Bottled water is safer than tap water Essay Example | Topics and Well Written Essays - 750 words

Bottled water is safer than tap water - Essay Example Mineral water accumulates various minerals as it flows over rocks before it is collected while spring water emanates from the ground, having no chance to collect minerals. Tap water is treated with chemicals before distribution to consumers. The major chemicals used for tap water treatment are Chlorine and fluorine. It is normally treated to eradicate any pathogens that might be present in the water, and which may cause diseases. This is water that is packaged directly from the source. It is significant due to the fact that it is taken in its natural state, without chemicals. Mineral water contains important elements such as calcium and magnesium that are needed in the body. They are acquired from water that flows along a course composed of rocks that are rich in minerals. Bottled water has established a market in the word population due to the standards that have been set by many governments in order to protect the consumers. It is advantageous because once packed, the water has a long shelf life. Bottled water can also be used for emergency supplies in cases of water shortage. Travelers can conveniently carry bottled water with them when they travel over long journeys. However, there has been a rise in the level of pollution in the environment, causing pollution in the natural water sources. Land fills and incinerators are a major source of pollutants. It is progressively becoming un-advisable for people t o drink bottled water because of the associated levels of pollution. According to Feldman (2003, p.27), â€Å"The quantity of plastic waste generate every year are predictable at half a million tons.† These are mainly disposed in land fills and incinerators. They end up polluting surface water bodies During the rainy seasons, soil erosion causes fertilizers and other pollutants emanating from land to be transported to the rivers, springs and wells, which are the major source of bottled water. Nutrients from the soil are leached in to the ground

Personality Assessments Essay Example for Free

Personality Assessments Essay Psychologists use the method of personality assessments to test personalities. Testing personalities is much like testing intelligence and because it measures something that is intangible and invisible it can be quite the difficult task. There are different theories of personalities and different methods of assessing those personalities; however some methods of assessment are shared between theories. The four theories are psychodynamic, humanistic, trait and social learning and all have different roots. The methods of assessment are projective tests, personal interview, objective tests, and direct observations. The projective tests consist of simple ambiguous stimuli that can elicit an unlimited number of responses. The personal interview is used to obtain information from the person being interviewed and can be structured or unstructured. An objective test is generally a written test that is administered and scored according to a standard procedure. Usually the tests require simple yes or no responses or for one answer among many to be chosen and are widely used. Direct observation observes a person’s actions in everyday situations over a long period. To assess the psychodynamic theory the methods of projective tests and personal interviews is used. To assess the humanistic theory objective tests and personal interview are used. To assess the trait theory objective tests are used. Social learning theory is assessed with the use of interviews, objective tests and observations. Direct observation observes a person’s actions in everyday situations over a long period. To assess the psychodynamic theory the methods of projective tests and personal interviews is used. To assess the humanistic theory objective tests and personal interview are used. To assess the trait theory objective tests are used. Social learning theory is assessed with the use of interviews, objective tests and observations.

Central Giant Cell Granuloma in Eight Year Old Patient

Central Giant Cell Granuloma in Eight Year Old Patient INTRODUCTION Central giant cell granuloma (CGCG) is a benign aggressive destructive osteolytic lesion of osteoclastic origin1 that ocur in the mandible and maxilla and accounts for approximately 7% of all benign tumours of jaws2. The world health organization (WHO) has defined CGCG as an intraosseous non-neoplastic lesion, consisting of cellular fibrous tissues that contain multiple haemorrhage multinucleated giant cells, and, occasionally trabeculae of woven bone3. The nature of CGCG is still controversial. Jaffe was hypothesized that this is a reactive and self curing lesion and included the terminology giant cell reperative granuloma. Later, the neoplastic hypothesis was raised to explain the aggressive subtype4. Recently, both reperative and neoplastic assumptions are true, so that CGCG lesions are patially reactive and partially neoplastic4. CGCG is an uncommon lesion that occurs in young adults before the age of 30 years with a female preponderance5. There was a peak incidence for males between the age of 10-14 years and for females between 15-19 years of age6. It is more common in the anterior mandible than in the maxilla. Histological characteristics are highly cellular, fibroblastic stroma with plump, spindle- shaped cells with a high mitotic rate; the vascular density is high. The multinucleated giant cells are prominent throughout the fibroblastic stroma but are not necessarily abundant. They are often located most numerously around of haemorrahge6. Clinically, CGCG shows a wide variety behavior that is ranging from a non-aggressive, asymptomatic (indolent) and slow growing lesions to an aggressive, large, expansive lesion with rapid growth and aggressive sign and symptoms. Choung et al.7were the first described between the differences aggressive and non- aggressive lesions based on signs and symptoms and histological features. Aggressive lesions are characterized by one or more of the following features: pain, paresthesia, root resorption, rapid growth, cortical perforation, and a high recurrence rate after surgical curretage. Radiogically, the lesion appears as a radiolucent area and it can be unilocular or multilocular with either well-defined or can be ill-defined margins8. Multiple lesions are rare and are often associated with a syndrome (i.e. Noonansyndorme, neurofibromatosistype I ) or with cherubism6. The radiological and histological apperances of CGCG are not pathognomatic, and therefore further examination such as blood tests, including calcitonin, phosphate, parathyroid hormone and alkaline phosphate levels must be performed to confirm the diagnosis and to exclude hyperparathyroidism8. One of the treatment choice for CGCG is curratege with or without adjuvant therapy, i.e. liquid nitrogen, cryosurgery, peripheral ostectomy and Carnoy’s solution and another treatment modality is aggressive en- bloc resection, resulting in varying degrees of deformity5. It results in serious mutilation of the jaw and face. Loss of teeth and of dental germs in young patients is also often unavoidable9. In growing patients, to preserve both aesthetic and functional necessity non-surgical methods such as intralesional injections with corticosteroids, IFN-ÃŽ ± 2a and systemic dose of calcitonin are increasingly used by clinicans. These alternative therapeutic strategies come in useful for large aggressive lesions to cure or reduce the size and thus minimize the need for extensive surgical resection that can result in functional and aesthetic deficits in young patients. Calcitonin therapy for CGCG was first announced by Harris in 1993 and since then several case reports have been published of successful treatment of this lesion using different types of calcitonin and different strategies of administration5. In this report a patient is presented with massive aggressive CGCG who were treated with salmon calcitonin, as a single treatment modality, after initial treatment with intralesional steroid had failed. CASE REPORT An 8- year- old male patient complaining of a tender/ non-tender swelling on the left mandibular molar area was referred to the oral and maxillofacial surgery service at the Selcuk University, Faculty of Dentistry, in 2010. There was neither medical history nor trauma. Physical examination †¦Ã¢â‚¬ ¦.cm, lymphadenopathy, Radiographically, in the left mandibular molar area a diffuse radiolucency†¦Ã¢â‚¬ ¦ Based on clinical and radiological findings pre-diagnosis of CGCG was made and laboratory investigations were required to eliminate hyperparathyroidism (brown tumors) before treatment. Parathyroid hormone levels were found in normal reference ranges. Additionally low level of haemoglobin and high level of creatinin and phosphate were examined. An incisional biopsy was performed under local anesthesia. Histologically diagnosis of the lesion was proved as CGCG. Because of the patient’s age and dental development conservative therapy was preferred. Intralesional steroid injections of a solution of Kenacort-A (10 mg/ml triamcinolone aqueous suspension, Bristol-Myers Squibb S.p.A, Loc.ta Fontana del Ceraso, Angani, Italy) were performed during 1 year but there was no resolution in the lesion. After initial steroid treatment was failed authors decided using intranasal (systemic) calcitonin treatment. Miacalcic ® 200 IU/day nasal spray (Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA) (calcitonin-salmon) was preferred and performed 2 yearlong. Luckily any side effect was seen and the patient was showed exceptionally good cooperation to treatment and. During systemic calcitonin therapy clinicians must be on the alert about some side effect such as bloating or swelling of the face, arms, hands, lower legs, or feet, chills, cough, difficulty with breathing, difficulty with swallowing, dizziness, fever, itching, joint pain, muscle aches and pains, nausea or vomiting, nervousness, puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue, skin rash, sweating, tightness in the chest, tingling of the hands or feet, trembling or shaking of the legs, arms, hands or feet, trouble sleeping, unusual weight gain or loss. Following calcitonin therapy there was a decrease in tumor size that was observed clinically. Preserving the teeth and growing jaw bone for natural mastication and facial aesthetic the tumor was not decided to operate. The patient has a three- year follow up and has any clinical or radiological sign or symptoms. DISCUSSION CGCG is an uncommon lesion that occurs more frequently in females. In most cases it appears before the age of 30 years. Mandibular lesion is more often than the maxillary lesion with a ratio 2:1. In the mandible the anterior and posterior regions are equally affected while in the maxilla, the anterior region is usually affected.(ant. Mu post. Mu) The clinical behavior of CGCG ranges from a slow growing asymptomatic swelling to an aggressive lesion that presents pain, local bone destruction, root resorption or tooth displacement. Some authors have classified CGCG into two types, based on clinical and radiographic features. The first is non-aggressive CGCG, which is characterized by slow, almost asymptomatic growth that does not perforate the cortical bone or induce root resorption and has a low tendency to recur. The second is aggressive CGCG, which is characterized by pain, rapid growth, expansion, and perforation of the cortical bone, radicular resorption and high tendency to recur. Histologically, CGCG is characterized by the presence of multinucleated giant cells (MGC) in background composed of mononucleated stromal cells (MSC) with ovoid or spindle-shaped mesenchymal nuclei. The giant cells are typically seen in a hemorrhagic field containing numerous poorly defined vascular channels, which may be quite prominent. A patchy distribution of cellular elements is one feature that helps differentiate CGCG fromtrue giant cell tumors. In aggressive lesions, Ficarra et al. reported more numerous giant cells in CGCG and Nougeria et al. showed that in aggressive lesions MGCs are usually more numerous, larger and uniformly scattered throughout the lesion. Flanagan et al. were the first to demonstrate that giant cells in CGCGs are osteoclasts through osteoclast- specific monoclonal antibodies staining. This report was provide in vitro reaction of giant cells to calcitonin and showed the behavior of giant cells in cortical bone excavation typical of osteoclasts. It has been demonstrated that giant cells express calcitonin receptors. Calcitonin therapy is based on these findings. It is though those giant cells are directly inhibited in their function by calcitonin. Others, however, debate that CGCGs develop from mononuclear precursor cells and, as such, are part of the granulocyte/macrophage lineage or are primarily of fibrotic origin. Although giant cells are the most prominent histopathological feature of CGCGs, the focus of interest has shifted to the role of the mononuclear cells. Recent studies have shown that mononuclear cells, rather than the giant cells are proliferating compartment responsible for the biological activity of the lesion. de Lange et al. reported that the giant cells of CGCG are derived from subset of mononuclear phagocytes. These mononuclear precursor cells differentiate into mature giant- cells under the influence of RANKL expressing, proliferating, spindle shaped (osteoblastlike) stromal cells. Nougeria et al. designed a study to determine receptors of MGCs and find out their origin. This study showed, positive immunohistochemical expression of receptor activator of nuclear factor –kB (RANK), tartrate- resistant acid phosphatase (TRAP), vitronectin receptor (VNR) and calcitonin receptor and these findings have suggested on osteoclastic phenotype for MGCs. The presence of CD68 glycoprotein and alpha-1-antichymotrypsin has suggested that MGCs have a macrophage/hystiocyte origin. In the light of these findings aim of the treatment of CGCGs should include both inhibit osteoclastic activity of the lesion and inhibit the differentiation of macrophage/ hystiocyte precursors into osteoblast like cells. Traditional treatment for CGCGs is surgical curettage. Some authors proposed excision via curettage for treatment of CGCGs and the overall recurrence rate has been reported to range from 16 % to 49 %. A higher incidence of recurrence was found in aggressive CGCG and younger patients, especially males. In growing patients, aggressive surgical approaches may result in facial deformities and patients may lose some of tooth germs. Eisenbud et al. indicate that surgical curettage with peripheral osteotomy is still not the safest treatment for CGCGs especially in aggressive lesions. The functional and aesthetic alterations as well as the psychological consequences caused by the surgical treatment of CGCG have encouraged researchers to look for effective alternative therapeutic strategies. Alternative therapeutic options for CGCGs are systemic calcitonin intralesional injection of corticosteroids and IFN-ÃŽ ±. Calcitonin has been administered as a nosespray and as subcutaneous daily injections. Recently only nosespray form is available. This hormone increases the influx of calcium into the bones, functions as an antagonist to parathyroid hormone, and inhibits osteoclastic bone resorption. Calcitonin has also been hypothesized to directly inhibit giant cells. In 1993 Harris was first reported total remission of CGCGs in 4 patients. On the contrary Kaban et al (1999) observed a significant growth following calcitonin therapy. Response of patients to calcitonin therapy is variable. Many factors can contribute to the various responses to calcitonin which have been reported in the literature. The different types of calcitonin (human, salmon) and the different types of administration (subcutaneous injections, nasal spray) are some of these factors. With regard to the efficacy of calcitonin therapy, 3 phenomena have been recognized: Primary resistance or primary non-response is noted. There is the so-called plateau phenomenon, denoting that the alkaline phosphates serum levels cannot be lowered beyond a certain point, irrespective of the calcitonin dose. The third potential problem is secondary resistance, also called the escape phenomenon. Patients who initially react well to calcitonin show a diminished reaction after some time. Increased activity of osteoclasts through loss of calcitonin receptors is the more likely explanation for this phenomenon. Intralesional corticosteroids injection for CGCGs treatment was first reported by Jacoway et al. (1988). This method hypothesized that the extracellular production of bone- resorption- mediating lysosomal proteases by giant cells in inhibited by steroids which also induce apoptosis of the osteoclast- like cells. In English literature, complete remission results from intralesional administration of corticosteroids in insufficient and the number of patients is very small. Especially, in large cases intralesional corticosteroid therapy may not be effective and may not provide of reduction in size. No reports in which the effectiveness of intralesional corticosteroid injection for CGCG is described separately for the aggressive type and non- aggressive type are available. Nougeria et al. indicated that MGCs may be similar to osteoclasts and macrophages/hystiocytes and that CGCG can be prompted to respond to calcitonin or intralesional glucocorticoid as shown in the literature. They reported the expression of glucocorticoid and calcitonin receptors in CGCG before and after treatment with intralesional injection of steroids. They concluded that glucocorticoid receptor expression in the MGCs was higher in patients with a good response. The difference in calcitonin reseptor expression was not statistically significant between the aggressive and non- aggressive lesions and between the patients with a good response and with a modatare/negative response to treatment. Although aggressive CGCG had higher calcitonin receptor expression no significant difference in calcitonin receptor expression in different clinical forms of CGCG was found in this study. The treatment response was determined using previously described scores. In which four criteria were conside red: stabilization or regression of the lesion size evaluated clinically and in follow-up radiographs; the absence of sumptoms; increased radio-opacity in radiographs, representing peripheral and/or central calcification of the lesion, increased difficulty in solution infiltrating the lesion during the sequence of applications. If a case provided all of these, the response was determined to be good; providing two or three criteria was determined to be moderate; and providing one criteria or no criteria implied a negative response to treatment. Another alternative therapeutic agent is IFN-ÃŽ ±, it has angiogenic potential and it is a mediator in differentiation from mesenchymall cells to osteoblasts thus leading to an increase in bone apposition. Similar to corticosteroids IFN-ÃŽ ± is also capable of stopping rapid growth of their lesions and reducing their size, but it still necessary to use additional surgery to eliminate the lesion. In the literature only one case report was showed complete remission with IFN-ÃŽ ± therapy. Several reports suggest that IFN-ÃŽ ± administered as a monotherapy for aggressive CGCGs is useful for inhibiting the rapid growth of lesions and for reducing their size. Total remission of lesion cannot be achieved, because IFN-ÃŽ ± has no direct inhibiting effect on proliferating tumor cells and additional surgery is probably still required to eliminate lesions. Therefore, the effectiveness of monotherapy with IFN-ÃŽ ± is still questionable. CGCG is found predominantly in young adults. Surgical treatment of these patients might have resulted in physical and psychological disorders, such as developmental disorder of the mandible, dysfunction of mastication, and facial deformities, non- surgical treatment with systemic calcitonin administration which is a minimally invasive procedure and less costly and should be considered the first choice for treatment of CGCG in young patients.

A Reasonable Approach to Euthanasia Essay -- Euthanasia Physician Assi

A Reasonable Approach to Euthanasia      Ã‚  Ã‚   One of the biggest controversies of this decade is euthanasia. Euthanasia is "inducing the painless death of a person for reasons assumed to be merciful?(Henrickson and Martin 24). There are four types of euthanasia voluntary and direct, voluntary but indirect, direct but involuntary, and indirect and involuntary. Voluntary and direct euthanasia is "chosen and carried out by the patient.? Voluntary but indirect euthanasia is chosen in advance. Direct but involuntary euthanasia is done for the patient without his or her request. Indirect and involuntary euthanasia occurs when a hospital decides that it is time to remove life support (Fletcher 42-3).    Euthanasia can be traced as far back as to the ancient Greek and Roman civilizations. It was sometimes allowed in these civilizations to help others die. Voluntary euthanasia was approved in these ancient societies. As time passed, religion increased, and life was viewed to be sacred. Euthanasia in any form was seen as wrong (Encarta 98).    In this century there have been many groups formed that are for and against euthanasia. In 1935 the first group that was for the legalization of euthanasia was formed. It was called the Voluntary Euthanasia Society and was started by a group of doctors in London (The Voluntary Euthanasia Society). The first society established in the United States came shortly after in 1938. It was called the Hemlock Society and it now consists of more than 67,000 members. The purpose of this society is to support your decision to die and to offer support when you are ready to die (Humphrey 186). This society also believes that a person must have believed in euthanasia for a certain amount of time be... .... Jack Kevorkian." Online. Internet. 25 Oct. 1996. Final Exit.org. Fletcher, Joseph. "The Case for Euthanasia." Problems of Death. Ed. David L. Bender. St. Paul: Greenhaven Press, 1981. 37-45. Harris, Curtis. "Withholding Food and Fluids: What Happens." Life Cycle. April 1991: 4. Henrickson, John and Thomas Martin. "Euthanasia Should Not Be Permitted." Problems of Death. Ed. David L. Bender. St. Paul: Greenhaven Press, 1981. 23-26. Horkan, Thomas. "Legislation That Complicates Dying." Eds. Gary McCuen and Therese Boucher. Hudson: Gary McCuen Publications, 1985. 69-72. Humphry, Derek. Dying With Dignity. New York: Birch Lane, 1992. Pahl, Stewart. "I Favor Merciful Termination of Life." Problems of Death. Ed. David L. Bender. St. Paul: Greenhaven Press, 1981. 18-22. Voluntary Euthanasia Society. Online. Internet. 14 Jan. 1999. ves.com.

Marilyn Monroe Essay

I have way too many influential people in my life. One too many. However there is one person I’ve looked up to for the past couple of years that really stood out from all the rest and although she doesn’t live today, I’m sure many young girls such as I look up to her and see her as an inspirational icon. Her birth name is Norma Jeane Mortenson but she’s greatly known today by her stage name, â€Å"Marilyn Monroe†. She was an actress, singer, model, showgirl, and soon also became a major sex symbol.   I look up to Marilyn, not only because of how good-looking she was, but because Marilyn Monroe was an incredible person that had gone through soooo many rough patches all throughout her life. She was very up front and bold and didn’t give a damn about what anyone thought about her and what she did, she was very smart. Not just book-smart, but street-smart too. Marilyn Monroe was an amazing person and I can go on and on about her and how wonderful she was. And still is to this day. Read more:  Person to admire essay Marilyn Monroe, as I said, had many rough patches all throughout her life. In a way, she relates to me. Very rebellious and like I said earlier, didn’t care what anyone else around her thought about her, just as long as she had her fun. She was a singer, which is one thing I most definitely love about her. Also, the fact that Marilyn has many of these quotes†¦ if you read all of the quotes from Marilyn Monroe, you’d definitely fall in love with them, just like I have. She came out to be deep and wise with the words she had left behind for the entire world to know. She seems to me†¦ as a realist and also a feminist, which I DEFINITELY LOVE to death, because I’m both a realist and also a feminist. The way she was growing up†¦ it seemed to me that everyone, well most, had tried bringing her down and holding her back most of her life. Telling her in a way that she couldn’t become whatever she wanted to become. That she wouldn’t be able to peruse any of her dreams. That she really wouldn’t go anywhere in her life. Despite all of the let downs and all the people who had tried to bring her down, Marilyn Monroe was still a strong person, who, despite what anyone said, proved them all wrong. I respect and look up to Marilyn Monroe for her confidence, her beauty, her  talent, and also for her perspective on many things in life. Although she had died at such a young age, Marilyn truly did bring out the meaning of â€Å"living life to the fullest†. She made the best out of her life. Had fun, day and night. She had persued her dreams and I look up to her for it because she just basically shows that you can do anything only if you set your mind to it and you let no one get in your way. It’s one of the reasons why I admire Marilyn Monroe so much.

African-American History and Women Timeline 1990-1999

African-American History and Women Timeline 1990-1999 More of the  Timeline:  1980 - 1989  /  2000 - 1990 Sharon Pratt Kelly elected mayor of Washington, DC, the first African-American mayor of a major American city Roselyn Payne Epps became the first woman president of the American Medical Association Debbye Turner became third African American Miss America Sarah Vaughan died (singer) 1991 Clarence Thomas nominated for a seat on the US Supreme Court; Anita Hill, who had worked for Thomas in the federal government, testified about repeated sexual harassment, bringing the issue of sexual harassment to public attention (Thomas was confirmed as Justice) Marjorie Vincent became fourth African American Miss America 1992 (August 3) Jackie Joyner-Kersee became the first woman to win two Olympic heptathlons (September 12) Mae Jemison, astronaut, became the first African-American woman in space (November 3) Carol Moseley Braun elected to the US Senate, the first African-American woman to hold that office   (November 17)  Ã‚  Audre Lorde  died (poet, essayist, educator)   Rita Dove named the US Poet Laureate. 1993 Rita Dove became the first African American poet laureate   Toni Morrison  became the first  African-American  winner of the  Nobel Prize for Literature. (September 7) Joycelyn Elders became the first African American and first woman US Surgeon General (April 8) Marian Anderson died (singer) 1994 Kimberly Aiken became fifth African American Miss America 1995 (June 12) Supreme Court, in Adarand v. Pena, called for strict scrutiny before establishing any federal affirmative action requirements Ruth J. Simmons installed as president of Smith College in 1995. becoming the first African-American president of one of the Seven Sisters 1996 1997 (June 23) Betty Shabazz, widow of Malcolm X, died of burns sustained in a June 1 fire in her home 1998 DNA evidence was used to test the theory that Thomas Jefferson fathered the children of a woman he enslaved, Sally Hemings most concluded that the DNA and other evidence confirmed the theory (September 21) track and field great Florence Griffith-Joyner died (athlete; first African-American to win four medals in one Olympics; sister-in-law of Jackie Joyner-Kersee) (September 26) Betty Carter died (jazz singer) 1999 (November 4) Daisy Bates died (civil rights activist) More of the Timeline:  1980 - 1989 / 2000 -