Nia Mack Essays (160 words) - Oliveira, Mesquita,

Nia Mack Period 2 http://www.bbc.com/news/world-latin-america-39813733 May 4, 2017 Brazil jailed eight men for planning attacks on the 2016 Olympics and for using the internet to promote ISIS. The men were arrested in August shortly after the games ended and after the FBI alerted Brazilian authorities. The ring leader, Leonid El Kadre de Melo, has been given a prison sentence of 15 years. The other men have been jailed for five to six years. The group had been sharing "bomb-making videos" online and via messaging apps. The men were not part of ISIS but tried to contact the group. Originally, 15 people were arrested. Seven suspects were later released, but the other eight were tried under Brazil's new anti-terrorism legislation. The six men jailed for six years are Alisson Luan de Oliveira, Oziris Moris Azevedo, Levi Ribeiro de Jesus, Israel Pe dra Mesquita, Hortencio Yoshitake, and Luis Gustavo de Oliveira.

Karl Doenitz - Bio of World War II German Naval Commander

Karl Doenitz - Bio of World War II German Naval Commander The son of Emil and Anna Doenitz, Karl Doenitz was born at Berlin on September 16, 1891. Following his education, he enlisted as a sea cadet in the Kaiserliche Marine (Imperial German Navy) April 4, 1910, and was promoted to midshipman a year later. A gifted officer, he completed his exams and was commissioned as an acting second lieutenant on September 23, 1913. Assigned to the light cruiser SMS Breslau, Doenitz saw service in the Mediterranean in the years prior to World War I. The ships assignment was due to Germanys desire to have a presence in the region following the Balkan Wars. World War I With the commencement of hostilities in August 1914, Breslau and the battlecruiser SMS Goeben were ordered to attack Allied shipping. Prevented from doing so by French and British warships, the German vessels, under the command of Rear Admiral Wilhelm Anton Souchon, bombarded the French Algerian ports of Bà ´ne and Philippeville before turning for Messina to re-coal. Departing port, the German ships were chased across the Mediterranean by Allied forces. Entering the Dardanelles on August 10, both ships were transferred to the Ottoman Navy, however their German crews remained aboard. Over the next two years, Doenitz served aboard as the cruiser, now know as  Midilli, operated against the Russians in the Black Sea. Promoted to first lieutenant in March 1916, he was placed in command of an airfield at the Dardanelles. Bored in this assignment, he requested a transfer to the submarine service which was granted that October. U-boats Assigned as a watch officer aboard U-39, Doenitz learned his new trade before receiving command of UC-25 in February 1918. That September, Doenitz returned to the Mediterranean as commander of UB-68. A month into his new command, Doenitzs u-boat suffered mechanical issues and was attacked and sunk by British warships near Malta. Escaping, he was rescued and became a prisoner for the wars final months. Taken to Britain, Doenitz was held in a camp near Sheffield. Repatriated in July 1919, he returned to Germany the following year and sought to resume his naval career. Entering the Weimar Republics navy, he was made a lieutenant on January 21, 1921. Interwar Years Shifting to torpedo boats, Doenitz progressed through the ranks and was promoted to lieutenant commander in 1928. Made a commander five years later, Doenitz was placed in command of the cruiser Emden. A training ship for naval cadets, Emden conducted annual world cruises. Following the re-introduction of u-boats to the German fleet, Doenitz was promoted to captain and given command of the 1st U-boat Flotilla in September 1935 which consisted of U-7, U-8, and U-9. Though initially concerned about the capabilities of early British sonar systems, such as ASDIC, Doenitz became a leading advocate for submarine warfare. New Strategies and Tactics In 1937, Doenitz began to resist the naval thinking of the time which was based on the fleet theories of American theorist Alfred Thayer Mahan. Rather than employ submarines in support of the battle fleet, he advocated for using them in a purely commerce raiding role. As such, Doenitz lobbied to convert the entire German fleet to submarines as he believed that a campaign dedicated to sinking merchant ships could quickly knock Britain out of any future wars. Re-introducing the group hunting, wolf pack tactics of World War I as well as calling for night, surface attacks on convoys, Doenitz believed that advances in radio and cryptography would make these methods more effective than in the past. He relentlessly trained his crews knowing that u-boats would be Germanys principal naval weapon in any future conflict. His views frequently brought him into conflict with other German naval leaders, such as Admiral Erich Raeder, who believed in the expansion of the Kriegsmarines surface fleet. World War II Begins Promoted to commodore and given command of all German u-boats on January 28, 1939, Doenitz began to prepare for war as tensions with Britain and France increased. With the outbreak of World War II that September, Doenitz possessed only 57 u-boats, only 22 of which were modern Type VIIs. Prevented from fully launching his commerce raiding campaign by Raeder and Hitler, who desired attacks against the Royal Navy, Doenitz was forced to comply. While his submarines scored successes in sinking the carrier HMS Courageous and the battleships HMS Royal Oak and HMS Barham, as well as damaging the battleship HMS Nelson, losses were incurred as naval targets were more heavily defended. These further reduced his already small fleet. Battle of the Atlantic Promoted to rear admiral on October 1, his u-boats continued attacks on British naval and merchant targets. Made a vice admiral in September 1940, Doenitzs fleet began to expand with the arrival of larger numbers of Type VIIs. Focusing his efforts against merchant traffic, his u-boats began to damage the British economy. Coordinating u-boats by radio using encoded messages, Doenitzs crews sank increasing amounts of Allied tonnage. With the entry of the United States into the war in December 1941, he commenced Operation Drumbeat which targeted Allied shipping off the East Coast. Beginning with only nine u-boats, the operation scored several successes and exposed the US Navys unpreparedness for anti-submarine warfare. Through 1942, as more u-boats joined the fleet, Doenitz was able to fully implement his wolf pack tactics by directing groups of submarines against Allied convoys. Inflicting heavy casualties, the attacks caused a crisis for the Allies. As British and American technology improved in 1943, they began to have more success in combating Doenitzs u-boats. As a result, he continued to press for new submarine technology and more advanced u-boat designs. Grand Admiral Promoted to grand admiral on January 30, 1943, Doenitz replaced Raeder as command-in-chief of the Kriegsmarine. With limited surface units remaining, he relied on them as a fleet in being to distract the Allies while focusing on submarine warfare. During his tenure, German designers produced some of the most advanced submarine designs of the war including the Type XXI. Despite spurts of success, as the war progressed, Doenitzs u-boats were slowly driven from the Atlantic as the Allies utilized sonar and other technology, as well as Ultra radio intercepts, to hunt down and sink them. Leader of Germany With the Soviets nearing Berlin, Hitler committed suicide on April 30, 1945. In his will he ordered that Doenitz replace him as the leader of Germany with the title of president. A surprise choice, it is thought that Doenitz was selected as Hitler believed that the only the navy had remained loyal to him. Though Joseph Goebbels was designated to be his chancellor, he committed suicide the next day. On May 1, Doenitz selected Count Ludwig Schwerin von Krosigk as chancellor and attempted to form a government. Headquartered at Flensburg, near the Danish border, Doenitzs government worked to ensure the loyalty of the army and encouraged German troops to surrender to the Americans and British rather than the Soviets. Authorizing German forces in northwestern Europe to surrender on May 4, Doenitz instructed Colonel General Alfred Jodl to sign the instrument of unconditional surrender on May 7. Not recognized by the Allies, his government ceased to rule after the surrender and was captured at Flensburg on May 23. Arrested, Doenitz was seen to be a strong supporter of Nazism and Hitler. As a result he was indicted as a major war criminal and was tried at Nuremberg. Final Years There Doenitz was accused of war crimes and crimes against humanity, largely relating to the use of unrestricted submarine warfare and issuing orders to ignore survivors in the water. Found guilty on charges of planning and waging a war of aggression and crimes against the laws of war, he was spared the death sentence as American Admiral Chester W. Nimitz provided an affidavit in support of unrestricted submarine warfare (which had been used against the Japanese in the Pacific) and due to the British use of a similar policy in the  Skagerrak. As a result, Doenitz was sentenced to ten years in prison. Incarcerated at Spandau Prison, he was released on October 1, 1956. Retiring to Aumà ¼hle in northern West Germany, he focused on writing his memoirs in entitled Ten Years and Twenty Days. He remained in retirement until his death on December 24, 1980.

Health and Wellbeing {physical fitness in adult from ages 28-40 years} Research Paper

Health and Wellbeing {physical fitness in adult from ages 28-40 years} - Research Paper Example Fortunately, not one wants or dreams to be sick in one-way or another, it is therefore everyone’s responsibility to create physical fitness schedules with qualified coaches or on their own. The ability to manage small and easy jogging sessions goes a long way in helping him adapt and increase his health and well being levels, and later do exercises that are more complex. This paper explores the importance of physical fitness in maintaining health and well being standards among the youth and elder people of between 28-40 years. It explains some of the practical fitness exercises that one can engage in to maintain his positive health status and well-being. Well being is an important state of the body that should be maintained by everybody irrespective of their age and other factors. Well being cannot merely be taken as the absence of disease or illness, as many people perceive it to be; instead, it is described as a complex combination of a person’s physical, mental, emotional as well as social health factors. Well being cannot be described as how a person feels about himself or herself, but how he takes considerable steps in ensuring that he is at peace with himself in his environment. For this reason, it is important that a person understands the particular requirements and factors to consider in maintaining his well-being. Health on the other hand refers to the state of absolute physical, mental as well as social well-being; in this case, it is not necessarily the absence of disease or infirmity in one’s body system. A person’s health status is largely determined by a multitude of various social, economic as well as cultural factors, in this case, people who live in a similar community or environment or those of a certain age bracket can have vastly different chances of good health. Sometimes, a person

None Research Paper Example | Topics and Well Written Essays - 1750 words

None - Research Paper Example This paper will present several principles of the Food Ethics, possible criticism for this approach as well as refutation of it. First of all, it would be highly important to provide a general perspective on the issue. Thus, one would not make a mistake pointing out that among the food that people consume there are certain groups of products that are different from others. For example, if pigs have been domesticated from numerous centuries and the production of their meat has been developed in great detail, there are some animals which are also consumed, but their meat or other parts of the body have been introduced to the people relatively recently. In addition to that, some meat might come from the animals the population of which is far less than the one of pigs or cows. Finally, the development of the science has brought up a new category of food which consists of Genetically Modified Organisms. So, the primary question focuses on the idea whether people have a moral duty to support certain food. Since the above mentioned question lies in the realm of Ethics, it would be logical to use several Ethical Theories than are relevant in this case. The first approach that is able to provide an answer to this problem is the Kantian Ethics. Thus, according to it, people should be considered to be responsible for the preserving of the wildlife as well as fragile ecosystems around the world and, therefore, they should never consume flesh of the animals that are endangered. In addition to that, since food that is made of Genetically Modified Organisms might be harmful to the bodies of the people, it should not be introduced to the market in any form. However, a completely different approach is presented by the Utilitarian Ethics. Indeed, it argues that there is no problem in eating meat of the endangered animals or the meat that was produced in a cruel way as long as it pleases the people and they are able to cope with the consequences of it.

How has the internet and social media changed our society Essay

How has the internet and social media changed our society - Essay Example This research will begin with the statement that the internet and social media has played a great part in transforming people’s life and making it be much easier and worth living it. In about 20 years ago, very few people had ever heard of the name internet if there were any. In 1991, if a person was asked to say what a domain name is, they could have looked at the one asking in a blank face. All that has changed since the internet was discovered. People use the internet services each and every day in their activities, which include online banking and communicating with their friends. Social media was launched about nine years ago. Social media has also changed the way people live to a better way since people can share their problems with their friends and get comfort and encouragement. The Internet can be considered as one of the greatest inventions that have been witnessed in our generation. This has prompted some people to claim that the internet has ushered in an important new revolution which they claim that is as important as the industrial revolution. The Internet has altered the way people communicate with each other, how people shop and how they get their information. The internet influence has spread far beyond the online world confines which have affected many aspects of the lives we live. One of the main ways the internet has transformed our lives is by giving us an access to any information that we need. It has helped in opening up a world of possibilities where information can be shared. Before internet was invented, students had a lot of difficulties doing their research since they had to do it in the library. That is not the case in the internet era since the information that the students want is right at their fingertips. There are search engines in the interne that have ready information that the students and other researchers look for. These search engines includes Google and Yahoo search engines (Golden 2010). The Google website is on e of the most successful sites which tend to be the most visited site and the leader in a market that is very competitive. Google has a big coverage and a high speed of results that makes it easier for the researchers. Internet has made the world to be seen as a global village. Internet has helped in eliminating communication barrier that is caused by geographical distance (Golden 2010). Through the social media sites, one can have friends from all over the world, from as far from Zimbabwe to China. Internet has also helped in growing of businesses. This is by having devices like the dedicated serves which allows the offices to remain connected every time. It has also made shopping easier which can nowadays been done online (Lyn Gorman and David McLean,2009). This has made the whole world to look like a normal shopping mall, where someone can buy dresses from Paris and designer shoes from London. Internet has also made banking easier, where one can bank online and manage their finances without having to go to the banking hall each and every time they need the banking services. In early days, searching for jobs was a difficult task where one could only find jobs from the local newspaper and the recruitment agencies (Dijck 2013). . This has however changed thanks to internet as one can now search for jobs online. Talking of jobs, internet has helped many people by giving them an opportunity to work on the comfort of their homes. This is through the online jobs where one can earn with their pajamas on. This is an easier way to work, where one becomes his or her own boss, meaning that they do not experience the wrath of the bosses as other workers do. However, the greatest gift that is brought by the revolution that internet has experienced is education, where a person can learn everywhere by having online classes (Golde

Pathophysiology Underlying Pernicious Anaemia Biology Essay

Pathophysiology Underlying Pernicious Anaemia Biology Essay The following essay explores the pathophysiology underlying pernicious anaemia, with reference to primary sources. In order to fully understand the pathophysiology of pernicious anaemia, normal physiology is also discussed. With this in mind, contemporary treatments and management strategies that are currently in place are then critically appraised using the latest literature. Pernicious anaemia, typically seen in the over 60s, is the most common type of megalobastic anaemia and is usually attributed to the end stage of type A chronic atrophic (autoimmune) gastritis, which in turn leads to Vitamin B12 (cobalamin) deficiency (Toh et al., 1997). Autoimmune gastritis and pernicious anemia are common autoimmune diseases with respective prevalences of 2 and 0.15-1% in the general population (De block et al, 2008). It only manifests once all cobalamin stores (from the liver) have been depleted. Fundamentally, pernicious anaemia results from a lack of intrinsic factor (IF), which is a glycoprotein required for the absorption in the gastrointestinal tract of dietary sources of cobalamin (Toh and Alderuccio, 2004). Pernicious anaemia presents with a vast spectrum of signs and symptoms, including glossitis, generalised weakness, parasthesia, weight loss, infections, nausea, confusion and an unsteady gait. On a long term basis, patients are predisposed to gastric cancer. Haematologically, erythrocytes are normochromic and megalobastic (mean corpuscular volume is increased above 80-95fl in adults (Hoffbrand and Proven, 1997)). The condition is more common in females and is also thought to be more common in people with blood group A. In addition, those with a family history of pernicious anaemia are at an increased risk, along with people suffering from other autoimmune diseases such as Addisons disease (Hoffbrand and Proven, 1997). A more thorough understanding into the pathophysiology of the disease will enable contemporary treatment and management of the disease to be critically appraised. Martens et al., (2002) explain that under normal circumstances, cobalamin is vital for nuclear maturation and DNA synthesis in erythrocytes by means of catalysing the action of methionine synthase and R-methylmalonyl-CoA mutase. Vitamin B12 cannot be synthesised by the body therefore dietary intake is essential. It is stored in the liver (2-5mg), and recommended daily amounts are 2-5ÃŽÂ ¼g (Malouf and Areosa, 2003). The pathway for absorption of dietary cobalamin is vital in maintaining hepatic stores. According to Berne et al. (2004), it takes four hours for cobalamin to appear in the blood following ingestion and peak plasma levels occur 6-8 hours after a meal. Andres et al., (2004) describe the metabolic pathway of cobalamin following ingestion. In short, cobalamin ingested in the diet is bound to animal protein which is released upon contact with pepsin and hydrochloric acid. Meanwhile, parietal and salivary cells release R-Protein which binds to the free cobalamin. Intrinsic factor is also released by parietal cells but this has a weaker affinity to cobalamin than R-Protein. The release of intrinsic factor by parietal cells is mediated by histamine, acetylcholine and gastrin which are physiological agonists of hydrochloric acid secretion (Berne et al., 2004). Pancreatic enzymes degrade both biliary and dietary cobalamin-R protein complexes. This releases free cobalamin, allowing it to bind with intrinsic factor. In the brush border of the ileum the intrinsic factor cobalamin complex attaches to mucosal cell receptors (cubilin) (Andres et al., 2004). Free intrinsic factor does not compete for binding, whilst free cobalamin is not recognis ed by cubilin (Berne et al., 2004). This highlights the importance of intrinsic factor. The cobalamin binds to transport proteins (transcobalamin I, II and III). Attached to the transcobalamin, the cobalamin is then transported systemically via the portal system. Absorption into the ileal cells occurs by means of receptor mediated endocytosis of the transcobalamin-cobalamin complex. The cobalamin is then separated from the transport protein and converted into one of two coenzymes, methylcobalamin and adenosylcobalamin. It should also be noted that passive diffusion of cobalamin occurs at a rate of 1.2% of that absorbed, across the small bowel (Nyholm et al., 2003). Once metabolised it then acts as a cofactor and coenzyme for DNA synthesis, methione synthesis from homocysteine and conversion of propionyl into succinyl coenzyme A from methylmalonate (Andres et al., 2004). As discussed above, cobalamin is essential for DNA synthesis. Inhibition of DNA synthesis in red blood cells results in the formation of fragile megaloblastic erythrocytes. In addition to this, symptoms involving the nervous system, such as parasthesia occur as a result of demyelination of neurones (Malouf and Areosa, 2003). In order to analyse treatments in place, the pathophysiology of pernicious anaemia will now be discussed. Much of the evidence surrounding pernicious anaemia connects it to autoimmune chronic gastritis. Later symtoms such as parasthesia are directly as a result of cobalamin deficiency. The lack of intrinsic factor required for the absorption of cobalamin is as a result of loss of parietal cells and antibodies towards both intrinsic factor and the parietal cells (Toh et al., 1997). In order to further understand the development of pernicious anaemia, the early stages of atrophic gastritis must first be understood. Alderuccio and Toh (2000) explain that in its early stages, atrophic gastritis begins with infiltration of the gastric submucosa with inflammatory cells. Over time, this extends into the lamina propria, which ultimately leads to the destruction of parietal and zymogenic cells. These are then replaced by mucus containing cells. Bergman et al., (2003) state that autoimmune gastritis, which underlies pernicious anaemia occurs due to autoantibodies to gastric parietal cells. Specifically, the H+/K+ ATPase part of parietal cells, which is responsible for the secretion of hydrogen by parietal cells, which are recognised by CD4+ T cells. Subsequently, achlorhydria, low serum levels of pepsinogen I and increased gastrin levels also results. In patients with pernicious anaemia, these autoantibodies, along with autoantibodies towards intrinsic factor can usually be detected in patient serum and gastric fluid, with levels being directly proportional to the concentration of parietal cells (Toh and Alderuccio, 2004). Toh and Alderuccio (2004) also explain that two types of intrinsic factor autoantibodies have been identified. Type I bind to the cobalamin binding site of the intrinsic factor, whilst type II bind to a remote site. Berne et al., (2004) state that these autoantibodies act by preventing the binding of cobal amin to the intrinsic factor. Toh and Alderuccio (2004) suggest that parietal cell antibodies are a marker of autoimmune gastritis, whilst intrinsic factor antibodies are actually a marked feature of pernicious anaemia. This is because the presence of only the antibodies to the H+/K+ ATPase of the parietal cell suggests that the gastric lesion is likely to remain at its preliminary stages. In contrast, when intrinsic factor antibodies are present the gastric atrophy is at its end stage, which is associated with pernicious anaemia. In patients with pernicious anaemia, 90% have intrinsic factor autoantibodies. However, as the parietal cell mass reduces, the number of antibodies reduces as a result of the loss of antigenic drive. Therefore the presence of parietal cell antibodies alone are not diagnostic of the progression to pernicious anaemia. Toh and Alderuccio (2004) also explain that as a result of limited research in the field over the past 30 years combined with a 20-30 year developmental timescale of pernici ous anaemia, it is currently unknown whether or not all patients positive for parietal cell antibodies will develop pernicious anaemia. Therefore, more research is required to confirm the developmental process of the antibodies. Genetic factors play a significant role in the development of chronic gastritis and therefore subsequently pernicious anaemia, demonstrated by the presence of autoantibodies and clustering of the disease within families and amongst those with underlying autoimmune diseases. Gorden et al., (2004) state that a lack of intrinsic factor secretion can be attributed to the destruction of parietal cells as a result of adult onset gastric atrophy, or it may be congenital. They claim that the congenital deficiency is thought to be autosomal recessive. Lahner and Annibale (2009) also suggest genetic susceptibility as a result of human leucocyte antigen- DR genotypes. In addition, they also provide a crucial link between pernicious anaemia and the development of intestinal type gastric adenocarcinoma and gastric carcinoid type I. De Block et al., (2008) suggest that in patients with type one diabetes the risk of autoimmune gastritis, in turn leading to pernicious anaemia is increased by three to five times. With this in mind, they suggest that this provides a strong rationale for the implementation of a screening programme with early diagnosis and periodic examination via gastroscopy. Toh and Gleeson (1997) also acknowledge that pernicious anaemia is associated with autoimmune conditions, especially those affecting the endocrine system such as autoimmune thyroiditis, type one diabetes and Addisons disease. However, they also recognise that chronic gastritis can also develop secondary to alcoholism, hot tea and smoking. In addition, partial or total gastrectomy causes intrinsic factor deficiency due to the loss of parietal cells. Helicobacter Pylori infection has been identified as a potential causative factor in the development of cobalamin deficiency (Kaptan et al, 2000). This is consistent with Hersko et al., (2006) who question previous claims that pernicious anaemia is a disease of the elderly. They agree that the autoimmune cascade is triggered by Helicobacter Pylori infection, occurring decades prior to the presentation of cobalamin deficiency. Toh and Alderuccio (2004) also state that Helicobacter Pylori is likely to induce autoreactive T cells, cause epitope spreading and bystander activation, although they do recognise that its involvement remains controversial. This should therefore be considered in the development of novel treatments, focusing on the screening and eradication of Helicobacter Pylori infection. Current recommendations for patients with autoimmune gastritis include testing and treatment (Toh and Alderuccio, 2004). Berne et al., (2004) discuss pernicious anaemia in childhood, which whilst is rare, should not be disregarded since this also challenges the idea of pernicious anaemia being exclusively a disease of the elderly. They claim that there are three forms in childhood which are autoimmune, congenital intrinsic factor deficiency (with normal pepsin and hydrochloric acid) and congenital Vitamin B12 malabsorption syndrome, where there are reduced ileal intrinsic factor cobalamin receptors. Ardill et al., (1998) proposed that in addition to intrinsic factor and parietal cells, there may also be an autoantibody to gastrin. They state that autoantibodies arise when there is a break down in immunological tolerance. In pernicious anaemia, gastrin levels are normally, but not always elevated due to achlorhydria at the end stage of autoimmune gastritis. This leads to failure of the negative feedback mechanism. However the recognition of potential gastrin autoantibodies may obscure plasma gastrin levels, giving lower results than would be the case without the presence of the autoantibodies. This suggests another potential line of treatment where more research is required to determine how effective it may be. Having discussed the pathophysiology of pernicious anaemia, current treatment and management of the disease will now be appraised. As discussed, cobalamin is essential for DNA synthesis. Pernicious anaemia is as a result of a lack of intrinsic factor leading to an inability to absorb cobalamin from the diet. With this in mind, current treatment in the UK involves regular intramuscular injections (monthly to three monthly), which bypass the gastrointestinal system, therefore avoiding any requirement for intrinsic factor (Nyholm et al., 2003). There is currently no long term cure of the disease with more focus on management as opposed to cure (Oh and Brown, 2003). Vidal et al., (2004) studied the effectiveness of oral versus intramuscular injections of Vitamin B12 in the knowledge that regular injections cost the health service time and money. Contrary to the UK, Canada and Sweden already use oral supplementation at doses high enough for passive absorption to take effect. Vidal et al., (2004) state that the passive diffusion of cobalamin across the ileum, without the requirement for intrinsic factor, accounts for 1.2% of the total absorbed. Therefore they propose through their own research, that a dose of 2000ÃŽÂ ¼g of oral vitamin B12 daily, reduced to 1000ÃŽÂ ¼g daily, then weekly, then monthly, is likely to be as successful as intramuscular injections at replacing hepatic stores and reversing short term haematological and neurological effects. Andres et al., (2008) state that in order to manage pernicious anaemia, 1000ÃŽÂ ¼g per day of oral cyanocobalamin is required. With a total storage in the liver of 2-5mg, and 1.2% of absorpti on occurring passively, hepatic stores should be replenished at this dose. Nyholm et al., (2003) also found oral to be equally effective whilst reducing costs of nurse visits and enabling patients to have the choice. They studied 89 patients over 18 months and found no haematological differences to intramuscular administration. Walraven et al., (2001) also agree and found that there would be substantial savings if guidelines were implemented on a national level to change the standard practice to oral versus intramuscular. More recently, Butler et al., (2006) carried out a systematic review comparing oral and intramuscular administration in Vitamin B12 deficient patients. Once again, they agreed with the above evidence. Lederle (1991) initially proposed oral supplementation as medicines best kept secret. Therefore, 19 years on, further research is still required for medics to use oral tablets preferentially with appropriate guidelines in place, or indeed to rule this out as an option. In order to ensure that patients are receiving the best possible treatment, effective tests must be performed to enable accurate diagnosis. Oh and Brown (2003) discuss the use of the measurement of methylmalonic acid and homocysteine levels which are raised in even the early stages of pernicious anaemia. The traditionally used Schilling Test is less sensitive and works by measuring urinary excretion of Vitamin B12, therefore estimating its absorption. Testing for Helicobacter Pylori would also dramatically improve outcomes by means of eradication of the infection (Alderuccio and Toh, 2004). Alderuccio and Toh (2004) also concluded that more research is required into the field of autoantibodies specific to pernicious anaemia. Further research would enable novel treatments to be considered. In addition, genetic testing may prove useful, since there is a confirmed link within families. Also, it has been suggested that regular screening should occur for those with other autoimmune condit ions (De Block et al., 2008). It should be questioned that with so much evidence to suggest that pernicious anaemia is directly associated with autoimmune gastritis, why is there not more screening in place to prevent its effects taking place. In addition, clear associations have been made within families and in individuals with other autoimmune diseases. In terms of the prevention of the autoimmune process, no cures have been found. However, more research should be implemented into the replacement of intrinsic factor. This would perhaps be an option since according to Berne et al., (2004) free intrinsic factor does not compete for binding at the mucosal cell receptors of the ileum. In addition, the eradication and treatment of Helicobacter Pylori should be addressed. In the meantime, the vast research that suggests that oral therapy may be just as effective as parenteral with large enough doses to take advantage of the passive diffusion of cobalamin across the small bowel. However, it is extremely important not to disregard the potential long term effects of pernicious anaemia, such as the predisposition to gastric carcinoma. This highlights the need to treat each patient on an individual basis, taking effective measures to monitor for changes. Word Count: 2533.

The Cancer of Ebonics :: Expository Exemplification Essays

The Cancer of Ebonics        Ã‚  Ã‚  Ã‚  Ã‚   American society has made concessions for many groups of people with special interests, such as animal activists, environmental activists and a host of ethnic groups. Tough animal rights laws have been passed to ensure the safety and future of a variety of species ranging from the domestic cat to the bald eagle. The development of Wetlands has been curtailed in an effort to protect our swamps and forests from extinction. Our educational system has implemented a program known as, English As a Second Language, which lends itself to the special needs of immigrants in our school systems. This program offers extra tutoring and extra time on tests for immigrants who primarily speak a language other than English. Dudley Scholarship and Bethel Foundation Scholarship, along with over twelve-hundred others, have been created exclusively for minorities in an effort to encourage furthering their education. A list of these scholarships can be found in Directory of Financial A ids for Minorities, 1993-1995. In an effort to promote equal opportunity in the work place, the United States Government adopted the Affirmative Action program, which forces companies to place a certain number of minorities within their work force. Now, some politicians and educators in this country want to make concessions for those Americans who have grown up learning to speak what some people call street slang, as opposed to speaking standard English, which at last I heard was still America's primary language. According to Caroline Boarder, a political columnist, a program known as Ebonics has been introduced in Oakland, Ca., as a way to bridge the gap between black English or bad English-speaking students and standard English-speaking students in an effort to raise reading and writing test scores of African Americans. She also states that the Oakland school board contends that this bridge is necessary because the speaking of Ebonics is genetically related to African Americans. ( Educators Sound Off on Ebonics, Washington Post, Jan 97) This hypothesis suggests that black students are incapable of learning the English language through conventional teaching methods, and we must devise an easier way to teach them. I encourage every tax paying American citizen to take a close look at this program; after all, it is you who will be paying the bill for its implementation. I agree with politicians and educators who have at least acknowledged the fact that our education system needs an effective way to instill proper English in all students across the country regardless of their race, but is Ebonics the answer?