while they were stressful to save other. There were attempts to loot property and drugs from the hospital and physicians offices. Hospitals need deployable incident command centers rather than fixed. Intra-operation communications was an immediate and continuing concern. Security forces could not be identified since they came in variety of uniforms. There was no common identification and no common radio frequency. Hospitals need the ability to install at to the lowest degree a 6 steel chain link fence around the perimeter as in brief as possible following the initial event.Know your staff was personally affected by the storm, many lost family members and homes. Many were not prepared to see the level of trauma and had difficulty dealing with the reality of this event. well-nigh all required debriefing and employee support services. Special equipments are required for immediate rescue. Know whom your local, state, and federal response partners are and have an established relationship with them prior to any event. In an event of this magnitude, if you try to survive in your facility you cannot do it. You will need to evacuate the facility as presently as safe to do so.Everyone should be included during the planning process. It is important to acknowledge that although a habituated natural di saster may last for only a short period survivors can be involved with the disaster aftermath for months or even years. Recovery Process The first step is security of the facility and campus. The next morning after the event the mass evacuation was complete and the facility was cleared. As stated earlier, contracted security forces need to be in the same uniform and on the same radio frequencies as the Hospital security forces so that the recovery process goes smooth.Arrangement for vehicles and fuel should be done and agreements must be in place to have them delivered from locations outside the affected area. The types of vehicles needed should be predetermined. The delivery mechanism should be established very effectively to even work without any phone service. inhabit operations became the first means of providing medical services followed by portable facilities. Facility Considerations During Disasters even emergency power outlets may not operate. Assuming you can use a power g enerator, consider the following facilities * Cameras intended for security purpose should be on power generator. Lighting on emergency power needs to be evaluated. * Exit signs, stairs should be marked with photo light tape or paint. * Knowledge on how to shut down utilities and medical gases quickly and establish a protocol for this procedure. * Proper lightning should be maintained in parking lots and facility areas during recovery phase. * The facility should be considered unstable until cleared by structural engineers. * Secure wiring, HVAC components, piping and light fixtures correctly preceding(prenominal) ceilings. * Plan for rapid deployment and connection trailer mounted equipment, portable buildings, and portable equipment. Debris removal is prolonged and complex. Lessons Learned at This Point in Response/Recovery * Intra department communication is a must. If the Hospital and response partners are not on common frequencies then effective communication will not be pos sible. * Purchase solar charging stations for cellular phones and radio batteries. * Social networks or texting services may not be available during disaster. Effective alternative ways to communicate should be taught to the staffs. * Telephone landlines and support from IT are vital. Electronic Medical Records were essential to the continuum of patient care and for identification of practitioners who were in the facility at the time of impact. * Know that your reserve supplies will be inadequate or may be lost. A 96 hour cache of supplies may last as few as 4 hours because of the out of the blue(predicate) demand. * If the generators operated the potential exists for several deaths by electrocution or explosion. * Stairwell sack will be lost. JCMH egress lighting is all generator fed with no battery emergency lighting. * Manage staff and provide staff support, including mental health services.This will help them in taking quick decision. * Security of the building is critical. Yo u have to protect your resources. * Badges will be lost during this type of event. Have wallet identification cards for your staff. Takeaways from this incident * What you practice is what you do. * Knowledge of response partners, local, state, and federal. * Rehearsals with your community partners for rescue related activities. * Add patient slippers/shoes to your weather plan. Have on bed during Code Grey Level I. * Warehousing emergency supplies and to make it easily accessible even without transport facility. Have emergency kits throughout the facility with pens, pencils, paper, and medical record forms. Also include gloves, masks, flashlights, and batteries. * Develop a common triage tag and process. It is best to have a standard triage system. voice and follow it with all of the hospitals in your region. * You need to develop a rapid response team for security and a component of the security team will need to be armed. * Staff adequately during such events. * Efficient disbur sement of supplies (Medicines, food etc) among staff for patient care and personal use. Consider staff physical and psychological needs shift relief, food, rest, and debriefing. * Many storms usually have a follow- up storm and to be ready to minimize damage caused to structure and building (eg Glass debris)during such events.. * The Joint Commission will arrive on site to assist with reestablishment of services and they proved to be a valuable resource. * test Scrub Racks with many sizes of scrubs to keep staff in suitable clothing. Conclusion Natural disasters are crisis situations. However, with planning, costly and ineffective interventions can be avoided.Improvisation and rush inevitably come with a high price, and there are many things health officials ought to avoid preferential use of expatriate health professionals emergency procurance and airlifting of food, water, and supplies that often are available locally or that remain in storage for long periods of time the tende ncy to adopt dramatic measures all contribute to making disaster relief one of the least cost effective health activities. . The occurrence of a major disaster can be the initial catalyst that helps health authorities recognize that disasters are a public health risk that must be addressed in an organized manner.Yet, preparedness cannot wait. A continual effort is needed to reduce possibility, by decreasing weakness through elimination and minimization and by increasing potential through ability methods. There needs to be a continuum between normal development, preparedness, and disaster response activities. Disasters are not likely to decrease in the foreseeable future. A sustained effort is needed to minimize risk, by reducing vulnerability through prevention and mitigation and by increasing capacity through preparedness measures.Disasters need to be addressed on a long-term and institutionalized basis through an established ministry of health program or department for prevention, mitigation, preparedness, and response for all types of disasters. References * Environmental health in emergencies and disasters A practical guide. WHO, 2002. * Disaster Help, US Department of Homeland Security. * Green Paper on Disaster Management, Department of Provincial and Local Government, South Africa * http//www. ehow. com/list_6847852_effects-disasters-health-care-organizations. tmlixzz1epfIqgRL * Guide to Emergency Management Planning in Health CareBy Joint Commission Resources, Inc * http//www. scsrc. org/wp-content/uploads/2011/08/Joplin_Tornado_Trip_Report. pdf * http//www. himss. org/content/files/ambulatorydocs/BridgeheadWhitePaper_HealthcareDisasterRecovery. pdf * http//www. healthcaredisasterplanning. org/ * http//www. sans. org/reading_room/whitepapers/hipaa/disaster-recovery-healthcare-organizations-impact-hipaa-security_1336 * http//pandemic. wisconsin. gov/docview. asp? docid=14447 * http//www. dcp2. org/file/121/