September 11th,
- 8:45 a.m.: A large plane, possibly a hijacked airliner, crashes into one of the World Trade Center towers, tearing a gaping hole in the building and setting it afire.
- 9:03 a.m.: A second plane, apparently a passenger jet, crashes into the second World Trade Center tower and explodes. Both buildings are burning.
- 9:30 a.m.: Bush, speaking in Florida, says the country has suffered an “apparent terrorist attack.”
- 9:43 a.m.: An aircraft crashes into the Pentagon, sending up a huge plume of smoke. Evacuation begins immediately.
- 9:45 a.m.: The White House evacuates.
- 10:05 a.m.: The south tower of the World Trade Center collapses, plummeting into the streets below. A massive cloud of dust and debris forms and slowly drifts away from the building.
- 10:10 a.m.: A portion of the Pentagon collapses.
- 1:27 p.m.: A state of emergency is declared by the city of Washington.
- 1:30 p.m. The country wants answers.
First shock, then terror, followed by sorrow, and lastly rage. How could such an act be committed on American soil? This country asks this question in disbelief. The US demands answers and revenge for this act of evil. Who is to blame for the possible tens of thousands of deaths? The only way to answer this question is to look at the people that could do such an act and what possible reasons they would have for doing it.
This county as a hole looks over seas for answers, they look to a county called Afghanistan that harbors a terrorist called Osama bin Laden. Bin Laden, an Islamic fundamentalist and the son of a Saudi billionaire, has been on the FBI’s Ten Most Wanted Fugitive list since 1999, and the U.S. State Department has offered a $5 million reward for his arrest. Quoted from www.cnn.com. Most U.S. prosecutors say bin Laden is the leader of a group called al Qaeda, this is a network blamed for successful and failed terrorist strikes on the U.S. Some are the millennium-bombing plot, last year’s attack on the USS Cole, in Yemen killing 17 U.S. sailors and wounding 39, and the nearly simultaneous bombings of the U.S. embassies in Tanzania and Kenya. Bin Laden, a Muslim believes that he is fighting a holy war in the name of his religion. Muslims are Followers of the Islam religion. They believe that Allah is the One True God.
Also they believe that Abraham, David, Moses Jesus and Muhammad’s are Prophets and that Jesus is not the true Son of God. Muhammad is believed to be the newest profit and has had the greatest effect on the Islam religion. Muhammads role as the last of the Prophets was to formalize and clarify the faith and to purify it by removing foreign ideas that had been added in error. Muhammad was visited in Mecca by the angel Gabriel. He developed the conviction that he had been ordained a Prophet and given the task of converting his countrymen from their pagan, polytheistic beliefs and what he regarded as moral decadence, idolatry, hedonism and materialism.
There are acts that Muslims perform in there religion. There is a chant that most devoted Muslims repeat at least daily. “There is no God but God and Muhammad is his Prophet”.Also part of the Muslim belief is to donate regularly to charity, a yearly 2.5% charity tax that goes to support Muslim beliefs. They should fast a month out of the year. And it is also believed that during a Muslims lifetime if economically and physically able, to make at least one pilgrimage to Mecca, the Muslims holly land. This dedication to religion and to there holy land is very strong and has been the reason for many wars. Mecca was taken by the Egyptians in the 13th century. In the 16th century control passed to Turkey. From 1517 the descendants of Muhammad through governed Mecca for the Turks. Then latter were driven from the city in 1916. In 1924 the British supported Husein ibn Ali. Who made Mecca the religious capital of Saudi Arabia. www.encarta.com. Under Husein jbn Ali leadership treaties were formed and led to the formation in 1945 of the Arab League. By leasing oil concessions in Saudi Arabia to British and American businessmen, the king became one of the richest men in the world. Needless to say Muslims were pissed that Holy land was being rented to the American and British. A new reason for war was formed over the holy land and with that came hate for the Americans and British.
The straw that broke the camels back for Muslims was the 1990 decision by Saudi Arabia to allow the U.S. to attack on Iraqi forces in Kuwait and Iraq. After the U.S. victory, the U.S. military decided to make their presence in those areas permanent. Laden said the ongoing U.S. military presence in Saudi Arabia is an “occupation of the land of the holy places.” To bin Laden this was a start of a holy crusade. In 1996, bin Laden issued a statement to all Muslims urging them to kill U.S. troops in Saudi Arabia and Somalia. A second order in 1998 called for attacks on American civilians.
This started the rain of terror. A car bomb in spring 1995 in Riyadh was the first major anti-American action in the British kingdom. Bin Laden never claimed responsibility, but the Saudi government tried to link the incident to bin Laden by showing video confessions of four “Arab Afghans” involved in the bombing.
June 1996, after his arrival in Afghanistan was the Khobar bombing. Nobody claimed responsibility, but sources from inside the Saudi ministry of interior confirmed involvement of Arab Afghans, with possible link to bin Laden. Bin Laden himself never claimed responsibility but gave many hints that he might have been involved. The Saudi government has acknowledged recently that bin Laden’s men were behind the bombing. www.cnn.comIn April 1998 Laden held a press conference in Khost and warned of impending attack in few weeks time. The bombings in Kenya and Tanzania July 1998 were not a big surprise. Despite his declaration of war against America anywhere, the attack was expected inside Saudi Arabia. Needless to say most believe that he was involved.
These are but a few attacks that have been committed angst the US, not to mention the countless attacks that have occurred in other countries. Osama bin Laden and the countries that allow him to reside there must be punished no matter what the costs. These attacks along with the recent Trade tower bombing are acts of war on the idea of freedom. The loss of human life is something that will stay with this country for as long as it remains a country. Images burned into the minds of todays youth will stay with them for all of there days. This act is an attempt to tear our country apart but has only made us come together and become stronger. We must as a country obtain revenge for this attack on democracy. Afghanistan and what other countries support the terrorist acts of bin Laden must be punished for these crimes angst humanity. The coming months are going to be hard on everyone. We are all ready at war, at war with terrorism. And it fills me with such rage to see cowards commit such acts. I feel sorry that people view their religious beliefs in such hateful manners and try to force their views on others.
I also feel sorry for non-hateful Muslims in this country. There have all ready been attacks and killings on innocent Muslims. To some degree I have a hate in my heart for Muslims as well, but I must remember that not all Muslims view their religion the same way that Bin Laden does. To take the extreme acts of one and place it on a group of people is wrong and is also un-American. This country was founded on something better than that. It was formed on the idea that we should accept people for who they, the individual and not the color of there skin.
We fell we must cast blame and we have more anger than we feel we can vent. But in the coming months we will find the perpetrators of this ungodly act and they will be punished. We should not take out our anger on the innocent, because that makes us no better than terrorist. All we can do is express our views and pray because god knows what is going to happen in the next coming months. I know this is a view many people take during a time of uncertainty and it could very well be an over reaction. But I just really feel this is going to be huge.
I guess we will know in the next 72 hours what is going to happen. In 72 hours if Afghanistan does not hand over Bin Laden they are going to be screwed royally. The one huge fear I have is Iraq getting involved in this and if that happens god know where this can go. Iraq is not really that powerful but depending how strong its current link with China is there could be some really bad alliances there. This could very well be the start of something very big. Thank you for giving this report I have been sitting in the computer lab for the past 3 hours typing and I think it has really helped me vent.
Childs Abuse And Nursing
Nurses who regularly see children in their practice are currently treating victims of child abuse, including sexual abuse and neglect, whether they know it or not. The causes of child abuse and neglect are complex and varied, and occur in all types of families and settings. Nurses must always remain alert to the possibility that abuse may be occurring in any family, regardless of their socioeconomic status. Nationally, in 1993, averages of 42.9 children per 1,000 were reported to authorities as victims of alleged abuse or neglect.
A 1995 Gallop Poll of 1,000 parents yielded the estimate that 3 million U.S. children were victims of physical abuse by their parents, or about 44 per 1,000 children (The future of children, 1998). Child characteristics may include, the child was prematurely born, the child has disabilities, either mentally or physically, the child exhibits certain behaviors of infancy and childhood, such as persistent crying, the child is chronically ill, and the child has already been victimized. Family characteristics may include, there is other violence in the home, substances, including alcohol, are abused by the parents or caretakers, the parents of caretakers lack necessary maturity, skills or knowledge to care for the child, parental expectations are inconsistent with the childs developmental abilities, the caretaker is socially isolated, the family is experiencing high levels of stress from events such as loss of a job, increased financial burdens, serious illness, death in the family, separation or divorce, adult members of the family have themselves been abused as children (Ohio State Medical Association, 1992).
Definitions of the major forms of maltreatment are as follows: Physical Abuse- An act of commission by a caregiver that results or is likely to result in physical harm, including death of a child. Examples of physical abuse acts include kicking, biting, shaking, stabbing, or punching of a child. Sexual Abuse- An act of commission, including intrusion or penetration, molestation with genital contact, or other forms of sexual acts in which children are used to provide sexual gratification for the perpetrator. This type of abuse also includes acts such as sexual exploitation and child pornography. Neglect- An act of omission by a parent or caretaker that involves refusal or delay in providing health care, failure to provide basic needs such as food, shelter, clothing, affection, and attention, inadequate supervision or abandonment. Emotional Abuse- An act of commission or omission that includes rejecting, isolating, terrorizing, ignoring, or corrupting a child. Examples are confinement, verbal abuse, withholding sleep, food, or shelter, exposing a child to domestic violence, and other inattentions that result in harm or potential harm to a child (The future of children, 1998).
Under section 2151.421 of the Ohio Revised Code, nurses, as well as many other health professionals, are required to report incidents of suspected abuse or neglect of a child to the Public Children Services Agency, the County Department of Human Services exercising the children services function, or to a municipal or county peace officer. Failure to report can result in a fourth-degree misdemeanor punishable by 30 days in jail or a $250 fine. If found guilty of a fourth-degree misdemeanor, the nurse may lose their nursing license.
The report can be made by telephone or in person, although the requesting agency may request a written report.
The nurse should report any child under 18 years of age, or any physically or mentally handicapped child under 21, who you have the reason to believe has suffered any wound, injury, disability, or condition of such nature as to indicate abuse or neglect. It is important to note that you need only suspect that abuse or neglect is occurring; physical proof or other forms of validation are not required. It is up to the children service agency to further investigate whether abuse or neglect has occurred.
In obtaining data in suspected abuse or neglect, the nurse must conduct a thorough health assessment including a history and physical exam as well as a developmental assessment. The nurse should assess the childs immediate medical needs, obtain the past medical and social history of the child and family members, assess the credibility of the history being provided in light of any pre-existing medical conditions, determine the level of risk to the child if he/she returns home. The following physical findings may be indicative of physical abuse: Bruises and welts, which form regular or symmetrical patterns, will resemble the shape of the article used to inflict the injury. Burns- cigarette, immersions burns, or patterned burns resembling an electrical appliance. Lacerations or abrasions- rope burns, palate, mouth, and external genitalia. Fractures- skull, ribs, or long bones. Abdominal Injuries- Bruises, hematomas, intestinal perforations, ruptured liver or spleen, ruptured blood vessels, kidney or bladder injury, pancreatic injury. Central Nervous System Injuries- Subdural hematoma, retinal hemorrhage, subarachnoid hemorrhage, cerebral infarction secondary to cerebral edema. Other injuries or signs- Munchausen syndrome by proxy, symptoms of suffocation, or chemical abuse.
Findings of neglect may include: Lack of appropriate well-child care, lack of appropriate medical care of chronic illnesses, absence of necessary health aides, such as glasses, absence of appropriate dental care, undernutrition, poor hygiene, developmental delay, untreated medical conditions, and rampant dental caries. Behavioral findings may include: Depression, anxiety, enuresis, excessive masturbation, impaired interpersonal relations, discipline problems, poor school performance, role reversal in which child assumes caretaker role, or excessive household duties including child care (Ohio State Medical Association, 1992).
Because children who are sexually abused are commonly manipulated into secrecy, nurses must remain alert to the possibility of abuse, even when the child says nothing or says that he/she has never been hurt. When the child gives a history of sexual abuse, the information must be received in a sensitive manner and must be taken seriously. An evaluation is mandatory. If the nurse/physician is unable to provide these services, a referral must be made immediately. Time loss can result in danger to the child or lack of evidence in prosecution of the perpetrator (Ohio State Medical Association, 1992).
Behavioral sign and symptoms which may be exhibited in a sexually abused child may include: Extremes of activity, poor self-esteem, poor relationships, express general feelings of shame or guilt, display a distorted self-image, regressive behavior, enuresis, appear frightened of adults, pseudomature behaviors, exhibit a deterioration in academic performance, have an eating disorder, display sexually provocative behavior, sexually abuse a sibling, friend, or younger child, become sexually promiscuous, become pregnant, run away, attempt suicide, specific signs are: rectal or genital pain or bleeding, sexually transmitted diseases in prepubertal children, sexually precocious behavior(Ohio State Medical Association, 1992).
If court evidence becomes necessary, well-documented medical records may eliminate or reduce the time a nurse may be required to spend in judicial proceedings. Medical records provide the most concrete and sometimes only evidence of abuse of a child. The records should be kept in a precise, professional manner and should include: A standard, thorough, pediatric health assessment, direct quotations verbatim, statements made by the child and caretaker, observed behavior, the location of the alleged abusive events, a detailed description of the injuries, results of all pertinent lab and other diagnostic procedures, photographs and imaging studies. For medical records to be admissible in court, the nurse must be prepared to testify: That the records were made during the regular course of business at the time of examination, that the records were made in accordance with routinely followed procedures, and about the care, custody and access of records (Ohio State Medical Association, 1992)The local reporting agencies for Gallia County include: PCSA Gallia County Courthouse, 740-446-4612 and CDHS/CSEA Third Avenue, 740-446-3222, ext. 11.
Although we have came a long way in acknowledging that child abuse existed and in identification and reporting, nurses certainly have a long way to go in order to become the no-tolerance for child mistreatment advocates that we need to be.
Bibliography:
- Ohio State Medical Association(1992). Ohio Physicians Child Abuse Prevention Project. The Future of Children- Protecting children from abuse(1998). R. E. Behrman, M.D.
Relationship Between Calcium Phosphate And Carious Lesions
At the start of my paper, I held particular ideas about the act of carrying.
Despite fluoride being widely recognized for its effectiveness in preventing tooth decay, there is a limited amount of research and information about the correlation between dental caries and calcium phosphate. Given my knowledge of enamel remineralization, I opted to investigate how calcium phosphate can contribute to cavity prevention through this process. The search for pertinent resources regarding this subject proved to be difficult; however, throughout my inquiry, I encountered several products that contain calcium phosphate and assert their ability to attain the desired outcome.
Carious lesions develop gradually, taking anywhere from six months to two years. The process of dental caries is constantly changing and includes cycles of demineralization and remineralization (Harris and Garcia-Godoy 45). Enamel is made up of tightly packed hydroxyapatite crystals that contain tricalcium phosphate. Demineralization results in the depletion of tricalcium phosphate.
When a certain amount of this mineral is depleted, it leads to the formation of a cavity due to the collapse of the tooth structure. Remineralization refers to depositing the lost ions back into an area that has experienced demineralization. The first stage involves a specialized acquired pellicle which acts as fly paper by capturing bacteria. As bacteria build up, it forms plaque. This bacterial plaque then generates acids that can ultimately result in enamel structure collapse (Winston 1580).
To achieve remineralization, it is necessary to replace the lost calcium and phosphate during demineralization. Calcium and phosphate are naturally present in saliva (Winston 1580). The concentration of these minerals in saliva can vary among individuals. It has been discovered that men generally have a higher level of salivary calcium compared to women (Sewon 917).
Among the various factors, a significant contributor to elevated salivary calcium is its abundance. A greater presence of calcium in the saliva facilitates a rapid process of remineralization after initial demineralization. A study found that individuals, particularly males, with high levels of salivary calcium had a lower occurrence of decayed, missing, or filled teeth. However, excessive mineral content in the saliva can also lead to drawbacks such as increased bleeding on probing due to heightened plaque accumulation.
Studies have shown that plaque with high levels of calcium hardens rapidly, forming calculus that has properties making it more prone to retaining plaque. This occurrence has been associated with a higher occurrence of periodontitis in males compared to females. The accumulation of calculus is a contributing factor to the onset of gum disease. Additionally, research indicates that an elevated concentration of calcium in saliva is positively linked to gingivitis, which could potentially advance into periodontitis. However, it is important to note that a high level of salivary calcium is also connected to enhanced dental health.
According to Sewon (918), there are individuals who may have fewer tooth decay issues. However, there are certain people who may have insufficient salivary production and minerals. These individuals include those who suffer from reduced salivation, commonly known as xerostomia, as well as those who undergo head and neck radiation treatment, use specific medications, or have certain diseases. Their compromised salivary function puts them at a higher risk for dental caries development because they lack saliva’s buffering properties and its ability to aid in enamel remineralization (Winston 1581).
Research conducted by Shen (2069) examined a sugar-free gum that contains Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP), specifically assessing its ability to aid in remineralization. The use of amorphous calcium phosphate, as opposed to calcium phosphate, was preferred due to its greater solubility (Winston 1583). The study demonstrated that CPP-ACP contributes to enhanced remineralization, and the mere act of chewing the gum promotes increased salivary flow within the mouth.
Our added ingredient, CPP-ACP, is crucial. When saliva and CPP-ACP are combined, they soak the teeth for 20 minutes per session. The outcome was remarkable, with a much higher level of remineralization compared to individuals who didn’t chew this gum.
Chewing any type of gum, including different flavors, can still provide beneficial effects. It is common knowledge that saliva has buffering properties and chewing gum enhances saliva production. However, it should be noted that gum containing sugar can promote the growth of dental plaque, which is a potential drawback.
In reference to bacterial plaque, Shen (2069) asserts that it possesses the ability to generate acids that can be detrimental to enamel. However, if calcium and phosphate were incorporated into toothpaste formulations, what would be the outcome? Generally speaking, toothpastes primarily contain sodium fluoride as their primary ingredient, accompanied by other components intended for aesthetic purposes such as teeth whitening. The concern over the whiteness of one’s teeth may not be a significant issue unless they have numerous fillings. It is worth mentioning that the whitening agents present in toothpastes are abrasive and have the potential to further demineralize enamel, particularly among individuals who have recently undergone orthodontic treatment.
Colgate Total and Enamelon are two different toothpastes with distinct ingredients. Colgate Total contains sodium fluoride and triclosan, known for its powerful antibacterial properties. On the other hand, Enamelon consists of amorphous calcium phosphate along with sodium fluoride.
A study was conducted on “caries-free molars” over a period of 14 days. These teeth were intentionally treated with acid to create carious lesions and then subjected to treatment using both Colgate Total and Enamelon toothpastes mentioned earlier. The levels of remineralization were measured after the treatments.
The results showed that both toothpastes, one containing fluoride and the other containing calcium phosphate and fluoride, demonstrated a reduction in lesion depth ranging from 30 to 42 percent (Hicks 22).
Hicks (25) discovered that both dentifrices were successful in remineralizing the lesion. However, the dentifrice containing calcium phosphate and fluoride exhibited better outcomes in decreasing the depth of the lesion. It is vital to prioritize caries prevention and educate parents about effective preventive measures and supplemental substances for regular home care. Frequently, pediatricians fail to inform mothers about the importance of avoiding putting babies to bed with bottles; instead, they merely inquire if it is being done.
Although many mothers may not openly acknowledge their awareness, I assure you that if they truly comprehended the reasons behind it, they would never try to do it again. Teenagers who wear braces necessitate a fluoride rinse and may even need a toothpaste with a higher level of fluoride prescribed to them. It is highly recommended to use a toothpaste that combines calcium phosphate and fluoride as it possesses the capability to restore minerals in teeth.
Regrettably, the Enamelon dentifrice brand, which contained these beneficial minerals, ceased operations. This poses a challenge for it to rival Crest and Colgate, both of which cater solely to the cosmetic preferences of their customers. Essentially, the issue lies in the necessity of educating consumers.