Abolition for Bilingual Education

One half of United States children who are not proficient in English live in California, a state who's future depends on these three million children becoming fluent in English. In 1968, the Bilingual Education Act was passed with the theory that if you academically instructed students in their native language first, learning English would be better and faster in the long run. Since the passage of bilingual education, there has been a continuing debate over whether or not the programs are benefiting children. Although there is not any research to support this conclusion, bilingual advocates believe that â€Å"bilingual students who first master Spanish and then make a transition to English, do at least as well academically in the long run as their English-only counterparts† (Netkin 1). Supporters feel that even if students are not gaining in English, the programs keep them from falling behind in content areas and also boost their self-esteem, which gives them the confidence to catch up later. The search for some proof that the five hundred million dollar industry works to help immigrant children learn English, in order to prosper in a California society, continues with little success. For decades throughout California, bilingual education has been commended as a miracle for schoolchildren who are not proficient in English, but the programs have been proven to be unsuccessful and should be abolished. Research indicates that bilingual programs are not helping children, but instead are bringing about high drop out rates and low test scores. There have been many struggles to educate children in bilingual programs. Teachers and instructional materials are hard to find, which makes instruction in academic subjects to the great number and mix of children difficult. Highly transient students and the inability to involve parents in their children's education present a barrier to instruction. Bilingual programs require great amounts of money that California taxpayers should not have to provide because taxpayers should not be responsible for teaching immigrants the American language. Proposition 227 was passed in June of 1998 that was to eliminate bilingual education and place children with limited English proficiency into classes where English is the only language spoken. This new law will enable California schoolchildren to succeed in America and taxpayers will no longer have to provide for a program that â€Å"actually keeps children from learning English, the language of their future, and hinders success in American society† (McCain). â€Å"63% of research shows no difference between bilingual education and doing nothing† (Research Evidence of Bilingual Education 4). Each year, only five percent of the bilingual schoolchildren gain English proficiency. Scores on comprehensive tests reveal that students who move from bilingual classes to English-only classes are unable to perform. Latino children in bilingual classes â€Å"end up not speaking either Spanish or English well† (Netkin 2). They have the highest dropout rate, forty percent, of any ethnic group and have consistently scored the lowest on Scholastic Assessment Tests. Instructing children in their official language and not teaching them English is making the children unable to succeed in society. Since this is an American country, children should be placed in English speaking classrooms in order to learn the language of the dominant group. Educating children in bilingual programs is difficult. Schools cannot provide the proper bilingual instruction because teachers and materials are limited or unavailable. Students speak languages that are not historically represented in the United States so bilingual teachers and materials for the languages are nonexistent. Even in schools where all students speak Spanish, teachers are hard to find and have to be recruited from Spanish speaking countries. However, sometimes the immigrant teachers cannot be certified to teach because they lack a college degree or simply cannot pass the English portion of a state teacher certification test. The California Department of Education estimates that about twenty-two thousand bilingual teachers are needed for instruction and studies predict that filling the need may be impossible. Bilingual education cannot provide children with the instruction needed to prosper in California so the programs should be eliminated. Immigrant students are highly transient which makes continuous instruction difficult. New students arrive to schools on a monthly basis, contributing to overcrowded classrooms that make teaching complex. Existing students move frequently or are regularly absent for long periods of time, disrupting their learning. Often times, students with excessive absences from school cannot be promoted to the next grade level or graduate, which makes the children discouraged and leads to them dropping out of school. Transient actions effect a student's ability to receive an education, contributing to the failure of bilingual programs. Parental involvement is important for student achievement, but extreme struggles arise when trying to involve parents in their children's education. Many parents are illiterate in their native language as well as English, making communication impossible. Translators are used successfully, but for uncommon languages, very few translators are available. Parental self-help classes are provided to parents who have trouble communicating. The classes have taught parents how to help their children in school, but several problems with parent involvement remain. Without the five hundred million dollars a year that taxpayers provide to the federal government, bilingual education programs would not exist. Why should the taxpayer be responsible for immigrants learning the American language? Before entering this country immigrants know that English is the dominant language, therefore, they should be responsible for learning the language themselves. By not knowing English and being unable to communicate effectively, newcomers are only hurting themselves. Taxpayers should not be responsible for educating immigrants. Learning English should be the responsibility of the person seeking to speak the language. Proposition 227 was passed to eliminate bilingual education. Children with limited English proficiency are to be placed into English-only classes where their native language is never spoken. This practice is called English immersion, a non-taxpaying system that will push children toward the quickest path to success in America. Students will learn English better and faster by being around the language all-day and everyday. The quicker they learn the language the sooner the students will be able to join in with their peers and develop an education. Although Proposition 227 was passed in June of 1998 to eliminate bilingual education, the programs remain in schools. â€Å"In Redwood City, south of San Francisco, the school district reports that eighty percent of Spanish-speaking children are still enrolled in bilingual† (Michels). Many other schools have confessed to not eliminating bilingual classes. The schools feel that the children need to be transferred to English-only classes slowly in order to avoid student confusion. Bilingual supporters feel that the programs give children self-esteem and a better education. This is absurd. Separating children from others because they cannot speak English makes them feel insecure and different. If anything, the students loose self-esteem and pride, making learning difficult. Bilingual programs are a failure and schools should obey the law and abolish the instruction. â€Å"The students will gain whatever added self-esteem they need when they develop proficiency in English, the language in which their peers are learning, and the language that they will need to succeed in the United States† (Netkin 1)

He Wished for the Cloths of Heaven and Love by George

This poem comes across as a declaration of love where the poet has used rich imagery and metaphorically described the sky as a cloth. He paints a beautiful image of the sky as being ‘inwrought with golden and silver light†, golden during the day and silver with the light of the moon. The picture created In the mind of the reader of spreading the cloths under her feet, Like a cloak, Is a romantic and chivalrous one. The tone In the beginning of ‘Cloths of Heaven' Is one of exuberance as it describes a joyful, effervescent declaration of love but awards the end it changes to fearful as the poet considers that his love might be rejected.I believe this poem captures the pain of unanswered love which is capable of permanently wounding a person, hence to avoid being a victim of such a situation, Yeats is warning his love to be careful with his heart and dreams for he feels fragile and vulnerable in his declaration of love. George Herbert ‘Love' on the other hand, ex plores his love for the Almighty. He draws attention to the fact that God is love. It shows God as a gracious host, perceptive and tolerant of the unavoidable failings of is honest followers, full of generosity and goodness, who overcomes all of objections to uniting ourselves with Him.The poet who Is keen on meeting God holds himself back because he feels undeserving as a result of the sins he has committed, which strengthen his belief In the fact that Is he not worthy enough to stand before the Almighty. God is portrayed to be so open, so loving and forgiving. All the poet's protests are met with gentle persuasion, which is something that we all identify God's loving nature with. Both the poems bring out different aspects of love.In ‘He wishes for the Cloths of Heaven', Yeats talks about romantic love and the pain one must bear if that love is rejected, while George Herbert ‘Love' not only describes his love for God but also talks about the Almighty loving nature but a lso the beauty of his love for mankind. Yet, the underlying factor in both the poems is Love. He wishes for the Cloths of Heaven – William Butler Yeats HAD I the heavens' embroidered cloths, Inwrought with golden and silver light, The blue and the dim and the dark cloths T nylon anon align an I would spread the cloths under your feet:But l, being poor, have only my dreams; I have spread my dreams under your feet; Tread softly because you tread on my dreams. Love – George Herbert Love bade me welcome; yet my soul drew back, Guilty of dust and sin. But quick-eyed Love, observing me grow slack From my first entrance in, Drew nearer to me, sweetly questioning If I lacked anything. ‘A guest,' I answer's, ‘worthy to be here:' Love said, ‘You shall be he. ‘ ‘l, the unkind, ungrateful? Ah, my dear, I cannot look on Thee. ‘ Love took my hand and smiling did reply, Who made the eyes but I? ‘ ‘Truth, Lord; but I have marred them: le t my shameGo where it doth deserve. ‘ ‘And know you not,' says Love, Who bore the blame? ‘ ‘My dear, then I will serve. ‘ ‘You must sit down,' says Love, ‘and taste my meat. ‘ So I did sit and eat. Question 3 On this cold winter's night Only poor street children are in sights She calls out to the man on the street â€Å"Sir, can you help me? It's cold and I've nowhere to sleep, Is there somewhere you can tell me? † No blankets no shoes How on earth will they make it through He walks on, doesn't look back He pretends he can't hear her Starts to whistle as he crosses the streetSeems embarrassed to be there Oh think twice, it's another day for You and me in paradise Oh think twice, it's Just another day for you, You Ana me In paradise He can see she's been crying It's such a sad sights To be out, on this cold night, 0 You should be in bed all nice and tight Not wet and cold, with no one to hold. She's got blisters on the soles of h er feet Can't walk but she's trying You are precious, were u ever told? 0 Someone should known Just where do they go? Oh lord, is there nothing more anybody can do Oh lord, there must be something you can sayFor, it is a sin! For these poor street children. To be in plain sights On this cold, wet winters night. You can tell from the lines on her face You can see that she's been there Probably been moved on from every place ‘Coos she didn't fit in there Another Day in Paradise – Phil Collins He walks on, doesn't look back Oh! Think twice, it's another day for Oh! Think twice, it's Just another day for you, can Chi. WA K out sense trying Street Children No blankets, no shoes How on earth will they make it through Besides their cold faces,0 Wet legs and muddy traces. They stand here all alone With no umbrella nor a phone. 0 To be out, on this cold night,0 Not wet and cold, with no one to hold. 0 You are precious, were u ever told? 0 Just where do they go? 0 For is a sin! 0 For these poor street children. O ‘Another day in Paradise' talks about the disheartening story of a poor, homeless child who has nowhere to sleep and is unable to bear the cold outside so she asks a man passing by if he knows of some place where she can go but her question is answered with silence as the man walks off, embarrassed to be there.The writer questions god f there is anything he can do to solve their problem and get rid of their pain. Hence, the plight of homeless children, their suffering and their pain is brought out in this Dialectal song Day panel Collins. An anonymous writer won napes to De a rescued homeless child has written the poem. Both, the song and the poem have an underlying theme, which is the pain and suffering of poor children with nowhere to go. In the poem, the poet compares the life of a street child to that of a regular child of the same age and brings out the difference between their lives.Like on a cold inters night, a child must be tucked in to bed, not Wet and cold with none to hold'. Street children do not deserve to grow up in such horrid conditions. It is indeed a sin to see them suffer this way, and do nothing about it. They have nobody to look after them or look out for them. In this poem, the poet brings out the sadness in her heart stemming from the pain she feels by seeing little homeless children endure all the pain and suffering they do not deserve. Hence, in my opinion the poem and the song go well together as both are directed towards a common issue, the plight of homeless children.

British Monarchy

Dudrova Julia, group 507 Essay The British Monarchy Today The United Kingdom is a constitutional monarchy. This means that it has a monarch as its Head of State. The monarch reigns with the support of Parliament. The powers of the monarch are not defined precisely. Everything today is done in the Queen’s name. It is her government, her armed forces, her low courts and so on. She appoints all the Ministers, including the Prime Minister. Everything is done however on the council of the elected Government, and the monarch takes no part in the decision – making process.In one article about Britain it was written that the British monarchy can be discussed in Britain as well and if it did have a vote the result outcome would be equal and would have a stronger and more interesting debate. In addition, the one important fact that Britain is very expensive country, for instance, for Russian tourists. It is not surprised because of any kind of taxes, which people should pay †Å"every hour of their life†. That is why people in Britain and in other countries think that the queen is the richest woman in the world.A lot of politicians, besides simple people today wants to prevent the British monarchy and moreover, for such thought there are many reasons. For instance, the fact that many times it has been the case that the monarch is not British and from somewhere else, that is why person can question him or herself: â€Å"I am British and still a worker, but she is from somewhere else and a monarch? Why does she deserve it? † This has a very harsh effect on the people and the state, since she might be helping her country with the money from the British people, from people who earn money by their own honest hands.It can be said that Britain and it's â€Å"blooming† turns out with a help of working-class people. In case of previous words it results that we may consider that the queen is not important because she does not participate in the government or running the country. The job is done by the Prime minister. The only thing she does is signs the final bill so that it becomes a law. Unfortunately, she does not check it, or read it. Therefore, people should not blame her for such big taxes and expensive things, with which tourist face with when come to the United Kingdom. You have to give the money to the queen for sitting and sleeping and eating all day.For example when the people come, they buy souvenirs, but they even stay here and we serve them. We have to have more space and more habitats for them to live. That costs a lot! In conclusion, it can be said that the British monarchy is quite controversial issue. As in other countries the authority and all it's branches has pros and cons. Therefore, about the monarchy in Britain, about trying to get rid of it people can speak for hours, but what is pitty†¦ Not anybody apart authority can change the life and the lows of the country. http://www. facebook. com/TheB ritishMonarchy? v=wall http://www. royal. gov. uk/ British Monarchy Dudrova Julia, group 507 Essay The British Monarchy Today The United Kingdom is a constitutional monarchy. This means that it has a monarch as its Head of State. The monarch reigns with the support of Parliament. The powers of the monarch are not defined precisely. Everything today is done in the Queen’s name. It is her government, her armed forces, her low courts and so on. She appoints all the Ministers, including the Prime Minister. Everything is done however on the council of the elected Government, and the monarch takes no part in the decision – making process.In one article about Britain it was written that the British monarchy can be discussed in Britain as well and if it did have a vote the result outcome would be equal and would have a stronger and more interesting debate. In addition, the one important fact that Britain is very expensive country, for instance, for Russian tourists. It is not surprised because of any kind of taxes, which people should pay †Å"every hour of their life†. That is why people in Britain and in other countries think that the queen is the richest woman in the world.A lot of politicians, besides simple people today wants to prevent the British monarchy and moreover, for such thought there are many reasons. For instance, the fact that many times it has been the case that the monarch is not British and from somewhere else, that is why person can question him or herself: â€Å"I am British and still a worker, but she is from somewhere else and a monarch? Why does she deserve it? † This has a very harsh effect on the people and the state, since she might be helping her country with the money from the British people, from people who earn money by their own honest hands.It can be said that Britain and it's â€Å"blooming† turns out with a help of working-class people. In case of previous words it results that we may consider that the queen is not important because she does not participate in the government or running the country. The job is done by the Prime minister. The only thing she does is signs the final bill so that it becomes a law. Unfortunately, she does not check it, or read it. Therefore, people should not blame her for such big taxes and expensive things, with which tourist face with when come to the United Kingdom. You have to give the money to the queen for sitting and sleeping and eating all day.For example when the people come, they buy souvenirs, but they even stay here and we serve them. We have to have more space and more habitats for them to live. That costs a lot! In conclusion, it can be said that the British monarchy is quite controversial issue. As in other countries the authority and all it's branches has pros and cons. Therefore, about the monarchy in Britain, about trying to get rid of it people can speak for hours, but what is pitty†¦ Not anybody apart authority can change the life and the lows of the country. http://www. facebook. com/TheB ritishMonarchy? v=wall http://www. royal. gov. uk/

Principles and Functions of Management Essay Example | Topics and Well Written Essays - 1500 words

Principles and Functions of Management - Essay Example This theory focused upon the achievement of short term objectives as a means to fulfilling the long term goals of the organization. (Birnbaum 2000:43-52). Employees in every department were to set out short-term objectives, which were to be achieved within a certain deadline. Companies such as General Motors and RCA Foods adopted this method of management. However, in actual practice, this theory failed to take into account the political bickering and rivalry that existed between various departments. In actual practice, the departments rarely bothered to make and adhere to short-term objectives and the theory was soon scrapped by 1985, because it was found to be ineffective. The reason for this was because the theory failed to take into account the unpredictable human factor, that often results in problems arising with the practical execution of a management theory that may be sound good on paper but fails in practice. Managers therefore failed to make use of this theory on a wide ra nging basis, because while it sounded good as a theory it was not effective in actual practice. This is a commonly used management practice today and the tool through which it functions is commonly known as the SWOT analysis. This theory was also derived from Peter Drucker’s rational approach with an attempt to also include political inputs. This method involves the analysis of the Strengths, Weaknesses, Opportunities and Threats to a business. This was a management technique that was set out with the purpose of identifying a particular niche for every business. The aim and objective behind this management theory was to enable an organization to survive and compete effectively in a rapidly changing, globalizing environment. According to this theory, the SWOT analysis helps to analyze external and internal data within the organization and compare it with others in the industry in order to evaluate the exact

Formal analysis of Grey Lines with Black, Blue and Yellow Assignment

Formal analysis of Grey Lines with Black, Blue and Yellow - Assignment Example During this period, at was taken as a tool that would only talk about social issues and not political. Photos that were taken during this period were of celebration as the French Republic was now going to detach itself from the Britain rule and was going to start a new life. This photo seems to emphasize the significance of social responsibility that lead to equality. It is full of life and it is able to relish the remarkable sensations that life brings, the different line in the photo can be used to represent the fact that everybody should live life vividly and pass each stage with fulfilment. It can be related to this period as it portrays a symbol of hope as people move from the darkness towards light. The photo can be compared to the two as it is able to invite a number of interpretations. As opposed to the two, the photo can be used to project equality. The first photo shows some form of courage as the aeroplane is able to fly over a body of water which people are always afraid of. This can be compared to the photo that we are analyzing as the inside it is dark at the centre but the outside parts are bright. The second photo tries to show the presence of life across the road. This is an indication that one can achieve his goal only after a struggle. The color used in the two pictures is dark as opposed to the bright ones used in the photo being analyzed. The texture of the two photos seems to be rough while the one being analyzed is smooth. This artwork has been used to show meaning. It has been used to show creativity and is a symbol of appreciation. It can be used as a medium to pass a message depending on how the person interprets it. It is a picture that is communicating to us but without words or a voice. From this photo, it is evident that the artist was in a joyful state and that is why he used bright colors. The museum is most likely going to choose this piece because of the message that it is

Psychological Aspects of Cybersecurity Assignment

Psychological Aspects of Cybersecurity - Assignment Example Today, when the dependency on the use of computer systems and internet technology has increased significantly, the understanding and incorporation of cyber security proves to be highly essential (â€Å"What is Cyber Security?† 2010). The present study has considered social networking as the primary focus in regard to the psychological aspects of cyber security. Social networking in the present times is used by millions of individuals as a means of remaining connected with the outer world, with friends, near and dear ones as well as for professional purposes. However, a lot of personal information is, in turn, being shared in the process that might be used by cyber attackers to spread malevolent codes, viruses, or may even access the personal information and misuse it for their own purposes (McDowell & Morda, 2011, p.1). Thus the need for cyber security arises, and this study focuses on the vulnerabilities and threats associated with social networking and having impacts on the services and the users, thus trying to determine the possible cyber security measures and the level of customer satisfaction that may be achieved. In the recent years, the use of social networks has been found to have increased significantly. There are several online social networking websites like Facebook, Myspace, YouTube, and LinkedIn, to name a few. The relative size of the addressees in these social networks is huge, which is often not known to the users of the site. Moreover, the nature of such users is also unknown. Hence individuals tend to reveal a lot of personal information. This may actually result in a number of security related threats for the members and hence for the services as well. Thus it proved to be necessary to incorporate such cyber security as to protect personal information on social networks (Hasib, 2008). When individuals post their personal information on social networks, a permanent record of the users is created that may be used

Planning and Preparing to Teach Essay Example | Topics and Well Written Essays - 2000 words

Planning and Preparing to Teach - Essay Example In the process of going through the discussion, appropriate teaching and learning approaches will be tackled in details followed by identifying some strategic ways on how the paramedics can deliver inclusion sessions to motivate the learners to learn the best technique in managing the patients’ airway. To meet the curriculum requirements, the use of teaching and learning strategies as well as important resources will be discussed one by one. The paramedics has a huge role and responsibilities to meet when teaching the students to conduct basic life support such as the cardiopulmonary resuscitation (CPR) and first-aid techniques when dealing with emergency and life-threatening cases (Hazinski, et al., 2004). Specifically the blood loss that may occur when the victim is seriously injured can lead to cardiac arrest (The American Heart Association in collaboration with the International Liaison Committee on Resuscitation., 2000). This situation requires immediate call for ambulance, CPR, early defibrillation (if necessary), and early advanced life support to prevent brain death (Hazinski, et al., 2004; Hickey et al., 1995). By encouraging the students to perform immediate action, paramedics will be able to increase the survival rate of the victim (Robertson, 2000). Obstruction in the patient’s normal airway functioning is a life-threatening scenario since the lack of oxygen that flows in the blood that flows through the human body can lead to end-organ damage, hypoxia, hypoxemia, and high mortality rates. (Eddleston et al., 2006; Levy, 2005; St. John, 2004; Ayus & Arieff, 1995) For this reason, it is crucial on the part of the paramedics to pay close attention with the patients’ breathing pattern during the assessment stage. Given that the patient shows signs and symptoms that there is an obstruction to the patients’ airway, paramedics should immediately establish the patient’s airway as part of the initial management

Mini case study Assignment Example | Topics and Well Written Essays - 500 words

Mini case study - Assignment Example to as â€Å"essential and enduring tenets† that help define the company and are â€Å"not to be compromised for financial gain or short term expediency,† (DesJardins, 2006, p. 5). It is evident from the definition given above that it is unethical to exploit women in promoting beauty products for financial gain. For instance, the aspect of stereotyping beauty has caused severe pressure on women who try hard to change their appearance in order to suit the ideal model of a beautiful woman. Claiming that certain beauty products would make women look more beautiful unethical since it causes more negative impacts than positive gains especially on the consumers. This leads to social unrest where some women would end up looking down upon themselves and try to imitate the beauty stereotypes. Enlightened firms should encourage their managers to be socially responsible and seek ways to protect the long-run interests of their consumers (Kotler & Armstrong, 2010). In other words, presenting other beauty products as ideal for women causes unnecessary social unrest among the targeted audiences and this practice in business is unethical. 2. In my opinion, I think there should be no standardized approach to defining beauty within the international advertising and fashion industry. First and foremost, beauty is natural and there can be no universal yardstick that can be used to measure it. Each individual human being has his or her own expectations of what constitute beauty and this cannot be contested. The issue of beauty mainly emanates from opinionated views of different individuals which cannot be standardised. The other reason is that we all come from different backgrounds and there are different races across the globe. For instance, there are whites, Indians, Chinese, black as well as Arabic races women from these groups significantly differ. By virtue of the fact that we come from different races, it can be seen that it is impossible to have a universally agreed standard

Applied Modelling and Data Analysis Essay Example | Topics and Well Written Essays - 3500 words

Applied Modelling and Data Analysis - Essay Example The aim of this project is therefore to analyse the behaviour of the share price of a given company by finding the relationship between share price inflation and other key market determinants and variables such as market index and Treasury bill interest rate. This means that share price of the company is the dependent variable for the study, while market index and Treasury bill interest rate are the independent variables for the study. The study is conducted with the approach of performing time series that checks for stationarity by applying the formal unit root tests of Augmented Dickey-Fuller (ADF) test. To get a better understanding of the relationship between the dependent variable and independent variables, the researcher will take a step further to estimate time series dynamics through the use of the GARCH family models. Because shares are traded with their derivatives, there is a common discussion in literature of the impact of the introduction of derivatives on volatility. Th rough the GARCH model, the effect of derivatives on the underlying market will also be determined. In pursuant to the achievement of the aim of the study discussed above, the researcher conducted a research that was based on both theoretical background and empirical evidence. The theoretical background of the research was performed mainly by the use of a brief literature review, which forms the second component of the study’s report. Under the literature review, the findings of major studies on stock price behaviour are critiqued by comparing different schools of thoughts against each other. This makes it possible to give the rationale behind various findings from literature. The third component of the study is the econometric methodology, where the researcher presented a detailed analysis of the methodology adopted for the study. Under this section, the market fraction hypothesis and how it was used to test the stationarity of the

Salient Features of Juvenile Justice Act, 2006 Essay Example for Free

Salient Features of Juvenile Justice Act, 2006 Essay The first central legislation on Juvenile Justice was passed in 1986, by the Union Parliament, providing a uniform law on juvenile justice for the entire country. Prior to this law each state had its own enactment on juvenile justice with there being differences in the way juveniles were treated by different state legal systems. The Juvenile Justice Act was thus passed to provide care, protection, treatment, development and rehabilitation of neglected or delinquent juveniles and for the settlement of certain matters related to and disposition of delinquent juveniles There are certain guiding principles which need to be adhered to in the administration of juvenile justice and they form the basis on which the Act and the Rules are formed. The juvenile justice functionaries should abide by the following fundamental principles in order to understand the Act, interpret according to the situation in which the child is taken into custody and most importantly contribute to better and effective implementation of the Act. They are basically drawn from all the national and international standards pertaining to children wherein a strong impetus is given to the fulfillment and protection of the child’s rights. Emphasis is also laid on reintegration of the child into the family system to ensure proper care and protection from all kinds of exploitative situations Principles to be followed in administration of the rules: Principle of presumption of innocence Principle of dignity and worth Principle of Right to be heard: Principle of Best Interest: Principle of family responsibility: Principle of Safety (no harm, no abuse, no neglect, no exploitation and no maltreatment): Positive measures to promote well being of the child, reduce vulnerabilities and aim at development of child’s identity : Principle of non-stigmatizing semantics, decisions and actions: Principle of non-waiver of rights: Principle of equality and non-discrimination: Principle of right to privacy and confidentiality: Principle of last resort: Principle of repatriation and restoration: Principle of Fresh Start When these principles are adhered to in letter and spirit, it would certainly ensure that every child who comes into contact with the JJ System is assured safety, care, protection and justice. History of Juvenile Justice Legislations in India since 1986 and their specific provisions: 1. Juvenile Justice Act 1986 ï‚ · JJ Act was enacted in pursuance of the Beijing Rules 1985, prior to the CRC Definition of juvenile or child – 16 years for boys and 18 years for girls Children were categorized as delinquent juveniles and neglected juveniles Both categories of children were kept in an Observation Home together pending inquiry Juvenile Welfare Board was formed to deal with the neglected juveniles and the Juvenile Court was the adjudicating authority for the delinquent juvenile The neglected juveniles were in the Juvenile Home and the delinquent juveniles to the Special Home The Government of India ratified the United Nations Convention on the Rights of the Child in 1992 thereby making it expedient to adhere to the standards prescribed in the Convention. Hence, the 1986 JJ Act had to be reviewed and changes had to be made in order to secure the best interest of the child and focus on social re-integration of the child without resorting to judicial proceedings. The JJ Act 1986 was repealed and the Juvenile Justice (Care and Protection of Children) Act 2000 was passed taking into consideration all the International standards prescribed as per the Convention on the Rights of the Child, the Standard Minimum Rules for the Administration of Juvenile Justice, 1985 (Beijing Rules), The UN Guidelines for the Prevention of Juvenile Delinquency called the Riyadh Guidelines, 1990 and the United Nations Rules for the Protection of Juveniles Deprived of their Liberty (1990) 2. The Juvenile Justice (Care and Protection of Children) Act 2000 The Title of the Act stresses on the need for care and protection to both categories of children Uniform age for both boys and girls – any child who has not completed the age of 18 fall within the jurisdiction of the Act to comply with the CRC definition of the child Separation of child in need of care and protection and child in conflict with law Constitution of Child Welfare Committees to deal with children in need of care and protection and Juvenile Justice Boards to handle children in conflict with law The category of children in need of care and protection has been expanded to include victims of armed conflict, natural calamity, civil commotion, child who is found vulnerable and likely to be inducted into drug abuse More legal protection assured for the child in conflict with law – detention to be resorted to as the last option, disqualification of past records and privacy maintained The innovation the law makes with respect to children in need of care and protection is the conceptualization of restoration of the child as being the focal point, with restoration being conceptualized as restoration to parents, adopted parents or foster parents. (Sec39). The law outline four options of restoration for children in children’s homes and special homes which include adoption, foster care, sponsorship and after care 3. The Juvenile Justice (Care and Protection of Children) Amendment Act, 2006 The JJ Act 2000 was subsequently amended and hereafter referred to as the Principal Act The Amendment Act brought about 26 amendments which are in force This Act forms the legal system and framework for the care, protection, treatment and rehabilitation of children of both categories i. The Objective of the Act: To Lay Down A Legal Structure For The Juvenile Justice System In The Country To Provide A Special Approach To The Protection And Treatment Of Juveniles To outline the machinery and infrastructure required for the care, protection, treatment, development and rehabilitation of juveniles To establish norms and standards for administration of juvenile justice To establish linkages and co-ordination between the formal system of juvenile justice and voluntary efforts in the welfare of juveniles To constitute special offences in relation to juveniles and provide punishment. ii. Salient features of JJA: 1. a. The Act known as ‘The Reformatory Act’ deals with two categories of children, namely children in need of care and protection and children in conflict with the law. b. The competent authority to deal with children in need of care and protection is the Child Welfare Committee which constitutes a Chairperson and four other members, one of whom atleast should be a woman. Chapter IV of this Module would focus in detail about Children in need of care and protection and the functioning of the CWC in rehabilitation and disposition of cases c. Juvenile Justice Board (JJB) is the competent authority to deal with children in conflict with law which comprises of three members. The Chairperson of the Board should be a First Class Judicial Magistrate and two honorary social workers out of whom atleast one should be a woman. Special provisions for children in conflict with law and the responsibilities of the Board are discussed in detail in Chapter III of this Module. 2. The Act provides for the establishment of various kinds of Institutions such as Children’s Home for the reception of child in need of care and protection. Special Homes for the reception of child in conflict with law Observation Homes which are meant for the temporary reception of children during the pendency of any inquiry. After-care Organizations which are meant for the purpose of taking care of children after they have been discharged from Children’s Home or Special Homes. 3. A few sections in the Act (Sec 23 – 26) are focused on the offences committed by anyone against a child such as assault, causing mental or physical suffering and employment of a child which are considered as non bailable offences. iii. Rules under the Juvenile Justice (Care and Protection of Children) Act 2000 (56 of 2000) and the Amendment Act 33 of 2006): The Ministry of Women and Child Development at New Delhi, the 26th day of October, 2007 notified the Model Rules under the Juvenile Justice (Care and Protection of Children) Act 2000 and the Amendment Act 2006 to be administered by the States for better implementation and administration of the provisions of the Act in its true spirit and substance. These rules called the Juvenile Justice (Care and Protection of Children) Rules, 2007 has come into force on the date of its publication in the Official Gazette and these Rules will be conformed to until the concerned State Government formulates Rules specific for the State with effect to implementation of the JJ Act. The Act in Section 68 prescribes various areas wherein the Rules can be applied to for better implementation of the Act, specifically with management of the homes, standards to be adhered to, roles and responsibilities of the JJ functionaries, procedures and functioning of the competent authorities, rehabilitation mechanism and operation of JJ Fund. It is recommended that the Act is implemented in line with the Rules to promote better understanding of the Act in order to benefit the children who come in contact with the JJ System.

Liver Functions, Anatomy and Diseases

Liver Functions, Anatomy and Diseases Sandra Marais Nikita Wiggil Charne Scott Chante Wiese   Sue-May van der Westhuizen Stephanie Willows Contents (Jump to) Introduction The Anatomy and function of the Liver Definition and description of the disease Fatty Liver Disease Symptoms PATHOPHYSIOLOGY AND ETIOLOGY OF FATTY LIVER DISEASES: Treatment and prevention Introduction The Anatomy and function of the Liver Anatomy is the science of the structure and shape of entities. It is important for the knowledge of hepatic anatomy and surgery. The liver is one of the largest organs of the human body after the skin it is the second largest. The liver is the largest gland in the human body, with an average weight of 1500g. The transverse measurements ranges between 20 and 22,5cm, its vertical measurements (close to its right/lateral surface) between 15 and 17,5cm and its antero-posterior diameter between 10 and 12,5cm. Its measurement, from opposite the vertebral column, is reduced to roughly 7,5cm. It is found underneath the diaphragm -in the right upper abdomen, mid abdomen as well as in parts of the left upper abdomen. The shape of the liver generally has the form of a wedge or a prism. According to Synington the shape resembles that of a right-angled triangular prism with the right angle rounded off. Its base faces the right and its apex to the left, the colour of the liver is dark reddish brown it has a soft degree of density, it contains a large amount of vessels and is very brittle. In an adult, it is smaller than in a fetus. In the later (side) it contributes roughly one thirty-six of the body weight. In the former (side) it contributes roughly one-eighteenth of the body weight. The liver has three surfaces namely the superior (Facies superior), inferior (Facies inferior/ visceral surface) and posterior (Facies posterior). The posterior surface is divided from the superior surface by a sharp margin. The superior surface attaches itself to the diaphragm as well as the anterior abdominal by the falciform ligament (ligamentum falciform hepatis). The falciform ligament separates the liver into a right lobe (lobus hepatis dexter) and a left lobe (lobus hepatis sinister). The right lobe is larger than the left. Five fossae divide the inferior and posterior surfaces into four lobes. The fossae are arranged like the letter ‘’H’’. The left limb of the H is divided into what is known as the left sagittal fossa (fossa sagittalis sinistra/longitudinal fissure) consisting off the fossa of the umbilical vein and the fossa for the ductus venosus. The right limb of the H consists of the fossa for the gall-bladder (fossa vesicà ¦ felleà ¦) and th e fossa for the inferior vena cava (fossa venà ¦ cavà ¦). The two limbs of the H surfs as a transverse fissure- the porta (porta hepatis/transverse fissure). The superior surface is part of is part of the left and right lobe. This surface is convex. The middle part is found behind the xiphoid process and it makes contact with the abdominal wall. It is entirely concealed by peritoneum, with the exception of the line of attachment of the flaciform ligament. The inferior surface is concave. It is aimed downward, backward as well as to the left. The surface is infused in peritoneum- the only parts that are without it, is where the gall-bladder and the liver attaches as well as at the porta hepatis. The posterior surface has a curved surface and is broad on the right, but narrow on the left. The diaphragm is attached with a triangular and coronary ligament that intertwine connective tissue, it leads to the intimate connection of the inferior vene cava that is connected with hapatic veins that holds up the posterior part of the liver. The abdominal viscera full the abdomen, where the muscular walls are in a state of tonic contraction. The superior surface of the liver fits under the diaphragm surface, so that the pressure is enough to hold the diaphragm. The lax falciform ligament creates no support for the lateral displacement and the latter creates negative pressure that is held up in the thorax (Gray, Henry. Anatomy of the Human Body. PHILADELPHIA: Lea Febiger, 1918; Bartleby.com, 2000. www.bartleby.com/107/. [DATE of Printout].) Functions of the liver The liver receives blood from two main sources: 30% is received from the hepatic arteries and 70% is received from the hepatic portal vein. The hepatic portal vein receives blood from the stomach, intestines, pancreas and spleen; which is then carried to the liver through the porta hepatis. All nutrients are absorbed by the small intestine, all nutrients reaches the liver by this route except for lipids. Arterial blood bound for the liver exists the aorta ant the celiac trunk. These arteries deliver oxygen and other materials to the liver. (SALADIN, p. 975-977) Digestion Liver produces bile; which is a mixture of water, bile salts, cholesterol and pigments of bilirubin. Bile is produced by hepatocytes in the liver. Bile passes through the bile ducts and is stored in the gallbladder. Fats are emulsificated by bile. Large fat clumps are turned into smaller pieces which makes it easy for the body to digest. Old worn oud red blood cells are destroyed by Kupffer cells in the liver. Kupffer cells pass their components to the hepatocytes. Haemoglobin is the red oxygen-carrying pigment of red blood cells, haemoglobin is metabolized into heme and globin components. Energy for the body comes from globin protein. Metabolism Liver is responsible for metabolizing carbohydrates , lipids and proteins into biologically useful materials. Blood entering the liver through the hepatic portal vein is rich in glucose from digested food. Some of this glucose is absorbed by hepatocytes. The glucose is stored as the macromolecule glycogen. Homeostasis is maintained by the absorption and release of glucose by the hepatocytes, it helps protect the body from spikes and drops that can be dangerous in the blood glucose level. Hepatocytes absorb and metabolise fatty acids to produce energy in the form of ATP. Through gluconeogenesis the hepatocytes convert glycerol and other lipid components into glucose. Cholesterol is a lipid which can also be produced by hepatocytes and gets excreted from the body as a component of bile. Amino acids is a component from dietary proteins. Amine groups are removed from the amino acids, by the hepatocytes, which is further converted into ammonia and urea. Urea can be excreted in urine as a waste product. Urea is less toxic than ammonia. Detoxification Hepatocytes cells of the liver monitor the contents of the blood and toxic substances are removed before they reach the rest of the body. Alcohol and drugs are metabolised into their inactive metabolites by the enzymes in hepatocytes cells. Storage Nutrients, vitamins and minerals obtained from the blood passing through the hepatic portal system are stored in the liver. Homeostasis of blood glucose is maintained by the storage of nutrients. Vitamins such as A, D, E, K and B12 is stored in the liver. Minerals such as iron and copper are stored in the liver. Production Vital protein components of blood plasma such as prothrombin, fibrinogen and albumins are produced by the liver. Prothrombin and fibrinogen proteins are factors involved in the formation of blood clots. Albumins maintain the isotonic environment of blood. Immunity Bacteria, fungi, parasites, worn out red blood cells and cellular debris are captured and digest by Kupffer cells. Large volumes of blood are cleaned very quickly by Kupffer cells due to the large volumes of blood passing through the hepatic portal system. (www.innerbody.com/image _digeov/card10-new2.html) American journal of Physiology: Gastrointestinal and Liver Physiology : physiology and pathophysiology of apoptosis in epithelial cells of the liver; pancreas and intestine. By Blake. A. Jones ; Gregory. J. Gores. Published 1 December 1997 (vol.273. no.6, G1174-G1188) Definition and description of the disease Fatty liver disease â€Å"Non-alcoholic fatty liver disease (NAFLD) is a clinical and pathological syndrome.† (Zeng, et al., 2008) The main feature of NAFLD is the swelling of the (liver cells) hepatocytes because of pathological factor, alcohol excluded, that injure the liver. NAFLD is ranged from fatty liver alone to steatohepatitis, steatonecrosis and non-alcoholic steatohepartitis (NASH). (NASH) is only a stage in non-alcoholic fatty liver disease. NAFLD may have the potential to progress into cirrhosis and liver failure.† Liver –biopsy features include steatosis, mixed inflammatory cell-infiltration, hepatocytes ballooning and necrosis, glycogen nuclei, Mallory’s hyaline and fibrosis.† (Angulo, 2002) According to Jansen (2004) NASH is an under diagnosed liver disease characterized by steatosis, necroinflammation and fibrosis. NASH can possibly develop into cirrhosis and hepatic cellular carcinoma. NASH incorporate mixed acute and chronic lobular inflammation, zone 3 perisinusiodal fibrosis and ballooning (Brunt, et al., 1999). Alcoholic liver disease. Alcoholic liver disease (ALD) includes a variety of spectrum of injury that can be from simple steatosis to frank cirrhosis. There are 3 groups of histological stages of ADL. Fatty liver or simple steatosis, alcoholic hepatitis and chronic hepatitis with hepatic fibrosis or cirrhosis. ALD can be caused by different types of factors including dose, duration and type of alcohol consumption and risk factors like obesity iron overload ect. Fatty Liver Disease Symptoms Non-alcoholic fatty liver disease causes no signs or symptoms that can be noticed but when it is noticed, it show signs of: Fatigue Pain in the right upper abdomen Weight loss. Inflammation and scarring of the liver Possible progression to liver failure. Symptoms consists of four (4) stages namely Simple fatty liver disease ( steatosis), Non-alcoholic Fatty liver Disease (NAFLD), Fibrosis And Cirrhosis. Simple fatty liver (Steatosis)- There are no clear symptoms and it can only be discoverd by an abnormal blood test result. Non-alcoholic Steotohepatitis (NASH)- It is the most aggressive form of this condition, it causes the liver to become inflamed creating a dull or aching pain in the top right abdomen, covering the lower side of the ribs. There may be no signs of any symptoms at all and it can only be discovered by specialized testing. Fibrosis- Constant inflammation in the liver which leads to the formation of scar tissue. Cirrhosis- Over a long period of time, it creates inflammation which can lead to the loss of liver function- which may lead to creating primary cancer. ALCOHOL-RELATED (ARLD) It shows no symptoms until the liver has already been severely damaged and it causes symptoms such as: Feeling sick, weak or tired Loos of weight Loss of appetite Jaundice- the yellowing of the eyes and skin The swelling of the stomach and ankles Confusion or drowsiness The excretion or the vomiting of blood. Alcohol related fatty liver disease is constantly diagnosed because of other conditions or other tests. PATHOPHYSIOLOGY AND ETIOLOGY OF FATTY LIVER DISEASES: Fatty Liver Disease encompasses two over head segments, namely Alcoholic Liver Disease and Non Alcoholic Liver Disease. ALCOHOLIC LIVER DISEASE (ALD) Alcoholic Liver Disease (ALD) encompasses the manifestations of the liver that is caused by the over consumption of alcohol (ethanol). It includes Fatty Liver, Alcoholic Hepatitis, and Chronic Hepatitis with liver cell fibrosis or cirrhosis.*1 Ethanol metabolization takes place in the liver. There are two main pathways of alcohol metabolism, namely alcohol dehydrogenase and cytochrome P-450 (CYP) 2 E1. The first pathway works as follows: Firstly ethanol is metabolized by Alcohol dehydrogenase (ADH) into Acetaldehyde in the cytoplasm. The second phase occurs in the smooth Endoplasmic reticulum of mitochondria, where Acetaldehyde is further metabolized by Aldehyde dehydrogenase into acetate. Acetate is then finally oxidized into carbon dioxide (CO2) and water. CYP 2E1 also converts ethanol into acetaldehyde (OShea, et al., 2010). Liver damage occurs in a few mutually related pathways: Acetaldehyde can form hybrid-adducts with reactive residues acting on proteins or small molecules, mediating lipid peroxidation and nucleic acid oxidation. (French, et al., 1984) During further metabolization of alcohol, Nicotinamide Adenine Dinucleotide (NAD) is reduced. This causes a shift in the NADH/NAD ratio. A higher NADH (reduced form of NAD) concentration increases the production of fatty acids, while lower concentrations of NAD result in decreased fatty acid oxidation. This altered ratio impair the metabolization of carbohydrates and lipids, resulting in the diversion from gluconeogenesis to ketogenesis and fatty acid synthesis. The liver cells compound the fatty acids to glycerol to form triglycerides. These accumulating triglycerides result in fatty liver. This leads to oxidative stress, which plays a pivotal role in ALD development. (French, et al., 1984) Furthermore, Acetaldehyde interacts through covalent binding with reactive residues of proteins found on the membranes of liver cells. This binding results in the formation of stable protein by-products which have been shown to be immunogenic. Tissue damage and ALD may be caused by this, because the neo-antigens may induce an immune reaction with anti-body production. CYP 2 E 1, when exposed to chronicle alcohol use generates free radicals through the oxidation of Nicotinamide Adenine Dinucleotide phosphate (NADPH) to NADP (OShea, et al., 2010). This exposure activates hepatic macrophages, also known as Kupffer cells, which leads to Tumor Necrosis factor-alpha (TNF-alpha). The production of reactive oxygen species (ROS) is increased by the mitochondria, which in turn was induced by the TNF-alpha. This also promotes oxidative stress, which leads to hepatocytes necrosis and apoptosis. Many alcoholics have a condition of malnutrition. The deficiency in anti-oxidants, such as vitamin E, only worsens the necrosis and apoptosis. Free radicals initiate the oxidative degradation of lipids, which causes inflammation and liver tissue becomes scarred. Although the over consumption of alcohol is the primary cause of ADL, it is not always a pre-requirement for ALD development. It is important to understand the mechanisms of liver damage. When liver cells are exposed to alcohol, ATP synthesis is reduced and the activity of mitochondrial complexes is depressed. This causes energy metabolism of liver cells to be severely weaker and results in tissue damage. Metabolization of ethanol takes place in the centrilobular area of the liver lobule. Hypoxia alters energy metabolism, therefore centrilobular hypoxia can also be responsible for liver injury. The pathophysiology of alcoholic liver disease is very complex and further in depth investigation to understand the disease and how to treat it is being done. NON-ALCOHOLIC FATTY LIVER DISEASE (NAFLD) Non-Alcoholic Fatty Liver Disease is an over arching term for a variety of conditions associated with fat depositions in liver cells. NAFLD ranges from Simple fatty liver to nonalcoholic steatohepatitis (NASH), to fibrosis and cirrhosis. The first stage of NAFDL is simple fatty liver or steatosis. It is considered harmless and only consists of a fat build up in the liver. The second stage, Nonalcoholic steatohepatitis is more serious, but not many individuals progress to this state from simple fatty liver. Two liver insults may lead to the development of NASH. With the first insult or hit, macro-vesicular steatosis (abnormal retention of lipids within a cell) occurs as a result of an excessive amount of triglycerides accumulating in the liver. The cause of triglyceride accumulation can result from excessive importation of free fatty acids from adipose tissue.*5 The accumulating lipids in the liver cells seem to be caused by insulin resistance. Insulin resistance leads to changes in the livers enzymatic pathways that control free fatty acid uptake, synthesis, degradation and the secretion of free fatty acids. A crucial paradox arises: the liver maintains its liver lipid metabolization, but carbohydrate metabolism is weakened or damaged. Hepatic steatosis caused by these factors can result into diminished hepatic free fatty acid oxidation, more hepatic lipogenesis or fewer lipids are secreted from the liver. Along with insulin resistance, obesity plays an important role in the development of NAFLD. These alterations make the liver sensitive for the second insult or hit, which is an inflammatory response and further liver damage (Carey, et al., 2013). Toxic inflammatory proteins are secreted by the cytokines in the liver.*6 Hepatocyte apoptosis, an organized form of cellular death, is a leading component of the second insult of NAFLD progression. Oxidative stress and resulting lipid peroxidation are involved in the progression of NAFLD to NASH. The term â€Å"oxidative stress† is frequently used to describe the imbalances in redox couples. *7 This metabolic reaction produce too much reactive free radicals called reactive oxygen species (ROS). This process usually occurs in the mitochondria. Lipid peroxidation can lead to changes in the cell membrane fluidity and these alterations cause tissue damage. Fibrosis is the third stage of NAFLD. NASH develops to form fibrosis if it is not treated. Fibrosis occurs where chronicle inflammation in the liver results in the formation of fibrous scar tissue around hepatic cells and blood vessels. The liver still functions normally, because there is still enough healthy tissue. The forth and most severe stage of NAFLD is cirrhosis. During this stage lots of scar tissue develops. This causes the liver to shrink and change morphologically. The damage caused by cirrhosis is permanent and cannot be saved or reversed. The progression of cirrhosis is slow, but it ultimately causes the liver to stop functioning.*8 Treatment and prevention Basic therapy: you have to work out a strategic plan of the intake of calories and adjustment of diet constitution. Medium aerobic exercise and the changing of some life styles and behaviour. Weight reduction: The most important fact of weigh reduction is not the amount of weight loss but how the weight is lost. Losing weight rapidly may increase portal inflammation and fibrosis. A relatively safe goal is to lose about 1.6kg per week. Liver transplantation: For some patients liver transplantation is recommended. Metabolic states should be examined before the transplantation. A BMI >40kg lm2 is a contrain dication (Zeng, et al., 2008) Abstinence: This is a very important therapeutic intervention for patients that have ALD. Abstinence helps to decrease portal pressure and lower progression to cirrhosis.

The Autoimmune Hemolytic Anemia Biology Essay

The Autoimmune Hemolytic Anemia Biology Essay Autoimmunity is a disorder in which an organism loses its ability to recognize the self and non-self antigen, which would further lead to immune response against its own cells and tissues. Diseases that results from such abnormal immune responses are termed as autoimmune diseases. Autoimmune hemolytic anemia (AIHA) is an autoimmune disorder in which endogenous antibodies are directed against the red blood cells and upregulated leading to erythrocyte death. This review article focuses on the types of AIHA based on the classification of the antibodies and the temperature at which they are active i.e warm AIHA, cold AIHA and mixed AIHA , based on the age of its occurance i.e adult or pediatric AIHA, causes, diagnostic techniques, diseases which may cause AIHA as a secondary disorder, treatment and its aftereffects, current and future prospectives of its studies. Abbreviations: AIHA Autoimmune hemolytic anemia, WAIHA Warm autoimmune hemolytic anemia, CAIHA Cold autoimmune hemolytic anemia, RBCs Red blood cells, DAT Direct antiglobin test. INTRODUCTION: Autoimmune hemolytic anemia (AIHA) is a disorder in which the auto-antibodies are directed against the persons own red blood cells (1). It is a relatively uncommon but not a rare disorder. It has an estimated incidence of 1 to 3 cases per 100,000 population per year (1). There are three types of AIHA based on the temperature of activity of the autoantibodies i.e warm AIHA, cold AIHA and mixed type AIHA of which warm AIHA has the most common occurance (more than 70%) followed by cold AIHA (about 20%) and mixed type has least occurance (2). Further AIHA is classified on the basis of age of the patient suffering from the disorder i.e pediatric AIHA and adult AIHA. Pediatric AIHA is from the age group of 1 to 16 (or 18) years and mostly has no underlying causes (2). Adult AIHA is from 18 years and above and is mostly associated with some underlying primary diseases. Sometimes AIHA is caused due to administration of some drugs and is called drug induced AIHA. AIHA may also be of secondary or idiopathic type. The further description of the different types of AIHA is explained below. TYPES OF AIHA: Based on the temperature at which the auto-antibodies are active: Warm autoimmune hemolytic anemia (WAIHA) It the most common type of AIHA. Warm auto-antibodies are usually IgG. It is called warm autoimmune hemolytic anemia because the antibodies have their peak activity at 370C. IgG effectively binds to the FC receptor of phagocytic cells. Hence the destruction of RBCs takes place mostly by phagocytosis. IgG may or may not fix complement. Hemolysis of RBCs also takes place in spleen. WAIHA may be idiopathic i.e when there is no primary infection causing the disorder or secondary to lymphoproliferative diseases, autoimmune diseases, viral infections, immune deficiency etc (1)(2)(3)(6). Cold autoimmune hemolytic anemia (CAIHA) Cold auto-antibodies are usually IgM antibodies. Rarely IgG or IgA antibodies can act as cold auto-antibodies. It is so called because the antibodies have their peak activity at temperature ranging from 0-40 C (1)(2)(3)(6). IgM antibodies are potent classical complement pathway activators. Hence causes complement mediated lysis of RBCs. Paraxysmal cold hemoglobinurea a form of CAIHA, is caused by cold active IgG hemolysin. It was usually associated with some underlying diseases like syphilis, measles, mumps or other viral diseases (1)(2)(6). Mixed autoimmune hemolytic anemia Both warm auto-antibodies and cold auto-antibodies are present the blood. It is more fatal than the WAIHA and CAIHA. Detection and diagnosis is also more difficult than the earlier types (1)(2)(3)(4)(6). Based on the age of the patient suffering from the disorder AIHA is classified as: Pediatric AIHA Affects the age group of 1-16 years, with a higher incidence of occurance in the first four years of life (1). It may spontaneously resolve on its own. It shows a good response to the steroid treatment. It has a severe onset and less morbity rate. Males are more prone to pediatric AIHA (2). Adult AIHA Affects the age group of 18 years and above. It is more often associated with the underlying lymphoproliferative, autoimmune and infectious diseases. Treatment is steroid therapy or spleenectomy. Has higher morbity rate compared to adult AIHA because of the difficulty or inability in treating the underlying disease (2). Based on the cause of its occurance, following are the types of AIHA: Secondary AIHA It is mainly caused due to some underlying diseases like bacterial, fungal or viral infections. The primary underlying diseases that may cause secondary AIHA are Sjogrens syndrome (10), lymphoproliferative and autoimmune diseases (2).Treatment of the secondary AIHA would also include the treatment of the underlying primary disease, for its complete remission (1). Idiopathic AIHA Has no particular underlying causes like infections or primary diseases for its occurance. Mortality rate is comparatively less than that of secondary AIHA (1). Drug induced AIHA Cause of occurance are drug molecules that binds to the surface of the RBC membrane, acts as non-self antigens, thus inducing the autoantibodies against the RBCs and further leads to hemolysis (2). Examples of the drugs that cause drug induced hemolytic anemia are Ibuprofen, Diclofenac, L-dopa, Procainamide (6). CAUSES In majority of the cases AIHA is caused due to some primary underlying diseases like lymphoproliferative, autoimmune and infectious diseases (2). For example, after the M.suis infection in pigs, warm IgG autoantibodies are directed against the RBCs and destroys it. In this case actin was the active component that played a vital role in inducing an autoimmune response. Actin acted as a target protein for the autoreactive antibody during the acute phase of the M.suis infection. The autoreactive antibody production is induced by a misguided upregulation of the naturally occurring B cells specific for self antigens, appearance of previously cryptic antigens, occurance of altered self antigens, tolerance to self antigens due to molecular mimicry. The autoimmune epitopes (in this case actin) on the RBCs may be due to contact with the proteolytic enzymes. Cytoskeleton of the RBCs gets modified by the attachment and invasion of the infectious agent. Also the infectious agent causes damage to the RBCs making the hidden cytoskeletal proteins of the RBCs accessible for the circulating antibodies. Due to all the above mentioned reasons the antibodies recognizes them as non-self and elicit an immune response (3). There are several other causes which may lead to AIHA other than due to a primary infections. For example higher incidence of occurance of AIHA after allogenic hematopoetic stem cell transplantation in adult patients. Further studies proved that the chances of development of AIHA is more in patients with HSCT from unrelated donors and also that they develop chronic extensive graft versus host disease (GVDH). In such cases it was observed that AIHA was never the primary cause of death, rather it was due to infection of GVDH (5). In some rare cases, liver transplantation or solid organ transplantation leads to the development of AIHA (11)(14)(15). DIAGNOSIS: The destruction or removal of red blood cells from the circulation before their normal life span of 120 days is called Hemolysis. Hemolysis manifests itself as acute or chronic anemia, reticulocytosis or jaundice. Intravascular hemolysis refers to the destruction of red blood cells in the blood with the release of contents into plasma. This is then followed by direct membrane degradation and cell destruction caused by mechanical trauma from a damaged endothelium, complement fixation and activation on the cell surface. On the other hand, extravascular hemolysis refers to the removal and destruction of red blood cells with membrane alterations by the macrophages of the spleen and liver. The hemolysis can be categorized broadly into the following types: HEMOLYTIC ANEMIA HEREDITARY (6) ACQUIRED (6) ( Due to infections (6) Microangiopathic (6) Autoimmune (6) Autoimmune (6) Alloimmune (6) Drug induced (2) (6) Paroxysmal (1)(2)(6) Mixed (1)(2)(3) (4)(6) Cold (1)(2) (3)(6) Warm (1)(2) (3)(6) Immune complex or Auto-antibody (6) Drug absorption (hapten induced) (6) Delayed transfusion reaction (6) Acute transfusion reaction (6) Flow chart 2: Broad classification of autoimmune hemolytic anemia. Since all the above said categories of hemolytic anemias have many similar symptoms and expressions, efficient diagnostic techniques should be developed to detect the correct category of hemolytic anemia for its appropriate treatment. DIAGNOSTIC TESTING Basic diagnosis for hemolysis on the basis of laboratory and peripheral smear findings: Hematologic tests Reticulocytosis which is the normal response of the bone marrow to the peripheral loss of blood cells is an important characteristic laboratory feature of hemolysis. Checking for the presence of reticulocytosis can be used for diagnosis of hemolysis. Review of the peripheral blood smear with an assessment for pathognomic red blood cell morphologies (spherocytes or schistocytes) along with examination of WBCs and platelets is very important for the evaluation of any anemia (6). Chemistry tests Increased unconjugated bilirubin, increased lactate dehydrogenase, and decreased haptoglobin levels are characteristic feature of the distruction of RBCs and thus can be used for diagnosis of hemolysis (6). c) In addition to the above tests, urinary tests are also be performed (6) After diagnosis of the basic hemolysis, its etiology is determined by performing further diagnostic tests. This review article focuses on the diagnostic techniques specific for AIHA. Microspherocyte on a peripheral smear and positive direct antiglobin test (DAT) is a characteristic feature of AIHA (1). The direct antiglobin test ,is also known as direct Coombs test (8). It demonstrates the presence of antibodies or complement on the surface of red blood cells which is the hallmark of autoimmune hemolysis (8). In this technique, the patients red blood cells are mixed with rabbit or mouse antibodies against human IgG or C3. The test would give a positive result if an agglutination reaction between the patients antibody or complement coated red blood cells by anti-IgG or C3 is observed. RBC agglutination with anti-IgG serum indicates warm AIHA and RBC agglutination with anti-C3 indicates the cold AIHA. However further efficient and very specific diagnostic techniques should be developed to distinguish mixed AIHA and paraxysomal cold hemoglobinuria from the other types. Also the present diagnostic techniques many a times failed to give an errorless distinction between these two types of AIHA (4). The three types of drug induced anemia based on their mechanism of their mechanism of action can be detected by a positive DAT and its type can be identified by the intravascular or extra-vascular hemolysis that it produces (6). TREATMENT: Treatment mainly depends upon the type of AIHA i.e warm antibody type, cold antibody type, mixed antibody type or paraxysomal cold hemoglobinuria and also on the secondary or the idiopathic forms. The following are the treatment options for AIHA. However each treatment stratergies has its own advantages and disadvavtages. Warm antibody autoimmune hemolytic anemia i) CORTICOSTEROIDS The initial therapeutic agent used for treatment of WAIHA patients are the corticosteroids. There is a rapid onset of response. This therapy is usually maintained for 1-3 weeks, however sudden ceasation of therapy may result in prompt relapse of hemolysis. The adverse effects of long term use of corticosteroids as a therapeutic agent would include pulmonary aspergellosis, central nervous system hemorrhage (2), osteoporosis, avascular necrosis, susceptibility to infection, abnormalities in glucose and lipid metabolism and growth suppression in children (7).The gluocorticoids may inhibit antimicrobial activity of macrophages thus showing side effects when treated with it (2). In cases of pediatric anemia, prednisolone along with folic acid supplementation was used for therapy which showed a positive response in 81% of the patients (8). ii) SPLENECTOMY Splenectomy is mainly considered in patients who donot respond to the corticosteroid therapy. The main advantage of splenectomy is that it has a potential for a complete and long term remission. The adverse effect of spelectomy would include overwhelming postspelectomy infection (OPSI) which may result in serious morbity or mortality in a small percentage of patients after spelectomy (2)(7)(8). iii) IMMUNOSUPPRESSIVE DRUGS This is the third therapeutic option after both corticosteroid therapy and spelectomy. Examples of the immuno-suppressive drugs would include azathioprine, cyclosporine (8), rituximab (9)(11) etc. iv) DANAZOLE It is an attenuated androgen with good responses and comparatively lesser side effects (2)(7). v) INTRAVENOUS IMMUNOGLOBIN In patients who doesnot respond to the corticosteroids, it is used as a second line therapy. However, intravenous immunotherapy is expensive (2)(7). vi) PLASMA EXCHANGE Used for acute reversal of severe hemolysis along with other therapeutic agents. Cold antibody autoimmune hemolytic anemia The simplest and the possible way for reducing the severity of CAIHA is avoidance of cold. Plasma exchange showed a temporary benefit in a small percentage of patients. Any other therapeutic options involved more potential risks than probable benefits. Paroxysmal cold hemoglobinuria In most of the cases hemolysis terminates spontaneously and hence only supportive care is required. Sometimes transfusion of RBCs and corticosteroid therapy may have a positive impact on the treatment. Atmost care should be taken in case of secondary autoimmune hemolytic anemia i.e the underlying diseases like chronic lymphocytic leukemia, systemic lupus erytromatous, lymphomas etc should be treated for complete remission from AIHA (7).Combinational therapy was used in some cases of AIHA as secondary infection. Example, a case in which AIHA was found in association with Plasmodium vivax infection was treated with chloroquine and primaquine (for P.vivax infection), prednisolone and transfusion of least incompatible RBCs (for AIHA) (12). CONLUSION This review article gives a very short explanation about autoimmunity as a disorder. It mainly focused on auto-immune hemolytic anemia which is a subset of autoimmunity. The types of AIHA, causes, diagnosis and possible treatment stratergies were discussed. The future area of research under this topic is in finding out more efficient and specific diagnostic techniques to detect mixed and paroxysmal cold hemoglobinuria and treatment options with maximum results and minimum side-effects. Drugs like Bortizomib (13), Alemtuzumab (humanized monoclonal antibody targeting CD52 antigen) etc are still under research for the treatment of hemolytic anemia (16).

Don’t Shoot the Sheriff: An overview of Rastafarians and the Legal System :: essays papers

Don’t Shoot the Sheriff: An overview of Rastafarians and the Legal System Rastafarianism is a way of life†¦ for many it is the only way of life. Growing up under a certain religion instills varying values and understandings into one’s moral fiber. These values are what shape a human’s character. In some countries, the government is trying to tell these peaceful people to disregard their upbringing and to conform to alien ways. Every religious sect has its own traditions and historical rituals that they abide to. In religions, almost everything has significance to it. And anyone concerned about the future of his/her religion, will continue to ensure that these traditions are followed, to preserve their own way of life. Now, most countries have religious freedom clauses in their constitutions that state that anyone living on their soil has the right to practice the religion of their choice. Now this might seem a minuscule fact for someone of a common religion, but to someone of a minority religion, this is all the protection they have from the legal system. This paper is only a taste of the justices and injustices that Rastafarians have faced in legal systems across the globe. Some instances a loophole for the "misfortunate", others an outcry from the oppressed. Every country’s legal system has problems. Some problems are masked with legal terms. Theses are the hardest to overcome. The "land of the free" is what the United States is sometimes referred to as, but for some, this statement seems phonier than an Ed McMahon sweepstakes. In the U.S. case, Belgrave vs. Coughlin, an inmate of the Sing-Sing Correctional Institution in New York, claims his religious rights were revoked. Nekyon Belgrave, a Rastafarian, says the Department of Correctional Services ("DOCS" hereinafter) denied his request to wear his religious head covering known as a crown. A crown is a loose-knit, circular hat that covers the wearer’s dreadlocks (Anderson, 1). Belgrave’s appeal reached the Second Circuit where acting Justice Anthony A. Scaprino Jr. sent the matter back to DOCS saying they overlooked their own regulations denying Belgrave’s request. The matter had already been solved in the precedent of Benjamin vs. Coughlin, 905 F2d 571, where the Second Circuit had agreed with a lower court ruling that denying a Rastafarian’s request to wear a crown did not break the First Amendment, ruling that is was an interest of security (Anderson, 2). This precedent and an August 8, 1990 memorandum stating that regulations allowed the wearing of certain head-coverings, was enough to send the matter back into the hands of the DOCS.

How Natural Processes Operate at Coastal Geographic Environment Essay

How Natural Processes Operate at Coastal Geographic Environment Natural Processes are actions or events that have natural causes, which result in natural events. The three main coastal environment processes that operate at Muriwai are Coastal Erosion, Coastal Transportation and Coastal Deposition. The elements that interact to produce natural processes are wind, waves and tides. Each phenomenon at Muriwai's coastal geographic environment has been produced by interaction. Coastal Erosion is a process at Muriwai that gradually wears away the rock particles of the earth's surface, transporting them to another location. There are many types of processes that cause erosion at Muriwai such as wave erosion, wind erosion and wave refraction. Thousands of years ago when sea levels dropped over years at the Southern end of Muriwai, the sedimentary rock and sandstone was exposed to the air. Rock from volcanic activity mixed with the sedimentary rock; this is called Breccia -- a mixture of all rock. An example of this is at Maori Bay. Coastal Erosion operates at different rates and different times. Limestone rock is eroded slower than sedimentary rock. The cliff at Muriwai made of sedimentary rock was eroded back to expose 'Fisherman's Rock' - the shore platform which, made of limestone -- tended to erode back slower than the cliff. The types of wave erosion that caused this are - Hydraulic Action, when waves hit the cliff, air is forced into cracks, and then as the wave retreats this air expands explosively. Over time the cracks enlarge, weakening the base of the cliff causing erosion. Attrition is the breakdown of rock particles when they hit Otakamiro point and each other causing the base of the headland to erode. Chemical Erosion/Corrosion occurs due to the content of limestone in the rockface of Otakamiro point. The seawater combined with the limestone produces a weak chemical solution, which erodes the base of the cliff and produces a pitted effect. Chemical Weathering is when water weakens the structure of the rock and Mechanical Weathering is where water seeps into the rock face causing fragments of rock to break off. These types of erosion have caused the formation of several phenomena at Muriwai. Motutara Island (stack) was produced by the formation of two caves on either side of the headland -- forming an arch and the roof slowly erodin... ...ll build up the dunes and travel inland. Surface Creep occurs when landing sand particles remove the larger and heavier particles, pushing them forward. Suspension is the picking up of sand by wind. This is when sand is airborne and then deposited anywhere. Coastal Deposition is the third main natural process occurring at Muriwai's coastal geographic environment. It is the process of sediment being deposited to form natural features. This is when the rock fragments from Otakamiro Headland are ripped away by waves, broken down by attrition and transported along the coast where they are deposited as beaches and sand dunes. The movement of the material is called Longshore Drift; the direction of the deposit depends on the direction of the winds. Titomagnetite sand (black sand) was deposited at Muriwai when it was bought from the south by Longshore Drift. Coastal Erosion, Coastal Transportation and Coastal Deposition are natural processes that have occurred at Muriwai's coastal geographic environment. These processes outlined have formed such phenomena as Motutara Island (stack), Otakamiro Point (headland/cliff), Fisherman's Rock (shore-platform), cave and the blowhole.