Poverty and the Global Sex Trade Essay

As the global economy continues to slide downhill, the global poverty case worsens. Major businesses are forced to shut down, causing more and more people to lose their jobs everyday. People are willing to do anything just to earn money in order for them to put food on their plates. Because of this, many are forced to do things they don’t even want to do. This is the case of the global sex trade. Fueled by the worsening global poverty, more and more people resort to prostitution in order to survive. The culprit: poverty Before we discuss the growing problem of global sex trade, we should focus first on its main cause: poverty. In the 2005 World Bank report on poverty, it is stated that almost half of the world’s total population or more than 3 billion people live on less than two and a half dollars a day (Shah, 2009). Also, around 80% of all humanity lives on less than ten dollars every day (Shah, 2009). With that established, we can say that majority of the people are suffering from poverty, pushing us to doing whatever we can to earn money for our survival. The facts mentioned above were taken even before the global economic crisis that we’re experiencing now. So if we consider it as another factor, it is easy to assume that the global poverty problem even worsened. From what I’ve read, I can say that everyone is affected by the global poverty problem. Even the rich people are shutting down their businesses. But still the ones more affected by the worsening case of poverty are the poor people. They are poor to begin with, so as the poverty problem worsens, their situation also worsens. They’re poor even when they have a job, so when they get fired or laid off because of the global economic crisis, then they’ll be the ones who will be forced to do anything just to earn money. They’re more likely to commit crimes or be involved in prostitution not because they wanted to, but because they have no other choice. The crime: global sex trade We have now established that poverty could push people into doing things they don’t want to do. We now focus on the specific problem of sex trade or sex trafficking. According to Sarah M. Gonzales, as spokesperson of Captive Daughters Organization, sex trade acts â€Å"as the delivery system for prostitution† and that it involves a lot of young, poor women and even under aged girls turning to sex trade and prostitution as that they would be able to provide for themselves and their families because they’re left with no other choice (Gonzales, 2008). What most of us don’t know is that usually, sex trade is a big business, wherein some people are exploiting others for their own profit. It is a big business, coming in second to drug and gun trafficking worldwide. According to the United States government, the profit that criminals make out of the sex trade business can reach up to $9. 5 billion annually. There are efforts to curb this problem, including the arrest of the people behind major sex trade business. But as the poverty problem worsens, more and more people resort to this business despite its illegal, exploitative nature. The trade has continued to grow worldwide, as we continue to suffer more with poverty. In order to address this problem, two aspects should be addressed properly. One is capturing the criminals who orchestrate the sex trade, and the other one is addressing poverty, which is the main reason why sex trafficking continues to proliferate. The victim: the youth For me, I am against sex trade, and with the worsening of its global condition, I firmly believe that we should give our best efforts to solve this problem. In order to further understand why we need to give more focus on this problem, we have to look at the ones who are directly affected by these problems. It isn’t really the middle-aged working class who suffer more from this problem. It’s the youth who bears this burden in their shoulders. At times of need, these young men and women are compelled to risk their bodies and their lives just to earn money to support their family. They’re the ones exploited; the ones who are supposed to be our future would end up getting exploited and abused all because of poverty. This exploitation of the youth in sex trade is not confined to one part of the world only. It affects every corner of the globe, rich and poor countries alike. As long as poverty exists, the youth will continue to be exploited and be a global commodity in the sex trade. According to Stephan Faris, a WEnews correspondent, a foreign prostitute in Italy could make â€Å"far more than Nigeria’s average income of less than a dollar a day† and this could be a very encouraging deal for a girl’s family to send their daughter into sex trafficking (Faris, 2002). When sex trafficking became popular, Nigerian girls were seen as good for making money, though before they were viewed as something dispensable (Faris, 2002). They found their worth only as a source of income for them, so the families are really open to sending their daughters to sex traffickers, not minding where they’re sent. It is a pretty harsh environment for these young women, because their only chance to survive is to sell themselves for sex, and in foreign soil, they have no one else to rely on except themselves. At a very young age, they have to experience such things already, all because of poverty. The adverse effects of Global Sex Trade Another reason why I believe that we should give more attention to worsening case of global sex trade is its adverse effects. These outcomes affect not only those directly involved with the sex trade, but also other people in our society. Probably the most evident effect is the increasing rate of HIV/AIDS prevalence. In a United Nations report made available through the U. N. Wire, it is said that â€Å"the influx of sex workers has sparked fears about the spread of AIDS† in various places including refugee camps, communities, and a lot more (Nuhu, 1999). The situation is worsened because some people, including government officials, lack a sense of commitment to address this problem, and the people living in the community have very limited understand about these diseases. It is also said that with the worsening case of poverty, those who are likely to be affected by HIV/AIDS are the young children who are trying to make a living out of prostitution. Solving the problem For me, I can see this as a challenge to us all. Of course, we have to consider ourselves first before we deal with others, especially in this time of need. But still, there are some things that we can do to help solve this problem. One is through information. We can contribute to the solution by spreading what we know, about the causes, the victims, and the effects of this problem. The people who are able to give or lend a hand should do so, especially if they have some extra money or help that they can spare. Even though we are dealing with the poverty problem ourselves, we could still do something to stop another problem like sex trade from worsening. It does not only protect the young people who engage in the trade, but it also protects the whole community, including us. References: Faris, S. (2002). Italy’s Sex Trade Pulls Teens Pushed by Poverty. Retrieved April 3, 2009, from http://www. womensenews. org/article. cfm/dyn/aid/1005/context/archive Gonzales, S. M. (2008). Poverty & Sex Trafficking. Retrieved April 3, 2009, from http://www. captivedaughters. org/gatesfoundation. htm Nuhu, A. (1999). Poverty Fuels Commercial Sex Trade, HIV/AIDS. Retrieved April 3, 2009, from http://www. unwire. org/unwire/19990618/3267_story. asp Shah, A. (2009). Poverty Facts and Stats. Retrieved April 3, 2009, from http://www. globalissues. org/article/26/poverty-facts-and-stats

Negotiations Between German Officials and Black September

The terrorists handed a communique to the police, in it they demanded the release of more than two hundred revolutionary prisoners from jails in Germany, Israel and else where. Black September spent weeks planning the assault on the Olympic Village but their original 9 a. m deadline for the release of the 200 prisoners was hopelessly optimistic. By 8. 45 a. m no progress had been made in meeting the demands of the terrorists and Olympic officials scrambled to secure a meeting with the terrorists in order to extend the deadline.A police officer Anneliese Graes who was acting as an intermediary set up a meeting between the terrorist leader Issa and a small delegation of senior German, Olympic and foreign officials. As these officials approached the building it was very clear that the terrorists were in total control of the situation. When negotiators made their way to the scene they knew nothing about the terrorists except for what they could see. Three terrorists were visible at any o ne time, Issa the leader of the group, his face blackened with shoe polish and two other gunmen who were seen pointing assault rifles from the windows of the hotel room.The Munich chief of police Schreiber said â€Å"on the first floor balcony was a man wearing a balaclava and pointing a sub machine-gun towards us, towards me! † (p57) The negotiators were clearly dealing with a very delicate situation and the atmosphere between the men was described as incredibly tense. It was clear to Schreiber the chief of police that these were very dangerous men that they were dealing with. Not only were there two men on the balcony pointing guns at the negotiators but the leader, Issa had a hand grenade in his hand through-out the negotiations.Schreiber described the leader, â€Å"Issa expressed his demands in a staccato manner and at times sounded like a fanatic or one of those people who aren’t completely anchored in reality or totally aware. He was very cool and very determine d, clearly fanatical in his convictions† Eventually the negotiators managed to convince Issa that the demands were being considered in Tel Aviv and Bonn and that the Israelis and Germans needed more time to locate and free all of the prisoners.Israel immediately told the German authorities that in line with their policies they would not give in to the terrorists demands the then Prime minister for Israel Golda Meir going on record saying â€Å"If we should give in, then no Israeli anywhere in the world can feel that his life is safe, it’s blackmail of the worst kind. † â€Å"When it became clear to me the negotiation was fruitless I said to the leader (Issa): ‘You know our recent history, what was done to the Jews by the Germans. You must understand that this makes the situation here particularly difficult. ’ I said, ‘why don’t you let them go and take me instead. But he refused An unlimited sum of money as well as German minister Hans- Dietrich Genscher was also offered in exchange for the the lives of the Iraeli hostages. According to the Iraeli chief of police Manfred Scrieber the terrorists responded by saying, â€Å"It is not a question of money or substitute hostages but only of the two hundred prisoners† In the opinion of Magdi Gohary an advisor to the Arab League who negotiated with the members of Black September for the release of the hostages the terrorists really believed in the possibility of their demands being met.In Gohary’s opinion at the time from a political point of view the release of over 200 extremist prisoners was â€Å"99. 9 percent unlikely† he says â€Å" I thought and still think that the Israelis would rather have let their whole athletic team be killed than let this happen† the negotiators tried to explain these things to Issa but he was very â€Å"sceptical and dismissive†. Israel however, remained adamant that no deal would be struck with the terrori sts. To buy time the negotiators lied to the terrorists and told them that they were still awaiting word from Jerusalem.

Marketing Essentials For Kleenex Essay Example | Topics and Well Written Essays - 3000 words

Marketing Essentials For Kleenex - Essay Example The Kimberly-Clark Corporation was founded in 1872 initially as a paper mill running business and has risen to become a top universal competitor in the market of paper goods. The company deals mainly with customer products which are paper based under a variety of brands such as Depend, Huggies, Scott, Kotex, Pull-Ups and Kleenex. The corporation has also extended into a worldwide Health and Hygiene market and provides a range of tissue and personal care products, and has also obtained a significantly profitable market share strongly attributed to their customer loyalty and strong trademark acknowledgment. In the year 2009, the corporation incurred a total of 19 billion dollars income. Furthermore, it is responsible for 3.3% of special paper products market only coming as a second in the world market. The mission of the company clearly states that it is focused on offering its customers with varieties of quality tissue and personal care products at affordable prices while also offering several career opportunities for workers and maintainable increase and profits to shareholders (Kimberly-Clark Reviews 2010). The company also recognizes the trip sized paper products sector as a good market which is deficient of distinct competitors. The Kleenex Germ Away is a product which market strategies will be analyzed accordingly in the paper and how to maximize the sales in the sector. Introduction Kimberly-Clark Company is a company which deals with the production of personal products. During the early days of its establishment, it manufactured a broad range of paper goods from wrapping paper, magazine grades, and books to newsprint. As the century progressed, the company had implemented conventional but dependable investment plans which had turned it into the biggest Midwestern paper company Current Company Situation The organization has been able to achieve a desirable but exceptional accomplishment in marketing through creating the trademarked brand identity names tantamount with the household goods in the minds of clients. Kleenex is one of the products which were made for consumers and the company uses catchy advertisements to target a large client base. Needing to blow or clean one’s nose, a customer could request for Kleenex tissues and safely anticipate to be given a disposable handkerchief. The company also produces other products apart from Kleenex such as Kotex and huggies (Heinrich & Batchelor 2004). Growth Outcomes The main challenge which was facing the company during its earlier yeas of founding was how to sustain a competitive advantage. The company devoted a total of $400 million in equipment, other programs and plants during this period. The company has managed to be the envy of other companies since the performance increased to that of a financially desirable business. Financial analysis K-C is a universal hygiene and health company providing special care and customer tissue products such as Scott, Kotex, Depend, Pull-ups, Huggies, Scott and Kleenex. In the financial year of 2010, it recorded income of $19,746 million which was a growth of 3.3% from the previous financial year 2009 (Lindsay, Perkins, & Karanjikar 2009). Income growth is credited to a boost in the volume of sales, improvement in product combination and net selling prices. In the financial year of 2010, the company’s operating profit was $2,773 which had decreased by 1.8% when matched up with 2009. However, in the same financial year, it had a net profit of $1,843 which, when matched up against the year 2009, was a 2.2% decline. Figure 1: Graph showing the recent performance of K-C (Dylan 2011) Mission Statement K-C has held fast to a set of uncomplicated yet insightful principles implemented by the founders- service, fair dealing and quality. These three are the regulations of achievement by which the employees and leadership are deliberated. In my opinion, these principles have aided to

Research Study Analysis Essay Example | Topics and Well Written Essays - 500 words - 1

Research Study Analysis - Essay Example The boards of two different schools took part in the action research. Each board consists of different secondary and elementary schools. The board worked with other staff members on the action research for around six years (Widemen, Delong, Morgan, & Hallet, 2003). All researchers and participants associated with the research report worked collectively and contributed in the different phases of the research analysis, including data collection and devising final research report. All participants took part in different meetings, conferences, and workshops. All conversations of the meetings and conferences were recorded. Along with this all participants filled a questionnaire and also a written report was presented by all participants at the end of the research study. This allowed to collect the data and information in effective and efficient manner. Similarly, different researchers participated in the informal and formal phases of the data collection (Widemen, Delong, Morgan, & Hallet, 2003). Critical theory research has been mostly used in the field of social research. In this research method the importance is given to the actual behavior of the research participants who can directly relate with the topic under investigation (Carspecken & Apple, 1992). Critical theory research is conducted by generating critiques and viewpoints of the participants about the issue under consideration (Kincheole & McLaren, 2002). Same was the case in the research study being discussed in this paper. Teachers and other educational staff took part in the action research to evaluate the current learning process and coming up with methods and techniques to improve the student learning. The teachers presented their own ideas and critiques about the research topic and presented their own conclusions and analysis (Widemen, Delong, Morgan, & Hallet, 2003). This allowed the researchers to come up with appropriate recommendations on the basis of the

Law Enforcement Challenges Assignment Example | Topics and Well Written Essays - 750 words

Law Enforcement Challenges - Assignment Example Therefore, the law enforcing agencies are faced with challenges such as detection of crime and its evidence (Brenner, 2010). In any criminal justice investigation, the evidence is an extremely vital factor since it must be collected from the site of a detected crime, it must be preserved safely and should not be tampered with, and eventually, it should be examined immediately after collection. Thus, is such crime cases detecting the crime itself and collecting evidence that goes along with the crime is challenging since a number of criminals involved in these crimes always delete and clear data from their computers in order to completely destroy the evidence. In addition, others always modify the data so as to show some difference from the previous evidence of the crime. Time being an essential factor here, a number of investigations fail since twenty-four hours seem to be late to recover evidence from computers which have automatic wiping applications just in case a wrong key is pressed. However, for law enforcing agencies with special tools and experts who can easily access any data, whether deleted or tampered with, obtaining evidence is easy and effective so long they act faster. Precisely, in criminal justice, jurisdiction refers to the body or rather the authority which is handling a particular case. This extends to geographical demarcations and legal restrictions on the type of courts to hear different cases. In many states, a law enforcing agency has jurisdiction over criminal activities that take place in a particular geographic location where the agency has authority; location of a crime, the location of victim or perpetrator. Thus, overlapping jurisdiction refers to the jurisdiction that is exercised simultaneously by several courts within the same territory over similar subject matter. Moreover, it overlapping jurisdiction can also be referred to as a jurisdiction which is shared by more than one state over geographical boundaries.     Ã‚  

Discussion Question Assignment Example | Topics and Well Written Essays - 250 words - 8

Discussion Question - Assignment Example He has an autocratic style that created an environment of fear among his managers which resulted in high employee turnover (Kapner, 1998). A former manager of the company described Schmitt as one who â€Å"destabilized the company and surrounded himself with Yes people. All the entrepreneurial spirit left" (Kapner, 1998). Some investors and analysts have faulted Schmitt because of his inability to react immediately to the changes in the marketplace (Kapner, 1998). Michael Hamilton, a portfolio manager at Invista Capital Management stated that Rubbermaid â€Å"lost control of the brand and expenses† (Kapner, 1998). Given the above scenario of Rubbermaid during Schmitt’s time, it would have been for the good of the company if Schmitt was more open to the opinions and suggestions of people who are more knowledgeable than him in certain aspects of the business. Major strategic decisions cannot be made with a snap of a finger; it should be discussed thoroughly and comprehensively. In an organization as huge as Rubbermaid, Schmitt cannot solely rely on his abilities to come up with major decisions. Schmitt can definitely learn a lesson from Howard Schultz, CEO of Starbucks who said, â€Å"I think its very difficult to lead today when people are not really truly participating in the decision. You wont be able to attract and retain great people if they dont feel like they are part of the authorship of the strategy and the authorship of the really critical issues. If you dont give people an opportunity to really be engaged, they wont stay" (Vogan, 2006). This statement from Schultz is certainl y the wisdom behind the amazing success of Starbucks. Jackson, E. (2012, January 2). The seven habits of spectacularly unsuccessful executives. Retrieved May 30, 2012, from forbes.com: http://www.forbes.com/sites/ericjackson/2012/01/02/the-seven-habits-of-spectacularly-unsuccessful-executives/ Kapner,

Planning and Managing for the Future - Inverleith Hotel - Edingburgh Assignment

Planning and Managing for the Future - Inverleith Hotel - Edingburgh - Assignment Example In addition, the managers and employees are identified to be focusing on the preferences of the customers facilitating in attracting more customers, which in turn aids towards the development of the hotel (Annual Report, 2014). One of the weaknesses of hotel is the limited sales volume and number of rooms, which is affecting the visibility of the brand name of the hotel. The major opportunity of the hotel is the competency of the employees based on which the hotel is able to perform its operations in a competitive manner. The entrance of new hotel can be one of the major threats for B&B. The owners and managers play a vital role towards the improvement of the performance of the hotel based on their good managerial skills. The owners and managers always support the employees in their work, so that the employees can perform their work effectively for meeting the satisfaction level of the customers (Annual Report, 2011). In the context, the assignment focuses on evaluating the plans as well as objectives of Inverleith Hotel (B&B) for having a better understanding of the performance of the company. Accordingly measures are needed to be adopted for implementing the changes effectively for enhanced growth as well as development of the hotel. The current business objectives and plans of Inverleith Hotel (B&B) are to increase exposure and expand market by using new and advanced technology. Other current business objective and plan is to increase the number of customers with the aim of increasing the profit as well as economic growth of the hotel. The hotel has planned to improve the quality of food products and also provide the best services to the customers based on the requirements of the customers (Annual Report, 2013). The business plans to hold a strong market position in the international market. The current business objectives and plans have been to enhance the performance of the hotel. To improve the current performance, the owners and

Leadership and Organizational Change Assignment

Leadership and Organizational Change - Assignment Example The driver in this case is the leader in the topmost organization post who is responsible for the running of all activities (Amagoh, 2008). This leader has to possess and apply styles of leadership that support positive organizational change, and not hinder it. The following text in discussion studies the importance and application of organizational change; highlighting Brunswick Indoor Recreation Group, which underwent the process to come out better, in additional to how a transformative or charismatic style of leadership contributed to the success of the said changes. Sengupta (2006) defines organizational change is that process through which an organization will optimize its performance, a move geared at achieving its ideal status. The need for the change is to either address a crisis situation or respond to put up with the ever-changing business environment. On another point, though, a progressive leader or manager can trigger organizational change, especially after a transfer or reshuffling of executive powers within an organization. Organizational power can be understood through three theories: the teleological, dialectical, and life-cycle theories. The teleological theory explains that an organizational change, strives to achieve an ideal status via a continuous strategy of setting goals, executing, evaluating, and restructuring to fit the required state. The dialectical theory uses a hypothesis that an organization is a context in society which occasionally encounters opposing values. The life-cycle theory on its part dictates that an organ ization is an entity which depends on the external environment, the stages through creating, growing, maturing, and declining (Chen, Suen, Lin, & Shieh, 2013). The Brunswick Indoor Recreation Group is a division unit of the larger Brunswick Corporation, which is based in the United States, a history dating back to 1845. Its headquarters are in Lake Forest, Illinois, in North Chicago. The organization deals with the

Earl of Louisiana Essay Example | Topics and Well Written Essays - 1750 words

Earl of Louisiana - Essay Example In the fight for justice and the Civil Rights movement, Earl Long’s activism and support for Blacks is synonymous with the struggles of the NAACP and other Black right activists. Earl Long was gifted with political insight. He is remembered for the steps he took in ensuring the voting process becomes more smooth and accessible to the African-Americans. The legislature opposed political franchise for the Negros, but Long called on to the African-American community to unite in the name of common cause. He urged them to show full participation in the elections despite the resistance they were facing from the higher authorities. There were about 150,000 Negros registered as voters in contrast to 850,000 whites. Negros compromised about 24 percent of the state and the discrepancy between this and their 15 percent state-wide registration is reflective of the obstacles that they faced in getting themselves registered (Liebling, 205). Backed with the supporters of Hey Long, Earl Long saw the potential in having the Blacks on his side. Making this as major a part of his political campaign, Long stood up for the rights of the blacks and secured a vast majority of vote s from the black community. Earl Long was a staunch believer of equal rights for everyone, and was not racially prejudiced and biased in advancing the rights of the Whites only. Besides the reformative measures Long took to provide Negros with voting rights, Negros gained significantly from his measures in education to increase the literacy level of the Blacks in the state. He held true to the belief that illiteracy was a major impediment to the progress of a state. He was of the viewpoint that there should be no discrepancy in the provision of education and other benefits between the whites and the blacks. During his tenure, he saw to the construction of over a hundred public schools, fourteen trade schools and an increase in the ratio of employment of black school teachers. This

Lobbying strategies used by financial services Essay Example for Free

Lobbying strategies used by financial services Essay General knowledge about patenting and the patent reform legislation. A patent can be said to be a se of exclusive rights given to an inventor or his assignee for a given period in exchange for the invention details. However in countries like us extras qualification utility patents is used to differentiate them from other types of patents, this should not be confused with utility models grants by other countries. (http://www.ipaustralia-gov.au/patents/what_index.sch.html)examples of these particular patents for invention includes biological patents, business method patents, chemical patents and software patents. In some other countries other types of intellectual property rights (IPR) are called patents while industrial design rights are referred to as design patents which protect the physical designs of objects which are not of great utility. As such therefore, patent should not be mistaken for a right to practice or use the inventor, it(patent) provides the authority to prevent other people from making, using, selling or offering for sale or importing the patented invention for as long as the term of the patent remains, which in most cases is usually 20years. In real sense a patent is a limited property right that the government leases to inventors in exchange of their (inventors) disclosure of the details leading to their invention. Patent therefore, like any other property rights can be leased, mortgaged, assigned, licensed, given away or even transfered.As briefly stated above the rights governing a patent varies from country to country. For instance in Australia, other people are allowed to build on top of already patented invention. This is possible by making use of exceptions from infringement procedures e.g. allowances for academic research (http. /paustralia- gov.au/patents/what_ index .sch.html). While on the other hand in US things are very different on patent rights governing research, whereby even developing of an existing invention amounts to infringement. The mystery of patents is exhibited when one wants to make an improvement of an already patented invention. This can only be done legally by seeking permission from the patent holder, assuming that the patent is still in force When the new improvement is made the owner of it can bar the original patent owner from using the improvement and hence denying him of the right to exploit the patent. However some countries require that the invention be exploited in the jurisdiction it covers. Again the penalties of not working an invention vary from country to country but the common penalties ranges from revocation of the patent rights to awarding of a license to any party in a position to exploit the invention. The patentee can seek legal redress and challenge the revocation or the issuance of the license. But there exists a big hurdle in offering of tangible evidence that, the requirement of the public have really been met by the working the invention. Generally patents can only be put in force through law suits (e.g. in US, patent infringements are handled in the US federal courts) in other countries like France and Australia criminal penalties for patent infringements are given. In case of an infringement the patent owner will demand to be compensated financially for past infringement and then also seek to bar the defendant (infringer)from engaging in any further acts of infringement. However it is not always easy for the patent owner to prove that infringement really took place. As such, he is required to establish that the accused practiced all that the patent was entitled to; again, the issue of independent jurisdictions patent rights tradition also arises. The above statements about the powers of a patent owner are enough evidence to show that there is a great limitation on the patent owner because the accused has a right to challenge the validity of a patent .It is common for civil courts hearing patent cases to declare patents invalid. The basis on which a patent can be declared invalid are stated on the patent agreement, and again this varies from one jurisdiction to another. However some countries like UK have laws discoursing infringers from challenging the validity of patents. In the UK this discouraged through the certificate of contested validity. Nevertheless not all patent rights disputes are settled through litigatation. Majority of these disputes are settled through private patent licensing agreements. These agreement are simply practical, effective contracts whereby the patent owner (also know as licensor) voluntarily decides not to sue an infringer in return of some payment .Research shows that this is common in companies which deals with complex products. These companies also issue patented licenses to other business rivals under what is known as cross licensing agreements. This in turn facilities the cross accessing of each other inventions (special problems in patent cases 66.FRD 529,197 by Howard T Markey) \ As seen above different jurisdictions have different traditions of approaching patenting, but it should be noted that in many nations both single entities (natural persons) and corporate entities can apply for a patent. On issuance of this patent then the entity (ies) becomes the owners of the patents. However, it is mandatory that the inventor (s) be named so that the public can get to know how the owner(s) of the patent acquired the rights. For example in US only the inventor(s) (natural person) can apply for a patent, in cases of multi inventors then each inventor is given a patent which s very independent from those given to other co- inventors . It is a normal practice also in US for inventors to assign their ownership rights to a corporate body, this is done in cases of multi-inventors so that only one single entity has the rights to grant a license. Another reason is to increase the liquidity of the patent as property, so that inventors can be in a position to sell them to a third party, who in turn owns the patent as though they were the real investors. From the above detailed information about the function ability of patents and patent rights it is evident that patents and patent rights need to be protected by relevant laws so that neither party i.e. patent owners, authorities, and infringers is vulnerable to mistreatment. Therefore nations and also internal communities have come up with laws that govern the enforcement of patents. Patents as such therefore, are governed by laws at a national level and at an international level through signing of treaties. It can be said that patents are therefore not national but territorial in nature. It is traditional that every nation forms a [patent office which carries out patenting responsibilities in regards of the laws of the country. However cases of infringements are left to be catered by national courts. On an international scale it is the work of the world Trade organization (WTO) to harmonize these patent laws. Agreement have been reached successfully in aligning these patent laws .Adherence to these agreements is a mandatory requirement for admission to the WTO, a factor leading to mass compliance by many nations .Even the developing countries are not left back although they have been known to enforce national laws protecting their local industries. A paramount international meting held in Paris relating to patent systems culminated in the signing of the above agreement. Although the agreement does not have a consequential legal effect in national jurisdictions its principles are largely inculcated in many current patent systems. For instance one such principle is the right to claim priority which allows an application filled in a member state of the Paris meeting to be valid for one year and also to be filled in any other member state and still receive its original filling date. This is a great achievement since patent ownership is entirely date oriented. Again the powers and dynamics of patents vary from sate to another. In US for example, the lands prime law (constitution), gives the congress the mandate to make laws, to promote, and uphold the progress of Science and useful Arts. These laws once passed, are then enshrined in Title 35 of the United States Code. The United States patent and trademark office (USPTO) was created under the above laws. (US patent activity, 1790 to present – http://www. Upstaged/web/ offices/ac/ido/oeip/taf/h-counts-html). In UR, patent laws are contained in the patents Act 1977 (amended). On international perspective, as mentioned above there exists international freely procedures e.g. procedures under European patent convention (EPC) which works under European patent organization (EPO) and patent cooperation Treaty (PCT) among many others. Similar treaties exist in African content countries. For a natural person or a corporate entity to be awarded a patent then an application requesting the same has to be filled at the relevant patent office. This application contains such information like how to make and put the invention into use and also the utility of the invention. Also contained in the application form is claims which explain more about the invention and the extend of patent rights in regards to applicants wishes. The above details together with a written description with drawings are part of the patent specification. In some nations like US, the applicant is also required to include the most effective way to make and practice the invention. The claim part acts as a disclosure to the public on the limits to which the patentee has over the invention. In other words a claim shows what the patent covers and what does not cover. It should be noted also that a single patent can have numerous claims, each regarded as an independent invention. Once the above requirements have been provided it is now the duty of the patent office to counter check whether the application is in order with the relevant legal provisions in relation to the particular specie of patents. Once it is approved the patent takes effect from the date issued and it is subject to yearly renewals so as to remain in force in relation to (Egbert vs. Lippmenn, 104 U.S. 333 (1881) â€Å"the corset case†) The US supreme court passed a decision that any inventor who has not applied for a patent for more than eleven years of using the invention, cannot be given one. Hence there is a need to seek for a patent once an invention has been made (http://www. Wolf Greenfield. Com/media/news. 9.pdf) In a summary of the above information about patent system four main aspects have clearly been discussed about, they include; i. Inventing: Through intensive research and consulting Scientists and artists are able to come up with inventions. The desire to dig more and come up with inventions is catalyzed by the existence of patent rights. Which comes with much money as a result of selling patent licenses ii. Disclosing the invention made: As per the meaning of patent, the disclosure of invention is for a common good. This is so because there are projections as to the rights of invention and hence inventors feel free to disclose their invention. This disclosure facilitates for exploitation of patent right when the current one expire or even improvements are made. iii. To invest in producing, experimenting, and marketing of the invention. This is done out the faith that infrequent cases are well protected against. iv. Designing and improving of earlier patents: This can only be possible is details of already existing patents are disclosed to the public. All the above stuff concerning modern patent system allows for infant inventors to gain exclusive rights and therefore becoming licensors. They therefore gain financially and in the long run promoting more innovations. Due to loopholes the legal systems governing patents cases of double awarding of patents have been common. (According to R.Buck minster Fuller 1938). Due to the increasing number of inventions the patent filling systems are becoming more complex day and day and hence there is a likehood of awarding a patent to an invention already patented before. However with the introduction of reliable computing system this has been kept at bay. According to Michael Heller, a law professor and Rebecca Sue Eisenberg in a 1998 in their 1998 science article, intellectual property Rights (IPR) have become so much fragmented that signing them will require an agreement with all the owners of fragments. Another big hurdle in patents is that they discourage innovations especially with corporate entities who may own many patents and enter into litigations incases of infringement although they are doing absolutely nothing to develop the invention. Other numerous problems also exist and as a result critisms have been common opposing the patents system and proposing for their abolition altogether. Lastly, it will be fair to put forth some historical information regarding the existence of patents. Reliable evidence suggests that the first stints of patents can be traced to ancient Greek cities whereby any one who came up with a new recipe was allowed to make the food for one year. On the other hand, modern patents can be traced to the republic of Venice whereby new inventions were publicly communicated to prevent undue infringement. Other countries followed suit e.g. U.K, US and therefore the idea of patents spread through other parts of the World. The above detailed account about patents gives a reader of this paper a sound basis to now tackle the issue of financial services industry, lobbying strategies in the addressing of the patent reform bill (legislation) before the 110th congress. As already explained above the patents system in united states are under the body known as United States patent and Trade mark organization (USPTO).This body is therefore incharge of issuance of patents to inventors. According to a 2004 report by National Agency of a sciences and another report of 2003 report by Federal Trade Commissioner a bill (patent Reform Act 2005) was proposed. The main aim of this bill was to try and bring a theme of modernity in the USA patent system. Although it was not until 2007 when this bill was introduced to the bicameral US parliament (Senate and House of representatives). This bill now known as â€Å"The patent Reform Act of 2007† was introduced as a proposal in the 110th US congress for discussion and eventual change of the United States Patent Laws. The bills main objective was to bring the American patent laws to the same level with other countries patent laws. (According to a patent system for the 21st century, by Stephen. A. Merrill Richard L. Levin and mark B. Myers, 2004- (http://www ton.nap.eds/catalog//76.html) The main changes brought by this legislation were I). Converting US from a first- to- invent system to a first- inventor- to -file system. This bill will bring US to conformity with other countries of world. This system will also reduce legal costs, simplify the patent process, improve fairness and also facilitate a movement towards harmonized international patent system. It is also agreed that this change will reduce the complexity associated with the current USPTO interference proceedings. This will therefore make inventors to focus more on inventing. Since this change would make US to be in harmony with other countries it will help US inventors to pursue their innovative dreams in more consisted manner. On the hand, critics have agreed that this system of first to file will encourage unnecessary USPTO with unharmonized disclosure information; therefore quality of patents is compromised. Again the small scale inventors will be at a disadvantage when competing with large co operations in the race to the pattern office. The next major change was apportionment of damages. The bill will seek to bring sanity in the award of damages due from infringements of patents. The bill allows a court of law to ensure that the damages are paid according to the prevailing economic conditions pertaining to the patented invention. This was seen a measure to cut excessive royalty payment infringed patented. Large technological companies and financial services industries supported this change because they lie on features which are in most cases in patented. Critics of this system argued that, the congress should not attempt to prioritize the factors that a court may apply when determining reasonable damage rights. This system may also undermine the existing licenses and therefore leads to the rise of litigation. Those critics included USPTO, the biotechnology among many others. Other charges embedded in the bill included; Allowing a third party assignee to file a patent application, Revising procedures for patent interference disputes; Allowing financial institutions to infringe patents on the check collection system, Allowing a person who is not the patent owner to file a petition with the board cancel a patent as invalid among many other changes. These changes sought to facilitate a general overhaul of the US patent system. Which according to the coalition for 21st century patent Return was in dire need for periodic examination and foundational changes (http://www.ipfrolmer.com/depts/artic.asp?id=14890deptid=4) This reform bill on patents was introduced to the House of Representatives by a democrat, MR. Howard Berman and in the senate by another Democrat, MR. Patrick Leahy. It was passed in the House of Representatives but put under more scrutiny pending voting in the senate following its introduction in the 110th United States Congress. The bill has been faced with positive and negative critisms from different organizations. Those organizations lobbying for its subsequent adoption argue that, the bill is necessary to bringing in the much needed changes and consequently reduce the number of soaring ills which are killing innovation. Some of these organizations include coalition for patent fairness, Business software alliance intellectual property owners association and lastly American institute of certified public accounts. Those according to them are weakening the rights of patent owners innovations included the following national small business organization, innovatiove alliance, Biotechnology industry organization among others (http://www.napp, org/resources/nap opp to 2007 senate Bill. pdf) According to the US department of commerce the only part which need some revision is section 4 which they argue may harm the nation’s intellectual property system. The bill also attracted critisms from international community with a Chinese expert calling the bill hypocritical; since it is weakening the rights of patent owners in US when US has been urging the Chinese government to strengthen the rights of their patent owners. An observation also comes from India pharmaceutical Alliance who argued the bills provision allows for the validity of a US patent to be challenged immediately after issuance. They also predict that the bill may favour Indian manufacturers since it reduces legal costs and risks. (Http.economictrimes.com/article show/mst 22256,pr+page – 1.cms1) The lobbying strategies The first question one should ask himself when tackling this debate is very simple, how is the proposed patent reform bill going to affect the performance of the financial institutions? Secondly has the current patent laws been in â€Å"favor† of the financial institutions? With these two questions in mind then it is very easy to the financial institutions stand in respect to these reforms. Consequently, therefore, the lobbying strategies they employ will be directly related to these effects. This issue of patent reforms may seem to a nonprofessional to be of no consequential impact and therefore does not deserve much thought but to the business community things are very different. The above detailed account of the pros and cons of the patent reform bill, it is very clear that there exists a tug-of war between some of the corporate US citizens. On one side of the war are much dreaded patent trolls or better known as patent sharks-small firms or individuals who wit fully trap large manufacturers in patent infringement suits in order to benefit from damage awards. On the other side of this war are financial institutions, which, includes banks and insurance firms who have joined hands with large tech-companies. It is understood that these two sectors have been faced with regular lawsuits coming from the much-dreaded patent sharks. At the center of the dispute is the current Americas patent system that is suffering from lack of a major policy overhaul for along period of time and struggling to stay in level with innovation in thev21st century. Therefore, financial institutions have always found themselves in a hot spot under the current patent laws. It is in this light that any reforms that seeks to address their plight is seen as a relieve to them. The first strategy therefore employed by these financial institutions was the formation of a bargaining platform in the form of â€Å"the coalition of patent fairness†. This group lobbied the senate to help curb the weak patents and bourgeois lawsuits from patent sharks. The group also lobbied against a ruling made by the federal appeals court that opened doors for patents on business methods, including different types of banking, investments and insurance techniques. It is through this lobbying that, the senate judiciary committee included a provision that grants banks immunity against lawsuits from patent holders like Texas Company Data Treasury, which holds patent on a method of digitally scanning, sending and storing checks. Another strategy used by financial firms is by applying for patents. These patents unlike those of other industries are not primarily for financial gains but for defensive purposes against the escalating number of patent infringement cases from the much-dreaded patent sharks. Financial institutions in US are also exploiting the fact that US is the only nation in the world to have been left back using the first-to-invent system of patenting to lobby the international organizations (WTO).this seems to have borne fruits because the USPTO seems to have yielded to the pressure and therefore agreed to bring some changes. This has worked through the harmonization of the US patenting system with the rest of the world. After the House of Representatives passed its version of the bill, many AUTM members frantically contacted their congressional members a move that enabled many parts of the bill to be amended. However the senate bill remained to be harmonized. Following great concern from the university community and other bodies, a number of changes were made. One lobbying strategy, which financial services institution used was voicing their concerns through the AUTM, an organization of many universities and other bodies that induces closeness to industries. It should be noted that the AUTM and the university community were not in anyway against the improvement of US patent system. Their main concern was to see that before the bill was finally voted for in the senate, the contentious parts should be first fine-tuned. As a show of great support to the improvement of the US patent system, the university group therefore put fourth the following suggestions (i) a one-year grace period for first inventor and strong inventor oath should be included. ii)Removal of the previous user rights expansion in favour of study of issue university patent can be in a risk of expanding prior user rights iii) Venue reform provision that exempt universities and technology transfer foundations that offer patent services to universities. The bill as it were had many provisions that were of great concern to US universities chiefly because it undermined the ability of the universities to transfer technology to local industries. This was due to the making of patents difficult to protect decreasing the amount of damages patent holder can get from an infringer and opening new avenues for infringers to put to task the validity of issued patents. This change of USPTO rules and the issue of Supreme Court in mind made it more burdensome, and expensive to get, maintain and even enforce patents. It also poses difficulties for Universities when starting companies, which attract venture funding. Other areas, which concerned Universities and financial institutions were, are as follows:- i. A compulsory search report and analyses, which reflect heavily on the financial aspects of Universities on technology, transfer offices. ii. Absence of meaningful inadequate contact reform iii. An open-ended, post-grant administrative review of patent quality. iv. Venue reform policy that forces patentee to file suits in the infringer home district court and v. Apportionment of damages in patent infringement suits. Another strategic lobbying device at the disposal of financial institutions and other concerned organizations was through approaching federal relations officer near them. These federal relations officers are discharged with the main duty of acting as the intermediaries between the people and senate (legislators). Due to the bill, having so many controversial sections, there was an urgent need for the stakeholders to harmonize their divergent views and come up with a consensus. This was achieved through the congressional research service (CRS) an arm of United State Congress that provides policy and legal advices to committees and members of both the house and the Senate regardless of party affiliations. The CRS committee collects views from the public and then they act accordingly. Again, this CRS also carries out civic education concerning the interpretation of bills and their effect to the lives of the common person. Holding of workshops and seminars with the other stakeholders was another worthwhile strategy used to help bring every concerned party on board so that when the legislation is adopted no one would feel shortchanged. Workshops are known to bring warring parties together on a mutual agreement. These workshops therefore lobbied the opposing bodies into ceding some of their unrealistic demands. Financial services institutions through their attorneys lobbied the senate judiciary committee into making provisions that gave them more power in the using of technologies made by other inventors. These technologies are necessary in the improvement of banking services offered to customers. The bill therefore needed to be lobbied and subsequently harmonized. Conclusion The AUTM through their technology transfer managers evaluated impact of the long legislation on its general operations and therefore come up with a strategy, educate the university management and also other interested and the work with the federal relations officer, who in turn contacts the lawmakers. This technology transfer managers advice the legislators on the need to go the dialogue way so that at end of it all no constituency feels as being shortchanged by the passing of the patent reform legislation. In general, the current state of the bill would weaken the entire American patent system by making patented under to protect. The damages entitled to a patent owner after an infringement has been reduced adding salt to the wound. New avenues for infringers to challenge an already issued patent have also been opened. Although the bill continues to be harmonized bit by bit, the university technology transfer system still view some areas as not fully catered for. The legislation also provides for a patent trial and appeal bond, which is charged with the responsibilities of reviewing decisions of examiners upon applications and reexamination proceedings. Financial services institution therefore can utilize this avenue in addressing and subsequent challenging of the patent reforms legislations. This board comes as an indicator on how this reform legislation has deliberately been drafted and therefore only needs to be harmonized on the small areas. However, it is fair to say that America need this bill to at least bring some uniformity with rest of the world because it has been the only country adopting the first-invent system of patenting. Two, according to Senator Leahy, America needs an efficient and streamlined patent system if it is to remain in the forefront of the world economy. This patent will bring quality and at the same time discourage counter productive litigations. Senator Berman on his side argued that, there should be no doubt, as to whether the US system of patenting produces high quality patents, and therefore changing the existing patenting practices through the congress is the only way out. The bill also, should not be viewed with suspicion since it was founded and introduced in the two houses on a bipartisan basis. It is also the bedrock of American innovation, and therefore there is great need to protect innovation and creativity, according to Senator Hatch. Financial services industry being one of the major economic players of the United State of America, needs also to standup on its own and voice out their grievances. In addition, financial services institutions like banks and insurance companies have a duty to challenge the patent reforms legislation because they have started to seek protection from infringement lawsuits from patent sharks. This was facilitated through the introduction of financial patents. References; More about patent reforms, available at, 1) http://www.ipfrolmer.com/depts/artic.asp?id=14890deptid=4, accessed on april30 2008 Effects of patent reforms, available at, 2)Http.economictrimes.com/article show/mst 22256,pr+page – 1.cms1) , accessed on april30 2008 Patent reforms for 21st cen. available at, 3) http://www ton.nap.eds/catalog//76.html) accessed on april30 2008 US patent and trademark office, available at, 4) http://www. Upstaged/web/ offices/ac/ido/oeip/taf/h-counts-html accessed on april30 2008 Regulations governing patent application, available at, 5) http://www. Wolf Greenfield. Com/media/news. 9.pdf) accessed on april30 2008 More about patenting, available at, 6)http://www.ipaustralia-gov.au/patents/what_index.sch.html) accessed on april30 2008 Patenting and innovations, available at, 7) Heller, M.A., Eisenberg, R.S. (1998). Can Patents Deter Innovation? The Ant commons in Biomedical Research. Science. Different organizations response towards the patent reform bill, available at; 8) http://dev.bsa.org/country/public%20policy/patents.aspx, accessed on april30 2008

Ethical And Legal Principles In Nursing | Reflective Essay

Ethical And Legal Principles In Nursing | Reflective Essay This following piece of reflection will be written by using the what model of structured reflection (Driscoll, 2007). The essay will focus on a practice based scenario and will include two ethical principles, these being, Non-Maleficence and Beneficence. It will also cover two legal principles; The Mental Capacity Act and Consent. In order to maintain patients confidentiality (Nursing and Midwifery Council 2008) a pseudonym name will be used throughout this reflective account and the patient will be referred to as Jean. As a trainee assistant practitioner I am accountable in my practice to identify and minimise risk to the patient when carrying out care. It is also my duty to ensure my knowledge and skills are maintained, thus providing equal care to all patients. Furthermore consent must be obtained from the patient prior to carrying out any care. I was asked by the community district nursing team to obtain a blood sample from an 88 year old lady who needed a diabetic review .This investigation will identify any potential problems associated with diabetes (Diabetes UK). Having this test is essential for the well being of the patient. Jean has type 2 diabetes and her condition is controlled by insulin therapy. Having this test is important for the well being of the patient. The nursing midwifery council state that obtaining patients consent is necessary before you can give treatment or care (2002). It is important to obtain consent and failure to do so could be viewed as physical assault on a patient (Lavery 2005). Consent should not be taken for granted and an explanation should be given to the patient prior to the procedure. This ensures that Patients are competent to make an informed decision and have the legal right to decline treatment at any time during their treatment. Jean also has a form of dementia and due to this; she experiences memory loss and confusion. According to Frude the general onset of dementia is one of progressive deterioration in the forgetfulness stages the person experiences difficulty in recalling events (2000.p.285). Within my role as a trainee assistant practitioner I have the responsibility to understand the Mental Capacity Act 2005 and to respect people rights and provide care within the realms of the law. A patient who lacks mental capacity is a person whose brain has been affected from an illness, in this case dementia. The Mental capacity act 2005 is to protect people who are unable to make decision for themselves. The Code of Practice states that last power of attorney can be used to appoint attorney to make decisions about personal welfare (2005 .p120) A person with a personal welfare of lasting power attorney can make a medical or treatment decision for another person. The office of the public guardian has a register for lasting power of attorney this is a legal document which people must be registered (Alzheimers society 2010). It is my responsibility to ensure that patients who lack capacity have the correct support in place so that they can assert their rights. In this case Jean had nominated her daughter to be her lasting power of attorney. Jean now moved in with her daughter and her family. I asked Jeans daughter for permission to take a blood sample from her mother and she gave her consent. However when I approached Jean to explain what I was going to do she seemed very confused and became aggressive towards me. I was told in report that Jean can get confused, but no mention of her being aggressive. I felt very uneasy and made the decision with the support of Jeans daughter, not to take the blood sample. Hendick states the principle of non-maleficence imposes duty to do no harm or to minimize harm (2001 p 22). As Jean was obviously distressed and I did not want to cause her any discomfort I decided not to carry out the procedure. My intention was also not to put Jean or myself at any risk from taking the blood sample as it could lead to either one of us being harmed from a needle stick injury. Hendick states beneficence means that you must act in the way that benefits others, and have both moral and legal duty to do good (2004 p72). Obviously having the test done is in Jeans best interests as her doctor needs to have recent blood values to ensure she is receiving the correct treatment. I believe however, that I acted in Jeans best interests by postponing her blood test to another day finding out from her daughter what the best time of day for Jean, when she would be likely to be more relaxed and approachable. Her daughter had agreed with this decision, another date was arranged As a trainee Assistant Practitioner, I ensure that I abide by ethical and legal principles in all aspects of my role. I feel that it is something that is incorporated into my job often without me even realising. For example, I would never carry out any procedure without gaining the patients consent. This could be verbal or non verbal. I will inform the senior member of staff about the situation I was in and fill in an incident form. I will also insure other team members are aware of Jeans aggression and to ensure that we call her daughter before we visit in the future. Hopefully my next visit will be more successful with better communication skills by planning the visit with her daughter I feel that I learnt a great deal about the Mental Capacity Act through my care of Jean and will continue to increase my skills and knowledge. I will continue to give Jean the care and support she needs. I will ask my Primary Care Trust for any future study days on the Equality Act that has come into force from October 2010, and then I will be able to understand how the act could be relevant within my practice. .

Salman Rushdie :: essays research papers

There have been very few writers who have been dogged by controversy throughout their careers. Some have been persecuted in less enlightened times such as Mark Twain, and some have been ridiculed by the press like Edgar Allan Poe. Yet, Salman Rushdie was the first author in the free world to have been pursued from across continents and forced into hiding because of a death sentence by a foreign government. To say Salman Rushdie is a very controversial writer in today’s society would be a gross understatement. Rushdie in fact could be considered the ideal poster boy for absolute freedom of the press. It is not that Rushdie prides himself on being rebellious, he simply presents his ideas bluntly and it just so happens that his ideas address extremely volatile topics such as the Islam religion. Rushdie’s philosophy was eloquently put when he wrote, â€Å"What is freedom of expression? Without the freedom to offend, it ceases to exist.†Contrary to many great authors, Rushdie did not endure a traumatic childhood, suffer from alcohol addiction, or live with chronic depression. Instead, Rushdie actually had what many would view as a close to perfect upbringing. Rushdie was born in 1947 to a middle-class Moslem family in the great city of Bombay, India. His paternal grandfather was an Urdu poet, and his father a Cambridge educated businessman. At the age of fourteen, Rushdie was sent to Rugby School in England where he excelled in his studies. Rushdie went on to continue his studies at King's College, Cambridge, where he studied history. After graduating in 1968 he worked for a time with television in Pakistan as an actor with the theatre group at Oval House in Kennington. Then, from 1971 to 1981 Rushdie earned his living by working intermittently as a freelance advertising copywriter for Ogilvy and Mather and Charles Barker. Rushdie eventually began his literary career in 1975 when he made his debut with Grimus, a sort of fantastical science fiction novel based on the twelfth century Sufi poem â€Å"The Conference of Birds†. Grimus however received little fame and Rushdie truly broke into the literary world with his second novel Midnight’s Children, in 1981, which won him the Booker prize and international fame. This novel began his controversial persona as well. The novel is a comic allegory of Indian history that revolves around the life of its narrator, Saleem Sinai, and the one thousand children born after India’s Declaration of Independence.

Texas :: essays research papers

Texas, one of the West South Central states of the United States. It borders Mexico on the southwest and the Gulf of Mexico on the southeast. To the west is New Mexico, to the north and northeast lie Oklahoma and Arkansas, and Louisiana bounds Texas on the east. Austin is the capital of Texas. Houston is the largest city. Texas is the size of Ohio, Indiana, and all the New England and Middle Atlantic states combined, and its vast area encompasses forests, mountains, deserts and dry plains, and a long, humid, subtropical coastal lowland. Texas's wealth of mineral resources is almost unequaled among the other states. Its rapid economic development stimulated by these resources and its vast size have made Texas an American legend. Oil wells, chemicals, ranches, and cattle have played a major part in that legend. For more than 100 years, Texas was part of the Spanish Empire in America. When Mexico gained its independence from Spain in 1821, Texas was for a while joined to Mexico. The section from San Antonio southward retains the flavor of the Hispano-Mexican period in its architecture, foods, and festivals. The name Texas is derived from tejas or teyas, the rendering by the Spanish in the mid-16th century of the Caddo people's word for friends or allies. It gradually became used to denote the region north of the RÃ ­o Grande and east of New Mexico, and was officially applied as Texas when the area was organized as a republic in 1836. Texas was an independent republic until it joined the Union on December 29, 1845, as the 28th state. Its single-star flag dates from its independent period and has given Texas the nickname the Lone Star State. IIPHYSICAL GEOGRAPHY Texas is the second largest state in the nation, after Alaska, and has an area of 692,244 sq km (267,277 sq mi), including 12,844 sq km (4959 sq mi) of inland water and 1046 sq km (404 sq mi) of coastal water over which it has jurisdiction. Extending for about 1240 km (about 770 mi) from east to west and for about 1290 km (about 800 mi) from north to south, the state comprises about 7 percent of the land area of the United States. The mean elevation is about 500 m (1700 ft). ANatural Regions Texas can be divided into four natural regions, or physiographic provinces: the Gulf Coastal Plain, the Central Lowland, the Great Plains, and the Basin and Range province.

Destiny, Fate, Free Will and Choice in Oedipus the King - Fates Triump

Destiny, Fate, Free Will and Choice in Oedipus the King - Fate's Triumph At the core of any tragedy there is a cruel change of fortune involved. This change of fortune is a key factor in man's demise and it can result in speculation that perhaps the gods plotted his ruin out of malice. To blame a higher power is the easy way to rationalize the downfall, but upon further investigation it becomes clear that it is actually man's attempt to escape his fate that leads to tragedy. Only when Oedipus was ruined did he realize his efforts to avoid what was pre-ordained were useless. Douglas Johnston states that "choice is at the heart of tragedy" (Johnston 14). In Sophocles' play Oedipus Rex Laius, Jocasta and Oedipus all choose to ignore Apollo's oracle; this decision, to attempt to escape fate, sets off a chain of events that leads to the defeat of these characters. We can only wonder how their lives may have differed if not for these fatal decisions. If one assumes that any attempts to control one's destiny will result in tragedy does the opposite also ring true? Perhaps the way to cheat fate is simply to accept it. Even before his birth Laius and Jocasta have been told that their son's fate is to kill his father and marry his mother. They are determined to save themselves and decide that Oedipus must be killed before he is old enough to carry out the prophecy. This attempt to beat the gods immediately begins Oedipus' journey to ruin as he grows up in nearby Corinth thinking that his parents are King Polybus and Queen Meropà ©. By assuming Polybus and Meropà © are his true parents Oedipus is in a situation where he can unknowingly kill his true father and marry his true mother. At the same time Jocasta and Laiu... ...it is a natural human instinct to seek to avoid one's fate when one knows something bad will happen. Even if man knows he is headed for doom it is one's foolishness, determination and stubborn nature that makes one try to fight the losing battle against destiny. The destruction of Oedipus in Sophocles' play is not an isolated occurrence; rather it is a story whose lessons apply to all of mankind. Works Cited and Consulted: Johnston, Douglas, and Brian Grandy. Greek Tragedy. Ascension Collegiate. 3 Oct. 2001 <http://www.stemnet.nf.ca/~hblake/tragedy1.html>. Rose, Lloyd. "The Greek Tragedy: Doom Is Booming." Washington Post 20 Dec. 1998: G02. 2 Oct. 2001 <http://academics.vmi.edu/english/greekdrama.html>. Sophocles.   "Oedipus Rex."   An Introduction to Literature, 11th ed.Eds. Sylvan Barnet, et al.   New York: Longman, 1997. 800-836.

Anorexia, bulimia and related eating disorders treatment Essay

Anorexia and Bulimia Introduction   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In the United States, millions of people are affected by severe eating disorders which are sometimes life-threatening. Bulimia nervosa and Anorexia nervosa are the most common destructive eating disorders. Over 90% of those individuals who are affected with these eating disorders are youthful women. About 1% of the young girls develop anorexia nervosa, which is a risky condition where those girls can starve themselves literary to death while another 2% or 3% of youthful women get bulimia nervosa, which is also a vicious pattern of extreme overheating which is usually followed by vomiting among other â€Å"purging† behaviors. Anorexia and Bulimia have gotten to epidemic proportions. For instance, a new study conducted by NEDA (National Eating Disorders Association) revealed that 50% of girls have noteworthy eating disorders during their teens. Anorexia and bulimia obviously are severe disorders that require and necessitate serious at tention. Nevertheless, many individuals are not knowledgeable regarding the disorders; therefore do not distinguish warning signs most of the times until when it is too late. Anorexia and bulimia are destructive eating disorders which can have adverse effects on human beings if not well treated (Buckroyd & Rother, 2008).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Anorexia nervosa refers to a disorder in which individuals starve themselves intentionally. The disorder, which usually begins in young individuals around the puberty stage, involves excessive weight loss. Different from normal dieting, which ends after the desired weight is attained, in anorexia weight loss and dieting persists until the sufferer is below normal limit for height and age. Numerous anorectics appear to be emaciated however are certain that they are suffering from overweight. The most frightening aspects of this disorder is that individuals suffering from anorexia continue perceiving that they are suffering from overweight even when they become bone-thin. In this regard these individuals get scared of gaining extra weight due to the unknown reasons. Bulimics also have this fear (Retrieved March 17, 2004, from http://www.nice.org.uk/nicemedia/pdf/CG9FullGuideline.pdf).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   As eating disorders usually develop in adolescence stage, they can blight social and physical development and numerous sufferers are unable to achieve their academic potential. A mood which is depressed is a frequent feature, partially because of these unfavorable effects and also due to the distressing nature of key warning signs of these disorders. Adverse physical effects of dieting, purging behaviors and weight loss are critical and usually prove to be fatal. In fact, anorexia has the highest rate of mortality of any adolescence psychiatrist disorder (Espejo, 2012).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Approximately 40% of anorexics start developing the bulimia disorder later. Bulimia nervosa differs a bit from the anorexia since individuals suffering from bulimia don’t shun eating. Instead, people with bulimia usually consume huge food amounts over short period of time after which they get rid of the eaten food quickly through taking diuretics or laxatives or vomiting. Bulimia is 2 or 3 times more prevalent compared to anorexia and is also more common in females compared to males. Nevertheless bulimia has an effect slightly on older age group, frequently women who are in their early to mid-twenties who were overweight during their childhood. Since many bulimics â€Å"binge and purge† in top secret and maintain body weight which normal or above normal, they can habitually hide their disorder successfully from other individuals for many years. The bulimics challenging eating pattern is an uncontrollable and compulsive one th at results to chemical imbalances in their bodies. These imbalances lead to depression, clouded thinking and lethargy (Retrieved March 17, 2004, from http://www.nice.org.uk/nicemedia/pdf/CG9FullGuideline.pdf ).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Both bulimia and anorexia when severe can lead to colon damage, constipation, muscle spasms, irregular or loss of menstruation, seizures, urinary tract infections, kidney dysfunction, chronic indigestion and strain on most of the organs of the body. The bulimia vomiting practices can result to a ruptured stomach, swollen salivary glands, erosion of dental enamel and also chronic sore gullet and throat. The anorexia malnutrition also has its own effects which include; growth of hair all over the body which is down-like, severe cold sensitivity and inability to concentrate and think rationally. Both bulimia and anorexia have severe physical effects which are reversible if dealt with during the early stages. Nevertheless the diseases are deadly and it is imprudent to disregard the warning signs and delay the treatment. In a case where the disorders are unattended, they can take away quality of life of an individual or even life altogether (Re trieved March 17, 2004, from http://www.nice.org.uk/nicemedia/pdf/CG9FullGuideline.pdf ).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Eating disorders consist of a variety of syndromes including social, psychological and physical features. Even as the acute physical impediments of these disorders might arouse immense concern in health care staff and family members, bulimia nervosa and anorexia nervosa are often chronic conditions having considerable long –term social and physical sequelae, from which recovery turn out to be complex. Long-term disabilities comprise negative effects on fertility, parenting, relationships and employment. The impact of an individual’s eating disorder on family life and home is usually significant and family members might carry a great burden over a long time. Frequently family members are at a loss to be acquainted with how to assist and offer support to a relative who is affected (Retrieved March 17, 2004, from http://www.nice.org.uk/nicemedia/pdf/CG9FullGuideline.pdf).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Various different ideas exist concerning the causes of anorexia and bulimia disorders and it is essential to recognize that not all these ideas apply to all the sufferers. Royal college of psychiatrists records on its website the potential causes of bulimia and anorexia; they include control, depression, puberty, social pressures, upsetting events and family. Social pressures for individuals to be thin are usually brought on by newspapers, magazines and television that are filled with pictures of men and women who are slim and attractive. Many individuals have a notion that they must look in accordance with the way the media enlightens them they look. Some individuals develop eating disorders since they perceive to be out of control in various aspects of their weight and life and what they consume is something which they can be able to control (Garner & Garfinkel, 1997).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The latest increases in prevalence and incidents of eating disorders can be accredited to both improved method of diagnosis and increase in number of cases. On the other hand, even with better eating disorder identification, numerous bulimics and anorectics do not look for assistance. Bulimia and anorexia are diseases that are often very quiet since they are not concerns that individuals like discussing openly. Receiving quality care during the early stages of the disorders is the predicator of an excellent outcome in bulimia and anorexia (Retrieved March 17, 2004, from http://www.nice.org.uk/nicemedia/pdf/CG9FullGuideline.pdf ).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Bulimia nervosa and anorexia nervosa are multidimensional and multifaceted; thus many experts have a perception that referral for professional assessment and assistance is necessary for people showing signs of eating disorders. According to college of Royal psychiatrists illustrates that recognizing that an individual is suffering from an eating disorder and also getting the treatment is challenging. Individuals suffering from anorexia have extreme and alarming weight loss but such sufferers will never admit that they have a problem. On the other hand, individuals suffering from bulimia usually feel ashamed and guilty of their behavior and may go on to greater extents with an aim of hiding it. Due to these reasons, all individuals should be knowledgeable regarding the warning signs of these disorders so as to distinguish them and reduce their existence (Friedman & Skancke, 2009).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In a case where it is recognized that a certain individual is a sufferer of either bulimia or anorexia or both, treatment is crucial. There are various different options when it comes to treatment which includes education, family therapy, possibly hospitalization, Cognitive Behavioral Therapy, psychotherapy, drug therapy and reality imaging. During therapy treatments, therapists assist the sufferers work to alter the unclear and inflexible thinking patterns relating to eating disorders. Mental health professionals’ efforts necessitate to be combined together with those of the other health professionals to get the most excellent treatment. Nutritionists give an advice on eating and diet regimes while physicians treat the medical complications (Lawton, 2005).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In conclusion, scientists have discovered that combination of medication and psychotherapy is also very effectual. There are no specific drugs approved for anorexia and bulimia, however numerous, including a number of antidepressants, are being examined for this use. Bulimics and anorectics can be perceived as dieting junkies and an effective treatment might be a drug which is regularly prescribed to the addicts (Espejo, 2012). A Detroit scientist examined Naltrexone, the drug which is given to do away with the heroin habit, in those women having bulimia and anorexia and established the drug to be productive. With the drug, the weight of the anorectics stabilized and bulimics essentially decreased their purges and binges. Effective treatment can save life of an individual with an eating disorder. Teachers, friends, relatives, physicians and relatives all play a great role in assisting the ill individual start and continue with a treatment program. References Buckroyd, J., & Rother, S. (2008). Psychological responses to eating disorders and obesity recent and innovative work. Chichester, England: John Wiley & Sons. Eating Disorders. (n.d.). Core interventions in the treatment and management of anorexia nervosa, bulimia nervosa, and related eating disorders. Retrieved March 17, 2004, from http://www.nice.org.uk/nicemedia/pdf/CG9FullGuideline.pdf Espejo, R. (2012). Eating disorders. Detroit: Greenhaven Press. Friedman, L. S., & Skancke, J. (2009). Eating disorders. Farmington Hills, MI: Greenhaven Press/Gale Cengage Learning. Garner, D. M., & Garfinkel, P. E. (1997). Handbook of treatment for eating disorders (2nd ed.). New York: Guilford Press. Lawton, S. A. (2005). Eating disorders information for teens: health tips about anorexia, bulimia, binge eating, and other eating disorders including information on the causes, prevention, and treatment of eating disorders, and such other issues as maintaining healthy eating a. Detroit, MI: Omnigraphics. Source document

Addiction and Genetics

Alcohol abuse is one of the most research subjects. Many people, young and old, are addicted to it though they already know the negative effects of it. Some researchers try to prove that alcohol abuse is inherited. To sum degree, alcohol abuse or alcoholism is adapted by an individual from his environment. What an individual observes daily may be inherited. It has great effects on our health and in our society.Many crimes and accidents happen because of drinking excessive alcohol. However, not all crimes are the result of alcohol intake but most likely, crimes happened because of excessive drinking of alcohol. True or false? In large amounts, alcohol is a depressant; in small amounts, it is a stimulant.False. Small doses of â€Å"spirits† may indeed, enliven a drinker, but they do so by slowing activity in brain centers that control judgment and inhibitions. Alcohol facilitates urges that the individual might otherwise resist by focusing attention on the immediate situation an d away from future consequences (Steele & Josephs, 2000). If provoked, people under alcohol’s influence respond more aggressively than usual.If asked to help, people under alcohol’s influence respond more helpfully than usual. In everyday life, alcohol disinhibits both harmful tendencies, as when sexually coercive college men try to disinhibit their dates by getting them to drink (Mosher & Anderson, 1999), and helpful tendencies, as when restaurant patrons tip more when tipsy (M. Lynn, 1999).Thus, alcohol makes us more aggressive or helpful—or self-disclosing or sexually daring—when such tendencies are present. Whatever urges you feel when sober, you are more likely to act upon if intoxicated.Low doses of alcohol relax the drinker by slowing sympathetic nervous system activity. With larger doses, alcohol can become a staggering problem: Reactions slow, speech slurs, and skilled performance deteriorates. These physical effects, combined with the lowering o f inhibitions, contribute to alcohol’s worst consequences—in America, the more than 100, 000 lives claimed annually in alcohol-related car accidents and violent crime (Lord, 2001).This paper scrutinizes the relation of alcohol abuse of an individual to genetic factor.II. BackgroundA. Negative effects of Alcohol abuseAlcohol has an intriguing effect on memory. It impairs neither short-term recall for what just happened nor existing long-term memories. Rather, it disrupts the processing of recent experiences into long-term memories.Thus, the day after being intoxicated, heavy drinkers may not recall whom they met or what they said or did the night before. This memory blackout stems partly from an inability to transfer memories from the intoxicated to the sober state (Eich, 2000). Blackouts after drinking may also result from alcohol’s suppression of REM sleep.Alcohol has another intriguing effect on consciousness: It reduces self-awareness. Compared with people wh o feel good about themselves, those who want to suppress their awareness of failures or shortcomings are more likely to drink. The Nazi doctors who selected â€Å"unfit† inmates for the gas chambers often did so while drunk, or got drunk afterwards (Lifton, 1999).As with other psychoactive drugs, alcohol’s behavioral effects stem not only from its alteration of brain chemistry but also from the user’s expectations. Many studies have found than when people believe that alcohol affects social behavior in certain ways, and believe, rightly or wrongly, that they have been drinking alcohol; they will behave accordingly (Leigh, 2002).For example, alcohol per se has some effect on sexual arousal, by decreasing cognitive inhibitions (Crow & George, 1999). But people become even more responsive to sexual stimuli if they believe alcohol promotes arousal and believe they have been drinking. From their view of research, Jay Hull and Charles Bond concluded (2001) that for so me people alcohol serves â€Å"as an excuse to become sexually aroused.†Consider one such experiment by David Abrams and Terence Wilson. They gave Rutgers University men who volunteered for a study on â€Å"alcohol and sexual stimuli† either an alcoholic or a nonalcoholic drink. (Both drinks had a strong taste that masked any alcohol.) In each group, half the subjects thought they were drinking alcohol and half thought they were not.Regardless of what they drank, after being shown an erotic movie clip, the men who thought they had consumed alcohol were morel likely to report having strong sexual fantasies and feeling guilt-free.Thus, being able to attribute their sexual responses to alcohol released their inhibitions—whether they actually had drunk alcohol or not. This illustrates an important principle: A drug’s psychological effects are powerfully influenced by the user’s psychological state.   

Bony Anatomy The Knee Joint Health And Social Care Essay

IntroductionThe undermentioned chapter intends to supply an overview of current literature pertinent to this survey. A brief lineation of related anatomy and biomechanics of the articulatio genus articulation will be discussed, every bit good as a theoretical association of articulatio genus degenerative arthritis and the lower kinetic concatenation. The clinical, aetiological and epidemiological facets of degenerative arthritis of the articulatio genus will be provided, along with the possible effects that assorted intervention option may hold on this disease.Anatomy2.2.1 Bony Anatomy of the Knee JointThe articulatio genus joint maps chiefly as a big hinge-type articulation, dwelling of three articulations ; two tibiofemoral articulations between the medial and sidelong femoral and tibial condyles, and one patellofemoral articulation between the posterior facet of the kneecap and thighbone ( Moore and Dalley, 1999 ) . Due to the comparative incongruence of the articulating surfaces, the articulatio genus articulation composite is inherently unstable, hence two fibrocartilage phonograph record ( semilunar cartilage ) exist in the infinite between the shinbone and thighbone, are attached to the intercondylar distinction of the shinbone, and farther addition the congruency of the joint every bit good as provide extra stableness ( Magee, 2008 ) . In add-on to the semilunar cartilage, legion environing ligaments play an of import function in stabilization of the articulatio genus. The name, location and specific map of these ligaments are outlined in the tabular array below.Table 2.1.1 Name Location and maps of articulatio genus ligamentsNameLocationFunctionMedial ( tibial ) collateral ligament ( MCL ) Anchored superiorly to the median femoral epicondyle, inferior to the adductor tubercle, and descends anteriorly to attach to the median border and median surface of the shinbone above and behind the fond regard of sartorius, gracilis, and semitendinosus sinews. Attaches by much of its deep surface to the underlying hempen membrane of the median semilunar cartilage. Stabilises the hinge-like gesture of the articulatio genus and prevents knee abduction Lateral ( fibular ) collateral ligament ( LCL ) Attaches superiorly to the sidelong femoral epicondyle, superior to the channel for the popliteus sinew. Inferiorly, it is attached to a depression on the sidelong surface of the fibular caput. It is separated from the hempen membrane by a Bursa Stabilises the hinge-like gesture of the articulatio genus and articulatio genus adduction. It is stronger than MCL Anterior cruciate ligament ( ACL ) Attaches to a aspect on the anterior portion of the intercondylar country of the shinbone and ascends posteriorly to attach to a aspect at the dorsum of the sidelong wall of the intercondylar pit of the thighbone Complect the thighbone and shinbone, stops tibia traveling frontward on thighbone, and prevents hyper-extension and inordinate internal rotary motion. ACL crosses sidelong to the PCL as they pass through the intercondylar part Articular capsule and the Bursa Articular capsule presents merely at the sides and posterior facets of the articulatio genus, where it covers the majority of the femoral and tibial condyles. It is stabilised and straighten by the joint ligaments and the musculus sinews. Bursa are extensions of the articulatio genus synovial pit and are filled with synovial fluid The capsule consists of an external hempen bed ( hempen capsule ) and an internal synovial membrane, which is uninterrupted with the synovial liner of the Bursa. They act to cut down clash between the sinews and implicit in castanetss ( hypertext transfer protocol: //andme26.hubpages.com/hub/Anatomy-of-the-knee-Bones-Muscles-Arteries-Veins-Nerves )2.2.2 Neurovascular StructuresTable 2.1.2 Neuravascular constructions of the articulatio genus2.2.3 Lower Limb MusculatureThe primary musculus groups responsible to making motion at the articulatio genus articulation are the quadriceps femoris ( extension ) and hamstrings ( flexure ) . The fond regards, excitation and action of the single musculuss within the quadriceps and hamstring are described in Table 2.1.3.1 and Table 2.1.3.2, severally.Table 2.1.3.1 Attachments, Innervation and Action of Quadriceps Femoris ComponentsMuscleProximal AttachmentDistal AttachmentExcitationActionRectus Femoris Anterior inferior iliac spinal column and Troy superior to acetabulum Via a common sinewy interpolation to the base of kneecap ; indirectly via patellar ligament to tibial tubercle Femoral Nerve ( L2, L3, L4 ) Extend leg at articulatio genus articulation ; rectus femur besides steadies hip articulation and helps iliopsoas musculus flex the thigh Vastus Lateralis Greater trochanter an sidelong lip of linea aspera of thighbone Vastus Medialis Intertrochanteric line and median lip of linea aspera of thighbone Vastus Intermedius Anterior and sidelong surfaces of shaft of thighbone ( Table abridged from Moore and Dalley, 1999 )Table 2.1.3.2 Attachments, Innervation and Action of Hamstrings ComponentsMuscleProximal AttachmentDistal AttachmentExcitationActionSemitendinosus Ischial tubercle Superior portion of shinbone on median surface Tibial division of sciatic nervus ( L5, S1, S2 ) Extend thigh ; flex leg and revolve it medially when articulatio genus is flexed Semimembranosus Ischial tubercle Posterior portion of shinbone on median condyle Bicepss Femoris Long caput: ischial tubercle Short caput: linea aspera and sidelong supracondylar line of thighbone Fibula on sidelong side of caput Long caput: Tibial division of sciatic nervus ( L5, S1, S2 ) Short caput: Common fibular division of sciatic nervus ( L5, S1, S2 ) Extend thigh ; flex leg and revolve it laterally when articulatio genus is flexed ( Table abridged from Moore and Dalley, 1999 )2.2.4 Lower Limb BiomechanicsThe primary motions of the articulatio genus are flexure and extension, with a smaller rotational constituent when the articulatio genus is flexed ( Moore and Dalley, 1999 ) . Table 2.1.4 outlines the chief motions of the articulatio genus articulation, every bit good as the name and action of the musculus bring forthing them.Table 2.1.4 Motions of the articulatio genusMotion and scope of motionNameActionKnee flexors 135A °-150A ° 1. Hamstrings ( semitendinosus, semimembranosus, biceps femoris ) 2. Popliteus Flexs and rotes leg medially, locks and unlocks the articulatio genus from beginnings of flexure Knee extensors 0A °-10A ° Quadricepss femoris ( rectus femur, vastus lateralis, vastus medialis, vastus intermedialis ) extends leg, ( but flexes thigh by action of rectus femur ) Medial rotary motion 0A °-10A ° Popliteus ( non-weight bearing articulatio genus extended ) , or semitendinosus and semimembranosus ( when knee flexed ) Weakly flexes articulatio genus, unlocks knee by revolving femur 5A ° laterally on fixed shinbone Lateral rotary motion 0A °-30A ° Bicepss femoris ( when knee flexed ) Weakly flexes articulatio genus, unlocks knee by revolving femur 5A ° medially on fixed shinbone ( hypertext transfer protocol: //andme26.hubpages.com/hub/Anatomy-of-the-knee-Bones-Muscles-Arteries-Veins-Nerves ) The comparative incongruence of the articular surface consequences in the articulatio genus being comparatively weak automatically, and a greater trust on the actions of environing musculuss, sinews and ligaments for strength and support ( Magee, 2008 ) . The anterior thigh musculuss are the most critical of these supports, with the quadriceps femoris musculuss being the most of import stabilizer of the articulatio genus articulation ( Moore and Dalley, 1999 ) . Because of the fond regard of the quadriceps femoris musculus across two articulations, it is capable of bring forthing action at both the hip and the articulatio genus ( Moore and Dalley, 1999 ) . The three vastus musculuss ( vastus intermedius, vastus medialis and vastus lateralis ) form the primary extensor musculus group of the articulatio genus ( Moore and Dalley, 1999, Magee, 2008 ) . The rectus femoris division of the quadriceps femoris musculus Acts of the Apostless, along with the iliopsoas, to flex the hip ( Moore and Dalley, 1999 ; Marieb, 2004 ) ; therefore its ability to widen the articulatio genus is compromised when the hip is flexed. As a consequence, the ability of the quadriceps femoris musculus group to bring forth knee extension is most effectual when the hip articulation is extended ( Moore and Dalley, 1999 ) . The hamstrings musculus group produces extension at the hip and flexure at the articulatio genus ( Moore and Dalley, 1999 ; Marieb, 2004 ) . These two actions of the hamstrings can non be performed maximally at the same clip, as full flexure of the articulatio genus requires so much shortening that the hamstrings can non supply the extra contraction needed for full extension of the hip, and frailty versa ( Moore and Dalley, 1999 ) . The hamstrings, nevertheless, demonstrate most activity when they are eccentrically undertaking to defy hip flexure and articulatio genus extension ( Moore and Dalley, 1999 ) . A survey by Wilson et Al ( 2011 ) aimed to look into the correlativity between articulatio genus articulation biomechanics and neuromuscular control and moderate articulatio genus degenerative arthritis radiographic and pain badness, higher articulatio genus adduction minutes ( during stance stage ) and lower articulatio genus flexure angles ( full pace rhythm ) were associated with higher RVAS. Higher hurting tonss were associated with lower pace velocities and reduced activation of the sidelong gastroc between early and late stance stage, which the writers suggested may be a mechanism to antagonize high median compartment articulation burden. Additionally, increased activation of the median hamstring between early stance stage and toe off may be declarative of higher coactivity of these musculuss in a guarding mechanism to increase joint stiffness and cut down the hurting, and perchance to compensate joint instability.2.2.4.1 Kinetic Chain TheoryThe kinetic concatenation is defined as â€Å" a combination of several in turn arranges myofascial, articular and nervous constituents, representing a complex unit † ( Bergmann & A ; Peterson, 2002 ) . In order for this system to map, it requires optimum alliance, mechanics and enlisting of these articulations. There are 3 sub-systems within a kinetic concatenation ( active, inactive and nervous ) , all of which contribute to the production of motion: In the lower limb there exists a functional relationship between the articulatio genus and the superior articulations in the hip and lumbopelvic spinal column, every bit good as the pes and mortise joint, inferiorly. When the pess are weight-bearing, the kinetic concatenation is closed and the links map interdependently, with a alteration in one articulation ensuing in an immediate consequence on the kinematics of other articulations in the concatenation. Therefore, a disfunction in the articulatio genus can hold a direct consequence on next articulation in the concatenation, and frailty versa. This highlights the importance of turn toing non merely the country of ailment, but besides next parts to rectify any potentially altered biomechanics of the kinetic concatenation in entirety.Overview of Osteoarthritis of the KneeEpidemiologyIncidence and PrevalenceBy the age of 60 old ages, about 100 % of the population will hold histologic alterations of devolution in their articulatio genus gristle, over 80 % will hold radiographic grounds of OA in at least one articulation, about 40 % will describe clinical symptoms of arthritis, and 10 % will see activity restriction ( Loeser 2000 ) .Hazard FactorsHarmonizing to the Framingham degenerative arthritis survey, the major hazard factors for KOA were age, female gender, fleshiness, non-smoking, occupational articulatio genus bending, physical labor, and chondrocalcinosis ( Felson 1993 ) . Other hazard factors identified are listed in the tabular array below.Table 2.2.1 Hazard factors and Protective factors for KOA harmonizing to the F ramingham OA surveyHazard factorsAge Female gender Geneticss Race Geographic Fleshiness Major articulation injury Occupational Immobilization High bone mineral denseness Joint hypermobility & A ; instability Insistent articulation usage Peripheral neuropathy Prior inflammatory articulation disease Congenital/developmental defects Crystal deposition in articulations Oestrogen surplus Diabetess, high blood pressure, hyperuricaemiaProtective factorsSmoking Osteoporosis Weight decrease Age: Age is the strongest hazard factor for OA, with an addition in prevalence of diagnostic OA from 7.0 % in those aged 63-69 old ages old to 11.2 % in those over the age of 80. Radiographic grounds of OA increased from 27.4 % amongst those in their 1960ss compared to 43.7 % prevalence in those in their 1880ss ( Felson 1987 ) . Gender: Age related increased in OA were found to be more evident in females ; non merely with respect to incidence, but besides in badness and rate of patterned advance ( grade 3/4 alterations increased in prevalence by 7.9 % from the 6th to eighth decennary of life ( Felson 1990 ) . Although there was small or no difference in gender prevalence of mild OA ( Roberts 1996 ) , females tended to hold more terrible OA, a greater figure of joint engagements, more symptoms, and a higher prevalence of manus and articulatio genus OA ( Kellgren-Lawrence 1963 ) ( Felson1995 ) . Recent surveies suggest that post-menopausal oestrogen lack may play a function in development of KOA in older adult females ( Nevitt 1996 ) . Males, nevertheless, had an increased prevalence of hip OA ( particularly in those aged 55 and supra ) ( Kellgren-Lawrence 1963 ) Fleshiness: Fleshiness is the strongest modifiable hazard factor for development of KOA, particularly in adult females ( Loeser 2000 ) . Harmonizing to the Framingham survey, higher organic structure mass index ( BMI ) was associated with an odds ratio of 1.6 per 5-unit addition in BMI. Similarly, a weight loss correlated to a 40 % lessening in hazard of KOA per 10-lb ( ~4.5kg ) weight loss ( Felson 1988/1997 ) . Hazard for development of KOA increased exponentially when fleshiness was present with an extra hazard factor, such as heavy physical activity. Aged patients in the upper tertile of BMI who performed at least 3 hours of physical activity daily had an odds ratio of 13 for development of KOA ( McAlindon 1999 ) . Major joint injury: The comparative hazard for development of radiographic KOA following meniscectomy for direction of stray meniscal cryings was 14 ( Roos 1998 ) . Surveies besides suggest that quadriceps failing increased the hazard of both radiographic and diagnostic OA ( Slemendra 1997 ) . Insistent articulation usage: While there is deficient informations to propose that featuring activities may take to generalised OA ( Lane 1993 ) , it has been shown that certain businesss may do the overexploitation of peculiar articulations, therefore increasing the hazard of development of localized OA ( Croft 1992 ) . For illustration, occupational articulatio genus bending is strongly associated with KOA and mineworkers frequently exhibit marks of spondylosis ( Felson 1990 ) . Muscle dysbalance & A ; wasting: Muscles play a major function in joint biomechanics as the green goods motions, absorb burden, and supply dynamic joint stableness. It is therefore possible that musculus failing due to aging or anterior injury my consequence in loss of the protective musculus control, inordinate joint motion and instability ( Slemendra 1997 ) . Ultimately this will do stress-induced microtrauma of the articular gristle due to the increased happening in physiological shear and extremum articulation forces. Over an drawn-out period of clip, this microtrauma will do gristle devolution, with pathological subchondral force per unit area addition and attendant subchondral induration, and joint prostration with axis maldeviation ( mention ) . Slemenda et Al. conducted a prospective survey in which reduced articulatio genus extensor strength was present in those topics who developed OA as compared to the unaffected participants ( Slemendra 1998 ) . Similar findings were seen in a survey by on patients with one-sided mortise joint OA, in which the affected side displayed reduced calf perimeter and decreased electromyography ( EMG ) frequences of lower leg musculuss ( Valdererrohano 2006 ) . In a healthy person, musculus biopsies have shown wasting of type-1 musculus fibers ( slow-twitch ) in the vastus lateralis following periods of articulatio genus immobilization. In KOA patients nevertheless, failing of the vastus lateralis was largely due to type-2 fiber wasting ( Nakamara and Suzuki 1992 ) . Fink et al so investigated the structural alterations in the vastus medialis and found type-2 fiber wasting in all specimens ( which was consistent with informations from Nakamara ) every bit good as extra type-1 fiber wasting in 32 % of patients ( Fink 2007 ) . Exercise preparation has been found to increase diameter of both type-1 and type-2 musculuss fibers ( Saltin 1977 ) , and was therefore the recommendation of the writers in order to antagonize the musculus wasting and therefore protract the oncoming of OA. As musculuss increase in size with exercising, it is suspected that wasting in creaky patients is non merely caused by neglect in the presence of joint stiffness and hurting, but besides by age-related sarcopenia ( generalized loss of skeletal musculus mass ) , physical immobilization and decreased physical activity ( Goodpaster 2006 ) . This musculus wasting, irrespective of its causative pathomechanism, has been found to be strongly correlated to the development of OA. Since exercising additions muscle mass and improves musculus map, it is likely to play an of import function in intervention and bar of OA.PathologyOA is characterised by focal loss of gristle with grounds of attach toing periarticular bone response. Clinically, it presents as joint hurting and crepitus in the aged age group, and is radiographically characterised by reduced joint infinite, osteophytes and a assortment of malformations that develop as the disease progresses.Pathogenesis and MorphologyNormal hyaline gr istle comprises chondrocytes ( 1-2 % ) embedded in extra-cellular matrix, which in bend is constituted by H2O, type-II collagen and proteoglycans. Articular gristle performs two chief maps: 1 ) along with synovial fluid, it provides virtually friction-free motion within the joint ; and 2 ) in weight-bearing articulations, it spreads the burden across the joint surface in a mode that allows the implicit in castanetss to absorb daze and weight. These maps require that gristle be elastic and have a high tensile strength. These properties are provided by proteoglycans and type II collagen, both of which are produced by chondrocytes. Articular gristle invariably undergoes matrix devolution and replacing. Any instability in normal chondrocytes ability to keep gristle synthesis and debasement can take to OA. Majority of the pathological alterations in OA occur in the gristle itself, nevertheless as the disease progresses, the organic structure and synovial constructions besides begin to de mo marks of devolution. ( Reference ) Cartilage Changes: Chondrocyte map can be affected by a assortment of influences, including mechanical emphasiss, aging, metabolic and familial factors, increased bone denseness and high oestrogen degrees. Regardless of the inciting stimulation, early OA is marked by the degenerating gristle incorporating more H2O and less proteoglycan ( mention ) . This occurs as a consequence of an enzymatic debasement of the major structural constituents, aggrecan and collagen, which causes reactive proliferation of chondrocytes to organize bunchs ( ringers ) with increased production of matrix constituents. Although the turnover of aggrecan constituents is increased, the concentration finally falls. The lessening in size of hydrophilic aggrecan molecules increases the H2O concentration and swelling force per unit area in gristle, farther interrupting the staying staging of type II collagen. Overall, gristle tensile strength and resiliency are compromised doing it susceptible to supporting hurts. ( BOON ET AL ) Progression of these alterations leads to transgress of surface unity, crevices, opposing, flaking of gristle and development of perpendicular clefts ( fibrillations ) , localised chondrocyte decease and lessening in gristle thickness. Cartilage loss is focal instead than widespread and normally restricted to the maximal supporting portion of the joint ( BOON ET AL ) . Gross scrutiny at this phase reveals a soft farinaceous articular gristle surface ( kumar et Al ) . Bone Changes: The bone instantly below the compromised gristle responds by increasing its trabecular thickness ( subchondral induration ) , which in some instances reflects healed trabeculate microfractures or countries of osteonecrosis caused by the increased force per unit area in bone as the gristle fails in its load-transmitting map. The break gaps allow synovial fluid to be forced into the subchondral parts, organizing hempen walled cysts. At the border of the joint there is formation of new fibrocartilage, which so undergoes endochondral ossification to organize osteophytes. Despite cardinal and fringy new bone formation, with terrible gristle loss, crevices may intensify and expose the subchondral bone to have on, with the unprotected bone ends going ivory-like due to inspissating and vascularization ( eburnation ) , frequently with deep linear furrows ( BOON ET AL ) . Small breaks can free pieces of gristle and subchondral bone into the joint, organizing loose organic structu res ( joint mice ) . Bone remodelling and gristle thinning easy alter the form of OA articulations, increasing their surface Other Changes: The synovial membrane undergoes variable grades of hyperplasia, sometimes as aureate although less widespread as RA ( In terrible disease, a hempen synovial pannus covers the peripheral parts of the articular surface ) . Osteochondral organic structures normally occur within the synovial membrane, reflecting chondroid mataplasia or secondary consumption and growing of damaged gristle fragments. The outer capsule besides thickens and contracts, normally retaining the stableness of the remodelling articulation. The musculuss that act over the joint normally show non-specific type-II fiber wasting ( BOON ET AL ) .Natural HistoryThe class of OA is extremely variable. Those patients with multiple affected articulations tend to hold a more rapid patterned advance of OA in their single articulations ( Felson 1993 ) . Advanced age ( Felson 1993 ) and fleshiness ( Felson 1993 ) are besides associated with more rapid patterned advance. Primary OA is regarded as by and large easy progressive, which is apparent in one 3rd to two tierces of radiographic OA instances ; while it has been known to brace for many old ages, betterments are rare ( kumar et Al ) . Diagnostic OA may come on, or better, or may even be arrested due to the fact that symptoms have been shown to be ill correlated to radiographic patterned advance ( Kellgren-Lawrence 1963 ) . Osteophye encroachments on spinal hiatuss are a common cause of nervus root entrapment, which may ensue in neurological shortages such as radicular hurting, musculus wasting or cramp, and centripetal loss. With clip, entire articulation prostration may happen, but unlike Rheumatoid arthritis, does non ensue in joint anchylosis ( merger ) . ( kumar et Al )Subsets of OAPrimary OA can be categorised into three major subsets, although it may non be easy to find an exact differentiation between the subsets ( Doherty 1994 ) . Nodal Generalised OA: GOA is characterised by distal, and proximal to a lesser extent, interphalangeal ( IP ) articulation engagement, Heberden ‘s nodes ( cadaverous expansion of DIP articulation ) , Bouchard ‘s nodes ( cadaverous expansion of PIP articulation ) and familial bunch. It peaks at in-between age and is common in females ( Doherty 1994 ) . Erosive OA: Characterised by engagement of IP articulations of custodies, frequently with aureate redness and erosive alterations, that subsequently take to malformations and anchylosis. A little proportion ( 15 % ) may germinate into seropositive rheumatoid arthritis ( Doherty 1994 ) . Isolated big joint OA: Knee: This is the most common signifier of OA, frequently happening bilaterally. It may affect preponderantly the median femorotibial, sidelong femorotibial or patellofemoral compartment. Hip: Predominantly involves the superior pole or the median compartment. Spinal column: Apophyseal joint engagement is the lone true signifier of OA that can affect the spinal column and is typically manifested my hurting on extention on the spinal column. Intervertebral phonograph record ( IVD ) devolution with osteophyte formation is considered an built-in portion of OA, and normally affects the lumbar and cervical parts. Diffuse intraosseeous skeletal hyperostosis ( DISH ) and ossification of posterior longitudinal ligaments ( OPLL ) are considered to be discrepancies of spondylosis, and comprise fluxing calcification of the disc border and anterior and posterior longitudinal ligament, severally ( mention ) .Clinical FeaturesSigns and symptoms of OA may take many old ages after the oncoming of the disease to go clinically apparent. This is due the fact that the patterned advance of the disease is extremely variable & A ; there tends to be hapless correlativity to radiographic and microscopic patterned advance. Another possible ground that there may be a hold in the visual aspect of symptoms after devolution has taken topographic point is because due to a deficiency of excitation within the gristle ( Lane 1993 ) . Joints normally involved in OA are the articulatio genus, fingers, and spinal apophyseal articulations. Less normally are the hips, acromioclavicular and sternoclavicular articulations, while carpal, cubitus, mortise joint and glenohumeral articulations are seldom involved in isolation.Signs and SymptomsSymptoms if OA often have an insidious oncoming and an asymmetrical distribution, subsequently going symmetric as the disease progresses. Factors that may foretell the presence of diagnostic OA and rate of patterned advance include advanced age, fleshiness and multiple affected articulations. The central marks of OA include bony puffiness, synovial gush, crepitus, restricted scope of gesture, joint malformation and, musculus failing and wasting. Symptoms associated with OA include hurting, joint stiffness and functional damage, although all need n't be present at the same clip & A ; badness: Pain: Pain normally begins as an intermittent localised deep aching in and around the affected articulation, frequently exacerbated by motion. As the disease progresss, hurting may go more relentless, going nowadays at dark and during remainder. In KOA, hurting is normally localised to the front tooth and median facets of the articulatio genus and upper thigh, normally occurs with step usage, mounting in and out of vehicles, and making day-to-day activities such as bathing, standing from a seated place and utilizing a lavatory. These jobs may be amplified in the presence of attendant hip pathologies, where normal walking pace is likely to be altered as a consequence of the inguen and leg hurting. Stiffness: Stiffness in the involved articulations is typically present and worst first thing in the forenoon ( forenoon stiffness ) and lasts between five and 30 proceedingss. Stiffness may besides be present subsequently in the twenty-four hours after periods of remainder or inaction ( gelling ) , but is brief and relieved by soft motion ( Doherty 1994 ) . This stiffness is frequently associated with impaired motion within the joint and my consequence from a figure of causes ; joint adhesion, capsular tightening and thickener, inflexibleness of the overlying soft tissue and/or altered joint construction ( eg. as a consequence of osteophyte formation ) . Functional Damage: The badness of functional damage is mostly dependent on the grade of devolution, type of joint involved every bit good as the specific location of the devolution within the joint. For illustration, if there is pronounced devolution with osteophyte formation on next jointing surfaces, which make contact during motion, one would anticipate to happen that scope of gesture is impaired. Similarly, loose organic structures may ensue in reduced scope of gesture every bit good as possible lockup or buckling, particularly if located within the articulatio genus articulation. Crepitus develops as a consequence of gristle loss articulation and abnormalities on jointing surfaces such that they longer skid swimmingly over one another. This creates a stuttered-type gesture, which can be palpated on scrutiny of scope of gesture. In terrible instances this crepitus may even make hearable â€Å" dads † . Crepitus is present in over 90 % of patients with KOA ( mention ) . In terrible instances, joint subluxation may happen when there is uneven wear of the joint surfaces. Over an drawn-out period of clip this will ensue in asymmetrical joint infinite narrowing and finally prostration. When this occurs in the articulatio genus, the median tibiofemoral articulation to typically more affected than the sidelong and in over 50 % of patients will do the development of a knee varus ( â€Å" bow leg malformation † ) . Functional damage may besides ensue non merely from structural alterations to the joint surfaces, but besides from other alterations associated with OA, such as arthrogenic musculus suppression. In this instance, the patient may see failing due to wasting of the surrounding musculuss, every bit good as stiffness or reduced scope of gesture due to inflexibleness ( Hurley 1998 ) .Table 2.2.2 Outline of Typical Symptoms of OsteoarthritisSymptomsPatient over age of 45 Insidious onset over months or old ages Variable or intermittent hurting over clip Chiefly related to motion and weight-bearing, relieved by remainder Merely brief forenoon ( & lt ; 15 proceedingss ) stiffness and â€Å" gelling † ( & lt ; 1 minute ) after remainder Normally merely one or two articulations painful ( non multiple regional hurting ) ( Adapted from Davidson ‘s )Table 2.2.3 Outline of Clinical Signs Characteristic of OsteoarthritisSignsRestricted motion ( capsular thickener, barricading by osteophytes ) Palpable, sometimes hearable, class crepitus ( unsmooth articular surfaces ) Bony swelling ( osteophytes ) around articulation borders Deformity, normally without instability Joint-line or periarticular tenderness Muscle failing, blowing No, or merely mild, synovitis ( gush, increased heat ) ( Adapted from Davidson ‘s )2.3.3.2 Arthrogenic Muscle Inhibition ( AMI )AMI is defined as the failure of a functional musculus group to enroll all motor units during maximum voluntary contraction ( Suter et al, 2000 ) . When joint receptors are subjected to distention, compaction, ligamentous stretch, gush and hurting, this protective mechanism is activated, doing automatic suppression of the environing muscularure to forestall farther hurt to the joint ( Crossman and Neary, 1995 ) . The hurting, joint annoyance and musculus cramps frequently associated with KOA, taking to biomechanical alterations and redness, consequences in an suppression of the joint motorneuron pool and inability to enroll all the musculus fibers within the musculus groups that cross the affected articulation. The net consequence is: lessening musculus strength ( existent and/or evident failing ) , doing holds in the rehabilitation advancement ( Hopkins and Ingersoll, 2000 ) Altered motion forms due to a alteration in motor control and joint proprioception, increasing the hazard of hurting, re-injury and accelerated devolution because of the deformed articulation forces ( Lee, 4004 )Diagnostic StandardsPrior to the development of clinical standards for diagnosing of OA in 1981? , the diagnosing of OA was frequently based on radiographic visual aspect and standards proposed by Kellgren and Lawrence in 1957, which is accepted by the World Health Organisation. The diagnosing of OA is mostly clinico-radiographic, that is both clinical and radiographic characteristics are taken into consideration to find the presence and badness of the disease. It is widely acknowledged that radiographic alterations may non be present in the early phases of devolution, while merely 40-50 % of patients with radiographic grounds of OA are clinically symptomless ( Roberts 1996 ) . For this ground the American Rheumatism Association devised diagnostic standards for OA in assorted articulations.Table 2.2.4 Clinico-radiographic Classification Criteria for Osteoarthritis of the KneeTraditional formatClassification tree formatKnee hurting OsteophytesPlusOne of three: Age & gt ; 50 old ages Stiffness & lt ; 30 proceedingss Crepitus Knee hurting and OsteophytesOrKnee hurting and age a†°? 40 old ages and forenoon stiffness a†°Ã‚ ¤ 30 proceedingss in continuance and crepitus on gesture( Altman 1986 )Table 2.2.5 Clinico-radiographic Classification Criteria for Osteoarthritis of the HipHip hurting At least two of the followers: ESR Westergreen & lt ; 20mm/hr Radiographic femoral or cotyloid osteophytes Radiographic joint infinite narrowing ( superior, axial and/or medial )( Altman 1991 )Table 2.2.6 Clinico-radiographic Classification Criteria for Osteoarthritis of the HandssHand hurting, hurting, or stiffness Three or four of the followers: Hard tissue expansion of 2 or more of 10 selected joints* Hard tissue expansion of 2 or more DIP articulations Less than 3 conceited MCP articulations Deformity of at least one of 10 selected joints* * 10 selected articulations are 2nd and 3rd DIP articulation, 2nd and 3rd PIP articulation, and 1st carpometacarpal joint( Altman 1990 )Radiographic DiagnosisThere are eight central marks of DJD: asymmetric distribution, non-uniform loss of joint infinite, osteophytes, subchondral induration, subchondral cysts, intra-articular loose organic structures, intra-articular malformation, and joint subluxation. The radiographic presentation of OA varies depending on the joint involved, the anatomic relationships, and the emphasis to which the articulation is subjected. Therefore all eight marks need non be present in order to set up a diagnosing of OA ; nevertheless they may be utile in in finding the grade of underlying diseased sequences affecting the joint compartments. The tabular array below is the scaling system used to set up radiographic badness of OA ( mention – Y & A ; R? ) .Table 2.2.7 Kellgren-Lawrence Classification of OsteoarthritisDescriptionNormal No alteration Class I Improbable narrowing of the joint infinite, possibleA osteophytes Grade II SmallA osteophytes, possible narrowing of the joint Grade III Multiple, reasonably sizedA osteophytes, definite joint infinite narrowing, some sclerosed countries, possible distortion of bone terminals Grade IV Multiple largeA osteophytes, terrible joint infinite narrowing, marked induration and definite cadaverous terminal malformation. mention Asymmetrical Distribution: There is often a seeable disparity when comparing the extent of joint engagement with the unaffected ( or lesser affected ) articulation on the contralateral side. The asymmetrical distribution of OA helps to separate it from inflammatory arthropathies, such as RA, when have a characteristically symmetrical engagement ( mention – Y & A ; R? ) . Non-Uniform Loss of Joint Space: Decrease in joint infinite is most likely to happen at the parts of greatest intra-articular emphasis, which is particularly apparent in weight-bearing articulations such as the spinal column, hip, and articulatio genus ( mention – Y & A ; R? ) . Osteophytes: Radiographically, these are seen as cadaverous branchs widening from the part of capsular interpolation into the joint infinite. In really terrible instances the osteophyte may wholly bridge the joint infinite, doing anyklosis of the joint ( cite – Y & A ; R? ) . Subchondral Sclerosis ( Eburnation ) : This is normally apparent in countries where there is the greatest loss in gristle tallness. It occurs as a consequence of increased mechanical forces being transmitted to the joint surfaces that lack the daze absorbing consequence of normal gristle thickness. In order to antagonize these increased forces, the bing trabeculate bone thickens and new bone is formed. This is seen on radiogram as increased countries of radio-opacity in the subchondral bone underlying parts of reduced joint infinite ( mention – Y & A ; R? ) . Subchondral Cysts ( Goedes ) : These are focal parts of loss in bone denseness, of variable size, which appear as rounded countries of radiolucency and frequently have a sclerosed border. They are located in countries of old subchiondral induration, and occur either as a consequence of synovial fluid invasion through the open articular home base or secondary to trabeculate break and subsequent mortification ( mention – Y & A ; R? ) . Intra-Articular Loose Bodies ( Joint Mice ) : As joint devolution advancements, flaking and atomization may ensue in intra-articular accretion of free drifting organic structures, comprised mostly of gristle and on occasion subchondral bone ( mention – Y & A ; R? ) . Articular Deformity: Progressive distortion of the articular surfaces may happen following insistent emphasis, doing big subchondral cysts, trabeculate remodelling, break and prostration, which may be exacerbated my mortification due to secondary vascular perturbations ( mention – Y & A ; R? ) . Joint Subluxation: The joint finally becomes unstable and prone to displacement due to joint surface distortion, loss of joint infinite, and laxness within the construction of the ligaments and sinews. This alters in the burden distribution, farther increasing the unbalances emphasiss of the joint, speed uping the degenerative procedure ( mention – Y & A ; R? ) .Clinical DiagnosisAltman et Al. ( 1986 ) developed sets of standards for the categorization of idiopathic OA of the articulatio genus.Table 2.2.8 Classification Criteria for Diagnosis of Idiopathic Osteoarthritis ( OA ) of the Knee *Clinical and research labClinical and radiolograohicClinical **Knee Pain + at least 5 of 9: Age & gt ; 50 old ages Stiffness & lt ; 30 proceedingss Crepitus Bony tenderness Bony Enlargement No tangible heat ESR & lt ; 40 mm/hr RF & lt ; 1:40 SF OA Knee Pain + at least 1 of 3: Age & gt ; 50 old ages Stiffness & lt ; 30 proceedingss Crepitus + Osteophytes Knee Pain + at least 3 of 6: Age & gt ; 50 old ages Stiffness & lt ; 30 proceedingss Crepitus Bony tenderness Bony Enlargement No tangible heat 92 % Sensitivity 75 % Specific 91 % Sensitivity 86 % Specific 95 % Sensitivity 69 % Specific * ESR = erythrocyte sedementation rate ( Westergreen ) ; RF = arthritic factor ; SF OA = synovial fluid marks of OA ( clear, syrupy, or white blood cell count & lt ; 2000/mm3 ) . ** Alternative would be 4 of 6, which is 84 % sensitive and 89 % particular. ( mention )Differentiation from other Arthritic DiseasesArthritic arthritis: associated with more marks of redness affecting the MCP, carpus, wrist bones and other peripheral articulations, every bit good as the cervical spinal column. Generalised OA involves the DIP, PIP and first CMC articulations in the manus and, cervical and lumbar spinal column parts. RA distinguished from erosive OA through positive research lab trial, such as arthritic factor, ESR, and synovial fluid analysis ( Boon et al, ) . Joints actively involved in arthritic arthritis seldom show osteophytes, therefore their presence is a utile index of OA if the patient presents with a assorted clinical image. If osteophytes precede arthritic engagement, it indicated that rheumatoid arthritis has evolved from an erosive OA. Conversely, they will merely develop in secondary devolution following RA burn out ( Yochum & A ; Rowe, ) . Pseudogout: differentiated from OA by presence of CPPD crystals in synovial fluid, every bit good the in engagement of articulations that are non typically associated with primary OA, such as the cubitus and shoulder ( McCarthy 1998 ) .Table 2.2.9 Categorization for Subsets of Idiopathic OsteoarthritisLocalised:Handss: Heberden ‘s and Bouchard ‘s nodes ( nodal ) Erosive interphalangeal arthritis ( non-nodal ) Scaphometacarpal Scophotrapezal Foot: Halux valgus Hallux rigidus Contracted toes ( hammer/cock-up toes ) Talonavicular Knee: Medial compartment Lateral compartment Patellofemoral compartment Hip: Eccentric ( superior ) Concentric ( axial, median ) Diffuse ( coxae senilis ) Spine ( peculiarly cervical and lumbar ) : Apophyseal Intervertebral ( phonograph record ) Spondylosis ( osteophytes ) Ligamentous hyperostosis [ DISH* or Forestier ‘s disease ] ) Other individual sites: Shoulder Temporomandibular Sacroiliac Ankle Wrist AcromioclavicularGeneralised ( includes 3 or more sites listed above ) :Small ( peripheral ) and spinal column Large ( cardinal ) and spinal column Mixed ( peripheral and cardinal ) and spinal column * DISH = Diffuse Idiopathic Skeletal Hyperostosis