Monday, September 30, 2019
The concept of interpersonal relationships and management involves ideas, taught, and beliefs that are related with social association and affiliations which are employed as approached to marketing, operations, training, management and executive decision (Giddens, 2001). These taught and perceptions constitute different philosophies used by various organizations that create a harmonious place for members and personnel. These beliefs allow the organizationÃ¢â¬â¢s business to improve. Business improves since personnel performances are able to maximize their potential because people are working perfectly as a team. It is no secret that in order for business to be successful, management plays a very important role (Virine, 2007). Thus, for business to prosper, philosophy in management should be carefully taken into consideration (Virine, 2007). Ã Ã Ã Ã Ã Ã Ã Ã Ã Ã Ã Ã In order to successfully manage an activity or personnel it is important that a manager is strong-willed, determined and possessed the Ã¢â¬Å"driveÃ¢â¬ needed to achieve the desired goal. Ã It is significant that a person should do a specific thing really well. In order to achieve this, a fine plan should be accomplished and when the plan is executed it is necessary that the plan is strictly followed. It is also important that the existing plan can adapt to changes that when problems are encountered, it can easily be resolved. Also in managing, it will be fitting to add that it is not enough that a person would know how to do things correctly, but it would be a welcome addition to recognize that a person knows how to things better. Ã Ã Ã Ã Ã Ã Ã Ã Ã Ã Ã A person should understand and put into his mind that there are occasions when great just isnÃ¢â¬â¢t good enough. He should not settle for less instead strive and work harder to deliver and perform things way beyond what people have expected. He should not be satisfied by saying Ã¢â¬Å"this will already doÃ¢â¬ and Ã¢â¬Å"this is alrightÃ¢â¬ . He should always work to be the best. Being the best should not be the endpoint that will mark the conclusion of a venture, but it should be a starting point of something that is great. Through sheer innovation one should take something that works, it could be ideas, or various products such as electric appliances, glassware or simple things like papers and plastics, then transform them and improve them to something that is really unexpected. A person should always try to work to achieve excellence. Ã Ã Ã Ã Ã Ã Ã Ã Ã Ã Ã However, in order to properly manage things there are other factors that should be taken into account. One major factor is inter-personal relationship. Relationship with others influences the way we manage things our everyday life (Kahneman, 2000). It is because of our relationship to our love ones that we strive to make things better. It is because of these people who are close to us and we hold dearly in our hearts that we struggle in order to create a better living condition. Because of them we Ã¢â¬Å"shoot for the starsÃ¢â¬ and aim for the best. Furthermore, our relationship in our workplace with fellow personnel and with the manager dictates the success or the failure of an activity. As mentioned before, it is important to achieve a working area that is surrounded by people which are friendly and are always prepared in lending help. Somehow, they can be your family that during the most challenging times in the work one would have somebody to lean on (Lauria, 1964). They would provide you support and the much needed boost during office hours. With someone to call on, personnel can fully utilize their skills and maximize their talents. Workers do not need to be worry of accidents that may happen, since a sense of security and protection is given to them, as a result they become more focused. Also, in return workers and personnel would work doubly harder to showcase their affection to the people who have helped them in work and their gratitude to the organization and their bosses. Another essential issue that arises from the proper managing of things is decision making. Making a sound decision is hard and when at one point an organization has arrived to a decision, it is always certain that not everyone would be pleased, there would always be contentions. Generally, there are no rules that would make a person a good decision Ã¢â¬âmaker (Plous, 1993). There are always risks that are involved and often times these risks impose immense problems that lead to the downfall of what seems a fair decision at the beginning. There are, however things that can help a person in making decision. Information should first be gathered and accumulated about the issue at hand. Careful study and precautions must be done to properly weigh things. In making a decision it is important to first ask who will be affected once the decision is handed out. Then, we should also understand who will benefit and to whom the decision is detrimental. In making a decision, one should decide for the good of majority and sacrifice his own self interest. To be a good decision maker one needs to be self-less. It is a noble act, a supreme sacrifice. A situation that recently took place in my office is the grudge that happens between two of my colleagues. The conflict occurs because of a misunderstanding for the division of labor in the office. Due to the misunderstanding, a part of the job was left undone. When the deadline arrives and portion of their proposal was still incomplete, pressure started to build up and emotions run high. As a result, a dispute between them existed. For a period of one month or so they started not to talk with each other after their proposal was dumped. Since, both are my friends and I am the one who is being caught from their fight I decided to talk to them and invite them to be part of a project that was assigned to me. Although they were hesitant to work with each other, I convinced them telling they are the most trusted person I knew that could help me and the only person which fitted the job. Professional as they are, they put aside their differences, and worked as a real team. With me calling the shots, and making sure everything is carefully attended and no single detail taken for granted we finished an astonishing job with lots of time to spare. We can infer that by setting aside their argument and their pride for a better cause, and giving each other another chance to work a fine output is achieved. They decided to be selfless and put the organization on top of their priority. References Giddens, A. (2001). Sociology. Cambridge: Polity. Kahneman, D. (2000). Choice, Values, Frames. Cambridge: The Unviersity Press. Lauria, A. (1964). Respeto, Relajo and Inter-Personal Relations in Puerto Rico Anthropological Quarterly, Vol. 3 (No. 2). Plous, S. (1993). The Psychology of Judgement and Decision Making New York: McGraw-Hill. Virine, L. (2007). Management Concepts: Vienna. Ã
Sunday, September 29, 2019
Ã¢â¬Å"the most difficult thing I ever learned to doÃ¢â¬ Most pepole have learned many things to do and some of the learning is the hardest of the others . For me ,The most difficult thing I ever learned to do in is how to live as an immigrant . Most of all,The lack of English proficiency was a barrier to a better life. When I came to the United States ,I couldn't find any word to express my self in English. Learning english was not easy for me especially when you want to learn academic English as third language .However ,my friends said Ã¢â¬Å"If you do feel that English is not easy don't worry you are not the only one Ã¢â¬Å". I know that who I am not the only onehas this problem. I don't give up, I'll try to do my best as good as possible. The second reason why moving to the United States was so hard to me,living to a different country has opened my eyes to many cultural differences. I was not sure If american society would accept me or if any one could ever talk to me. Iran ha s a very different cultural background in the ways of seeing things,traditions,and interpreting the world .I often felt torn between the U. S. culture and culture of mine. It took time to overcome these problems and communicate effectively across cultures. Another reason ,Since I lived with my parents I had never experience living alone . As an independent person , I have a lot of things to handle them such as working and money mangment . I can't imagine how could I organize all of these by myself . Probably, living independently can brings to be more responsiblility,but for me it was one of the hardest things I hade to leran in the U.S. The Last reason things were difficult for me , I had to control my emotions . When I migrated to another country ,I began a new life without support and attention of my family . I became far away from Enviroment which was full of sweet bitter memories and this fact got me depressed. After several month,I found some way to control my emotions and to make myself happy . Now , I think living in U. S. is the hardest thing i learned to but definetly It taught me Ã¢â¬Å"the past is past , live nowÃ¢â¬ and I can it do if I want to do.
Saturday, September 28, 2019
A Review of the Pirates' House and the History of the Restaurant The Pirates House is a notable eatery and bar built up in 1753. ItÃ¢â¬â¢s situated in Savannah, Georgia. It is believed that Pirates House is the oldest building standing in Georgia. This restaurant stands out as one of the major tourist attractions in Georgia. This comprehensive narrative reviews the restaurant as a business as well as a historic entry together with the activities that were undertaken in the restaurant since it was established. Criteria 1 Pirates House was based on a plot of land that had been set aside to be a botanical research garden. The garden was assigned to Oglethorpes Trustees. Oglethorpe selected botanists from around the globe to procure plants for the venture, such plants include, cotton, therapeutic herbs, indigo and flavors. The garden was put up with the hope of boosting the wine and silk industries that were mushrooming by then, the garden later centered its operations to growing mulberry trees. The soil and climate states in however did not favor the mulberry trees. The wine and silk industries also crumbled as a result of those factors. The garden would later develop cotton farming that quickly became the staple for the residents of Georgia. The small building had therefore been built to house the gardeners who worked in the farm. The house was formerly known as the herb house due to its old age. By 1754, Savannah was rapidly growing as a port town thus the residents decided that it was no longer relevant to have a botanical garden. The herb house was therefore transformed to serve as a tavern and an inn where visiting seamen from abroad would be housed (McGrath and Pirates House). The pirateÃ¢â¬â¢s house started to constantly house seamen and pirates and with time, it started to earn a bad reputation and the general public started to avoid it. The pirateÃ¢â¬â¢s house did not earn its status by rumor; many sailors had been reported missing from this restaurant. Duisburg captains who needed slave men frequented the inn and took away vulnerable drunkards. The restaurant was initially owned by captain Flint. The savannah gas company would later buy Pirates house and the neighboring land in the 1900s. Mrs. Hansell Hilyer who was the wife to the president of Savannah Gas Company was attracted to the design of the building in the premises they had bought. She rehabilitated the museum house into a restaurant with 15 dining rooms with a capacity of 120 guests. It started operations and served several varieties of southern dishes. Frances McGrathÃ¢â¬â¢s book Ã¢â¬Å"The Pirates House Cook Book lists the recipes that the restaurant offered. Criteria 2 The pirateÃ¢â¬â¢s house is a notable restaurant most significantly because of the stories that it is founded on. The restaurant holds an annual competition known as the Girl Scouts of Historic Georgias where they different entries showcase their innovative recipes and at the same time have a time to celebrate the history of the restaurant (McGrath and Pirates House). The restaurant has earned several good reviews for their delicious food and their exclusive service and theme. The residents of historic Georgia view it as a source of their pride and it relatively sees a consistent flow of tourists who come to share the experience and learn the history. The pirateÃ¢â¬â¢s house has been used in a handful of contexts which includes Robert StevensonÃ¢â¬â¢s book Ã¢â¬Å"Treasure IslandÃ¢â¬ which was written in 1881. It is believed that the novelist was inspired by the house and the activities that were happening in the house. Some pages of the novel where the action was from the res taurant are displayed in one of the rooms in the restaurant. The pirateÃ¢â¬â¢s house serves several people each with a different goal. May people travel from far destinations to have an exclusive service in a restaurant that is believed to be haunted by the souls of the initial owners and those of the sailors that died in the restaurant in the 17s and 18s. Besides that, people like to see the restaurant for its old design from the 17s (McGrath and Pirates House). Criteria 3 One of the most fascinating parts of the hotel is the set of ancient staircases that lead into unseen tunnels that are underneath the restaurant. It is believed that the tunnels beneath the restaurant ran to the banks of Savannah River. The strong men drinking at the bar were dragged via the staircases, to the tunnels and drugged. They would then be dragged through the tunnel to a ship and forced to be part of the crew. The restaurant is a vibrant business that has employed a handful of employees. In the event that the restaurant is closed, several people would lose their jobs and a spring of pride for the Historic Georgia would have dried. People visiting the town often visit the restaurant for delicious foods and interesting ghost stories. Since the 18s, the structure of the restaurant has barely changed. This is most likely because the restaurant needs to preserve the original feel of the house since it was built. Many people who would like to see the building and attribute it to the story behind it will often visit the restaurant and that acts as the restaurantÃ¢â¬â¢s point of sale. Conclusion This restaurant has been a favorite spot for everyone who visits as it was the same case for the privateers and sailors for several years. The food and drinks were as terrific as they still are now. It is no surprise that the pirates would hang around the place that they enjoyed and loved when they were alive, like we do today.
Friday, September 27, 2019
Writing argument using Zeitoun by Dave Eggers - Essay Example Every man who dares to answer the call of the unknown knows very well the dangers lurking ahead and he alone has to face them with courage and determination. Initially he may hesitate to respond to the call but then he is assured of supernatural assistance. This gives him the courage to begin his journey and face the challenges ahead. In his journey the Hero may get tempted to move away from his mission and surrender to unjust provocations. It is upon the mental strength of the hero that he will overcome all temptations and remain true to his mission. Once he attains his mission, he becomes hero in the true sense as he triumphs in the test of bravery and tolerance. David Eggers, in his book Zeitoun, has written about the real life events of ZietounÃ¢â¬â¢s family in New Orleans. The protagonist is Abdulrahman Zeitoun who is a Syrian-American. He and his family experienced the Hurricane storm called Katrina in 2005. The book describes ZietounÃ¢â¬â¢s deeds and how his life shaped up after the storm. He passed through difficult times and emerged like a true hero. The experiences of Zietoun after the Katrina can be viewed through the different stages that a hero has to experience. We can see his struggles to survive and help others in distress post the hurricane. The way Zeitoun managed his days through all the crisis he faced is a true characteristic of a Hero. Zeitoun along with his wife opened their own company in New Orleans Ã¢â¬â Zeitoun Painting Contractors LLC. When Hurricane Katrina struck New Orleans in August 2005, Kathy with the children took shelter in Balton Rouge which was her homeland. Zeiton could not go with his family and h e stayed back in New Orleans to take care of their home, work sites and their rental properties. Thus he showed bravery and a sense of duty to his fellowmen as he remained back and just like a hero is prepared to overcome all kinds of difficulties, Zeitoun too stayed back
Thursday, September 26, 2019
Describe social hierarchies and discuss their relevance for ethnic studies - Essay Example better comprehension of the processes of social stratification and inequality in the general society but more importantly the business world (Karin 7). Ethnic minorities encounter a lot of challenges such as labor market discrimination to an extent that some of these people face health differences where those with low socio-economic status are at a disadvantage. Significantly, a good example is where in the United States there are groups that experience inequality through discrimination when it comes to acquiring jobs i.e. Africans, Asians and Latinos (Karin 23). It is very hard to find people from these ethnic groups in the top level management of prominent organizations; once they get jobs in these organizations and are at the bottom of the hierarchies, it is very hard for them to get any promotions or even job upgrades. Generally, ethnicity is a significant category of social hierarchies in contemporary societies that contain a significant number of ethnic communities with most parts of the society dealing with challenges associated with racism, ethnic discrimination, ethnic identity or even minority rights. This has actually resulted to the ethnic communities in the United States relying on social ties and latter groups that look upon state agencies for employment and trying to find ways that they can employ so as to improve labor market chances like acquiring high level skills (Karin
Growing up - Thesis Example In this context passing could represent the journey from city to city, it could also represent to passing form one lover to another or one musical genre to another starting which gospel choir to punk to blues to jazz to rock. Passing could also indicate passage of time and in that effect growing up. The story begins with the Youth as a young person who is in a state of spiritual confusion not knowing what to do. As expected he wants to become a better person someone he is proud of. Despite being brought up by a conservative single mother he turns to Zen Buddhism. However this goes only for a short while before he succumbs to her mothersÃ¢â¬â¢ persuasion to find God. During this time instead of having a spiritual awakening his musical affinity is awakened by the gospel choir. He later joins the choir mainly because of his attraction to a girl in the choir. During his life in the choir he meets with Franklin Jones who was the choir master who introduces the youth to drugs. He develops a liking for the guitar and soon afterward deserts the choir to form a punk rock band with fellow ex-choir members. With the passage of time he abandons his band mates and starts saving money to travel to Europe where he anticipated becoming a musician which his mother and the community disapprove . In the film the youth says, Ã¢â¬Å"Slaves have options, cowards only have consequences.Ã¢â¬ This depicts his state of discomfort with his reality and how he had resolve to go to Europe.. After a long argument with his mother the youth goes to promiscuous Amsterdam where for the first time in his life he discovers freedom. He suddenly has easy access to all the social evils such as sex and drugs he lamented Ã¢â¬Å"All vices in full view Ã¢â¬Å"when he say hashis on the menu of a coffee shop with topless women serving coffee. The Youth also first experiences acceptance in the form of a girl named Marianna who willingly gives her the keys to her
Wednesday, September 25, 2019
Argument Analysis - Essay Example In order to build an excellent and convincing argumentative essay it is necessary for the writer to take in account various aspects that are involved in the construction of a good essay. This includes the tone, style of writing, use of statistical data and the art of building an essay on the basis of the data collected, targeting and securing an audience for his essay etc. similarly the author of this article is also observed to be using such techniques as a result of which his essay provides the readers with a lot of a variety of aspects to be explored. The approach used in depicting this essay is explicit because the article deals with a critical topic that can have hazardous affects if remedies are not taken. This essay reflects the writers concern for his environment as well as the health of his fellow beings because he tries to convince the readers about the adverse effects of using fossil fuels in contrast to the benefits of nuclear power plant. ... Yet at the same time analogies and facts are used to compare and contrast the state of his country with other governments without confining the comparison to a particular country. As mentioned in the article, Ã¢â¬Ëother governments are enthusiastically embracing nuclear power as a way to lessen their greenhouse emissions and their dependence on imported oil. Hence the writerÃ¢â¬â¢s point of view depicted in this article is not only acceptable but also gives the readers food for thought and consequently results in convincing them. The article very tactfully states all the pros and cons of starting a new power plant. The essay strategically first talks about the importance and the benefits of nuclear power plants and gradually moves towards the amount of risk and finance involved in this essay. So this gradual descend from the glory to the risk is a good strategy on the writerÃ¢â¬â¢s part. As states, Ã¢â¬ËÃ¢â¬ ¦with advanced designs, new construction techniques and strong over sight should be even saferÃ¢â¬ ¦ The tab for a new reactor can run as high as $7 billion to $8 billion, and overruns can add more. There is a long lead time before a plant starts selling power and paying returns. The target audience of the writer appears to be the investors of the private sector as well as the government officials who are responsible for providing assistance to the citizens of the country in beginning a new venture. The tone of the essay is formal since the target audience is also the group of investors and the government officials. The use of formal tone helps in enhancing the over all impact of this article on the readers since the purpose of this article is to attract the citizens of
Tuesday, September 24, 2019
MDCM (B) write up - Case Study Example & Norton, J. F., Ã¢â¬Å"MDCM, Inc. (B): Strategic IT Portfolio ManagementÃ¢â¬ ). Along with defining, prioritizing and framing useful recommendations, the paper also constitutes a score card in order to evaluate each prioritized projects and also comparing the prescribed projects using the Portfolio Application Model Matrix (Jeffery, M. & Norton, J. F., Ã¢â¬Å"MDCM, Inc. (B): Strategic IT Portfolio ManagementÃ¢â¬ ). The MDCM corporate board should keep prime focus upon defining, initiating and prioritizing top IT projects that should support or help MDCMÃ¢â¬â¢s strategic business goals in order to compensate huge losses that the organization faced during the last five successive years. In this connection, the MDCM board should assess their prioritized projects initiative that would ultimately provide high value and low risk towards the business organization. Moreover, the corporate board of MDCM should lay emphasis upon the long-term competitive advantage of the organization along with tackling the risk issues that are mainly associated or related with them (Jeffery, M. & Norton, J. F., Ã¢â¬Å"MDCM, Inc. (B): Strategic IT Portfolio ManagementÃ¢â¬ ). The most appropriate IT project initiatives that MDCM analyses can become a part in order to improve its global IT. The organization took the initiative on unifying its methodology and technical values. The corporate team of MDCM wanted to eliminate the numerous different standards and IT methodologies that are prevailing across the company. This approach would help them to reduce the project sequence and encourage information distribution across IT development teams. This initiative was very much essential for MDCM in order to improve the future system development capability of the organization (Jeffery, M. & Norton, J. F., Ã¢â¬Å"MDCM, Inc. (B): Strategic IT Portfolio ManagementÃ¢â¬ ). The other significant project initiative of
Sunday, September 22, 2019
Human Resources - Essay Example An HRD professional assumes the duty of the staff trainer or instructional designer. HRD professionals maintain the organizationÃ¢â¬â¢s reward system to guarantee fair and equitable pay rates. Administer and design the companys reimbursement program, as well as pensions and health insurance. They report any gaps between outputs and expectations and assess workers performance. They conduct training programs, which improve employees skills and enhance their abilities to function as a group. Finally, HRD professionals evaluate training schemes and propose future options for frequent learning. They serve an extremely crucial role in the development of an organization. Their philosophy is that they need to possess numerous skills, as well as competencies, which will assist them to bring success in the organization they work in. They consider their roles to be more crucial than the actual owners of the organization who, therefore, assume the role of a leader. What I learnt about the HRD field, while conducting this interview, was that the field in extremely critical in determining the success of an organization. This is because people who function in this field are the ones responsible for creating the powerful workforce that will bring success to the company. As a child, my father crafted me in to being a leader. I was amazed of how he handled matters as the head of the family with ease. Therefore, I grew up also hoping to play a critical role in bring success to this world. Through jobs, people are able to be successful; hence, no other field would have suit me better than the HR field. This is a place where a person could shape others to becoming successful people in this world. My strengths as a HR professional are that I work diligently. It is always in me to see a task completed successfully, and after that I find myself coming up with a new task. I also opt to listen to other peopleÃ¢â¬â¢s opinions
Saturday, September 21, 2019
Law governing Turkey Essay IVF (in vitro fertilization) refers to treatment for infertility, in which eggs are removed from a womans body, fertilized with sperm in a laboratory, and then returned to the womb shortly afterwards to continue developing. IVF has been greatly achieved by the Turkish Medicine community such that even individual mothers and couples from other countries hospitals in go into Turkey in order to get children through this process. The sperms donated by sperm donors undergo screening in order to check their health status and the desirable traits required by most patients (ourbodiesourselves para2). These advances in technologies are not in harmony with the culture and the law governing Turkey. The paces at which the technologies are advancing are greater than the rate at which the society is responding to such changes, especially by those in lower socioeconomic class. But again many people would prefer the idea of surrogate motherhood and oocyte donation to some new techniques that are applied in medical practice today. All over the world, Turkey included, people are still debating on the social and ethical impacts of oocyte donation and surrogacy on the society. According to (Selim, et al 34), not many studies have been carried out in Turkish society to get their views on surrogate motherhood and oocyte donation. But studies that have been conducted with an aim of investigating the ethical dilemmas faced by the Turkish people on in vitro fertilization and oocyte donation have shown that even most infertile married females would still not accept surrogate motherhood and egg donation. Most of them had preferred adoption to IVF method. They reason that, these advancements in medicine are against nature (Selim, Et al 54). Interestingly, many studies carried out in Turkey show that many people agree to oocyte donation. Analysis Ethics is the belief and principles that determine peopleÃ¢â¬â¢s behavior which in turn forms peopleÃ¢â¬â¢s culture. IVF and oocyte donation for a long time has been a topic of debate especially concerning their conflicting values to societal norms and at the same time the need to fulfill patientsÃ¢â¬â¢ desires to have children. Normally infertile couples can make decision on what they want regarding having children but this is limited the laws that govern reproduction in Turkey. The laws have to be consistent with the socio-cultural and religious values, which in Turkey does not permit certain reproductive treatments. Ethical issues that have risen since this technology came to place include the spread of gay marriages which is against Islamic and Christian teachings and is a threat to moral being of most societies in the world (Jinemed Hospital para 4). Unfortunately, even Lesbian couples and gay men hire surrogates to give birth to their children. This is against the purpose for which the technology was developed. Another issue is the sustainability of most marriages not just in Turkey but in the whole world in general especially in USA where most divorce cases occur. Some women particularly those of high socioeconomic status prefer to stay single because after all there is oocyte donation and they can afford to pay surrogates. Some just do this because she would never want to be seen pregnant or to bear the pain of carrying the baby in her womb. These technologies have serious effects on marriages today since anybody can have a child whether in a relationship or not. Although Turkey does not experience high divorce rates as the USA, but it still poises a problem. The issue about the stability of the family has also been a major concern especially on the side of the surrogate mother comes from. The first surrogate mother in the world, Elizabeth Kane describes her ordeal as surrogate mother to be one of the worst experiences in her life since normally the society has eyes on you and your family. She says that being a surrogate psychologically and emotionally affects the mother, her husband and even their children. It even becomes difficult to think of surrendering the child to the mother due to the emotional attachment between the surrogate mother and the child. She considers being a surrogate to be prostitution (Ourbodiesourselves para 2). Conclusion IVF (in vitro fertilization) and oocyte donation had all the good intentions but its negative impacts were not seriously looked into before putting it into practice for human beings and that is the reason why coming up with a proper and all inclusive legislation has not been possible not only in Turkey but in any country in the world. Just like cloning has been a big issue and threat to humans, IVF might be different but it poses almost the same threat to human beings. Proper legislation is necessary to curb the ethical issues that have been raised by religious communities and the civil society. Again, just like abortion, legislation alone may not contribute much in reconsidering such practices. The most important is the attitude of the people towards such technologies. Works Cited Page Jinemed Hospital: Infertility treatment in Turkey. Intuition Communication Ltd, Istanbul 2010 Retrieved from http://www. treatmentabroad. com/infertility-treatment-abroad/turkey- infertility/jinemed-hospital/ Our Bodies Ourselves: The Politics of Womens Health. Health Resource Centre, Boston. 2008 Retrieved from http://www. ourbodiesourselves. org/book/companion. asp? id=31compID=67 Selim; Muharrem; Hakan; Mahir; Gulec; Adnan; Fatma; Ceren and Ozlem et al. Determination of the attitudes of Turkish infertile women towards surrogacy and oocyte donation. Professional Medical Publication, Karachi 2009
Friday, September 20, 2019
Effect of Microhardness on Chemical Degradation Abstract Objective: The aim of this study was to evaluate the effect of chemical degradation media associated with brushing on surface roughness (Ra) and Knoop microhardness (KHN) analyses of different composites. Material and Methods: Eighty specimens were prepared for each composite: Grandio SO (Voco), Amaris (Voco), Filtek Supreme (3M/ESPE), Filtek LS (3M/ESPE). The specimens were divided into four groups according to the immersion in chemical degradation media for 7 days: artificial saliva (control), heptane, 0.02M citric acid, 70% ethanol. The surface of specimens was submitted to 10950 brushing cycles (200g load) in an automatic tooth-brushing machine with abrasive slurry. Surface roughness and microhardness measurements were obtained at baseline, after immersion in chemical degradation media and after brushing. Data were submitted to three-way repeated measures ANOVA and TukeyÃ¢â¬â¢s test (pResults: The KHN means for composites were: Grandio (153.5Ã ±35.9)a, Filtek Supreme (87.0Ã ± 24.9)b, Amaris (64.5Ã ±24.5)c, LS (69.0Ã ±15.3)c; for storage media: artificial saliva (97.3Ã ±46.7)a, ethanol (93.3Ã ±49.9)a, citric acid (95.8Ã ±42.1)a, heptane (87.6Ã ±36.7)b; and after treatments: after chemical degradation (104.8Ã ±49.7)a, baseline (93.8Ã ±42.5)b, after brushing (81.9Ã ±36.5)c. The Ra results for composites were: LS (0.15Ã ±0.25)a, Grandio SO (0.19Ã ±0.24)ab, Filtek Supreme (0.20Ã ±0.22)ab, Amaris (0.23Ã ±0.37)b; for storage media: artificial saliva (0.18Ã ±0.31)a, heptane (0.18Ã ±0.25)a, ethanol (0.20Ã ±0.26)a, citric acid (0.21Ã ±0.28)a; and after treatments: brushing (0.11Ã ±0.14)a, after chemical degradation (0.23Ã ±0.32)b, baseline (0.24Ã ±0.32)b. Conclusions: Brushing after chemical degradation reduced surface roughness values. In general, chemical degradation did not affect composites roughness, but microhardness was significantly reduced. Heptane produced the biggest reduction in composites microhardness. Clinical Relevance: The food-simulating solutions and brushing simulating alter the composites properties, and these alterations are material-dependent. Keywords: composites, chemical degradation, brushing, Knoop microhardness, surface roughness. Introduction Improvements on the composition and mechanical properties of resin-based materials along with increased esthetic demands have resulted in the enlarged use of direct composite restorations in anterior and posterior teeth [1,2]. These improvements provided more strength and durability to the composite restorations under the conditions of the oral environment. Most of the available composites contain a polymer matrix of dimethacrylate monomers, such as Bis-GMA, UDMA, and TEGDMA (organic phase), inorganic filler particles (dispersed phase) coated with a methyl methacrylate-functional silane coupling agent to bond the filler to the organic matrix, a photoinitiator system to allow photoactivation by light units and other minor additions including polymerization initiators, stabilizers and coloring pigments [3-5]. However, the critical oral environment conditions (pH changes or humidity) may increase the composite biodegradation over time . Under oral conditions, dental materials may be exposed either intermittently or continuously to chemical agents present in saliva, food and beverages . Previous studies have shown that some dietary foods and beverages can cause surface degradation of restorative materials [7-14]. Their constituents can soften the organic phase and promotes disintegration of the dispersed phase, altering the surface hardness [1,15]. Besides of chemical environment, the toothbrushing is another condition that influences the longevity of composites restorations in vivo. Although toothbrushing plays an important role in oral hygiene, the effects of abrasion constitutes another important issue on dental materials wear processes, which can result in alterations in surface roughness, loss of contour, staining and plaque retention . There are several types of composites nowadays, such as nanohybrid, nanofill and microhybrid, which have the similar polymer matrix composition. However, the inorganic phase (size, type and distribution of filler particles) are different. Therefore, the effects of chemical degradation liquids and toothbrushing on surface roughness and microhardness of these types of composites must be reported. Thus, the aim of this study was to evaluate the effects of chemical degradation associated with toothbrushing on surface roughness and microhardness of different composites. The null hypothesis tested was that the immersion in chemical degradation media and brushing are not able to modify the surface roughness and microhardness of the tested materials. Material and Methods Specimens preparation Eighty cylindrical specimens of each composite were fabricated (shade A3) using a metallic matrix with 2 mm in height and 3 mm in diameter. A mylar strip was placed over the composite and pressed with a glass plate to provide a flat surface, being removed after curing. The composites were applied in increments of 2 mm and cured on the top surface using LED photocuring unit (Elipar Freelight 2, 3M/ESPE, St. Paul, MN, USA) at 1200 mW/cm2 power density, activated for 40 s. After curing, they were stored in individual containers with deionized water for 24 h. Then, they were polished using a sequence of 1200, 2400 and 4000 grit aluminum oxide abrasive disks (Extec, Enfield, CT, USA) in a polishing device (DP-10, Panambra, SÃ £o Paulo, Brazil). After polishing, all the specimens were immersed in deionized water at 37 Ã ºC for 24 h. Four direct restorative materials were tested, as described in Table 1. Knoop microhardness measurements The microhardness measurement was performed with a microhardness tester (FM-700, Future-Tech, Tokyo, Japan), Knoop tip, under 25 g load for 10 s. Three indentations were performed 100 Ã µm apart from each other, at the surface of the specimens. The means were determined as Knoop Hardness Number (KHN). Surface roughness analysis The mean surface roughness (Ra) was evaluated using a profilometer (MaxSurf XT 20, Mahr, Goettingen, Germany). The diamond stylus moved 2.5 mm long starting the first measurement 0.2 mm from the lower area of specimen. Three profile measurements were performed for each specimen at intervals of 0.25 mm and a final average was used. The mean Ra values were determined with a cut-off value of 0.8 mm, a transverse length of 0.8 mm, and a stylus speed of 0.1 mm/s. Chemical degradation media immersion The specimens of each composite were randomly divided according to the food-simulated substances tested (n=20). The solutions tested are mediums recommended by FDA (1976) to be used as food-simulating liquids . Heptane P.A. (Synth Ã¢â¬â Labsynth, Diadema, SÃ £o Paulo, Brazil) was used to simulate butter, fat meals and vegetable oils. Citric acid 0.02M (Synth) simulated beverages, vegetables, fruits and candies. Ethanol 70% (Zulu Hospitalar 70% Companhia Nacional de Ã lcool, Piracicaba, SÃ £o Paulo, Brazil) simulated alcoholic beverages and mouthrinses. Artificial saliva was used as control and prepared according to Gohring et al.  using 22.1 mmol/l hydrogen carbonate, 16.1 mmol/l of potassium, 14.5 mmol/l sodium, 2.6 mmol/l hydrogen phosphate, 0.8 mmol/l boric acid, 0.7 mmol/l calcium, 0.4 mmol/l thiocyanate and 0.2 mmol/l magnesium. The specimens were kept in individual vials with 2 ml of each solution for 7 days at 37 Ã ºC. After this period, the specimens were washed thoroughly, and stored in deionized water at 37 Ã ºC, for 24 h. The microhardness and surface roughness were evaluated. Brushing protocols Subsequently, the experimental units were subjected to brushing abrasion in an automatic toothbrushing (TB) machine (ODEME Biotechnology Ã¢â¬â JoaÃ §aba, Santa Catarina, Brazil) which imparted reciprocating motion to 6 soft bristle toothbrush heads (Sanifill Ultraprofissional, Hypermarcas Ã¢â¬â SÃ £o Paulo, Brazil). This apparatus provides linear brushing movements across the specimens at a speed of 120 cycles per min at 37Ã °C, with a double pass of the brush head over the surface. The top surface of resin composites cylinders were submitted to 10950 brushing stokes under a vertical load of 200 g with abrasive slurry, simulating one year of clinical situation . The abrasive slurry consisted of fluoridated dentifrice (Colgate Tripla AÃ §Ã £o, Colgate-Palmolive, SÃ £o Paulo, Brazil) and artificial saliva, in a ratio of 1:3, by weight . Toothbrushes were replaced after the completion of each brushing cycles. After brushing, the specimens were kept in deionized water at 37Ã ºC, for 24 h. At the end of this protocol, the microhardness and surface roughness was obtained. Statistical analysis This experiment followed a factorial scheme of the 4x3x4 type. The experimental variables under study were composites [Grandio, Amaris, Filtek LS, Filtek Supreme], time [baseline, after chemical degradation (CD) and after brushing (TB)] and the food-simulating media [artificial saliva (AS), heptane (H), citric acid (CA) and ethanol (E)]. The variable responses were the mean roughness measurement value obtained in profilometer, and the average of three microhardness readings. Data were submitted to statistical analysis using the computer software Statistica for Windows (Statsoft, Tulsa, OK, USA). The inferential statistics consisted of three-way repeated measures ANOVA (composites, time, and chemical degradation media), in which the variable time was considered as a repeated factor, followed by TukeyÃ¢â¬â¢s test. The level of significance was the conventional value of 5%. Results Microhardness evaluation The mean KHN values of the composites after chemical degradation media are shown in Figure 1. The application of RM-ANOVA showed significant differences for the factors composites (p=0.0001), time (p=0.0001) and chemical degradation (p=0.0001). Grandio SO composite presented the highest KHN values for all times tested. Amaris and Filtek LS exhibited values significantly lower than Filtek Supreme and Grandio SO (Table 2). For the chemical degradation media factor, the immersion in heptane produced the lowest microhardness means, compared to the other tested media (Table 3). Regarding the different times, the microhardness (KHN) values significantly increased after immersion in chemical degradation media and decreased after brushing, compared to baseline means (Table 4). Surface roughness analysis The means of roughness surface (Ra) for the composites are shown in Figure 2. The application of RM-ANOVA showed no significant differences for composite (p=0.034) and time (p=0.626) factors. The roughness means obtained for Amaris composite were significantly higher than Filtek LS. Grandio SO and Supreme exhibited intermediate means (Table 2). For the chemical degradation media, no significant differences were obtained for surface roughness (Table 3). The Ra means after brushing were lower than at baseline and after chemical degradation CD (Table 4). Discussion The chemical environment is one aspect of the oral conditions which has an appreciable influence on the in vivo degradation of composites . Some chemicals substances from food and drinks can lead to surface degradation of composite restorations, resulting in unaesthetic appearance and increased surface roughness, accelerating the wear of dental materials [22,23]. This degradation is mainly due to the softness of composite matrices with exposure to organic acids and various food and liquid constituents [24,25,12]. Previously published studies have reported that acidic conditions show a tendency to degrade glass ionomer cements, polyacid modified composite resins, and composite resins [9,26,10,27,11]. The present study was performed to investigate the Knoop microhardness and surface roughness of four composites, before and after simulating oral conditions. Hardness is defined as the resistance to permanent indentation or penetration [28,1]. It is used to predict the wear resistance of a material and its ability to cause abrasion opposing tooth structure . The composites exposed in food-simulating media can suffer chemical softening, reducing their physico-mechanical properties. Changes in the composite hardness usually occur within the first 7 days after exposure to chemical solutions . Therefore, this study conducted the initial readings of the hardness in the specimens after post-cure , and another reading after the exposure period of immersion. In the present study, specimens stored in heptane showed significantly reduction in microhardness, as also observed previously [14,28]. Heptane simulates butter, fatty meals and vegetables oil [14,1] and may damage the resin matrix,[12,28] producing cracks in the interface, and consequently, weakening the material. It is questioned if alcohol-containing beverages may compromise the longevity of composites restorations , since it presents the potential of damaging polymers [1,12], by fully penetrating the resin matrix and promoting the release of unreacted monomers . The partial dissolving of the resin matrix may result in the degradation of the filler-matrix interface, thereby impairing the flexural strength and hardness . In this study, the concentration of ethanol solution (70%) was used according to previous  but it showed no significant effect in the microhardness of composites. The differences in hardness values compared to previous studies could be related to the surface characteristics of the composites, filler distribution and conversion rate . Furthermore, the period of 24 h of storage before immersion in ethanol may lead to complete polymerization of the composites, reducing the presence of unreacted monomers on the surface [1,14]. The effects of intraoral organic acids, as citric acid, besides producing tooth erosion, can cause surface degradation of composites , favoring the breaking of bonds in Bis-GMA molecules of composites [24,11]. Despite of others studies that citric acid reduced the hardness of composites [7,9], in this study no differences were observed in the microhardness of the composites when immersed in citric acid for 7 days. Nevertheless, the period of storage may have been insufficient to promote differences in the mechanical properties of the specimensÃ¢â¬â¢ surface [7,14]. Differences in microhardness means among the composites exposed to the tested solutions were found and are related to their composition and particle content [14,29]. Grandio SO, Filtek Supreme and Amaris have similar matrix composition (Bis-GMA, UDMA, TEGDMA), however, differ in size and amount of filler particles (Table 1). The higher resistance of Bis-GMA to the degradation effects of immersion media can be explained by the fact that bis-acryl resin composite materials contain bifunctional acrylates, which cross-link to provide increased mechanical strength and resistance to weakening in the presence of solvents [28,31]. Grandio SO and Filtek Supreme present nanoscale particles, which provide better mechanical resistance compared to hybrid resins, superior polishing than microfilled resins, higher strength and reduced polymerization shrinkage . Due to their nanoscale, these materials showed the highest microhardness values in this study. By the other hand, Filtek LS is constituted of silorane, with quartz and yttrium fluoride as inorganic filler, which increased hydrophobicity and reduced water sorption . Differences in microhardness among Filtek LS and others composite could be attributed to the lower filler content (76% w/w), as observed by Yesilyurt et al. . Therefore, the differences in composites compositions could have contributed to the differences in hardness. After simulated toothbrushing, there was a reduction in microhardness values. This fact may be due to changes on the surface of the resin matrix when immersed in the solutions before brushing. According to a previous study , the immersion in food-simulating media increased the exposure of filler particles by softening the matrix. Additionally, toothbrushing can change the surface of composites [2,34,35]. In clinical situation, the consumption of food or beverages occurs before brushing habits, making this association clinically relevant. Although an increase of the composite surface roughness and degradation after brushing have been previously reported, significantly lower roughness means were obtained after brushing in this study. Likewise, previous studies showed that most of composites did not present significant changes by the immersion on chemical degradation media in surface roughness over time [2,9,15]. This study found differences on surface roughness of mycrohybid, nanofill and nanohybrid composites, as results of their differences in their compositions. Filtek LS, myycrohybrid composite, had the lowest surface roughness, probably due to low filler content. Filtek Supreme e Grandio SO had an intermediate smoother texture, whereas Amaris showed the roughest surface. Nevertheless, despite of these initial differences, the immersion in chemical solutions did not interfere in the final surface roughness. However, interaction between immersion in food-simulating media and simulated brushing decreased surface roughness, as observed by Turssi et al.  This may be attributed to the reaction of the solutions with the polymer matrix. Toothbrushing after the immersion on food-simulating media resulted in the removal of part of the organic matrix around the loosen fillers . Then, the softened matrix have become mixed with the abrasive slurry, decreasing its abrasive potential . Roughness surfaces of composite favors the accumulation of plaque, gingival inflammation, superficial staining and secondary caries. It is noteworthy that the effect of brushing on the composites depends on several factors, such as the type of toothpaste, type and shape of the brush bristles, the proportion of deionized-water solution, as well as speed and weight applied during simulation process. As these parameters were standardized for all groups, it can be suggested that the surface roughness varies with the size, hardness and percentage of composite particles, as reported previously [20,36]. The different treatments tested resulted in alteration of composite properties, and these alterations were material-dependent; thus, the null hypothesis tested was rejected. The present study is important for guiding the improvements of the present composite resins against the challenges they will face during clinical service. It is also relevant to state that esthetics represents only one of the reasons for composite resin restorations failure. Improvements in other areas such as bonding degradation, material deterioration and ability to prevent caries progression/activity should be also considered. Conclusion According to the limitations of this study, it can be concluded that: The microhardness means of the tested composites were influenced by the material; Toothbrushing reduced Ra values of the materials tested, but the solutions used for chemical degradation did not affect the results. Conflict of Interest The authors declare that they have no conflict of interest.
Thursday, September 19, 2019
Breast Implants One of the first uses of silicone in a medical implant came in the form of lifesaving tubes implanted into young children to funnel excess fluid from the brain into the chest cavity, where the fluid could be safely metabolized and excreted. Since these "shunts" were first used, in the late 1950s, silicone in various forms has come to be an important part of many implants. "It is used in tracheotomy tubes, in artificial lenses for the eye, in artificial heart valves and in facial implants for birth defects or re-constructive surgery after cancer" (Ames 1). The most widely used implementation of silicone is through breast re- constructive surgery through elective surgery of an individual, or re- constructive surgery to replace breasts due to women recovering from mastectomies from breast cancer or miscellaneous types of accidents. The early history and use of implants showed no ill effects of the use of paraffin or silicone. Because of this newly developed surgical process and relatively little use of FDA guidelines there was no comprehensive testing done to ensure the utmost safety of a silicone recipient. By this time the millions of women throughout the world who already had Dow's silicone prosthesis implanted into their breasts had no idea of the dramatic health risks. Because of these potential health risks, women should avoid the use of breast implants. In 1976, Congress gave the FDA authority to regulate breast implants. By this time breast implants had been in use for a significant amount of time and were considered "grandfathered." This means that they were allowed to remain on the market, even though they have not gone through stringent testing. The FDA felt there was no evidence to substantiate that the implants were harmful. Furthermore Congress also gave the FDA the power to go back and require manufactures to provide proof that the implants were indeed safe and effective, if it was felt that there was a reason to do so. (Bruning 7) "In 1977, Richard Mithoff, a Houston attorney, wins the first lawsuit for a Cleveland woman who claims that her ruptured impla... ...'s internal memo's, thousands of these memo's revealed lack of long term testing, complaints from doctors, and leakage of silicone from the implants. The most outrageous incident discovered was complaints from surgeons of implants rupturing in the operating room, as they tried to install them into women's breasts (Byrne 98). Pathology reports indicate considerable silicone reaction to the extruded material can cause severe foreign body reaction in susceptible individuals. A letter written to Dow Corning from Charles A. Vinnick a predominant cosmetic surgeon in California wrote: " I am loathe to publish my series of cases as I feel that it may open Pandora's box. I do feel, however, that rapid dissemination of this information is very necessary to protect your comapny and my colleagues" (Bryne 98). Vinnick complained to Dow about an incident when he removed a pair of silicone implants, the gel in a ruptured implant was terribly runny while the gel inside the other implant was of ideal cohesion. This difference led him and some others to believe that when silicone gel came into contact with tissue fluids and fat the gel's consistency changed.
Wednesday, September 18, 2019
Pollock also became very interested in nature. Jackson Pollock only studied under Thomas Hart Benton for about two year but they remained friends until JacksonÃ¢â¬â¢s early death. The mid 1930Ã¢â¬â¢s were a bit of a hard time for Pollock. He had a hard time finding a job because America was in the middle of the Great Depression. In 1935 Jackson Pollock joined the Federal Art Project of the Works Progress Administration. He, along with five thousand other artists were hired at one time or another by the project to paint murals in public buildings to make art part of everyday American life. The influence for this was the Mexicans mural program, which Ã¢â¬Å"hired artists for workmenÃ¢â¬â¢s wagesÃ¢â¬ (Cernuschi, 29). The primary Mexican muralists were Diego Rivera, Jose Clemente Orozco, and David Alfara Siqueiros. Pollock had been interested in OrozcoÃ¢â¬â¢s work since the 1930Ã¢â¬â¢s and in 1936 he took a course called A Laboratory of Modern Techniques in Art with Siqueiros. Jackson explored powerful expressionism through experimentation of different techniques in this class. They painted in large scale, used poured, drip, and splatter techniques and Siqueiros taught them about Futurism and how to paint using emotional impulses. Futurists believed that you must not only move the spectator physically but you must also move them emotionally. The style of the Mexican Muralists Orozco and Siqueiros influenced JacksonÃ¢â¬â¢s technique in later paintings such as Bald Woman with Skeleton, which he painted in 1938. In 1937 Jackson met artist-critic John Graham after writing him a letter requesting they meet. Graham had become a great influence to Pollock after he wrote an article titled Primitive Art and Picasso. Graham stated in the article that, Ã¢â¬Å"an evocative art is the means and the result of getting in touch with the powers of out unconsciousÃ¢â¬ (Fineberg, 88). Graham believed that Ã¢â¬Å"the unconscious mind provided essential knowledge and creative powers for the artistÃ¢â¬ (Fineberg, 88). Pollock had become very interested in inner content of paintings rather then figurative content, which was also known as Surrealism. Picasso and Miro were the most popular Surrealists of this time and PollockÃ¢â¬â¢s work began to move away from the ideas of Benton and the Muralists and began to reflect their style.
Introduction Many countries have faced situations in which their citizens demand accountability for injustices or atrocities committed by their own domestic governments, which are in violation of their human rights. The manner in which varying nations have provided for and acknowledged these facts, on their various public platforms, have been both controversial and diverse. These problems tend not to fade into obscurity if left unaddressed. History has dictated that struggle for truth has been adopted by subsequent generations, who demand responsibility from their own government in power as, in many cases, the events will have occurred at the hands of a preceding government. The passing of time has illustrated that the quest for truth does not dissipate but can cause emotions to escalate and heighten the resolve of the aggrieved parties. Commentators suggest that establishing truth about the past is a precondition for preventing the recurrence of abuses in the future. This paper submits, in extension to this theory, that it is an essential ingredient in the desired passage towards restoration in public confidence and synonymous to the concept of justice in this modern legal world. The focus of this question is specifically the model of Tribunal of Inquiry which is governed by Section 1 of the Tribunals of Inquiry (Evidence) Act 1921 , which is the legislation used to handle inquiries involving an official element, and truth commissions, the alternative model that has been internationally adopted, largely as a result of military agitation or liberation coups. This paper will also touch upon inquiries hosted in other countries. Public inquiries themselves are rare and, this paper suggests, much resisted events, indeed Northern Ireland has borne witness to just three such inquiries under the aforementioned Act. These were the Scarman Inquiry in 1969, followed by the Widgery Inquiry in 1972, , the unsatisfactory outcome of which gave rise to the Saville Inquiry in 1998. Countries such as South Africa, Sierra Leone and Argentina, among others, have had their human rights redress distinctively characterized by the construction of truth commissions . Whether this type mechanism would be more conducive to the pursuit of truth, in matters of vast public concern within the context of Northern Ireland, is a matter for this paper to explore. The Character and Necessity of Inquiries Walsh states that an inquiry of this nature can be established under the Act where it is resolved by both Houses of Parliament
Tuesday, September 17, 2019
Good Clinical Practices are some of the guidelines to be purely followed while carry oning clinical tests on human topics. There are different GCPs which are fundamentally similar guaranting the well being of topics, and besides good and ethical behavior of clinical surveies of new drugs every bit good as approved drugs. Assorted calamities such as sulfanilamide calamity, Nazi homo trails, thalidomide calamity, and pox survey at Tuskegee lead to the creative activity of different regulations for conductivity of clinical tests and besides good clinical patterns. GCP is an international scientific for proper design, ethical behavior, and coverage of clinical tests affecting human topics. Basically it is a set for regulations that protect the human topics from any injury due to take parting in the survey and to mistakes and errors to maximum and minimum agony for the topics. FDA ( Food and Drug Administration ) expanded and included GMP in 1963, IRBs in 1973 and GCP in 1977.Duties:WHO GCP guidelines are divided into different chapters which describe duties of different personalities concerned with the behavior of clinical tests. The IRB/IEC is responsible for the safety, good being and safeguarding the rights of human topics. IRB is responsible for reexamining the proposal, test site, capable enlisting & A ; informed consent signature, amendments, research worker Ã¢â¬Ës booklet, research worker Ã¢â¬Ës CV etc. The research worker should be a qualified individual, exhaustively familiar with the investigational merchandise by the patron, audit and inspect the merchandise and conformity with GCP. Investigator has the duty of making indispensable paperss for two old ages after blessing of drug, documenting fiscal understandings with patron and research worker, happening of Serious Adverse Events, expiration of trails prematurely.MEDICAL CARE FOR SUBJECTS:A qualified medical practician should take test related medical determinations. If necessary the household physician of the topic should be informed about the topic Ã¢â¬Ës engagement in test.INFORMED CONSENT OF SUBJECTS:The topics should be informed about the process both orally and visually and must acquire a signed informed consent signifier and this should be approved by IRB/IEC. An impartial informant is required in instance the topic could non compose and read.RESPONSIBILITIES OF SPONSOR:Quality confidence and quality control with SOPs, choice of research workers, delegating a proctor, information sing IP merchandise and its use, indemnifying topics, besides assists in the readying of presentment to reexamine board and to investigator.WHO GCP GUIDELINESIt is a set of guidelines globally applicable for the behavior of biomedical research of pharmaceutical merchandises on human topics. Biding these guidelines will assist in the common exchange of clinical research informations between interested states. States which do non hold their ain guidelines can follow WHO guidelines as a portion or whole, as a footing on which clinical tests will be conducted.PROVISIONS AND PREREQUISITES FOR A CLINICAL TRIAL:The clinical test should be ethically justified. It should be on the footing of ethical rules laid by the Declaration Of Helsinki, and the three chief rules of justness, beneficence and regard. There should be proper and echt Preclinical day of the month should to formalize the test. The research worker should be qualifi ed and adept to take up clinical research. The test should run into all the regulative demands.Protocol:The test should be held harmonizing to the written protocol signed by patron and research worker. The protocol appendices should be monitored and approved by the moralss commission.PROTECTION OF THE TRIAL SUBJECTThe personal unity and public assistance of the test topics as defined in the Declaration of Helsinki should be the chief concern of clinical test. Any alterations from DOH should be documented and reported. The moralss commission has been set up for the protection of human topics in test. The research worker and the patron must confer with and subject the proposed protocol. Apart from the blessing the moralss commission will make an on-going monitoring of the clinical test procedure. For the intent of guaranting safety of the test subjects a procedure called Informed Consent procedure is done and this IC papers should be submitted to the EC prior to the beginning of test. Informed consent should be given both orally and written and besides should acquire it signed. Any information that becomes available during the test which may be of relevancy to the test topic must be made known to the research worker. Apart from the test topic, legal defender and the household physician should be informed about the engagement of the topic in the clinical test. The research worker must keep confidentiality of the information sing the topics.RESPONSIBILITIES OF THE INVESTIGATOR:Adequate medical attention for the topics is the duty of the research worker. He must be a qualified and experienced in the medical specialty or dental medicine harmonizing to the protocol and should hold a thorough cognition about the procedure of clinical test. The research worker is responsible for the choice of the test topics. Other duties of the research worker includes rigorous attachment to the accepted protocol, giving equal information sing the test to the topic, giving information about the merchandise to the staff, subjecting inside informations sing the test to the regulative authorization, guaranting the protocol has been reviewed and approved by the moralss commission, describing any serious inauspicious reactions to the patron and regulative authorization, accepting scrutinizing or review by regulative commissions and proctor, subjecting concluding study based on the test which is documented and signed by the research worker. The research worker must inform regulative authorization, patron and whomever applicable in instance of premature expiration of survey.RESPONSIBILITIES OF SPONSOR:The patron is responsible for the choice of research workers, conformity of the process with GCP, supplying investigational merchandise, supplying research workers with research worker Ã¢â¬Ës booklet, supply of investigational merchandise, naming commission or members to oversee the test, supplying compensation to test topics in instance of inadvertent hurt being partic ipated in test, quality confidence, guaranting the readying of appropriate blessing of concluding clinical survey study for regulative governments sing the test. Amendments to the protocol which may impact the safety of the topic should be informed to the EC straight by the patron or through the research worker. If the patron wishes to end the survey the same must be informed to investigator and the authorization. The patron is responsible for the quality confidence of the trail guaranting that all the patterns are recorded and reported harmonizing to GCP and the protocol.RESPONSIBILITIES OF MONITOR:The proctor is a individual appointed by the patron and acts as a communicating between the patron and the research worker. He is responsible for supervising the advancement of the test, commanding the attachment to the protocol, guaranting the informations are right reported and recorded, corroborating the inform consent from the topics, appraisal of test site, educating the staff, assists the research worker in describing the information to the patron, information direction, guaranting right filling of CRFs, assists the research worker in advising the drug regulative of the clinical test and subjecting any necessary certification, record the inside informations of each visit to the test site and the phone calls made.Monitoring OF SAFETY:The patron should supply particular signifiers to describe i nauspicious effects. The national ordinances require patron and/ research worker to describe the inauspicious events to regulative authorization. The research worker has to describe any inauspicious events to patronize, regulative authorization every bit good as EC. During the test the patron is responsible for describing test related AE.Record KEEPING AND HANDLING OF DATA:The overall duty of truth and completeness of the study is on research worker. The record should be signed by patron, research worker every bit good as statistician. The research worker should keep a confidential record of unambiguous codifications to place the topics. Monitor should take steps to avoid losing of informations. The patron must be able to place the informations entered for each topic utilizing the codification ; besides he must do a list of individuals who are authorized to do corrections to the information. The patron has to retain all the paperss, protocols, certifications, review studies etc.Stat isticss AND CALCULATIONSIt should be done by a biostatistical expert. The certain codification used for blinding and randomisation should be with both patron and research worker.Handling OF PHARMACEUTICAL PRODUTSThe patron is responsible for the safety of the merchandise to be tested on human topics and should be of sanctioned quality. Everything sing the storage and despatch of the merchandise must be recorded and the research worker should non provide the investigational merchandise to anyone who is non supposed to have it. The patron is responsible for the proper packaging and labeling of the IP. The research worker has to utilize the merchandise harmonizing to the protocol and has to return the fresh merchandise. It is the duty of the proctor to look into the termination of the IP and should guarantee that it has non exceeded the day of the month of termination.ROLE OF DRUG REGULATORY AUTHORITYThey should guarantee that the proposed protocols are submitted in progress and are ap proved harmonizing to the national ordinances. They should measure the adequateness of oversing the test harmonizing to the studies of the proctor to the patron. They may transport out on site supervising.MULTICENTRIC TRIALSThey require particular administrative system which depends on the terminal point and the cognition of the IP involved. A coordinative commission could be set up with the duty of commanding the public presentation and advancement of test and keeping contacts with the drug regulative authorization.ICH GCP GUIDELINESPrinciplesClinical tests should be conducted in conformity with the ethical rules harmonizing to Declaration of Helsinki, GCP and the applicable regulative demands. Foreseeable hazards and incommodiousnesss should be weighed against the awaited benefits. The rights, safety, and wellbeing of the test topics are the most of import considerations Nonclinical and clinical information on an investigational merchandise should be equal for the test. Should be scientifically sound, and described in a clear, elaborate protocol. A test should be conducted in conformity with the protocol that has reviewed by IRB/IEC The medical attention should be given by a qualified doctor or a tooth doctor. Each person involved in carry oning a test should be qualified by instruction, preparation and experience. Freely given informed consent should be obtained from every topic prior to clinical test engagement. All clinical test information should be recorded and reported. The confidentiality of records that could place topics should be protected. Investigational merchandises should be manufactured, handled, and stored in conformity with GMP and used in conformity with the approved protocol. Quality confidence of systems and processs.IRB/IECThe IRB should dwell of at least five members from assorted Fieldss of life and qualified 1s. Its duties include: To see the makings of the research worker, Continuing reappraisal of each on-going test at intervals, Protection of the rights, safety and/or wellbeing of the topics, Consent of the topic Ã¢â¬Ës lawfully acceptable representative, in instance of non curative tests, Reviewing both the sum and method of payment to topics to guarantee their safety and rights. Merely those IRB/IEC members who are independent of the research worker and the patron of the test have the right to vote or supply sentiment on a trial-related affair. It should work harmonizing to the written SOPs and should follow with GCP. IRB/IEC should do its determinations at proclaimed meetings at which at least a quorum, as stipulated in its written operating processs, is present. IRB/IEC should advise the patron in composing sing its test related sentiments, determinations etc. it should retain all the paperss.Research workerThe research worker should be qualified by instruction and preparation, and should be exhaustively familiar with IP. The research worker could implement alterations in protocol without anterior consent from IRB/IEC if it is believed to do inauspicious reactions and subsequently on informations has to be submitted with justification to IRB/IEC for reappraisal and blessing, to the patron and regulative governments. Research worker is responsible for obtaining IC. Non curative tests should be conducted with the consent of topic Ã¢â¬Ës lawfully acceptable representative. When in exigency that could n't take consent of the topic, consent from LAR is necessary. Essential paperss should be retained for a lower limit of two old ages after the blessing or even longer period if insisted by the regulative demands.PatronThe patron is responsible for procuring understanding from all parties involved to hold a direct entree to all test related sites, paperss and repots for review by domestic and foreign regulative governments. Sponsor may reassign one or all of his test related responsibilities to CRO. He should denominate qualified medical forces. Sponsor may set up an independent information monitoring commission ( IDMC ) to measure the advancement of a clinical test. Any transportation of the ownership of the paperss should be decently documented and the patron should retain all patron specific papers s. The patron is responsible for supplying compensation to the topics, IP, IRB blessing. He appoints proctor, who monitors processs and studies.INVESTIGATOR Ã¢â¬ËS BROCHUREInvestigator Ã¢â¬Ës booklet is a digest of all clinical and non clinical informations on the IP provide by patron relevant to the survey merchandise on human topic. It should be simple, concise, nonsubjective and non promotional that enables the clinician or possible research worker to understand it and do his /her ain indifferent hazard benefit assessment rightness of the test. An extended IB is non required if the merchandise Ã¢â¬Ës pharmacological medicine is widely understood by the medical practicians. It should be renewed yearly and reviewed harmonizing to the patron Ã¢â¬Ës written processs. Sponsor should do certain that an up to day of the month IB is made available to the research worker. IB should incorporate a rubric page and a confidentiality statement. It contains table of contents, debut, belongingss of preparation, consequence on worlds, and counsel for the research worker.Essential DOCUMENTSEssential paperss are those which permit the rating of the behavior of the trail and the quality of the informations produced. They demonstrate the conformity of the research worker, patron and proctor with the criterions of GCP and other regulative demands. Essential paperss are inspected by regulative governments and audited by patron Ã¢â¬Ës independent audit map. They are grouped into three subdivisions harmonizing to the phase of trail where in it is generated. One before the beginning of clinical test, the 2nd one during the behavior of the test and 3rd one after the expiration of test. Trial maestro files should be established at the beginning of the test, both at the research worker Ã¢â¬Ës and patron Ã¢â¬Ës office. A concluding stopping point out of the file can be done merely when both the research worker and patron files are re viewed by the proctor and confirmed that all necessary paperss are in appropriate files.INDIAN GCPThe clinical test should be supported by pre clinical informations on the IP back uping the proposed protocol. The protocol should incorporate an appropriate survey design, inclusion exclusion exclusion standards, quality control and quality confidence, ethical and safety considerations which includes the rule of essentialness, rule of voluntariness, IC and community understanding, rules of non development, rules of privateness and confidentiality, rules of safeguard and hazard minimisation, rules of professional competency, rules of answerability and transparence, rules of maximization of the public involvement and distributive justness, rules of institutional agreements, rules of public sphere, rules of entirety of duty, rules of conformity.ETHICS COMMITTIEE:They review and O.K. protocol. Harmonizing to Indian GCP the commission should consists of lower limit of 5 members and a upper limit of 12 to 15. There should be equal representation of age, gender, community etc. the ethical reappraisal should be done through formal meetings and consensus. The research worker should subject an application in the prescribed format along with the protocol at least 3 hebdomads in progress. The IEC should be able to supply complete reappraisal of the proposals and should inform their base by composing to the patron.INFORMED CONSENT AND SPECIAL GROUPS:In instance of non-therapeutic surveies the consent should be given by the topic. Pregnant or nursing adult females should non be a capable unless the research carries no more than minimum hazard. Research related to expiration of gestation could be conducted in adult females who wish to make MTP. Pregnant adult females can besides be included if he study is sing techniques to observe foetal abnormalcies. Children should non be included in research that could be carried out every bit good with grownups. IC should be obtained from parents every bit good from the kid and the kid should be made cognizant about the test procedure and his/ her refusal to take part in the clinical test is considered. Adequate justification is required while enrolling vulnerable topics.DutyThe patron is responsible for research worker choice. The patron should come in into a legal and formal contract with institute/ research worker, sing conformity with GCP, entering and coverage, scrutinizing review and monitoring. Sponsor has to corroborate the reappraisal by moralss commission, supply information on IP, providing IP, ongoing safety rating of the merchandise, safeguarding survey topics, turn outing ADR/ AE describing signifiers to the research worker, guaranting appropriate readying of survey studies, naming proctors to supervise the survey, executing audit as portion of QA system, particular agreements in instance of multicentric tests, make agreements to ease communicating between research workers of different test centres. If the patron is a foreign company or individual, it shall name a local representative or CRO to carry through the duties by national ordinances. The guideline mandates that the patron and the research worker should subscribe a transcript of the Standard Operating Procedures ( SOPs ) . Besides, the research worker and his staff have to be cognizant and comply with SOPs. Indian GCP demands that the research worker should subscribe and send on the informations like Case Report Forms ( CRF ) , consequences and readings, analyses and studies of the survey from his/her Centre to the patron and the moralss commission. Monitor should be to the full cognizant of the IP. He oversees the advancement of the survey, observe and describe the capable enlisting rate to the patron, aids investigator in describing he data to patronize, guarantee all CRFs are filled right, subjecting written study to patronize after sing each site, The research worker should hold makings prescribed by MCI. He is responsible for all survey related medical determinations, guaranting the blessing of protocol by moralss commission, indifferent choice of survey topics, answerability of IP at survey site, subjecting written drumhead of the survey study to patronize.RANDOMISATION AND BLINDINGDone to avoid prejudice and there are certain codification to place the topics which are unbroken secret during the survey and broken merely harmonizing to the protocol. The types of statistical analyses used must be clearly identified and should organize the footing of the survey.Particular Concerns:Clinical tests for vaccinumsSponsor and research worker should be cognizant of the procedure for carry oning clinical tests affecting vaccinums. They should be familiar with the guidelines provided by DCGI, DBT and GEAC. Subjects should be informed if they are injected with unrecorded or attenuated micro-organisms. There should be equal research lab i nstallations and besides installations for the laboratory rating of seroconversion. Blessing from IEC should be ensured by the patron. Post selling surveies are required following seroconversion surveies. Relevant information sing the quality control is compulsory.Clinical tests for preventives:Subjects should be informed about the options. Children borne due to failure of preventives should be medically followed. Proper followup for the remotion of implant is necessary if implant is used as a preventive for test.Clinical tests with surgical procedures/medical devices:Animal safety informations is required. Phase 1 tests are non required as tests with medical devices can non be done on healthy voluntaries. Safety processs should be followed for the debut of medical devices. Informed consent should be followed as in with drug tests.Diagnostic agents- radioactive stuffs and ten beams:Informed consent should be obtained and the topics should non be exposed to radiation more than that o f normal. Research should be done on patients undergoing processs for diagnostic or curative intents. Safety steps should be taken to protect them. Pregnancies should non be included to avoid hazards to embryo. Non radioactive diagnostic agents are considered as drugs and are to follow the same guidelines of drugs.Herbal redresss and medical workssPhase 1 surveies are non necessary and the plat and herbal redresss are presently in usage or mentioned in literature of traditional medical specialties and are prepared harmonizing to GMP. Toxicity surveies are non required for stage 2 tests if it is non found toxic when used for more than 3 months. Clinical tests with herbal merchandises should be carried out merely after standardisation and development of marker. Trails have to acquire blessing from regulative governments. Tests should be held in the presence of competent ayurvedic, siddha, unani doctor as co-investigator on in such a test.
Monday, September 16, 2019
There are many different causes and diagnoses for leg pain in children.Ã Developmental stage or age groupsÃ many of these causes.Ã Some, however, can occur at any age.4The numerous causes of leg pain in children include Legg-Calve-Perthes disease, sports injuries, toddlerÃ¢â¬â¢s fractures, Slipped Capital Femoral Epiphysis(here forward referred to in the medical jargon of SCFE), and leg length differences. 4 Related article: Identify Circumstances When Children and Young People Might Require Urgent Medical AttentionLegg-Calve-Perthes is also referred to as Legg-Perthes, here forward to be referred to as LCP.Ã LCP is rare, and in the United States only occurs at the ratio of 1:1200 children under the age of 15.Ã Ã The developmental stage when LCP becomes clinically evident is between the ages of 3-12 years of age, with 7 yrs being the median age.1Ã However, other sources site the specified age range as between 4-8 years, which actually is a representation of the median 7 years stated earlier. 3LCP is characterized not just by developmental age, but by sex, familial, and racial factors as well.Ã Most LCP patients are Caucasian; in addition, most have a parent or close relative who suffered from the disease as well.1Ã Males are affected 4-5 times more frequently than females, but this is not a sex-linked trait.Ã A genetic factor is implied, but with no identifiable gene as of yet.1LCP is defined Ã¢â¬Å"as the idiopathic avascular osteonecrosis of the capital femoral epiphysis of the femoral head.Ã¢â¬ 1What happens in the case of LCP is this:Ã due to unknown etiology, the head of the femur, which contains the epiphysis and epiphysial plate, becomes necrotic.Ã Necrosis, meaning dead or dying tissue, in this case means that no further bone growth can occur, owing to the fact that blood supply has been cut off. 3,4Since new bone cells are produced primarily at the epiphysial plate, no bone growth in the affected leg means that, until treated, it will become shorter than the unaffected leg.Ã Ã Soon afterward, a noticeable limp occurs due to pain and compensation for the self same pain.Ã Children suffering from LCP may also have pain in the groin, knee, and thigh as well. 1,2,4Necrosis in the femoral head leads to inflammation, thus being the initial cause of pain.Ã Activity, especially excessive hip-leg activity such as running or ju mping, will irritate the femoral head and increase the pain level.Ã The pain can be relieved or lessened by rest. 4X-ray films arrive at definitive diagnosis, but doctors suspecting the problem will look for clinical signs that LCP is present.Ã These clinical signs include difficulty rotating the knee.Ã If LCP has existed for some time and gone undiagnosed, other clinical signs will be indicative of its presence, such as atrophy of the buttocks, calf, or thigh muscle.1, 2Those afflicted with LCP receive a myriad of treatments. The treatment plan is most likely individualized for each child depending on the severity of pain, atrophy, and gait difficulties.The treatments used most commonly are Ã¢â¬Å"leg exercises, crutches, casts, bracing, and occasionally traction and surgery.Ã With proper treatment, the bone will grow back and the child will be able to walk normally without pain.Ã¢â¬ 4ToddlerÃ¢â¬â¢s fractures can occur quite easily with a simple fall.Ã Signs to look for are irritability of the child, persistent complaints of pain, and refusal to walk. These should be relied on heavily as a parentÃ¢â¬â¢s diagnosis of a problem, for inflammation and redness are minor at the site above the break. 4The bone fractured in these cases is typically the tibia.Ã The above-mentioned symptoms warrant immediate medical attention and typically reflect that a fracture has occurred if the child is between 2-4 years old. 4Sports injuries can occur at any age of the active child.Ã When a sports injury has occurred, pain and limping may result due to , i.e., ankle and knee sprains, or muscle strains.Ã However, if limping persists after a few days of rest, or if the child refuses to bear weight on the leg,Ã immediate medical attention is warranted. 4Slipped Capital Femoral Epiphysis, with the medical acronym of SCFE, Ã¢â¬Å"is a common hip disorder in overweight adolescentsÃ¢â¬ ¦Ã¢â¬ Ã 4Ã The symptoms resulting from the slipped epiphysis are severe pain occurring in the hip and knee.Ã This, in turn, results in limited movment of the affected hip, and limping.Ã Diagnosis is by x-ray. 4Treatments would include pain relief as prescribed by the doctor; a usual program of alternating Tylenol and Ibuprophen might be prescribed.Ã Included in the treatment plan would be immediate counseling of the family and adolescent on proper diet, and allowable exercise considering the ailment.Sickle Cell Disease(SCD) is the severest form of the sickling syndromes; this is because it is homozygous recessive.Ã In other words, the child carries both recessive alleles on the chromosome.Ã In all sickling syndromes, the problem results from the genetic error of the red blood cell design.Ã In the United States, it is estimated that 1:12 BlacksÃ are carriers of the sickle cell trait, and 1:65 develop sickle cell anemia.Ã Though predominantly affecting Blacks in the U.S., otherÃ races are susceptible as well:Ã peo ple from the Mediterranean, India, Asia-Minor, and the Caribbean.Rather than the normal shape of RBCÃ¢â¬â¢s, the genetic disorder causes sickle-shaped cells that do not allow oxygen to attach to the protein heme in an effective manner.Ã This reduces oxygen available in the blood.5The prognosis for children with SCD is poor, in that death occurs during the middle-aged years.Ã Ã¢â¬Å"Anemia usually is severe, chronic and hemolytic.Ã¢â¬ 5Ã Ã Ã Both acute and chronic exacerbations will occur, the frequency of which is most likely tied to emotional and environmental factors.Ã These environmental factors include emotional upset, situations that lead to dehydration, change of oxygen tension in the body(by infection, which is common, i.e.,), and weather changes Ã¢â¬â in particular cold.Ã Environmental factors that can be eliminated altogether to help reduce the recurrence or severity of attacks are alcohol and tobacco. 5The worst-case scenario, which does occur wi th these patients, is vaso-occlusive episodes. In these episodes, circulation is greatly hampered, resulting in pain concentrated in areas of localized necrotizing bone marrow, i.e., the sternum, ribs, long-bones, spine and pelvis.Ã The occlusion is from clumped, sickle cells that cannot flow out of the area. 5No specific therapy exists for SCD.Ã However, depending on the type of crisis, be it the need to lower Hb S during an infarction, too little oxygen and RBCÃ¢â¬â¢s, severe dehydration, etc., transfusion is a frequent treatment Ã¢â¬â usually packed red blood cells are the blood component used. 5Ã¢â¬Å"Transial Synovitis of the hip is a cause of hip pain in children.Ã¢â¬ 7 Ã Ã The adjective Ã¢â¬ËtransialÃ¢â¬â¢ is used because the condition does not last long Ã¢â¬â approximately a week.Ã Symptoms of pain occur in one hip, but pain may also be felt in the medial aspect of the knee and thigh.Ã The pain occurs in the tissue surrounding the hip, not in t he bones themselves. Ã 7The pain increases with different rates in children; some are in the doctorÃ¢â¬â¢s office within 1-3 days of onset, some a few days later as the pain peaks.Ã The child may have a limp, or have trouble standing and walking by the time heÃ¢â¬â¢s seen.Ã Once again, boys are affected more than girls.Ã The age range affected is from 3-10 years of age. 7Treatment is bed rest for 3-4 days and use of non-steroidal anti-inflammatories for pain relief, reduction of inflammation and swelling.Ã The child returns to normal after this time period.Ã If a temperature is present, the doctor may order x-rays and blood tests to rule out other hip conditions.7Leg Length Differences.Ã The name is self-explanatory.Ã Ã¢â¬Å"Some children are either born with or develop a difference in the length of the bones in their legs.Ã¢â¬ 4Ã Ã Ã No etiology is given for either scenario, and both situations receive the same set of treatment choices.Ã Diff erences in leg length between 0-2cm require no treatment most of the time, but shoe lifts may be used.Ã If the length difference is between 5-15cm, surgery to lengthen one leg or to shorten the other is necessary, unless a prosthesis is chosen for the shorter limb. 4In summary, there are many conditions and diseases that add to the suffering and cause of leg pain in children.Ã The hip disorders and diseases discussed that are accompanied by knee and/or thigh pain, can be misdiagnosed as injuries originating in the knee, other than compensational pain as the symptoms really are.Ã Though many affect children at different stages of life and bear different severity of diagnosis and prognosis, all are significant.BIBLIOGRAPHYwww.mrsci.com/Orthopedics/Perthes_disease.php, 10/26-27/06www.hopkinsmedicine.org/orthopedicsurgery/perthes.html, 10/26-27/06Hall & Brody:Ã Therapeutic Exercise:Ã Moving Toward Function, 2nd Editionc 2005, Lippincott, Williams, and Wilkins.www.keepkids healthy.com/symptoms/legpainlimping.html, 10/26-27/06Phipps, Cassmeyer, Sands, Lehman, Medical-Surgical Nursing,Concepts and Clinical Practice, c 2005, Mosby.Shiel, Jr., William C., MD,www.medicinenet.com/ankylosing_spondylitis/article.html, 10/26-27/06www.familydoctor.org/181.xml, 10/26/06DIFFERENT CAUSES FOR LEG PAINÃ IN CHILDREN2006
Sunday, September 15, 2019
Ã¢â¬ËNeuroses are only acquired during early childhood even though their symptoms may not make their appearance until much later. The events of the first year are of paramount importance for a childÃ¢â¬â¢s whole subsequent lifeÃ¢â¬â¢. (Freud, 1902) Regardless of age, nationality, gender or ethnicity every human has something in common; we are all born as babies. This essay will examine and research factors in depth in order to simplify the complicated process of identifying key factors including scientific data as well as theories and methods derived from experts of different fields.A diverse view will be analysed of the developing process in order to understand the intricate events underlying these factors from the first beat of the heart to a moment by moment development and co-ordination of thousands of biological events of the nervous and endocrine systems of the new-born will also be monitored. Our research will engage in a holistic approach, reflecting on the nativism ver sus empiricism debate.After looking at a broad spectrum of topics, issues and views and their implications on certain theories and methodologies, this evidence will guide us to conclude a hypothesis on factors that relate to the effect of the development of a baby in its first year. Looking from an evolutionary perspective, biological explanations suggest that the bond of attachment occurs naturally as a result of innate urges on the part of their baby and their carer during a critical period (Bowlby).In support of this, Lorenz carried out an experiment on geese that had just hatched and been removed from their mothers, only for them to see humans and sure enough they imprinted the scientist instead of their mothers. Similarly, this lead Bowlby to hypothesize that both human infants and mothers has evolved an innate need made in an optimal time which propelled them towards their mothers. For this reason he also predicted that young children who do not experience a warm and continuin g attachment in the first year would fail to develop a healthy relationship in the future.In other words Bowlby claimed that Ã¢â¬Ëmother love in infancy is as important for mental health as are vitamins and proteins for physical healthÃ¢â¬â¢. In contrast, a longitudinal study conducted on a large number of boyÃ¢â¬â¢s aged 9-12 years found quite a few who had been separated from their mothers as infants but seemed well adjusted as they entered adolescence (Rutter, 1933). However, causality is difficult to determine making it difficult to disentangle the effect of maternal separation on later behaviour as there may be other confounding factors that may contribute or even cause the final result.By far, the most critical blow to attachment theory comes from Ã¢â¬ËreversalÃ¢â¬â¢ studies which show early disruption followed by complete recovery (Clarke and Clarke). Similarly, recent research has shown that babies are much more flexible and resilient than Bowlby thought and the bo nd between the mother and child is not irreplaceable or irreversible but babies are capable of forming attachments to several adults and have been revealed possible and successful e. g. adopted children (The Tizard study of adopted children).Still, much of this information is based on retrospective data and so may not be accurate in drawing firm conclusions to maternal attachment being an exclusive factor that can affect the development of babies in their first year of life. Additionally, the human givens approach also asserts the view that there are biological needs which when not met lead to severe distress in humans such as an infant growing up in a socially deprived environment.This has also been positively correlated to poorer health and thus weaker cognitive development in young children (DCSF, 2009) which may be because living in a low income household or deprived area makes it more likely that infants will be exposed to risk factors that affect their life chances for example domestic violence, smoking, illness, low aspirations etc. (SETF, 2008) and even poor nutrition. Like all mammals, humans obtain life-sustaining nourishment through suckling and throughout the history of the human species; the only or primary source of nourishment for infants was breast milk which has many virtues (Newman, 1995).Alongside it also involves the necessary skin-to skin contact from the mother which gives the baby a feeling of warmth and security as well as strengthening the infantÃ¢â¬â¢s immune system. In spite of this, the majority of infants are still formula-fed predominantly in undeveloped countries where poor, uneducated parents often dilute the formula in an effort to make the expensive powder last longer. As a result, in such circumstances the parentÃ¢â¬â¢s attempts to promote the health of their babies end up having the opposite effect (Popkin and Doan, 1990) with later development of inadequate growth and physical deficiencies.And although every individual has a Ã¢â¬ËblueprintÃ¢â¬â¢ for growth, but realisation of this growth potential is only possible if nutrient supplies in childhood are adequate (Jackson, 1996). From this it could again be inferred that situational factors such as poverty also have a detrimental effect on childhood development which is why low birth weight is more likely in children from lower socio economic groups. This has been exemplified from the recent case of Humzah khan whose mother starved him in a cot for 21 months and was more concerned about feeding her alcohol addiction in place of her malnourished son.Although the health services were called they were turned away many times before the case was brought into global attention which points to the difficulty in gaining access to the private sphere of oneÃ¢â¬â¢s home. On the whole, Statistics do highlight that children from low-income households are more likely to experience problems with nutrition leading to a negative influence on the mental well-bein g of children and in the long run may even lead to childhood obesity.Consequently, health economics even point to the bidirectionality of this relationship and propose that Ã¢â¬Ëpoverty breeds ill-health, ill-health maintains povertyÃ¢â¬â¢ (Wagstaff, 2002). Furthermore, scientific evidence also illustrates that infants with vulnerable and stressful environments at home can lead to physical changes that affect a babyÃ¢â¬â¢s cognitive ability and performance of their brain in the first year of life (DCSF).Neuropsychologists demonstrate how the negative impact of stress sculpts the developing brain architecture by reducing the number of synapses in the prefrontal cortex and thus weakening the connections in neurones. Besides, other scientific research also explains that that excess amount of cortisol also has major toxic effects on a developing child as well as the ACE study pyramid which illustrates that certain experiences during a childÃ¢â¬â¢s first year of life are major ri sk factors for the leading cause of illness, trauma and even death in later life.Hence, this gives reason for us to believe how crucial the environment is as a factor that can affect the development of babies in their first year of life. However, unlike broken bones irreversible maldevelopment of brain areas mediating empathy resulting from emotional neglect in infancy is not readily available.On the other hand while rarely studied in humans the neurodevelopmental impact of sensory deprivation is the subject of hundreds of animal studies (Coleman and Riesin, 1968) although it could be argued that it is quite difficult to extrapolate the results from animals to human. Nevertheless, others counter argue that this is only done when it would be unethical to manipulate human lives due to practical and ethical reasons and even though caution is necessary in generalizing results from animals to people, similarities between species sometimes allow this to be done.Besides, case studies of hu mans e. g.Ã Genie Curtiss also emphasize the view that social deprivation and neglect does in fact influence later development who suffered from extreme privation since birth and even though she did later learn some language it was not deemed as Ã¢â¬ËnormalÃ¢â¬â¢ and so she never caught up developmentally. (Curtiss, 1977). Albeit, it was very detailed on the other hand critics have argued that it was only a case study and so cannot be generalised to the wider population.However, wider support and brain research have strengthened this study by using a triangulation of methods, thus making it more valid and less prone to doubt. Through these cases many policies were also implicated resulting in far-reaching changes for example through BowlbyÃ¢â¬â¢s maternal deprivation hypothesis practices were derived to avoid the unnecessary separation of children from their parents for example parents being encouraged to remain with their children in hospital and the provision of facilities for them to stay overnight (NCT policy).Likewise, other policies such as the Green paper: every child Matters (HM treasury, 2003) was published in response to the death of Victoria Climbie whose plight was ignored by 12 different professionals. In response the Green paper with its strong focus on better support for parenting and families starts with five overall aims for all children including being healthy (NHS reforms) and not being prevented by economic disadvantage from achieving their full potential (Dfes 2002).Therefore, it can be insinuated that the political factor is also dominant in the physical and emotional development of babies in the first year of life. In spite of this it is important to consider the continuous change in child culture particularly in the 21st century. Yet, this has also had many positive implications for example the newly emerging idea of babies as the Ã¢â¬ËnationÃ¢â¬â¢s futureÃ¢â¬â¢ led to a marked change in the level of influence the governme nt was now prepared to try to exert upon families thereby displaying a significant reduction in the number of infant mortality rates (Dwork, 1987).Moreover, the emergence and notion of a child-centred society set new laws including family allowances in 1945 for children in low income households as well as the reform of a national health service to create Ã¢â¬Ëcomprehensive health and rehabilitation services for the prevention and cure of diseaseÃ¢â¬â¢ (1948). However, differences in broader culture means that not all countries have similar policies and practices particularly in collectivist cultures where children are seen as an economic liability (Greenfield, 1995).Nonetheless, todays interconnected society means that many agencies are now working together with a multi-agency approach based on an international level This reinforces the view that ecology, the environment and nurture shape the development of babies in their first year of life. in the same way empiricists have ins isted that at birth the mind is a blank slate a Ã¢â¬Ëtabula rasaÃ¢â¬â¢ and that all knowledge is created by experience (Locke, 1704). Conversely, within developmental psychology with the growth of new technology there is now a growing emphasis on Ã¢â¬Ëinborn biasesÃ¢â¬â¢ or Ã¢â¬ËconstraintsÃ¢â¬â¢ on development.So in essence, the baby is programmed with certainÃ¢â¬â¢ operating principlesÃ¢â¬â¢ that govern the way they listen to and try to make sense out of the flow of sounds coming at them ( Slobin, 1985b). This is another reason why very young babies already seem to understand that objects will move downwards unless it encounters an obstacle (Spelke, 1991). Notwithstanding, current theorists do not propose that these built-in response patterns are the whole factors; rather they are the starting point.What then develops is a result of experience filtered through these initial biases; however those biases do constrain the developmental pathways that are possible (Camp bell and Bickhard, 1992). Likewise, the interactive approach to an infantÃ¢â¬â¢s development in the first year also states that Taking all the above mentioned into account this essay is lead to the conclusion that each factor is parallel and relative to one another and that the balance of biology and social expectations is different in different areas of an infantÃ¢â¬â¢s development.Moreover, it is inevitable that both aspects of nature and nurture work in a collaborative manner alongside an organic system that operates together which is why even in those areas of development that appear to be the most clearly biologically determined can only occur if the child is growing in an environment that falls within the range of sufficient environments. After all, Albert Einstein did claim that Ã¢â¬Ëall that is valuable in human society depends upon the opportunity for development accorded the individualÃ¢â¬â¢ (1950).