Teen Stress Essay Example | Topics and Well Written Essays - 1000 words

Teen Stress - Essay Example Learning the stress management techniques helps teenagers to handle stress and minimize the negative effect of the difficult or painful experiences. Teenage stress must not be ignored by adults, especially parents, because if left untreated, it can result in the serious problems such as mental disorder and de-socialization. The events that cause stress are called stressors and the stressful event can be anything starting with the fear, peer pressure, passing the exam, divorce of the parents and death of the relative or the friend. Teens have the psychological predisposition to perceive the situations more dangerous than they are in reality (Sluke 11). Most of the situations causing teen stress are not problems in the eyes of the adults. For example, the failure to become the cheer leader in the school team can be a huge stress for the teenager, while the adults would not consider it to be the failure at all. This is one of the causes why teen stress is often not treated seriously by the adults and teens have to cope with their inner pain on their own even if they have no resources to cope with it. Some sources of the teen stress include but not limited to the school frustration, negative self-perception, body changes, misunderstandings with friends, separation of the parents, changing schools, setting too high expectations, and financial problems in the family If teenagers become overloaded with stress and do not receive the outside help or support, they are at risk of developing anxiety, social withdrawal and even physical illness. Stress impacts the teen’s health – faster heart rate, increased muscle pressure and upset stomach (Sluke 39). The similar changes occur when the teen feels relieved from stress. Teen who learn to relax emotionally using stress coping techniques are less helpful and are able to respond to stressful situations. When the teen

The Theory of the Invisible Hand Essay Example | Topics and Well Written Essays - 4500 words

The Theory of the Invisible Hand - Essay Example The above theory is further explained as a condition by which an individual in a society will toil enough to put his capital in the domestic industry so as to encourage its produce for getting a better value, and by doing this, the individual is trying to put in his labor, unknowingly or indirectly, towards bringing in a larger revenue to the society as a whole. In this sort of constructive endeavors the individual actually does not intend to promote the public interest at all, and also does not know to what extent he is promoting it. This unintended promotion bestowed on the society will naturally be more than the actual worth if the individual has really intended it. The theory of the Invisible Hand affirms that if a consumer is given the chance to select freely, that is, at his own will without any external coercion or persuasion, from the several options or products before him, then each producer responsible for the options or products will get the total freedom to choose what to sell or what to produce and how to produce it. This will allow the intended market to settle upon a very convenient product distribution and pricing system so that it will benefit all the members of the society. The reason for deriving such an outcome is vested in the truth that the greed and self interest of an individual will force the attributes to transform into a state of collective and gainful qualities benefiting the society. In economics related to industrial organizations, this theory is applied in the viable and effective production methods in order to maximize the profits. Pricing of products will be fixed to the minimum to compete with the rivals. For getting the required profits the investors will put more money in industries which are considered to be the neediest to people or the target group instead of investing in less profitable industries. According to Adam Smith, "It is not from the benevolence of the butcher, the brewer or the baker, that we expect our dinner, but from their regard to their own self interest. We address ourselves, not to their humanity but to their self-love, and never talk to them of our own necessities but of their advantages." (Smith, Adam. Wealth of Nations, http://www.econlib.org/LIBRARY/ Smith/smWN1.html#B.I%2C%20Ch. 2%2C%20Of%20the%20Principle%20which%20gives%20Occasion%20to%20the%20Division%20of%20Labour%2C%20benevolence. Retrieved on 25th April, 2009) Thus, the Invisible Hand theory acts as a balancing mechanism in its entirety in the field of customer oriented production and its strategic marketing and in the matter of building customer relationships so as to increase the gains of the entrepreneurs. In this respect it cannot be construed that these entrepreneur's actions are fully motivated to benefit the interests of the society, but it is focused on himself and his kith and kin, and in reality, the net result of its application is nothing but the exploitation of the common people who are in dire wants of necessities and amenities in their struggle to survive in this world. Explanations of "Invisible Hand" in Society by different authors: Every individual...generally, indeed, neither intends to promote the public interest, nor knows how much he is promoting it. By preferring the support of domestic to that of foreign industry he intends only his own security; and by directing that industry in such a manner as its produce may be of the greatest value, he intends only h

Human Resource Management 1 Research Paper Example | Topics and Well Written Essays - 1500 words

Human Resource Management 1 - Research Paper Example In the following paragraph we are going to discuss about all the six features of a multicultural organization – Pluralism  refers to the mixed group of members in an organization and it also means taking proper measures to involve all the employees entirely that are different in terms of the central group dominating the organization. The concept of pluralism should take into account all the factors relating to race, religion, language, ethnicity, gender and culture which proves to be the basic component of a person’s identity and hence are sensitive facets of a person’s life. Pluralism is a part of the acculturation process. Acculturation helps to a great extent to introduce the concept of pluralism among the employees. Acculturation is the means by which the cultural disparity between the host/dominant cultural group and a minority cultural group are treated or resolved. There are a number of options for practicing acculturation within the organization, among which the most well-known being: 1. An unilateral procedure by which members of the minority culture take on the values and norms of the principal group within the workplace (this is called assimilation); 2. A course of action by which both majority and minority members of different cultural backgrounds accept some customs and rules of the other group (this is known as pluralism); 3. A state of affairs where there is modest scope of variation from each of the culturally different groups (this situation is referred to as cultural separatism). Pluralism further refers to the means of encouraging the minority culture groups are to enact the practices from the other cultural groups as well as from the dominant cultural group. They are as a result capable of retaining a sense of individuality within their minority cultural group. The concept of acculturation on the other hand is related to the cultural (customs and attitudes) characteristic of amalgamation of the diverse teams, as contra sting to simply make themselves physically available in the same setting (Buenker & Ratner, 2005, pp.18-20). Full structural integration:  An organization generally comprises of people from various backgrounds and different locations. When the firm has minority team members offering their service at every organizational level like responsibly handling all functions and enthusiastically taking part in all work teams, then it is said that the firm has attained full structural integration. Though, in order to obtain an appropriate knowledge of the structural integration framework it is significant to look further than the organization oriented summary data, and study the cultural blend in terms of function, individual work team and the level of work done. This involves dealing out with educational specializations and the variations in expertise and treating those evenly all through the organization. Full integration of informal networks:  integration in informal networks in a multi cultural organization is fostered through supervising and mentoring programs, particular social occasions and sustaining the cultural groups for the minorities. Such firm

UK supermarket sector is an oligopoly Essay Example | Topics and Well Written Essays - 2750 words

UK supermarket sector is an oligopoly - Essay Example The entire functioning in the supermarket is looked after by the Commission. Although the commission tries to disrupt the impacts of oligopoly, there is evidence that there is prevalence of oligopoly in the UK supermarket sector. This is because the supermarket sector in the UK is predominantly operated by a few firms, i.e. Tesco, Sainsbury’s and ASDA. The rapidity of the deliberation with regards to oligopolies concern has gained acceleration during the past five years. The supermarket sector in the UK falls under the category of grocery market that had accounted for a total market share worth  £146.3 billion in the year 2008. Supermarket sector is the largest sector among all other sectors under the grocery market in the UK and it accounted for a total of 73 percent of the sales in grocery market. In the UK grocery market, the three biggest chains are Tesco, ASDA and Sainsbury’s that accounted for a share of 67.9 percent (Li, 2008). In this research paper, the UK supermarket sector will be analysed with reference to the performance of the three giants in the market. The belief that the supermarket in the UK is dominated by oligopoly will be critically evaluated in this research paper. ... The most important characteristics of an oligopoly market are existence of a few firms, high barriers to entry or stiff competition and earning of high or above-normal profit. 2.1 Firms in the UK Supermarket It has already been mentioned earlier that the UK supermarket’s four biggest chains are the Tesco, ASDA, Sainsbury’s and Morrisons. The share of these chains in total accounts to 67.9% of the grocery market. This data explains that more than half of the market share belongs to these chains and thus resembles the scenario of an oligopoly market. The data about the operational efficiencies of the three topmost chains will support the fact that the UK supermarket sector is an oligopoly. 2.1.1 Market Share and Performance of Tesco in the UK Market Tesco is the third largest retailer in the world and is the topmost in the UK; and at present it is observing a steady recovery in the consumer market segment in the UK. The expectation is supported by the sales figure during the period September-November, 2010. The market share of Tesco had grown up to 30.7 percent during the year 2010. According to the article published in Bloomberg Business week, the sales that boosted up during the period of Christmas last year had been initiated by the shift in the preference of consumers to products with better quality. The performance of Tesco in the UK market provides evidences of dominance in the supermarket sector (Shannon, 2010). 2.1.2 Market Share and Performance of ASDA in the UK Market ASDA, with a market share of 16.8 percent is the second largest operator in the UK supermarket sector. Although its performance level declined as it faced competition from its rival

Existentialism in Literature Essay Example for Free

Existentialism in Literature Essay Existentialism in literature is a movement or tendency that emphasizes individual existence, freedom, and choice. While Existentialism was never an organized literary movement, the tenets of this philosophy have influenced many diverse writers around the world and readers can detect existential elements in their fiction. Americans writers like William Faulkner, Ernest Hemingway and John Steinbeck reveal existential elements in their writing. Perhaps the most prominent theme in existentialist writing is that of choice. Humanitys primary distinction, in the view of most existentialists, is the freedom to choose. Because we are free to choose our own paths, existentialists have argued, we must accept the risk and responsibility of following our commitments wherever they lead. American writers Henry David Thoreau and Ralph Waldo Emerson often wrote about these concepts. Existentialism is not dark. It is not depressing. Existentialism is about life. Existentialists believe in living—and in fighting for life. The politics of existentialist writers around the world varies widely, but each seeks the most individual freedom for people within a society. Despite encompassing this wide range of philosophical, religious, and political ideologies, the underlying concepts of existentialism are constant: ? Mankind has free will ? Life is a series of choices ? Few decisions are without any negative consequences ? Some events and occurrences are irrational or absurd, without explanation. ? If one makes a decision, he or she must follow through. So existentialism, broadly defined, is a set of philosophical systems concerned with free will, choice, and personal responsibility. Because we make choices based on our experiences, beliefs, and biases, those choices are unique to us—and made without an objective form of truth. There are no â€Å"universal† guidelines for most decisions, existentialists believe. Even trusting science is often a â€Å"leap of faith. † The existentialists conclude that human choice is subjective, because individuals finally must make their own choices without help from such external standards as laws, ethical rules, or traditions. Because individuals make their own choices, they are free; but because they freely choose, they are completely responsible for their choices. The existentialists emphasize that freedom is necessarily accompanied by responsibility. Furthermore, since individuals are forced to choose for themselves, they have their freedom—and therefore their responsibility—thrust upon them. They are â€Å"condemned to be free. † Many existentialist writers stress the importance of passionate individual action in deciding questions of both personal morality and truth. Personal experience and acting on ones own convictions are essential in arriving at the truth. 17th-century French philosopher and existentialist Blaise Pascal saw human existence in terms of paradoxes. He believed that â€Å"We know truth, not only by reason, but also by the heart. † And as many existentialists, he acknowledges that â€Å"It is the fight alone that pleases us, not the victory. † The modern adage that the journey is more important than the final destination applies to this idea. Danish philosopher Soren Kierkegaard, who was the first writer to call himself existential, reacted against traditional thoughts by insisting that the highest good for the individual is to find his or her own unique vocation. As he wrote in his journal, â€Å"I must find a truth that is true for me . . . the idea for which I can live or die. † Existentialists have argued that no objective, rational basis can be found for moral decisions. The 19th-century German philosopher, Friedrich Nietzsche contended that the individual using free will must decide which situations are to count as moral situations. He believed that â€Å"There are no facts, only interpretations. † . . . and he is famous for this well known adage:â€Å"That which does not kill me, makes me stronger. † The 19th-century Russian novelist Fyodor Dostoyevsky is probably the most well-known existentialist literary figure. In his book Notes from the Underground the alienated anti-hero questions experiences in life that are unpredictable and sometimes self-destructive. French writer, Jean Paul Sartre wrote that man can will nothing unless he has first understood that he must count on no one but himself; that he is alone, abandoned on earth in the midst of his infinite responsibilities, without help, with no other aim than the one he sets himself, with no other destiny than the one he forges for himself on this earth. There is no ultimate meaning or purpose inherent in human life; in this sense life is absurd. We are forlorn, abandoned in the world to look after ourselves completely. The only foundation for values is human freedom, and that there can be no external or objective justification for the values anyone chooses to adopt. † When the Swedish Academy granted the Nobel Prize in Literature to Sartre for his work which, they recognized as â€Å"rich in ideas and filled with the spirit of freedom and the quest for truth, [that] has exerted a far-reaching influence on our age,† Sartre made it known that he did not wish to accept the prize. In a public announcement, in1964, Sartre expressed his regret that his refusal of the prize had given rise to a scandal, and he wished it to be known that his refusal was not meant to slight the Swedish Academy but was rather based on personal and objective reasons. Sartre pointed out that due to his conception of the writers task he had always declined official honors so this act was not unprecedented. He had similarly refused other awards offered to him. He stated that a writers acceptance of such an honor would be to associate his personal commitments with the awarding institution, and that, above all, a writer should not allow himself to be turned into an institution.

Early Ages Essay Example for Free

Early Ages Essay The Middle Ages is a catchall phrase often used by historians alluding to the thousands of years between the fall of the Roman Empire and the period of discovery and reawakening. The term Middle Ages was coined during the period that followed it, which was the Renaissance (Roseinwein, 2008). Since people from the Renaissance period thought of themselves as â€Å"advanced and civilized,† they deemed the time between them and the earlier world as the â€Å"Middle Age† (2008). The term derived from the Latin medium, which means middle and aevium, referring to age (2008). The Early Middle Ages, which occurred from 5th – 8th centuries, was dominated by Christianity which eventually became the rationale for uniting Europe culturally and linguistically (Herrin, 2002, p. 609). It was also a period marked by distinctions of social classes- the noble, the peasants and the clergy, with peasants populating more (Kamien, 1998, p. 62). This was the reason by medieval society was often described as a period with lack of food supply, poor agriculture, and poor economic conditions (p. 612). As aforementioned, the Early Middle Ages brought forth the importance of religion, specifically that of the Roman Catholic Church. It was during this time when the Holy Roman Empire was established. . One outstanding work from this period and perhaps had the earliest record was medieval music, particularly the Gregorian chant. The Gregorian chant was the official music of the Roman Catholic Church (Kamien, 1998, p. 65). Although the Gregorian chant was named in honor of Pope Gregory I, it was said that the pope was in fact not its creator (p. 65). Historians accounted the existence of Gregorian account or what they believed was its evolution to psalm singing in Jewish synagogues in the first centuries after Christ (p. 65). However the case may be, Pope Gregory could still be held responsible for the popularity of the Gregorian chant. The Gregorian chant is actually a body of unaccompanied vocal music. It was meant to set the mood for certain religious services (Kamien, 1998, p. 65). Set in Latin, Gregorian chants swept the music of the Early Middle Ages. Gregorian chant is like no other music for has no meter nor regular rhythms (p. 65). However, it is this distinct characteristic that makes the Gregorian chant a somewhat free-flowing disposition. Listening to a Gregorian melody invokes serenity, as if disengaging the listener from any anxieties. It is considered monophonic since it is music for one line and is sung in unison. It is said that there are only few names of Gregorian chant composers. This is because composers did not think of themselves as composers but as conduits of the voice of God. One of the most known contributors of the Gregorian chant was Hildegard (p. 68). A nun, Hildegard composed O Successores (You Successors), a chant intended to give praise to the â€Å"holy confessors who are successors of Christ† (p. 68). In the period that followed the Middle Ages, the Renaissance, the predominant sound continued to be unaccompanied vocal music. However, the dawn of the Baroque period saw the musical style embracing the use of musical instruments like the harpsichord, violin and viola (Kamien, 1998, p. 104). Likewise, the melody has become wider instead of the narrow range that accompanied the Gregorian chant. While the Renaissance period still had Mass music, the Baroque period ushered in opera, sonata and concertos (pp. 100-115). Church music, especially the Lutheran service, was called a church cantata (p. 129). Whereas the Middle Ages was limited to the culture of the Church, the succeeding periods created new attitudes- that of showing that people have the capacity to create and shape their world instead of merely serving as conduits. The Gregorian chants, which was passed on by oral traditions, ebbed away slowly until a 1994 release of ‘Chant† by the Benedictine monks of Santo Domingo de Silos. This made Gregorian chant popular again due its similarity with New Age Music- smooth, uniform and non confrontational. The Early Middle Ages may have focused on sublime spirituality but the beauty of it has emanated throughout the centuries. Listen to a church hymn and feel how it has evolved from a simple, monophonic music to the finely crafted yet polyphonic texture of today. References Herrin, J. E. (2002). Early Middle Ages. In The new encyclopedia Britannica (Vol. 16, pp. 609-612) USA: Encyclopedia Britannica, Inc. Kamien, R. (1998). Music an appreciation 3rd ed. USA: McGraw-Hill. Rosenwein, B. (2008). Middle Ages. Retrieved February 5, 2009, from Microsoft Encarta Web site: http://encarta. msn. com/text_761578474___0/Middle_Ages. html

Joint Illnesses and Diseases: Causes and Treatments

Joint Illnesses and Diseases: Causes and Treatments Herniated Disc Herniated (slipped) disc happens when all or only a portion of an intervertebral disc is forced through the weak part of the disc thus exerting pressure to the adjacent nerves or spinal cord. Intrinsic degeneration of the intervertebral disc or extrinsic compression of the neural structures in the spinal canal can cause radicular pain. The loss of disc height, which can alter the mechanics of the axial skeleton, may result to disc degeneration. The said changes might produce in other structures such as the zygapophyseal (facet) joints and may result to spinal stenosis. Radicular pain is defined as pain radiating in the distribution of spinal nerve caused by the irritation of the dorsal root ganglion while discogenic pain is an axial pain originating in a degenerative disc. [39] [40] [41] [45] Considered to be a critical part of the load-bearing structures of the spinal column, the structural component of the invertebral disc make it capable of changing shape and absorbing shock thus allowing movement. The dysfunction of the intervertebral disc is brought about by multiple factors namely trauma, aging or the degenerative disorders of the spine. [46] The boundary between nucleus and annulus become less evident as a person ages, furthermore as a person grow older the nucleus of the intervertebral disc becomes less gel-like and more fibrotic. Trauma results from activities such as slipping, lifiting while in a flexed position, suppressing a sneeze or falling on the buttocks. Degeneration like in osteoarthritis or ankylosing spondylitis predisposes the misalignment of the vertebral column of the client. [46] A research on the mechanism of intervertebral disc pointed out several pathophysiologic processes. It includes the changes that occur in aging, loss of proteoglycan which is mentioned as the most significant biochemical change that occurs in disc degeneration. It is inferred that the loss of proteoglycan leads to loss of hydration. Another mechanism is the loss of collagen fiber. Unlike with the proteoglycan, the loss of collagen is not that evident. Furthermore, it is deduced that the biochemistry of disc degeneration do not just include increase fragmentation of collagen and proteoglycans but also it includes the increase fragmentation of fibronectin populations. The said mechanisms contribute to the functional changes of the intervertebral disc. [6] The cervical and lumbar portion of the vertebrae is commonly affected by the dysfunction because it is the most flexible areas of the spine where bending of the vertebral column and support of the mass are greatest. Around 90 to 95% of herniations in the lumbar vertebrae occur in L5 or L% to S1 regions respectively. With regards to the herniation at the cervical spine, the most often affected portion is C1 to C7 and C6 to C6. The protrusion usually happens posteriorly toward the intervertebral foramen where the annulus fibrosus is thin and poorly supported by the anterior or posterior ligaments. Pain is the first and the most usual symptom of herniated disc. The nerve roots namely L4, L5, S1, S2 and S3 give rise to back pain that radiates down back of the leg and over the sole of the foot. Major weakness is rare but slight weakness may occur. Also the most common sensory deficits are paresthesia and numbness, specifically of the leg and foot. There are instances also that knee and ankle reflex may also be absent or decreased. [46] Osteoarthritis Osteoarthritis is a disease in the joints that usually affects middle-age to elderly people. The disease is commonly referred as OA or as the wear and tear of the joints although it also involves the cartilage, joint lining, ligaments, and bone. Osteoarthritis is undoubtedly the most usual type of arthritis. [47] Almost 27 million Americans are living with osteoarthritis and almost 1 million people consults medical professional because osteoarthritis. [47] Perhaps, it is the most cause of disability and pain among elderly people. [48] [49] Among the risk factor in the development of osteoarthritis are old age and obesity, in fact in the United States it is concluded that by the year 2020, the prevalence of osteoarthritis is already 66 to 100%. [49] Epidemiologic data shows that age, gender and race interact in the development of osteoarthritis. Men is said to be affected at a younger age compare to women however the prevalence of women affected with osteoarthritis exceeded men by mi ddle age. [50] Heredity influences the occurrence of osteoarthritis. There is a lower prevalence of hip osteoarthritis among Chinese than Europeans, perhaps representing the influence of other factors such as occupation, obesity or heredity. White women will most likely experience hand osteoarthritis on the other hand knee osteoarthritis is more common on black women. [49] In addition, excess fat may have might have a direct metabolic effect on cartilage beyond the effects of excess joint stress; hence weight loss reduces the risk of developing knee arthritis. The disease is defined as a breakdown of joint cartilage brought about by mechanical strees or biochemical alteration, resulting to the failure of the bone underneath. Osteoarthritis used to affect various joints in the body which includes hip, knee, first metatarsal pharyngeal joint and, cervical and lumbosacral spine. [47] [48] With regard to hands, the base of the thumb and, the proximal and distal interphalangeal joints are most commonly affected. Osteoarthritis is a joint failure wherein all structures of the joint have undergone structural change which is pathological. [49] As mentioned earlier, osteoarthritis is popularly known as wear-and-tear arhthritis. Osteoarthritis undergoes substantial mechanical and composition change in the properties of cartilage. [48] The first structural change happens in the cartilage followed by the soft tissue. The progressive wear and tear of the cartage leads into thinning of the surface of the joint and bone ulceration. Later on, inflammation of the joint, increased in the blood flow and hypertrophy of subchondral bone will occur. Consequently, new cartilage and bone will be formed at joint margins resulting to osteophytosis or bone spurs which cause alteration in the shape and size of the bone. The primary manifestation of osteoarthritis is a long-standing pain in one or more joints that aggravate with weight bearing or joint use. There is also a presence of morning stiffness usually for 30 minutes and bone deformity (osteophyte) or enlargement of the joint. In some cases there are crepitation and effusion. [51] Spondylolisthesis Spondylolisthesis is a bone condition wherein a vertebral body in the spine slips out of the proper position onto the bone below it. It can be associated with spondylosis, infection, lumbosacral junction congenital anomalies, osteoporosis, trauma, tumor, degenerative spine or prior surgery. It is most common to women than men. The slippage of the vertebral body may be asymptomatic or may cause low back pain, hamstring tightness, nerve root injury which is more frequent in L5, or spinal stenosis. The tenderness of spondylolisthesis can be produced near the segment that has slipped forward. There might be a protrusion of the abdomen and shortened trunk because of the extreme forward displacement of L4 on L5. Surgery is usually recommended for patients who are not recovering through rest and physical therapy. [33] In children spondylolisthesis usually happens between the L5 and S1. It is sometimes because of a birth defect in the spine area or an acute injury in the portion of the spine. In adults, the most often reason behind the development of spondylolisthesis is the abnormal wearing off of the bones and cartilage such as in arthritis. Individuals playing sports such as gymnastics, football and weight lifting is at risk in developing the disease. [52] Anteroposterior and lateral plain radiographs of the lumbar spine should be obtained in patients complaining of back pain. The lateral view of plain radiograph is useful in identifying spondylolithesis for it can demonstrate the pars interarticularis. Pars interarticularis is the region of junction of the lamina and the pedicle. Incases wherein there is an absence of nerve involvement, computed tomography (CT) scanning of the lumbar spine provides necessary information with regards to spondylolithesis and its possible cause. CT myelography can give information regarding nerve impingement to patients with radiculopathy. Magnetic Resonance Imaging is advantageous for it protects the patient from being exposed to radiation while imaging is being done. Typically sagittal and axial planes are used. [52] Fibromyalgia Fibromyalgia is a poorly understood type of myofascial pain syndrome. Patients with fibromyalgia usually have severe muscle pain and tenderness having specific trigger points, easy fatigability and disturbances in sleep. People with fibromyalgia have â€Å"tender points† such as on neck, shoulders, hips, arms, legs and back. These areas hurt if pressure is exerted to them. In the United States, fibromyalgia has a prevalence rate of 3 to 5 % in females and 0.5 to 1.6% in males. Fibromyalgia is the second most common disease that experts in rheumatology encounter with 15% among those who are evaluated. It is also ascertained that around 8% of patients cared in primary care clinics have fibromyalgia. In 2005, the United State spend 10, 199 dollars per patient per year and it has been also estimated that overall, fibromyalgia costs the United State economy over 9 billion dollars every year. [53] With respect to gender, epidemiologic data reveals that fibromyalgia is more common to women than in men with a female-to-male ratio of around 9:1. Furthermore, it can occur to patients at any age of either sex. It can occur to pediatric patients, especially the adolescents. [54] The current understanding about fibromyalgia is that it is a disorder of central pain processing or a syndrome of central sensitivity. It is described as a problem with pain threshold. Researchers suggests that patients with fibromyalgia have a lower threshold to pain and other stimuli namely noise, heat and strong odor. It is also believed that neurobiologic changes causes hypersensitivity of patients. These neurobiologic changes are related to psychological factors in that this change affects the person’s perception to pain, expectancy or vigilance. Disturbed sleep has been linked to the pathogenesis of fibromyalgia. Studies have ascertained that awakening unfreshed or nonrestorative sleep has been observed in most of the patients with fibromyalgia. Sleep electroencephalographic studies have shown disruption of normal stage 4 of sleep (non-rapid eye movement). Deprivation in stage 4 sleep has a role in causing fibromyalgia as supported by the observation that symptoms of fibromyalgia developed to normal individuals with disrupted sleep in stage 4. Decreased serotonin metabolites are seen in the cerebrospinal fluid of patients with fibromyalgia. Since serotonin is known to be a neurotransmitter that regulates NREM sleep and pain, it is believed that it might also be involved in the pathogenesis of fibromyalgia. Autonomic dysfunction is also suspected to be involved in the development of fibromyalgia. Individuals with the said disorder were observed to have low levels of cortisol. Low level of urinary free cortisol decreased respo nse to corticotrophin-releasing hormone suggest abnormal hypothalamic-pituitary-adrenal axis. There is also low level of growth hormones. Growth hormone is released during stage 4 or NREM sleep. Many patients have accompanying psychological abnormalities. Almost 30% of patients fit the diagnostic criteria of anxiety, depression, somatization and hypochodriasis. There is also high prevalence of physical and sexual abuse, and eating disorder. [55] The goal of treatment for patient with fibromyalgia is to relieve pain and other symptoms, and to help a person cope with the said symptoms. It includes: physical therapy, stress relief methods, exercise and fitness program, antidepressants, muscle relaxants and cognitive behavioral therapy. The Haunting Of Hill House | Analysis The Haunting Of Hill House | Analysis Eleanor life is characterized by numerous challenges that happen because of her mother. She has a difficult responsibility of taking care of her ailing mother without any help from the society. She leads a strange life blending with people that sees her outcast in the society as she has grown with the attitude that people hate them because they do not mix with them. She later learns that her mother defied the society norms, and that is the reason that the society abandoned her. Others believe that perhaps that is the reason that she is ailing. Even though, Eleanor is aware of the existence of the social norms, she never knew their significance because she was never into them. After she drives into the Hill House, at first, she is not certain about her identity in the society, and she thinks that in the Hill house, she might experience some difference. She enters the house and her life changes, she starts seeing things in a completely different way and after contemplating on her relationship with the society, and she has no option, but to become a witch. Her death is mysterious as other character restores their lives back. It is true that many critics and readers believe that, in the end, Hill House consumes Eleanor and she willingly allows this to happen. Hill House consumes Eleanor Eleanor mothers poor health deprived Eleanor more than just her precious moment. The main reason that Eleanor rides forth to the house is an event that happened when she was young that certainly integrated some kind of supernatural manifestations. Despite of the situation, Eleanor tells Dr. Montague afterward in the story that she cannot clearly recall her mother claimed that the neighbors never appreciated them, and that was the reason that she would never mix with them (Jackson 73). The reader learns that, Eleanor and her sister had supposed at the time that the other was responsible for the supernatural incident (Jackson 7). This incident although, Dr. Montague reassures Eleanor that the event is long forgotten, means the incident must have had a negative impact on Eleanors family and, certainly did not affect Eleanors personality (Jackson 74). She is still uncertain whether she will ever be accepted in the society after her mother defying the social norms. It is difficult to face the reality in order to fight the stigma from the society. However, that is the only way out if she has to survive in the society. From the start, Eleanor grew up with a mother who was against the societys norms. Perhaps the ailing mother suffered out of her ignorance to the societal norms, and Eleanor suffers because of her mother. The journey to the Hill House is move that Eleanor fails tom resist. At one point, he thinks it is the right call for her to make, considering her relationship with the society and at another point, he wrestles with that spirit that pushes her to accept the invitation into the house. It becomes almost impossible for her to make a decision. From the onset of the book, Eleanor is in a dilemma. Even though, there are some characters in the Hill House that accepts to be part of the Hill house that does not mean that Eleanor should be inclusive. As opposed to Eleanor, the four characters have weird characters and perhaps that is the reason they feel comfortable being part of the Hill House. For instance Luke, despite being an heir of the house, steals from his aunt. Theodora too, an artist by profession is a lesbian. Doctor Montague, although a scholar, has an interest in the occult. This shows that, even though it is difficult to accept these characters within the social culture, they are better off than Eleanor, who cannot face the society. To worsen the matter, Eleanor is homeless, and this secludes her from the rests of Jacksons characters. Theodora engages into a conflict in the Hill House, but she cannot return, she remains there. The house has already consumed her. In depicting a homestead setting far from the Hill House, Jackson reveals to the reader that Dr. Montague is a family man and in the later chapters, we see his wife cleaning dishes together with Mrs. Dudley in Hill House, and this shows a kind of familiarity. Similarly, Dudley and her family own a house in town (Jackson 39) which keeps them safe from the house during late night hours. Moreover, Luke Sanderson could say that he owned the house, but he never took care of it. Luke is an affluent man, and he could buy the house, but it is not clear why he does not have one. Instead of accepting her situation and predicaments in life, for instance, being homeless, Eleanor says that she has a home. She is aware of the social values, even though she has never been deep into them. Hill house is a strange house as depicted in the previous discussions. When Eleanor accepts to be consumed by the house, she turns out to be an outsider. The House consumes Eleanor, and it blends both her fear and attraction of the House. She is lured into mysterious place, and she becomes interstitial that her pas life when she enters the house. Eleanor fits neither with her friends, nor in the society, and she turns out to be outrageous. The society rejects her , she turns to be a fringe member, and she does not have an option, but to fit into the skin of a witch. The five characters in the house have their differences, but Eleanor believes that with time they will adopt tom each others behavior (Jackson 58). She anticipates that sooner they will be a friend, and Theodora, affectionately refers to her as a cousin. They lived in the house as one family and even shared meals together. However, some scholars look at this situation in a different perspective, for instance, Tricia Lootens, in Whose Hand I Was holding, says that the characters live together as one family. However, Lootens is not certain about the continuity of this group and she cites this as terror of [Jacksons] entire culture: the brutal, inexorable visionà ¢Ã¢â€š ¬Ã‚ ¦of nuclear families that kill what they are supposed to nurture (151). Even though, Lootens believes that the group has a hidden agenda of ruining each others life, I refute with her perception. The characters are in harmony with one another, and there is no sense or fear between them. Eleanor is the one who is undisputed and seems rejected and deserted. This is evidenced at the novel closes its chapters, whereby Theo, Luke, and Dr. Montague observe Eleanor and she distances herself from the Hill House. Jackson mentions about the death of Eleanor and the other characters going back to their normal lives. Novel Dental Materials for Root-end Applications: A Review Novel Dental Materials for Root-end Applications: A Review Abstract Achieving a good apical seal is crucial for ensuring successful endodontics; especially in cases that involve a wide apex (e.g. immature apices, apical resorption, and fracture involving the tooth apex). An efficient root-end material is an absolute requisite towards achieving this goal. The recent years have witnessed a decent outflow of new products for root-end applications. However, their merits, and claims of superiority over MTA, have to be ascertained via sustained research. Keywords: Apical seal, bioactive, MTA, novel root-end materials, review. Introduction The quest for an ideal material for root-end applications has produced a plethora of products that are based on different compositions and exhibit varied setting reactions. Though many of them have been proven to be effective, none of them can be described as ideal yet, thus generating scope for further development. MTA as the gold standard Since its introduction by Torabinejad in 1993, MTA has been extensively studied and used. Over the years, it has emerged as the time-tested and attested material. MTA is essentially Portland cement (Sio2, CaO, Al2O3, MgO, and Fe2O3), to which a radioopacifier (Bi2O3), and dehydrated(anhydrous) calcium sulphate have been added. MTA is biocompatible and osteogenic. It is bioactive: i.e. MTA is capable of interacting with living tissues and allows deposition of apatite crystals in the MTA-tissue interface. This material is capable of inducting hard tissue formation.1 Apart from exhibiting excellent sealing properties, it also has the capacity to set and also remain steady in the presence of moisture. Hence, a recent review has described it as ‘hydraulic silicate cement’.2 However, this material is not devoid of disadvantages. Re-entering MTA-treated teeth is difficult. High acidity and alkalinity (beyond a pH of 8.4) can unfavorably influence the surface hardness of set MTA. MTA is shown to expand uncontrollably.3 Grey MTA has been found to discolor tooth and the neighboring gingival tissues. Both grey and white MTA contain toxic substances and impurities. The material is fairly difficult to manipulate owing to its sandy consistency; though the small particle size of white MTA may aid in producing a thicker mix; hence, better workability.4 MTA exhibits low washout resistance during initial set especially when a setting accelerator is not incorporated into the MTA mixture. Its initial solubility is undesirable when used as a root-end filling material.5 In lieu of MTA’s potential drawbacks, the search for superior materials has resulted in the emergence of newer materials in the market; the majority of which, bear resemblance to MTA with minor alterations in their composition. Bioaggregate This novel water-based, hydraulic cement, consists of tricalcium silicate as its primary component. Tantalum oxide imparts radioopacity; hydroxyapatite and amorphous silicon oxide have been added to reduce the level of formation of the weak phase- calcium hydroxide.6 Purity is ensured via elimination of aluminum. Though the manufacturer states that trace amounts of naturally occurring contaminants may be detected during chemical analysis, the lack of detection of heavy metal contamination is noteworthy. The material is bioactive.7 Sayeed et al. suggested that Bioaggregate be considered as an alternative to MTA owing to the former’s better sealing ability. The authors attributed the hermetic seal associated with bioaggregate to: (1) Its nano-sized particles that exhibit excellent adhesion to the dentinal walls of the root canal, (2) Its hydrophilicity.The presence of a gel-like calcium silicate hydrate as the main component, resulted in improved strength, hardness, and sealing characteristics to the set material.8 Bioaggregate also exhibited excellent biocompatibility and induced periodontal regeneration.9 Biodentin Biodentine, marketed by Septodont is available as a powder and liquid formulation. Tricalcium silicate and dicalcium silicate form the core materials of the powder. Purity of calcium silicate is enhanced by eliminating the contaminants namely aluminates. Calcium carbonate and calcium oxide, and zirconium oxide have been added as the fillers and as the radioofacifier respectively. Liquid comprises of calcium chloride as the accelerator. Hydrosoluble polymer and water reducing agents are also present. Biodentine can be used as a root repair material but is not indicated for root amputation and hemisection. The working time is over 1 minute and the setting time ranges between 9 and 12 minutes. The final hardness of Biodentine approximates that of the dentin, thus rendering retreatment difficult if not impossible. 10 On performing cytotoxicity assay and cell growth on set materials, human gingival fibroblasts responded similarly to Biodentine and MTA extracts.11 EndoSequence Root Repair Material EndoSequence Root Repair Material (Brasseler USA) is based on bioceramic technology and is essentially composed of nanoparticles of tricalcium silicate, dicalcium silicate, calcium phosphate monobasic, amorphous silicon dioxide, and tantalum pentoxide.12 It differs from white MTA mainly in that it is aluminium free and contains calcium phosphate monobasic and tantalum pentoxide (radioopacifier).13 It is marketed as a pre-mixed formulation in two different consistencies: syringeable paste, and condensable putty. `The former has bendable tips to facilitate intra-canal material placement. 14 According to the manufacturer, the material exhibits superior handling properties owing to its pre-mixed formulations, short setting time (~2 hours), and high resistance to washout. The material is radiopaque, hydrophilic, and highly alkaline (+12 pH), thus bactericidal. Its setting reaction is initiated by dentinal moisture. 15 Endo sequence is bioactive. 16 Hirschberg et al. compared the sealing a bility of ERRM with MTA, and concluded that leakage was greater in samples restored with ERRM when compared to that of MTA-restored samples.17 In simulated root resorption defects, intracanal placement of white MTA resulted in greater and sustained release of hydroxyl ions, and thus a higher pH when compared to EndoSequence. This, the authors attributed to the quicker set of ES as compared with MTA. But, few MTA samples exhibited discoloration, while none of the ES samples did. This may be esthetically relevant.18 Top of Form Bottom of Form iRoot BP Plus These bioceramic materials are primarily composed of calcium silicate, and require the presence of moisture to set and harden. They also contain zirconium oxide, tantalum pentoxide, calcium phosphate monobasic, and filler agents They are available in three forms: (1) iRoot ® BP Plus putty root canal filling andrepair material- white hydraulic premixed puttyintended to be used for root canal repair and restorative applications, (2) iRoot ® BP Injectable Root Canal RepairFilling Material- white hydraulic premixed injectable paste intended to be used for root canal repair and restorative applications, and (3) iRoot ® SP Injectable Root Canal Sealer- injectable white hydraulic cement paste intended to be used for permanentroot canal filling and sealing applications. 19 According to the manufacturer, these materials are insoluble, radiopaque, aluminum-free, possess excellent physical properties, and do not contract on setting.20 iRoot ®BP Plus was biocompatible and did not elicit critical cytotoxic effect. However, its long-term performance was inferior as compared to White MTA.21 Another study observed that both materials i.e. iRoot BP Plus and iRoot FS exhibited negligible cytotoxicity. Under simulated clinical conditions, iRoot FS was able to completely solidify within an hour, whereas iRoot BP Plus set only after seven days.22 Ceramicrete Developed at Argonne National laboratory, Ceramicrete is essentially a chemically bonded phosphate ceramic (CBPC), which was developed to function as a binder for waste management. The material was inducted into dentistry owing to its inherent strength, biocompatibility, and bioactivity. Radioopacity is achieved by incorporation of radio opacifiers (bismuth oxide, cerium oxide). Wagh and Primus found Ceramicrete to be a strong material exhibiting lower porosity and permeability due to the formation of potassium-magnesium phosphate hexahydrate ceramic matrix phase. The decreased porosity also contributes to Ceramicrete’s superior sealing capacity.23 The use of an acid conditioner prior to application of ceramicrete may result in better adaption due to removal of smear layer, thus improving the seal. Incorporation of calcium silicate whiskers resulted in the formation of a brushite phase, which improves mechanical properties. Though, initially, the material tends to be acidic, set Ceremicrete-D is alkaline (pH of 11 after 72 hours). However, the acidic pH (2.2) of a fresh mix may exacerbate the acidic condition of an already inflamed tissue. 24 The low pH may be the reason why ceramicrete D caused initial death of primary osteoblasts and failed to support further cell growth, since low pH is shown to inhibit osteoblast activity. 25 The radioopacity of ceremicrete was substantially less (3.2mm of aluminium) than white MTA (8.5mm of aluminium). Handling properties and resistance to washout were superior. According to porter et al, Ceremicrete-D retained a weak chalk like consistency even after seven days of setting. They suggested the original formula be modified to effect increase in the strength of the material.26 Capasio Capasio (Primus Consulting, Bradenton, FL) is an experimental calcium-phospho-aluminosilicate–based cement that is mixed with a water based gel. Bismuth oxide has been added as a radiopacifier.27 When mixed, Capasio develops dough like consistency and can be rolled into a rope which enables better handling. Ceremicrete-D and Generex A also demonstrate this desirable property. Capasio displays good washout resistance, and improved physical characteristics such as setting time (9 minutes), compressive strength, and washout resistance.26 It exhibited slightly less basic pH (10.9) when compared with white MTA. 28 The radiopacity of Capasio was significantly less as compared to MTA but marginally greater than Ceremicrete-D.26 Capasio is also bioactive. It has the ability to precipitate apatite crystals on its surface. The smaller particle size of Capasio (a mean particle size of 5.3 µm as compared to 10 µm of MTA) may be perceived as an advantage. Materials that demonstrate the capability of penetrating dentinal tubules exhibit improved marginal adaptation, retention, and also entomb the residual bacteria. The material was shown to penetrate dentinal tubules up to a depth of 18-26  µm; much greater than that of MTA.29 Penetration of an endodontic material into the dentinal tubules results in improved marginal adaptation, increase mechanical retention, entombs residual bacteria and improved antibacterial effects owing to closer proximity of the material to the bacteria.30 Quick-set Capasio (Primus Consulting, Bradenton, FL) has been further developed and has been renamed as Quick-Set (Primus Consulting). The refinement has been performed via removal of the cationic surfactant from the liquid gel component, which was thought to affect its biocompatibility. Using murine dental papilla-derived odontoblast-like cell line (MDPC-23), Wei et al. observed that the in vitro cytotoxicity of Quick-Set was similar to that of WMTA.31 Ashraf et al. concluded that the in vitro osteogenic/dentinogenic differentiation potential of Quick-Set was favorable. 32 Generex A and B Generex A (Dentsply Tulsa Dental Specialities, Tulsa, Usa) and B are calcium-silicate-based materials with novel setting reactions. Generex A contains tricalcium silicate, dicalcium silicate, and tricalcium alumunate. Its composition is similar to that of MTA but for the fact that the powder is finer, and unique gels are used for mixing instead of water as is the case with MTA.25 Usage of the gel results in: improved handling characteristics and reduced setting time.26 Among the materials evaluated for their osteogenic potential (Generex A, Capasio, Ceramicrete, and MTA), only Generex A and MTA allowed primary osteoblast growth.25 In a study conducted by Porter et al, Generex A exhibited the shortest setting time (1.25 hrs) as compared to Capasio and Ceramicrete, which set in 2.5 hours. Generex A also emerged as the strongest among the other materials tested. 26 Endobinder Endobinder differs from MTA in that, MgO and CaO (cause undesirable expansion of the material), and Fe2O3 (causes tooth darkening) are eliminated from its composition. Al2O3 and CaCO3 are calcined at temperatures between 1315deg C and 1425d C, and are ground following which, Bismuth oxide is added to obtain radioopacity. Purity is ensured by eliminating traces of MgO, CaO, and Fe2O3.32, 33 Endobinder assisted early differentiation of a higher osteoblastic cell population in comparison to MTA. this, the authors attributed to the lower calcium hydroxide release from endobinder when compared with MTA.34 While slightly higher concentration of extracellular calcium can stimulate osteoblast cell viability, proliferation, differentiation, and function, an overload can be cytotoxic. 35 According to Oliveira et al., Endobinder exhibited better fluidity, improved handling properties, higher mechanical strength, and reduced porosity (with lower pore size) when compared with MTA.36 The material was biocompatible when tested in subcutaneous tissue of rats.37 Conclusion The past few years have witnessed the development of novel materials with a purpose of overcoming the disadvantages of MTA. Some are primarily composed of calcium silicate (Endobinder, Endosequence, Generex A and B, and iRoot BP Plus), some are primarily tricalciumsilicate-based (Bioaggregate, and Biodentine) or calcium-alumino-silicate based (Capasio and quickset), and one is a chemically bonded phosphate ceramic (Ceramicrete). The focus behind developing these materials has mainly been- improved physical and biological properties over the present gold standard i.e. MTA. While some of these novel materials have exhibited improved characteristics, more research in the form of in vivo and in vitro studies are required in this direction, in order to ascertain the same. Also, newer materials with a composition differing from that of MTA, may bring a fresh approach with regard to this application. 1