Relationship between obesity and type 2 diabetes.

Relationship between obesity and type 2 diabetes. Diabetes and obesity have been highest in the most serious threats in worlds health. Diabetes is now one of the serious chronic diseases which have affected many of the Australians as it is the sixth highest cause of the death by disease in Australia (â€Å"Type 2 Diabetes and Obesity still on the Rise† 2007). It is caused by the constant increase in the blood glucose level in the body due to the inability to either produce or properly use insulin, which lead to many complications which can be acute and long term (Greenbaum Harrison, 2008, pg. 1). According to the recent data, it has been shown that the prevalence of diagnosed diabetes has been doubled from the last studies. This disease and it complications were found to 8% of the total burden of disease in Australia in 2003 such as person with diabetes is at twice at the risk of developing cardiovascular, eye and kidney disease (Australian Institute of Health and Welfare, 2008). This article is mainly based on the data from 200-08 National Health Survey conducted by the Australian Bureau of Statistics. It involves type 2 diabetes related factors such as demographics, medical history, height, weight, smoking, and physical activity. In 2007-08, national health survey estimated that 818,200 people or 4% of the population have been diagnosed with diabetes which excludes gestational diabetes (Australian Government: Department of Health and Ageing, 2009). By comparing this data with data from 2004-05, it has been increased by 0.5% that is number of people reporting to have diabetes is increased from 700,000 to 818,200 (Australian Bureau of Statistics, 2010). Recent national data indicate that with every one diagnosed case, there is one undiagnosed case (Australian Institute of Health and Welfare, 2008). Type 2 diabetes is the most common type of diabetes as people diagnosed with diabetes, 88% reported to have this type 2 diabetes where as only reported to have type 1 diabetes. The other 2% left was not being diagnosed with particular type of diabetes. Even though there is increase in number cases of developing this disease, there is also improvement in early detection of this disease and people are living longer (Australian Government: Department of Health and Ageing, 2009). There are more cases of type 2 diabetes since 2004-05 survey, it increased from 83% to 88% in total diagnosed diabetes. Type 2 diabetes increases in obesity and physically inactive lifestyles, and with the age. Diabetes is more prevalent among Aboriginal and Torres Strait Islander peoples as compared to non-Indigenous people. Demography does play a role in diabetes prevalence as it was least prevalent among people born in north-west Europe (2.7%) as compared to people born in southern and central Asia (8.7%). Be ing overweight and lack of physical activity can increase the risk of developing type 2 diabetes (Australian Bureau of Statistics, 2010). The majority of diabetes is classified into two types that is type 1 which is insulin dependent diabetes and second is type 2 which is insulin independent diabetes. Type 1 diabetes can be defined as an autoimmune destruction of pancreatic beta cells which slows or stops the production of insulin in the body. Type2 diabetes can result from insulin resistance that is inability to use insulin properly or insulin deficiency that is inability to produce adequate amount of insulin in the body (Type 2 Diabetes and Obesity Research, 2007, p. 1). This type 2 diabetes is responsible for 85-90% of all diabetes (Greenbaum Harrison, 2008, pg. 1). Due to the inadequate insulin production, body could convert sugar which is present in the blood in the energy needed for that body. After eating, body need insulin which is produced by pancreas to transport sugar from the blood into the cells and also to inhibit the production of glucose produced in liver. When inadequate insulin is produced by the bod y, glucose is overproduced by the liver which stays in the blood. This cause high blood sugar level which damage blood vessels and body organs (â€Å"Diabetes Type 2† n.d.). Type2 diabetes can be caused by both genetic and environmental factors. Some genes can cause impaired insulin production in the body and family history can also increase the risk of developing diabetes. Other lifestyle factors such as poor diet, obesity and lack exercise can also cause diabetes. Obesity is the most common factor which is found in most the people suffering from type2 diabetes (â€Å"Diabetes Type 2† n.d.). Obesity defined as having body mass index greater than 30 kg/m2. Obesity is the major risk factor for the type2 diabetes that is more is the body mass index (BMI) greater is the risk of diabetes which is also associated with hypertension, cardiovascular disease and hyperlipidaemia (Marks, Coyne, Pang, 2001). As per the research 90% of the people suffering from diabetes are obese or overweight (World Health Organization, 2005). As per researched statistics, over 7 million Australians adults were obese in 2004-2005. Obesity is a serious health problem which is mainly influenced by various risk factors such as heredity, diet, and lack of exercise. Type 2 diabetes cases in 2009 versus Body Mass Index Data sourced from (â€Å"Australian National Diabetes Information Audit and Benchmarking†, 2009, pg. 139). This graph above shows the increase in the prevalence of type 2 diabetes with an increase in Body Mass Index (BMI) that is BMI greater than 30 is at the highest risk of developing diabetes type 2. Insulin resistance Insulin resistance refers to metabolic abnormality state in which body cells become insensitive to insulin. Inability of cells to utilise insulin to enhance glucose uptake by muscle and adipose tissue can lead to high blood glucose level. This insulin resistance is mainly associated with abdominal obesity and high blood pressure (Dolson, 2010). This insulin resistance can be both genetic and acquired. Impairment in insulin receptor signal transduction pathways can decrease the biological response to insulin which will ultimately affect glucose uptake and increase in blood glucose (Surampudi, Kalarickal Fonseca, 2009, p.218). Acquired insulin resistance is associated with obesity which can result from circulating free fatty acid that disrupt insulin signal pathways and resists insulin action to transport glucose in muscles which cause type 2 diabetes. (Guilherme, Virbasius, Puri Czech, 2008, p.367). There are more factors which are involved such as fat distribution, genetic susceptibility and some metabolic problems. Fat distribution Body fat can be divided into two parts, first is subcutaneous fat which accounts 80% of the total body fat where as other 20% is visceral fat which lies within thorax, abdomen and pelvis (Langin et al, 2009). This visceral fat is the main contributor to the problems such obesity. This visceral fat increase the production of adipocytokines, which cause the inflammation and insulin resistance and also reduce the secretion if insulin sensitizing adipocytokines. Hepatic and muscle insulin resistance can be caused by the increased amount of free fatty acids in the portal and systemic circulation system (Bays et al, 2004). Study revealed that distribution of the abdominal fat is more effective in diagnosing diabetes than the total abdominal fat. Through CT scanning, they found that the diabetics had greater amount of intra-abdominal fat than non-diabetic groups with the mean difference of 14.1 cm3. Stieler and Yelland (2009) elaborates that the abdominal fat within the peritoneum layer is more common with diabetic patient that non-diabetic patients. Free fatty acids Lipolysis refers to breakdown of triglycerides into free fatty acids which is more frequent in visceral tissue than the subcutaneous fat. When fat mass increases, it increases the rate of lipolysis which is more common in obese people and those with type 2 diabetes. These free fatty acids stimulate gluconeogenesis and can lead to insulin resistance and also reduce the insulin secretion. The ability of ÃŽ ² cells to secrete sufficient insulin so as to compensate insulin resistance in the individual to maintain their normal blood glucose level will help to determine that whether the person will remain insulin resistant with normal glucose level or will the person develop type2 diabetes (Whitmore, 2010, p.880-881). Adipocytokines Adipose tissue in the body helps for the fat storage which increases insulin sensitivity by secreting large amount of cytokines and other related hormones. Bays et al (2004) states that in type2 diabetes, due to the reduced secretion of adipocytokines and increased production of inflammatory cytokines can cause adipocyte dysfunction. To prevent this dysfunction, it is important to control cytokines in the body system. As per Dewan Wilding (2005), these hormones can be controlled by reducing body weight/mass. Adipose tissue plays an important role in balancing glucose level in the body in both normal and disease body state. It helps to secrete appropriate level of adipokines which influence metabolism in the whole body and neuroendocrine control of the behaviours related to feeding. It also helps to store lipids as adipose triglycerides which reduce the harmful effects of both circulating free fatty acids and ectopic triglycerides stores. In the normal body, adipocytes help to synthesise and store triglycerides during feeding whereas in fasting stage, it help to hydrolyse and release triglycerides as free fatty acids and glycerol. In most lean individuals, insulin sensitivity and glucose uptake is normal in skeleton muscles. In obese body, deposition of triglycerides increases due to high caloric intake which cause adipocytes enlargement. Due to this enlargement, adipocytes continue to store further triglycerides even in fasting stage. As the adiposity increases, it affects adequate funct ioning of adipocytes as endocrine cells. The development of inflammatory state in adipose tissue due to large amount cytokines secreted by adipocytes can cause insulin resistance. Accumulated triglycerides in the form of long chain in skeleton muscles disrupt normal metabolic and secretory function of these tissues. Due to prolonged high caloric intake can cause inflammatory response which ultimately leads to adipocyte dysfunction (Guilherme, Virbasius, Puri Czech, 2008, p.368-369). Prevention/ management of Type 2 diabetes Poor dietary habits decreased physical activity and obesity can increase the risk of developing diabetes as it affects insulin action or secretion in the body system. Therefore it is important to control the unwanted weight gain. To address the significant growth of type 2 diabetes and to lower its risk, Council of Australian Governments announced the Prevention of type 2 diabetes program in April 2007. To address risk for type 2 diabetes, health practitioners use Australian type 2 diabetes risk assessment tool (AUSDRISK) which help to prioritize people with high risk of developing this diseases. Some of the other program which assists in prevention of type 2 diabetes is lifestyle modification program (Australian Government: Department of Health and Ageing, 2010). Australian type 2 diabetes risk assessment tool (AUSDRISK) which will help to get a score from the question related to ones life. If a person scores more than 12 points in AUSDRISK, than that person may have undiagnosed type 2 diabetes or is at high risk of developing this disease (Australian Government: Department of Health and Ageing, 2010). Lifestyle modification programs help participants to make positive lifestyle changes which include diabetes risk factors, nutrition advice and education, goal setting for weight loss, energy balance, physical activity goals and encouraging participants to self-monitor their progress (Australian Government: Department of Health and Ageing, 2011). National health survey, 2007-08 showed that 61.4% of the Australian population are either overweight or obese in which 25.6% of males and 24% of females were classified as obese (Australian Government: Department of Health and Ageing, 2010). It is not possible to change specific risk factors like age and genetic background but it still possible to minimise the risk of developing this disease by maintaining healthy weight, healthy eating such as eating plenty of vegetable, fruits and high fibre cereal products every day, and by increasing physical activity. Type 2 diabetes is strongly linked to obesity as recent data showed that 80-90% of people diagnosed with type 2 diabetes are over-weight or obese. International studies revealed that regular physical activity of at least 30 minutes and 5-7% of weight loss can reduce the risk of developing diabetes by 60% (â€Å"Type 2 Diabetes and Obesity still on the Rise† 2007). This weight loss can reduce the risk of related comorbidities such as cardiovascular diseases, sleep apnoea and obesity-related malignancy by improving blood glucose level and blood pressure. People with type 2 diabetes will need to work 50% more than non-diabetic people to lose weight it can be a slower process as compared to general population and will be more difficult for the obese patient suffering from type 2 diabetes (Whitmore, 2010, p.881). Using pharmacotherapy for obesity like orlistat that works well by blocking the hydrolysis of dietary triglycerides and inhibit fat absorption. Bariatric surgery can also be one of the option for the patient with BMI more than 35 kg/m2 (Whitmore, 2010, p.884-885). Conclusion Obesity and type 2 diabetes are strongly linked as obese person is at the higher risk of developing type 2 diabetes than the normal person with the healthy weight. Healthy weight, healthy eating and regular physical activity will improve insulin sensitivity, blood glucose level and the other health related issues such as cardiovascular risk factors. Weight management will the best way to reduce the risk of developing this disease. By using the AUSDRISK and diabetes related programs initiated by Australian government will help to prevent type 2 diabetes.

Death of a Salesman, Arthur Miller :: essays research papers

Dangerous Ground of Illusion Relations between fathers and the younger generation have been and continue to be an important theme for various literary genres (King Lear, Shakespeare; Fathers and Sons, Turgenev). For many famous writers the significance of fathers’ influence on their children forms a subject of particular interest. . In the play, Death of a Salesman, Arthur Miller shows in a very striking manner that the father's influence can be either positive or fatal. The dispiriting story of the three generations of the Lomans family contrasts with the happy account of the life of their neighbors, Charley and his son Bernard. The author details father-and-son relations in the Lomans family over a long period of time. He effortlessly demonstrates that a younger generation both inherits the father's way of life and assimilates his best or worst features. He tells us almost nothing about Willy Loman’s, the main character's, father. All we know is that he played a flute. Also he was a handy man, because he invented a gadget to make flutes. He was making and selling flutes, traveling across the country in a wagon. He took his family with him wherever he went. When Willy was about four years old, his father went to Alaska seeking to earn a fortune and disappeared amidst Alaska's expanses. Though the period when his sons Ben and Willy were with him was short, it left an indelible impression on the boys’ memory. Later, each of them inherited a part of this way of life: the older son Ben got a passion for adventure and travel, and the younger son Willy got a profession of salesmen and an interest to work with wood. Though the father's influence was quite indirect; he mostly figured in their afterglow and rather idealistic fancies, both of them became decent and hard-working people. At the age of seventeen, Ben left his home for Alaska, but soon found himself in Africa and at twenty-one he was already rich. He spent the rest of his life in Africa where he died. He was a wealthy, influential and successful man and fathered seven children. He preferred to be brutal but effective, as befits the jungles of life. On one of his brief visits to Willy's home he admonished Biff, his nephew: "Never fight fair with a stranger, boy. You'll never get out of the jungle that way." Unlike his elder brother, Willy did not have enough strength to be aggressive and to take advantage of the opportunities offered by life.

The Life of William Carlos Williams Essay -- English Literature Essays

The Life of William Carlos Williams â€Å"Nothing whips my blood like verse.† These are the famous words of the great poet, William Carlos Williams. Williams was born on September 17, 1883 in Rutherford, New Jersey. He spent most of his life in Rutherford, so today he is a local hero. Williams’ mother was Puerto Rican and almost had pure Spanish blood. His father was American. As a child, Williams’ dad was a salesman and was often away from home. Thus, they didn’t see each other very much. When Williams was four, he attended school in Switzerland and France for three years. Then his family moved back to Rutherford. Williams started writing poetry at Horace Mann High School, in New York City. His parents loved literature and the visual arts, so Williams had a large vocabulary and a gift for writing poetry. Even though Williams’ parents were all for literature, they wanted him to become a doctor. So in high school, Williams decided he would go to medical school but continue to write poe try. Williams soon was accepted into the University of Pennsylvania Medical School and went off to college. At the University of Pennsylvania, he stuck to his word, practicing medicine and writing poetry. His parents really influenced him to study to become a doctor so Williams worked extremely hard. In college, Williams was befriended by poet Ezra Pound. He was the main person who encouraged him to continue writing poetry. Williams would come to his dormitory every night and Ezra would help him. Slowly, Ezra developed him into a great poet. After Williams completed his studies, he had his heart set on both writing poetry and a medical career. Three years later (in 1909) Williams’ first poems were published. A year after that Williams began a private medical practice in Rutherford, something which lasted for over 40 years. Every day he’d practice medicine, and then come home around one o’clock in the morning and write poetry. By 1912, his medical practice had given Williams the financial freedom to write what he wished. Williams started writing poetry all day. Many of these poems got published, and during the 1920’s-1950’s, he was venerated by other poets because he rejected formalism. Over this period of time Williams received many awards and published many other poems. Williams also married Florence Herman in 1912. Sadly, Williams Carlos Williams died on March 4, 1963. He may... ...or answer. Even though back when Williams’ published his first poems they seemed different and strange, they caught on and were loved. Today, many poets use Williams’ techniques. There were dozens of poets to choose from for the ORP, but out of all of them I chose William Carlos Williams. The main reason I chose Williams as my poet was because he’s my dad’s all-time favorite poet. He had many of his poetry books and information about him, so if I had any questions my dad knew all the answers. When I first started reading Williams’ poems, I thought they were rather strange. But as my dad explained how he wrote and what some of the poems meant, I started really understanding his poetry and now he is my favorite poet. From reading Williams’ poetry, I have learned one extremely special and important thing about writing poetry. That you don’t always have to write about things that have a message to have a great poem, you can write about random objects and still have a wonderful poem. I would recommend Williams to more advanced readers who really understand poetry and already know a little bit about his past, because knowing Willi ams’ background really helped me understand his poetry. The Life of William Carlos Williams Essay -- English Literature Essays The Life of William Carlos Williams â€Å"Nothing whips my blood like verse.† These are the famous words of the great poet, William Carlos Williams. Williams was born on September 17, 1883 in Rutherford, New Jersey. He spent most of his life in Rutherford, so today he is a local hero. Williams’ mother was Puerto Rican and almost had pure Spanish blood. His father was American. As a child, Williams’ dad was a salesman and was often away from home. Thus, they didn’t see each other very much. When Williams was four, he attended school in Switzerland and France for three years. Then his family moved back to Rutherford. Williams started writing poetry at Horace Mann High School, in New York City. His parents loved literature and the visual arts, so Williams had a large vocabulary and a gift for writing poetry. Even though Williams’ parents were all for literature, they wanted him to become a doctor. So in high school, Williams decided he would go to medical school but continue to write poe try. Williams soon was accepted into the University of Pennsylvania Medical School and went off to college. At the University of Pennsylvania, he stuck to his word, practicing medicine and writing poetry. His parents really influenced him to study to become a doctor so Williams worked extremely hard. In college, Williams was befriended by poet Ezra Pound. He was the main person who encouraged him to continue writing poetry. Williams would come to his dormitory every night and Ezra would help him. Slowly, Ezra developed him into a great poet. After Williams completed his studies, he had his heart set on both writing poetry and a medical career. Three years later (in 1909) Williams’ first poems were published. A year after that Williams began a private medical practice in Rutherford, something which lasted for over 40 years. Every day he’d practice medicine, and then come home around one o’clock in the morning and write poetry. By 1912, his medical practice had given Williams the financial freedom to write what he wished. Williams started writing poetry all day. Many of these poems got published, and during the 1920’s-1950’s, he was venerated by other poets because he rejected formalism. Over this period of time Williams received many awards and published many other poems. Williams also married Florence Herman in 1912. Sadly, Williams Carlos Williams died on March 4, 1963. He may... ...or answer. Even though back when Williams’ published his first poems they seemed different and strange, they caught on and were loved. Today, many poets use Williams’ techniques. There were dozens of poets to choose from for the ORP, but out of all of them I chose William Carlos Williams. The main reason I chose Williams as my poet was because he’s my dad’s all-time favorite poet. He had many of his poetry books and information about him, so if I had any questions my dad knew all the answers. When I first started reading Williams’ poems, I thought they were rather strange. But as my dad explained how he wrote and what some of the poems meant, I started really understanding his poetry and now he is my favorite poet. From reading Williams’ poetry, I have learned one extremely special and important thing about writing poetry. That you don’t always have to write about things that have a message to have a great poem, you can write about random objects and still have a wonderful poem. I would recommend Williams to more advanced readers who really understand poetry and already know a little bit about his past, because knowing Willi ams’ background really helped me understand his poetry.

Generators: Electric Power and Ashe Members

[pic] Regulatory Advisory A service to members, advisories are produced whenever there is a significant development that affects the job you do in your community. A Message to ASHE Members: The Joint Commission (JCAHO) is conducting a Field Review of its proposed addition to standard EC. 7. 40 on the inspection, testing and maintenance of emergency power systems. JCAHO proposes to add a new Element of Performance (EP) requiring annual testing of each emergency generator for four continuous hours, under load.ASHE members are encouraged to take full advantage of this opportunity to: †¢ Provide your input on the actual need for this new requirement, †¢ Comment if this requirement will assure greater reliability, †¢ Inform JCAHO of the specific impact to your facility from implementing this requirement as it is proposed. The Field Review will close on February 20, 2006 Standard EC. 7. 40 – Proposed Element of Performance #5The [organization] tests each emergency gen erator at least once every 12 months for a minimum of four continuous hours. This test shall be conducted under a load (dynamic or static) that is at least 30% of the nameplate rating of the generator. The Field Review is being conducted on the JCAHO website at: www. jcaho. org/accredited+organizations/hospitals/standards/field+reviews/ec740_std_fr. htm The notice contains background information that identifies emergency electrical generators as a critical resource for delivery of safe care.The background information further explains that â€Å"Testing generators for sufficient lengths of time increases the likelihood of detecting generator reliability problems and reduces the risk of losing this critical resource when it (is) most needed†. A key question ASHE members should comment on is: As it is written – will the proposed requirement lead to more effective detection of generator reliability problems and in doing so reduce the risk of failure under emergency conditi ons? † The Field Review is organized to challenge both the premise for and the wording of the proposed standard.The survey questions and ASHE’s guidance on responding to these questions are on pages 2 and 3 of this alert. All answers should be for your specific facility based on your experience. In addition to providing input on whether this standard will meet its intent, you should focus on possible obstacles to complying with this requirement including resources (fuel and labor costs), disruption to services and patient care during the test, and air emission regulatory compliance issues. ASHE urges you to seize this opportunity to comment!Your input is essential to ensure this proposed revision is well thought out and will actually improve system reliability. JCAHO Field Review – Proposed Emergency Power Testing Standards The Field Review is an on-line survey launched from the Field Review web page at: www. jcaho. org/accredited+organizations/hospitals/standard s/field+reviews/ec740_std_fr. htm The actual survey is conducted through surveymonkey. com with results compiled for JCAHO. Below are the survey questions with guidance on how to respond to each question 1.Name – this is listed as optional but we suggest you provide your name 2. Organization – again this is optional but we suggest you provide this 3. In which one of the following categories are you primarily responding? – there is a list provided to chose from – in most cases you will select the first choice as being a ‘Joint Commission Accredited Organization’. 4. If you are primarily representing a Joint Commission accredited organization, which one category best describes your role in that organization? similar to the previous question this is a list – most ASHE members will choose ‘Facility Maintenance’, Facility Design’, or ‘Safety Management/Security Management’. 5. For which accredited program ar e you responding to this field review? – a list is provided of each of the JCAHO programs for which this proposed standard will apply. Please select your primary facility (e. g. Hospital). If you have multiple care settings, please consider filling out a survey for each different type of care setting. 6. Does your organization rely on an emergency generator to provide care, treatment, and services during electrical power outages? Yes/No 7. Would your organization rely on an emergency generator to continue care, treatment, or services for four hours or more during extended electrical power outages? – typically this is Yes unless your program allows for the discontinuation of services and facility evacuation 8. Are the proposed revisions illustrated in â€Å"Element of Performance #5†, understandable or clear to your organization? – this is where the â€Å"rubber hits the road†. Comment on the proposed standard as it is written – don’t read into it what you think it is trying to say.If it is not clear please take the time to comment on what is unclear and/or if there is a better way to clearly state what they want you to do. 9. Regarding â€Å"Element of Performance #5†, is the required frequency for testing emergency generators appropriate? – the real question is – should this be an annual test? The 2005 edition of NFPA 110 – Standard for Emergency and Standby Power Systems – requires Level 1 EPSS (Emergency Power Supply Systems) to be tested for at least 4 hours, at least once within every 36 months.ASHE members are represented on the technical committee of NFPA 110 along with manufacturers and designers. This technical committee has voted that a 4 hour test, every three years provides adequate assurance of reliable performance. If you agree with NFPA 110 you should select No. 10. If you indicated no, what would be the appropriate frequency of testing? – NFPA 110 require s 36 months (NFPA 110 – 2005, section 8. 4. 9) 11. Do you feel that a load of 30% of the nameplate rating of the generator required in â€Å"Element of Performance #5† would adequately assess the generator’s fueling and cooling systems during the test? NFPA 110 requires the test load to be the EPSS load running at the time of the test. This is to test the ability of the EPSS to deliver the required power to the outlets, lighting, and systems that are on the emergency power system rather then to simulate it with a load. As written, EP 5 could be met through use of a resistive load bank without testing other vital components of the EPSS including transfer switches and paralleling switchgear. This is a fundamental question – will â€Å"cooking† the engine for 4 hours adequately test he fuel and cooling systems and therefore enhance system reliability? Or is should the entire EPSS be tested? If you feel that the entire system should be tested as requir ed by NFPA 110 – 2005, section 8. 4. 9. 1, answer question 11 as No and list your reasons in the provided space for comment. 12. Would the proposed revisions in â€Å"Element of Performance #5† be burdensome for your organization? – ASHE recommends that you discuss this issue with your administration and safety committee to fully identify all the implications of performing this test annually.Issues to discuss include additional resources (fuel consumption and labor to conduct the test), increased amounts of air emissions from the test (state or regional clean air regulations), and disruption to services during the test such as computer based systems on emergency power, lighting, transportation systems, and ventilation systems. Organizations that have experienced any difficulty in scheduling and performing the currently required monthly tests must ensure that all stakeholders are fully informed and supportive of the scheduling and performance of this proposed 4 h our test. 3. If â€Å"Element of Performance #5† became effective immediately, how long would it take for your organization to be in compliance? – this question only allows one of four responses, with a maximum of 12 months. Your response should be informed by the discussion from question 12. If you feel that none of the listed time frames are adequate, utilize the â€Å"additional comments† area at the end of the survey to discuss the compliance timeframe 14. Would your organization utilize outside sources to perform this test required by â€Å"Element of Performance #5†? For example, would your organization need to utilize a load bank to meet the 30% test load requirement? ) – Consider if you have the available staff, the available expertise on staff, and/or the available current load to perform this test without taking on additional outside expenses. If you anticipate additional expenses, provide a ‘best-guess’ of that cost. For que stions or comments contact Dale Woodin at [email  protected] org or 312-422-3812 https://www. premierinc. com/safety/safety-share/05-06-downloads/11-ashe-fda-bed-rail-entrapment-05-06. pdf

Skeletal, Muscular & Articular Systems

|Skeletal, Articular and Muscular Systems | |Human Anatomy & Physiology Assignment 6 | |A short study of the human bodies skeletal, muscular and joint types. | Contents Task 12 Task 23 Task 3a8 Task 3b0 Task 4a10 Task 5a10 Task 6a11 Task 6b14 References16 Pictures/Figures16 Task 1 Task 1A A patient with a bone mineral density T-score of -2. 7 would be suffering from osteoporosis. †¢ Normal BMD, T-score -1 SD> †¢ Osteopenia, T-score between -1 & -2. 5 SD>< †¢ Osteoporosis, T-score -2. SD< †¢ Severe Osteoporosis, T-score -2. 5 SD< with associated fractures. [1] Task 1B Key hormones associated with bone formation in men/women are PTH (parathyroid hormone) produced by the parathyroid glands, and Calcitonin produced by C-cells. In children, HGH is important and is most involved in epiphyseal plate activity; in adolescents the sex hormones testosterone and oestrogen play an important role in bone growth, growth hormone (HGH) is modulated by the activity of the thyroid h ormones, ensuring that the skeleton has proper proportions as it is growing.Later in adolescence, the sex hormones testosterone and oestrogen induce epiphyseal plate closure in the long bones; an excess of growth hormone during this development phase can lead to gigantism, while a deficiency of HGH and/or the thyroid hormones would produce dwarfism. Low blood levels of ionic calcium will stimulate the release of PTH; in turn stimulating osteoclasts to resorb bone and thus releasing more calcium to the blood. Osteoclasts will break down both old and new bone matrices, osteoid escapes assimilation due to its lack of calcium salts. Read Renal System Physiology PhysioexRising levels of blood calcium will end the stimulus of PTH, declining levels of PTH will reverse these effects; causing the level of blood Ca2+ to fall, calcitonin only has a negligible effect on calcium homeostasis in humans. (Marieb & Hoehn, 2010, pp. 185-86) Task 1C The major supplements used to help sufferers of osteoporosis are calcium and vitamin D, aim for at least 700mg of calcium from food/drink intake; when using calcium and vitamin D to help osteoporosis then a formulation prescribed by a doctor should be sought.Most over the counter calcium/vitamin D supplements do not contain the correct amount and ratio of calcium/vitamin D, to help treat osteoporosis a formulation containing 1. 2g of calcium and 800iu of vitamin D[2] should be taken. (NHS , 2011) Other good dietary sources of calcium are small fish (with bones – sardines/pilchards), low-fat dairy products and dark green leafy vegetables (broccoli/cabbage/okra) as are tofu (s oya) and nuts. (NHS, 2011) Good dietary sources of vitamin D include all oily fish, eggs; fortified spreads and liver.It is also important to get the appropriate amount of sunlight, as the UVB rays penetrate skin where they are converted into pre-vitamin D3 by cutaneous 7-dehydrocholesterol. Aim for at least 5-30 minutes per day of UVB during the hours of 10am to 3pm, to the legs; face; back and arms for sufficient vitamin D production; cloud cover and darker skin tones will reduce the available UVB. (USA. Gov, 2011) Task 1D High impact sports, such as running; weight training; walking; aerobic exercise and squash are all good for increasing BMD, low impact sports such as swimming and cycling have no positive effect on BMD.Exercise regimes should be undertaken at least twice per week, preferably three times p/w of 30 minutes or more, and of course should be supervised by a qualified individual. The level of intensity should be low at the start of the regimen, increasing the number o f repetitions and/or weight over time. Any BMD gains achieved would be lost if the exercise regime is stopped, and thus regular face-to-face contact is important to help foster a positive mental attitude. (Todd & Robinson, 2003)Individuals suffering from osteoporosis should be careful when undertaking vigorous high impact exercise, due to the weakness of the skeletal system; most importantly, an active lifestyle coupled with regular exercise should be followed to help combat osteoporosis in advancing years. Task 2 Task 2A – Axial Skeleton Eighty bones separated to form three regions (skull, vertebral column & thoracic cage) make up the structure of the axial skeleton. The parts of the axial skeleton form the longitudinal axis of the body, protect the brain/spinal cord and support the neck/head/trunk.The skull formed of the cranial and facial bones is an exceptionally complex bony structure; the skull serves as a compound for the frail brain, and has connection positions for t he head/neck muscles. The vertebral column comprises of 26 asymmetrical bones connected to form a curved flexible structure that supports the trunk; extending from the skull to the pelvis the vertebral column transmits weight to the lower limbs. Providing attachment points for the muscles of the neck/back and for the ribs, it also acts as protection for the spinal column.The thorax, more commonly known as the chest consists of thoracic vertebrae; ribs; sternum and costal cartilages that secure the ribs onto the sternum. Forming a protective cage around vital organs, the thorax has a rough cone shape that is quite broad; the thorax also supports the shoulder girdles; upper limbs and provides the muscles of the back/neck/shoulders and chest with connection points. (Marieb & Hoehn, 2010, pp. 199,216) Task 2A – Appendicular Skeleton The appendicular skeleton is made up of the limbs and their girdles, the appendicular skeleton is appended to the axial skeleton; hence the name appe ndicular.The upper limbs attached via a yoke like girdle (pectoral) to the trunk of the body; and the lower limbs secured by the pelvic girdle. The bones of the upper/lower limbs have different functionalities and mobility, but still have the same essential plane; that the limbs are constituted of three key divisions linked via alterable joints. The appendicular skeletal structure allows us movement such as taking a step, picking up a cup or kicking a ball. The pectoral girdle is comprised of an anterior clavicle and a posterior scapula; the shoulders formed from the associated muscles and the paired pectoral girdles.Attaching the upper limbs to the axial skeleton, the pectoral girdles also present points of attachment for muscles that are responsible for moving the upper limbs; mobility is high as these girdles are very light. The upper limbs form from 30 bones, each bone described locally as a bone of the hand, arm or forearm; the arm is considered in an anatomical sense to be the upper limb between the shoulder and elbow. The lower limbs attach to the axial skeleton via the pelvic girdle and diffuse the weight of the upper body to the lower limbs, and provide support for the pelvic visceral organs.Some of the strongest ligaments in the body attach the pelvic girdle to the axial skeleton, the pelvic girdle is very stable but lacks the mobility of the pectoral girdle; carrying the weight of the body the lower limbs are subject to astonishing forces. Compared to the bones of the upper limbs, the bones of the lower limbs are much thicker and stronger. (Marieb & Hoehn, 2010, pp. 223,233,237) Task 2b – Axial/Appendicular Attachments The thoracic cage is thinly attached to the pectoral girdle, not like the pelvic girdle that is affixed to the axial skeleton by some incredible strong ligaments, some of the strongest in the body.The sockets of the pelvic girdle are deep and cuplike, the femur head is secured firmly in place in these sockets, the pectoral gird le is far more moveable but the pelvic girdle is much more table. The shoulders are formed from the paired pectoral girdles and their associated muscles, a girdle usually refers to a belt like structure that encircles the body, however in the case of the pectoral girdles this does not satisfy the said description. The medial end of each clavicle is joined anteriorly to the sternum and the distal ends encounter the scapulae laterally.The scapulae do not perfect the girdle posteriorly, as their medial rims fail to join to each other or to the axial skeleton, however the scapulae attach to the thorax and the vertebral column via muscles that garb their exteriors. The upper limbs are attached to the axial skeleton via the pectoral girdles and also provide connection points for the upper limb muscles. The girdles are light and this allows a freedom of movement that is not accomplished elsewhere in the body, as only the clavicle fastens to the axial skeleton, this allows the scapulae to m ove easily across the thorax.The hip joint being a ball and socket joint has a good range of motion; however, the shoulder has a wider range of motion. The joints strong ligaments limit movements, but do occur in all planes. Formed from the articulation of the femurs spherical head and the greatly cupped acetabulum of the hipbone is the hip joint. A circular lip of fibrocartilage (Acetabulor labrum) enhances the depth of the acetabulum; the diameter of the labrum is smaller than the head of the femur making for a snug fit of these articular surfaces; dislocations of the hip are a rare incident.Extending from the brim of the acetabulum up to the stem of the femur, the heavy articular casing wholly surrounds the joint; there are several robust ligaments that reinforce the hip joint capsule. These ligaments include the iliofemoral ligament, an anteriorly placed v-shaped ligament, and the pubofemoral, which is a triangular condensing of the lesser fragment of the capsule, and the ischio femoral ligament that is a coiling posterior ligament. On either side of the pelvic girdle, the iliolumbar ligament connects the pelvis and vertebral columns. (Marieb & Hoehn, 2010, pp. 225-226,233,267) Ligaments of the pelvic girdle: Iliolumbar ligament ? Anterior Sacroiliac ligament ? Sacrospinus ligament ? Sacrotuberous ligament ? Pubofemoral ligament ? Iliofemoral ligament ? Ischiofemoral ligament ? Sacroiliac ligament ? Ischiofemoral ligament ? Ligamentum teres Ligaments of the thoracic girdle: ? Capsular ligament ? Coracoclavicular ligament ? Costoclavicular ligament ? Coracohumeral ligament ? Glenohumeral ligament Task 2c – Lordosis, Kyphosis, Scoliosis Cervical and lumbar secondary curvatures being convex anteriorly, are associated with a Childs development, this is a result of reshaping of the intervertebral discs and not from modification of the vertebrae.The cervical curvature being present at birth does not become distinct until 3 months when the baby will start t o raise its head, whereas the lumbar curvature will develop when the baby begins to walk. During the early childhood years the vertebral problems of scoliosis or lordosis may appear as rapid growth of the long bones stretches muscles, lordosis is most often present during preschool years but is more often than not remedied when the abdominal muscle strengthen. This firming up tilts forward the pelvis and the thorax widens, thus developing the military posture in adolescence.At the onset of old-age many parts of the skeleton are affected, principally the spine; the discs thin and loose elasticity and hydration resulting in a probable rise in disc herniation, at 55 years old it’s not uncommon to have a loss of up to several centimetres in stature. Osteoporosis can produce further shortening of the spine as can kyphosis, in the elderly this is referred to as a dowager’s hump, with age the thorax develops rigidity due to ossification of the costal cartilage, thus resulting in shallow breathing from a loss of rib cage elasticity.Abnormal spine curvatures, of which some are congenital and some resulting from muscle weakness, disease and bad posture. In the thoracic region of the spine, an abnormal lateral curvature is referred to as scoliosis (twisted disease) most often presenting during adolescence and more common in girls. Scoliosis can also be a result of muscle paralysis, unequal lower limbs (length) or severe abnormal vertebra structure, non-functioning muscles on one side of the spine will cause the muscles of the opposite side to exert an unopposed pull; forcing the spine into a misaligned position.Body braces and/or surgery are used to treat scoliosis during childhood and thus preventing a permanent deformity. Scoliosis can also cause breathing difficulties, due to the nature of the disease a compressed lung in not unusual. Kyphosis, often referred to as hunchback, is a thoracic curvature that is dorsally exaggerated; very common due to osteop orosis in elderly people and can also reflect rickets, osteomalacia or tuberculosis of the spine.An accentuated curvature of the lumbar vertebrae is called Lordosis (swayback), this too can be caused by spinal tuberculosis or osteomalacia. Lordosis can also be caused in a temporary form by carrying a heavy frontal load, a pregnant woman being one example. These individuals will usually pushback their shoulders in order to preserve their centre of gravity, this of course emphasises the lumbar arch. (Marieb & Hoehn, 2010, pp. 217,243-244) Task 3a Structural Class |Structural |Types |Type of Mobility | | |Characteristics | | | |Fibrous[3] |Articulating bones joined by |Sutures (Short Fibres) |Child/Limited | | |fibrous connective tissue. |Adult/Synarthrosis | | | |Syndesmosis (Longer Fibres) | | | | | |Amphiarthrosis/Immobile | | | |Gomphosis (Periodontal Ligament) |Immobile | |Cartilaginous[4] | |Synchondrosis (Hyaline Cartilage) |Immobile | | |Articulating bones joined by | | | | |fi brocartilage or hyaline | | | | |cartilage. | | | | | |Symphysis (Fibrocartilage) |Slight Movement | |Synovial[5] |Joint capsule containing synovial |Plane |Nonaxial | | |membrane and synovial fluid. | | | | |Hinge |Uniaxial | | | |Pivot |Atlantoaxial | | | |Condyloid |Biaxial | | | |Saddle |Biaxial | | | |Ball & Socket |Multiaxial | Task 4a |Characteristic |Skeletal |Cardiac |Smooth | | |Attached to bones, facial muscle & skin. |Walls of the heart. Single unit muscle in walls of hollow | |Location | | |visceral organs (other than the heart) & | | | | |multiunit muscle in intrinsic eye muscles, | | | | |airways & large arteries. | | |Single, very long, cylindrical, |Branching chains of cells; uni-|Single, fusiform, uninucleate; no | |Shape and appearance |multinucleate cells with obvious |or binucleate; striations. |striations. | | |striations. | | | | |Epimysium, perimysium and endomysium. |Endomysium attached to fibrous |Endomysium. |Connective Tissue components | |skeleton of hea rt. | | | |Voluntary via axon terminals of the |Involuntary, intrinsic system |Involuntary; autonomic nerves; hormones, | |Regulation of contraction |somatic nervous system. |regulation; also autonomic |local chemicals; stretch. | | | |nervous system controls; | | | | |hormones; stretch. | | | Slow to fast |Slow |Very slow | |Speed of contraction | | | | | |No |Yes |Yes, in single unit muscle | |Rhythmic contraction | | | | Task 5a The classification of muscles falls into four purposeful groups: prime movers (agonists), antagonists, synergists and fixators.A prime mover or agonist is a muscle that has the chief responsibility of producing an explicit undertaking, for instance the biceps brachii is the fleshy muscle of the anterior arm that is the agonist of elbow flexion. An antagonist is a muscle that opposes the movements of agonists, an active agonist will result in a stretched or relaxed antagonist; however, antagonists usually help to regulate movement of the agonist with a sli ght tightening to provide resistance to slow or stop movement as not to overshoot the mark. Agonists and antagonists are located opposite each other on the joint of which they act, antagonists can also work as agonists and one example of this is the biceps brachii causing flexion of the forearm that is antagonised by the triceps brachii, the agonist for forearm extension.In supplement to the agonists and antagonists, the majority of muscle movements also involve synergists, synergists work alongside agonists to add extra force to movements or they work to reduce detrimental movements that can arise when the agonists move. (Marieb & Hoehn, 2010, p. 321) Task 5b |Elbow Flexion |Elbow Extension |Pronation |Supination | |Biceps brachii (Prime mover) |Triceps brachii (Prime mover) |Pronator teres |Biceps brachii | |Brachialis (Prime mover) |Anconeus |Pronator quadratus (Prime mover) |Supinator | |Pronator teres (Weak) | Brachioradialis | Task 5c Biceps brachii, Brachialis, Brachioradiali s Task 5d Triceps brachii, Anconeus Task 5e Triceps brachii, Anconeus Task 5f Biceps brachii, Brachialis, Brachioradialis Task 6a Contraction refers to the activation of myosin cross bridges, these bridges are the force generating sites; when the tension is generated then contracting occurs through the cross bridges of the thin filaments, this force must surpass forces opposed to shortening; this then pulls filaments toward the m-line. When tension declines and the cross bridges inactivate, then contraction ends thus inducing relaxation in the muscle fibre.In the sliding filament model of contraction, thin filaments will slide past thick filaments, and as a result, the actin[6] and myosin[7] strands will overlap to a larger gradation. Relaxed muscle fibres only have thick and thin fibres overlapping at the tips of the a-bonds, stimulation of the muscles fibres by the nervous system activates the myosin heads of the thick filaments to clasp onto the myosin fastening position on the a ctin of the thin filaments, and this process begins sliding. [8] In the course of contraction, these cross bridge connections are forced/broken numerous times, the attachments act like miniscule ratchets in order to create pressure and thus impel the thin filaments further toward the sarcomeres centre.This contraction event occurs concurrently throughout all sarcomeres in a cell shortening the muscle cell, it should be noted as the thin filaments slide towards the centre; the z-disc to which they are attached to will be pulled toward the m-line. [9] In an overall look at contraction, the muscle cell contracts as do the i-bonds and the distance between consecutive z-discs is reduced and the h-zones vanish, moving the contiguous a-bonds closer together; however, they do not change in length. (Marieb & Hoehn, 2010, p. 284) Task 6b Direct Phosphorylation The demand for ATP rises as we begin vigorous exercise, within a few contractions stored ATP is consumed, creatine phosphate is then u sed to egenerate ATP and this process is ongoing while the metabolic pathways acclimatize to the bodies demand for increased ATP. Pairing CP with ADP results in an almost instantaneous energy transfer, and a phosphate group to form ATP from the CP to ADP. Two to three times as much CP as ATP is stored in muscle cells, the CP-ADP feedback is incredibly efficient and the volume of ATP in muscle cells does not change by much during the preliminary contraction phase. Maximum muscle power can be provided for 14-16 seconds using stored CP and ATP, this is roughly long enough to invigorate muscle for a 100-metre surge; this reaction is reversible and CP resources are refilled during rest periods. [10] (Marieb & Hoehn, 2010, pp. 298-99) Anaerobic PathwayMore ATP is engendered by catabolism as stored ATP and CP are expended; this catabolism of glucose is through the blood or from glycogen stored in muscle, glycolysis is the opening phase of glucose breakdown, glycolysis occurs in both the pr esence and absence of oxygen; however, it does not use oxygen and is therefore anaerobic. Glucose is destroyed to form two pyruvates during glycolysis, this releases enough energy to form some ATP (two ATP per glucose); usually, pyruvate manufactured would then enter the mitochondria and reacting with oxygen would provide even more ATP using the aerobic pathway. Vigorous muscle contraction at about 70% causes the bulging muscles to compress blood vessels, thus impairing blood flow and oxygen delivery.During these anaerobic conditions, the majority of pyruvate produced is transformed into lactic acid, this process is referred to anaerobic glycolysis. Anaerobic glycolysis yields around 5% of the ATP produced via the aerobic pathway from each glucose molecule, however it produces ATP about 2. 5 times faster than the aerobic pathway. [11] (Marieb & Hoehn, 2010, pp. 298-99) Aerobic Pathway Ninety-five percent of ATP used for muscle activity during moderate exercise and rest is produced v ia the aerobic respiration pathway. Occurring in the mitochondria, aerobic respiration requires oxygen and encompasses a series of chemical reactions. During these reactions, the links of fuel molecules are destroyed liberating energy for ATP production.Glucose is broken down utterly to yield water, CO2 and great quantities of ATP, diffusing out of muscle tissue into the blood; the lungs remove CO2. With the onset of exercise, glycogen stored in the muscles provides a large amount of the fuel, briefly, after this circulating glucose, pyruvate and free fatty acids are the main source of fuel, roughly 30 minutes after this fatty acids will be the main energy source. Aerobic glycolysis provides a great deal of ATP (32), but is slow due to its numerous steps; it also requires a constant supply of oxygen and nutrients to continue. [12] (Marieb & Hoehn, 2010, pp. 298-99) [pic] References Marieb, E. N. & Hoehn, K. , 2010. Bones and Skeletal Tissue. In A. Wagner, ed.Human Anatomy & Physiolo gy. 8th ed. San Francisco: Pearson International Ltd. pp. 185-86. Marieb, E. N. & Hoehn, K. , 2010. Bones and Skeletal tissue. In A. Wagner, ed. Human Anatomy & Physiology. 8th ed. San Francisco: Pearson International Ltd. pp. 199,216. Marieb, E. N. & Hoehn, K. , 2010. Bones and Skeletal Tissue. In A. Wagner, ed. Human Anatomy & Physiology. 8th ed. San Francisco: Pearson International Ltd. pp. 223,233,237. Marieb, E. N. & Hoehn, K. , 2010. Covering, Support and Movement of the Body. In A. Wagner, ed. Human Anatomy and Physiology. 8th ed. San Francisco: Pearson International Ltd. p. 284. Marieb, E. N. & Hoehn, K. , 2010.Covering, Support and Movement of the Body. In A. Wagner, ed. Human Anatomy & Physiology. 8th ed. San Francisco: Pearson International Ltd. pp. 225-226,233,267. Marieb, E. N. & Hoehn, K. , 2010. Muscles and Muscle Tissue. In A. Wagner, ed. Human Anatomy and Physiology. 8th ed. San Francisco: Pearson International Ltd. pp. 298-99. Marieb, E. N. & Hoehn, K. , 2010. The Muscular System. In A. Wagner, ed. Human Anatomy & Physiology. 8th ed. San Francisco: Pearson International Ltd. p. 321. Marieb, E. N. & Hoehn, K. , 2010. The Vertebral Column. In A. Wagner, ed. Human Anatomy & Physiology. 8th ed. San Francisco: Pearson International. pp. 217, 243-244. NHS , 2011.Osteoporosis – Treatment. [Online] Available at: HYPERLINK â€Å"http://www. nhs. uk/Conditions/Osteoporosis/Pages/Treatment. aspx† http://www. nhs. uk/Conditions/Osteoporosis/Pages/Treatment. aspx [Accessed 13 May 2011]. NHS, 2011. Vitamins and Minerals – Calcium. [Online] Available at: HYPERLINK â€Å"http://www. nhs. uk/Conditions/vitamins-minerals/Pages/Calcium. aspx† http://www. nhs. uk/Conditions/vitamins-minerals/Pages/Calcium. aspx [Accessed 13 May 2011]. Todd, J. A. & Robinson, R. J. , 2003. Osteoporosis and Exercise. Postgrad Medical Journal, 4(79), pp. 320-23. USA. Gov, 2011. Vitamin D. [Online] Available at: HYPERLINK â€Å"http://ods. od. nih. ov/fa ctsheets/VitaminD-HealthProfessional/† http://ods. od. nih. gov/factsheets/VitaminD-HealthProfessional/ [Accessed 13 May 2011]. Pictures/Figures http://samedical. blogspot. com/2010/07/contraction-of-skeletal-muscle. html (Figure 6. 1/6. 2/6. 3/6. 4/6. 5) http://i. acdn. us/image/A2868/286833/300_286833. jpg (Figure 7. 1) http://www. mindfiesta. com/images/article/Respiration_clip_image001. gif (Figure 7. 2) ———————– [1] http://www. gpnotebook. co. uk/simplepage. cfm? ID=-1979318262&linkID=32590&cook=no [2] Per day of both supplements. [3] See figure 3. 1, pictures A & B [4] See figure 3. 1, pictures C & D [5] See figure 3. 1, pictures E, I & F 6] See figure 6. 3 (Page 13) [7] See figure 6. 2 (Page 13) [8] See figure 6. 1 (Page 12) [9] See figure 6. 1 [10] See figure 7. 1 [11] See figure 7. 2 [12] See figure 7. 2 ———————– Monday, 22 April 2013 Figure 3. 1 Task 3b A. Skull (Fibrous) B. Ankle – Tibiofibular/Distal (Synovial/Fibrous) C. First rib/Sternum (Cartilaginous) Hyaline Cartilage D. Vertebrae (Cartilaginous) Fibrocartilage E. Pubis (Cartilaginous) Fibrocartilage F. Scapula/Humerus (Synovial) G. Humerus/Ulna Radius (Synovial) Hyaline cartilage H. Intercarpal (Cartilaginous) Plane joint/Nonaxial A C F G D E H B Figure 6. 1 Figure 6. 3 Figure 6. 2 Figure 7. 2 Figure 7. 1

Impact of Gay Marriage on Children Essay

Take a look at the picture of a gay and a lesbian couple (see Figure 1). Long ago people would have raised their eyebrows and glared at such obvious display of affection between two men and two women. They would have scurried away and cursed them who engaged in activities that compromise morality. They would have felt anger to know that a man would even think of marrying another man or a woman to another woman. But years later, this picture has become normal. Wherever people go, they see gay and lesbian couples. They are everywhere. And the government has also come to accept this phenomenon, although there are still debates whether gay marriage, or same-sex marriage, should be legalized and accepted. Gay marriage has been one of the critical issues still not resolved and still plagued lots of people today. There are debates and protests whether this should be legalized or accepted in the society. Many are strongly against gay marriage because of their various beliefs about marriage itself. On the other hand, many are also for gay marriage because they think that marriage is all about equality and freedom to choose and decide. However, we must look at what gay marriage does to the children, because they are also adversely affected by this. This paper will show that gay marriage (the term will be used interchangeably with same-sex marriage in this paper), has a negative impact on children. In 1989, Denmark granted â€Å"registered partnership† to same-sex couples; Norway, in 1993; Sweden, in 1994; and Iceland, in 1996. Other countries in Europe, such as France, Germany, Finland, the Netherlands and Belgium also did the same (Lee Badgett 2). Meezan and Rauch reported that gay marriage (or same-sex marriage) is a reality in the United States and other parts of the world. They added that for the advocates of same-sex marriage, it is a civil rights issue. For the opponents, it is a matter of morality. Both sides are correct, but most importantly, it is a family-policy issue which has not been regarded with the right amount of attention in the American scene (97). The most important question to be considered is: How will same-sex marriage affect the well-being of children? The statistics showed significant trends. In 2007, Craft reported that in 1976 alone, there were about 300,000 to 500,000 gay and lesbian parents. In Bahamas alone, the number of homosexuals is increasing. Many of these, who keep their homosexuality secret, have positions in companies and in governments. The Rainbow Alliance of The Bahamas showed that gay individuals makes up five percent while bisexuals make up 29 percent of The Bahamas population (see Chart 1). Additionally, there are about eight to 10 million children living in gay and lesbian households. It is estimated that the number of gay and lesbian people who are interested to adopt children is nearly two million. The highest concentration of adopted children living with homosexual parents could be found in California. These children tend to be younger. Gates, Lee Badgett, Chambers and Macomber estimated that there were about 65,000 adopted children living in a gay or lesbian household. Moreover, out of the estimated 3. 1 million gay and lesbian households in U. S. , 1. 6 percent includes an adopted child under the age of 18 (7) (see Table 1). In the Frequently Asked Questions article by The American Civil Liberties Union (ACLU) marriage is all about love, commitment, sharing and compromise. It should not be denied to couples just because of their sex; marriage is a personal choice. However, many believed that the purpose of marriage is procreation; producing children is the natural end of marriage (Cline). Since gay marriage is unnatural (it can’t produce children), Cline said that it would violate this very idea. It would undermine marriage because it is a moral institution for promoting and protecting procreation. Although this paper posits that gay marriage has positive impact on children, it is still important to look at both views about the same-sex marriage in order to make light of the things which are significant for the welfare of the children. Impact on Children Why should the children be considered when it comes to same-sex marriage? Children are helpless, according to Kurts. They rely upon adults. They need the society to provide them with institutions that keep them safe from chaos. Additionally, they cannot articulate their needs and cannot even vote. But, they are society. They are the future of the world. These are just some of the reasons why children’s well-being must be supported and encouraged. Baskerville is right in saying that the impact of gay marriage on children wasn’t paid much attention because the focus was on the debate over gay marriage. It is important to recognize the needs of the children because they deserve to grow in an environment where they have two legally recognized parents (Committee on Psychosocial Aspects of Child and Family Health). Their relationship with their parents, the Committee furthered, must be stable and recognized. This must apply to all, whether the parents are of the opposite or of same sex. For those who advocate gay marriage, they said that gay marriage will have positive impact on the children. In an article by Sara Miles, she argued that banning gay marriage will deny children justice since marriage is good for kids. It is true that marriage is good for kids. Most of the literature about marriage would indicate that marriage brings positive outcomes for the children as it provides them with warm, close relationships with their parents. Advocates of gay marriage believe that these reasons must be taken into consideration and let someone marry whoever he wants to marry. Cline reported that those who oppose gay marriage will do anything to keep it from being legalized. However, there will come a time when gay marriage will be legal and recognized. In fact, there were actions taken in other countries to make this possible. With the rise of the issue of gay marriage in America, other areas were also considered, such as adoption of children. Baskerville quoted what Democratic state Sen. Therese Murphy. She believed that almost half of all adopted children in Massachusetts live in households with homosexually-behaving adults. Baskerville added that allowing gay couples to â€Å"have† children, or to give them the right to adopt, is nearly the same as granting them the right to claim the children of a couple. The question here is whether the biological parents will agree to be separated from their children. This is made easy by the government’s initiative to give other people’s children to gay or lesbian couples. The government also has the power to take back the children from their biological parents even though the parents did not do something that would make the government take back the children. This is because the government now had the incentive and the means to take children from their parents with no due process. Baskerville reported that the 1974 Child Abuse Prevention and Treatment Act (CAPTA) gives financial incentives to the states to remove children from their original parents. As a result, CAPTA became instrumental in tearing children away from their parents. Additionally, the federal funds went to the foster-care providers. Even now, there are still children removed from their families despite the fact that foster homes were more abusive than the children’s original families. This problem existed for a long time until the government thought of another program. The government provided another program to solve the problem created by CAPTA, which is the 1997 Adoption and Safe Families Act. It provided more financial assistance to transfer children from foster care to adoption. This expanded the client base of stakeholders who had vested financial interest in available children. Gay marriage, it seemed, made this even worse. Baskerville reported that through having kids adopted by gay couples, the government officials can take advantage of the adoption. These government officials can very well benefit through the funds that are set for the Act. Rekers provided three reasons on why Arkansas has prohibited homosexually-behaving adults from being given license to be foster parents. First: The inherent nature and structure of households with a homosexually-behaving adult uniquely endangers foster children by exposing them to a substantial level of harmful stresses that are over and above usual stress levels in heterosexual foster homes. (Rekers 2) This means that those children entering foster care usually have high incidence of psychological disorder. Rekers explained that if homosexual parents adopted those children, they (the children) are likely to be at risk of psychological harm and maladjustment. This happens when the children are exposed in greater stress brought upon them by the mere presence of a homosexual in a foster home. Moreover, Rekers believed that the children are affected in such a way that they are at risk of depression or psychological disorders (2). Second, Rekers reasoned out the relationships between homosexually-behaving adults tend to be less stable and short-lived, unlike the relationship between a married man and woman. Therefore, this would not be appropriate for children because they will be easily influenced. Furthermore, Rekers believed that suicidal attempt, substance abuse, psychological disorders and breakups happen most often with homosexual partners. Thus, they are incapable of providing a secure and stable home that foster children needed. And if children are to be adopted by these homosexually-behaving adults, it would mean that children will be removed and transfer to another home. Sometimes the transition is traumatic for these children. Third, the household structure of foster-parents consisting of one or more homosexually-behaving members denies children their needs for adjustment that can be found in heterosexual foster homes. Rekers backed this third reason by explaining that unlike heterosexual households, a household with homosexually-behaving adults lack the concrete role of a mother and a father, which is necessary for the growth and development of children. Additionally, homosexual households lack the role of a mother and a father in raising children. Also, the children have no chance to witness a husband/wife relationship, which the society thinks is socially stable and healthier for the children. Rekers said that the children who live with a married man and woman are better adjusted compared to those who live in households with homosexually-behaving adults. Children in foster care must be placed with heterosexual married couple because this will provide them with their needed benefits and leads to better child adjustment. A study presented by Jacobs in her article showed that nearly all 50 studies done on the children of gay and lesbian couples (between six and 14 million in the United States) showed no significant difference between children raised by heterosexual or homosexual couples. However, those who oppose gay marriage argued that most of the studies done were small, there were methodological flaws, and mostly were politically biased. Jacobs reported a study which showed that there’s no significant difference whether a child is raised by a gay or lesbian parents. In short, a child with gay or lesbian parents does not necessarily make him different from his peers. However, Jacobs presented some interesting findings from other researches regarding these differences. She mentioned that in 2001, Judith Stacey, a sociologist, and her colleague, Timothy Biblarz, found out that there are, in fact, some differences. They said that although gay and lesbian parenting is not harmful for children, those who have gay parents differ in some ways from those who have heterosexual parents. For instance, a study headed by Susan Golombok concluded that having homosexual parents does not encourage their children to become homosexuals. However, the daughters of lesbians were more open to the idea of being attracted to the same gender than the daughters of heterosexual mothers. Another finding was that out of the 25 children of lesbians, six of them had had relationship with someone of the same gender. The 21 children of heterosexual mothers did not have a relationship with the same gender. Kurts countered that gays have special case because the difficulties and challenges they experience are not from â€Å"discrimination† of marriage. The challenges and difficulties are due to the problem of sexual difference. He added that marriage is just a consolation for the challenges that are usual in situations faced by gays. Although gays are much tolerated in the United States, using marriage for the wrong purpose will not change the situations of gays. Instead, it will be the end of marriage, and the protection it provides for the children who are helpless. Gay marriage will also have an effect on heterosexual marriage. Supporting gay marriage, according to Gallagher (qtd. in Darby), would mean that the courts will not fully support the views of those who advocate heterosexual marriage. Moreover, if heterosexual marriage is confirmed as a special institution that must be protected and upheld, the number of fatherless children will decrease. Heterosexual marriage will prevent the incidences of children born outside marriage. Kotulski (qtd. in Darby) contradicted this by saying that there will still be fatherless children. There will be factors that would continue to break families, such as poverty and violence. Other Effects Pawelski et. al have noted some other effects of same-sex marriage to children. These effects, as noted, were experienced at different levels. In the psychosocial level, gay and lesbian individuals usually undergo peer rejection, harassment, depression or isolation. In fact, Pawelski et. al reported that almost half (47%) of gay and lesbian teens have thought about committing suicide while 36% actually attempted. Oftentimes, these individuals experience rejection from their loved ones, maltreatment in schools, homelessness, and violence. As adults, they experience discrimination, marginalization and violence. Various debates over the issue of same-sex marriage intensified the unstable environment for the homosexuals in the society. Lack of support and acceptance for them and their children will have effects on their physical and psychosocial health and safety. The children of gay or lesbian couples may, in the same way, experience marginalization and discrimination by those who do not approve of gay or lesbian parenting. More often, these children do not know how or where to find support. Even alliances in schools that admit straight gays can make the situation worse. Pawelski et. al reported that children are brought into long-term partnerships with gay and lesbian parents through surrogacy, adoption and alternative insemination. Their study also delved into the attitudes and behavior, personality and adjustment of parents when it comes to parenting. The authors found out that there were only few differences recorded regarding the comparison between lesbian and heterosexual mothers’ psychological adjustment, self-esteem and attitudes about child rearing. Lesbian mothers, the study showed, passed the psychological assessments and interviews. Furthermore, the study showed that the attitudes of lesbian mothers did not differ much from those of heterosexual mothers. In the same way, gay fathers did not differ much from nongay fathers. In fact, there are more similarities than differences. However, there is concern over the effect of the parent’s sexual orientation on the children because this might lead to embarrassment and thus keep the children from interacting with their peers. It was found out that the children of divorced lesbian mothers experienced more teasing from peers during childhood than the children of divorced heterosexual mothers. It is of interest that Pawelski et. al mentioned that the children who grew up with gay or lesbian parents were more tolerant of diversity and more nurturing than those children with heterosexual parents. Pawelski et. al mentioned another study which showed that children of heterosexual parents considered themselves more aggressive. Their parents and teachers regarded them as more domineering, bossy and negative. On the other hand, the children of lesbian parents considered themselves as more lovable. Their parents and teachers regarded them as more responsive, affectionate and protective of other younger children. Another study showed that the self-esteem, aggressiveness and sociability of children with lesbian parents and those with heterosexual parents have similarities. There were also studies conducted which showed that children of lesbian parents who were satisfied with their relationships have fewer behavioral problems and were better adjusted. There was also a study by the National Longitudinal Study of Adolescent Health wherein the population consisted of 12105 adolescents in the United States. The authors found out that 44 adolescents, ranging from 12 to 18 years old, who were living with two women, were similar to others who have heterosexual parents when it comes to measures of anxiety, depression, self-esteem and school success. There were also similarities regarding family relationships, care from others, neighborhood integration, regardless of whether the children come from opposite-gender or same-gender families (Pawelski et. al). Since the legalization of same-sex marriage in Massachusetts back in 2004, researches today showed that it may have positive impact in strengthening the ties between couples, their children and extended families. It is interesting to note, however, that a large number of young people in America seemed to support gay and lesbian issues. Olander, Kirby and Schmitt mentioned a survey done by the Council for Excellence in Government (CEG) and CIRCLE which asked young people from 15 to 25 years old their perspective about the rights of homosexuals. The survey found out that youths supported gay and lesbian issues such as protection in housing, employment and hate crime, legal partnerships or civic unions and the ability to adopt children (2). There are others who view gay marriage on a positive note. Carpenter believed that gay marriage helps children. He said that gay parenting nowadays is very common in the United States, and that there are children in every gay and lesbian household. He did not seem to agree that children are better raised by a married man and woman. He furthered that gay marriage will not take away children from their biological parents. Although there is no reported shortage of children, the number of married couples is not enough to raise these children. And this is the reason why singles and unmarried couples are allowed sub-optimal parenting. Carpenter thought that this arrangement is better than foster care where the effects on children are unfavorable. Brinkmann countered Carpenter’s views. She believed that if a child is exposed to both sexes in a household, it will have positive effects on his developmental needs. She explained that this aids them in forming their sexual identity. Since the breakdown of marriage in the country had negative effects especially on children, it must be considered that a heterosexual marriage will provide the children stability with regards to family relationships. Brinkmann furthered that without heterosexual marriage, the society will disintegrate. Times have changed and more changes will manifest in the future. Amidst these changes, the welfare of children who are affected by gay marriage must be the utmost consideration. This means that supporting heterosexual marriage will be beneficial for these children. The government and families must make sure that every step of the way, these children will be encouraged and supported. Their needs must be met in order for them to grow as responsible citizens in our society.

The Jack Roller

Peter Wilke Professor Callais Analysis Paper February 11, 2013 The Jack Roller In the book The Jack Roller author Clifford Shaw is a criminologist who has researched many different youthful deviants to see exactly when the deviance begins and how it evolves. The book dives deep into the mind of a particular case of a boy named Stanley in Chicago during the 1920’s. From the beginning of the book Stanley is abused by his stepmother often being set aside so she could tend to here actual children. I believe this book is most accurately depicts the social learning theory.Stanley has been exposed to a multitude of positive outlooks of crime from his family and friends at an extremely young age. I support the blank slate theory because in the very beginning of the book Stanley’s stepmother encourages him to act in deviant behavior. â€Å"One day my stepmother told William to take me to the railroad yard to break into box-cars. † (52-53). So Stanley has been taken under the wing of his step-brother who is stealing stuff for there stepmother, in return they are rewarded for stealing. This is a perfect example of an exposing Stanley to a positive outlook on crime.With this happening it kick started Stanley’s deviant behavior he began stealing for fun for many years, constantly being picked up by the police and taken to detentions homes which were not much of a punishment for him. Stanley enjoyed being in the detention home more than his real home so the consequence for his criminal behavior almost was a reward for him. In the detention home, Stanley was able to meet other criminal that furthermore gave him positive reinforcement of crime, â€Å"I was really awed by the bravery and wisdom of the older crooks. Their stories of adventure fascinated my childish imagination, and I felt drawn to them. (57). These criminal that Stanley met inspired him; they gave him someone to look up to, someone that he could aspire to be through crime. After bein g released Stanley was picked up by his step mother only to run away yet again to survive a couple days then be picked up by the police on the street. This process happened a multitude of times until eventually he was sent to the St. Charles School for Boys. â€Å"The strict discipline, hard punishment, no recreation, fear, and unfair breaks made life miserable. † (68). St. Charles was the first negative consequence for his crimes.Stanley was absolutely miserable there and yearned to get out just to go back to stealing. In observing this book you realize that all Stanley knows is crime, he frequently is in and out of a job, and keeps one for rarely over a month. Stanley knows nothing but crime it has been engraved into his â€Å"clean slate†, and he has learned how to survive off of it. After serving 16 months Stanley was released for St. Charles only to be arrested not soon after and return back to St. Charles for another month. After being released Stanley makes some what of an attempt at earning his money honestly and goes though a multitude of jobs.He starts out living with this stepsister, only to be kicked out because of missing rent. He then meets a very friendly woman who takes him into her homes and lets him live. Stanley enjoys the company of this woman and uses her as somewhat of an emotional release, â€Å"This time I was not afraid, but felt a wave of depression and sadness come over me, because a woman was offering me sympathy; something I had never received before. † (76). Stanley lived with this woman for about a month soon to find out she was a prostitute, although he was shocked he did not condemn her for it and Stanley understood.He still left her to go to the YMCA only to return to the detention home. The interaction with Stanley and the prostitute enforces the social learning theory because it is exposing Stanley to his first mother figure that is a criminal. The only positive female influence in his entire life makes h er living based off of crime; one could see how this could impact such an impressionable youthful mind. Eventually the vice president of a company he worked for took in Stanley, the man had no children and was very wealthy.Stanley enjoyed living with him and his wife but yearned for the freedom of his city, and at the first opportunity gather up his money and ran away. After this Stanley began to become involved in much more elaborate burglaries and â€Å" Jack Rolling†, he became with a â€Å"gang† of other boys and was making a large amount of money robbing and stealing. â€Å"So we plied our trade with a howling success for two months. Sometimes we made as much as two hundred dollars in a single day. † (97), this expressed an enormous positive reinforcement of crime to Stanley.Stanley has never made this type of money in his life before, it is much more fun and easier in his opinion than working a job and you can make much more than a job. In this book I beli eve Stanley was raised on a life of crime, nearly everything he was exposed to provided a positive outlook on this crime. He simply never was exposed to any real punishment before it was to late. All of the friendly people he met were criminals, such as the prostitute and his gang, he made a large amount of money â€Å"jack rolling†, and he enjoyed the ego from his criminal record with all the respect it earned him from the youth.The social learning theory supports Stanley’s case because his family, peers, school, and his environment all directed him into a life of crime. The other possible theory I could see one choosing would be the control theory, assuming that people are naturally inclined to commit crime could seem like it could fit Stanley’s case. The reason I did not choose it is because the environment that Stanley was in I feel created him. His stepmother, his siblings and stepsiblings, the detention home, his gang, and people such as the prostitute all impacted his deviant life an extreme amount. The Jack Roller Peter Wilke Professor Callais Analysis Paper February 11, 2013 The Jack Roller In the book The Jack Roller author Clifford Shaw is a criminologist who has researched many different youthful deviants to see exactly when the deviance begins and how it evolves. The book dives deep into the mind of a particular case of a boy named Stanley in Chicago during the 1920’s. From the beginning of the book Stanley is abused by his stepmother often being set aside so she could tend to here actual children. I believe this book is most accurately depicts the social learning theory.Stanley has been exposed to a multitude of positive outlooks of crime from his family and friends at an extremely young age. I support the blank slate theory because in the very beginning of the book Stanley’s stepmother encourages him to act in deviant behavior. â€Å"One day my stepmother told William to take me to the railroad yard to break into box-cars. † (52-53). So Stanley has been taken under the wing of his step-brother who is stealing stuff for there stepmother, in return they are rewarded for stealing. This is a perfect example of an exposing Stanley to a positive outlook on crime.With this happening it kick started Stanley’s deviant behavior he began stealing for fun for many years, constantly being picked up by the police and taken to detentions homes which were not much of a punishment for him. Stanley enjoyed being in the detention home more than his real home so the consequence for his criminal behavior almost was a reward for him. In the detention home, Stanley was able to meet other criminal that furthermore gave him positive reinforcement of crime, â€Å"I was really awed by the bravery and wisdom of the older crooks. Their stories of adventure fascinated my childish imagination, and I felt drawn to them. (57). These criminal that Stanley met inspired him; they gave him someone to look up to, someone that he could aspire to be through crime. After bein g released Stanley was picked up by his step mother only to run away yet again to survive a couple days then be picked up by the police on the street. This process happened a multitude of times until eventually he was sent to the St. Charles School for Boys. â€Å"The strict discipline, hard punishment, no recreation, fear, and unfair breaks made life miserable. † (68). St. Charles was the first negative consequence for his crimes.Stanley was absolutely miserable there and yearned to get out just to go back to stealing. In observing this book you realize that all Stanley knows is crime, he frequently is in and out of a job, and keeps one for rarely over a month. Stanley knows nothing but crime it has been engraved into his â€Å"clean slate†, and he has learned how to survive off of it. After serving 16 months Stanley was released for St. Charles only to be arrested not soon after and return back to St. Charles for another month. After being released Stanley makes some what of an attempt at earning his money honestly and goes though a multitude of jobs.He starts out living with this stepsister, only to be kicked out because of missing rent. He then meets a very friendly woman who takes him into her homes and lets him live. Stanley enjoys the company of this woman and uses her as somewhat of an emotional release, â€Å"This time I was not afraid, but felt a wave of depression and sadness come over me, because a woman was offering me sympathy; something I had never received before. † (76). Stanley lived with this woman for about a month soon to find out she was a prostitute, although he was shocked he did not condemn her for it and Stanley understood.He still left her to go to the YMCA only to return to the detention home. The interaction with Stanley and the prostitute enforces the social learning theory because it is exposing Stanley to his first mother figure that is a criminal. The only positive female influence in his entire life makes h er living based off of crime; one could see how this could impact such an impressionable youthful mind. Eventually the vice president of a company he worked for took in Stanley, the man had no children and was very wealthy.Stanley enjoyed living with him and his wife but yearned for the freedom of his city, and at the first opportunity gather up his money and ran away. After this Stanley began to become involved in much more elaborate burglaries and â€Å" Jack Rolling†, he became with a â€Å"gang† of other boys and was making a large amount of money robbing and stealing. â€Å"So we plied our trade with a howling success for two months. Sometimes we made as much as two hundred dollars in a single day. † (97), this expressed an enormous positive reinforcement of crime to Stanley.Stanley has never made this type of money in his life before, it is much more fun and easier in his opinion than working a job and you can make much more than a job. In this book I beli eve Stanley was raised on a life of crime, nearly everything he was exposed to provided a positive outlook on this crime. He simply never was exposed to any real punishment before it was to late. All of the friendly people he met were criminals, such as the prostitute and his gang, he made a large amount of money â€Å"jack rolling†, and he enjoyed the ego from his criminal record with all the respect it earned him from the youth.The social learning theory supports Stanley’s case because his family, peers, school, and his environment all directed him into a life of crime. The other possible theory I could see one choosing would be the control theory, assuming that people are naturally inclined to commit crime could seem like it could fit Stanley’s case. The reason I did not choose it is because the environment that Stanley was in I feel created him. His stepmother, his siblings and stepsiblings, the detention home, his gang, and people such as the prostitute all impacted his deviant life an extreme amount.