Health and Social Care Level 3 Essay Example for Free

Health and Social Care Level 3 Essay Objectives: All learners should be able to define basis of discrimination. All learners should be able to explain basis of discrimination Most learners should be able to demonstrate discriminatory practice Some learners should be able to describe effects of discriminatory practice. Basis of discriminatory Culture A person’s culture is important to them and identifies who they are in the world. In health and social care profession, respecting a person’s culture is important for all concerned. It also important to health and social care professionals because they see the benefits of their care value base which underlines respecting and individual’s culture Disability In health and social care you will work or support people with various disability. This disability Act status it unlawful to discriminate against someone has disability. Are covered include: employment, access to goods, facilities and services of organisation, education etc. Age Age discrimination happens when someone is treated unfavourably because of their age without justification or harassed because of their age. Controversies regarding dispensing of expensive drugs to older people because of shorter life expectancy. Denying a person a drug is illegal. Social class Our social class is apparent from where we live. The higher the class the better place is kept and maintained. The poor are more likely to get cancer than the rich and their chances of survival are poor. Human rights emphasises that everyone should be treated equally and with dignity no matter of their circumstances. Gender A person cannot be discriminated because of their gender. Health and social service should not discriminate unfairly due to a person’s gender. Equality rights of access, health and social care rights must be adhered to. Sexuality Sexual orientation can be referring to a person who is attracted to another person of the same sex. E.g. gay and lesbian. Discrimination against someone due to their sexual orientations against the law. Health status Taking into account the cost of treatment and the expected quality of life after treatment and overall life expectancy, people taking these decisions should always keep their own assumptions and prejudices. Family status This is lead to a variety of discriminations: against gay/lesbian parents, single parents, parents of different genders, parents from different race with mix race children and other family grouping

Importance of Vaccinations

Importance of Vaccinations Kasandra Padilla Each year the Department of Health and Human Services releases a list, essentially a schedule, of optional vaccines for children 0-18 months. Although these shots are not required, they are highly recommended. However, in recent years there has been speculation that the rise in childhood immunizations has caused excessive and unnecessary medical issues among children in the United States. This hearsay, spurred on by a handful of studies, claims causal relationships between developmental disabilities and certain elements found in vaccines. These studies, along with certain religious teachings and personal beliefs, have caused a number of parents across the United States to opt out of vaccinating their children. This decision has, unfortunately, caused the recent outbreaks of several, previously manageable, viruses in a number of America’s cities. In his article â€Å"Anti-Vaccination Movement Causes a Deadly Year in the U.S.† (2013), Brian Krans stated, â€Å"The anti-v accination movement continues to leave the door open to outbreaks of diseases that have been all but eradicated by modern medicine. These diseases include measles, polio, whooping cough, and more.† According The Center for Disease Control [CDC] measles is considered to be the deadliest childhood disease (2013), and all previously mentioned diseases (measles, polio, and whooping cough) are spread easily and simply by coming in contact with an infected individual. Although, in some cases, there may be side effects to certain vaccinations, the positive aspect of being immunized against a number of fatal diseases far outweighs the possible effects or reactions that may occur. Firstly, as briefly mentioned, vaccines save children from preventable diseases. Children are going to be children. So, parents protect them from sharp pointy objects, install gates to protect them from unsafe areas of the house, only feed them certain food for the first few months of their life, and do not feed them other foods until a certain age. Vaccines are another way to prevent one’s child from danger. According to Dr. Vincent Iannelli, a pediatrician in Dallas, Texas, today’s parents did not grow up in an era riddled with disease like Polio and therefore often forget the importance of vaccines (Vaccine Preventable Diseases, 2014). The World Health Organization [WHO] fact sheet classifies polio as, â€Å"a highly infectious disease caused by a virus. It invades the nervous system, and can cause total paralysis in a matter of hours,† and includes symptoms such as, â€Å"fever, fatigue, headache, vomiting, stiffness in the neck and pain in the limbs† (2014). Global Health Strategies [GHS], an international consulting firm that focuses on research in health care, mirrors Dr. Ianelli’s view and the issue of Polio, â€Å"Few remember a time in the US in the 1940’s and 50’s when fear of this crippling disease pervaded all pockets of society. Images of shuttered swimming pools and children in iron lungs and on crutches colored every mother’s daily worries† (2012). Therefore, due to the effectiveness of the very vaccines that they often contest, some individuals may not realize the severity and complexity of a disease. Individuals that choose not to vaccinate their children, known as anti-vaxxers, sometimes claim religious beliefs as the main reason for choosing not to immunize their children. One main issue that people cite is that certain vaccines contain fibroblast cells of fetal tissue. These fibroblast cells aid in holding connective tissue together (Hot Topics: Fetal Tissues, 2013). According to Paul Offit, a doctor at The Children’s Hospital of Philadelphia, the tissue resulted from two terminated pregnancies that occurred in 1960, and â€Å"No further sources of fetal cells are needed to make these vaccines† (2013). In other words these cells are not taken from fetuses today, like some anti-vaxxers claim. In the same article Dr. Offit continues on to state that these cells are used for two reasons: â€Å"Viruses need cells to grow and tend to grow better in cells from humans than animals (because they infect humans),† and because of the Hayflick limit, where cells die a fter being divided a certain number of times, fetal cells are used because they are able to â€Å"go through many more divisions before dying† (2013). Dr. Offit also notes, in â€Å"Parents Fake Religion to Avoid Vaccines,† that religious beliefs have come to be the default; because of state laws protecting religious practices, people claim religious exemption when it is that they just do not believe there is a need for immunizations (2007). The second reason that immunizations are beneficial is that they prevent outbreaks from occurring. In her article, â€Å"Measles Is Spreading In Our Largest Cities Because People Aren’t Vaccinating Their Kids† (2014), Tara Culp-Ressler, the health editor for ThinkProgress, a non-partisan web-based news source, discussed how recent outbreaks have occurred in â€Å"Boston, San Francisco, San Diego, and Dallas areas. Measles have also recently been reported in suburban areas in Connecticut and Illinois.† Anti-vaxxers claim that other countries do not have as many vaccines and they do not experience outbreaks. J.B. Handley (2011) stated â€Å"Iceland, Sweden, Singapore, Japan, and Norway give 11, 11, 13, 11, and 13 vaccines respectively—all less than 1/3 the number of vaccines the U.S. mandates.† Each vaccine on the CDC’s schedule is highly recommended, they are not â€Å"mandated.† If they were mandated no parent would have a choice in va ccinating their child and there would be no exemptions. Also, Handley mentioned that each of these countries only have 11-13 vaccines. The US only has 14 vaccines; these fourteen are given in a series from 0-18 months, not 36 separate vaccinations as Handley leads one to believe. It is necessary to highlight, because of the sheer difference in land mass and therefore population size, the population of each of the countries Handley mentioned. The most current statistics show Iceland: 326,340 (Statistics Iceland, 2014), Sweden: 9.7 million (Statistics Sweden, 2014), Singapore: 5.4 million (Department of Statistics Singapore, 2014), Japan: 127 million (The World Bank, 2014), Norway: 5 million (The World Bank, 2014), and the United States: 317.3 million (United States Census Bureau, 2013). These statistics emphasize Handley’s error in comparing countries with a much smaller population to that of the United States, and further underscores the previous inaccuracies contained in his argument regarding vaccination requirements. In countries where they do not promote vaccinations, such as Nigeria, Pakistan and Afghanistan (GHS, 2012), there are outbreaks of several diseases. For example, according to WHO, each of these countries remains endemic (2014). That is to say that communicable disease, such as polio and measles, are found regularly in these parts of the world. The probability of dying before one’s fifth birthday in Pakistan is almost 9% (86 in every 1,000 births) (WHO, 2014). Tara Culp-Ressler stated outbreaks in the United States tend to occur because families travel abroad, become infected, and then bring the virus back the US, infecting others who have not been vaccinated (2014). Lastly, vaccines are safe. Due to a handful of studies conducted by the previously mentioned J. B. Handley and Andrew Wakefield, the public now associate vaccines, particularly the MMR vaccine, with causing autism. Each of these individuals has been criticized for their lack of scientific objectivity in their experiments, with Wakefield in particular being barred from practicing medicine in Britain because of his falsified study (BBC, 2010). Unfortunately, their claims still remain on the public’s mind. It also does not help to quell the public’s concern when a celebrity, Jenny McCarthy, takes these falsified studies and uses them as a platform in an attempt to further frighten parents with the claim that her child suffers from autism because of the vaccinations he received. A study conducted by Sharpe, Gist, and Baskin (â€Å"Autism Spectrum Disorder and Their Unaffected Siblings Exhibit Hypersensitivity to Thimerosal,† 2013) point their fingers at Thimerosal, which, according to the Immunization Action Coalition (2011), is a â€Å"preservative that has been used in some vaccines since the 1930s.† The CDC, as well as the Immunization Action Coalition, point out that Thimerosal is present in only one influenza vaccine, and has been reduced to trace amounts. It should also be noted that, should one choose, there are other available alternatives to that particular influenza vaccine which contain no Thimerosal (2011). So, this preservative that anti-vaxxers claim causes autism is, in fact, is not contained in the MMR vaccine. Parents, undoubtedly, want to provide the safest environment for their children in order to keep them out of danger. Vaccinating one’s child is no different. Unfortunately, there is an abundance of information available that can cause a person to feel overwhelmed. When a well-known celebrity is claiming her child suffers from autism because of a vaccine, a great deal of the public is going to believe that individual because she is famous and has resources the parent may not have. These claims perpetuate the myths of preservatives being harmful to a child, or that vaccines are unnecessary because such diseases they protect against have been eradicated when they haven not. Each parent has the option to speak with a doctor regarding vaccinations. In fact, the CDC (2014) recommends speaking to a doctor in order to receive all relevant and up-to-date information so that each person can make an informed decision regarding having their child immunized. References Countries: Pakistan. (2014). Retrieved from http://www.who.int/countries/pak/en/ Culp-Ressler, T. (2014, March 14). Measles is spreading in our largest cities because people aren’t vaccinating their kids. Retrieved from http://thinkprogress.org/health/2014/03/14/3408461/measles-outbreaks-cities-vaccination/ Handley, J. B. (2011) Compelling evidence shows that vaccines trigger autism. Epidemics. Detroit: Greenhaven Press. Iannelli, V. (2014, March 30). Vaccine preventable diseases. Retrieved from http://pediatrics.about.com/od/immunizations/a/0408_im_illness.htm Infants, Children, and Teens. (2014) Retrieved from http://www.vaccines.gov/who_and_when/infants_to_teens/index.html Key Figures. (2014). Retrieved from http://www.scb.se/en_/ Krans, B. (2013). Anti-vaccination movement causes a deadly year in the U.S.. Retrieved from http://www.healthline.com/health-news/children-anti-vaccination-movement-leads-to-disease-outbreaks-120312 Latest Key Indicators. (2014). Retrieved from http://www.singstat.gov.sg/ Measles Vaccination. (2013). Retrieved from http://www.cdc.gov/vaccines/vpd-vac/measles/default.htm Offit, P. A. (2013). Hot topics: fetal tissues. Retrieved from http://www.chop.edu/service/vaccine-education-center/vaccine-safety/vaccine-ingredients/fetal-tissues.html Parents Fake Religion to Avoid Vaccines. (2007). Retrieved from http://www.cbsnews.com/news/parents-fake-religion-to-avoid-vaccines/ Polio Eradication. (2012). Retrieved from http://ghstrat.com/issues/polio Poliomyelitis. (2014). Retrieved from http://www.who.int/mediacentre/factsheets/fs114/en/ Population (Total). (2014). Retrieved from http://data.worldbank.org/indicator/SP.POP.TOTL Population in the 1st quarter 2014. (2014). Retrieved from http://www.statice.is/Pages/444?NewsID=10348 Sharpe, M. A., Gist, T. L., Baskin, D. S. (2013). B-lymphocytes from a population of children with autism spectrum disorder and their unaffected siblings exhibit hypersensitivity to thimerosal. Journal of Toxicology, 2013, 1-11. Thimerosal in Vaccines. (2014). Retrieved from http://www.fda.gov/biologicsbloodvaccines/safetyavailability/vaccinesafety/ucm096228 Triggle, N. (2010). Lancet accepts MMR study false. Retrieved from http://news.bbc.co.uk/2/hi/8493753.stm Vaccine Concerns: Thimerosal. (2011, February 25). Retrieved from http://www.immunize.org/thimerosal/

Effect of Phototherapy on Sleep Disorders

Effect of Phototherapy on Sleep Disorders In the natural world, the light – dark cycle entrains our rhythm. Light is a very effective ‘Zeitgeber’. In the presences of environmental time cues, sleep-wake physiology, and gene expression continue to exhibit a near-24-hour circadian rhythm regulated by the Suprachiasmatic Nucleus in the Hypothalamus. Phototherapy is an accepted modality for non- pharmacological management of Circadian Disorders such as Delayed Sleep Phase Syndrome, Insomnia etc. This review discusses the physiological principle and highlights evidence based literature of phototherapy and its management in Sleep Disorders. Introduction; Living organism’s exhibit a biological periodicity, this rhythm when occurs on a 24 hour cycle is known as ‘Circadian Rhythm’. A rhythmic biological cycle that displays an endogenous entrainable oscillation of less than 24 hours in known as ultradian rhythm. and that last for more than 24 hours is known as Infradian rhythms. Circadian Rhythms generate rhythmic cycling of sleep patterns, food intake, sexual behavior, core body temperature and secretion release of hormones such as ACTH, Prolactin, Gonadotorophin and Melatonin. Circadian Rhythms are generated by the Suprachiasmatic Nucleus (SCN) of the Anterobasal Hypothalamus. Pineal gland regulates the rhythmic production and release of melatonin. The duration, phase and amplitude of melatonin and cortisol secretion, are influenced by changes in light-dark cycles. The plasma levels are low during day time and are high at night. This rhythm is maintained by the SCN and is entrained by the light-dark cycle. Low light intensities like 100 to 500 lux also have been shown to suppressed levels of melatonin. Phototherapy or light therapy utilizes light boxes which are typically LED square bright lights, ranging from 8-12 x 12-24 inches that emit 10,000 Lux (highest Lux) light, cool color temperature light acts as natural sunlight without the harmful effect of UV rays. This mode of entraining the sleep wake cycle is an accepted modality and mainstay treatment in the non-pharmacotherpeutic management of Circadian Rhythm Disorders. Principles of Phototherapy The goal of the Circadian Rhythm is to maintain a bridge between sleep patterns and the internal clock that is set at a optimally synchronized time. This results in a normal sleep-wake pattern. The Biological Model-Phase response curve The Phase Response curve is modulated by two efficacious modalities i.e. light and melatonin, both of which are exploited to entrain the circadian cycle. Bright light is very helpful in synchronizing the human rhythms and the melatonin serves as a ‘‘dark pulse’’ helping to induce night-time behaviors. Bright morning light advances circadian rhythms; bright evening light delays them. Melatonin in the evening advances circadian rhythms; melatonin in the morning delays them. Circadian Disturbances and Insulin Resistance Type 2 Diabetes Mellitus is a multifactorial disorder, of which Circadian Disturbances is one of the lifestyle factors that contribute to it. Sleepdisturbances including sleep insufficiency, sleep loss, sleep fragmentation, are connected to abnormal Glucose Metabolism and thus, increase the risk of Type 2 Diabetes Mellitus. Studies in rodent models suggest that disruption of Circadian Rhythms leads to impaired glucose homeostasis and beta-cell failure, culminating in increased susceptibility to Type 2DM. Disturbed Circadian Rhythm is causative factor in the recent epidemic â€Å"Obesity†. In controlled clinical studies, acute 1-3 week circadian misalignment (alone) or in combination with sleep restriction results in dysregulation of glucose homeostasis and consequent glucose intolerance attributed in part to loss of beta-cell function as well as decline in insulin sensitivity. CIRCADIAN RHYTHM PROBLEM CONTRIBUTES TO INFLAMMATORY DISEASES. Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohns disease (CD), is a chronic and recurrent inflammatory disorder of the intestinal tract. Study says that sleep disturbances are one of the main reasons of pathogenesis of the patients with IBD. In addition melatonin plays a vital role in regulation of inflammation as well as immune system and antioxidant system in the intestinal disorders. (16, 17) CIRCADIAN RHYTHM and visually Impaired Bright light has been shown to suppress Melatonin secretion even in visually impaired subjects which substantiates the fact that non-visual photoreceptors in the eye mediate the Circadian Rhythm regulating effects of light CIRCADIAN RHYTHM AND IMMUNITY Sleep restriction and sleep deficit increase your vulnerability to disease. The immune system is connected to the sleep regulatory system and actions of the immune system to fight disease.Sleep is regulated partly by immune system components called cytokines. Blood counts of T-cells and levels of proinflammatory cytokines are high during the night while leukocytes and the anti-inflammatory cytokine IL-10 go up during daytime. Changes in the immune system seem associated with the onset of narcolepsy, which has a neurological cause (brain cell death) inflammatory diseases increase cytokine levels and make people feel fatigued. This is a good thing during a short-term injury or illness, as it drives the person to rest. For those with chronic inflammation, however, the immune system keeps them tired for long periods, which may explain symptoms of fibromyalgia and chronic fatigue disorder. The trouble in sleeping that people with those conditions experience is not due to just the discomforts of the illnesses, but because the sleep regulation system is affected. The different phases of sleep are responsible for different functions within our bodies. The first and second phases involve settling in, resulting in rhythmic breathing and a lowered body temperature. The third and fourth stages are when our bodies are working to restore themselves. During this time our muscles relax and the blood supply going to them increases. Our bodies use this time to repair tissue damage and grow new tissue. Important hormones are released and our energy is renewed. These stages appear to be a critical factor in maintaining a healthy immune system and any sleep disturbance that impacts them, impacts our health. It is becoming increasingly evident that disruption of daily rhythms, such as from sleep deprivation, affects the immune response. Toll-like receptor 9 (TLR9), is an immune system protein that can sense bacterial and viral DNA Role of Phototherapy Cognitive Impact Light intensity has a direct impact on cognitive performance and alertness and on the subjective feeling of sleepiness. The researchers found that volunteers subjected to higher light intensity during the afternoon were more alert all the way into the early evening than those who were not. But when subjected to light intensity 10 times weaker, they showed signs of sleepiness and obtained lower scores on the memory tests. Artificial light is used to phase shift circadian rhythm and help improve performance, sleep, and well-being during shiftwork simulations , this was proved in study designed for NASA personals during t he prelaunch week. The treated subjects were self exposed to 10, 000 Lux. The treated personnel showed a positive result reporting better sleep, performance, and physical and emotional well-being than control subjects and rated the treatment as highly effective for promoting adjustment to their work schedules for the study. Nocturnal alertness, performance, and daytime sleep could be improved by light exposure of tolerable intensity and duration in a real work place. This was proved in a cross-over design study conducted on 12 night Shift nurses with three different treatment procedures: Room Light (RL) exposure in the night followed by a 1hr sunlight or 10,000 lux light next morning(08:30 to 09:30), Bright Light (BL) a 4-hour nocturnal light exposure of 4,000-6,000 lux (from 01:00 to 05:00) and Bright Light with Sunglasses (BL/S) the same nocturnal light exposure as in BL was done with light attenuation in the morning. Nocturnal alertness was measured by a visual analog scale. Daytime sleep was recorded with actigraphy. Nocturnal alertness was the highest in the BL/S. The improvement was maximized by attenuating morning light. Sun-Downing phenomenon Sundowning is a clinical phenomenon characterized by the emergence or increment of neuropsychiatric symptoms such as confusion, disorientation, anxiety, agitation, aggression, pacing, wandering, resistance to redirect screaming, yelling and so forth observed late afternoon, evening or at night and occurs among cognitively impaired, demented, or institutionalized elderly patients. In a 6-week, double-blind, placebo-controlled, cross-over trial the effects of bright light therapy combined with melatonin on motor restless behavior in demented patients had been evaluated. This study concluded that bright light therapy (10,000 lux bright light) has a positive effect on motor restlessness in subjects with dementia. Mood disturbances Manic-Depressive Illness (MDP): MDP is recurrent illness in which episodes of Mania and Depression occur and remit spontaneously. Several clinical studies say that disturbance in the Circadian Rhythms play a crucial role in its pathophysiology. Melatonin secretion shows abnormal levels in some bipolar patients (MDP). Patients with MDP exhibit circadian sleep wake rhythm in which patients spent one complete sleepless night in between two nights of normal sleep. In a study, 143 patients with a major depressive episode in the course of bipolar disorder (DSM-IV criteria) treatment with 3 consecutive totalsleepdeprivation cycle (each composed of a period of 36 hours awake followed by recovery sleep), light therapy, and lithium rapidly decreased the depressive suicidality and prompt antidepressant response in patients with drug-resistant major depression in the course of bipolar disorder. Borderline personality disorder (BPD) is typically characterized by instability and impaired behaviour , affectivity, interpersonal relations and lifestyle. This open study assessed 13 female patients for the effectiveness of the application of bright light (10,000 lux, 6:30 to 7:30 a.m. for 6 weeks) added to SSRIs in drug-resistant depressed patients with comorbid BPD who did not show any improvement to 6-week administration of antidepressants. The participants were regularly evaluated using the CGI, HAMD and MADRS scales and the BDI and BDI self-report inventories. All the assessments proved that the application of Bright light leads to a significant improvement. SAD: Phototherapy acts through Retinal Melatonin or Rhodopsin, which regulates Dopamine release in the eye where it acts as the main neurotransmitter. The retina-SCNvpineal gland forms a link, which is disturbed in SAD. By suppressing retinal Melatonin, Phototherapy has been suggested to correct the underlying biochemical abnormality seen in SAD and thereby inducing clinical remission.In Non- Demented people, light therapy is an accepted and validated treatment for seasonal affective disorder, but has also been reported to be effective in Non –Seasonal Depression (15). Recently it has been noted that exposure of SAD patients to natural sunlight in the morning hours resulted in complete remission of depressive symptoms. In the study, N=24(12 SAD patients and 12 controls) were exposed to morning light therapy in the winter and the melatonin profiles being sensitive to light were measured before and after treatment. The SAD Patients showed a phase advance of melatonin rhythms in response to phototherapy which showed an association between phase position and phase shift in the SAD patients. This instability may be secondary to impaired serotoninergic function in the afferent pathways to the suprachiasmatic nuclei. This seems to be a significant advancement in the etiology of SAD that links light with Mood Disorders. In Seasonal Affective Disorder (SAD) is common when vitamin D stores are typically low. wavelengths between 280-320 nm which are Broad-spectrum light therapy that allow the skin to produce vitamin D. In a prospective, randomized controlled trial was conducted N=15 subjects with SAD (8 subjects-100,000 I.U. of vitamin D and 7 subjects–phototherapy). At the onset of treatment and after 1 month of therapy subjects different depression scale were administered. Vitamin D status improved in both groups (74% vitamin D group, p ADHD Morning bright light therapy is associated helps reduce both subjective and objective measures of core ADHD pathology, improves mood symptoms, and phase advance in circadian preference. Multiple regressions showed that the shift toward an earlier circadian preference with LT was the strongest predictor of improvement on both subjective and objective ADHD measures. In the Elderly The risk of developing depression increases with old age. The occurrence of a major depressive episode in Alzheimer’s disease is as high as 20-25%and minor depressive symptoms occur in an additional 20-30% (9, 10). In a randomized double-blind placebo-controlled trial, patients with early Alzheimer’s Disease (AD), Mild Cognitive Impairment (MCI) and Subjective Memory Complaints (SMC)(N=79, Age = between 50 75). Patients were exposed to ~10,000 lux for two years, the active condition or ~300 lux in the placebo condition, daily, for two half-hour sessions at fixed times in the morning and evening. Neuropsychological, behavioral, physiological and endocrine measures are assessed at baseline and follow-up every five to six months. The evaluation showed long-term daily bright light prevented worsening of sleep-wake rhythms and depressive symptoms in elderly people with memory complaints. Elderly experience increased difficulties with sleeping, and thus could be one of the contributing factor for mood problems.(11) Factors contributing in Aging process Aging process | | Impaired Ocular light transmission due to age related eye deficiencies | | Requires high demand of light intensities inorder to maintain a sufficient input to SCN | | Diminished SCN input | | Arrhythmia in the Sleep Wake cycle Studies report that it is possible to reactivate the SCN and improve ‘Sleep –Wake Rhythm’ by applying extra light. Light therapy provides a safe treatment option (13).It’s reported that, bright light therapy is decreasing common health issues (14). In 10 Alzheimers patients with sundowning behavior and sleep disturbances were studied for a week who received 2 hours/day of exposure to bright light between 7:00 p.m. and 9:00 p.m. The results showed that the proportion of total daily activity occurring during the nighttime decreased during the light-treatment week. The relative amplitude of the circadian locomotor activity rhythm, a measure of its stability, increased during the light-treatment week. This kind of effect mediated through a chronobiological mechanism. Artificial light is used to phase shift circadian rhythm and help improve performance, sleep, and well-being during shiftwork simulations , this was proved in study designed for NASA personals during t he prelaunch week. The treated subjects were self exposed to 10, 000 Lux. The treated personnel showed a positive result reporting better sleep, performance, and physical and emotional well-being than control subjects and rated the treatment as highly effective for promoting adjustment to their work schedules for the study. In study bright light exposure improved sleep quality in 7-18% subjects, the study consisted of 13 interventional studies with 1154 participants. Jet lag causes distress to the number of travelers impairing sleep, mood and cognitive performance. Timed exposure to bright light and melatonin administration can help to reduce symptoms. Specific recommendations using bright light and melatonin for eastward and westward travel before and after departure are provided for time zone changes of up to 6, 7–9 and 10 or more hours. Timed bright light and melatonin administration, by helping to adjust underlying circadian rhythms to the new time zone, can serve to mitigate the symptoms of jet lag. Reducingthe symptoms of jet lag by this methods can lessen the mood, cognitive and behavioral symptoms resulting from these desynchronized rhythms.(

Louis XIV :: essays research papers

Louis XIV was only four years old when he succeeded his father to the French throne. Often uncared for, he nearly drowned because no one was watching him as he played near a pond. This began to shape in his young mind an early fear of God. Louis' character was also shaped by the French Civil War. In this, the Paris Parlement rose against the crown. For five years, Louis would suffer fear, cold, hunger and other spirit-breaking events. He would never forgive Paris, the nobles, or the common people. Finally, in 1653, Cardinal Jules Mazarin was able to end the rebellion. He began to instruct Louis on his position as king. Even though Louis XIV was now of age, the Cardinal remained the dominant authority in French politics. French kings gained respect as a soldier; Louis served with the French army during France's war with Spain. His biggest battle, however, was sacrificing his love for Mazarin's niece for politics. In 1660 he married the daughter of the king of Spain to bring peace between the two countries. Mazarin died March 9, 1661. On March 10, Louis claimed supreme authority in France. Not since Henry IV had such a claim been made. Louis saw himself as God's representative on earth, therefore, infallible. He oversaw roadbuilding, court decorum, defense, and disputes within the church. He had the support initially of his ministers, then that of the French people. He had given France the image it desired-youth and vitality surrounded by magnificence. Louis won the favor of the nobles by making it evident that their future depended on their ability stay on his good side. This weakened the nobility, and would eventually weaken France. Louis had among his supportors a wide spectrum of individuals. Writers such as Moliere were ordered to glorify him. Monuments rose throughout the country and Louis had palaces built in his honor. The most elaborate was Versailles, located outside Paris. Away from disease, Versailles also isolated the king from his people. The aristocracy became mysterious. France was also undergoing an economic revolution. Exports were increased, and a navy, merchant marine, and police association emerged. Roads, ports and canals were being built. He invaded the Spanish Nederlands in 1667. The restarted war between France and Spain would be on again, off again for the remainder of Louis' reign. In 1668, the French army retreated under pressure from Dutch and English forces. Louis swore to defeat the Dutch and ruin their Protestant mercantile republic.

My Favourite Vacation Spot is St. Martin Essay -- Personal Narrative,

I got dazzled once again by the beauty of St. Martin. St. Martin is undoubted a special place for vacation and one of the most beautiful islands in the world. Among all the places I have visited, it is the most unique. If anybody asks me about a vacation spot, the first thing that comes up in my mind is St. Martin. This is not for it is in my country but for its explicit natural beauty, social environment and the facilities available there. Natural has its own world in St. Martin. The island is about two kilometres long and the deep blue water all around it is outstanding to watch. Rocks of different sizes and types are all around the beach, some of which are with razor sharp spikes that can cut your foot into pieces if you step on them. Moreover, different coloured sea weeds and live corals can be seen on the rocks which are submerged in the water. St. Martin is the only Island in the world with live corals. There are more than thousands of different types of coral in this island. Scientists say that this island actually grew from this coral by the metamorphosis of different c...

Night World : The Chosen Chapter 12

The voice was shrill, almost hysterical. Unbalanced, Rashel thought dazedly, looking around. The sound of her secret being yelled out loud stunned her. But just for an instant. The next moment she was moving swiftly between the rows of girls, looking for†¦ â€Å"Nyala!† â€Å"I know why you're here!† Nyala sat up tensely. She looked just as she had when Rashel had seen her last, cocoa skin, queenly head, wide haunted eyes. She was even dressed in the same dark clothes she'd been wearing the night they caught Quinn. â€Å"You're here because you were in on it all along! You pretend to be a vampire hunter-â€Å" â€Å"Shut up!† Rashel said desperately. Nyala was shouting loud enough to be heard on the other side of the door. She knelt on Nyala's bed. â€Å"I'm not pretending, Nyala.† â€Å"Then how come you're free and we're all chained up? You're on their side! You call yourself the Cat-â€Å" Rashel clamped a hand over her mouth. â€Å"Listen to me,† she hissed. Her heart was pounding. All the girls around her were staring and she expected to hear the cellar door open at any moment. â€Å"Nyala, listen. I know you don't like me or trust me-but you've got to stop yelling that. We may only have one chance to get out of here.† Nyala's chest was heaving. Her eyes, the color of dark plums, stared into Rashel's. â€Å"I am a vampire hunter,† Rashel whispered, willing Nyala to believe it. â€Å"I made a mistake letting that vampire go that night†¦ I admit it. But I've been trying ever since to put things right. I got captured on purpose so I could find out what was going on here-and now I'm going to try to get all these girls free.† She spoke slowly and distinctly, hoping Nyala could sense the truth of her words. â€Å"But, Nyala, if the Night People find out I'm a vampire hunter-much less the Cat-they are going to take me out and kill me right this minute. And then I don't think the rest of you have a chance.† She stopped to breathe. â€Å"I know it's hard to trust me. But please, please try. Do you think you can do that?† A long pause. Nyala's eyes searched hers. Then, at last, Nyala nodded. Rashel took her hand off Nyala's mouth. She sat back on the bed and they stared at each other. â€Å"Thank you,† Rashel said. â€Å"I'm going to need your help.† Then she shook her head. â€Å"But how did you get here? How did you find the club?† â€Å"I didn't find any club. I went back to that street with the warehouses on Wednesday. I thought maybe the vampire might come back. And then-somebody grabbed me from behind.† â€Å"Oh, Nyala.† Wednesday night, Rashel thought. The night Daphne saw Ivan carry in a new girl and put her on a cot. That girl was Nyala. Rashel put a hand to her head. â€Å"Nyala-I almost saved you. I was there the next night-when Daphne fell out of the truck. Do you remember that? If I had only known†¦Ã¢â‚¬  Nyala wasn't listening. â€Å"Then there was this whisper in my mind, telling me to sleep. And I couldn't move-I couldn't move my arms or my legs. But I wasn't asleep. And then he carried me into a warehouse and he bit me.† Her voice was detached, almost pleasant. But her eyes froze Rashel in place. â€Å"He bit me in the neck and I knew I was going to die, just like my sister. I could feel the blood coming out. I wanted to scream but I couldn't move. I couldn't do anything.† She smiled oddly at Rashel. â€Å"I'll tell you a secret. It's still there, the bite. You can't see it, but it's still there.† She turned her head to show a smooth unblemished neck. â€Å"Oh, God, Nyala.† Rashel had felt awkward trying to make gestures of comfort with Daphne, but now she didn't think. She just grabbed Nyala and hugged her hard. â€Å"Listen to me,† she said fiercely. â€Å"I know how you feel. I mean-no, I don't know, because it hasn't happened to me. But I'm sorry. And I know how you felt when you lost your sister.† She leaned back and looked at Nyala, almost shaking her. â€Å"But we have to keep fighting. That's what's important right now. We can't let them win. Right?† â€Å"Yes†¦Ã¢â‚¬  Nyala looked slowly around her bed, then up at Rashel. â€Å"Yes, that's right.† Her eyes seemed to sharpen and focus. â€Å"I'm making a plan to get out of here. And you have to stay calm and help me.† â€Å"Yes.† Nyala sounded more definite this time. Then she smiled almost serenely and whispered, â€Å"And we'll get our revenge.† â€Å"Yeah.† Rashel pressed her hand. â€Å"Somehow, we will. I promise you.† She walked back to her cot feeling eyes on her, although nobody asked any questions. Her own eyes were stinging. What had happened to Nyala was her fault. The girl had already been on the edge, and because of Rashel, she'd gotten herself caught and attacked by a vampire. And now†¦ Now Rashel was worried about Nyala's sanity, even if they did manage to get off the island. She's right about one thing, though, Rashel thought. Revenge. It's the only way to wipe out the things that have been done to these girls. The fire in her chest was back-as if there were coals where her throat and heart ought to be. She let it harden her and burn away any stray thoughts of mercy for Quinn. Strange how she kept having thoughts of him, long after she'd made the resolution to kill him. â€Å"Is she okay?† Daphne said worriedly. â€Å"I remember her from the warehouse.† â€Å"I know.† Rashel took the lockpick and sat on Daphne's cot. She began to work at Daphne's shackles. â€Å"I don't know if she's okay. The vampires haven't been living in harmony with her.† She glanced bitterly at Fayth, who just looked back gravely and steadily. â€Å"Nobody thinks all the Night People are good,† Fayth said. â€Å"Or all the humans. We don't approve of violence. We want to stop it all.† â€Å"Well, sometimes it takes violence to stop violence,† Rashel said shortly. Fayth didn't answer. â€Å"But why was she calling you a cat?† Daphne asked. Rashel could feel Fayth's gaze on her. â€Å"The Cat. It's the name of a vampire hunter, one who's killed a lot of vampires.† Daphne's dark blue eyes widened slightly. â€Å"Is it you?† Rashel sprung a lock. Somehow, with these two girls staring at her, she didn't feel quite so brash as she had a moment ago. She didn't feel terribly proud of being the Cat. Without looking up, she said, â€Å"Yes.† Then she glanced behind her at Fayth. Fayth said nothing. â€Å"There's going to be more killing before this is all done,† Rashel said. â€Å"And I can't think of anybody who deserves it more than the vampires who brought us here. So you let me take care of that, and we won't argue about it. All right?† She sprung the other lock on Daphne's shackles. Daphne immediately stretched her legs luxuriously, then swung them to the floor. Fayth just nodded slowly. â€Å"All right, then. Listen. The first thing we've got to do is get these girls organized.† Rashel moved to work on Fayth's chains. â€Å"You're both good talkers. I want the two of you to go around and talk to them individually. I want to know who's going to be able to help us and who's still under mind control. I want to know who's going to be a problem. And I especially want to know who has any experience with boats.† â€Å"Boats?† Fayth said. â€Å"No place on this island is safe. We have to get off. There are four boats in the harbor right now- if we can just find somebody to handle them.† She looked from Daphne to Fayth. â€Å"I want you to bring me back at least two sensible girls who have some chance of not sinking a powerboat. Got it?† Daphne and Fayth glanced at each other. They nodded. â€Å"Right, boss,† Daphne murmured, and they started off. Rashel sat, weighing a chain in her hand and thinking. There was no need to tell Daphne-yet-that she didn't plan to ship out with the boats. Half an hour later Daphne and Fayth stood before her beaming. At least Daphne was beaming; Fayth was wearing that grave smile that was starting to drive Rashel crazy. â€Å"Allow me to introduce Annelise,† Daphne said, leading Rashel to a cot. â€Å"Originally a native of Denmark. She's done the race circuit in Antigua-whatever that means. Anyway, she says she can handle a boat.† The girl in the cot was one of the oldest there, eighteen or nineteen. She was blond, long-legged, and built like a Valkyrie. Rashel liked her at once. â€Å"And this is Keiko over here,† Fayth said in her simple way. â€Å"She's young, but she says she grew up around boats.† This one Rashel wasn't so sure about. She was tiny, with hair like black silk and a rosette mouth. She looked like a collector's doll. â€Å"How old are you?† â€Å"Thirteen,† Keiko said softly. â€Å"But I was born on Nantucket. My parents have a Ciera Sunbridge. I think I can do what you're asking-it's just the navigation that worries me.† â€Å"There isn't anybody else,† Daphne stage-whispered in Rashel's ear. â€Å"So my advice is we trust the kid.† â€Å"I think the navigation will be straight west,† Rashel said. She smiled reassuringly at Keiko. â€Å"Anyway, even the open ocean will be safer than here.† She gestured to Daphne and Fayth to come back to their corner. â€Å"Okay. Good job. You're right about trusting the kid; I don't think we have any other choice. We definitely need two boats for all these girls. What else did you find out?† â€Å"Well, the ones that are still under mind control are the ones that came with us,† Daphne said. â€Å"Juanita and Missy. And the one that might cause trouble is your buddy Nyala. She's not completely hinged, if you know what I mean.† Rashel nodded. â€Å"The mind control may be a problem-how long did it take to wear off the others, Fayth?† â€Å"A day or so after they came in. But that's not the only problem, Rashel. Annelise and Keiko think they can handle the boats-but not tonight. Not until tomorrow.† â€Å"We can't wait until tomorrow,† Rashel said impatiently. â€Å"That's cutting it way too fine.† â€Å"I don't think we have a choice. Rashel, all these girls are tranquilized. Drugged.† Rashel blinked. â€Å"How-?† She shut her eyes. â€Å"Oh.† â€Å"The food,† Fayth said, as Rashel nodded in resignation. â€Å"I realized right off that there was something in it. I think most of the girls know-and they'd rather be tranquilized than think about what's happening to them.† Rashel rubbed her forehead wearily. No wonder the girls hadn't asked her any questions. No wonder they weren't all screaming their heads off. They were doped to the gills. â€Å"From now on we've got to keep them from eating,† she said. â€Å"They need clear heads if we're going to escape.† She looked at Fayth. â€Å"Okay. We wait. But that's going to make everything more dangerous. How often do they bring food in here?† â€Å"Twice a day. Late morning and around eight at night. And then they take us to the bathroom two by two.† â€Å"Who does it?† â€Å"Rudi. Sometimes he has another werewolf with him.† Daphne bit her lip anxiously. â€Å"Are we equipped for werewolves?† Rashel smiled. Holding her knife, she pulled the decorative knob at the end of the sheath. It came off, revealing a metal blade. She reversed the knob and stuck it in the end of the sheath, so the blade stuck out like a bayonet. The hard wooden sheath itself was now a weapon. â€Å"The blade is silver-coated steel,† she said in satisfaction. â€Å"We are equipped for werewolves.† â€Å"You see?† Daphne said to Fayth. â€Å"This girl thinks of everything.† Rashel put the knife away. â€Å"All right. Let's talk to everybody again. I want to explain my plan. When we do this tomorrow night, it's going to take cooperation and precision.† And, she thought, a lot of luck. â€Å"Chow time!† Rudi walked between the rows of cots, tossing packages from a plastic bag to either side of him. He looked, Rashel thought, exactly like a trainer throwing herring to seals. She scanned the aisle behind him. No other werewolf at the door. Good. It had been a long night and a longer day. The girls were dizzy from lack of food, keyed up, and getting more tense with each untranquilized hour. A couple of them couldn't seem to shake their first impression of Rashel-which had come from Nya-la's yelling. â€Å"Eat up, girlies. Got to keep up your strength.† A slightly warm foil package hit Rashel's lap, another hit the mattress. Same thing as brunch-hot dogs of the kind you get at a convenience store. Smeared with mustard and drugs. The girls had been surviving on the grapefruit juice he'd poured for them. As Rudi turned to throw a package to Juanita, Rashel rose smoothly from her cot. In one motion she leaped and came down right on target. â€Å"Don't make a sound,† she said in Rudi's ear. â€Å"And don't even think about changing.† She had his arm twisted behind his back and the silver knife to his throat. Rudi didn't seem to know how he'd gotten there. There were hot dogs all over the floor. â€Å"Now,† Rashel said. â€Å"Let's talk about jujitsu. This is what you call a proper hold. Resistance to it will cause serious pain and quite possibly a fractured joint. Are you getting this, Rudi?† Rudi wiggled a little and Rashel exerted pressure upward on his knuckles. Rudi yelped and danced on his toes. â€Å"Hush! What I want to know is, where is the other werewolf?† â€Å"Guarding the dock.† â€Å"Who else is on the dock?† â€Å"I-nobody.† â€Å"Is there anybody on the stairs or in the kitchen? Don't lie to me, Rudi, or I'll get annoyed.† â€Å"No. They're all in the gathering room.† Rashel nodded at Daphne. Daphne jumped out of her bed. â€Å"Remember-quick and quiet everybody,† she said, like a cheerleader who'd been promoted to drill sergeant. Rashel felt Rudi boggle as every girl in the room kicked off her covers and stood up free. â€Å"What the-what the-â€Å" â€Å"Now, Rudi.† Keeping his elbow trapped against her, Rashel exerted pressure again, moving him easily in the direction she wanted. â€Å"You go first. You're going to unlock the top door for us.† â€Å"Annelise and Keiko in front,† Daphne said. â€Å"Missy right here. Let's go.† â€Å"I can't unlock it. I can't. They'll kill me,† Rudi muttered, as Rashel moved him up the stairs. â€Å"Rudi, look at these young women.† Rashel swung him around so he had a good view of the prisoners behind him. They stood in one tense, dear-eyed, lightly breathing mass. â€Å"Rudi, if you don't unlock that door, I am going to tie you up and leave you alone with them†¦ and this silver knife. I promise, whatever the vampires do to you won't be worse.† Rudi stared at the girls, who stared back at him. All ages, all sizes, united. â€Å"I'll unlock the door.† â€Å"Good boy.† He fumbled getting the door open. When it was done, Rashel pushed him through first, looking tensely around. If there were vampires here, she had to change tactics fast. The kitchen was empty-and music was blasting from somewhere inside the house. Rashel gave a quick savage grin. It was a lucky break she wouldn't have dared to pray for. The music might just save these girls' lives. She pulled Rudi out of the way and nodded to Daphne. Daphne stood at the head of the stairs, silently waving the girls out. Fayth led the way with the Valkyrie Annelise and the tiny Keiko behind her. The other girls hurried past, and Rashel was proud of how quiet they were. â€Å"Now,† she whispered, pushing Rudi back into the stairwell. â€Å"One last question. Who's throwing the bloodfeast?† Rudi shook his head. â€Å"Who hired you? Who bought the slaves? Who's the client, Rudi?† â€Å"I don't know! I'm telling you! Nobody knows who hired us. It was all done on the phone!† Rashel hesitated. She wanted to keep questioning him-but right now the important thing was to get the girls off the island. Daphne was still waiting in the kitchen, watching Rashel. Rashel looked at her and then helplessly at Rudi's bushy brown head. She should kill him. It was the only smart thing to do, and it was what she'd planned to do. He was a conspirator in the plan to brutally murder twenty-four teenage girls-and he enjoyed it. But Daphne was watching. And Fayth would give her that look if she heard Rashel had done him in. Rashel let out her breath. â€Å"Sleep tight,† she said, and hit Rudi on the head with the hilt of her knife. He slumped unconscious and she shut the cellar door on him. She turned quickly to Daphne. â€Å"Let's go.† Daphne almost skipped ahead of her. They went out the back door and picked up the hiking path. Rashel moved swiftly, loping across the beaten-down wild grass. She caught up to the string of girls. â€Å"That's it, Missy,† she whispered. â€Å"Nice and quiet. Nyala, you're limping; does your leg hurt? A little faster, everybody.† She made her way up to the front. â€Å"Okay, Annelise and Keiko. When we get there, I'll take care of the guard. Then you know what to do.† â€Å"Find which boats we can handle. Destroy whatever we can on the others and set them adrift. Then each take half the girls and head west,† Annelise said. â€Å"Right. If you can't make it to land, do your best and then call the Coast Guard.† â€Å"But not right away,† Keiko put in. â€Å"Lots of islanders use ship-to-shore radio instead of telephones. The vampires may be monitoring it.† Rashel squeezed her shoulder. â€Å"Smart girl. I knew you were right for the job. And remember, if you do call the Coast Guard, don't give the right name of the boat and don't mention this island.† It was perfectly possible that there were Night People in the Coast Guard. They were almost at the bottom of the cliff, and so far no alarms had sounded. Rashel scanned the moving group again, then became aware that Daphne was behind her. â€Å"Everything okay?† â€Å"So far,† Daphne said breathlessly. She added, â€Å"You're good at this, you know. Encouraging them and all.† Rashel shook her head. â€Å"I'm just trying to keep them together until they're not my problem anymore.† Daphne smiled. â€Å"I think that's what I just said.† The wharf was below them, the boats bobbing quietly. The ocean was calm and glassy. Silver moonlight gave the scene a postcard look. Ye Olde Quaint Marina, Rashel thought. She loped to the front again. â€Å"Stay behind me all of you.† She added to Daphne, â€Å"I'll show you what I'm good at.† A few feet of rocks and sand and she was on the wharf. Eyes on the shack, knife ready, she moved silently. She wanted to take care of the werewolf without noise, if possible. Then a dark shape came hustling out of the shack into the moonlight. It took one look at Rashel and threw back its head to howl.

Nature Versus Nurture Essay

Nature versus Nurture The nature versus nurture debate has been one that has been around for centuries. This debate was spawned from the idea that nature and nurture are both pieces of the human puzzle. Are we as humans shaped because of our genes only or are we influenced by our peers and environment? The opinion of this writer is that a person is who he or she is based on both principals of nature and nurture. Personal Thoughts My thoughts on nature and nurture have never been explored until now. I have always assumed that I am who I am because God made me this way. Now that I have learned a bit more about this debate, I find that I am a product of both nature and nurture. I am tall, have brown hair, wear glasses, and speak with a country accent because of my gene structure given to me by my parents. The way that I act and my thought processes come from influences in my environment and the teachings of my family. â€Å"We are a product of nature and nurture, but we are also an open system† (Myers, pg. 167). This means that even though genes and culture are influences in a person’s overall structure, a person can defy each. For example, as a teenager, I was always pressured to go with the crowd and conform to their ways of thinking and acting. I wanted so badly to fit in and found it difficult because I was tall, lanky, and had acne which was all given to me by my nature or genetic structure. Growing up in a smaller town, teenage drinking was a pressure of my social group and while I knew it would be the â€Å"thing to do†, I opposed what culture was telling me was okay. I chose not to go with the crowd and for that, I enjoyed my high school experience in my own way. I was taught by my parents the consequences of right and wrong and knew that making such choices were wrong for me which was instilled in me through the nurture part of my makeup. God says â€Å"Train up a child in the way in which he should go† (Prov. 22:6) which must have been a very important verse as I was growing up. My parents and grandparents have always been influential in making me a self-respecting, confident adult who can make conscious decisions on my own. History The nature versus nurture debate first began in the 13th century in France. Our genes give us our internal imprint that tell us what color our eyes are, how tall we will be, and how big our feet will be. Our genetic structure makes us unique. Psychological influences refer to our beliefs, feelings, and expectations of life experiences. These characteristics are based on the â€Å"gene-environment interaction† and can give us â€Å"responses evoked by our own temperament, gender, etc. † (Myers, pg. 167). Finally, social-cultural influences are how society influences our development. These can come from our parents, friends, culture, and even gender. A person’s social-cultural influences can cause them to see people differently than they normally would. I could see this being the state where racism is influenced. Unfortunately, I see this becoming a bigger influencing factor in the years ahead and we, as a society, have many different cultural groups in our everyday lives. Conclusion In conclusion, the nature versus nurture debate can take on many different forms in how it is perceived. One could see that they are who they are based on their heredity while another could see it from an environmental viewpoint.