Ornette Coleman Paper Essay

Ornette Coleman is one of the most influential artists in jazz and considered an American icon and legend. There are not many musicians that emerge who dramatically changed the way we listen to music. Ornette Coleman was of the major innovators of free jazz as well as a great saxophonist and composer. Coleman’s bluesy, playful music revolutionized jazz by ignoring regular harmonies and rhythm. He even created his own theory â€Å"harmolodic† and applied it to rock instrumental in his group Prime Time. The musician’s new style helped to regenerate jazz by allowing for the genre to go into a new direction and be placed for his music to be placed in a group of major 20th century composers. This paper will discuss how Ornette Coleman borrowed from the world of jazz to influence concert hall compositions. Ornette Coleman was a revolutionary saxophone player who expanded contemporary boundaries of music. He gained those remarkable skills by teaching himself how to play saxophone at the age of 14 and by playing with musicians in local rhythm and blues bars while growing up in Fort Worth, Texas in the late 1940s and early ‘50s. Some of his legends include Charlie Parker and two local musicians in Fort Worth Ben Martin and Reed Connors. Coleman loved Charlie Parker and bebop and thought of it as the most advanced collective way of playing a melody and at the same time improvising. Parker taught Coleman many lessons especially about the quality of what he could play and knowing the audience (Ratliff 63). The musician decided to travel to L.A. and played in various establishments. He eventually made his way to New York with his first band having a good sense of melody and ideas of playing without any preconceived chord changes (Ratliff 55). People thought of him as a genius and others denounced him as a charlatan. His music was considered controversial for instance in his quartet th ey had no chordal instruments such as the piano. Listeners said his music was radically rejecting jazz traditions, but a few praised him and said the music was an extension of the historical practice (Martin,Waters). As he was traveling  in R&B jazz bands across the country, he switched back and forth between alto and tenor sax. Resistance was normal for Coleman, and he was use to being fired. In 1950, he wrote an unpublished book that deals with a theory that melody has nothing to do with harmony, chords, or key centers. In 1958, he formed his own band that was established on a mode of playing which no one player had the lead but anyone could come out and play at any time. Beginning in 1959, Coleman and his quartet went to New York and developed the concept of free jazz (George-Warren and Pareles). Free jazz and improvised music did away with any of the strict forms of jazz and classic music such as tonality, chord changes, formal shape and structure, etc. Coleman was put into the category along with Cecil Taylor and Albert Ayler, and they abolished the traditional hierarchy of instrumentation in jazz, classical rock, and pop allowing for any instrument to be equal in improvising. Many performers were encouraged by these individuals to go beyond the regular technique to develop â€Å"extended† techniques (Cox, Warner 252). Coleman’s group debut in New York was unlike anything anyone had ever heard. The bassist or drummer did not function in a conventional rhythm sense, and there was no piano to provide chordal harmonies. When Coleman played with his group, they did not have any idea what the end result would be. The group was even able to get the attention and approval from conductor-composer Leonard Bernstein and composer Virgil Thompson along with other writers and painters (Europe Jazz Network). Each player in his group contributed what he felt in the music at any moment, and each member is not told what to do but play what they hear in the piece themselves. He also stated that in a sense that there is no start or finish to any of his music, but there is a continued expression, continually evolving strands of thoughts that link all of his compositions together (Coxer, Warner 254). Other things that summarized Coleman’s style of music include: fragmented, pointed melodies, melodic connections based on motive structure and large-scale gestures and abstract relations among pitches, little or no use of conventional harmony and voice leading, but solos often have loose shifting tonal centers, variety of melodic rhythm, nasal insistent tone, loose rhythms, use of middle and upper range o n instrument, passionate expression, and deviation from standard intonation (Martin, Waters 271). Coleman started to explore different music possibilities by mixing and  extending elements of honky-tonk, blues, funk and bebop in areas of harmony, rhythm and the melodic structure. His musical styles alienated him from the jazz world that musicians walked off the stage when he showed up for a show. His new innovations later became known as â€Å"harmolodic†, which helped change jazz by pointing it in a direction away from the musical styles of bebop, but also established a place in a group of major 20th century composers such as Charlie Parker, Harry Partch, Charles Ives, and John Cage (Europe Jazz Network). From 1962 to 1965, Coleman withdrew himself from the spotlight and taught himself to play the trumpet and violin. He began to turn his attention to writing compositions for various musical forms such as woodwind quintets, chamber orchestras, string quartets, symphonic works and vocal works. This is the point in his life where his music began to affect the concert hall. The first public performance of one his pieces was the string quartet piece Dedicated to Poets and Writers. Performances of some of his works are scarce and have not been performed or recorded. The release of his two pieces Saints and Soldiers and Space Flight performed by the Philadelphia Orchestra cleared the way for his most famous piece Skies of America symphonic suite. The piece is scored for jazz ensemble and orchestra and debuted in 1972 at Newport in New York Festival and recorded by the London Symphony Orchestra (George-Warren and Pareles). This work stands as Coleman’s harmolodic manifesto. There are some themes that people can recognize. Coleman enters the scene halfway through the piece with his saxophone during â€Å"The Artist in America†. His modulations have a fresh, sometimes abrupt sound as a result of movement of the melody and the chords. There are a number of different c hord changes which are considered correct even though it does not sound correct. Throughout the piece the works of Charles Ives comes to mind with the jumble of melodies and heavy densities. The entire work introduced his â€Å"harmolody† theory in which harmonies, rhythms, and melodies function independently and equally (George-Warren and Pareles). The theory relates to the use of similar melodic material in different clefs and keys, producing a texture of predominately parallel motion (Martin, Waters 271). He wanted to be like famous musicians George Gershwin, Duke Ellington, and Charles Mingus so that he could help break down boundaries between â€Å"modern jazz† and â€Å"serious concert† music. Coleman translates his ability as an improviser into orchestral terms. With his  orchestral works, he was able to create a peculiar timbre and certain licks unlike any other composer writing orchestral works. During the 1970s Coleman’s musical horizons continued to expand. He formed the group Prime Time which incorporated rock and funk rh ythms and melodic fragments similar to R&B music along with its harmonic possibilities. The free jazz/classical composer now created dance music that combined elements of jazz, funk, R&B, and rock with an unusual mix of instruments two guitarists, two drummers, two bassists, Coleman on the sax, violin, and trumpet. This group’s music included multi-layered melodies, polytonal and polyrhythmic textures which were defined as harmolodics. This style shaped more music other than jazz, and Coleman’s music influenced affected many rock musicians during the 70s especially Frank Zappa (Europe Jazz Network). While Coleman influenced rock musicians, he continued to diversify his music and became interested in African cultures. He traveled throughout Africa with Prime Time and created a new album Dancing in Your Head featuring field recordings with the group while they were working with tribal musicians in Morocco. In the 1980s Coleman revised and completed Skies of America after being commissioned by Caravan of Dreams, an arts center that opened in his hometown of F ort Worth, Texas. Coleman continued to write for all instrumentation and group sizes. He continued compositions for the concert hall such as the Meet the Modern series and The Sacred Mind of Johnny Dolphin. His group Prime Time eventually mixed ac (Martin and Waters)oustic and electric instruments. In 1993, his most monumental recordings from Atlantic were released in a box set entitled Beauty Is a Rare Thing. He went on to be inducted into the American Academy of Arts and Letters and was featured by the New York Lincoln Center which hosted a festival of his works featuring a performance of the Skies of America by the New York Philharmonic and surviving members of his band Prime Time (Europe Jazz Network). One of the greatest jazz artist and composer of all time is Ornette Coleman who influenced music for the concert hall and popular music genres such as jazz and rock and roll. His music for the concert hall was innovative and creative as stayed true to his artistic style and capabilities. One of his most influential pieces for the concert hall was Skies of America which helped blend many different styles of music into an orchestral work. Individuals were influenced by his pioneering work in  creating free jazz and the use of improvisation styles as well as his newly created harmolodic theory. Coleman was not afraid to step out on the limb to perform and create music without boundaries and that did not follow the traditional Western theory practices. He did receive a lot of criticism for his approach but affected and changed many by his abilities. Bibliography Cox, Christoph and Daniel Warner. â€Å"Audio Culture: Readings in Modern Music.† Change of the Century. New York: The Contiuum International Publishing Group, 2004. Europe Jazz Network Musicians . 20 February 2010 . George-Warren, Holly and Jon Pareles. â€Å"Rolling Stone Encyclopedia of Rock And Roll.† Ornette Coleman. Boston: Simon & Schuster , 2001. Martin, Henry and Keith Waters. Jazz: the frst 100 years. Belmont: Thomas Schirmer, 2006. Music, The Jazz Ear: Conversations Over. â€Å"Ratliff, Ben.† I Know Who You Are Ornette Coleman. New York: Henry Holt and Company, LLC, 2008.

“Beloved” by Toni Morrison

â€Å"Beloved† by Toni Morrison discusses slavery’s deconstruction of identity as well as explores the emotional, physical and spiritual devastation caused by slavery. Toni Morrison assumes that former slaves are haunted by devastation even in their freedom. Thus he raises important themes, because the question of slavery is still under discussion. Moreover, â€Å"Beloved† is discussed in accordance with supernatural dimension. Therefore, the paper will discuss the negative impact of slavery on sense of self and self-alienation.Further, the paper aims at discussing main themes and motifs involved in â€Å"Beloved† as well as providing thorough examination of Morrison’s ideas and narrative style. The paper will progress through the methods of in-depth analysis and description. The purpose of the paper is to enlarge knowledge and to become more informed about slavery and community solidarity. Annotated Bibliography Badt, Karin. The Roots of the Body i n Toni Morrison: A Mater of â€Å"Ancient Properties†. Journal Title: African American Review, 29, 4 (1995): 567-576.The article discusses the ambivalence about maternal power and the uneasiness of the novel stating that Morrison's novels signify the mother and evoke the desire for her meet with a depressing end. Furthermore, the article defines renovation of the self and the African-American community and says that, according to Morrison, deadly sacrifice is required. The article may be used to examine the catharsis and renewal of former slaves and to provide overview of religious experience of reincarnating. Bennett, Juda. Toni Morrison and the Burden of the Passing Narrative. African American Review, 35, 2 (2001): 205-215.The article is devoted to examination of the passing myth, sometimes in only one or two paragraphs and often with indirection. Also the article emphasizes the contours of black identity throughout the novel and admits that the novel is important for histo ry. Actually, Morrison conveys a rather standard, albeit postmodern, suspicion of truth. Therefore, the article will be used to examine and analyze the identity of black community in the novel and to outline the historical significance of the novel. Drake, Kimberly. Toni Morrison: A Critical Companion. Contributors: Kimberly S. Drake – author. African American Review, 35, 2 (2001): 333-334.The article underlines interest in Morrison’s own texts’ blank spaces, in her usage of imagination and approach to her fiction. The article explains theoretically sophisticated concepts in a responsible and clear manner providing examination of novel in terms of identity development and Christian religious. Furthermore, the article discusses minor plot errors of the novel. Thus the article will be used to critically asses the novel and to analyze the concept of self as well as to discuss the role of the black community in identity development. Jones, Carolyn. â€Å"Sula† and â€Å"Beloved†: Images of Cain in the Novels of Toni Morrison.African American Review, 27, 4 (1993): 615-623. The article provides thorough comparison between Morrison’ â€Å"Sula† and â€Å"Beloved† to find out similarities in author’s style of narration and themes involved. Carolyn states that memory is the main essential category of the author and Morrison wants to â€Å"re-memory† meaning he wants to use moral imagination shape the events of one's life into story. The article will be used to provide in-depth analysis of author’s main themes and style of narration as well as to apply theoretical framework to the concept of identity deconstruction caused by slavery. Okoso, Yoshiko.Elizabeth Ann Beaulieu, Ed. the Toni Morrison Encyclopedia. African American Review, 38, 1 (2004): 168-174. The article examines narrative style of Morrison stating that she prefers to neither explain everything, nor to provide solutions or to resolv e every detail of the plot. Morrison’s works are filled with enigmatic, shifting and vibrant aspects being not merely an accompaniment, but a provider of essential background knowledge. Thus the article will be useful in analyzing the negative impact of slavery on sense of self and self-alienation and in providing in-depth examination of the author’s style and novel’s themes.Parrish, Tony. Imagining Slavery: Toni Morrison and Charles Johnson. Studies in American Fiction, 25, 1 (1997): 81-86. The article compares and contrasts theme of slavery and identity deconstruction in the novels of Morrison and Johnson providing similarities and differences. It is stated that â€Å"Beloved† has similarities with Johnson’s slavery novels, because both authors offer negative meaning of slavery and explore African-American identity. The article will be used to describe how African-American identity is involved in the novel and how it continues to be created nowad ays.Further, the article gives the opportunity to examine Morrison’ philosophy. Rubenstein, Roberta. Singing the Blues: Toni Morrison and Cultural Mourning. Mosaic, 31, 2 (1998): 147-156. The article examines Morrison’s imagery of dismemberment and stating that it is â€Å"trope for the profound damages inflicted on African Americans by the emotional dismemberments of slavery and its aftermath†. Further, the article touches symbolic figures and transfiguration and provides links between emotional/psychological and aesthetic/cultural losses.Therefore, the article will be used to examine novel’s symbolism and aesthetics as well as to define main novel’s motifs. West, Genevieve. Conner, Marc C. , Ed. the Aesthetics of Toni Morrison: Speaking the Unspeakable. Studies in the Novel, 35, 2 (2003): 272-275. The article examines the aesthetics of Morrison. The author provides the idea that Morrison has explicitly worked to distance herself from Western trad itions in favor of situating her writings within an African-American cultural and aesthetic tradition.Therefore, the article will be used to examine the aesthetics of â€Å"Beloved† and to develop two versions of the grotesque: emphasizing play, humor, and renewal; emphasizing alienation, estrangement, and terror. Works Cited Badt, Karin. The Roots of the Body in Toni Morrison: A Mater of â€Å"Ancient Properties†. Journal Title: African American Review, 29, 4 (1995): 567-576. Bennett, Juda. Toni Morrison and the Burden of the Passing Narrative. African American Review, 35, 2 (2001): 205-215. Drake, Kimberly. Toni Morrison: A Critical Companion. Contributors: Kimberly S. Drake – author. African American Review, 35, 2 (2001): 333-334.Jones, Carolyn. â€Å"Sula† and â€Å"Beloved†: Images of Cain in the Novels of Toni Morrison. African American Review, 27, 4 (1993): 615-623. Okoso, Yoshiko. Elizabeth Ann Beaulieu, Ed. the Toni Morrison Encyclopedia. African American Review, 38, 1 (2004): 168-174. Parrish, Tony. Imagining Slavery: Toni Morrison and Charles Johnson. Studies in American Fiction, 25, 1, 81-86. Rubenstein, Roberta. Singing the Blues: Toni Morrison and Cultural Mourning. Mosaic, 31, 2 (1998): 147-156. West, Genevieve. Conner, Marc C. , Ed. the Aesthetics of Toni Morrison: Speaking the Unspeakable. Studies in the Novel, 35, 2 (2003): 272-275.

Theodicy and the Free Will Defense Essay Example | Topics and Well Written Essays - 750 words

Theodicy and the Free Will Defense - Essay Example This paper deems to tackle the concepts revolving around theodicy and free will; this also aims to know whether the free will defense meet all the three criteria for an effective theodicy. Free Will Human free will and freely chosen good actions are of high value, even though free will opens up the possibility of evil (Pinnock 5). Furthermore, as guided by the definition of freedom, free will or free act is an act that is not determined casually in any way by one’s genetic makeup, by one’s environment or even by God (Pinnock 5). Likewise, every free person is possibly sinful and free to choose evil; thus, given the independence of human freedom from divine control, it is obviously impossible for God to guarantee that individuals will always freely choose to do what is morally noble (Pinnock 5). In simple terms, Pinnock implied that free will is considered as a key justification to evil (4). Individuals deem that they have free will if they view themselves as agents capa ble of influencing the world in a variety of ways (Kane 5). Moreover, persons feel that it is up to them what they will choose and how they will act and this means they could have chosen and acted otherwise (Kane 5). Furthermore, Kane suggests that the basis of the actions of individuals exercising free will lie in themselves and not outside them which is something that could be beyond their control (5). The Biopic Teleological Argument Edwards inquired about how a powerful transcendent Creator can be a Benevolent Super-intellect when evil is evident in the world (299). Edwards then emphasized that no single, magic bullet neatly solves the problem of theodicy for if there is an available solution, it usually results from cumulative weight of many considerations; hence, the success or failure of theodicy is a matter of fallible and variable judgment (299). Massive evil in the world is indeed the greatest obstacle of all to have faith and believe that a good God created the universe f or benevolent purposes (Edwards 299). Without theodicy, individuals would deprive God of devotion instead contempt might linger in their mind and hearts (Edwards 299). The Free Will Defense amidst the Criteria of Theodicy The Free Will Defense by Alvin Plantinga denotes that much of the evil most notably the moral evil that exist in the world is a consequence of God’s endowing humans with significant moral freedom (Nash 199). In lieu of the first criteria of effective theodicy, the premise handled only human-caused suffering satisfactorily in the sense that it rationalizes why one experiences such. Such outcome is based on the fact that a free and responsible choice originates with the intelligent moral agent who makes it (Edwards 299). Thus, being responsible for a choice and its consequences such as suffering means picking that option or choice knowingly (Edwards 299). As what Edwards (299) highlighted that moral agents are responsible only for the decisions they made that originated from them, other than that, they may not be held accountable (Edwards 299). The second criteria of an effective theodicy was tackled by the Free Will Defense, in such a way that this approach stressed that God allows moral evil in order to bring about the greater good of allowing his creation to encompass significantly free moral agents, without whom there could be no moral good (Nash 199). Though pain and suffering may be experience due to the

Nestle Research Paper Example | Topics and Well Written Essays - 750 words

Nestle - Research Paper Example In order to improve its performance, it also shifted its executive offices to the United States. Another major organizational change took place when Nestle took its first step towards diversification by becoming a major shareholder in L’Oreal, the largest company in the cosmetics industry. Instead of investing in developing markets like cosmetics, Nestle purchased Alcon laboratories and entered the pharmaceutical industry. The main focus of Nestle during this time was to restructure its organization by focusing on strategic acquisitions and improve its financial improvement through diversification. In the later period, however, the new CEO focused on slow and conscious organizational change. 2. Identify whether the changes were first-order and/or second-order changes and the rationale for your decision.   In simple words, first order change is when a company does something which is similar to that done before and is a reversible option. A second order change is an irreversib le practice that an organization adopts which is fundamentally different from the practices adopted before (Leadership and institutional change, n.d.). According to the case studies, Nestle incurred both first order and second order changes. The first change of relocating its executive offices from Switzerland to the United States during the World War 2 is considered to be a first order change because the core identity of the company as well as its organizational values were maintained. During this change, the company underwent an organizational climatic change which is a king of a transactional change. The second order changes incurred by Nestle would be the decision of global expansion and diversification. By buying out shares in L’Oreal and Alcon Laboratories the company underwent transformational change as it had to face radical transformation as well as organizational development. This organizational change transformed the core organizational values and practices of Nest le. Together these changes made up the stream of organizational changes that Nestle went through. 3. Discuss whether or not the changes made were with an incremental approach as emphasized by Brabeck-Letmathe.   The CEO of Nestle, Brabeck-Letmathe, believed in sustaining and developing the strengths of the organization and introducing radical changes only if the company is facing a crisis. He believed in slow and conscious changes which are considered to be an incremental approach. He also believed that any change should only be adopted after conscious decision making which should be focused on long term rather than short term success of the organization. The first change made by the CEO was changing the entire executive board and replacing it with 10 new executive members. The CEO also focused on reinforcing and sustaining the strengths and relying on the commitment of the managers. But the overhaul of the executive board might demotivated these managers and instill in them a fea r of losing their own jobs. Also, slow and conscious growth in today`s fast paced world hinders the growth of the organization and might affect Nestle negatively. 4. Identify three examples of lessons from the front line that were evident in the Nestle case and how these issues may be overcome.

Orthodox Interpretation of Japanese War Memories Essay

Orthodox Interpretation of Japanese War Memories - Essay Example The other argument is based on the assumption of the Allies that the government of Japan has declined in properly addressing the country’s war responsibilities during the war. It is also the view of the English speaking Allies that the people of Japan do not adequately acknowledge the responsibility of Japan during the war. Hence, the Japanese should accept the responsibility of the country during the war and this will propel the Japanese government doing the ‘right’ things in context of the war (Seaton 2). Seaton is of the view that this interpretation is flawed. He attributes this to the fact that there are two varying proportions of the interpretation. One of the proportions is described as the ‘state-centered approach’ whereby there is the political and parlance of the war memory (Seaton 2). The other is described as the ‘culturally determinist’ approach where it is analyzed in both sociological and anthropological focusing on the cha racteristics of the Japanese society as unwilling and conforming (Seaton 3). Why this Interpretation is flawed According to Seaton (p. 9), there are three aspects of how this interpretation is flawed. One of the aspects is that it moves precariously between war responsibility and war memories. This is because war responsibility in the current context is highlighted by constantly by political, moral and legal implications of war conduct. On the other hand, war memories are concerned about the way people see past events from the perspective of today’s context. Although the two aspects are related to some aspect, it is important to note that they are very distinct from each. Seaton (p. 9) asserts that while the Japanese government may refuse to compensate, there are Japanese people and the government that remembers the war. Hence, the way Japanese people feel about the way their government compensating could be based on their memory of the war. The development of memory studies has been greatly enhanced by the society acknowledging the fact that history is based on the environment that is changing constantly. Hence, technological, political, and social environments have affected the way many people are viewing past events. Hence, the Japanese cannot be limited to the environments that were present during the Second World War. There are two paradigms within which war memory and commemoration are studied which are; the political and psychological paradigms (Seaton 9). Seaton in Chapter 3 further argues that although Japan has been accused frequently of failing to address the past, the orthodoxy fails to note the main fact that ‘addressing the past’ is kind of unhelpful because it puts the roles of responsibility and memory into one and in so doing smudges the difference between individual, collective and official narratives. The orthodoxy has put across many texts that argue about Japan failing to address the war responsibility issues officially which has in turn spilled over to the orthodoxy claiming that Japan has an inadequate memory. This has led to observers of the Japanese people on how they remember the war being obscured. It is in this context that the orthodoxy has also ignored to look into how other nations handles their war memory including the English speaking Allies. Hence, the Japanese people are held responsible and in so doing, other nationals who were also responsible for the war have

Whole Food Plan Book Essay Example | Topics and Well Written Essays - 3500 words

Whole Food Plan Book - Essay Example During the year 2005, the sales were 1.3 million which rose to 1.7 million in the year 2007. Although market capitalization is rising, the profit margin has reduced considerably over the past three years. The stores operated by the company are approximately eight years of age; it is young age in a grocery industry. The stores are averagely about 30,000 sq. ft. As reported in the year 2006, among 180 stores of the company 113 were larger or 30,000 sq. ft. The physical resources are newer as the company. Human resource of the company is knowledgeable and well trained; they strive for a better customer experience. The payroll, bonus and other benefits of the staff have been increased during the year 2004 to 2005. Employee of the company are motivated by mission statement of the company and feel proud to be a part of the team that supports organic and natural food. The staff feels good about their job as they are contributing towards the betterment of the society. Whole Foods Market is a supermarket chain specializing in providing its customers with natural and organic foods of the highest quality on the market. Son una empresa con unos muy altos està ¡ndares de calidad en todo lo que hacen ya lo largo de sus 3 dà ©cadas de historia se han convertido en el là ­der mundial en su sector. They are a company with very high quality standards in everything they do and along its three decades of history have become the world leader in this sector. 1. Unmet needs: Usually the food items sold as suitable for children, young and adults are not only grain-based foods, but often they have a high content of salt and usually high sugar content. In the defense of this allegation, it is always said that high sugar and salt is due to demand in certain countries and not in others. In order to promote the concept of healthy eating, it was necessary to create awareness among consumers about the magic of less processed

Hematology Essay Example | Topics and Well Written Essays - 500 words

Hematology - Essay Example In the blood system, Pluripotent haematopoetic cells become any type of cell. The type of a cell to become is determined by pluripotent cells that differentiate it in a wise way. 1 Proliferation is multiplication of blood cells in a human being. When an embryo is being developed, formation of blood takes place in the yolk sac in aggregate of blood cells. Blood formation takes place in the liver, spleen and lymph nodes and development goes to advance stages. Eventually, the task of blood formation is taken by bone marrows in the entire body system when they develop. However, proliferation of lymphoid cells usually occurs in the secondary lymphoid organs such as lymph nodes, spleen and thymus. In adult, haematopoiesis usually takes place in marrows of long bones like femurs and also in ribs and sternum where we have spongy bones. At times, spleen, liver and thymus recommence their haematopoietic function commonly known as extramedullary haematopoiesis. 2 Differentiation is a process whereby cells acquire a type in regard to haemopoiesis. During differentiation, cell morphology changes drastically although generic material still remain the same with some few exceptions. In many aspects of cell physiology, differentiation involves changes in regard to shape, metabolic activities, polarity, size, and responsiveness to signals whereas gene expression profil

Denzel Washington Essay Example | Topics and Well Written Essays - 500 words

Denzel Washington - Essay Example hington is an inspiring figure to me as an African-American fan of his movies, because he shows just how much anybody can achieve if they work hard and are passionate about their work. One of the most inspiring things about Denzel Washingtons career is the story of his early childhood. When he was only 14, his parents got a divorce and he and his sister had to be sent to a boarding school for the rest of their education. Obviously, this must have had a big effect on the young mans life, but he did not let it bother him and he then went on to Fordham University, where he studied Journalism for a while (â€Å"Denzel Washington,† 2012). Beyond his parents problems, Denzel Washington also had some of his own, although they were not major. Basically, he could not decide what he wanted to do, and even dropped out of school for a semester because of being on academic probation (Washington, 2006, p16). However, after he worked as a camp counsellor over the summer at a YMCA camp and from a friends comment there â€Å"became as passionate about drama and acting as [he] had ever been† about anything else (Washingon, 2006, p18). Many people might have been satisfied with completing a bachelors degree in drama, but Denzel Washington did not stop there. Instead, he went to the American Conservatory Theater in San Francisco, even winning a scholarship which allowed him to continue his studies further (â€Å"Denzel Washington,† 2012). No doubt this extra education played a big part in his later success, but it also shows that he was already accepted as a skilled actor, or he would not have gotten a scholarship for such an important school. Because of his ability to â€Å"disappear into a role and mesmerize audiences† (â€Å"Denzel Washington,† 2012 ) which probably comes from this time and education, he has been able to win several Oscars and Golden Globes, and also play in theatrical parts of all sorts. One of the most important things to take away from this story of Denzel

The Function of Performance Management Article Example | Topics and Well Written Essays - 2250 words

The Function of Performance Management - Article Example Performance management decides the basis for the future business activities and the processes that have to be given the proper budgets as well as the resources on the part of the organization. The business process reengineering (BPR) aspects are in line with how these divisions are made in the quarter of the performance management functions and boundaries. For the human resources tenet, the role of performance management is all the more vital since it has to devise ways and means through which different activities are sequenced in terms of importance, vitality, etc. Thus it is important to state here that the role of performance management does not end here, though its basis might just lessen a little bit in the financial and different departments that we consider our attention upon. However within the realms of the human resources division, the importance is made more and more essential since employees need to be appraised time and again about their performances and functioning. What this performance management system does is to ensure that the right people get the bonuses, incentives and so on as well as point out the ones who have fallen short on the company's expectations over a period of time. This would help in giving them rewards and incentives which will eventually make one and all happy at the end. Also this will continue their desire to achieve more and more within a specified period of time and thus come into the good books of the company. In return, they can be given all these rewards so that they could be encouraged in line with their work attitudes. Moreover, the people who lag behind with regards to their work schedules and dedication levels will stand up and take notice and thus would want to be counted as the effective and efficient ones within the company as well. The role of organizations in the maintenance of these systems is also very paramount. The difference from the annual appraisals and so on lies in the fact that the traditional manner of doing things relies more on the basis of paper work where a lot of time, effort and money is rather wasted to state the least. The role played by the organizations in advancing their performance management systems is immense since a lot of the population depends on them for their needs and wants. This is met in a fair manner courtesy the E-government initiative adopted by several different companies and organizations. All such innovations which help and facilitate the related process must indeed be given thumbs up since these try to solve the miseries of the people and it is because of these people that the performance management systems are put into place originally. This further pinpoints the fact that the deployment of an efficient performance management system policy within the organization would indeed help it to essentially tackle its internal issues in a better and more effectiv e manner possible. There is a lot of growth potential for the sales force to be automated in the business to business environments since performance management systems are in place, more so because the business to business scenarios boost a trend of interaction in between the channel members no matter which marketplace they hail from. This could either

Tourist Breaks Back on Sentosa Ride Law Analysis Essay Example for Free

Tourist Breaks Back on Sentosa Ride Law Analysis Essay Factual Summary of Case Australian tourist, Michael McCarthy, suffered a fall and broke his back while riding Sentosa’s MegaZip, which is a flying fox adventure ride run by Flying Dragon Adventures (FDA). The riders would initially slide down the zipline fast and would be slowed down by a braking mechanism as they approach the landing platform. However, in this case, McCarthy was travelling towards the landing platform at a faster speed than usual. As a result, he crashed onto the platform and broke several vertebrae in his back. He felt incredible pain and could not breathe for a minute and a half. McCarthy had no immediate medical help as there was no medical staff on-site. He only received assistance half an hour later and was taken to Singapore General Hospital 1 hour 15 minutes later. He received 35 stitches to his back and spent 5 days in and out of the intensive care unit. As for the ride, McCarthy satisfied safety requirements of being at least 0. 7m tall and less than 140kg in weight. This was the first accident in its two-year history of operation. Before the accident, the ride had been taken by at least 200,000 visitors in total and was already taken by 140 people on that day. Alexander Blyth, managing director of the ride, believed that all safety procedures were followed, that nothing failed and nothing snapped. The ride also requires customers to sign indemnity forms, in which contains an exemption clause that states that they are not responsible for any deaths or personal injuries unless through gross negligence. Blyth reported the case to the Building and Construction Authority (BCA), the regulatory body for amusement rides. Lawyers are attempting to seek compensation for McCarthy’s injuries, as they question the validity of the exclusion clause in the indemnity form by bringing up the Unfair Contract Terms Act (UCTA). Following McCarthy’s injuries, McCarthy wants to claim his recoverable losses. It can be assumed that FDA is using its exemption of liability clause as a defence. McCarthy’s lawyers are stating that the exemption clause is invalid under section 2(1) of the UCTA, which states that â€Å"a person cannot exclude or restrict liability for negligence in relation to personal injury or death†. The Contract Before riding, McCarthy was made to sign an indemnity form. The terms of the indemnity form could be regarded as the express terms of the contract between McCarthy and FDA. A contract was formed between both parties when McCarthy signed the indemnity form. Since, the express terms to the contract were introduced before the contract was formed, they are, prima facie, binding to both parties. There was an exemption clause in the contract stating that FDA is not responsible for any deaths or personal injuries unless through gross negligence. Crucial Questions Before we speculate on the legal outcome of the case, a few crucial questions have to be asked. 1. Was FDA negligent? If so, this would render their exemption clause invalid, and they will be made liable for McCarthy’s losses. 2. Did FDA breach any implied terms in the contract? 3. Is BCA liable to any extent? If so, to what extent? Before the crucial questions are asked, it is important to consider the section of The Amusement Ride Safety Act (2011) which states the scope of responsibilities of parties with statutory responsibilities. They are as follows. Parties with statutory responsibilities The Amusement Rides Safety Act (ARSA) defines statutory duties and liabilities for the following stakeholders to ensure proper accountability for the safety of rides: a. Person responsible (i. e. FDA): The person responsible, who is primarily the holder of an operating permit, will be the person who has the charge, management or control of the ride. He will have overall responsibilities for all matters concerning ride safety. b. Ride manager: The ride manager, who is employed by the holder of an operating permit, will manage and oversee daily and routine operations and maintenance of the ride. He has to possess prescribed technical qualifications and experience. c. Qualified person (QP): The qualified person, appointed by the applicant of the permit or the holder of the permit, will carry out specific technical duties, such as certifying technical compliance with design codes, supervising ride installation or modification and conducting annual inspections to ensure ride safety. Was FDA negligent? The court could question whether FDA was negligent in declaring the true safety limits of the ride and if the ride manager was negligent in handling the situation. The safety limit that was declared could have been that the system would not suffer any breakage or malfunction at the stipulated weight but the braking system was unable to be effectively utilized to ensure the safety of the user. In addition, the ride manager could arguably be negligent in the handling of the situation in not pulling on the emergency stop that should have been installed in every amusement ride to stop the ride in the event of an adverse incident. In the event that the ride manager had been negligent in due diligence, the ride manager would also be liable for breaching section 17(1)(a) or ARSA. There are a few possible outcomes regarding negligence on the part of the FDA, and the possibilities of each outcome will be examined. The first possibility is that the court could reason that the FDA was negligent in checking that the braking system was functioning properly and at optimal level. It could state that the braking mechanism is a very integral and crucial component to the system, and hence negligence in the area of ensuring the functionality of the braking system could amount to negligence in ensuring the safety of the system as a whole. In addition to this, the court could also rule the FDA was negligent in ensuring adequate safety limits for the ride. If this was the case, then it is likely FDA will be held fully liable for McCarthy’s recoverable losses. This is because its exemption clause would then be invalid, by virtue of section 2(1) of the UCTA. The second possibility could be that the court could consider contributory negligence as a defence. This however, would be almost impossible because it would be almost impossible for FDA to prove that there was a degree of negligence on the part of McCarthy. It was most likely that McCarthy had to comply with the necessary safety measures before riding, such as wearing a helmet and safety harness. As such, it would be almost impossible for the court to hold both McCarthy and FDA partially liable for McCarthy’s recoverable losses. Did FDA breach any implied terms? If FDA had breached any implied terms in the contract, and McCarthy suffered losses as a result, then it follows that McCarthy can sue FDA for his recoverable losses. The Duty of Care The duty of care can be an implied term in the contract between McCarthy and FDA, even if it was not expressly provided for in the contract. This term would be implied by statute, by virtue of section 13(1)(b)(i) of the ARSA. In addition to the exemption clause being invalid due to negligence, the courts could also rule that FDA’s negligence could have resulted in it breaching its duty of care when the braking mechanism failed to work properly and McCarthy was injured. Furthermore, despite the dangerous nature of the ride, FDA did not have an on-site medical team to ensure that immediate action could be taken in the event of an accident. This is a breach of an implied term for FDA to provide for the safety of its customers in the event of an adverse incident. This term is implied by statute; according to regulation 16(6)(b) of ARSA, â€Å"The operator of an amusement ride shall ensure that at all times when the amusement ride is in operation there are in attendance to render first aid when the necessity arises, a sufficient number of persons who are properly trained by a first aid training organisation acceptable to the Commissioner;† FDA can be held liable for McCarthy’s recoverable losses based on the breach of these implied terms alone. Is BCA liable? Under the ARSA, it states that all amusement rides has to be assessed and certified by a Qualified Person (QP), which must be an amusement ride specialist engineer registered under the Professional Engineers Board. However, as the MegaZip ride involves an aerial ropeway, it is further classified as a major amusement ride under the ARSA. With it being a major amusement ride, the QP is also required to engage and consider the advice and opinion of a conformity assessor (CA). The CA has to carry out procedures such as inspections, tests and certifications to determine if the design and specifications, the proposed installation method or programme or the proposed modification method or programme relating to a major amusement ride or the major modification thereof conform to any technical standard or requirement. Besides technical support, the CA will complement the qualified person with expertise in nontechnical but critical aspects of ride safety such as ride management (e. . layout of queue areas) and crowd control (e. g. access routes and barriers). In order to ascertain whether BCA is liable for the accident, it is important to determine if the accident arose as a result of: 1. QP and CA’s inadequate safety inspections, overlooking of fundamental technical faults and establishing poor safety standards during construction. 2. FDA’s lack of day-to-day management of ride safety. In order to ascertain if the accident occurred due to the QP and CA’s lack of rigorous inspection on the ride, we must determine if they approved the ride without proper assessment of its safety. If the accident arose due to the fault of QP and CA’s poor safety assessment and haphazard approval of the ride, then some degree of liability may fall onto the QP and CA. With this assumption, FDA could then argue that the accident was caused by the QP and CA’s negligence in highlighting and rectifying safety issues during construction. FDA could state that their ride was certified by the QP and CA, assuring FDA that the ride was acceptable and followed all safety aspects. In addition, if FDA was certified through a document of approval signed by the QP and CA, FDA could use this certification as evidence in court to back up their case. This is due to the fact that it would be unfair for FDA to take up the liability if we were to consider that FDA followed all of BCA’s ACRA requirements and sought necessary approval by the QP and CA for the ride. However, the possibility of the scenario above is rather small as it is most likely that at the point of construction, all safety limits proposed by the FDA met the safety requirements of BCA and that the QP and CA properly checked and certified the ride. As the QP and CA’s duties were only restricted to the period of construction, it was the FDA’s responsibility to ensure that the day-to-day operations of the ride were well within the safety limits and that regular maintenance was conducted on the ride. In addition, considering that the accident took place two years after the construction, it would be unfair to attribute blame onto BCA, as the ride would have undergone much wear and tear and weathering. Furthermore, BCA does not have proper control over FDA’s maintenance of safety standards beyond the initial construction phase of the ride. Also, as BCA is a statutory body in ensuring that operators of amusement rides complies with the safety regulations, it would be unreasonable to expect them to be responsible for all safeties of all rides at every point in time. In addition, its role does not extend to ensuring that the ride’s safety features are continuously maintained. As such, it is extremely difficult to hold BCA liable for the accident to any degree, because the onus lies on the FDA to ensure the constant safety of the rides beyond the construction phase. Our Final Evaluation In conclusion, it is highly likely that the court would rule out that FDA was negligent in verifying the safety of the ride, and hold FDA liable for McCarthy’s losses. Assuming McCarthy’s weight was within the true weight limit of the ride, and the braking system of the ride did malfunction on that day, it is most likely that FDA will be held liable as the onus of verifying the efficiency of the brakes is solely on FDA. Should the braking system have been working well that day, but McCarthy’s weight was not within the true weight limit of the ride, it is also most likely that FDA will be held liable in this case as the court can then rule that FDA was negligent in determining the true safety limits of the ride. In saying this, we are assuming that McCarthy was not negligent himself in adhering to any of the safety procedures (e. g. wearing safety harness etc. ). Hence we can assume that there was no contributory negligence on the part of McCarthy. This, in turn, is also not likely as it was not stated in the facts of the case. We can also assume that BCA will also not be held liable to any extent at all, as the onus of ensuring the day-to-day safety of the ride system is on FDA. In a nutshell, from our points of evaluation, we can conclude that the the court will most likely rule that FDA was negligent, be it in verifying the physical safety of the system, or verifying the true safety limits of the system. In committing an act of negligence, the FDA’s exemption clause will be rendered invalid, by virtue of section 2(1) of the UCTA. On these grounds alone, FDA will likely hold liability for McCarthy’s injuries. In addition, FDA’s negligence can also be ruled out to be in breach of the implied duty of care. On these separate grounds alone, it is also likely that FDA can hold liability for McCarthy’s injuries. As such, we can conclude that the likely legal outcome will be that FDA will be held liable for McCarthy’s recoverable losses. If ruled in McCarthy’s favor, it is likely that operations of the ride will be suspended until all investigations and modifications to the ride have been made and verified to be safe. By section 30 of ARSA, FDA â€Å"shall be liable on conviction to a fine not exceeding $10,000 or to imprisonment for a term not exceeding 12 months or to both†. FDA would also be held liable for all costs with regards to McCarthy’s personal injury.

Womens Health Education On Anemia And Its Dangers

Womens Health Education On Anemia And Its Dangers Anemia is a common global public health problem (GPHP) affecting both developing and developed countries with major consequences for human health as well as social and economic development. It occurs at all stages of the life cycle, but is more prevalent in pregnant women and young children in both rich and poor countries. In 2002, iron deficiency anemia (IDA) was considered to be among the most important contributing factors to the global burden of disease (1). Anemia is one of the most common factors complicating pregnancy worldwide specially in the development countries, and Palestine is one among of those countries .In Gaza strip ,an overall prevalence of anemia is more than 35% among pregnant women .most studies have demonstrated adverse effects of anemia to both pregnant women and their offsprings mainly in developing countries due to several factors. The more etiologic factor for anemia among pregnancy being iron and folic acid deficiency(2-4) Anemia is the result of a wide variety of causes that can be isolated, but more often coexist. Globally, the most significant contributor to the onset of anemia is iron deficiency so that IDA and anemia are often used synonymously, and the prevalence of anemia has often been used as a proxy for IDA. It is generally assumed that 50% of the cases of anemia are due to iron deficiency (5), but the proportion may vary among population groups and in different areas according to the local conditions. The main risk factors for IDA include a low intake of iron, poor absorption of iron from diets high in phytate or phenolic compounds, and period of life when iron requirements are especially high (i.e. growth and pregnancy). Among the other causes of anemia, heavy blood loss as a result of menstruation, or parasite infections such as hookworms and ascaris can decrease blood haemoglobin (Hb) concentrations level. Acute and chronic infections, including malaria, HIV, tuberculosis, and cancer can also lower blood Hb concentrations level. The existence of other micronutrient deficiencies, including vitamins A and B12, folate, riboflavin, and copper can increase the risk of anemia. Furthermore, the impact of haemoglobinopathies on anemia prevalence needs to be within some population. Anemia is an indicator of both poor nutrition and poor health. The most dramatic health effects of anemia, i.e., increased risk of maternal and child mortality due to severe anemia (6-8). To tackle the problem of iron deficiency and anemia, WHO recommended the adoption of a multidisciplinary approach tailored to specific circumstances including increased iron intake, public health measures and food versification. Consistent with this strategy, UNRWA implemented a programme for prevention and treatment of iron deficiency anemia. comprising medicinal iron supplementation, fortification of wheat flour distributed to the target groups benefiting from the Agencys regular and emergency food aid programmes, and expanding the use of modern contraceptive methods (3,4). In addition, the negative consequences of IDA on cognitive and physical development of children, and on physical performance particularly work productivity in adults are of major concern (5). Previous studies have shown a very high prevalence of anemia among Palestinian refugees specially among antenatal mothers(3). Hence , it is essential that in Palestine, especially in Gaza strip the women should be aware of anemia to reduce the complication during pregnancy. Objectives of the study 1-To assess the level of awareness and public knowledge of anemia among the Palestinian refugee pregnant women in Gaza strip. 2-To assess if there is a difference between women with and without health education session. 3-To develop a baseline data regarding awareness of anemia among pregnant women for further studies. Scope of the study The study aims to assess the level of public knowledge and awareness of anemia among pregnant women who attended UNRWA health care centers(HCCs) for antenatal care in the middle district of Gaza strip by collecting the information from 164 women from four UNRWA health care centers in Gaza. Hypothesis 1-The Palestinian refugee pregnant women were awareness and had a knowledge of anemia at a medium level . 2-There is a difference between women with and without health education session regarding anemia . Benefits of the study 1-To know the knowledge and awareness regarding anemia among pregnant women living in Gaza strip and who are attending UNRWA health care centers (HCCs) for antenatal care and follow-up. 2-To know if attending health education sessions about anemia affects the knowledge and awareness of women by assessing the women with and without health education sessions about anemia in Gaza strip. Literature review studies To conduct the study, the researcher has reviewed related studies and reports about anemia status among pregnant women attending UNRWA health care centers for antenatal care in Gaza strip. Nutritional survey conducted by UNRWA in (1961,1978 and 1984) Nutrition surveys conducted among the Palestine refugees in 1961, 1978 and 1984 revealed that more than 50 per cent of preschool children 0-3 years of age and women in reproductive age suffer from iron deficiency anemia. Nutritional survey conducted among pregnant women by WHO in (1990) In 1990, a nutrition survey was conducted by the WHO Collaborating Center at Centers for Disease Control and Prevention (CDC), Atlanta in four Fields of UNRWAs area of operations, namely Jordan, the Syrian Arab Republic (SAR), Gaza Strip and the West Bank. The survey revealed that the prevalence of iron deficiency anemia among pregnant women ranged between 31.3% in the first trimester to 58.9% in the third trimester Agency-wide, while the prevalence among children 6-36 months of age ranged between 57.8% in the West Bank and 75.3% in SAR. A new intervention strategy for iron supplementation was then introduced in 1991, which was amended in 1995 placing special emphasis on treatment. Nutritional survey conducted among infants ,preschool children and pregnant women by WHO in (1998) In October 1998, the WHO Collaborating Centre at CDC conducted a nutritional survey in Gaza Strip, the results of which revealed that iron-deficiency anemia was still high among high-risk groups, namely infants, preschool children and pregnant women. A study conducted among pregnant women by UNRWA in (1999) In 1999, UNRWA conducted a study to assess the maternal health programme which revealed inter-alia that the prevalence of anemia among pregnant women was 44.7% in Gaza, 35.5% in the West Bank, 32.1% in Jordan, 28.6% in Lebanon and 27% in Syria. In addition, the study showed that the prevalence of anemia progressively increases during the course of pregnancy as well as with parity. Anemia below 9g/dl constituted 1.4% of pregnant women. This suggests that in spite of the interventions that the Agency had, so far, undertaken, iron-deficiency anemia, still represents a major public health problem. A study conducted among pregnant women, nursing mothers and children 6-36 months by UNRWA during (2004) During 2004, UNRWA conducted a follow-up study to assess the prevalence of anemia among pregnant women, nursing mothers and children 6-36 months of age in order to assess the impact of these strategies on the prevalence among pregnant women, nursing mothers and children. The study revealed that the overall prevalence of anemia among pregnant women varied from 35.7% in Gaza, to 29.5% in the West Bank, to 25.5% in Lebanon, to 22.4% in Jordan and 16.2% in Syria. Although, the overall prevalence of anemia among pregnant women in all Fields dropped since the last assessment in 1999, these rates are still considered to be high. The reason for this drop could be attributed to the prophylactic iron supplementation which is provided for all pregnant women upon registration. There is a progressive rise in the prevalence of anemia during the course of pregnancy, which confirms that iron intake during pregnancy, does not meet the increased physiological requirements. Another study conducted among children 6-36 months, pregnant women and nursing mothers by UNRWA in (2004) Another study by UNRWA in 2004 on the prevalence of iron deficiency anemia among children 6 to 36 months of age, pregnant women and nursing mothers, revealed that anemia in Gaza Strip was fairly high (54.7% among children, 35.7% among pregnant women and 45.7% among nursing mothers. The corresponding rates in the West Bank were 34.3% among children, 29.5% among pregnant women and 23.1% among nursing mothers). The high prevalence of anemia for many children may cause permanent negative effects on their physical and mental development. It is worth mentioning that the prevalence of anemia among infants 6 to 12 months of age reached 75% in Gaza(9). CHAPTER 2 BACKGROUND Definition of anemia Anemia is defined as a decrease in the number of red blood cells (RBCs) or in the total hemoglobin levels in the blood due to lack of sufficient iron (10,11).more specifically , it means lack in the concentration of hemoglobin, red blood cell volume, or red blood cell (RBCs) number(12). Normally hemoglobin carries oxygen from the lungs to the body tissues, anemia leads to hypoxia which means lack of oxygen in the blood .There are three main types of anemia which include : 1- Excessive blood loss such as bleeding 2-Excessive blood cell destruction 3-Insufficient red blood cell production within the human body (13). Signs and symptoms of anemia The signs and symptoms of anemia can be related to the anemia itself, or other causes and the women may experience these symptoms differently : In common cases, most women with anemia has a non-specific symptoms such as weakness, or fatigue, general malaise and sometimes poor concentration. In addition, the signs may include abnormal pallor or lack color of the skin, and nail beds upon clinical examination is performed . In severe cases of anemia, there may be signs of circulation disturbances such as tachycardia, and cardiac enlargement. There may be signs of heart failure. and restless legs syndrome is more common in those with iron deficiency anemia (IDA) patients . Swelling of both legs, arms, vomiting, chronic heartburn, and bloody stool may appear in rare cases(14). mhtml:file://C:Documents%20and%20SettingsMARWANMy%20DocumentsAnemia%20-%20Wikipedia,%20the%20free%20encyclopedia.mht!http://upload.wikimedia.org/wikipedia/commons/thumb/9/91/Symptoms_of_anemia.png/260px-Symptoms_of_anemia.png Main symptoms that may appear in anemia (14) Diagnosis of anemia In general, In the first time of diagnosis of anemia a simple blood test is ordered by the physician called complete blood counts (CBC ) .Another blood tests can be ordered is examination of a stained blood smear (SBS) by a microscope which could be helpful in the diagnosis of anemia, and sometimes it will be necessary in some countries internationally where automated analysis is not easily accessible. Usually and commonly four blood components are ordered and measured consists of hemoglobin concentration , RBC count, RDW and MCV, allowing others (hematocrit, MCH and MCHC) to be calculated, and to be compared to values according to age and sex. Some counters measurement estimate hematocrit level (Hct) from direct measurements in the same time (15). Table 2.1 WHOs Hemoglobin thresholds used to define anemia (1 g/Dl = 0.6206  mmol/L)(15) Age or gender group Hb threshold (g/dl) Hb threshold (mmol/l) Children (0.5-5.0 yrs) 11,0 6,8 Children (5-12 yrs) 11,5 7,1 Children (12-15 yrs) 12,0 7,4 Women, non-pregnant (>15yrs) 12,0 7,4 Women, pregnant 11,0 6,8 Men (>15yrs) 13,0 8,1 Anemia during pregnancy Anemia in pregnancy is defined as hemoglobin level less than (11g/dl ) or hematocrit level less than (33%) (16). It aggravates the effects of maternal blood loss and infections at childbirth, and is associated with increased maternal mortality and morbidity(17,18). iron deficiency is usually considered as the most common cause of anemia in pregnancy (16). Anemia occurs when the number of red blood cells are very low under the normal level . Red blood cells are very important blood component because they carry oxygen from lungs to all body organs. Without sufficient amount of oxygen, the body cannot work as well as it should. Anemia can affect any individual, but women are at greater risk for this condition. In women, iron and red blood cells are lost when bleeding or hemorrhage occurs from very heavy or long periods (menstruation). Anemia is common among pregnant women because a woman needs to have adequate red blood cells to carry oxygen to women body and to her baby. So its important for women to prevent anemia before, during and after pregnancy. Women will probably be tested for anemia regularly at least twice during pregnancy: during the first prenatal visit and then again between 24 and 28 weeks(19). Anemia is a condition of less red blood cells, or a lack ability of the red blood cells to carry oxygen or iron in the blood. Tissue enzymes dependent on iron in the blood can affect cell function in the body mainly in muscles and nerves .then the fetus is dependent on the mothers blood and anemia can cause problems before and after pregnancy such as preterm birth, poor fetal growth , and low birth weight(20). Main causes of anemia during pregnancy Iron deficiency anemia Women often become anemic during pregnancy because the demand for iron and other vitamins is increased. The mother must increase her production of red blood cells and, in addition, the foetus and placenta need their own supply of iron, which can only be obtained from the mother. In order to have enough red blood cells for the foetus, the body starts to produce more red blood cells and plasma. It has been calculated that the blood volume increases approximately 50 per cent during the pregnancy, although the plasma amount is disproportionately greater. This causes a dilution of the blood, making the hemoglobin concentration fall. This is a normal process, with the hemoglobin concentration at its lowest between weeks 25 and 30. The pregnant woman may need additional iron supplementation, and a blood test called serum ferritin is the best way of monitoring this(21). Illness or Disease Some women may have an illness that causes anemia. Diseases such as sickle cell anemia or thalassemia affect the quality and number of red blood cells the body produces. If you have a disease that causes anemia, talk with your health provider about how to treat anemia(22). Types of anemia in pregnancy There are several types of anemia that may occur during pregnancy: Iron deficiency anemia This is the most common type of anemia during pregnancy. It is known as the lack of iron in the blood, which is essential to produce hemoglobin the part of blood that carries oxygen from the lungs to tissues and many organs in the body. Good nutrition system to the women before becoming pregnant is very important to help build up these stores and prevent iron deficiency anemia during pregnancy period. Blood loss Blood loss at delivery and after delivery (postpartum) can also cause anemia. The average blood loss with a vaginal birth is about 500 milliliters, and about 1,000 milliliters with a cesarean delivery. Sufficient iron stores can help a woman replace lost red blood cells during delivery. Vitamin B12 deficiency Vitamin B12 is essential in forming red blood cells (RBCs) and in protein synthesis. Women who eat no animal products (vegans) are commonly most likely to develop vitamin B12 deficiency. Including animal foods in the diet such as meats, milk, eggs, and poultry can prevent vitamin B12 deficiency. Very severe vegans usually need supplemental vitamin B12 which usually administered by injection during pregnancy. Folic acid deficiency Folic acid, is a B-vitamin that works with iron to help with cell development and growth. Folic acid deficiency in pregnancy is most commonly associated with iron deficiency since both folic acid and iron are found in the same types of nutrition. Several Studies revealed that folic acid is necessary for women during pregnancy ,this maybe because folic acid help reduce the risk of having congenital baby with certain birth defects of the brain and spinal cord if taken by the women before conception and in early pregnancy (20). Symptoms of anemia during pregnancy Women with anemia during pregnancy may not have obvious symptoms unless the cell counts are very low. The following are the most common symptoms of anemia that may occur in pregnancy. However, each woman may experience symptoms differently. Symptoms may include: pale skin, ,nails, lips, palms of hands labored breathing underside of the eyelids vertigo or dizziness fatigue rapid heartbeat (tachycardia) The symptoms of anemia may similar other conditions or medical problems .So you should always consult your physician for a diagnosis and treatment(20). Diagnosing of anemia during pregnancy Depending on clinical symptoms, anemia is usually discovered during antenatal screening specially in the first visit of pregnant women to the antenatal care clinics for antenatal care and follow up. Normally ,Blood tests are usually measured on the first visit to antenatal health center, and again during pregnancy . A description of Hemoglobin(Hbs) ,red blood cells (RBCs) and their different components will be included in the blood test result. Possible complications of anemia and iron deficiency anemia during pregnancy There are several possible complications may occur during pregnancy which threats women health such as: Breathing difficulty, palpitations and angina. Severe anemia due to hemorrhage or loss of blood after the delivery. In this condition, the woman may be advised to have a blood transfusion as soon as possible (21). Severe anemia related to any reason may lead to hypoxemia and enhances the occurrence of coronary insufficiency and myocardial ischemia. (23). In women with severe iron deficiency, disturbances in function of epithelial tissue is usually occurred . Atrophy of the lingual papillae in the tongue may occur and show a glossy appearance. Also , angular stomatitis may develop associated with fissures at the corners of the mouth. The occurrance of dysphagia may appear with hard diets. Atrophic gastritis occurs in cases of iron deficiency with progressive lack of stomach enzymes production such as loss of acid secretion, pepsin, and intrinsic factor and development of an antibody to gastric parietal cells. Cold intolerance occurs in some cases with chronic iron deficiency anemia and is characterized by neurologic pain , vasomotor disturbances, or tingling and numbness. In rare conditions, severe iron deficiency anemia is associated with increased intracranial pressure. These symptoms can be treated with iron therapy. Impaired immune function is shown in cases with iron deficiency. Moreover, there are reports revealed that those patients are at high risk to develop infection (23). Treatment for anemia in pregnancy Specific treatment for anemia will be identified prescribed by physician based on: Your pregnancy status Overall health, and medical history Extent of the disease Your tolerance for specific medications, or procedures Expectations for the course of the disease Your opinion or preference Treatment of anemia depends on the type and severity of anemia. In cases of iron deficiency anemia treatment includes iron supplements therapy. Some forms are time-released, while others must be taken several times every day. Having iron supplements with a citrus juice can be help with the absorption into the body. Taking antacids may decrease absorption of iron in the blood. There are side effects may occurs when taking Iron supplements such as nausea and stools become dark greenish or black in color. In addition , Constipation may also occur with iron supplements. Prevention of anemia in pregnancy Anemia can be prevented during pregnancy with following a good pre-pregnancy nutrition system not only helps in preventing anemia, but also helps in building other nutritional stores in the mothers body. Having a healthy and balanced diet with essential products of food during pregnancy helps maintain the iron levels and other necessary nutrients needed for the mother health and growing her baby(20). Women education It is important for the public health officials in the geographical regions in which the iron deficiency is prevalent need to be more aware of the significance of iron deficiency, its effect on work performance and activities, and the importance of giving iron supplements during pregnancy and childhood. Moreover, Addition of iron to basic foodstuffs usually employed to solve this problem (24). CHAPTER 3 Women health in Palestine Womens Health Palestinian women have a fundamental right to enjoy the highest possible levels of health and quality of life. MOH works towards the improvement of their health during all phases of lives with wide participation with other key health providers as UNRWA and NGOs. Indicators value Indicators value % of women of child bearing age of total pop 22.3 Prevalence of anemia among pregnant women in MOH 35.7 Total fertility rate (5.8 in GS and 4.1 in WB) 4.6 T.T. immunization coverage among newly pregnant women in MOH (99.1 in UNRWA) (%) 42.4 Maternal mortality ratio per 100,000 live birth 15.4 % of children received breastfeeding 95.6 % of pregnant women attended antenatal care out of total live births 96.5 Mean duration of breastfeeding (months) 10.9 The number of visits paid per pregnant woman in MOH (7.6 in UNRWA) 5.5 Contraceptive prevalence rate (43 in GS, 55.1 in WB) 50.6 % of deliveries in health institution 97 % of IUDs used of total contraceptive methods 32 % of deliveries in home (0.4 in GS, 5.5 in WB) 3.2 % of pills used of total contraceptive methods 38.7 Prevalence of anemia among nursing mother in UNRWA 45.7 Antenatal care services Antenatal care is an essential part of modern health care; such care is every womans right. Health providers must pay serious attention to the health of the pregnant woman and her fetus. In Palestine there are four health sectors providing maternal care; the MOH, UNRWA, the NGOs and the private doctors. There are 353 MCH clinics in MOH and 53 clinics in UNRWA providing antenatal care. The number of visits paid per pregnant woman was 5.5 in Palestine (6.5 in GS and 4.8 in WB). In UNRWA, it was reported at 7.6 visits per pregnant women in Gaza Strip, the percent of women who paid 7-9 visits was 47.5%. According to DHS in 2005, Data showed that 96.5% of women aged 15-49 years received antenatal care in Palestine. There is direct relationship between education level and receipt of antenatal care; women who did not receive antenatal care were more likely to be less educated more than women who received antenatal care. In addition, access to antenatal care decreased with parity, with fewer women accessing antenatal care for their 4th pregnancy or more. High risk pregnancy services Certain conditions or characteristics, called risk factors, make a pregnancy high risk and woman or baby is more likely to become ill or die than usual. Doctors identify these factors and use a scoring system to determine the degree of risk for a particular woman. Identifying high-risk pregnancies ensures that women who most need special medical care. The high-risk program has been implemented in 26 referral governmental clinics in the Gaza Strip and 18 MCH clinics in UNRWA. The percentage of newly pregnant women visits with high-risk pregnancy was 14% of total newly pregnant women in MOH (17.8% in the GS and 11.6% in the WB). The number of visits paid per high-risk pregnant women was 5.2 visits. In UNRWA, the percentage of newly pregnant women visit at high risk and alert pregnancy was 44% from total antenatal visits of newly pregnant women. Out of the total, 40% paid 3-4 visits and 47.7% paid 7-9 visits. During home visit program in Gaza Strip, the factors associated with high risk pregnancy were as shown in the following table; taking in consideration that one woman may have more than one complication: Table 3.1 factors associated with high risk pregnancy Factors Percent % Anemia 48.8 Multipara 27.5 Primapara 25.4 Previous CS 21.6 Hypertention 16 Diabetes 5.5 Pre-eclamptic 2.1 Others 6 Tetanus toxoid immunization The vaccination for pregnant women is taken based on MOH protocol during the first antenatal visit. Immunization coverage among newly pregnant women was 42.4% (25.2% in WB and 64.1% in Gs). In UNRWA, out of total (11,100) pregnant women of 20 weeks and over of gestation, the vaccinated pregnant women were 11,005 with a coverage rate of 99.1% (25) . Anemia among women in Palestine WHO define anemia as Hb is less than 11 gm/dl. The percentage of anemic mothers whom visited the governmental MCH for antenatal care was 38.5% (27.2%in the GS and 50% in the WB) .During study conducted in UNRWA in the year 2005, the prevalence rate of anemia among pregnant women was 35.7% and 45.7% among nursing mothers visited UNRWA-PHC centers for antenatal services in the Gaza Strip. During home visits program which are conducted by Womens Health and development Directorate in MOH, Hemoglobin (HB) has been examined for 1,950 visited mothers after delivery in Shifa as 38.5% (27.2%in the GS and 50% in the WB). During home visits program which are conducted by Womens Health and development Directorate in MOH, Hemoglobin (HB) has been examined for 1,950 visited mothers after delivery in Shifa hospital especially those at high-risk pregnancy or who has complication/s during delivery. The results indicated that 61.6% of women were anemic. Out of the total women, HB was diagnosed 10 gm/d l 11 gm/dl among 38.4% of visited women. Ferrous sulfate and folic acid as a tonic is distributed for pregnant women and children under 3 years in MOH and UNRWA centers free of charge (25) . Table 3.2 Prevalence rate of anemia among women visited UNRWA-PHC centers in Gaza Strip, 2005 Pregnant women Nursing mothers Samples HBà ¢Ã¢â€š ¬Ã‚ ¹11gm/dl % Samples HBà ¢Ã¢â€š ¬Ã‚ ¹12gm/dl 920 328 35.7 810 370 CHAPTER 4 METHODOLOGY Study design A cross-sectional study design was conducted during August,2009 in order to assess awareness among pregnant women attending UNRWA health care centers for antenatal care , based on health clinics of UNRWA in Gaza strip. Target population All pregnant women who was registered at UNRWA clinics ,both old and new ,who attended for antenatal care during August,2009 in Gaza strip . Sample size A total of 164 women from UNRWA clinics in the middle region of Gaza strip were selected randomly to participate in the survey taking into account the distribution of population in each area to represent the study population fairly. The sample size was calculated by assuming a 95% confidence interval and sampling error no more than (5%) using Yamane formula (1967:886) as follows: Where n is the sample size N is the population e is the sampling error rate (5%) Instrument of the study The instrument used in this study was questionnaire which created to cover the objectives of the study .the questionnaire included four divisions . 1st division: The question is about socio-demographical data of the women including age, educational level, occupation, number of children, economical status and attending health education session .the questions in this division were closed-ended and open-ended. 2nd division: The questions is about knowledge and awareness of women regarding anemia concept ,nutrition ,iron supplements ,and the tea with meals. The questions included 3 choices (completely agree, partially agree and disagree). 3rd division: The questions about opinions and attitudes of women regarding anemia .It included 3 choices (completely agree, partially agree and disagree). 4th division: The questions about health education session regarding anemia. It included 3 choices (completely agree, partially agree and disagree). Data collection Data was collected using the structured questionnaire as a tool to collect data from the samples of study by individual interview performed by the researcher and with assistant of staff in UNRWA clinics who has the experience in data collection and methodology. data analysis After data collection ,the questionnaires were collected and the data was entered to computer software for processing and analysis. the programme used for analysis is (SPSS) statistical package for social sciences software version 15. Ethical consideration Clearance and permission was obtained from Chief Field Health Section of UNRWA in Gaza strip in order to conduct questionnaires survey among refugees pregnant women who attended UNRWA clinics for antenatal care and follow-up in Gaza strip. In addition, the permission was taken from the head of UNRWA clinics and also oral permission was obtained from the women who participated in the survey. CHAPTER 5 RESULTS The current study aimed to assess the awareness of anemia among pregnant women who attended UNRWA clinics for antenatal care. Table 6.1 Age distribution of pregnant women Percent Frequency Age groups (years) 8.5 % 14 Less than 20 34.8 % 57 20 -25 25 % 41 26-30 31.7 % 52 More than 30 100 % 164 Total Table 1.6 shows that most (34.8%) of parti

A Long Way From Chicago by Richard Peck :: A Long Way From Chicago Richard Peck

â€Å"A Long Way From Chicago† by Richard Peck The book â€Å"A Long Way From Chicago† is an adventurous and funny story. The story takes place at Joey Dowdel’s Grandmothers farm house in the country. Joey and his sister Mary Alice were sent to their Grandma’s house during the summer because their parents had to go to Canada for their work. At first, Joey felt uncomfortable with his Grandmother because he had never met her before but eventually he got to know her and they became close friends. On the first week at Grandma’s, a man named Shotgun Cheatman died. Everyone in the town went to the funeral because he was the well known assistant to the Mayor. The funeral was held in Grandma’s house and a creepy thing happened that night when Tom the cat crawled inside the casket. The next day, Joey, Mary Alice and Grandma left the house and walked across fields of tall grass and â€Å"cow pies aplenty† to Salt Creek to go fishing. They found an old wooden boat and Grandma rowed the boat out into the creek. While on their fishing adventure, they encountered a cottonmouth snake that fell into the boat and a party of drunken men on land dancing in their underwear. Strange things began to happen the next couple days. First, Joey was in the living room of Grandma’s house making a jig saw puzzle. He heard the sound of a horses hooves walking slowly on the street then the sound stopped in front of the house and heard someone put something in Grandma’s mail box. Joey heard the horse walk away and a little while later Grandma’s mailbox blew up. Next, Ms. Wilcox’s outhouse was destroyed by a cherry bomb. Then, a dead mouse was found floating in the bottle of milk that was delivered to the front

Buffalo Bill Essays -- essays research papers

Buffalo Bill   Ã‚  Ã‚  Ã‚  Ã‚  William Frederick Cody, also known as Buffalo Bill, was born into an anti-slavery family. He had a rough childhood, but despite this hardship he grew up to be an adventurous wild west showman, and achieve many historical goals.   Ã‚  Ã‚  Ã‚  Ã‚  On February 26, 1846, near the small town of LeClair, Iowa, William F. Cody was born to Isacc and Marry Ann Cody. At the time William had two sisters, Martha and Julia, and a brother, Samuel. But he ended up with three more sisters, Eliza, Helen, and May, and another brother, Charlie. In the first eight years of his childhood, William grew up on a farm his father owned and worked. During this time, William had plenty of space on the Plains to play with his brother Sam and his black dog, Turk. William also had some young Indian friends he met while on a picnic with his sisters. The Indians were trying to steal the Cody's lunch, but Bill stopped them and became friends with them. Besides picnics, young Will also enjoyed riding horses, having pretend Indian fights with Sam, and hunting in the woods. Sadly, Samuel died when he was thrown from his horse. Because of this, William not only lost a brother but he lost a very good friend.   Ã‚  Ã‚  Ã‚  Ã‚  In 1854 William, along with his anti-slavery family, moved near the city of Leavenworth, Kansas. This was not an easy move for the Cody family seeing how most of that part of Kansas was pro slavery. They were worried about this because earlier in Iowa a dispute about slavery between Isacc and his brother Elijah, led to Elijah stabbing Isacc. Luckily, he survived and nothing like this happened in Kansas. While in Iowa, Bill had received no education. After moving to Kansas he attended several sessions of country school organized by his father. In the two and a half months he attended, Bill learned to read and write which would help him in his future careers.   Ã‚  Ã‚  Ã‚  Ã‚  In order to help his family after his father's death in 1857, William took his first job working for the firm, Russel Majors & Waddel, making wagon- train trips across the Plains. It was rough, but William enjoyed these frequent trips. Later, Will road for the Pony Express when it was established in 1860, and was a scout and guide for the Union Army.   Ã‚  Ã‚  Ã‚  Ã‚  When the Civil War started in 1863, Bill... ...g buffalo in his show and raising them on his ranch, Bill helped save them from possible extinction. Buffalo Bill's Wild West Show also offered Indians employment at a time when their opportunities were few, and many of them, for the first time thus learned of a world beyond the limits of their villages.   Ã‚  Ã‚  Ã‚  Ã‚  After 1894 Cody lived on a ranch in the Bighorn Basin in northwestern Wyoming where he raised buffalo. He also founded the town of Cody where he built the Irma Hotel, named after his daughter, which still stands today.   Ã‚  Ã‚  Ã‚  Ã‚  On January 10, 1917, near Denver, Colorado, the wild west legend, Buffalo Bill Cody, died. His grave is located on Lookout Mountain, near the town of Golden, Colorado, and can be seen by tourists.   Ã‚  Ã‚  Ã‚  Ã‚  Buffalo Bill Cody was very important to the west. Even though he made the mistake of killing thousands of buffalo, he realized this and made up for it by repopulating and raising buffalo. Cody was lucky in some aspects; one was living in the wide open Plains. William Frederick Cody should be remembered as a wild west legend who showed what life was like in The Great Plains of America.

Graduation Speech -- Graduation Speech, Commencement Address

Well, this is it. Our last night. The last page of the scrapbook we call high school. Our scrapbooks are filled with memories from the first day we walked into these halls ... to this very night. Pictures crammed in, ticket stubs nestled between them, adorned by dried corsages and newspaper clippings, yellowed with every fond recollection. The smiling pictures are the friends we?ve made in high school. Friends are what make life special. Every person we encounter has a definite effect on our lives. If one face in our scrapbook were missing, a part of our lives would disappear also. Remember the football game where you finally got the fight song right? That?s your ticket stub. Maybe it was the musical that you rehearsed months for. Or cheering at the state basketball tournament. Or ... Graduation Speech -- Graduation Speech, Commencement Address Well, this is it. Our last night. The last page of the scrapbook we call high school. Our scrapbooks are filled with memories from the first day we walked into these halls ... to this very night. Pictures crammed in, ticket stubs nestled between them, adorned by dried corsages and newspaper clippings, yellowed with every fond recollection. The smiling pictures are the friends we?ve made in high school. Friends are what make life special. Every person we encounter has a definite effect on our lives. If one face in our scrapbook were missing, a part of our lives would disappear also. Remember the football game where you finally got the fight song right? That?s your ticket stub. Maybe it was the musical that you rehearsed months for. Or cheering at the state basketball tournament. Or ...

Case Solution

Problems Q. 1 Consider a five-year coupon bond with a face value of $1000 paying an annual coupon of 15%. (i) If the current market yield is 8%, what is the bond’s price? (ii) If the current market yield increases by 1% what is the bond’s new price? (iii) Using your answers to part (i) and (ii) , what is percentage change in the bond’s price as a result of 1% increase in interest rates. Q. 2 Consider the following FI balance sheet: M. Match Ltd Assets| Liabilities| –year Treasury bond $175,000| 1-year CD$135,000| 15-year corporate bond$165,000| 5-year deposit$160,000| Notes: All securities are selling at par (equal to book value). The two-year Treasury bonds yield 5%; the 15-year corporate bonds yield 9%; the one-year CD issue pays 4. 5% and the five-year deposit pays 8%. Assume that all instruments have annual coupon payments. (a) What is the value of M. Match Ltd’s equity? (b) What is the weighted average maturity of FI’s assets? (c) What i s the weighted average maturity of FI’s liabilities? d) What is the FI’s maturity gap? (e) What does your answer to part (d) imply about the interest rate risk exposure of M. Match Ltd? (f) Calculate the values of all four securities on M. Match Ltd’s balance sheet if all interest rates increase by 2%. (g) What is the impact on the equity of M. Match Ltd? Calculate the percentage change in the value of equity. (h) What would be the impact on M. Match Ltd’s risk exposure if its liabilities paid semi-annually as opposed to annually? Q. An insurance company issues a $100,000 one-year bond paying 7% annually in order to finance the acquisition of a $100,000 one-year corporate loan paying 9 % semi-annually. (a) What is the insurance company’s maturity gap? What does the maturity model state about interest rate risk exposure given the insurance company’s maturity gap? (b) Immediately after the insurance company makes these investments, all interes t rates increase by 3%. What is the impact on the asset cash flows? What is the impact on the liability cash flows?

Epo in Sport

Competitive athletes are constantly in search of ways to get better, seeking a slight edge over their closest competition. They are willing to practice for countless hours, put themselves through rigorous training and follow a very strict diet. Those who are passionate about their sport are willing to do just about anything to improve performance, but just how far are athletes willing to go? With recent advancements in sports science, it has become possible to alter some elements of human physiology.The human body has been meticulously studied over the years, and as a result we are able to comprehend how complex systems function enabling the human body to perform simple everyday functions, as well as, impressive athletic performances. Science has discovered there are ways to improve the physiology of the human body to enhance athletic performance. By carefully tailoring specific functions to enhance a specific task an athlete will most likely be able to get the â€Å"one up† o n the competition.Science has also discovered there are dangers associated with tampering with these complex systems that keep the human body alive and well. Unfortunately, some athletes ignore the physiological risks/ professional repercussions and indulge in enhancing some physiological processes in order to gain a slight edge against the competition. Today, as well as in the past, various sporting organizations have had to deal with performance-enhancing issues through testing of their athletes, yet these people continue to seek out ways to sneak under the wire, undetected.One example of athletes trying to beat the system is that of the recently publicized performance-enhancing dispute with blood doping in the sport of cycling, namely the use of recombinant human erythropoietin (Robinson, Mangin, and Saugy 2003). The following will discuss the function of erythropoietin, its uses in medicine and athletics, the benefits and risks of artificial along with testing methods for detect ion of illegal use. In order to perform in endurance sports, efficient oxygen delivery from lungs to muscles is crucial.The cells responsible for oxygen delivery are erythrocytes, or red blood cells. The functional portion of the red blood cell that acts as an oxygen carrier is the protein molecule hemoglobin (Kraene, Fleck and Deschenes 2012). Hemoglobin is a four part haem-iron containing protein, with two alpha and two beta subunits associated with each molecule. Hemoglobin accounts for 99% of the protein composition of an erythrocyte (Lippi, Franchini, Salvengo et al). Circulating blood contains approximately 40-45% red blood cells in its composition (Kraene, Fleck and Deschenes 2012).The hemoglobin associated with each red blood cell has a specific mechanism for pick-up and delivery of oxygen. This mechanism depends on varying physiological body conditions during which oxygen has differing affinity for the hemoglobin molecule. The conditions at which affinity for oxygen is high include lower body temperature, low carbon dioxide, and low 2,3-diphosphoglyerate (Elliott 2008). As these are the conditions found in the lungs, plentiful oxygen will bind to the hemoglobin for transport to the tissue cells in the body.In the tissue where carbon dioxide concentrations are high, body temperature increases, higher hydrogen ion and ,2,3-disphosphoglycerate concentrations, oxygen affinity for hemoglobin is reduced, resulting in the delivery of oxygen to tissues (Elliott 2008). During physical exercise, the body's consumption of oxygen is increased due to the demand of working muscles. As a result of this process, the carrying capacity of hemoglobin is adjusted automatically to deliver adequate oxygen to the muscle tissues (Lippi, Franchini, Salvango et al 2006).Applying this principle of supply and demand, to an endurance sport, one can see how an athlete’s aerobic training regime aims to peak the efficiency of the process of oxygen delivery from lungs to muscl e tissue. To maximize the process of oxygen delivery, a high number of circulating erythrocytes is desired, resulting in more available hemoglobin and therefore more oxygen can be delivered to working muscles. Red blood cell (RBC) production, called erythropoiesis, is carefully controlled and monitored by the body (Lippi, Franchini, Salvango et al 2006).This monitoring system involves oxygen-sensing cells to detect hypoxia (low oxygen concentration) in the body. During oxygen deprivation, a nerurosecretory mechanism is activated through chemoreceptors found in the carotid body ( in the carotid artery found in the neck) and in the lungs. If out of balance, the body undergoes rapid cardiopulmonary adjustments to compensate for the current stress of hypoxia (Kraene, Fleck and Deschenes 2012). One of the factors present during hypoxia is the hypoxia inducible factor, HIF-1.This molecule acts as a transcription factor for controlling several genes (Lippi, Franchini, Salvango et al 2006). When oxygen levels are low, the enzymes that normally inhibit HIF-1 cease their activity. The HIF-1a molecule becomes available is now capable of binding with HIF-b to cross the nuclear membrane of the cell and promotes gene transcription (Lippi, Franchini, Salvango et al 2006). One of the main coding events that occurs as a result of the gene transcription is production of erythropoietin (Epo).This endogenous Epo is then produced in the body, specifically in the peritubular capillary-lining cells of the renal cortex of the kidneys, with minute amounts produced in the liver and brain (Kraene, Fleck and Deschenes 2012). When the Epo molecule is synthesized, the composition is initially a 193 amino acid molecule that eventually is released as a 165 amino acid protein with much of the total molecule composed of carbohydrate (Lippi, Franchini, Salvango et al 2006). The release of Epo from the kidney to the blood then stimulates erythropoiesis in the bone marrow (Kraene, Fleck and Desch enes 2012).Science advancements in the 1980’s have led to a synthetic form of Epo known as recombinant human Epo (rHuEpo) (Spedding and Spedding 2008). It was first introduced by a team of researchers at the Northwest Kidney Centres, who conducted clinical trials that resulted in the first successful artificial form of this hormone (Eichner 2007). The production of rHuEpo, from mammalian cells to treat anemic patients was approved by the U. S. Food and DrugAdministration in 1989 (Elliott 2008). Today human recombinant erythropoietin is available in a variety of forms.It is synthesized with an amino acid sequence identical to that of endogenous erythropoietin, with slight differences in composition of carbohydrate portions of the molecule (glycosylation) (Lippi, Franchini, Salvango et al 2006). Alpha and beta erythropoietin are produced from Chinese hamster ovary cells with the only differences being a slightly longer half-life and slight difference in molecular weight (Lippi, Franchini, Salvango et al 2006). Another form of Epo is Erythropoietin gamma. It is produced from a different host cell and as a result has a different glycosylation pattern (Lippi, Franchini, Salvango et al 2006).Erythropoietin delta, yet another variation of the synthetic hormone, is the most recently introduced form. This type is produced from human cells, and has identical amino acid and glycosylation patterns as endogenous Epo, with a longer half-life of 18-20 hours compared to the 7-12 hour range of alpha and beta forms (Lippi, Franchini, Salvango et al 2006). The current research is clinically testing a protein called Continuous Erythropoietin Receptor Activator (CERA). This protein has a half-life of 133-137 hours, which equates to less frequent dosing.CERA unlike other synthetic forms of this hormone, has very mild side-effects and has yet to produce any serious adverse effects (Lippi, Franchini, Salvango et al 2006). This type of synthetic Epo may be the best option avail able for patients who require treatment for anemia (low hemoglobin levels). Unfortunately, some people suffer anemia due to various medical issues such as kidney disease, chemotherapy for cancer, HIV, blood loss, et cetera (Kraene, Fleck and Deschenes 2012). The body's demand for Epo becomes more significant when such medical conditions arise.Often times Epo needs to be artificially supplemented to compensate for the lowered hemoglobin production/ hemoglobin loss (Catlin, Fitch and Ljungqvist 2008). Originally, recombinant human erythropoietin was developed as a substitute for endogenous Epo for those who suffered from abnormal blood conditions. It is highly effective in increasing hemoglobin levels, and as a result has numerous benefits such as, reduction in required blood transfusions, restoring energy levels, increase in exercise capacity, improves cognitive function and overall quality of life improvement (Elliott 2008).When administering this hormone, the dose, frequency of adm inistration, the rate of rise of hemoglobin and target hemoglobin levels are strictly controlled (between 10-12g per 100mL), slightly lower than the range for normal range of 13-15g per 100mL. The lower range is maintained in order to keep the risks and side effects of the rHuEpo minimal (Lippi, Franchini, Salvango et al 2006). Careful monitoring and control is used to maximize the benefits for patients while minimizing the risks.Recombinant Epo not only benefits those who are suffering a blood condition but it has significant benefits to athletic performance (Elliott 2008). It is used illegally as an ergogenic aid primarily in endurance sports, such as cross-country skiing, track, swimming, and most notoriously, cycling (Bento, Damasceno, Neto 2003). One study, as noted in Exercise Physiology (Kraene, Fleck and Deschenes 2012), that involved well-trained male endurance athletes administered recombinant human erythropoietin 3 times a week for 30 days or until hematocrit levels reach ed 50%.The following resulted: an average hematocrit increase of 18. 9% (range of 42. 7-50. 8%), cycling time to exhaustion had increased 9. 4% (12. 8-14. 0 minutes longer), and cycling VO2 peak had increased 7% (range of 63. 8-68. 1 ml/kg/min). Another study also noted in Exercise Physiology (Kraene, Fleck and Deschenes 2012) gave low-dose subcutaneous injections of rHuEpo over a 6 week period to moderately to well-trained athletes and what resulted was a 6-8% increase in VO2 peak, time to exhaustion on a treadmill increased 13-17%, and hemoglobin concentration and hematocrit both increased by approximately 10% each.The use of recombinant human erythropoietin is found to have clear benefits in athletic performance, with higher trained individuals exhibiting enhanced results. At an elite level, where competition is so close, it is tempting for athletes to gain an edge over their competition though the use of rHuEpo. There is a certain amount of pressure on athletes in cycling to use ergogenic aids due to the fact that so many of the sport's top competitors are using it to boost performance (Vogel 2004). In cycling, the abuse of this ergogenic aid has recently come to light in the media.Although many benefits can be reaped in athletic performance from recombinant erythropoietin, it is not without risks. When synthetic forms were first introduced, many of the risks were unknown to athletes and use was not medically monitored as would be the case with an anemic patient. As a result, sudden heart attacks occurred that led to more than a dozen deaths of Dutch and Belgian cyclists (Vogel 2004). Their deaths were connected to inappropriate administration of rHuEpo. This form of Epo had not yet been clinically studied from an athletic perspective.The combination effect of increasing hemoglobin to well above normal range along with other factors associated with endurance sports, makes tampering with the body's natural blood physiology dangerous and potentially deadly ( Robinson, Magin and Saugy 2003). Myocardial infarction, cerebrovascular disease, transient ischemic attack and venous thromboembolism were all found to be potential events associated with the misuse of rHuEpo (Catlin, Fitch and Ljungqvist 2008). Due to the increase of red blood cells, the blood becomes more viscous and leads to an increased frequency risk of thrombotic events.There have also been proven reports of increased risk for migratory thrombophlebitis, microvascular thrombosis and thrombosis of cerebral sinuses, retinal artery, and temporal veins. The increased blood viscosity also increases systolic blood pressure during sub-maximal exercise and increases platelet reactivity resulting in risk of more blood clotting (Bento, Damasceno, and Neto 2003). One of the most serious risks found to be associated is that of red cell aplasia in which red blood cell formation ceases. Although rare but ife-threatening, this condition was found to be linked to the use of subcutaneous alpha -Epo (Lippi, Franchini, Salvango et al 2006). Anemia may also develop in individuals who mis-use rHuEpo after they discontinue the hormone, as it causes progressive erythroid marrow exhaustion due to prolonged periods of use. Some other risks and side effects include headache, muscle cramps, incomplete deviation of red blood cells, convulsion, and upper respiratory tract infections (Kraemer, Fleck and Deschenes 2012). The risks of using rHuEpo are more significant for athletes than average patients who are using for treatment.Athletes pushing to increase hemoglobin outside of a normal range run the risk of life-threatening circulatory/blood abnormalities. Testing for the use of banned erythropoietin in sports has been an ongoing challenge. As quickly as testing laboratories can produce testing methods for banned substances, new ways to slide under detection are being found (Cazzola 2000). It is difficult to directly identify rHuEpo as it has a relatively short half-life in most form s, for example an administration of 50 IU/kg given subcutaneously has a half-life of approximately 35. hours, and intravenous administration has a half-life ranging from 4 to 7 hours (Lippi, Franchini, Salvango et al 2006). Athletes could selectively time the administration of Epo and combined with concealing strategies to slip under the wire. As a result, laboratories are required to look at specific biomarkers that indicate past or current use of rHuEpo (Delanghe, Bollen and Beullens 2007). Human recombinant erythropoietin was initially a challenge to detect as various forms are extremely similar to that of endogenous Epo (Skibeli, Nissen-Lie and Torjesen 2001).As it is a rising issue in sport, laboratories are required to find better ways to detect the illegal use of rHuEpo. Initially as a measure to deter doping and identify usage, cutoff levels of hematocrit (the percentage of red blood cells in the blood) were established in some sports (Adamson and Vapnek 1991). For example, the International Cycling Union established cutoff hematocrit levels of 47% for women and 50% for men. This method was flawed, as it sometimes produced false positive results in athletes with naturally high hematocrit levels (Casoni, Ricci, Ballarin et al 1993).Currently, there is no foolproof testing method to detect the use of recombinant human erythropoietin. A combination of indirect and direct testing is currently the most effective method to identify blood dopers (Cazzola 2000). Indirect testing uses a blood sample and is based on the analysis of hematological parameters, including measures of hemoglobin, hematocrit, soluble transferrin receptors, serum Epo, percent reticulocytes, and macrocytes (Delanghe, Bollen and Beullens 2007).Changes observed in the above measures are often a result of introducing recombinant Epo to the body and can be used as an indirect marker to detect the substance (Skibeli, Nissen-Lie and Torjesen 2001). There is a reference range of parameters set for this form of testing, one indicating current use of Epo while the other can indicate recently discontinued use of Epo (Parisotto, Wu, Ashenden et al 2001). Indirect testing has the advantage of being able to detect Epo use several weeks after it has been administered, however the disadvantage of possibly producing false-positive results (Delanghe, Bollen and Beullens 2007).Changes in the measuring parameters used in indirect testing can also be the result of the body's natural modifications from training methods such as altitude training (increasing RBC levels due to lower oxygen at higher altitude, a naturally occurring body compensation) (Kraemer, Fleck and Deschenes 2012). Indirect testing is useful in being a primary indication of recombinant erythropoietin use, yet it is not completely reliable.If use of Epo is suspected after using indirect testing methods, direct testing will follow to confirm or deny the results (Birkeland and Hemmersbach 1999). Direct testing for recomb inant Epo involves the collection of a urine sample. The urine sample needs to be fairly large (20ml) and strongly concentrated (between 700-1000 fold) (Elliott 2008). The approved test that uses the direct approach is based on differences in glycosylation between endogenous Epo and artificial forms (Elliott 2008).The recombinant and endogenous forms of erythropoietin have varying isoelectric points (pI). Using isoelectric focusing (IEF), the isoelectric points can be determined (Skibeli, Nissen-Lie and Torjesen 2001). The normal range for the pI of endogenous Epo is 3. 7-4. 7, while alpha and beta Epo have a slightly higher range of 4. 4-5. 1. The Aransep form of Epo has 2 extra N-glycosylaton sites in order to increase its stability, resulting in a pI range of 3. 7-4 (Parisotto, Wu, Ashenden et al 2001).In order to see the isoforms of Epo, double immunoblotting is used in combination with monoclonal anti-Epo antibodies. The interaction of the antibodies with the recombinant forms of Epo shows if illegal forms are present in the urine (Skibeli, Nissen-Lie and Torjesen 2001). The purpose of the double immunoblotting technique is to avoid secondary antibodies interacting with proteins in urine and affect the test. A technique known as chemiluminescence is used on the blot to image the Epo (Skibeli, Nissen-Lie and Torjesen 2001).Direct testing can detect most forms synthetic Epo. When a test is found to be positive for an illegal form of Epo, a second test is performed due to the fact that occasionally enzyme activity causes a shift in the electrophoretic banding pattern of the molecule (Parisotto, Wu, Ashenden et al 2001). Additional stability testing is performed where the urine sample is incubated overnight in an acetate buffer and rHuEpo. If a banding shift is observed during the isoelectric focusing, it can be determined that the sample is negative for rHuEpo (Parisotto, Wu, Ashenden et al 2001).The direct testing method is currently the most reliable and a pproved approach and can be used during competition and off-competition periods (Elliott 2008). The development of recombinant human erythropoietin was originally an approach to treat low hemoglobin levels in anemic patients. The athletic gains that can be exhibited through introducing rHuEpo have caused abuse at the elite level in many sports. Other than disqualification and loss of credibility as an honest athlete, there are also medical risks associated with tampering with the blood's physiology in artificial ways.A combination of testing methods is currently used to identify those using rHuEpo as an ergogenic aid, as there is no single test that can clearly deny of confirm use. New ways to slip under the wire with testing are being discovered and used by athletes and laboratories are constantly working to keep up. The use of recombinant human erythropoietin is a serious issue of misconduct in sport and needs to be ended in order to keep competition ethical and fair.