Planning And Decision Making Essay Example for Free

Planning And Decision Making Essay Many organizations lack a better planning and decision making systems that usually leads to the failure of there operations, in this case planning refers to the overall integrated planning system within an organization which incorporates both strategic and corporate planning. An organization is a consciously coordinated social unit composed of two or more people that functions on a relatively continuous basis to achieve a common goal or set of goals. Therefore corporate planning can only be achieved through management functions; planning, which encompasses defining organization goals establishing an overall strategy for achieving those goals and developing a comprehensive hierarchy of plans to integrate and coordinate activities, organizing, which is the determination of what tasks have to be done, who does them how the tasks are to be grouped? Who reports to whom and where decisions are to be made. Controlling, this involves monitoring the organizations performance, leading, which involves managers motivating subordinates, directing the activities to be done, selecting the most appropriate channels of communication and resolving any conflicts among the employees Taking a look at Toyota Industries Corporation that was started in the year 1937 by Kiichirro Toyoda. It started off by manufacturing and selling automatic looms. Later on it extended by manufacturing automobiles including vehicles, car air conditioning compressors and engines. Toyota Company is widely known all over the world as an automobile manufacturer. It proudly owns the title of the world’s largest automaker company. It is known to be the largest then followed by General Motors Company. This company made sales worth 4. 72 million in the first half of the year 2007. It actually made a profit of $ 15. 09 billion. This paper is dealing with an evaluation of the success that this Company is having. This company is known to have production bases in Asia, Europe, Japan, India, China and North America. Toyoda, 2005) Orientation This company is reported to have a better management system that is referred to as the Toyota Production System which is made up of practices that are meant to organize the company’s logistics and its production; it is also found to encouraging a better communication between the company and its clients. Evaluation of Toyota Company shows tremendous success in the year 2007. This has actually ended the reign of the world best selling trademark of General Motors. An evaluation of the success of Toyota Company shows that it has really expanded various markets worldwide. This has enabled it to reach a very wide scope of customers. Evaluation on the success of Toyota Company shows that it has really opened up so many outlets all over the world including Africa. This has helped customers to easily access Toyota products unlike before. That is why this Company is really enjoying the booming success. (Dr. Shoichiro 2006) Planning is very important in any organization. This is because it helps the organization to easily replace personnel who get promotions or those who get transfers. This is because organizations nowadays carry out management development on all the leaders and managers in an organization. This helps an organization to have a pool of qualified personnel. It also helps an organization to carry out technological advancement. This is because the organization’s personnel are qualified and quite updated in the current technology. (www. onesixsigma. com) Key Processes  The system was founded between the years 1948 and the year 1975 which at the moment referred to as â€Å"Just in Time production† it was regarded as a house like design through which most of its workers once they are recruited they first of all get trained first before they start working in the company this actually shows how committed Toyota is in implementing a good performance oriented workforce, in this case we find that after an employee is trained and found to be successful then he is promoted with an ambition of meeting the expected company standards that are set. From the Toyota Production we find that the Managers can use this to identify the training goals. A manager needs to review his employee’s skills and the areas that they need to improve. These needs in the managerial skills will help in making goals. To find out this, the manager needs to asses the workforce and through this he can know what they are able to do and what they can’t do. Therefore the manager cannot just do this by himself. He needs assistance from other people. They can assist in reviewing his performance. Such people include the supervisors. These people can give invaluable information on the areas that need to be improved and give insight on the behaviors exhibited at work. During the planning the manager needs to consider the training programs that are being offered. The manager needs to carry out plan implementation. After that the manager needs to evaluate himself if he achieved his goals. The TPS also ensures that there is a minimal wastage of resources in the company, since the company regards wastage of resources as a result of de-motivation to its employees. Any organization that carries out management development usually experiences an increase in its productivity. When the personnel in an organization get skills in management there will be an increase in production. (www. onesixsigma. com) The founders of the Toyota production system had an ambition of eliminating the burdens which was referred to as the â€Å"muri†, also to curb the inconsistency referred to as the â€Å"mura† and the other reason for establishing the system is avoid wastage which was referred to as â€Å"muda† therefore we find that the company using the system has therefore discovered on how to reduce factors leading to wastage in the production of the firm. (www. onesixsigma. com) This has led to a better decision making in the firm whereby the system defines that better results are always founded on the right process of production whereby the companies are always urged to come up with a continuous flow of communication in order to indicate the threats of the company, we also find that the company encourages the use of the pull system which is directed towards the avoidance of overproduction, the other way that will enable a company to achieve its goals is to have a levelised workload whereby the employees are allowed to work at a lower speed in order to have better production results rather than working with a high speed to give poor results. In figure one, we find that the diagram has indicated that the company operates in two ways the Jidoka and the Just on Time processes whose goal is to enable a high quality production at a lower cost and within the shortest time limit. Here we find the company actually deals with the reduction of the cost of its products and also on the improvement of the quality of its products. Research indicates that Toyota is in a position of producing one vehicle in every six seconds which results into a total of six million vehicles per year, we also find that the company does not employ people who are given the responsibility but the members themselves report to be disciplined in a manner that they always clean their own offices, this policy has been found to be successful in ensuring that the workers report to their working areas with aim of improving their productivity. Key Learnings Management development is very beneficial to organizations. Many organizations that have embraced this usually have efficient and effective personnel. This improves the productivity hence leading to financial gains. The managers are skilled and will deal with issues that can cause losses efficiently. Figure two below indicating the ways Toyota puts together it production process, the company is reported to be successful as a result of encouraging its employees to work together as a team Whereby in terms of staffing, we find that the Toyota company actually employs more than 4,000 workers each day who are always provided with a number of two working shifts, in this company we find that the employees work in terms of teams, under which each team is made of a minimum of four to six employees, research also indicates that eight teams in the company make a whole group which is therefore provided with a team leader. Under the management in the organization we find that the company improves the performance of their workers through a better paying system which research indicates that every member in the team is paid at least ? 7,000 including this is inclusive of shift and overtime premium, they are also provided with a private healthcare. (www. onesixsigma. com) Where also find that there exist the policies of continuous improvement which is the company terms it as Kaizen action meetings which are regarded as circles of quality whereby the member staffs are involved in the improvement of the performance of the employees. This is well encouraged where the company is found to be offering Kaizen prizes after every six months. in the meetings a manager managing a team of twenty five groups is given an opportunity of deciding which group manager is the best after which all the managers in the company decides which group manager is the best to win the presentation. Then the two of the managers are given a chance to travel to Japan for a kaizen conference and give the story about their performance. For all these reasons we find that this Kaizen is used a way of improving the employees performance in the Toyota company and therefore the other companies planning to be as successful as Toyota one needs to implement the same policy in his or her organization. (www. onesixsigma. com) When evaluating the success in this Company, one can’t fail to notice the improved marketing strategies that have been incorporated therein. The company carried out outsourcing of experts who carried out market research on the target customers of this nation. The Company was therefore in a position to strategize so that it could overthrow the previous automobile manufacturer-General Motors. Marketing strategies were put in place to target the affluent customers all over the world. This played a big role in the success of Toyota Company. These marketing strategies included participating in sports. Toyota Company vehicles were used in motor spots and this actually marketed the vehicles. The Super 2000 Corolla and Peugeot were won in motors spots that were carried out late in the year 2007. (Toyoda, 2005) Toyota Company has had various acquisitions which influenced its success. It acquired 8. 7% of Fuji Industries. This Company is the manufacturer of Subaru vehicles. Toyota Company also acquired 5. 9% of Isuzu Motors. These strategies highly influenced the success of Toyota Company in the year 2007. This made Toyota Company to overtake General Motors. Toyota Company really strategized and incorporated new technologies in its manufacturing system. These technologies include an advanced parking guidance system and automatic power buttons. This resulted in the manufacture of hybrid gas-electric vehicle. This was produced in very large numbers. This hybrid gas-electric vehicle is sold at one million all over the world. This played a big role in the entire success of Toyota Company. (Dr. Shoichiro 2006) Evaluation of the success of Toyota Company shows that one of the factors that influenced its overall success in the year 2007 is branding. This company manufactures a wide variety of brands. This gives customers a wide variety of vehicles to choose from this Company. These brands include Lexus GS, Toyota Camry, Toyota 4Runner, Toyota Tundra, Toyota Land Cruiser, Toyota Prius etc. This has also played a big role in the success of Toyota Company. Surveys carried out on Toyota Company products show a great improvement on the quality of its products. This influenced the general success of this Company until it overtook the previous world leader- General Motors Company. It brands are actually preferred by customers because of quality and durability. Toyota produced Lexus and Scion automobiles which ranked top in reliability and quality surveys. They also ranked best according to various consumer reports. According to the annual report of Toyota Company 2007, there was much incorporation of team work which greatly influenced the success of Toyota Company. This Company has a large market share in United States and Asia. (Wooly, 2006) Conclusion According to the annual report in Toyota Company, approximately 4. 72 million vehicles were sold by the first half of the year 2007. This ended seventy six year reign of General Motors Company. Evaluation of the success of Toyota Company’s success in the year 2007 shows that this company incorporated various strategies that played a big role in its success. These included outsourcing of experts, incorporation of new marketing strategies and opening up of very many outlets all over the world. Branding aspect in this Company was well used by the marketing experts and this is how Toyota Company managed to overthrow the previous world leading manufacturer – General Motors Company. The market share for Toyota Company in United States of America is enviable. This Company currently has the challenge of maintaining its leadership role in the automobile industry.

Protective Effects Of Fluoride Toothpastes Health And Social Care Essay

Protective Effects Of Fluoride Toothpastes Health And Social Care Essay The main aim of this report is to discuss the evidence for the protective effects of fluoride toothpastes and varnishes. In addition, I will discuss their application and mode of action. To begin with, I will give a brief history of fluoride and how it fits into the reversal of tooth decay. I will discuss fluoride varnishes namely Duraphat, Fluor Protector and Duraflor and their effect on the DMF Index and their roles in school based prevention programmes. There are other varnishes such as Lawefluor and Bifluorid but these are less commonly used and therefore, I will not be discussing them. After discussing fluoride varnishes, I will consider fluoride toothpastes. I will give a description on the composition of a typical toothpaste and the effect of fluoride toothpastes on the DMF Index. In addition, I will discuss the effects of high fluoride concentration toothpastes. Finally, I will compare both toothpastes and varnishes. Contents Pages Summary Contents Introduction Deposition of fluoride in enamel What is tooth decay? Fluoride: Mode of Action Who is at risk of decay? Optimum fluoride concentration required for remineralisation DMF Index Main Section What are fluoride varnishes? Effect on DMFT/S The effect of fluoride varnishes according to different caries risk School based prevention programmes The use of fluoride varnish in inhibiting secondary carious lesions What are fluoride toothpastes? Use of fluoride toothpastes in clinical trials High Fluoride toothpastes The use of fluoride toothpastes in advanced enamel lesions Comparison of Toothpastes and Varnishes Conclusion Acknowledgements Word Count References Introduction I have decided to carry out this report on fluoride as I realise the importance of its role in the prevention of tooth decay (dental caries). Fluoride is a negative ion of the element fluorine and is found naturally in water, foods, soil, and minerals such as fluorite (calcium fluoride) and fluorapatite. Fluoride can also be synthesised in laboratories where it can be added to oral hygiene products and to water. Fluoride utilisation has occurred in two phases: before water fluoridation in the 1950s and after the widespread use of fluoridated dentifrices in the 1980s (Cury, Tenuta 2008) when less than 10% of toothpastes contained fluoride compared with 96% at present. Fluoride is most effective post-eruptively (Oganessian, Lencova Broukal 2007) where the effects are generally topical and therefore, it is important for a constant fluoride concentration to be maintained in the oral environment. Topically applied fluoride provides high concentrations of fluoride to surfaces of the denti tion. This provides a local protective effect and prevents ingestion of large amounts of fluoride. (Marinho et al. 2004) Deposition of fluoride in enamel During apatite crystal formation, low concentrations of fluoride are incorporated into the tooth structure. This leads to supersaturation with respect to fluoridated hydroxyapatite: {{66 ten Cate,J.M. 2008) Ca10(PO4)6(OH)2+ F-= Ca10(PO4)6(F)2 + 2OH- (Fluorapatite) After calcification is complete and prior to eruption, additional fluoride is taken up by the surface enamel. After eruption, the enamel continues to take up fluoride from its oral environment leading to its profound topical effects (Kidd 2005). What is tooth decay? It is important to consider the causes of tooth decay and how fluoride can be used to reverse the carious process. Dental Caries is a multifactorial disease caused by the action of acidogenic and aciduric bacteria (Streptococcus Mutans and Lactobacilli ({{32 Featherstone,J.D. 2008}}) on fermentable carbohydrates such as sucrose. Salivary glycoproteins form a pellicle on the tooth to which these bacteria attach to forming a pathogenic biofilm and over time, acid demineralisation and proteolytic destruction of the organic component of the enamel and dentine takes place (Young, Kutsch Whitehouse 2009). Dental Caries can be classified in several ways According to location-Caries may be restricted to pits and fissures but may also progress to expose the pulp. Restorative status of the tooth- Primary caries occurs on previously unrestored teeth whereas secondary caries occurs at margins of restorations {{52 Kidd,Edwina A.M. 2005}}. Secondary caries is caused by local factors that are involved in the formation of cariogenic plaque. Most secondary carious lesions develop at the gingival margins of restorations primarily in areas of stagnation areas (Mjà ¶r, 1998). Large gaps between the restoration and the wall of the cavity preparation can create an environment that favours secondary caries formation (Mjà ¶r, 1998). Secondary caries is also known as recurrent caries. Caries can be arrested whereby a lesion which was previously active has now stopped progressing. Fluoride: Mode of Action Fig 1: Demineralisation Process and the role of fluoride (Cury, Tenuta 2008) Figure one shows how sugars such as sucrose, glucose and fructose are converted to acids in the plaque biofilm. When the pH decreases below 5.5 (critical pH of enamel), the saliva is no longer supersaturated with calcium and phosphate. Therefore, demineralisation occurs. However, in the presence of fluoride and if the pH is higher than 4.5, hydroxyapatite is converted to fluorapatite which has a lower solubility. As a result, net demineralization is reduced and the dental hard tissues are more acid resistant. Tenuta and colleagues calculated that fluorapatite would not dissolve until the pH dropped below approximately 4.4. However, researchers have found that the effect of fluoride is not only due to the decreased solubility but also due to the effect of fluoride on the rates of demineralisation and remineralisation (Stoodley et al. 2008). In order to enter bacteria, fluoride must be combined with a hydrogen ion forming hydrogen fluoride (HF), which readily diffuses into the cell. Once inside the bacterial cell, the HF dissociates into fluoride and hydrogen ions. The fluoride inhibits intracellular bacterial enzymes such as enolase. As a result, less phosphoenolpyruvate and lactate are formed. The reduced lactate formation limits the ability of bacteria to cause caries. Similarly, the uptake of glucose is also reduced by fluoride {{63 Featherstone,J.D. September 2004}}. The fluoride concentration in saliva increases after brushing with a fluoride toothpaste. After three minutes, the concentration is 100 times greater than the baseline value (normally 0.03ppm or 1.6umol/l) {{65 Murray, J.J 1991}}. Two hours later, the concentration returns to normal. It is important to avoid rinsing out the mouth as the most profound effects of fluoride are within two hours of brushing. Fluoride is spread throughout the oral cavity and is stored in compartments on the tooth surface and the remaining pellicle (Cury, Tenuta 2008). Calcium Fluoride globules are formed and are reservoirs of fluoride, releasing it as the pH falls, thereby, reducing time spent in the demineralisation phase. The main effects of fluoride can be attributed to the maintenance of constant fluoride levels in the biofilm. Overall, fluoride has multiple ways of reducing caries. It is believed that the most important of these methods is the remineralisation concept {{40 Oganessian,E. 2007}}, which requires a constant flow of fluoride. Bacterial enzyme inhibition plays a supplementary role when the concentration of fluoride is high which is achieved by topical fluoride applications and toothpastes (Murray, Rugg-Gunn Jenkins 1991). Who is at risk of decay? There are certain groups in the population who are at risk of decay and therefore, would benefit from the use of fluoridated dentifrices. These include patients with: Xerostomia, which may have resulted from the radiotherapy to the head or neck leading to salivary gland exposure. This leads to a decrease in both the resting and stimulated salivary flow rates. Xerostomia is defined as the complete absence of saliva or hyposalivation. Hyposalivation leads to decreased levels of calcium, phosphate and hydrogen bicarbonate ions. As a result, there is a longer demineralisation phase Sjà ¶grens syndrome- this is clinically defined as at least two of kerataoconjuctivitis sicca, Xerostomia(dry mouth) and rheumatoid arthritis or another connective tissue disease {{62 Newbrun,E. 1996}} A high incidence of caries in their primary dentition Hypersensitivity Root caries Removable orthodontic appliances and partial dentures A poor diet and those who regularly snack on fermentable carbohydrates {{37 Evans,R.W. 2008}}. However, this risk has decreased due to better plaque control and increased fluoride exposure. Multiple restorations suggesting a high prevalence of caries Optimum fluoride concentration required for remineralisation Bjarnason and Finnbogason (1991) found that fluoride levels in dentifrices had no effect on the progression of enamel lesions detected radiographically. However, a higher fluoride concentration (1000ppm F-) led to reduction in caries initiation compared to a dentifrice with a lower fluoride concentration (250ppm F-) {{69 Bjarnason, S. 1991}}. It is ultimately difficult to decide the optimum fluoride concentration required for remineralisation as different areas of the mouth are more at risk of caries due to unique ecological factors. However, it was thought that lesion progression in enamel was slowed down only in patients with low caries activity whereas patients with high caries activity still experienced rapid progression (Hellwig, Lussi 2001). DMF Index The DMF index is a measure of caries activity in a population and changes in the DMF index can be used to highlight the protective effects of the fluoride toothpastes and varnishes (Kidd 2005). D: decayed teeth with untreated carious lesions M: missing teeth (extracted teeth) F: filled teeth DMFT denotes decayed, missing and filled teeth DMFS denotes decayed, missing and filled surfaces in permanent teeth and therefore, the number of surfaces attacked on each tooth are accounted for. There are similar indices for deciduous tooth, which are the defs and deft scores. The e represents extracted teeth to differentiate(Johansen et al. 1987) between natural loss of teeth through exfoliation. Burt in 1998 suggested that greater emphasis has to be placed on the assessment and early diagnosis of caries {{77 Burt, B.A. 1998}}. This has been backed up by cohort studies {{83 Johansen, E. 1987}} (Axelsson, Lindhe Nystrom 1991), which found that the use of preventive strategies (fluoride application) resulted in a substantial reduction in lesion development and progression. Fluoride varnishes What is fluoride varnish? Fluoride varnish was first developed in New York in 1968 by Heuser and Schmidt in the form of sodium fluoride and was marketed under the name Duraphat. The Duraphat varnish contains 22,600 parts per million of fluoride (ppm Fˆ°) as shown in figure 2. In the 1970s, there was a switch from sodium fluoride to difluorsilane which was marketed under the name Fluor Protector (7000ppm Fˆ°) in Germany {{42 Azarpazhooh,A. 2008}}. Fluoride Varnish Type of fluoride Fluoride Concentration(ppm) Fluoride Concentration(%) Duraphat Sodium Fluoride 22,600 2.26 Duraflor Sodium Fluoride 22,600 2.26 Fluor protector Difluorsilane 7,000 0.70 Fig 2: The table above shows the fluoride varnishes that are most commonly used. Other types of fluoride varnishes include: Fluoride Varnish Type of fluoride Fluoride Concentration(ppm) Fluoride Concentration (%) Lawefluor Sodium Fluoride 22,600 2.2 Bifluorid Sodium and Calcium Fluoride 56,300 5.6 Fig 3: The table above shows other fluoride varnishes which are available but are less commonly used {{24 Davies,G.M. 2008}}. Most fluoride varnishes contain fluoride in an alcoholic solution of natural tree resin. The main advantage of the varnish is that the resin base is very adherent to the tooth prolonging contact time between the fluoride and enamel {{26 Miller,E.K. et al 2008}}. Varnishes are easy to apply and relatively safe regardless of the high fluoride concentration as the amount of varnish applied to one child is only 0.5 ml on average (Ripa 1990; Petersson 1993). Varnishes are slow-releasing reservoirs of fluoride preventing immediate release of fluoride after application (Ogaard 1994). As a result, they are most effective at protecting against primary caries. The food and drug administration centre in America has not yet accepted fluoride varnish as an anti-caries agent but considered it as a liner/desensitising agent (Mason 2005). There is some debate as to the amount of fluoride taken up by the tooth surfaces. It was found that approximately half of the fluoride taken up by sound surfaces from Fluor Protector varnish was lost after 6 months suggesting that the large amount of fluoride taken up after one week does not bind permanently to enamel and that the effects of fluoride are more short term. There has also been a debate over whether fluoride varnish should be applied to wet or dry surfaces. Koch et al found that the fluoride uptake was much greater when the varnish was applied to dry tooth surfaces (Koch, Hakeberg Petersson 1988). Fluoride varnishes can be applied professionally up to two to four times a year. Marinho et al in 2002 investigated the effectiveness of fluoride varnish in preventing dental caries in children compared to a placebo or no treatment. Over 2700 systemically healthy children aged 16 or less received fluoride varnish containing 22,600ppm sodium fluoride. There was a large caries inhibiting effect on both permanent and deciduous dentition. However, the confidence intervals were relatively wide and the variation among the results was substantial. The success of the treatment may have been over estimated, as the results of the few trials may not have been representative. As a result, it is important to carry out more trials before a definite statement can be made of the effects of the fluoride varnish (Marinho 2002). In addition, more information is required on the scale of the fluoride effect and the adverse effects of fluoride. Effect on the DMFT/dmft Primary Dentition There was a 33% decrease in the decayed, missing and filled surfaces (Marinho 2002). A two year randomised clinical trial carried out on children with a mean age of 1.8 years, found that the application of fluoride varnish once, twice and three times a year reduced the mean dmfs by 53%, 58% and 93% respectively {{67 Davies,G.M. 2009}}. This highlights the importance of frequent varnish application. (Petersson, Twetman Pakhomov 1998)Petersson et al. in 1998 found a 19% and 25% reduction in the increment of approximal caries in children with a moderate or high caries risk respectively. This shows that children with a high caries risk benefit the most from the application of fluoride varnishes (Zimmer 2001). Ages 0-3 Weintraub and colleagues carried out a two year randomised controlled trial on 376 children aged between 6-44 months (Weintraub et al. 2006). The children were split into three groups: Those who received counselling Those who received counselling and the annual application of Duraphat Those who received counselling and the twice yearly application at six monthly intervals The number of lesions only increased in children who received counselling alone highlighting the protective effects of the varnish. Those children who received no varnish application were twice as likely of developing decay as those who received the annual application of fluoride. As the frequency of fluoride varnish application increased, the number of carious lesions decreased. One drawback of this trial was that simultaneous counselling and varnish application led to some ambiguity as to whether the effects were due to varnish application or counselling although fluoride application was seen to play a key role. Ages 3-6 According to the Cochrane Review, there was an overall 38% reduction in the DMFS/dmfs (Marinho 2002). A two year randomised study of 1,275 children in Canada aged between 6 months and 5 years found that twice-yearly application of Durafluor led to an 18.3% reduction in the dmfs increment (Lawrence et al. 2006). Mixed dentition There was on average a 46% decrease in dmfs. The fluoride varnish was an effective preventive measure for partially erupted permanent molars. Equally, patients who are insufficiently co-operative benefit from fluoride varnish application (Marinho 2002). Permanent dentition A randomised clinical trial used to examine the impact of fluoride varnish on the incidence of approximal caries, detected radiographically in 13 year olds over a three year period, found that the varnish applied monthly and twice a year reduced caries by 76% and 57% respectively again highlighting the importance of frequent fluoride application{{67 Davies,G.M. 2009}}. The caries reduction in permanent teeth shown in the Cochrane review of trials was similar to that achieved in a metaanalysis carried out by Helfenstein in 1994 when Duraphat was applied 2 times a year in children aged 9-15 years (Helfenstein, Steiner 1994). There was a 38% reduction in the caries. It is likely that most of the participants benefited from the use of a fluoridated dentifrice as the majority of the studies were carried out in Scandinavian countries between 1973 and 1987. However, as both the Cochrane review and the Helfenstien study were carried out involving a different selection criteria, it is debatab le as to whether the results from both these trials can be compared. In conclusion, application of fluoride varnish two to four times a year on both permanent and deciduous teeth is associated with a reduction in the caries increment (Marinho 2002). The effect of fluoride varnish according to different caries risks Mà ¶berg Skold carried out a trial which involved the application of fluoride varnish to approximal caries in adolescents living in different caries risk areas. The trial involved 758 students aged between 13 to16 years old. The large sample size meant that the results of this study were representative. This is because as the sample size increases, the variability of the results decreases. This means that the results have a greater statistical power and smaller confidence intervals. Fig 4: (Azarpazhooh, Main 2008) The figure above shows the groups which were chosen according to their caries risk and whether they had any fluoride in their tap water. Duraphat was applied to the approximal surfaces from the distal surface of the canines to the mesial surface of the second molars. Each group had different intervals of application shown in the figure below: Group No. of participants Frequency of Duraphat application One 190 Twice yearly in six-monthly intervals ( 6 times in 3 years) Two 186 Three times a year with a one week period each year(9 times in 3 years) Three 201 Eight times a year during school terms with one month intervals ( 24 times in 3 years) Four(Control) 181 No application Fig 5: (Azarpazhooh, Main 2008) The frequency of Duraphat application The results from this trial show that the biggest difference was between group one and the control group in high caries risk area (Gà ¶teborg). However, there was no significant difference between the groups regarding filled approximal lesions and approximal enamel lesions. There was a greater incidence of caries in the control group in comparison to the fluoride varnish groups in all risk areas highlighting the protective effects of the fluoride varnish (Mà ¶berg Skold et al. 2005). Overall, it was found that the school based monthly application of fluoride varnish is the best method of preventing approximal caries in areas of medium and high caries risk (Mà ¶berg Skold et al. 2005). School based prevention programmes A cluster randomised trial was carried out by M.C Hardman and colleagues involving 2,091 school children living in a non-fluoridated area. One group of students (1,025 students) received the twice-yearly application of Colgate Duraphat varnish whilst the other group (1,066 students) served as a control. This study found that the twice-yearly application of fluoride varnish did not lead to a reduction in caries in children living in the community {{43 Hardman,M.C. 2007}}. This is contrary to what was found by Marinho and colleagues. They found that the biannual application of Duraphat in a school-based programme provided a caries inhibition of 38% in children aged 9-15 years (Marinho 2002). The study carried out by M.C Hardman and colleagues did not prove to be conclusive as the level of consent in the community was low. Approximately 110 students were lost during the study. The control group had lower caries levels than anticipated and therefore, it was difficult to tell the true eff ect of fluoride. In addition, the application of varnish was carried out under sub-optimal conditions (teeth could not be cleaned prior to application and the consumption of food and drink after application could not be controlled), which could have resulted in less profound effects. In conclusion, it was found that this type of fluoride varnish intervention is not effective in the prevention of caries in the public {{43 Hardman,M.C. 2007}}. A similar study was carried in a small town located in the American Southwest on children attending a head start nursery using Duraflor as the varnish of choice. The trial began in the head start class of 2002. Duraflor was applied during well child visits every 9, 12, 15, 18, 24 and 30 months. The class of 2003 had no fluoride application and therefore, served as the control. The mean age was 4.40 years and approximately 168 males and 189 females took part. The results showed that children who received no treatment had a mean dmfs of 23.6 with a 95% confidence interval. Those children who received 1-3 treatments had a similar dmfs to those with no treatment. Only those children who had 4 to 5 treatments showed a reduction in dmfs again suggesting the importance of frequent application. However, this study was an observational study not a randomised study and therefore, the reliability of the results can be questioned. In addition, no attempt was made to determine whether the childre n who received four or more applications of fluoride varnish differed from the other children in terms of diet and oral hygiene history {{58 Holve,S. 2008}}.. The use of fluoride varnish in inhibiting secondary carious lesions As mentioned earlier, secondary caries forms at the margins of restorations. Larger amounts of fluoride varnish may be trapped in the gap formed between the restoration and the cavity wall. This may serve as a slow releasing reservoir of fluoride, which could also provide a physical barrier against wall dissolution. In a study carried out by M. Fontana in 1996, two experiments were carried out. Experiment one involved the application of Duraflor. Experiment two involved the application of Duraphat a year after the application of Duraflor. The effects of fluoride varnish on secondary caries remineralisation and lesion progression were measured. The varnish was applied to dry tooth surfaces and rinsing after fluoride application was prevented to enhance the remineralisation potential. The varnish was applied for 24 hours to prolong the contact time between the varnish and the tooth surface. The results from these two experiments showed that fluoride application slowed down lesion progression around both amalgam and composite restorations {{48 Fontana, M. 2002}}. The placebo varnish slowed down lesion progression to a lesser extent than the fluoride varnish suggesting that the effects may not only be attributed to the fluoride in the varnish. These results matched those in a previous study carried out by Hellwig et al. in 1993. They examined the effect of Duraphat varnish on artificially created primary carious lesions and found that fluoride varnish led to remineralisation in the outer layers of enamel {{78 Hellwig, E.K. 1993}}. This slowed down lesion progression. Seppa suggested in 1988 that the benefits of fluoride varnish were attributed to their ability to enhance remineralisation of primary caries rather than their ability to increase the fluoride content of the tooth surface. This is contrary to what was previously thought that the effects of topical fluoride were due to their ability to maintain high levels of fluoride on the surface of the tooth. Seppa also found that the efficacy of the fluoride varnishes was dependent on the number of applications rather than the concentration of fluoride {{79 Seppà ¤, L. 1988}}. This backs up the results found by Marinho et al that showed that the more frequent the applicati on, the lower the incidence of new caries or the greater the decrease in mean dmfs/DMFS. Fluoride toothpaste What is fluoride toothpaste? Fluoride toothpaste is the most widely used method of fluoride application in the population due to its ease of use. Fluoride toothpastes can be incorporated into community and school based prevention programmes. Most oral health care workers recommend brushing twice a day, once just before going to bed, as this is when saliva flow is at its lowest and once at another time of day{{68 Davies,R.M. 2003}}. They recommend spitting out the toothpaste after use rather than rinsing as this dilutes the fluoride concentration in the oral cavity as previously mentioned. The widespread use of fluoride toothpastes had made it more difficult to distinguish whether a reduction in caries is due to mechanical plaque removal or due to the incorporation of fluoride. Before the widespread use of fluoride toothpastes, the importance of fluoride was illustrated in a three-year study. This study involved two groups of children aged 9 to 11 years who had benefited from supervised brushing either with or without fluoride toothpaste. Both groups showed a reduction in plaque and gingivitis but a significant reduction in caries was only seen in the group which used fluoridated toothpastes (Davies et al. 2003). A typical toothpaste contains abrasives such as calcium carbonates, which help to remove surface debris, and stains on the tooth surface. Most toothpastes contain fluoride (added to toothpastes in the 1970s) to make the tooth more resistant to acid attack and is one of the most recognised agents in toothpastes. Stannous fluoride (also known as tin fluoride) was the first fluoride to be used due to its compatibility with the abrasive, calcium phosphate. Sodium fluoride could not be used at first as the calcium in the abrasive renders it ineffective and therefore, is not compatible. Sodium Monofluorophosphate was next used as it was compatible with the abrasives used with it. Sodium Fluoride could only be used when hydrated silica and sodium bicarbonate became the abrasive of choice. Studies have shown that the sodium bicarbonate-sodium fluoride combination lead to a caries reduction of one surface per child over two years (Murray, Rugg-Gunn Jenkins 1991). Fluorides have been shown to work better in combination with detergents such as sodium lauryl sulphates, which aid the remineralisation process and create foaming whilst brushing. Toothpastes contain humectants such as glycerol, which prevent the loss of water in the toothpaste. To provide taste, saccharin and other sweeteners are added. To stabilise the toothpaste, thickening agents such as seaweed colloids are included to ensure that the toothpaste stays on the toothbrush when it is applied. The use of fluoride toothpastes in clinical trials The Cochrane review of trials found that children who used fluoridated toothpaste had fewer decayed,missing and filled permanent teeth after three years. Brushing twice a day helps to increase the benefit of fluoride (Marinho et al. 2003 England). Researchers believe that the effects of fluoridated toothpastes are underestimated in two to three year trials due to the life long used of fluoride. They also found that the use of fluoride toothpastes in areas of fluoridated water increased the protective effects. The normal concentration of fluoride in toothpastes is between 1000 and 1100 parts per million (ppm Fˆ°). Toothpastes with higher fluoride concentrations (1500ppm) and lower fluoride concentrations (500ppm) are available in many countries. Toothpastes containing higher fluoride concentrations offer greater protection against caries (Stephen 1988; OMullane 1997). Since the 1940s, more than a 100 clinical trials have been carried out and by the late 1970s, the protective effects of fluoride toothpastes were greatly accepted. As a result, many clinical trials could not have a control, as the removal of fluoride toothpaste for the trial was considered unethical. Therefore, the effectiveness of different concentrations of fluoride toothpastes have not been investigated extensively in placebo-controlled trails. The guidelines of caries trials have since been changed in order to combat this problem, by increasing the sample size so that the measurement error could be reduced (Marinho et al. 2003 England). Children or adolescents aged sixteen or less were chosen to take part in the study carried out by Marinho et al. To assess the effect of the fluoride toothpaste, the caries increment was measured as a change in the value of the DMFS Index, in all permanent teeth erupted at the start and erupting over the course of the study. Evidence from this study suggested that the use of fluoride toothpastes leads to a 24% decrease in dmfs. The confidence intervals for this reduction were 21-28%. This means that 1.6 children need to brush with fluoride toothpaste to prevent one decayed, missing or filled tooth surface in a population where the caries increment is 2.6 DMFS per year. Where the caries increment was lower (1.1 DMFS per year), 3.7 children needed to use a fluoride toothpaste in order to avoid one decayed, missing or filled tooth surface(Marinho et al. 2003 England). There was also a substantial reduction in caries increment (37%) of deciduous teeth in a trial carried out on 2008 children aged 6 to 9 years. Another aim of the Cochrane review (Marinho et al. 2003 England) was to establish whether there was any relationship between the caries-preventive effects of fluoride toothpaste and the initial level of caries, previous exposure to fluoride and the frequency of fluoride toothpaste use on the prevented fraction. The prevented fraction (PF) is the proportion of disease occurrence in a population averted due to a protective risk factor or public health intervention (Gargiullo, Rothenberg Wilson 1995). The prevented fraction was measured as the diffe

What Influences Juveniles to Join a Gang?

What Influences Juveniles to Join a Gang? When it comes to gangs, juveniles are the ones that are being lured in the most. You’ll come across a certain neighborhood and encounter juveniles that are almost around the age of 12-18. You may ask what influences them to be in a gang? Regardless of the many crimes and violations they’ll have to commit in order to be granted in. There’s been various studies out there that reveal so many factors that makes them want to become a part of these organizations. Some are: male partner gang involvement, disadvantaged neighborhoods, family structure and peer association. These factors tend to come into play often because of what these juveniles endure, personally, and makes them want to become a part of something that will give them a sense of power and acceptance. To start off, when it comes to knowing what a gang is, it can be defined in various ways. There’s no right definition but there are certain ways to describe what it is. In the textbook,† American Street Gangs†, they go into detail about how gangs are a group of people who band together for any number of reasons†. Which may include criminal activity, delinquency and rule of certain territories (neighborhoods). Here are some interesting statistics about gangs based on the Federal data (Justice.gov): America showed 95% of criminal activity was caused by youth gangs, youth gangs are more violent while engaging in illegal money-making activities, and has increased in gang violence especially within large cities. With all that being said, you can see how much of a negative impact gangs are making towards society and the youth. Female juveniles are also considered gang members and tend to join gangs because of relations to their boyfriend or partner. As stated in an article,† The Relationship Between Male Gang Involvement.†, it goes in depth with the idea that females whom are involved with gang members are highly likely to join a gang too, especially in ages between 13-17. The article points out important factors that come along with it, such as emotional abuse and how that can lead them to being gang-involved partners, they’ll seek comfort on being engaged in drug activity, crime and other acts that they’ve never done before. However, it’ll also cause negative outcomes such as mental risk factors, intimate partner violence and objectifying them as sex objects. This concludes that female juveniles who are involved with gang members, will most likely follow their steps out of love and respect, regardless of the outcomes. Another article that goes into detail of female juveni les in gangs, known as,† Female Gang Members†, tells us that throughout the years, rates on female juvenile gang activity have increased. An interesting quote I came across states, â€Å"they’re afraid of our gang, and because I’m in the gang, people show me respect and wont mess with me. I like that feeling of power†. With that being said, you can see how female juveniles feel when being involved in a gang. The sense of power and fear other people have towards them, contrary to not being in a gang and don’t get the respect they think they deserve. Another factor that influences juveniles to become a part of a gang is being in disadvantaged neighborhoods. When it comes to impoverished neighborhoods, more gang activity is being exposed because of the lack of resources the community has. In other words, gang members make money by the distribution of drugs and crimes, making people that’s in desperate need, become a gang member. The fact that neighborhoods play a huge role, environmental deterioration and social disorganization, as talked about in â€Å"Affiliation to youth gangs During Adolescence†, are the effects of an impoverished neighborhood. The views a juvenile has towards society are also important because if they feel a sense of unattachment towards their norms, it makes them want to engage in delinquency and crime. Gang organizations feel as if they have control of everything and run every block in the neighborhood. Why? Because of lack of social control and collective efficacy. Neighborhoods that are most impoverished, tend to be at risk of being controlled by youth gangs. These neighborhoods are seen as a playground for them, giving them access to hang around in every corner, playground and front porch because of the fact that people are scared of them and won’t do anything to interfere; not prevented. This concludes that juveniles that live in a disadvantaged neighborhood are more likely to get in a gang because that’s all they see around them, especially growing up, being exposed to gang activity at an everyday basis makes it difficult for them to avoid it. From a personal experience, I have lived in a neighborhood where there was gang activity everywhere you’d go. In the Little Village area, where I grew up, I’d see juveniles as young as 12-17 that would hang with the heads of gang members and follow the same steps they would. It was really upsetting seeing a 14-year-old boy on the corners selling drugs just to make dirty money, the reality of it was surreal. Family structure is one of the issues that occur the most. Many juveniles will experience lack of family support, love and guidance and can lure them away. Parental supervision tends to lessen when there’s problems such as: single parent households, parents being incarcerated, neglecting their child and relatives being involved in gangs. The loss of a father or mother figure can really have a negative impact on a juvenile, causing them to contribute to criminal activities and bad habits. Especially when it comes to losing a father figure, juveniles don’t have that strict supervision or support a man will give to his son contrary to a mother. In other words, family structure impedes socialization. In effect to that, juveniles will turn to gang organizations because they feel a sense of belonging, loyalty and connection, something they would look for within their family. In the textbook,† American Street Gangs†, it states a pretty compelling fact,† famil ies that can’t provide enough security or support so the gangs become their kind of surrogate family† (page 84). In other words, if you’re committed to the gang, they will reward you with protection, power and love. In the text, it defines what a gang is and what characteristics it consists of, which is a group of more than two members, fall within certain age groups, share a sense of identity, require permanence and most importantly are involved in criminal activity. With that being said, you can conclude that being in a gang, you have to follow strict regulations but also, there’s a sense of loyalty/trust, love, being respected/feared and actually feeling a part of something. Take for example, the Latin Kings. In a video Gangland, the show how much they value their gang members and look out for one another, but are very critical when it comes to anyone turning their back on them (distrust, snitching, which is telling on someone). Lastly, peer association is also one of the factors that influence gang membership. Nowadays, juveniles will make friends with anyone that shows them acceptance and since they tend to be susceptible, it’s easy for them to fall into temptation. A lot of gang members tend to recruit juveniles the most because they’ll do anything for money, power and the reputation. Take into consideration the differential association theory as a factor for antisocial behavior. Edwin Sutherland was a famous social theorist and came up with this theory, which he defines as, all behavior is learned. Such as: learning criminal behavior, process of communication within the gang, and getting to know the basic principles of a gang and incorporating it to their everyday lives and do everything that is expected of them. It can be seen as peer pressure but in this case, juveniles are committed to this. This theory best describes peer association because of the fact that many of these juveniles will do whatever it takes to become a gang member, they’ll endure any violation just to become one of them. Seeing gang members gain power and have all the things they desire, will definitely influence juveniles to want it as well. To conclude, juveniles tend to start being involved in gangs at such an early age despite the negative consequences they’ll face in the long run. Factors such as family structure, peer association, disadvantaged neighborhoods and relationships in gangs will definitely influence a juvenile to join these organizations at whatever cost. It’s important to take into consideration that most of this can be prevented with the right guidance and support from their family. Gang membership will only take you so far; death or in jail, just for their show and satisfaction and it’s really not worth it. References Flexon, J. L., Greenleaf, R. G., & Lurigio, A. J. (2012). The Effects of Self-Control, Gang Membership, and Parental Attachment/Identification on Police Contacts Among Latino and African American Youths.  International Journal Of Offender Therapy & Comparative Criminology,  56(2), 218-238. doi:10.1177/0306624X10394116 Dupà ©rà ©, V., Lacourse, É., Willms, J. D., Vitaro, F., Tremblay, R. E., Dupà ©rà ©, V., & Lacourse, E. (2007). Affiliation to youth gangs during adolescence: the interaction between childhood psychopathic tendencies and neighborhood disadvantage.  Journal Of Abnormal Child Psychology,  35(6), 1035-1045. doi:10.1007/s10802-007-9153-0 Molidor, C. E. (1996). Female Gang Members: A Profile of Aggression and Victimization.  Social Work,  41(3), 251-257. King, K., Voisin, D., & Diclemente, R. (2015). The Relationship Between Male Gang Involvement and Psychosocial Risks for their Female Juvenile Justice Partners with Non-gang Involvement Histories.  Journal Of Child & Family Studies,  24(9), 2555-2559. doi:10.1007/s10826-014-0057-7 103. Gang Statistics. (n.d.). Retrieved April 25, 2018, from https://www.justice.gov/usam/criminal-resource-manual-103-gang-statistics Delaney, T. (2016).  American street gangs. Brantford, Ontario: W. Ross MacDonald School Resource Services Library. Health Issue: The Debate on Vaccinations Health Issue: The Debate on Vaccinations Current Trend in Health Care: MMR Vaccines Brittany Core Nothing is more heartbreaking than a young life that has been taken by the infection of a killer disease. Diseases kill children every year. Many diseases are bacteria, inhaled by the victim, infecting several areas of the body. The bacteria lives and grows while its victim dies. Other diseases are caused by viruses; a non-living infection that attacks the immune system and other living cells. Children are much more vulnerable to disease because of their weak immune systems. They’re weak because they have not lived life long enough to build immunities for such infections. However, in medicine, there are always risks. So, parents argue that vaccinations should not be mandatory for children. For many years, immunizations have continued to keep the spread of disease low. They have lowered the amount of deaths and saved lives. On the other hand, what if it was against families’ religion or they say their child is a â€Å"tough one† and they can handle the severe symptoms of disease? Those are the arguments made by people who believe that vaccines should not be mandatory for children. Are those arguments strong enough to counter all the children’s lives that have been saved by intelligent medicine? Unless America wants to unleash the beast of infectious killers, vaccinations for children should be mandatory to keep it from spreading and eventually killing. Research shows that the benefits of vaccination outweigh the risks because vaccines can prevent serious illness and disease in individuals, vaccinations can also prevent widespread outbreaks of diseases in populations and the side effect of vaccinations, though occasionally serious, are very rare. In 1912, measles became a nationally notifiable disease in the United States, requiring U.S. healthcare providers and laboratories to report all diagnosed cases (Measles History, 2014). In the first decade of reporting, an average of 6,000 measles-related deaths were reported each year (Measles History, 2014). In the decade before 1963 when a vaccine became available, nearly all children got measles by the time they were 15 years of age (Measles History, 2014). It is estimated 3 to 4 million people in the United States were infected each year. Also each year an estimated 400 to 500 people died, 48,000 were hospitalized, and 4,000 suffered encephalitis (swelling of the brain) from measles (Measles History, 2014). In 1954, John F. Enders and Dr. Thomas C. Peebles collected blood samples from several ill students during a measles outbreak in Boston, Massachusetts (Measles History, 2014). They wanted to isolate the measles virus in the student’s blood and create a measles vaccine. They succeeded in isolating measles in 13-year-old David Edmonston’s blood (Measles History, 2014). In 1963, John Enders and colleagues transformed their Edmonston-B strain of measles virus into a vaccine and licensed it in the United States (Measles History, 2014). In 1968, an improved and even weaker measles vaccine, developed by Maurice Hilleman and colleagues, began to be distributed (Measles History, 2014). This vaccine, called the Edmonston-Enders (formerly â€Å"Moraten†) strain has been the only measles vaccine used in the United States since 1968 (Measles History, 2014). The MMR shot protects your child from measles, a potentially serious disease (and also protects against mumps and rubella), prevents your child from getting an uncomfortable rash and high fever from measles, keeps your child from missing school or childcare and keeps you from missing work to care for your sick child (Vaccine and Immunizations, 2015). The measles, mumps, and rubella vaccine is recommended for children 12 months to 12 years old (MMR, 2013). Children should receive the first dose of mumps-containing vaccine at 12-15 months and the second dose at 4-6 years (Mumps Vaccination, 2012). All adults born during or after 1957 should have documentation of one dose (Mumps Vaccination, 2012). Adults at higher risk, such as university students, health care personnel, and international travelers, and persons with potential mumps outbreak exposure should have documentation of two doses of mumps vaccine or other proof of immunity to mumps (Mumps Vaccination, 2012). Pregnant women and persons with an impaired immune system should not receive the MMR vaccine (Mumps Vaccination, 2012). It is a single shot, often given at the same doctor visit as the varicella or chickenpox vaccine (MMR, 2013). Measles can be dangerous, especially for babies and young children (Vaccine and Immunizations, 2015). For some children, measles can lead to pneumonia, lifelong brain damage, deafness and death (Vaccine and Immunizations, 2015). Measles is a respiratory disease caused by a virus. The virus lives in the mucus in the nose and throat of an infected person (Measles, n.d). Measles remains a common disease in many countries throughout the world, including some developed countries in Europe and Asia (Measles, n.d). While the disease is almost gone from the United States, measles still kills nearly 200,000 people each year globally (Measles, n.d). However, children younger than 5 years of age and adults older than 20 years of age are more likely to suffer from measles complications (Measles, n.d). Measles virus causes rash, cough, runny nose, eye irritation, and fever (MMR Vaccine (Measles, Mumps, Rubella), 2015). It can lead to ear infection, pneumonia, seizures (jerking and staring), brain damage, and death (MMR Vaccine (Measles, Mumps, Rubella), 2015). Pregnant women can give birth prematurely or have a low-birth-weight baby (Measles, n.d). Mumps is a contagious disease that is caused by the mumps virus. The mumps virus affects the saliva glands, located between the ear and jaw, and may cause puffy cheeks and swollen glands (MMR, 2013). Mumps virus causes fever, headache, muscle pain, loss of appetite, and swollen glands (MMR, 2013). It can lead to deafness, meningitis (infection of the brain and spinal cord covering), painful swelling of the testicles or ovaries, and rarely sterility (MMR, 2013). Most people who have mumps will be protected (immune) from getting mumps again (Mumps Vaccine, 2006). There is a small percent of people though, who could get infected again with mumps and have a milder illness (Mumps Vaccine, 2006). Rubella, also known as German measles or three day measles is an infectious viral disease, but dont confuse rubella with measles, which is sometimes called rubeola (MMR, 2013). The two illnesses share similar features, including a characteristic red rash, but they are caused by different viruses (MMR, 2013). Rubella virus lives in the mucus in the nose and throat of infected persons (MMR, 2013). Rubella is usually spread to others through sneezing or coughing. In young children, rubella is usually mild, with few symptoms. They may have a mild rash, whichusually starts on the face and then spreads to the neck, chest, arms, and legs, and it lasts for about three days (MMR, 2013). A child with rubella might also have a slight fever or other symptoms like a cold. Adults are more likely to experience headache, pink eye, and general discomfort one to five days before the rash appears (MMR, 2013). Adults also tend to have more complications, including sore, swollen joints, and, less commonl y, arthritis, especially in women (MMR, 2013). A brain infection called encephalitis is a rare, but serious, complication affecting adults with rubella (MMR, 2013). However, the most serious consequence from rubella infection is the harm it can cause to a pregnant womans unborn baby (MMR, 2013). Measles spreads when a person infected with the measles virus breathes, coughs, or sneezes (Vaccine and Immunizations, 2015). It is very contagious. A person can catch measles just by being in a room where a person with measles has been, up to 2 hours after that person is gone, and you can catch measles from an infected person even before they have a measles rash (Vaccine and Immunizations, 2015). Almost everyone who has not had the MMR shot will get measles if they are exposed to the measles virus (Vaccine and Immunizations, 2015). Measles, mumps, and rubella (MMR) vaccine can protect children and adult from all three of these diseases. Thanks to successful vaccination programs these diseases are much less common in the U.S. than they used to be, but if we stopped vaccinating they would return (MMR, 2013). Between 2000 and 2007, the number of measles cases reached a record low, with only 37 cases being reported in 2004 (Medical News Today, 2015). Last year saw the highest number of reported measles cases in the US since the virus had been declared eliminated (Medical News Today, 2015). There were 23 measles outbreaks in 2014 causing 644 people to become infected (Medical News Today, 2015). According to the CDC, the majority of these cases were brought into the country by travelers from the Philippines (Medical News Today, 2015). Where a large outbreak of the virus was occurring at the time and most of the people who became infected in the US were part of unvaccinated Amish communities in Ohio, but while last years statistics seem bad, this years are set to be even worse (Medical News Today, 2015). Last month alone saw 102 measles cases reported over 14 US states, including California, Texas and Washington (Medical News Today, 2015). The majority of these cases are thought to have stemm ed from Disneyland, CA, where a number of people reported developing the virus after visiting the amusement part in mid-December (Medical News Today, 2015). If you dont have insurance or if your insurance does not cover vaccines for your child, the Vaccines for Children Program may be able to help (CDC, 2015). The Vaccines for Children (VFC) program provides vaccines for children who are uninsured, Medicaid-eligible, or American Indian/Alaska Native (CDC, 2015). No federal vaccination laws exist, but all 50 states require certain vaccinations for children entering public schools (State Laws: Vaccines and Requirements, 2014). Vaccination coverage in America has been historically high as a result of school requirements, caregiver intervention with vulnerable populations, and seasonal influenza-shot drives, but it still falls short (MMR, 2013). Physicians or other providers must provide the current Vaccine Information Statement (VIS) each time they administer a vaccine covered under the National Vaccine Injury or purchased through the Centers for Disease Control and Prevention grant (Kimmel Wolfe, 2005). They must record in each patients medical record the date of administration, the vaccine manufacturer, the lot number, and the name and business address of the provider, along with the edition of the VIS that was given and the date on which the vaccine was administered (Kimmel Wolfe, 2005). An effective interaction can address the concerns of vaccine supportive parents and motivate a hesitant parent towards vaccine acceptance (Leask, Kinnersley, Jackson, Cheater, Bedford Rowles, 2012). Conversely, poor communication can contribute to rejection of vaccinations or dissatisfaction with care and health professionals have a central role in maintaining education (Leask et al., 2012). These concerns will likely increase as vaccination schedules inevitably become more complex, and parents have increased access to varied information through the internet and social media (Leask et al., 2012). In recognition of the need to support health professionals in this challenging communication task conducted in usually public trust in vaccination; this includes addressing parents’ vaccine concerns (Leask et al., 2012). There are several reasons why parents are choosing not to vaccinate their children. Parents who decided not to give their child MMR were concerned that the vaccine might cause a reaction in their child (Immunizations, n.d). Most children who have the MMR vaccine do not have any problems with it, or if reactions do occur they are usually mild (Immunizations, n.d). Parents were concerned that the long-term effects of the combined MMR vaccine were not known (Immunizations, n.d). Other reasons given for deciding not to go ahead with MMR were concern about the ingredients of the vaccines and that live vaccines were used and that these would be too much for a childs body to cope with (Immunizations, n.d). A very small number of parents personally believed that immunity derived from actually having the disease was more effective than the immunity obtained from vaccines (Immunizations, n.d). There is no scientific evidence that MMR vaccine causes autism. The suggestion that MMR vaccine might lead to autism had its origins in research by Andrew Wakefield, a gastroenterologist, in the United Kingdom (DPH, 2013). In 1998, Wakefield and colleagues published an article in The Lancet claiming that the measles vaccine virus in MMR caused inflammatory bowel disease, allowing harmful proteins to enter the bloodstream and damage the brain (DPH, 2013). The validity of this finding was later called into question when it could not be reproduced by oth ­er researchers (DPH, 2013). In addition, the findings were further discredited when an investigation found that Wakefield did not disclose he was being funded for his research by lawyers seeking evidence to use against vaccine manufacturers (DPH, 2013). Wakefield was permanently barred from practicing medicine in the United Kingdom (DPH, 2013). There will always be some cases of measles in the US, as it can still be brought into the country by individuals from other countries who have not been vaccinated. The CDC says the MMR vaccine is safe, and one dose of the vaccine is around 93% effective at preventing measles, while two doses is approximately 97% effective (Medical News Today, 2015). Immunization is the only effective way of protection for children against these diseases because children’s immune systems are defenseless against them because they are not fully developed yet, and once infected in most cases there is no cure or at least a very low chance of one. References Center for Disease Control (2015, February 5). Retrieved March 18, 2015, from http://www.cdc.gov/vaccines/vpd-vac/measles/fs-parents.html DPH: Infectious Diseases. (n.d.). Retrieved March 22, 2015 http://www.ct.gov/dph/cwp/view.asp?a=3136q=397352 Immunization. (n.d.). Retrieved March 18, 2015, from http://www.healthtalk.org/peoples-experiences/pregnancy-children/immunisation/deciding-not-give-my-child-mmr-measles-mumps-and-rubella Kimmel, S. R., Wolfe, R. M. (2005). Communicating the benefits and risks of vaccines. The Journal of Family Practice, 54(1 Suppl), S51-S57 State Vaccines and requirements. (2014, December 12). Retrieved March 22, 2015, from http://www.cdc.gov/vaccines/imz-managers/laws/state-reqs.html Leask, J., Kinnersley, P., Jackson, C., Cheater, F., Bedford, H., Rowles, G. (2012). Communication with parents about vaccination: a framework for health professionals. BMC Pediatrics, 12154. doi:10.1186/1471-2431-12-154 Measles History. (2014, November 3). Retrieved March 18, 2015, from http://www.cdc.gov/measles/about/history.html Medical News Today (2015, February 5). Retrieved March 18, 2015, from http://www.medicalnewstoday.com/articles/289060.php MMR (Measles, Mumps, Rubella) Vaccine. (2013, June 18). Retrieved March 18, 2015, from http://www.cdc.gov/vaccines/hcp/vis/vis-statements/mmr.html MMR Vaccine Does Not Cause Autism Examine the Evidence! Retrieved March 19, 2015, from http://www.immunize.org/catg.d/p4026.pdf Mumps Vaccine. (2006, October 16). Retrieved March 22, 2015, from http://www.cdc.gov/vaccines/vpd-vac/mumps/vac-faqs.htm Mumps Vaccination. (2012, July 2). Retrieved March 22, 2015, from http://www.cdc.gov/mumps/vaccination.html Vaccine and Immunizations. (2015, February 5). Retrieved March 22, 2015, from http://www.cdc.gov/vaccines/vpd-vac/measles/fs-parents.html Measles. (n.d.). Retrieved March 22, 2015, from http://www.vaccines.gov/diseases/measles/index.html MMR Vaccine (Measles, Mumps, and Rubella): MedlinePlus Drug Information. (n.d.). Retrieved March 22, 2015, from http://www.nlm.nih.gov/medlineplus/druginfo/meds/a601176.html

The Importance of Language in Clare Rossini’s Final Love Note and Louis

The Importance of Language in Clare Rossini’s Final Love Note and Louise Gluck’s Mock Orange Love is such an abstract concept for the human mind to figure out. Along with the love of a mother for her child, there are many types of sensual love or brotherly love; friendship is frequently described as a type of love, as well. This abstraction can also be distorted and made to fit into categories that would normally be associated with negativity and abuse not "love." Think of why a woman will continually go back to an abusive spouse with the irrational reason that "he loves me." If he loved you, he wouldn't beat you†¦Would he? In a poem, the confusion seems only to extend, as writers will describe a beautiful event that is tainted by a bad experience or emotion. In this manner, word choice plays a primary role in determining the actual meaning of the poem. Clare Rossini, in her poem entitled "Final Love Note" and Louise Gluck, in her poem "Mock Orange," both use carefully chosen language to portray different aspects of the concept that we, in individual and often irrationa l ways, use to explain "love." These particular writers use words of love and hate to explain extremely passionate feelings toward their personal relationships-and nature, an elm tree, and a Mock Orange bush, to be exact. Clare Rossini's ", Final Love Note," reflects a depth of emotion that, on the surface, is directed towards an elm tree that has died and must be cut down. She opens the poem describing an intensely intimate state in a relationship, and it is her word choice that reflects deeper into her love, than merely sadness due to the loss of a tree. "For months we've been together, hardly wanton,/ never touching. Yet your shade commingled/ with my clot... ...n the world?" (lines 21-24). Although Gluck and Rossini write of separate experiences and emotions related to both love and plants, their word choice is what keys the reader in to their meaning. By evaluating the language usage of a poet, a reader comes to appreciate the careful planning and preparation that goes into each poem of value. These writers know each of the meanings and definitions of the words that they chose, and as we have seen with Gluck, and especially Rossini, that choice has a great impact on how a reader will relate to the poems. With such abstract concepts as love and intimacy, it is the word usage that a writer must rely upon to convey the appropriate message. Sources Cited Gluck, Louise. Mock Orange Available at http://www.geocities.com/bjlandry_00/Otherwriters/gluckmockorange.html Rossini, Clare. Final Love Note Class Handout

Acting To Save Mother Earth Essay -- essays research papers

Everday we hear more bad news about our planet. Reports tell us that wildlife and forests are disappearing at an alarming rate. Newscasts give the latest word on how quickly earth is losing its protective shirld and warming up. Newspapers lament the pollution of our air, water, and soil. What can we do in the face of such widespread gloom? In fact, we do not have to feel helpless. We can each learn practical ways to better our environment. For example, saving and recycling newspapers has a number of positive results. First, recycling newspaper saves trees. The average American consumes about 120 pounds of newsprint a year-enough to use up one tree. That means close to 250 million trees each year are destroyed for paper in this country alone. If we recycled only one-tenth of our newpaper, we would save 25 million trees a year. Second, making new paper from old paper uses up much less energy than making paper from trees. Finally, this process also reduces the air pollution of paper-making by 95 percent. Another earth saving habit is "precycling" waste. This means buying food and other products packaged only in materials that will decay naturally or that can be recycled. The idea is to prevent unrecyclable materials from even entering the home. For instance, 60 of the 190 pounds of plastic-especially styrofoam-each American uses a year are thrown out as soon as packages are opened. Be kind to your planet by buying eggs, fast food, and other products in cardboard in...

Traffic Jam In Jakarta

Jakarta’s traffic has always been a big problem for the government. Every morning Jakarta has been always and always enjoyed with the name stuck. Well, indeed, what can we do, as the center of the capital which will never slept through the night to come pick. Traffic jams are everywhere in Jakarta. It is hard for people in Jakarta and in its suburbs like Tangerang, Bekasi, Depok, and Bogor to move around. It takes too long than it should be to get to one place from another. The most significant causes of the problem lay on some factors. One of the causes is the number of vehicles in Jakarta.There are too many buses, cars, motorcycles, and any other kinds of public transportation in the streets. no longer wonder, when rain flooded and jammed into one hell feels like a home for all the work. Not just one or two hours, private car users can be up to 3 hours not moving. If we talk to dealing with this beautiful country, government is not honored will be no end. A little opinion on our system of government from the beginning until now. I think the bottleneck can be overcome by the reduction of private vehicles. Yes indeed, almost every head of the family has a personal vehicle. But all of this can we reduce the government a lot of money, funds allocation and so on.Make public transport comfortable, safe, plentiful, easy to reach, etc. With this people will switch to not use private vehicles. Why use a private vehicle anyway no public transport is safe, comfortable. Once people’s minds when they developed public facilities. It would certainly reduce the number of vehicles. Reduce pollution as well right? how do you cope with traffic, public transportation in Indonesia now just become a tool for criminals to rape, robbery, sexual abuse and many more. No wonder if the interest in public transport is less than private vehicles.If indeed there are many cases like this, remove the serious legal, proper and in accordance with the actors do. If public transpor t is made more secure, convenient, effective, would jam a little loose. At least the volume of vehicles is reduced because they prefer public transportation. It’s just not regularly public transport, indiscriminate parking, driving like crazy, especially away from the comfortable security. So, my opinion still haunts Jakarta traffic jam to us before public transport facilities could be improved and the system works. Provide safe and convenient  facilities, cheap price reach and act decisively on the laws, give severe punishment, retribution to the perpetrators of crime on public transport.With this, it might be a little to reduce traffic jam in Jakarta. Actually the government of DKI Jakarta has also think about the traffic jam problem and they come out with PRODASIH (clean air program). One of the example is â€Å"three in one† which means there should be three people or more in one car, but in the reality lots of the car owner use jockey to avoid the regulation. So it comes back to the people of Jakarta consciousness to make the traffic in Jakarta more enjoyable. If they can not do this then may be in the next year there will be all traffic jam in the street of Jakarta that make the people harder to go through even to go out of their home.I realize that now the traffic jam seems to be more crowded and long. Even in the place where usually never been any traffic jam now there is a jam and it is quite long and heavy. Maybe the government can be stricter about the regulation that they have already made. And I suggest to the government if the want to build street infrastructure such as the busway for Trans Jakarta they should make a better planning in it. Because what I see now is that they make it all in one time which make all the street suffering worse in traffic jam because all the street are under construction.Can’t you make it just one by one Mr.Goverment? because if you make it one by one it will be easier for others to find alterna tive way in order to avoid the street construction. To conclude, the city government must do the research in order to find the solution for these problems and build more facilities like highways and streets. Creating and implementing strict regulation for the traffic systems can also solve the problem.

Bad Habits while Driving Essay

For the revision of one of my essay’s, I choose to do my Illustration essay. For my illustration essay I choose to do the topic â€Å"Bad Habits While Driving.† Before some of the essay was wrong and supposedly copyrighted but I rewrote it into my words again so therefore this time it shouldn’t be wrong. Now on one of the quotes that I gave I forgot to give credit to the website and that was definitely copyrighted and I totally forgot to put that. I added the website to the statistic I gave and changed a few of the spelling and grammatical errors I noticed. So all in all I believe that this essay is better than my last. Hope you enjoy reading it. I remember the first time I got my license, I wanted everyone to see me and to see what I could do in the parking lot with my new truck. The first day I drove after I got my license I thought I knew everything there was about a vehicle and I could handle anything. Well I was wrong, there was a lot of things that I needed to learn and realize how dangerous it actually is driving. When I got out of school just like any teenager now a days was on there telephone texting and calling there parents or friends to hang out. They were getting behind the wheel of the car and driving off to go get something to eat and eating behind the wheel driving to fast trying to impress everyone. Driving is a privilege that should be taken serious and not have any distractions. There are some bad habits while driving that the every common person has from driving to fast, eating, and most worst habit using a cellphone. Every time you turn on a TV or listen to the radio nine times out of ten I  would bet that you would hear something about someone dieing in a car accident. I know for my self when I have to get someone on a certain time and I’m late I’ll drive fast to get there. That is one of the main reason of all accidents caused by. Each year in America there are about 32,000 people that die from speeding in a vehicle. You see in movies all the time people flying right through red lights and getting into a wreck and the person that was just sitting there dies. I remember when I was in the seventh grade my mom and grandma was sitting at this red light and it turned green, and my mom is one of them people who waits and sees if it is clear after the light turns green; after she checked she started to drive but next thing she knows they got hit in the back because the guy was going to fast and run the red light. There is no telling where I would have ended up if I would have lost my m om in that wreck that day. You can turn on the TV and you can see a commercial about texting and driving. They warn us about how bad it is to text and drive. In drivers education they made us watch a movie that showed the dangers of texting and driving, it showed these teenagers and the one driving was texting and they got in a wreck and died. If every the teacher or program could just tell each young driver how important it is on how dangerous it is to text and drive. But you know how us teenagers are is like we let it go through one ear and it goes out the other. According to the the study by the Cohen Children’s Medical Center in New Hyde Park, New York; texting and driving has surpassed drinking and driving and is the leading cause of death among teens. Dr. Andrew Adesman, Cheif Developmental and Behavioral Pediatrics, Cohen Children’s Medical Center told a reporter Carolyn Gusoff â€Å" The reality is kids aren’t drinking seven days per week, they are carrying their phones and textin g seven days per week, so you intuitively know this a more common occurrence.† Which is true, I don’t drink and don’t want to, but kids my age isn’t worried about carring around there alcohol they are more worried about seeing who’s texting them and where the parties are going to be at. Driving is a privilege and any body, young or old getting behind the wheel of a vehicle should always treat that machine with respect. A problem that I have while driving, is I am always rushing or in a hurry  and I have to eat on the go. I don’t like to but sometimes I have to. Although eating and driving is very danger’s I’ve come to be able to do it a lot better than I used to. â€Å"Distractions like eating can become a problem for drivers who can’t react quickly to a sharp curve,† according to a study by the National Highway Traffic Study Administration (http://www.nydailynews.com/). The same people say that a new study they have conducted stated that 80% of all car accidents and 65% of near misses are caused by distracted drivers more focused on their burgers than the road (http://www.nydailynews.com/). I never really knew how dangerous it was to just eat a burger and drive down the road, and also how much attention is lost when eating and driving. Driving is a privilege and it can become very dangerous from doing the little things to having no attention on the roads. I know for myself I’ll think twice about answering that text and driving a little to fast, or what I have a problem with is eating and driving. All those videos I watch in drivers ed. I can still picture the images of the boy who died in the crash from the other guy text while driving. So many lives are lost because we’re in a hurry or we have to do this, and we can’t wait. Life is to short for all nonsense we do while driving and we just shorten our lives every time we do it. So who’s with me and taking the vowel to never text and drive and eat and drive?