Law Enforcement Innovations in Reaction to The 9/11 Terrorist Attacks a

The terrorist attacks to the World Trade Center towers in New York City on September 11, 2001 has changed the way federal, state and local police departments communicate with each other, their structures, and operations. The new federal organization known as Homeland Security set out to coordinate their work at the state level, collect, analyze and share pertinent information and intelligence, protect key infrastructure and assets, secure the nation’s borders and ports, team up with federal and local task forces, and prepare new response training, equipment, systems and strategies (Foster and Cordner, 2005). The Federal Bureau of Investigation also shifted focus from addressing traditional crimes to preventing terrorist attacks. This is a change in strategy much like the change between the reform and community policing eras (National Research Council, 2004). It would be next to impossible for federal agencies to work directly with local agencies since there are around 18,000 local departments throughout the nation (Foster and Cordner, 2005). Occurrences such as these are the downfall of a decentralized police system, but 9/11 has created more cohesion through the federal, state and local agencies (National Research Council, 2004). This resulted from state agencies that were selected as a liaison between the federal and local law agencies to do business such as disseminating information, sharing resources and asking for assistance (Foster and Cordner, 2005). This centralization makes more levels of administration responsible for strategies and tactics (Kelling and Moore, 1988). State agencies saw a 75.4 percent increase in terrorism related intelligence gathering, analysis and dissemination, 61.3 percent increase in ... ..., 2008; Rush, 2008; Kelling and Moore, 1988). These systems fall into the category of community policing as these campus police departments engage the community in the prevention of crime (Walsh, 2001). 9/11 has placed terrorist prevention in the hands of the local law enforcement agencies and reorganized the systems of law enforcement throughout our country. School shootings such as the massacre at Virginia Tech have heightened the need for security measures that can reach people quickly and on a mass scale. Where we once thought we were safe, now large-scale acts of lawlessness have brought safety and security to the fore. These acts of violence have already changed the strategies of law enforcement. If these changes give any picture of the future strategies and tactics will become more centralized and the community will be engaged to a higher degree.

The role of government in fostering intermodal transport innovation

Freight transportation systems are very important all over the world and are considered to be very significant to the world for regional and local economies (Konings & H. Nijkamp, 2008). The author has explained that using 1994 gross national product numbers freight transportation made 6. 3 per cent of total expenditure (Knoning & H.Nijkamp, 2008).Freight transportation represents a percentage of total expenditures 38. 52 per cent of the total. Here in the United States freight transportation system has become very important of global network, which has increase capacity and demand for the needs of customers that are placed on freight services.There have been past studies and concerns about environmental and health issues, for these reasons, yes, I do agree with the author and that he did provide several reasons â€Å" to implement proactive policies to foster intermodal transport innovation and ultimately, enhance the competitive edge of the American economy, foster the role of fre ight transportation as an agent of economic development and efficiency of the freight system, and to reduce the negative environmental and health externalities, and congestion, produced by freight transportation activity† (Knoning & H.Nijkamp, 2008).The author also explained and shows that the absence of intermodal innovation initiatives in the United States and that the analysis may provide proof and insights into how to tackle the problem of defining, implementing intermodal innovation initiatives† (page, 304). It is very clear that that the author has also explains that â€Å"well-documented American case provides insights into how best to overcome the challenge associated with defining policies, programmes to foster intermodal innovation (page, 304).The analysis does provide supporting information that assess the role of the government. The United States is known to be a major the head of transportation research and innovation. The author explained that â€Å"it wa s not easy to identify a consistent or coherent focus on the systemic challenges of freight transportation† due to part of which could be found in the institutional diversity and durability of American transportation finance planning and operations.The twentieth century, research efforts by the government and universities and private industries has grown and so have diversity (page, 305). The major agency that identifies and sponsor or conduct freight transportation research in the United States that highlights their influence role. (1) National Science Foundation (NSF)-and expanding the partnership with USDOT, based on successful model of public-private research partnership in the semiconductor industry.(2) Federal Highway Administration (FHWA) largest best funded of USDOT, responsible for managing the Federal Aid Highway program. (3) Federal Railroad Administration (FRA) conducts research in the area of safety. Bur of Transportation Statistics (BTS) is the America’s p rimary repository of data on all aspects of mobility, and in cooperation with the US Census Bureau, BTS is conducts a Commodity Flow Survey (CFS) every five years.The Department of Transportation (DOT) supports and participates in applied transportation research aimed at for improving maintenance or enhancing their operations and funds freight research projects that is through local universities and the federally sponsored University Transportation Centers (UTCs), which are projects that focus on either specific operational issues or freight transportation modeling to support statewide planning efforts.National Cooperative Highway Research Program (NCHRP), administered by the Transportation Research Board under the guidance of the Standing Committee on Research of the American Association of State Highway and Transportation Officials (AASHTO). All can be found in additional locations for American transportation research, Metropolitan Planning Organizations (MPOs), by law focus on tr ansportation and land use issues in the United States urbanized areas, and diverse geography from across the MPO jurisdictions, which only some of them would identify freight movement.The Intermodal Surface Transportation Efficiency Act, supports exploration of the freight transportation opportunities has enabled intermodal planning and project development which is to become a central focus of the federal and state transportation agencies work according to the author on (pages, 308, 309). The author did show the main challenges of implementing a research programme that could stimulate intermodal innovations in freight transportation.The author stated that† the size and complexity of the American freight system poses a challenge that the implementation of freight research programme, which conflicting objectives of different freight modes are a reflection of competing with each other. The competition includes all modes and across the whole geography of the country† (page, 315).Singapore for example, the Netherlands, has a close association between the success or failure of a particular freight enterprise, meaning that the Port of Singapore and Port of Rotterdam and the economic development of the country, shows the importance of freight transportation and intermodal innovation which shows more cooperative working environment between the private industry and the government(page, 316).So in other words the planning horizons of the system’s operators, which are part of the private sector that keeps day-today operations of time horizons, short. This makes the public agencies responsible for planning, financing and implementing transportation projects. For as planning cycles is complex decision making and to implementing procedures is short term-within two years, medium terms two to five years, long term 10-20-50 year planning horizon.This planning horizon complicates the process by trying to define goals with transportation agencies and freight in dustry. When trying to advance the innovations from freight transportation research, disparity needs to take things into account, meaning that the research community and the freight industry should join and work together to consider freight issues for the nation’s economy. The freight industry leaders need to play a very critical role by raising the level of awareness with transportation research, education and training (page, 318).The analysis did show the focus on the American case conclusions, recommendation, and identified challenges that are related to an institutional setting and features that are related to the American freight transportation system, and related to the government agencies. There needs to be larger steps towards using research for intermodal transport innovation. The public and private policy people need to come together to engage to implement efforts for change.

Biochemical and hormonal changes in childhood obesity - Free Essay Example

Sample details Pages: 18 Words: 5308 Downloads: 8 Date added: 2017/06/26 Category Statistics Essay Tags: Childhood Essay Childhood Obesity Essay Obesity Essay Did you like this example? The prevalence of chronic or non communicable disease is escalating much more rapidly in developing countries than in industrialized countries. According to World Health Organization (WHO) estimates, by the 2020, non communicable diseases will account for approximately three quarter of all deaths in the developing countries (WHO. Global Strategy for non communicable disease prevention, 1997). Don’t waste time! Our writers will create an original "Biochemical and hormonal changes in childhood obesity" essay for you Create order In this regard, a potential emerging public health issue for the developing countries may be increasing incidence of childhood obesity with associated complications, which in turn is likely to create public health burden for poorer nations in the near future (Freedman et al, 2001). Lower to middle income nations face the double burden of having both malnourished and over nourished population, with most overweight and obese children being concentrated in urban areas. Rapid urbanization is associated with unhealthy lifestyle or New World Syndrome. In addition, in such communities, childhood obesity is still considered a sign of healthiness and high social class. There is no universal consensus on a cut off points for defining overweight and obesity in children and adolescents, usually, for clinical practice and epidemiological studies, child overweight and obesity are assessed by means of indicators based on weight and height measurements, such as weight for height measures or body mass index (weight (kg)/height (m2))(WHO. Report series no.847, 1995).The US Centers for Disease Control and Prevention (CDC) defines obese as being at or above 95th percentile of body mass index for age (Kuczmarsk RJ et al, 2000). History of obesity is both interesting and gives details of its progression. Obesity is an age-old health condition. Through out the history of obesity, its reputation varies from appreciation and opposite among cultures and in time. Ancient Egyptians are said to consider obesity as disease. Perhaps the most famous and earliest evidence of obesity is the Venus figurines, Statuettes of an obese female torso that probably had a major role in rituals. Ancient China has also been aware of obesity and dangers that come with it. They always were a believer of prevention as a key to longevity. The Aztecs believed that obesity was supernatural, an affliction of the gods. Hippocrates, the father of medicines was aware of sudden deaths being more common among obese men than lean ones as stated in his writings. In certain cultures and areas where food is scarce and poverty is prevalent, is viewed as symbol of wealth and social status. To date, an African tribe purposely plumps up a bride to pre pare her for child bearing. Before a wedding can be set, a slim bride is pampered to gain weight until she reaches the suitable weight. Through out the history of obesity, the publics view and status of obesity changed considerably in the 1900s. It was regarded as unfashionable by the French designer, Paul Poi ret who designed skin-revealing clothes for women. About the same time, the incidence of obesity began to increase and become wide spread. Later in 1940s, Metropolitan life insurance published a chart of ideal weight for various heights. They also advocated that weight gain parallel to age is unhealthy. The government and medical society become more hands-on with obesity by imitating campaign against it. This was preceded by a study of risk factors for cardiovascular disease revealing obesity in the high ranks. Since then various diets and exercise programs have emerged. In 1996, the Body Mass Index (BMI) was published. This statistical calculation and index determined that a person is obese or not. At this time ,obesity incidence have soared, led by children and adolescent obesity, tripling in just a few short years, greater than any number in the history of obesity. This increase in the incidence of childhood obesity with associated cardiovascular risks, type 2 diabetes mellitus and stroke is supported by a considerable body of evidence. The prevalence of overweight and obesity in childhood and adolescents has been increasing throughout much of the developed and developing world for the past few decades. It has become increasingly clear that excess adiposity in childhood predisposes individual not only to increased risk of adiposity and its sequaele as adults (Freedman et al, 2001), but also to increased risk of multiple chronic diseases in childhood and adolescence (Rosen bloom et al, 1999). Though mechanism not clearly delineated, excess body weight and adiposity is associated with type 2 diabetes mellitus and its complications, cardiovascular disease risk factors, non alcoholic fatty liver disease and asthma in youth. Childhood Obesity 1930 1972 Risk factors for coronary heart disease (CHD) such as hypertension, dyslipidemia, impaired glucose tolerance and vascular abnormalities were present in overweight children. CHD is likely to be increased in overweight children when they become adults as a result of established risk factors. This study investigated whether excess weight in childhood was associated with CHD in adulthood among a very large cohort of persons born in Denmark in 1930 through 1972. They underwent mandatory annual health examination at public or private schools in Copenhagen. Each child was examined by school doctors or nurses and was assigned a health card bearing childs name, date of birth, birth weight reported by parents. 10,235 men and 4,318 women, for whom childhood BMI data were available, received a diagnosis of CHD or died of CHD as adults. The risk of CHD event, a non fatal event, and a fatal event among adults was positively associated with BMI at 7-13 years of age for boys and 10 to 13 years of ag e as girls. The associations were linear for each age and risk increased across the entire BMI distribution. Childhood Obesity 1930 1972 Risk factors for coronary heart disease (CHD) such as hypertension, dyslipidemia, impaired glucose tolerance and vascular abnormalities were present in overweight children. CHD is likely to be increased in overweight children when they become adults as a result of established risk factors. This study investigated whether excess weight in childhood was associated with CHD in adulthood among a very large cohort of persons born in Denmark in 1930 through 1972. They underwent mandatory annual health examination at public or private schools in Copenhagen. Each child was examined by school doctors or nurses and was assigned a health card bearing childs name, date of birth, birth weight reported by parents. 10,235 men and 4,318 women, for whom childhood BMI data were available, received a diagnosis of CHD or died of CHD as adults. The risk of CHD event, a non fatal event, and a fatal event among adults was positively associated with BMI at 7-13 years of age for boys and 10 to 13 years of ag e as girls. The associations were linear for each age and risk increased across the entire BMI distribution. Childhood Obesity and Economic Growth 1930-1983 Childhood obesity was related to the economic growth during the 50 years of economic growth in the industrialized world especially in Denmark. Annual measurements of height and weight were available for all children born between 1930 and 1983 attending primary schools in Copenhagen Municipality. 165,389 boys and 163,609 girls from the age of 7 through 13 years were included in this study. After computerization SBMI (kg/m2) were calculated and the prevalence of overweight and obesity according to international age and genderà ¢Ã¢â€š ¬Ã¢â‚¬Å"specific criteria. Economics growth was indicated by the Gross National Product and the overall consumption per capita, adjusted for inflation. Prevalence of overweight and obesity among Danish children rose in phases, which were not paralleled by trends in economic growth. The microeconomics growth indicators seem inappropriate as proxies for the environmental exposures that have elicited the obesity epidemic. Childhood obesity and television viewing Children spend a substantial portion of their lives watching television (TV). Investigators have hypothesized that TV viewing causes obesity by one or more than three mechanisms: Displacement of physical activity. Increased calorie consumption while watching or caused by the effects of advertising. Reduced resting metabolism. The relationship between TV viewing and obesity has been examined in a relatively large number of cross sectional epidemiological but few longitudinal studies. Many of them have found relatively weak, positive association or mixed results. Many experimental studies have found that reducing TV viewing may help to reduce the risk of obesity. One school based experimental study was designed specifically to test directly the casual relationship between TV viewing behaviors and body fatness. The results of this randomized controlled trial provide evidence that TV viewing is a cause of increased body fatness and that reducing the TV viewing is a promising strategy for preventing childhood obesity (Robinson; 2001). The objective of another study (Utter J et al, 2006), was to explore how time spent watching television (TV) is associated with the dietary behavior of New Zealand children and young adolescents. Total number of participants was 3275 children aged 5-17 years. The findings suggest that longer duration of TV watching (thus more frequent exposure to advertising) influences the frequency of consumption of soft drinks, some sweets and snacks and some fast foods among children and young adolescents. Efforts to control the time spent watching TV may result in better dietary habits and weight control for children and adolescents. Childhood Obesity US- A decade of progress, 1990-1999 Current data suggest that 20% of US children are overweight .An analysis of the secular trends suggest that 20% of US children are overweight, and a clear up ward trend in body weight in children of 0.2 Kg between 1973 and 1994. In addition, childhood obesity is more prevalent among minority sub groups such as African Americans. Obesity that begins early in life persists into adulthood and increases the risk of obesity related conditions later in life. There has been tremendous increase in the number of studies examining the etiology and health effects of obesity in children (Goran MI, 1990-1999).1980 (boys 0.2% girls 0.5%) and 1997 (boys 1.2%, girls 2.0%). Ten years trends of childhood obesity in Israel 1990-2000 Cross sectional data was collected from 13284 second and fifth class school; children between 1990-2000. Prevalence of obesity was determined using Israeli and US reference values. BMI values at 95th percentile increased overtime in all ages and sex categories. Between 1990 and 2000, 95th centile values were increased by 12.7%and 11.8% among second grade boys and girls respectively. Among fifth graders in 2000, 10.7% of boys and 11.1% of girls exceeded the 1990 BMI reference values. The proportion of obese children increased over time using both Israeli and US reference values (Huerta Michael et al, 2008). Netherlands. Overweight, Obesity in 2003: V.1980-97. Data on 90,071 children, aged 4-16 years were routinely collected by 11 Community Heath Services during 2002-2004. International cut -off points for BMI to determine overweight and obesity. On average, 14.5% of boys and 17.5% of the girls were overweight (including obesity), which is a substantial increase since 1980 (boys 3.9% and girls 6.9%) and 1997 (boys 9.7% and girls 13%). Similarly 2.6% of the boys and 3.3% 0f the girls aged 4-16 years were obese, which is much higher than in 1980 (boys 0.2% and girls 0.5%) and 1997 (boys 1.2% and girls 2.0%), (KatjaVan Den Husk, 2007). Obesity trends in US. 2003-2006 Height and weight measurements were obtained from 8164 children and adolescents as apart of the 2003-2004 and 2005-2006 National Health and Nutrition Examination Survey (NHANES). Because no statistically significant differences in the prevalence of high BMI for age were found between the estimates for 2003-2004 and 2005-2006, data for four years were combined to provide more stable estimates for the most recent time period. Over all, in 2003-2006, 11.3% of children and adolescents aged 2 through years were at or above 97th percentile of the 2000 BMI- for- age growth charts, 16.3% were at or above 95th percentile. Prevalence estimates vary by age and by racial/ethnic group. Analysis of the trends in high BMI for age showed no statistically significant trend over the four time periods (1999-2000, 2001-2002, 2003-2004, and 2005-2006) for either boys or girls (Cynthia l.Ogden et al, 2008). 11-March 2005. Public Release Date: Consensus on Childhood Obesity, Recommends classification as disease A common statement on childhood obesity was published to day in the journal of Chemical Endocrinology and Metabolism (one of the journals of Endocrine Society). The consensus statement reflects the conclusions from an international summit held in Israel last year (2004) and includes a controversial recommendation to classify obesity as a disease. This decision was based upon the available research on the diagnosis, prevalence, causes (including endocrine disorders), risks, prevention and treatment of childhood obesity. Pediatric obesity is now recognized as a major health problem all over the world. Researcher have found that children who are obese have a higher risks adult obesity, which is strongly associated with many serious medical complications that impair quality of life and lead to additional increased risks. The statement also noted the prevalence of overweight/obesity among children 6-11 years (in the US) doubled between the years 1980-2000. By classifying obesity as legiti mate disease, public funding and in user sreimbursement for obesity treatment becomes legalized (consensus on childhood obesity, 2005). Serious health risks will likely to begin to appear in obese children and adolescents as they grow older. These may include diabetes mellitus, metabolic syndrome, hyperandrogenism, heart disease, hypertension, respiratory factors, and sleep disorders. Obese children are also at greater risk of anxiety and depression. It also recommended a number of measures that can be implemented by parents; schools, health providers and government and regulatory agencies to help to prevent the onset of childhood obesity Endocrine Regulation of Energy Metabolism Adipocytokines and Obesity The mechanism underlying obesity was further explained by the discovery of adipocytokines, the role of peripheral thyroid hormones (T4, T3), thyroid stimulating hormone and insulin the regulation of energy metabolism. The levels of some of the adipocytokines were shown to be related to visceral obesity, type 2 diabetes mellitus and coronary artery disease. Plasma levels of all the adipocytokines increase with the obesity except adiponectin (Yuji Matsuzawa et al, 2003). Recent studies point out to the adipose tissue as a highly active organ secreting a range of hormones, Leptin, Adiponectin, and Resistin. They are considered to take part in the regulation of energy metabolism. Leptin, Adiponectin and Resistin are produced by the adipose tissue. Leptin and Adiponectin are insulin sensitizing while Resistin increase the insulin resistance. Leptin The notion that genetic abnormalities contribute to obesity gained important support with the identification of the Ob gene and its protein product in 1994 (Zhangy et al, 1996). The Ob gene termed Leptin from the Greek Leptos, meaning thin, is produced in adipose tissue and is thought to act as an afferent satiety signal in a feed back loop that affects the appetite and satiety centre in the hypothalamus of brain. The ultimate effect of this loop is to regulate body-fat mass. In human, as noted by Considine et al, 1996; caloric restriction reduces leptin concentrations and Ob mRNA levels in adipose tissue, and refeeding increases these levels. One fundamental mechanism of obesity is insensitivity to the action of Leptin, presumably in the hypothalamus. The Leptins primary physiological function is to provide a signal to suppress body fat by decreasing food intake or increasing energy expenditure. Serum leptin concentrations change more during weight loss than during weight gain (Rose nbaum M et al, 1997). Adiponectin Adiponectin or Adipo Q, an adipocyte specific secreted protein with roles in glucose and lipid homeostasis (Insulin stimulates the secretion of adiponectin). Circulating adiponectin concentrations are high 500-30,000  µg/l (5-30mg/ml) accounting for 0.01% of total plasma proteins (Berget et al, 2002). Adiponectin was discovered in the mid 1990s by four different groups of researchers (Hu E et al, 1996). Adiponectin has various biological functions including insulin sensitizing (Hotta K et al, 2000), antiatherogenic (Yamauchi T et al, 2003), anti-inflammatory (Ouchi N et al, 2003), antiangiogenic and anti tumor functions (Brakenhielm E et al, 2004). Adiponectin acts through Adiponectin receptors, Adipo R1 and Adipo R2. Adipo R1 is mostly expressed in skeletal muscles and Adipo R2 is abundant in liver. These receptors are also expressed by the pancreatic ÃÆ'Ã… ¸ cells (Kharroubi et al, 2003), macrophages and atherosclerotic lesions (Chinetti et al, 2004) as well as in brain (Yamauchi et al, 2003). Circulating Adiponectin levels display diurnal variation with a nocturnal decline and maximum levels in the late morning (Gavrila et al, 2003). Adiponectin is also found in breast milk, which in turn is implicated in childhood obesity prevention (Savino et al, 2008). Among the various adipocytokines, adiponectin, which is an abundant circulating protein (247 amino acids) synthesized purely in adipose tissue, appears to play a very important role in carbohydrates, lipid metabolism and vascular biology. Adiponectin appears to be a major modulator of insulin action and its levels are reduced in type 2 diabetes mellitus, which could contribute to peripheral insulin resistance in this condition. It has significant insulin sensitizing as well as anti inflammatory properties that include suppression of macrophage phagocytosis and TNF-a secretion and blockage of monocytes adhesion to endothelial cells in vitro. Although further investigations are required, Adiponectin administration, as well as regulation of the pathway controlling its production, represents a promising target for managing obesity, hyperlipidemia, insulin resistance, type 2 diabetes mellitus, and vascular inflammation (Manju Chandran et al, 2003). Resistin Human resistin is 108 amino acids prepeptide and is cleaved before its secretion from the Adipose tissue. Resistin circulates in the blood as dimeric protein consisting of 92 amino acids polypeptides that are linked by a disulfide bridge. Holcomb et al, 2000 first described the gene family and its tissue specific distribution. Originally described as lung specific, is also produced by the adipose tissue and peripheral blood monocytes. It is also present in dividing epithelia of the intestine. Resistin increase blood glucose and insulin concentration in the mice and impairs hypoglycemic response to insulin infusion. In addition, anti resistin antibodies decrease blood glucose and insulin sensitivity in obese mice (Ukkalo O, 2002). The physiological role of resistin in human remains controversial. There more resistin protein in obese than lean individuals, with a significant positive correlation between resistin and BMI. BMI is a significant predictor of insulin resistance, but resisti n adjusted for BMI is not. These data demonstrate that resistin protein is present in human adipose tissue and blood and that there is significantly more resistin in serum of obese individuals. Serum resistin is not a significant predictor of insulin resistance in human (Youn et al, 2003, Rear R and Donnelly R, 2004). Tumor Necrosis Factor-a It will be unreasonable not to mention the Tumor Necrosis Factor a and its role in vascular inflammation related to atherosclerosis especially in obesity. It is a cytokine involved in systemic inflammation and is a member of a group of cytokines that stimulate the acute phase reaction. The primary role of TNF is in the regulation of immune cells. TNF is able to induce apoptotic cell death, to induce inflammation and to inhibit tumourgenesis and viral replication. Dysregulation and, in particular, over production of TNF have been implicated in a variety of human diseases, as well as cancer (Locksley et al, 2001). The theory of antitumoural response of the immune system in vivo was recognized by the physician William B in 1968. Dr A Granger reported a cytotoxic factor produced by lymphocytes and named it Lymphotoxin (Kalli WB and Granger GA, 1968). Dr L Loyal old, in 1975 reported another cytotoxic factor produced by macrophages and named it Tumor Necrosis Factor (TNF) (Cars well et al, 1975). Interleukin à ¢Ã¢â€š ¬Ã¢â‚¬Å" 6 (IL-6) Chronic inflammation is linked to endothelial dysfunction, atherosclerosis, and insulin resistance (Fernandez-Real JM and Ricart W, 2003 and Fernandez-Real JM, Ricart W, 2005). Plasma concentrations of proinflammatory cytokines, such as interleukin (IL) 18, IL-6, and tumor necrosis factor (TNF)-a, and of several other inflammatory markers are increased in patients with ischemic heart disease (Fernandez-Real JM and Ricart W, 2003, Ridker PM et al, 2002, Engstrom G et al, 2004, Ridker PM et al, 1997, Pradham AD et al, 2002). Circulating cytokines also are elevated in type 2 diabetes, obesity, and insulin resistance syndrome and play a central role in the pathogenesis of these disorders (Fernandez-Real JM and Ricart W, 2003). IL-6 is a mediator of the inflammatory response, and it is linked to dyslipidemia, type 2 diabetes, and risk of myocardial infarction (Fernandez-Real JM and Ricart W, 2003, Ridker PM et al, 2000, Esteve E et al, 2005, Yudkin JS et al, 2000). IL-6 is secreted by a variety of different cell types, including lymphoid and endothelial cells, fibroblasts, skeletal muscle, and adipose tissue. Circulating IL-6 levels correlate with obesity and insulin resistance and may predict the development of type 2 diabetes mellitus (Yudkin JS et al, 2000, Pradhan AD et al, 2001, Akira S et al, 1993, Mohamed-Ali V et al, 1997). Endothelial dysfunction is regarded as a causal factor in the development of atherosclerosis (Hansson GK, 2005). It is one of the earliest abnormalities that can be detected in people at risk for cardiovascular events, and it is linked to insulin resistance and type 2 diabetes (Steinberg HO and Baron AD, 2002, Natali A et al, 2006). Cytokines have an important role in the endothelial injury induced by inflammation. The vascular endothelium is involved in the inflammatory response to atherosclerosis (Hansson GK, 2005, Steinberg HO and Baron AD, 2002, Natali A et al, 2006, Widlansky ME et al, 2003), and changes in endothelium function could underlie the association between cardiovascular disease and inflammation. Obesity Related Insulin Resistance: Definition and Pathogenesis Insulin resistance is a state in which a given amount of insulin produces a subnormal biological response (Kahn CR, 1978). In particular, it is characterized by a decrease in the ability of insulin to stimulate the use of glucose by muscles and adipose tissue and to suppress hepatic glucose production and output (Matthaei et al, 2000). Furthermore, it accounts a resistance to insulin action on protein and lipid metabolism and on vascular endothelial function and genes expression (Bajaj M and Defronzo RA, 2003). Several defects in the insulin signaling cascade have been implicated in the pathogenesis of insulin resistance, Insulin resistance is believed to have both genetic and environmental factors implicated in its etiology (Matthaei et al, 2000 and Liu et al, 2004). The genetic component seems to be polygenic in nature, and several genes have been suggested as potential candidates (Matthaei et al, 2000). However, several other factors can influence insulin sensitivity, such as obesity, ethnicity, gender, perinatal factors, puberty, sedentary lifestyle and diet (Liu et al, 2004). The Role of Fatty Acids and Adipocytokines Obesity represents the major risk factor for the development of insulin resistance in children and adolescents (Caprio S, 2002), and insulin resistance/hyperinsulinemia is believed to be an important link between obesity and the associated metabolic abnormalities and cardiovascular risk (Weiss R and Kaufman FR, 2008). Approximately, 55% of the variance in insulin sensitivity in children can be explained by total adiposity, after adjusting for other confounders, such as age, gender, ethnicity and pubertal stage (Caprio S, 2002). Obese children have hyperinsulinemia and peripheral insulin resistance with an ~40% lower insulin-stimulated glucose metabolism than non-obese children (Caprio S et al, 19996). Adipose tissue seems to play a key role in the pathogenesis of insulin resistance through several released metabolites, hormones and adipocytokines that can affect different steps in insulin action (Matsuzawa Y, 2005) (Fig. 1). Adipocytes produce non-esterified fatty acids, which inhibit carbohydrate metabolism via substrate competition and impaired intracellular insulin signaling (Matsuzawa Y, 2005, Griffin ME et al 1999 and Randle PJ, 1998). In children, as in adults, several adipocytokines have been related to adiposity indexes as well as to insulin resistance. Adiponectin is one of the most common cytokines produced by adipose tissue, with an important insulin sensitizing effect associated with anti-atherogenetic properties (Despres JP, 2006 and Gil-Campos M et al, 2004). Whereas obesity is generally associated with an increased release of metabolites by adipose tissue, levels of Adiponectin are inversely related to adiposity (Matsuzawa Y, 2005). Therefore, reduced levels of this adipocytokine have been implicated in the pathogenesis of insulin resistance and metabolic syndrome (Matsuzawa Y, 2005). Decreased levels of Adiponectin have been detected across tertiles of insulin resistance in children and adolescents (Weiss R et al, 2004), where it is a good predictor of insulin sensitivity, independently of adiposity (Lee S et al, 2006). Adipose tissue also produces tumour necrosis factor-a, an inflammatory factor, which can alter insulin action at different levels in the intracellular pathway (Matsuzawa Y, 2005). Interleukin-6 (IL-6) is ano ther inflammatory cytokine released by adipose tissue and its levels are increased in obesity (Matsuzawa Y, 2005). IL-6 stimulates the hepatic production of C-reactive protein and this can explain the state of inflammation associated with obesity, and could mediate, at least partially, obesity-related insulin resistance (Matsuzawa Y, 2005). Data based mainly on animal studies also suggest that increased levels of resistin, another molecule produced by adipose tissue, could impair insulin sensitivity (Matsuzawa Y, 2005). The close relationship between Leptin levels and insulin resistance in children has also been suggested by the data (Chu NF et al, 2000). Serum levels of retinol-binding protein 4 (RBP4) correlate with insulin resistance in subjects with obesity as well as in those with impaired glucose tolerance (IGT) or type 2 diabetes mellitus, therefore suggesting that it could be useful in assessing insulin resistance and the associated risk for complications (Graham TE et al, 2006). Serum RBP4 is independently related to obesity as well as to components of the metabolic syndrome in normal weight and overweight children (Aeberli I et al, 2007). Diet composition in obese children might be an additional factor promoting and/or worsening insulin resistance. Animal and human studies suggest that a high energy intake as well as a diet rich in fat and carbohydrates and low in fiber could increase the risk of developing insulin resistance (Canete R et al, 2007). The Role of Fat Distribution An altered partitioning of fat between subcutaneous and visceral or ectopic sites has been associated with insulin resistance (Weiss R and Kaufman FR, 2008). Visceral fat has a better correlation with insulin sensitivity than subcutaneous or total body fat (Caprio S et al, 1995), in both obese adults and children. Visceral fat has higher lipolytic activity compared with subcutaneous fat, therefore a greater amount of free fatty acids and glycerol gain entry or carried out to the liver (Matthaei et al, 2000). Visceral fat in girls is directly correlated to the glucose-stimulated insulin levels and inversely correlated with insulin sensitivity and the rate of glucose uptake. No correlation was found between abdominal subcutaneous fat (Caprio S et al, 1995). Ectopic deposition of fat in the liver or muscle can also be responsible for insulin resistance in obese subjects, as the accumulation of fat in these sites impairs insulin signaling, with a reduced glucose uptake in the muscle and a decreased insulin-mediated suppression of hepatic glucose production (Weiss R and Kaufman FR, 2008). Intramyocellular lipid (IMCL) accumulation has been shown as a factor related to decreased insulin sensitivity (Jacob S et al, 1999 and Thamer C et al, 2003). Obese insulin sensitive children and adolescents present lower levels of visceral fat and IMCL when compared with obese insulin resistant children (Weiss R et al, 2005). Accumulation of fat in the liver has also been associated with insulin resistance, independently of adiposity (Kelley DE et al, 2003). It has also been suggested that deposits of fat around blood vessels can produce several cytokines and therefore contribute to the development of insulin resistance, through a so-called vasocrine effect (Yudkin JS et al, 2005). Insulin Resistance and Associated Complications Insulin resistance in obesity is strictly related to the development of hypertension (Marcovecchio ML et al, 2006 and Cruz ML et al, 2002), dyslipidemia (Howard BV and Howard WJ, 1994), impaired glucose tolerance (IGT) (Sinha R et al, 2002), hepatic steatosis (DAdamo E et al, 2008), as well as to the combination of these factors, also known as metabolic syndrome (Eckel RH et al, 2005). Furthermore, insulin resistance is associated with systemic inflammation, endothelial dysfunction, early atherosclerosis and disordered fibrinolysis (Dan Dona P et al, 2002). It is alarming that these metabolic and cardiovascular complications are already found in obese children and adolescents (Dietz WH, 2004). The presence of these alterations in prepubertal children is then particularly worrying, as insulin resistance and related complications might be further exacerbated by the influence of puberty, due to the physiological decrease in insulin sensitivity associated with normal pubertal development (Caprio S et al, 1989). Insulin resistance in childhood can track in adult life (Sinaiko AR et al, 2006). Insulin resistance at the age of 13 years predicts insulin resistance at age 19 years, independently of BMI, and is also associated with cardiovascular risk in adulthood (Sinaiko AR et al, 2006). The fundamental role of insulin resistance in human disease was already recognized in 1988 by Reaven (Reaven GM, 1988) who emphasized its role in the development of a grouping of metabolic abnormalities, which he defined as syndrome X. Later studies strengthened the concept of insulin resistance as a key component of the metabolic syndrome, a cluster of impaired glucose tolerance (IGT), dyslipidemia, hypertension, hyperinsulinemia, associated with an increased risk of type 2 diabetes mellitus and cardiovascular disease (Eckel RH et al, 2005). Insulin resistance represents a serious and common complication of obesity during childhood and adolescence. A timely diagnosis and an appropriated prevention and treatment of obesity and insulin resistance are required in order to reduce the associated risk of metabolic and cardiovascular complications. Childhood Obesity at Present While children and adolescents in many developing countries are experiencing dramatic increase in the rates of overweight (obese), youths in the United States are the heaviest in the world. The National Health and Nutrition Examination Surveys (NHANES), a series of cross-sectional examinations conducted on nationally representative samples in the US between 1971 (NHANES I) and the present day, have documented a marked increase in the prevalence of overweight among children of all race/ethnic groups. With overweight in youth defined as having a BMI95th percentile for age and sex (Himes JH and Dietz WH, 1994, Kuczmarski RJ and Flegal KM, 2000, Ogden CL et al, 1997), the prevalence among white children increased from 5% to 12%, among black children from 6% to 18% and among Mexican-American children from 8% to 21% from 1971 to 2002 (Freedman DS et al, 2006, Hedley AA et al, 2004, Ogden CL et al, 2006). The upward trend in rate of overweight does not appear to be abating as the NHANES 20 03-2004 data indicate a 1.1% increase over the 1999-2002 data in the overall rate for youth in the US (Ogden CL et al, 2006). While it is generally accepted that the highest rates among youth occur in the most industrialized countries, almost all regions of the world experience some degree of overweight, with sub-Saharan Africa being the most notable exception (Lobstein T et al, 2004). Regardless of differences in global prevalence estimates, multiple surveys have identified particular regions as being of primary concern for excess weight: the Middle East, North Africa and the Americas, including Mexico (Hedley AA et al, 2004, Ogden CL et al, 2006, Lobstein T et al, 2004, de Onis M and Blossner M, 2000, Martorell R et al, 2000, Rivera-Dommarco J et al, 1999, del RÃÆ' ­o-Navarro BE et al, 2004). Among older children in Mexico, 6-11 years of age, the prevalence of overweight was quite high at 8.8% at the national level in 1999, with regional differences ranging from 5.5% in the south to 12.7% in the north (Rivera-Dommarco J et al, 1999). Childhood Obesity 6-11 years, the Present Study, 2005-2008. Background: Childhood obesity is a global epidemic involving both developed and developing countries. It is a stare of over-nutrition with long term complications such as dyslipidemia, hypertension, and coronary artery disease and type-2 diabetes. Underweight is the result of under nutrition leading to reduction in growth and development of every body organ especially the Central Nervous System. Long term under-nutrition causes failure in linear growth (height) of the child. Growth is further retarded by the repeated attacks of respiratory infections, diarrhea and anemia as a result of reduced immunity. Methods: This study was carried out eight primary schools of Dera Ismail Khan (Private, semi government organizations, and welfare foundations) having mixed population with some of the wards belonging to high socioeconomic group. Thorough clinical examination excluded those suffering from chronic heath problems. Height and weight of each one was taken body mass index of determined according to Quatelets index. Body mass index number was plotted on the CDCs age and gender specific growth charts 2-20 years for BMI-for age percentile and body mass status (underweight, normal weight, overweight/at the risk of overweight and obese/overweight. Results: 1338 school going children (6-11years) were examined with 865 (67.75%) boys and 471(35.25%) as girls. 13.39%, 72.15%, 8.83% and 5.61% as underweight, normal weight, overweight and obese respectively. Percentage of underweight was higher in girls (25%) than boys (13.22). Percentage of obesity was higher (5.17%) in boys than girls (1.39%). Conclusion: Awareness about balanced diet, improvement in the level of education and socioeconomic conditions, easy access to health facilities and prevention of the gender discrimination, are the remedial measures to be taken to redress the situation.

The Lights On The Eyes - 951 Words

The lamp posts caste themselves like trees on the narrow path. The bright lights on the other side cover the vast sky. The enormous white arch introduces itself first and then allows the plentiful structures behind it to shine under the restless night. Although the humid air perturbed my skin, the temperature was perfect to contemplate my thoughts. The night was almost silent and all that could be heard was the noise the rapid cars made as they passed through the highway. The buildings seemed minuscule from far away, but I knew that they were enormous when standing in front of them. The city buildings and lights provided a sense of security, a place where the city’s arms awaited. The city’s arms were not home; instead home awaited with an overly stressed life, one parent, and a few wild children. The sudden announcement that my mother was to stay in the hospital for the next 7 months due to her risk in labor and later suffer postpartum depression startled me, how cou ld such a strong healthy women fall into this situation? My mother’s state became a burden onto my arms, as the eldest I would have to adapt to handle house tasks, create a more close relationship with my siblings, and continue to be successful in my educational life. Most things were handed. Any situation that came up my mother would always have a solution. Coming home I would launch my bag on the couch and instantly smell the fresh scent of lilacs that would surround the living room. I would then marchShow MoreRelatedThe Theory Of Light And Its Effects On The Human Eyes963 Words   |  4 PagesLight, a concept that has been worked with for many years dating back to 500 B.C. 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Christians and Persecution Essay - 1146 Words

Christians and Persecution In the year 64 A.D. in the city of Rome, the centre of the Roman Empire, there was a huge fire which wiped out most of the city. A rumour started to circulate that the Roman Emperor, Nero, had started the fire as it was well known that Nero thought that much of the city was ugly. It was thought he burned it down so he could re-design and rebuild it himself. Because of this he needed to find someone to blame it on. The Christians were an obvious choice as they were not well like by the roman people. This was mainly because of a number of misunderstandings. The Roman people thought that Christians were cannibals because they ate the body and blood of Christ at mass.†¦show more content†¦The Gospel was written in Greek originally but it contains some Aramaic words which Jewish Christians would understand. But non-Jewish Christians would not have been able to read these Aramaic words. Mark explains what these words mean in Greek which suggests that he was writing for non-Jewish. Jewish customs such as Corban were also explained in Marks Gospel, this furthers the suggestion that Mark was writing for non-Jewish that were being persecuted at the time of Nero. The parables told by Jesus in Marks Gospel appear to be describing persecution and trying to give the people hope. In Mark 4:16-20people are described as seeds. Those that fall in the good soil hear the word and take it for what it is. They prosper and grow to produce many more times the original. Others fall in the barren soil or on the rocks, hearing the word, but the meaning becomes strangled and corrupted. In Mark 4:35-41, the calming of the storm, the persecution of the Christians. Could be conveyed as a great storm, and maybe the story is trying to say that their faith would get them through the storm safely. 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Day 3 Hw free essay sample

Emerging Markets Spring 2013 Sarath Nonis CASE 3-2 Hong Kong Disneyland 1. What led to the eventual woes experienced by Hong Kong Disneyland in its first year of operation? How should Hong Kong Disneyland rectify its market situation? Cultural Adaptation: The Chinese did not easily connect with the characters in the park because they were unfamiliar with the product; they enjoy focusing on what they can buy, eat, and bring home, and taking pictures and bringing them back home rather than the experience of being in the place itself. Chinese Tourist Behavior: Going to Hong Kong means a shopping experience, so they choose the cheaper one, which is Ocean Park; also, the Chinese people put a premium on education, where Ocean Park provides the educational slant. Relationship with Travel Agents: The Hong Kong Disneyland did not heed too much attention to building a relation- ship with the travel agents while Chinese tourists depend a lot on travel agents. We will write a custom essay sample on Day 3 Hw or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Thus, the best way for Hong Kong Disneyland is to determining differences in the Chinese culture and adopting it; to understand Chinese tourist behavior in depth, then to handle the pressures of local demand in terms of the need of Chinese shoppers and tourists; try to pay more attention to building a relationship with the travel agents. 2. To what extent could Hong Kong Disneyland adapt its product to Chinese consumers without diluting its image? Put more educational materials about its image. Taking photos with Donald Duck at the Hong Kong Disneyland. Providing goods which are connected its image for tourist to buy as gifts to bring home. 3. How should Hong Kong Disneyland address competition? Expand the theme of the Hong Kong Disneyland; it should consider the culture and behaviors of Chinese. For example, connect the park theme with children’s education. Cut the price to make people think it is worth to pay. It should understand that travel agents are the most important sales channel in the mainland China. It is very popular in mainland China to provide a group discount.

Exclusionary Rule Evaluation free essay sample

The exclusionary rule exempts some evidence even when the seizure or location of the evidence may violate the Fourth Amendment. The rule also provides some benefits and detriments for members of the criminal justice system when gathering evidence or prosecuting offenders. However, the exclusionary rule is an important doctrine to members of the criminal justice system demonstrating a means to introduce evidence in the furtherance of justice. The exclusionary rule prevents evidence obtained by the criminal justice system in violation of the Fourth Amendment guarantee against unreasonable search or seizure is not allowable to prove the guilt of an accused person in a criminal prosecution. However, the primary purpose of the rule is to deter police misconduct by preventing the gathering of evidence in violation of the Fourth Amendment (Del Carmen, 2010). The rule also strengthens the protections offered by the Fourth Amendment by allowing defendants a means to object to illegally obtained evidence. We will write a custom essay sample on Exclusionary Rule Evaluation or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page The rule originally applied to federal courts only. However, the decision of the United States Supreme Court in the case of Mapp v. Ohio (1961) incorporated the inclusion of state courts for using the exclusionary rule from the Fourteenth Amendment to include the protections of the Fourth Amendment thereby requiring the state courts to provide the protections of the Bill of Rights to defendants. This inclusion of state courts ensures defendants receive the same protections from tainted evidence or police misconduct (Del Carmen, 2010). The exclusionary rule provides extra protections for defendants; however, certain circumstances exist allowing the introduction of gathered evidence that violates the defendant’s Fourth Amendment rights. These exceptions include good faith errors, independent sources, inevitable discovery, and the purged taint exception. The good faith exception allows the introduction of evidence collected by law enforcement that on review violates the defendant’s Fourth Amendment rights. A defective search warrant may taint the collected evidence; however, law enforcement officers acting under good faith a search warrant is valid may present the tainted evidence at trial because the initial error lies with the judge approving the probable cause for the warrant (Del Carmen, 2010). The independent source exception allows the introduction of evidence obtained via the direct result of an illegal search or seizure if the connection between the illegal police conduct and the seizure of the evidence dissipates the taint of illegality. If the police possess an independent source used to obtain entry on a search and discover contraband based on the source in an illegal manner, then the seizure of the evidence is admissible regardless of the illegal entry or search (Del Carmen, 2010). The inevitable discovery doctrine allows the introduction of evidence of a defendant’s guilt that is inadmissible under the exclusionary rule. The doctrine states evidence obtained in violation of a defendant’s constitutional rights may be admissible if normal police investigation will inevitably lead to the discovery of the evidence. In Nix v. Williams (1984), the Supreme Could held the statements made a defendant at the prodding of a police officer after the defendant’s refusal to speak without an attorney could be introduced as evidence. The basis for the decision was the concurrent search for evidence by volunteers in the same area as the defendant indicated after the prodding by the officer. The court held police would locate the evidence because of the concurrent search regardless of the defendant’s statements; therefore, the evidence is admissible (Del Carmen, 2010). The purged taint exception allows evidence collected or obtained illegally to be admissible when certain actions â€Å"purge† the taint of illegal seizure. In Wong Sun v. United States (1963), the Supreme Court held the confession of Sun was admissible because Sun voluntarily returned to a police station and confessed to a crime after a previous illegal search by police officers. The voluntary return and confession purged the taint from an illegal search making the confession admissible as evidence (Del Carmen, 2010). The exclusionary rule offers a few benefits for the criminal justice system. The rule deters law enforcement from violating the rights of citizens when gathering evidence. The rule also reinforces the due process clause of the Fourteenth Amendment as it prevents members of the criminal justice system from ignoring the guarantees of the due process laws. This prevention of police abuse and recognition of due process laws allows the individuals of society to be secure in their freedoms (Del Carmen, 2010). The exclusionary rule also offers a major detriment according to opponents. Members of the criminal justice system who make errors in searching or seizing a person or property may create a loophole for an offender to escape prosecution. A court may suppress evidence because of the taint of the violation of the defendant’s rights. Additionally, a violation by a court can create an infringement of a defendant’s due process rights resulting in a complete dismissal of criminal charges (Del Carmen, 2010). There are several alternatives available in lieu of the exclusionary rule. However, they seldom see use. Officers who violate a person’s rights may be held civilly responsible under tort class actions. Individuals may sue officers and their departments for damages related to the rights violations. An illegal search or seizure may be criminally actionable resulting in the prosecution of an officer for abuse of office. While a damage remedy or incarceration may be more effectual, the Supreme Court emphasizes the exclusion of evidence from illegal searches or seizures as a more effective enforcement of the exclusionary rule (Del Carmen, 2010). The exclusionary rule is an important aspect of the American criminal justice system and should be continued. It provides exceptions to potential mistakes members of the criminal justice system may make under good faith. Even though there are other alternatives to the exclusionary rule, the rule provides enhanced protections for citizens while allowing exclusions to prevent some criminal cases from ever receiving a day in court.