Supply and Demand of Gasoline Essay Example | Topics and Well Written Essays - 1250 words

Supply and Demand of Gasoline - Essay Example The gasoline price has ostensibly undergone extensive fluctuations mainly because of the product nature and the industry which supplies the world with oil. Note that a bulk of the aggregate oil output is produced by the Organization of Petroleum Exporting Countries (OPEC). This influential group is organized as a cartel and composed of nations in the Middle East including United Arab Emirates, Saudi Arabia and Kuwait among others. The main produce of these countries is oil and other petroleum products. Other countries, including the United States, are largely dependent on these countries for their oil supply (Case & Fair, 2002). With their rich oil resources, these nations created the cartel which has the ability to control member countries’ oil production capacity and output quotas of enabled them to collude to raise the oil price by. Given its mandate, supply of oil including gasoline is significantly affected by political unrest arising between these oil-exporting countries and other countries as well. To illustrate this point, supply of petroleum products was adversely affected by the war between Iran and Iraq in 1979. This tumultuous battle between two of the largest oil producers had caused a global oil supply shock and resulted in a dramatic increase in the price of oil. The limited oil supply then was further aggravated by the restricted means of transporting oil products to the rest of the world.

Case study Example | Topics and Well Written Essays - 1750 words - 8

Case Study Example The business model followed by Hanon compelled the managers to follow all the rules laid down by the corporate office down to every word. Therefore, the corporate office had complete control over all the operational activities of the restaurant chain. Looking at the initial results of success, the higher management decided to expand the business of China Delight. After the expansion the problem started surfacing. As a result of the expansion, the management had to hire general managers from outside. This decision making eventually proved to be the root cause of the downfall of China Delight. The previously implemented model of close control by the corporate office started creating friction with the newly appointed managers. Moreover, they did not possess any experience to run chain restaurants, so they had to be trained in order to get them habituated with the business and operational structure of Hanon. The training did not prove to be fruitful for China delight, as the managers mos tly ignored the instructions from the higher management and decided to run the operations based on their own knowledge and expertise. This as a result led to severe deviations from the operations manual provided by the corporate office thereby reducing its control over the restaurant chain. The newly appointed managers who did not had any experience in running restaurant chains failed to maintain consistency and quality standards, which hampered the brand image of the restaurant chain thereby reducing the foot fall level. The decreasing revenue and severe loss making became a severe concern for the company. Moreover, there was a communicational gap between the general managers and the corporate office, as the managers did not file regular reports and mostly ignored the instructions from the higher management; this as a result worsened the problem even further. There was also a great

Water fluoridation

Water fluoridation ABSTRACT The safety and efficacy of water fluoridation has been a topic of great controversy throughout Americas communities. Scientific evidence has shown that ingesting low to moderate levels of fluoride can benefit the dental health of a community, especially those populations in a community that may be classified as having low socioeconomic status. Children in all areas, but especially those with low SES, are at greatest risk for developing dental caries and having a community water fluoridation program (CWFP) will help them reduce their dental caries. Moderation of fluoride ingestion for individuals is the key. Low to moderate daily ingestion of fluoride, averaging 1.0 mg/liter per day is optimum. Dental and skeletal fluorosis can occur if ingestion levels are greater than 3.0 mg/liter per day for long periods of time. This is a discussion on the safety and efficacy of water fluoridation. INTRODUCTION This commentary presents the on-going controversy on community water fluoridation in the United States, and I will attempt to analyze science-based evidence in support of water fluoridation. There have always been questions on the safety and efficacy of fluoride in drinking water, some school of thought believes that fluoridation has some adverse effects to exposed human populations, especially in infants and children. Another school of thought believes that water fluoridation is essential in preventing tooth decay, and therefore the practice should be sustained. According to the Center for Disease Control and prevention (CDC) water fluoridation is one of the 10 great public health achievements of the 20th century in the United States (CDC, 1999), which is attributable for increased lifespan of Americans by 25 years ( Bunker et al., 1994). This paper will discuss science-based evidence that proves the efficacy and safety of water fluoridation among children as well as offer some reco mmendations to the various stakeholders. POSITION STATEMENT Water fluoridation is the adjustment of the concentration level to the optimally regulated level of which the naturally occurring fluoride presents in public or community drinking water supplies. In most cases, deflouridation is needed when the naturally occurring fluoride level exceeds recommended limits. The recommended fluoride concentration in drinking water by the U.S. Public Health Service (PHS) is 0.7-1.2mg/L, to effectively prevent dental caries and minimize the occurrence of dental fluorosis (NRC, 2006). Low decay rates were found to be associated with continuous use of water with fluoride content of 1ppm (Meskin, 1995). There has been serious questions as to the efficacy of fluoride intervention in preventing both tooth decay, as it benefit is said to be merely cosmetic or topical (CDC, 1999). Such topical effect of fluoride can be achieved by the use tooth without the risking the overexposure from ingested fluoride (NRC, 2006). However, it has also been reported that fluor ide exposure provides both systemic and topical protection. Ingested fluoride deposited on tooth surface during tooth formation, and fluoride contained in saliva provides long-lasting systemic protection against booth tooth decay than topical application using tooth paste or fluoride foams (CDC, 2001). WHAT IS FLUORIDE Fluoride is a naturally occurring element. It is found in rocks and soil everywhere. Fluoride can be found in fresh water and ocean water. Naturally occurring fluoride levels ranges from 0.1ppm to over 12ppm (NRC, 2006).Fluoride is present in the customary diets of people and in most portable water sources. The average dietary intake of fluoride is approximately 0.5mg daily from either naturally occurring fluoride in the water or the fluoride found in produce. It is also a normal component of tooth enamel and bone studies have shown that the calcified tissues of both enamel and bone are made up of a combination of hydroxyl- and fluor-apatites of varying composition depending on the abundance of fluoride at the site of formation. These tissues are the principal sites of deposition of fluoride (NRC, 2006). HOW FLUORIDE PREVENTS AND CONTROLS DENTAL CARIES Dental caries is an infectious, transmissible disease in which bacterial by-products (i.e., acids) dissolve the hard surfaces of teeth. Unchecked, the bacteria can penetrate the dissolved surface, attack the underlying dentin, and reach the soft pulp tissue. Dental caries can result in loss of tooth structure, pain, and tooth loss and can progress to acute systemic infection. Cryogenic bacteria (i.e., bacteria that cause dental caries) reside in dental plaque, a sticky organic matrix of bacteria, food debris, dead mucosal cells, and salivary components that adheres to tooth enamel. Plaque also contains minerals, primarily calcium and phosphorus, as well as proteins, polysaccharides, carbohydrates, and lipids. Cryogenic bacteria colonize on tooth surfaces and produce polysaccharides that enhance adherence of the plaque to enamel. Left undisturbed, plaque will grow and harbor increasing numbers of cryogenic bacteria. An initial step in the formation of a carious lesion takes place when cryogenic bacteria in dental plaque metabolize a substrate from the diet (e.g., sugars and other fermentable carbohydrates) and the acid produced as a metabolic by-product demineralizes (i.e., begins to dissolve) the adjacent enamel crystal surface (CDC,2009). Demineralization involves the loss of calcium, phosphate, and carbonate. These minerals can be captured by surrounding plaque and be available for reuptake by the enamel surface. Fluoride, when present in the mouth, is also retained and concentrated in plaque. Fluoride works to control early dental caries in several ways. Fluoride concentrated in plaque and saliva inhibits the demineralization of sound enamel and enhances the remineralization (i.e., recovery) of demineralized enamel (Featherstone, 1999 Koulourides, 1990). As cryogenic bacteria metabolize carbohydrates and produce acid, fluoride is released from dental plaque in response to lowered pH at the tooth-plaque interface. The released fluoride and the fluoride present in saliva are then taken up, along with calcium and phosphate, by de-mineralized enamel to establish an improved enamel crystal structure. This improved structure is more acid resistant and contains more fluoride and less carbonate (Featherstone, 1999). Fluoride is more readily taken up by demineralized enamel than by sound enamel. Cycles of demineralization and remineralization continue throughout the lifetime of the tooth. Fluoride also inhibits dental caries by affecting the activity of cryogenic bacteria. As fluoride concentrates in dental plaque, it inhibits the process by which cryogenic bacteria metabolize carbohydrates to produce acid and affects bacterial production of adhesive polysaccharides. In laboratory studies, when a low concentration of fluoride is constantly present, one type of cryogenic bacteria, Streptococcus mutans, produces less acid. Whether this reduced acid production reduces the carcinogenicity of these bacteria in humans is unclear (Van Loveren, 1990). Saliva is a major carrier of topical fluoride. The concentration of fluoride in ductal saliva, as it is secreted from salivary glands, is low approximately 0.016 parts per million (ppm) in areas where drinking water is fluoridated and 0.006ppm in non fluoridated areas. This concentration of fluoride is not likely to affect cryogenic activity. However, drinking fluoridated water, brushing with fluoride toothpaste, or using other fluoride dental products can raise the concentration of fluoride in saliva present in the mouth 100- to 1,000-fold. The concentration returns to previous levels within 12 hours but, during this time, saliva serves as an important source of fluoride for concentration in plaque and for tooth remineralization (Murray,1993). Applying fluoride gel or other products containing a high concentration of fluoride to the teeth leaves a temporary layer of calcium fluoride-like material on the enamel surface. The fluoride in this material is released when the pH drops in the mouth in response to acid production and is available to remineralize enamel. In the earliest days of fluoride research, investigators hypothesized that fluoride affects enamel and inhibits dental caries only when incorporated into developing dental enamel (i.e., preeruptively, before the tooth erupts into the mouth) (Murray,1993). Evidence supports this hypothesis, but distinguishing a true preeruptive effect after teeth erupt into a mouth where topical fluoride exposure occurs regularly is difficult. However, a high fluoride concentration in sound enamel cannot alone explain the marked reduction in dental caries that fluoride produces . The prevalence of dental caries in a population is not inversely related to the concentration of fluoride in enamel, and a higher concentration of enamel fluoride is not necessarily more efficacious in preventing dental caries (Mcdonagh etal.,2000). The laboratory and epidemiologic research that has led to the better understanding of how fluoride prevents dental caries indicates that fluorides predominant effect is post eruptive and topical and that the effect depends on fluoride being in the right amount in the right place at the right time. Fluoride works primarily after teeth have erupted, especially when small amounts are maintained constantly in the mouth, specifically in dental plaque and saliva (Mcdonagh etal., 2000). Thus, adults also benefit from fluoride, rather than only children, as was previously assumed. RISK FOR DENTAL CARIES The prevalence and severity of dental caries in the United States have decreased substantially during the preceding 3 decades. National surveys have reported that the prevalence of any dental caries among children aged 1217 years declined from 90.4% in 19711974 to 67% in 19881991; severity (measured as the mean number of decayed, missing, or filled teeth) declined from 6.2 to 2.8 during this period (Burt, 1989). These decreases in caries prevalence and severity have been uneven across the general population; the burden of disease now is concentrated among certain groups and persons. For example, 80% of the dental caries in permanent teeth of U.S. children aged 517 years occurs among 25% of those children. Populations believed to be at increased risk for dental caries are those with low socioeconomic status (SES) or low levels of parental education, those who do not seek regular dental care, and those without dental insurance or access to dental services (Meskin,1995). Persons can be at high risk for dental caries even if they do not have these recognized factors. Children and adults who are at low risk for dental caries can maintain that status through frequent exposure to small amounts of fluoride (e.g., drinking fluoridated water and using fluoride toothpaste). Children and adults at high risk for dental caries might benefit from additional exposure to fluoride (e.g., mouth rinse, dietary supplements, and professionally applied products). All available information on risk factors should be considered before a group or person is identified as being at low or high risk for dental caries. However, when classification is uncertain, treating a person as high risk is prudent until further information or experience allows a more accurate assessment. This assumption increases the immediate cost of caries prevention or treatment and might increase the risk for enamel fluorosis for children aged NATIONAL GUIDELINES FOR FLUORIDE USE PHS recommendations for fluoride use include an optimally adjusted concentration of fluoride in community drinking water to maximize caries prevention and limit enamel fluorosis. This concentration ranges from 0.7ppm to 1.2ppm depending on the average maximum daily air temperature of the area (PHS, 1991). In 1991, PHS also issued policy and research recommendations for fluoride use. The U.S. Environmental Protection Agency (EPA), which is responsible for the safety and quality of drinking water in the United States, sets a maximum allowable limit for fluoride in community drinking water at 4ppm and a secondary limit (i.e., non-enforceable guideline) at 2ppm (EPA,1998). The U.S. Food and Drug Administration (FDA) is responsible for approving prescription and over-the-counter fluoride products marketed in the United States and for setting standards for labeling bottled water and over-the-counter fluoride products (e.g., toothpaste and mouth rinse) (ADA,2007). Nonfederal agencies also have published guidelines on fluoride use. The American Dental Association (ADA) reviews fluoride products for caries prevention through its voluntary Seal of Acceptance program; accepted products are listed in the ADA Guide to Dental Therapeutics (ADA, 2007). A dosage schedule for fluoride supplements for infants and children aged 16 years, which is scaled to the fluoride concentration in the community drinking water, has been jointly recommended by ADA, the American Academy of Pediatric Dentistry (AAPD), and the American Academy of Pediatrics (AAP) (Meskin,1995). In 1997, the Institute of Medicine published age-specific recommendations for total dietary intake of fluoride. These recommendations list adequate intake to prevent dental caries and tolerable upper intake, defined as a level unlikely to pose risk for adverse effects in almost all persons. COST-EFFECTIVENESS OF FLUORIDE MODALITIES Documented effectiveness is the most basic requirement for providing a health-care service and an important prerequisite for preventive services (e.g., caries-preventive modalities). However, effectiveness alone is not a sufficient reason to initiate a service. Other factors, including cost, must be considered. A modality is more cost-effective when deemed a less expensive way, from among competing alternatives, of meeting a stated objective (Garcia,1989). In public health planning, determination of the most cost-effective alternative for prevention is essential to using scarce resources efficiently. Dental-insurance carriers are also interested in cost-effectiveness so they can help purchasers use funds efficiently. Because half of dental expenditures are out of pocket (Garcia, 1989), this topic interests patients and their dentists as well. Potential improvement to quality of life is also a consideration. The contribution of a healthy dentition to quality of life at any age has not been quantified, but is probably valued by most persons. Although solid data on the cost-effectiveness of fluoride modalities alone and in combination are needed, this information is scarce. In 1989, the Cost Effectiveness of Caries Prevention in Dental Public Health workshop, which was attended by health economists, epidemiologists, and dental public health professionals, attempted to assess the cost-effectiveness of caries-preventive approaches available in the United States (Downer et al., 1981). Community Water Fluoridation Health economists at the 1989 workshop on cost-effectiveness of caries prevention calculated that the average annual cost of water fluoridation in the United States was $0.51 per person (range: $0.12$5.41) (Burt, 1989). In 1999 dollars, this cost would be $0.72 per person (range: $0.17$7.62). Factors reported to influence the per capita cost included: size of the community (the larger the population reached, the lower the per capita cost); number of fluoride injection points in the water supply system; amount and type of system feeder and monitoring equipment used; amount and type of fluoride chemical used, its price, and its costs of transportation and storage; and expertise of personnel at the water plant. When the effects of caries are repaired, the price of the restoration is based on the number of tooth surfaces affected. A tooth can have caries at >1 location (i.e., surface), so the number of surfaces saved is a more appropriate measure in calculating cost-effectiveness than the number of teeth with caries. The 1989 workshop participants concluded that water fluoridation is one of the few public health measures that results in true cost savings (i.e., the measure saves more money than it costs to operate); in the United States, water fluoridation cost an estimated average of $3.35 per carious surface saved ($4.71 in 1999 dollars). Even under the least favorable assumptions in 1989 (i.e., cities with populations A Scottish study conducted in 1980 reported that community water fluoridation resulted in a 49% saving in dental treatment costs for children aged 45 years and a 54% saving for children aged 1112 years (Downer et al., 1981). These savings were maintained even after the secular decline in the prevalence of dental caries was recognized. The effect of community water fluoridation on the costs of dental care for adults is less clear. This topic cannot be fully explored until the generations who grew up drinking optimally fluoridated water are older. School Water Fluoridation Costs for school water fluoridation are similar to those of any public water supply system serving a small population (i.e., Assessment of the Adverse Health Effects of fluoride Evidence of the adverse health effects of prolonged exposure to high concentrations of fluoride are well documented by several peer reviewed studies, which are examined in this paper. Higher concentrations of total ingested fluoride from potential sources like drinking water, food and beverages, dental-hygiene products such as toothpaste, and pesticide residues can have adverse health effects on humans (NRC, 2006). Some of the adverse health effects of fluoride in drinking water are enamel fluorosis, skeletal fluorosis, bone cancer and bone fracture. (NRC, 2006, PHS, 1991). Fluorosis is caused mainly by the ingestion of fluoride in drinking water (Viswanathan et al., 2009). Fluoride has high binding affinity for developing enamel and as such high concentration of cumulative fluoride during tooth formation can lead to enamel fluorosis, a dental condition from mild to severe form characterized by brown stains, enamel loss and surface pitting (DenBesten Thariani, 1992). These dental ef fects are believed to be caused by the effects of fluoride on the breakdown rates of early-secreted matrix proteins, and on the rates at which the degraded by-products are withdrawn from the maturing enamel (Aoba Fejerskov, 2002). Children are much more at risk of enamel fluorosis, especially in their critical period from 6 to 8 years of age, than adults. Fluoride uptake into enamel is possible only as a result of concomitant enamel dissolution, such as caries development (Fejerskov, Larsen, Richards, Baelum, 1994). There is a 10% prevalence of enamel fluorosis among U.S. children in communities with water fluoride concentrations at or near the EPAs MCLG of 4 mg/L (NRC, 2006). The CDC estimates that 32% of U.S. children are diagnosed with dental fluorosis (CDC, 2005). Today, there are convincing evidence that enamel fluorosis is a toxic effect of fluoride intake, and that its severe forms can produce adverse dental effects, and not just adverse cosmetic effects in humans (NRC, 200 6). Burt and Eklund (1999) states: â€Å"The most severe forms of fluorosis manifest as heavily stained, pitted, and friable enamel that can result in loss of dental function†. Epidemiological data from both observational and clinical studies have been examined. Sowers, Whitford, Clark Jannausch (2005) investigated prospectively for four years bone fracture in relation to fluoride concentrations in drinking water in a cohort study, by measuring serum fluoride concentrations and bone density of the hip, radius, and spine. The authors reported higher serum fluoride concentrations in the communities with fluoride concentrations at 4 mg/L in drinking water; and higher osteoporotic fracture rates in the high fluoride areas that were similar to those in their previous studies in 1986 and 1991. It is unclear in their recent study whether existing factors in the population like smoking rates, hormone replacement and physical activity were examined as potential cofounders for fractures. Fasting serum fluoride concentrations are considered a good measure of long-term exposure and of bone fluoride concentrations (Whitford, 1994; Clarkson et al., 2000). Findings by t he Sowers studies were complemented in several ways by Li et al. (2001) in a retrospective cohort ecologic study. The combined findings of Sowers et al. (2005) and Li et al., (2001) lend support to the biological gradients of exposures and fracture risk between 1 and 4 mg/L of fluoride concentration. Evidently, the physiological effect of fluoride on â€Å"bone quality† and the fractures observed in the referenced animal studies are consistent with the effects found in the observational studies. RECOMMENDATIONS Before promoting a fluoride modality or combination of modalities, the dental-care or other health-care provider must consider a persons or groups risk for dental caries, current use of other fluoride sources, and potential for enamel fluorosis. Although these recommendations are based on assessments of caries risk as low or high, the health-care provider might also differentiate among patients at high risk and provide more intensive interventions as needed. Also, a risk category can change over time; the type and frequency of preventive interventions should be adjusted accordingly. Continue and Extend Fluoridation of Community Drinking Water Community water fluoridation is a safe, effective, and inexpensive way to prevent dental caries. This modality benefits persons in all age groups and of all SES, including those difficult to reach through other public health programs and private dental care (CDC, 2001a). Community water fluoridation also is the most cost-effective way to prevent tooth decay among populations living in areas with adequate community water supply systems. Continuation of community water fluoridation for these populations and its adoption in additional U.S. communities are the foundation for sound caries-prevention programs. In contrast, the appropriateness of fluoridating stand-alone water systems that supply individual schools is limited. Widespread use of fluoride toothpaste, availability of other fluoride modalities that can be delivered in the school setting, and the current environment of low caries prevalence limit the appropriateness of fluoridating school drinking water at 4.5 times the optimal concentration for community drinking water. Decisions to initiate or continue school fluoridation programs should be based on an assessment of present caries risk in the target school(s), alternative preventive modalities that might be available, and periodic evaluation of program effectiveness (CDC, 2001a). Frequently Use Small Amounts of Fluoride All persons should receive frequent exposure to small amounts of fluoride, which minimizes dental caries by inhibiting demineralization of tooth enamel and facilitating tooth remineralization. This exposure can be readily accomplished by drinking water with an optimal fluoride concentration and brushing with fluoride toothpaste twice daily(CDC, 2001a). Supervise Use of Fluoride Toothpaste among Children Aged Childrens teeth should be cleaned daily from the time the teeth erupt in the mouth. Parents and caregivers should consult a dentist or other health-care provider before introducing a child aged Use an Alternative Source of Water for Children Aged 8 Years Whose Primary Drinking Water Contains >2 ppm Fluoride In some regions in the United States, community water supply systems and home wells contain a natural concentration of fluoride >2ppm. At this concentration, children aged 8 years are at increased risk for developing enamel fluorosis, including the moderate and severe forms, and should have an alternative source of drinking water, preferably one containing fluoride at an optimal concentration. In areas where community water supply systems contain >2ppm but 8 years. For families receiving water from home wells, testing is necessary to determine the natural fluoride concentration (CDC, 2001a). Label the Fluoride Concentration of Bottled Water Producers of bottled water should label the fluoride concentration of their products. Such labeling will allow consumers to make informed decisions and dentists, dental hygienists, and other health-care professionals to appropriately advise patients regarding fluoride intake and use of fluoride products (CDC, 2001). CONCLUDING POSITION STATEMENT When used appropriately, fluoride is a safe and effective agent that can be used to prevent and control dental caries. Fluoride has contributed profoundly to the improved dental health of persons in the United States and other countries. Fluoride is needed regularly throughout life to protect teeth against tooth decay. To ensure additional gains in oral health, water fluoridation should be extended to additional communities, and fluoride toothpaste should be used widely. Adoption of these and other recommendations in this paper could lead to considerable savings in public and private resources without compromising fluorides substantial benefit of improved dental health. What is consistent from the literature review is the fact that infants and children are much more at risk of overexposure and the development of adverse health effects. A community water fluoridation program (CWFP) is very safe and efficient, not only in terms of reducing dental caries, but also on the communitys budg et (CDC, 2001a). A CWFP can especially help those communities who have populations in the low SES category. These populations have children whose parents or guardians dont always have access to dental insurance and so regular dental checkups to curb the dental caries is not always an option. Reducing dental caries before they lead into more extreme oral morbidity can be very beneficial to these children. Implementing a fluoridated water program can also be beneficial to a whole community in terms of saving communities thousands and millions of dollars. Implementing a water program would follow strict guidelines set by the EPA, so the optimum level of fluoride would be followed, staying in the range of 0.7 to 1.2, where people would ingest no more than an average of 1 mg/liter of fluoride per day. Moderation is the key. There are studies confirming that ingestion of fluoride greater than the optimum level could produce dental fluorosis. Though unconfirmed by studies, individual reports have even suggested that ingestion of fluoride >8 mg/liter per day over a long period of time could produce skeletal fluorosis. However, with proper surveillance and reporting of fluoride in water systems, the greater population could be served, increasing the dental health of all individuals, especially the youth and saving dollars from excessive health care costs (ADA, 2009). Remember, a little prevention now can go a long way later. REFERENCES ADA (2005).Fluoridation Facts: ADA statement commemorating the 60th anniversary of community water fluoridation. Retrieved October 19, 2009 from www.ada.org/public/topics/fluoride/facts/fluoridation_facts.pdf ADA.(2007). ADA Guidelines to Dental Therapeutics. Retrieved October 23, 2009 from http://www.ada.org/prof/resources/pubs/advocacy.asp ADA (2009). Fluoride: Natures tooth decay fighter. J of the Am. Dental Ass., 140(1), 126-126. Alphajoh, C.(2009). (PhD Student). Service Learning Activity: Environmental Health. Walden University. Assessed November 13, 2009 from http://environmentalhealthtoday.wordpress.com/2009/05/13/commentary-and-position-statement-on-the-safety-and-efficacy-of-water-fluoridation/ Aoba, T., Fejerskov, O. (2002). Dental fluorosis: Chemistry and biology. Crit. Rev. Oral. Biol. Med., 13(2), 155-170. Bowden, G.(1990). Effects of fluoride on the microbial ecology of dental plaque. J Dent Res 1990; 69(special issue):653—9 Brunelle, J.(1987. The prevalence of dental fluorosis in U.S. children. J Dent Res.(Special issue) 68:995. Bunker, J.P., Frazier, H.S., Mosteller, F. (1994). Improving health: measuring effects of medical care. Milbank Quarterly,72, 225-58. Burt, B. (1989).(Ed.). Proceedings for the workshop: Cost-effectiveness of caries prevention in dental public health, Ann Arbor, Michigan, May 1719, 1989. J Public Health Dent 1989; 49(special issue):3317. Burt, B.A., Eklund, S.A. (1999). Dentistry, dental practice, and the community. Philadelphia, Pennsylvania: WB Saunders Company, 204-20. CDC (1999). Ten great public health achievements United States, 1900 1999. MMWR,48(12), 214-243. CDC (2001a). Promoting oral health: intervention for preventing dental caries, oral and pharyngeal cancers and sport-related craniofacial injuries a report on recommendations of the Task Force on Community Preventive Services. MMWR 2001, 50(21), 1-12. CDC. (2001). Recommendations for using fluorideto prevent and control dental

Analyzing Suzie Essay -- Health and Wellness

Aspirin binds to COX-2, a protein that makes prostaglandins, inhibiting it from its function. Prostaglandins are normally released by the damaged tissues at Dave’s sprained ankle site, stimulating nerve endings to produce the sensation of pain (Martini, p. 46). Aspirin is also known as an anticoagulant because it inhibits the production of prostaglandins that also form platelets, used for blood clotting. This is why people who tend to have heart attacks take aspirin, to reduce the chance of blood clots. (Hoffman, 2011) B. Fainting 1. Why did Suzie faint when she got up from the table? Explain the specific changes in her CVS that to caused her to faint. There are few reasons that contributed to Suzie’s fainting spell. Skeletal muscle helps propel the blood in veins back to the heart. Suzie has low blood pressure primarily because she is starving herself. Without nutrients from the small intestine, the body is forced to use to stored fats and proteins. The cold environment in the kitchen decreased her blood pressure even more. As a homeostatic mechanism, blood vessels constrict to keep Suzie and the vital organs warm. The lack of oxygen being delivered to the brain caused Suzie to faint and lose consciousness temporarily (Martini, p. 722). Another reason Suzie fainted is because of her prolonged QT interval, detailing the ventricular depolarization/ repolarization time of her heart by the Purkinje fibers. Thirdly, Suzie’s development of anemia contributed to her fainting because there were probably was not enough healthy red blood cells to deliver oxygen to her brain. When Suzie collapsed, she laid in a horizontal position increasing deliverance of blood and oxygen to the brain. (Martini, p. 722) C. Ectopic Hear... ...als.org/content/94/6/2129.full  · Hoffman, Lucas, MD, PhD. â€Å"Aspirin 101† 2011. http://health.howstuffworks.com/medicine/medication/aspirin3.htm  · Lacroix, Pierre. An Overview of QT Interval Assessment in Safety Pharmacology. Figure 10.7.1. Current Protocols in pharmacology. July, 2006  · Martini, Frederic C. Fundamentals of Anatomy & Physiology. 7th Ed. Pearson.  · National Heart Lung & Blood Institute. â€Å"Explore Long QT Sydrome†. September 2011. http://www.nhlbi.nih.gov/health/health-topics/topics/qt/  · Pritts, Sarah D., MD. University of Cincinnati College of Medicine. Diagnosis of Eating Disorders in Primary Care. January 15, 2003. http://www.aafp.org/afp/2003/0115/p297.html  · Yanowitz, Frank G., MD. The Alan E. Lindsay Center ECG Learning Center. The University of Utah School of Medicine. 2006 http://library.med.utah.edu/kw/ecg/ecg_outline/Lesson12/index.html

Marianna Moore “Poetry” Essay

While reading this poem, at first it was difficult to completely understand what is happening or what is exactly is being told. I decided to break down sentence by sentence to make it easier and it helped bring out the poems true colors. â€Å"I too dislike it: there are things that are important beyond all this fiddle†. After reading this segment it points out to me that our speaker shares that she too doesn’t like it referring to the reader that they must not like it too since majority of people do not. The question is why does she say it and not say poetry. â€Å"Reading it, however with a perfect contempt for it, one discovers it after all, a place the genuine†. This tells me that the speaker explains that reading poetry with perfect understanding is hard and confusing, but its achievable to find a place inside your self that can appreciate it. â€Å"Hands that can grasp, eyes that can dilate, hair that can rise if it must, these things are important because a high sounding interpretation can be put upon them but because they are useful†. This specific passage explains to me that the speaker is telling the author that poetry can be so powerful and meaningful with the right keen hands to fully grasp it, and the right eyes that can see past it and find the meaning as well as the hairs on yourself that will tense up from the message of the poem and its way of creation. She also states its important cause with these abilities it is vital and important because they are useful not just for poetry but for other things. â€Å"When they become so derivative as to become unintelligible, the same thing may be said for all of us, that we do not admire what we cannot understand†. This tells me that its true that for people sometimes when we don’t understand something, it becomes unimportant to us because we don’t have that drive or push to make us understand it since its to hard or to confusing. The author is saying that for us, many do not understand poetry making us give up on it since we don’t full grasp the true understanding of it. â€Å"The bat holding on upside down or in quest of something to eat, elephants pushing, a wild horse taking a roll, a tireless wolf under a tree, the immovable critic twitching his skin like a horse that feel a flea, the baseball fan, the statistician† . This creates imagery in the readers head by giving examples of what the author is trying to convey and creates images in ones head. Its relating to how these examples are hard to understand but make sense in a way once you dig deep enough and find the answer to it. â€Å"Nor is it valid to discriminate against â€Å"business documents and school books†; This part shows me that even though we hate books and documents the purpose of it is to teach us something, so instead of hating it since its hard to understand, take time to see its purpose of making us only smarter. â€Å"All these phenomena are important. One must make a distinction however: when dragged into prominence by half poets, the result is not poetry, nor till the poets among us can be literalists of the imagination†. The structure of this creates the message to me that all phenomena in things are important but its hard to see at first, and it takes a close eye to see this distinction. By addressing that dragging half poets into prominence the result is not poetry, and neither till the poets among us can be literalists of the imagination pin points that all poets can create poetry but the good kinds are the ones with imagination and a voice to it. It doesn’t have to have this deeper meaning to it but has to be genuine to the poet and have something real to them. â€Å"Above for inspection, â€Å"imaginary gardens with real toads in them shall we have it. † This creates images in the readers head and creates that sense of imagery by giving it direction on how anything can be imaginative but adding reality to it can be worthwhile and she be taken for accounted for. â€Å"In the meantime, if you demand on the one hand, the raw material of poetry in all its rawness and that which is on the other hand genuine, you are interested in poetry. † The ending to this poem stands out to me the most because this part says that even raw poetry can be good, and having that rawness as a good thing can make it genuine since anything can be poetry but it has to be genuine. The speaker address the reader by saying if you can appreciate rawness in all its power, then you can appreciate poetry in all its rawness.

A Picture Is Worth a Thousand Words Essay

â€Å"A picture is worth a thousand words†, is a common saying that rings true. Which is why many newspapers decide to compliment their articles with visual elements such as photographs, drawings, or political cartoons. However, many people feel that some of the images newspapers decide to print are in bad taste. Huge Hewitt, an Evangelical Christian, compared a political cartoon of Muhammad with a bomb for a turban, to a drawing of Jesus with a crown of TNT atop his head at an abortion clinic. Because both cartoons are equally distressing and offensive, wether you are Muslim or Christian, I doubt that a newspaper in the United States would print either image. On the other hand, if I was the editor of a newspaper I would print both pictures. After the terrorist attacks of September 11th there was a huge backlash on the Muslim culture and its people in this country. The cartoon of Muhammad with a bomb as a turban illustrates, literately, how ignorant and insensitive we are to Muslim beliefs. As editor, I would add an article to the cartoon explaining how it is not created out of malice or hatred, but it is a form of satire. It was drawn to grab your attention and inspire you to ask questions about the Muslim world, what is currently happening there, and how are we, as a country, involved. As editor, I would treat the cartoon of Jesus with a crown of TNT the same way. The accompanying article would clearly state that the image in no way mocks the Christian belief system. The picture does, however, raise questions about how God, or Jesus, would view the bombing of an abortion clinic, wether the life of a fetus is more important than that of its mother, and so forth. As I have stated previously, the cartoons are satire, not actual opinions or suggestions. The drawings are to be viewed as debate starters or to help you to create your own opinions about what is being portrayed. Furthermore, under the First Amendment of the Constitution of the United States, freedom of the press is clearly stated. These pictures, however disagreeable they maybe to some, the newspaper has its right to print them and the readers have the right to view them. In conclusion, I do not feel that any form of imagery is too bold to be printed in a newspaper, least of all a political cartoon of Jesus with TNT as a crown. As long as the readers do not take the picture for face value and can read deeper into the topic being presented, then there is no problem. As for offending people, they can just buy another newspaper if they don’t like the pictures in mine.