Are Cell Phones Good for Health Essay Example for Free

Are Cell Phones Good for Health Essay Talking on a cellular phone or living near to a cell site does not cause cancer, according to a report by the Royal Society of Canada. The society looked at GSM networks, mobile phones, cell site antennas and roof top aerials, on behalf of Health Canada. They did, however say that the existing safety limits for maintenance staff working on the cell sites, and should be revised to take into account possible damage to the eyes, due to the unique physiological make up of the eye. Upgrade handsets: If you are using too old handset, upgrade it to some recent handset which has released in last 1-2 years. Recent handsets use low power and take care of reflections to save battery as well as high radiations. Use standard handsets: Some cheap mobiles do not maintain standards. Always use handsets from branded companies. Cheap phones can be harmful to life. Use Bluetooth: Use Bluetooth headset/hands free to talk on phone. Bluetooth operates on low frequency. You can put the phone in back pocket. Use PC software: SMS chatting is most common in youngsters. Most of brands provide PC connectivity software’s; some 3rd party tools are also available. Connect cell phone to PC through Bluetooth, keep mobile at a distance and enjoy SMS. Use Flight Mode: Switching off and on mobile might be tedious when it’s not in use. Use flight mode profile of phone to deactivate radio signals, it will perform same operation as switch off but keeping other functions on. Avoid Mobile Internet: Get a wired internet connection for PC to use at home. Avoid using mobile internet connections (GPRS and 3G based). You will always find a cheaper wired internet option in this competitive market.

About Cervical Cancer

About Cervical Cancer Abstract: Cervical cancer is the second most common cause of cancer death in developing countries. The cause of cervical cancer is the human papilloma virus (HPV). Cervical cancer has other risk factors, like: having multiple male sexual partners, starting to have sexual intercourse at an early age, having other sexually transmitted disease, having weak immune system and smoking. Cervical cancer can be prevented by avoiding risk factors and undergoing regular screening tests. The most common methods used in cervical screening are Pap testing and HPV testing. World Health Organization estimated that about 510,000 new cases of cervical cancer were diagnosed yearly. HPV testing is used as a primary screening method in some developed countries. Fewer amounts of tests required and better cost efficiency can be achieved by doing HPV testing first and Pap testing as a second test. Some studies suggested that HPV testing might be the effective cervical screening method and other studies did not suggest that. The study HPV Screening for Cervical Cancer in Rural India indicated that HPV testing was the most objective and reproducible of all other cervical screening tests. It seems to be a good study with well designed methodology and reliable results and conclusions, but it was criticized by R Marshall and Chengquan. They showed clearly that the study marred by test group biases and ethical concerns. More well designed studies are needed to clarify this issue and to show which method is proper to that country or to this geographical area. Introduction: Cervical cancer is the cancer of the lowest part of the uterus, which is known as cervix. Cervical cancer is very slow growing, but in some cases it can grow and spread quickly (Dolinsky Hill-Kayser, 2009). There are many types of cervical cancer. The most common type is called squamous cell carcinoma (figure 1), which found in about 80% of cervical cancer cases, whereas adenocarcinoma is the second most common type of cervical cancer (Dolinsky Hill-Kayser, 2009). Cervical cancer is more common in developing countries than it is in developed countries. It is the second most common cause of cancer death in developing countries. It can affect young women who are 20 years old or some time younger than that (Dolinsky Hill-Kayser, 2009). The cause of cervical cancer is the human papilloma virus (HPV) (figure 2) which was discovered by Harald zur Hausen who won the Nobel Prize in 2008 for this discovery (Nobel Prize organization, 2009). This virus is a sexually transmitted virus. It can cause genital warts which may or may not change to a cervical cancer (Dolinsky Hill-Kayser, 2009). The subtypes of HPV which have been confirmed to cause cervical cancer are 16, 18, 31 and 33 (Murray et al., 1998; Dolinsky Hill-Kayser, 2009). Other researches suggested that subtypes 35 and 45 also can cause cervical cancer (NHS cancer screening programmes, 2009). A woman has HPV infection does not mean that she is going to have a cervical cancer (Dolinsky Hill-Kayser, 2009). Other risk factors for cervical cancer are: having multiple male sexual partners, starting to have sexual intercourse at an early age, having other sexually transmitted disease (herpes, syphilis, gonorrhea or Chlamydia), having weak immune system (HIV, organ transplantation or Hodgkins disease) and smoking (Dolinsky Hill-Kayser, 2009). The early stages of this disease usually do not have any symptoms, but as tumor increase in size, some non-specific symptoms for cervical cancer will occur, like: abnormal bleeding, abnormal vaginal discharge, pelvic or back pain, pain during urination and bloody stool or urine (Dolinsky Hill-Kayser, 2009). Cervical cancer can be diagnosed by Pap testing, HPV testing, liquid-base cytology and by taking a biopsy during Colposcopy. The biopsy is the only way to be sure if the patient has a cervical censer. Radiologic testing may also help in the diagnosing of this disease (Dolinsky Hill-Kayser, 2009). Cervical cancer can be treated by Surgery, radiotherapy and chemotherapy (Dolinsky Hill-Kayser, 2009). It can be prevented by avoiding risk factors which have been discussed previously and undergoing regular screening tests (Dolinsky Hill-Kayser, 2009). In Islam religion for example, smoking and any sexual relationship not done between wives and husbands (reducing sexually transmitted diseases) are strictly forbidden, this can reduce the chance of having cervical cancer within Muslim societies (Adam, 2009). In addition, male circumcision which is a part of Islam religion has found to be a good factor in cervical cancer prevention as researches have found that the wives of circumcised men have less risk of getting this disease than the wives of uncircumcised (Mission Islam, 2009). Moreover, many countries have started to do cervical cancer screening to diagnose this disease in its early stages. Pap testing (cytological testing), HPV testing and liquid-base cytology can be used in this screening programs which will be discussed later (Kufe et al., 2003; Jamison et al., 2006). Now a day, the vaccine Gardasil is used to prevent cervical cancer in women who are not exposed to HPV (Dolinsky Hill-Kayser, 2009). This study is aimed to discus the importance of HPV screening in the control of cervical cancer and clarifies the most appropriate method for cervical cancer screening. The Global Burden of Cervical Cancer and the Available Methods for Controlling the Disease: Cervical cancer is the second most common cancer among females worldwide with about 493,000 new cases and 274,000 deaths in 2002. Cases occur in developing countries are estimated to be about 83% (Bosch et al., 2009). Thomas Rohan and others stated that opportunities for cervical cancer prevention have been created by our understanding of the cause, particularly the role of HPV infection (Rohan et al., 2003). In addition, World Health Organization estimated that about 510,000 new cases of cervical cancer were diagnosed yearly. In Africa, about 68,000 new cases are reported every year, whereas 77,000 new cases are reported in Latin America and 245,000 in Asia (Pagliusi, 2009). In United Kingdom, about 25.51 millions females who are 15 years old are at risk of having a cervical cancer during their life. This kind of cancer is ranked as the 11th most common cancer in females in UK and the 2nd most common cancer in females between 15 and 44 years old. In addition, about 8.9% of females in the population of UK are estimated to have HPV infection at a given time. Currently in UK, it is estimated that about 3181 females are reported with a cervical cancer yearly and about 1529 deaths (Bosch et al., 2009). Many researches suggested that the decline in incidence and mortality of cervical cancer which have been observed in the last 50 years in developed countries can be related to the introduction of screening programs (Kufe et al., 2003). The most common methods used in cervical screening are Pap (cytological) testing and HPV testing (Kufe et al., 2003). The most widely used method in the world is the Pap testing. This method is simple, cheap and some times is used as a secondary screening method. It basically involves exfoliating epithelial cells collection from the squamocolumnar junction of cervix or transformation zone (Walker et al., 1990; Kufe et al., 2003). In addition, HPV testing is used as a primary screening method in some developed countries. It is used mostly to distinguish between a high risk women group and others (Kufe et al., 2003). The study of Joakim Dillner and others suggested that HPV testing as a screening method is safe and effective when it is done every six years (Dillner et al., 2008) and it should be done for women who are 30 years old or older because they are typically past the peak age of self-limited infection (Castle, 2008). HPV DNA testing might be a more clinically effective method than cervical smear, but its specificity is low because it could lead to unnecessary repeated screening and follow up (Nelson (I), 2009). Fewer amounts of tests required and better cost efficiency can be achieved by doing HPV testing first and Pap testing as a second test (Medscape Medical News, 2009; Nelson (I), 2009). Existing Randomized Controlled Trails Investigating the Use of HPV Testing in the Control of Cervical Cancer: Many randomized controlled trails have been done to investigate the use of HPV testing in the control of cervical cancer. Some studies suggested that HPV testing might be the effective cervical cancer screening method (Grce and Davies, 2008; Rebar, 2008; Nelson (II), 2009). On the other hand, other studies suggested that HPV testing does not improve cervical cancer screening (Brown, 2009; NHS cancer screening programs, 2009). In Italy, the second recruitment phase of the study titled: New Technologies for Cervical Cancer Screening (NTCC), women to conventional cytology (24,661 women) with referral to colposcopy if cytology indicated a typical squamous cells of undetermined significance or more sever abnormality or to HPV DNA testing alone by Hybrid Capture 2 (24,535 women) with referral to colposcopy if the test was positive at a concentration of HPV DNA 1 pg/mL or greater were randomly assigned. It has been concluded that HPV testing with a cutoff of 2 pg/mL achieves a substantial gain in sensitivity compared to cytology with only a small reduction in Positive Predictive Value among a group of women aged 35 to 60 years. In contrast, for women aged 25 to 34 years, it is suggested that there is a frequent regression of CIN2+ that is detected by direct referral of younger HPV testing-positive women to colposcopy as a result of the large relative sensitivity of HPV testing compared with conventional cytology (Ronco et al., 2008). In addition, the results from a 6-year prospective study in Rural China demonstrated that a single oncogenic HPV DNA testing is more effective than cytology in predicting future CIN2+ status (Shi et al., 2009). The study Human Papillomavirus DNA versus Papanicolaou Screening Tests for Cervical Cancer which was done in Canada, conducted a randomized trial comparing the two methods, found that HPV testing has greater sensitivity than Pap testing for the detection of cervical intra-epithelial neoplasia (Mayrand et al., 2007). The Population Based Screening Study Amsterdam (POBASCAM) which is a population based randomized controlled trial for implementation of hrHPV testing by GP5+/6+ PCR-enzyme immunoassay (EIA) with a classical cytology as a control group was done between January 1999 and September 2002. It was done among 44,102 women aged between 29 and 61 who participated in the regular Dutch screening program. This study (POBASCAM) indicated that large scale hrHPV testing is accepted by both participating women and general practitioners, is practically feasible and yield highly reproducible results (Bulkmans et al., 2004). In 1997, a 10-year study Randomized Controlled Trial of Human Papillomavirus Testing in Primary Cervical Cancer Screening (SWEDESCREEN) was started. This study aimed to investigate whether HPV-based cervical cancer screening which is known to increase sensitivity for detection of high grade cervical intraepithelial neoplasia (CIN) is represent overdiagnosis or a protective effect. It included 12,527 women aged between 32 and 38 years and were randomized (1:1) to HPV testing and cytology testing (intervention arm) or cytology only (control arm). Its conclusion indicated that HPV testing with a cytology testing is more sensitive than cytology testing alone (U.S. National Institute of Health, 2009). In another study, titled Randomized Controlled Trial of Human Papillomavirus Testing Versus Pap Cytology in the Screening for Cervical Cancer Precursors, the Canadian Cervical Cancer Screening Trial (CCCaST), randomized women aged between 30 and 69 years were categorized in to Pap testing group and HPV testing group. The findings at recruitment phase of this study indicated that HPV testing is more sensitivity and less specificity than Pap cytology testing (Mayrand et al., 2006). An Overview on the Methodology, Results and Conclusions of the Study: HPV Screening for Cervical Cancer in Rural India: Rengaswamy and others began their study HPV Screening for Cervical Cancer in Rural India in 1999 and finished after 8 years. In this study, 52 clusters of villages with a total of 131,746 healthy women aged between 30 and 59 years were randomly assigned to 4 groups of 13 clusters each. These groups assigned to go through screening by: HPV testing group (34,126 women) (27,192 were screened and 2812 (10.3%) had positive results). Cytology testing group (32,058 women) (25,549 were screened and 1787 (7.0%) had positive results). Visual Inspection of the Cervix with Acetic Acid (VIA) group (34,074 women) (26,765 were screened and 3733 (13.9%) had positive results). Standard care group (control) (31,488 women) (not offered screening but were advised on how to seek screening) (only 1946 (6.2%) requested screening and that means (93.8%) stayed without screening. Women who had positive results went through colposcopy and biopsies were taken and those with cervical precancerous lesions or cancer received appropriate treatment (Sankaranarayanan et al., 2009). The results of this study showed that:   In HPV testing group: cervical cancer was diagnosed in 127 women and 34 deaths occurred. In Cytology testing group: cervical cancer was diagnosed in 152 women and 54 deaths occurred. In VIA group: cervical cancer was diagnosed in 157 women and 56 deaths occurred. In Control group: cervical cancer was diagnosed in 118 women and 64 deaths occurred. In addition, this study indicated that of the 131,806 women, 60 died or migrated before the study began. The study groups were equally distributed in terms of household type, religion, occupation, marital status and number of pregnancies. The well balanced study will help to remove any biases to any group of the study. The results of this study showed also: Invasive cervical cancer developed in 8 (0.033%) of 24,380 HPV negative results women. Invasive cervical cancer developed in 22 (0.093%) of 23,762 cytology negative results women. Invasive cervical cancer developed in 25 (0.109%) of 23,032 VIA negative results women (Sankaranarayanan et al., 2009). The protocol of this study was reviewed and approved by the scientific and ethical review committees of the International Agency for Research on Cancer (IARC), the Tata Memorial Center (TMC) and the Nargis Dutt Memorial Cancer Hospital (NDMCH). It was supported by the Bill and Melinda Gates Foundation through the Alliance for Cervical Cancer Prevention (Sankaranarayanan et al., 2009). This study concluded that a single round of HPV testing was associated with a significant decline in the rate of advanced cervical cancers and associated deaths compared with the unscreened control group, whereas there was no significant reduction in the rate of death in either the cytology testing or the VIA group compared with the control group. Previous conclusions indicated that HPV testing was the most objective and reproducible of all other cervical screening tests (Sankaranarayanan et al., 2009). This study seems to be a good one with well designed methodology and reliable results and conclusions, but it is clear that about 93.8% of the control group did not do any cervical screening during the 8 years which may raised an ethical issue might affecting the approval of this study if it was done in different country. Further more, the courses and training period given to different staffs who participated in this study may be not enough to give them good experience in order to have less chance of error during the diagnosis. An Overview on the Criticizing Article Titled: Test Group Biases and Ethical Concerns Mar New England Journal of Medicine Articles Promoting HPV Screening for Cervical Cancer in Rural India:   A few months after the publication of previous study, R Marshall and Chengquan had criticized it. They suggested that unexpected biases might have occurred in some of the test groups of the study. The study stated that the positive predictive value for detecting CIN 2-3 was 19.3% in the cytology testing group, higher than 11.3% in the HPV testing group and the study results indicated that essentially the same number of cervical cancers was detected after positive screening test results in the cytology group (88 women) and in the HPV group (87 women) (Austin Zhao, 2009). Also, they observed that in the report of 2005, this study indicated that the detection rates of HPV testing did not show any improvement over cytology, but its conclusion of 2009 indicated different findings (Austin Zhao, 2009). I think this is not a problem as findings and conclusions of scientific studies usually change over time. In addition, of 54 cervical cancers related deaths in the cytology group, 27 deaths were in the assigned but not screened group and another 18 deaths were in patients who had abnormal cytology results. In HPV group, 19% fewer cervical cancer deaths (22 women) were in the assigned but not screened group and 33% fewer deaths (12 women) occurred in women with abnormal HPV testing results. These data supported the hypothesis that biases were introduced in the study groups. (Austin Zhao, 2009). I think it is possibly true, because these data can show that the follow up and treatments were not equally effective in the two groups. So, even when cytological detection is successful, women can still die from cervical cancer due to inappropriate management. In addition, these data also can show that the effectiveness of cytology as a cervical screening method is depended on its acceptance by women.   R Marshall and Chengquan have raised questions about the partnership between AACPs coordinating organization and the HPV test manufacturer (Austin Zhao, 2009). I think this partnership if it is real, it can affect the final results and conclusion in way that show the advantages of HPV testing in order to increase the income of the manufacture. Also they stated that it is not fare to allow a large number of control group to go without any screening during the study (Austin Zhao, 2009). I think it is true that it is not fare to leave women in the control group without any screening and this can lead to ethical concerns. In addition, cytology screeners were trained for only three months, which was very short period. They concluded that cytology screening is better than HPV screening according to the results of the previous study (Austin Zhao, 2009). In my opinion, the criticizing letter might be in the correct direction. From a brief reading and viewing of the study, the reader might believe that its finding indicated that HPV testing as a cervical cancer screening method is better than other tests, but deep reading will show him the limitation errors of this study which were firstly published by R Marshal and Chengquan. They showed clearly that the study marred by test group biases and ethical concerns. The study might try to cover and exclude some facts which can show that cytology testing was better than HPV testing. Use or Not to Use HPV Testing as a Primary Screening Test for Cervical Neoplasia: It has been argued that HPV testing is the best method for cervical cancer primary screening. I think that HPV testing is a good method to be used in cervical cancer primary screening in developing countries as well as in developed countries to reduce the incidence and mortality rates of cervical cancer. Studies which concluded that HPV testing is better than cytology testing are more than those which showed the opposite. The high cost of HPV testing can be overcome by the support of WHO and privet sector companies in these developing countries. Also, the high cost of HPV testing can be overcome by the selective use of HPV testing, e.g. in the over 30s. Many studies suggested that Human Papillomavirus is found in most of cervical cancer cases if not all. So, the use of HPV DNA testing in a well designed screening program may help in diagnosis early stages of cervical cancer, giving better chance for treatment compared with Pap testing which may give false negative results.   Ã‚   In conclusion, it is clear that different results and findings were gathered from different studies which try to find the proper method for cervical cancer screening. These differences may be occurred because the studies done in different countries. And is it known that each country has its own geography, rate of mortality, rate of incidence and other factors which may affect the burden of cervical cancer disease. So, more well designed studies are needed to clarify this issue and to show which method is proper to that country or to this geographical area in order to save womens lives. References: Adam, A. (2009), Sexually Transmitted Diseases and Islam. Kuwait.   Available from: http://www.islamset.com/hip/anvir_adam.html [Accessed 30-11-2009]. Austin, R. M., Zhao, C. (2009), Test group biases and ethical concerns mar New England Journal of Medicine articles promoting HPV screening for cervical cancer in rural India. CytoJournal, 6 (12), pp. 1-5. Bosch, F. X., Castellsague, X., Sanjose, S., Alarcon, F., Albero, G., Bruni, L., Ferrer, E., Louie, K. S., Miralles, C., Monfulleda, N., Munoz, J., Perez, S., Rajo, C., Roura, E. (2009), Human papillomavirus and related cancers. United Kingdom, WHO/ICO Information Centre on HPV and Cervical Cancer.   Available from: http://apps.who.int/hpvcentre/statistics/dynamic/ico/country_pdf/GBR.pdf?CFID=278048CFTOKEN=18959369 [Accessed 1-12-2009]. Brown, A. J. (2009), HPV testing does not improve cervical cancer screening. The Lancet Oncology, 16 (52), pp. 02 -0400. Bulkmans, N. W. J., Rozendaal, L., Snijders, P. J. F., Voorhorst, F. J., Boeke, A. J., Zandwijken, G. R., van Kemenade, F. J., Verheijen, R. H., Groningen, K., Boon, M. E., Keuning, H. J., van Ballegooijen, M., van den Brule, A. J., Meijer, C. J. L. M. (2004), POBASCAM, a population-based randomized controlled trial for implementation of high-risk HPV testing in cervical screening: design, methods and baseline data of 44,102 women. International Journal of Cancer, 110, pp. 94-101. Castle, P. E. (2008), Invited commentary: is monitoring of human papillomavirus infection for viral persistence ready for use in cervical cancer screening. American Journal of Epidemiology, 168 (2), pp. 138-144. Dillner, J., Rebolj, M., Birembaut, P., Petry, K. U., Szarewski, A., Munk, C., Sanjose, S., Naucler, P., Lloveras, B., Kjaer, S., Cuzick, J., Ballegooijen, M., Clavel, C., Iftner, T. (2008), Long term predictive values of cytology and human papillomavirus testing in cervical cancer screening: joint European cohort study. British Medical Journal, 337 (1754), p. a1754. Dolinsky, C., Hill-Kayser, C. (2009), Cervical Cancer: The Basics. United States of America, Abramson Cancer Center of the University of Pennsylvania. Available from: http://www.oncolink.org/types/article.cfm?c=6s=17ss=129id=8226p=1 [Accessed 30-11-2009]. Grce, M., Davies, P. (2008), Human papillomavirus testing for primary cervical cancer screening. Expert Review of Molecular Diagnostics, 8 (5), pp. 599-605. Jamison, D. T., Breman, J. G., Measham, A. R., Alleyne, G., Claeson, M., Evans, D. B., Jha, P., Mills, A., Musgrove, P. (eds.) (2006), Disease Control Priorities in Developing Countries.   Washington: The World Bank and Oxford University Press. Kufe, D. W., Pollock, R. E., Weichselbaum, R. R., Bast, R. C., Gansler, T. S., Holland, J. F., Frei III, E. (eds.) (2003), Cancer Medicine. Canada: BC Decker Inc. Mayrand, M. H., Duarte-Franco, E., Coutlee, F., Rodrigues, I., Walter, S. D., Ratnam, S., Franco, E. L. (2006), Randomized controlled trial of human papillomavirus testing versus Pap cytology in the primary screening for cervical cancer precursors: Design, methods and preliminary accrual results of the Canadian cervical cancer screening trial (CCCaST). International Journal of Cancer, 119 (3), pp. 615-23. Mayrand, M. H., Duarte-Franco, E., Rodrigues, I., Walter, S. D., Hanley, J., Ferenczy, A., Ratnam, S., Coutlà ©e, F., Franco, E. L. (2007), Human papillomavirus DNA versus papanicolaou screening tests for cervical cancer. New England journal of Medicine, 357, pp. 1579-1588. Medscape Medical News. (2009), UK Government Announces Initial Adoption of HPV Testing. United States of America. Available from: http://www.medscape.com/viewarticle/411529 [Accessed 30-11-2009]. Mission Islam. (2009), Male Circumcision in Islam. Available from: http://www.missionislam.com/health/circumcisionislam.html [Accessed 30-11-2009]. Murray, P. R., Rosenthal, K. S., Kobayahsi, G. S., Pfaller, M. A. (1998), Medical Microbiology. London: Mosby. Nelson (I), R. (2009), HPV testing followed by cytology triage improves cervical cancer screening. Journal of the National Cancer Institute, 101, pp. 88-99. Nelson (II), R. (2009), HPV testing most successful method for cervical cancer screening in developing countries. The New England Journal of Medicine, 360, pp. 1385-1394. NHS cancer screening programmes. (2009), Human Papilloma virus. United Kingdom. Available from: http://www.cancerscreening.nhs.uk/cervical/hpv.html [Accessed 30-11-2009]. Nobel Prize organization. (2009), The Nobel Prize in physiology or medicine 2008. United States of America. Available from: http://nobelprize.org/nobel_prizes/medicine/laureates/2008/press.html [Accessed 10-12-2009]. Pagliusi, S. (2009), Initiative for Vaccine Research. Switzerland, WHO.  Ã‚   Available from: http://www.who.int/vaccine_research/diseases/hpv/en/ [Accessed 1-12-2009]. Rebar, R. W. (2008), HPV testing improves yield of cervical cancer screening. Journal Watch, 7 (11). Rohan, T. E., Burk, R. D., Franco, E. L. (2003), Toward a reduction of the global burden of cervical cancer. American Journal of Obstetrics and Gynecology, 189 (4), pp. S37-S39. Ronco, G., Giorgi-Rossi, P., Carozzi, F., Confortini, M., Palma, P. D., Mistro, A. D., Gillio-Tos, A., Minucci, D., Naldoni, C., Rizzolo, R., Schincaglia, P., Volante, R., Zappa, M., Zorzi, M., Cuzick, J., Segnan, N. (2008), Results at recruitment from a randomized controlled trial comparing human papillomavirus testing alone with conventional cytology as the primary cervical cancer screening test. Journal of the National Cancer Institute, 100 (7), pp. 492-501. Sankaranarayanan, R., Nene, B. M., Shastri, S. S., Jayant, K., Muwonge, R., Budukh, A. M., Hingmire, S., Malvi, S. G., Thorat, R., Kothari, A., Chinoy, R., Kelkar, R., Kane, S., Desai, S., Keskar, V. R., Rajeshwarkar, R., Panse, N., Dinshaw, K. A. (2009), HPV screening for cervical cancer in rural India. The New England Journal of Medicine. 360 (14), pp. 1385-94. Shi, J. F., Belinson, J. L., Zhao, F. H., Pretorius, R. G., Li, J., Ma, J. F., Chen, F., Xiang, W., Pan, Q. J., Zhang, X., Zhang, W. H., Qiao, Y. L., Smith, J. S. (2009), Human Papillomavirus Testing for Cervical Cancer Screening: Results From a 6-Year Prospective Study in Rural China. American Journal of Epidemiology, 170 (6), pp. 708-716. Stephens, J. (2010), Therapy Analysis Human papillomavirus. United Kingdom, Pharmaprojects. Available from: http://www.pharmaprojects.com/therapy_analysis/hpv_1009.htm [Accessed 10-1-2010]. U.S. National Institute of Health. (2009), Randomized controlled trial of human papillomavirus testing in primary cervical cancer screening (SWEDESCREEN). United States of America. Available from: http://clinicaltrials.gov/ct2/show/NCT00479375 [Accessed 1-12-2009]. Walker, H.K., Hall, W.D., Hurst, J.W. (eds.) (1990), Clinical Methods: The History, Physical, and Laboratory Examinations. Stoneham: Butterworth Publishers. Zmuida, C. (2009), Cervical cancer FAQs. United States of America. Available from: http://www.ehow.com/about_5378940_cervical-cancer-faqs.html [Accessed 10-12-2009].

Free Awakening Essays: An Analysis of The Awakening :: Chopin Awakening Essays

An Analysis of The Awakening  Ã‚  Ã‚   The first thing I would like to do is go through and pick out the chapters I found to be significant in the novel. Chapter 1: *there is symbolism of a well trained â€Å"caged† bird, (like we read in the hypertext) which represents what wives were to be in Edna’s lifetime *well trained *speaks of pleasantries *begins with Summer a time of beauty, fullness and fruition *Grand Isle *vacation from New Orleans life (imprisonment) *ends at Summer after 1 yr *this vacation follows Edna back to New Orleans where she gradually begins to see how trapped she really is *it is after this vacation that Edna begins to â€Å"awake† Chapter 2: *Edna was from Kentucky and married a Creole *this is a conflict in religion *she is Presbetyrian and he’s Catholic *this presents a problem for Edna for she has to live a Catholic life style Chapter 3: *we first see here the marital problems that M&M Pontellier have *the ideals of what Mr. Pontellier expects of Edna *looking after the children was very important *marital state: bored, unlively, becomes more depressing on her *impt: Edna’ s breakdown, her crying Chapter 4: *Adele, the perfect woman *embodies all the qualities of what a woman-mother should be *she’s been married 7 yrs and has a child about every 2 yrs, again fullfilling her womanly and motherly duties. *her identity seems to be consumed by having children and her current â€Å"state† Chapter 7: *this chapter we see Edna begin to slip away, she doesn’t pay as much attention to things *daydreaming/ Adele asks her a question and Edna is not with her Chapter 10: *Edna learns to SWIM!!!!!!! very impt. *she gains control of her body *the sea becomes her friend, close, intimate, sensuous Chapter 11: *this section we see a bit of Edna’s rebellious nature *her husband commands her and Edna says â€Å"NO!† Chapter 17: *we see yet another confrontation between M&M Pontellier, more marital problems *I think we also begin to see ore hatred and violence under the surface of her husband *we also see another problem, Tuesday was to be the â€Å"calling† day and Edna wasn’t prepared for the callers, she realizes that she no longer cares to do the things that her husband wants her to Chapter 24: *Edna’s father comes for a visit *he also portrays that the females should submit to the males *males are dominant?

President Bill Clinton :: William Jefferson Clinton Essays

Bill Clinton   Ã‚  Ã‚  Ã‚  Ã‚  In recent history, one would be hard pressed to find one politician surrounded in more controversy than Bill Clinton. His scandals have included drugs, adultery, treason, and fraud. The latest opprobrium that has plagued his presidency resulted in him becoming only the second president in the history of the United States to be impeached.   Ã‚  Ã‚  Ã‚  Ã‚  After a long and drawn out sexual harassment trial, Paula Jones’ lawyers deposed former White House intern Monica Lewinsky. What would follow in the next 14 months, even Clinton’s most adamant critics couldn’t have predicted. It all began with Clinton’s now infamous words; “I have never had sexual relations with that woman, Monica Lewinsky.'; Several videotapes, sapeanas, and cigar jokes later, the American public found out that he did, indeed, had sex with that woman. Many were outraged, many thought it was his personal business, and many just didn’t care. The nation became divided on what actions should be taken against a popular president that had just admitted to lying to his public and possibly lying under oath. Every constitutional scholar had an opinion about what constituted high crimes and misdemeanors. The 146th congress had to determine that for themselves, and in early January of 1999, William Jefferson Clinton was impeached. As the focus then turned to the Senate, many debates arose. Did the President’s sexual indiscretion deserve to get him removed from office? Other options such as censorship were debated, but whether or not other options could even be discussed brought disagreement. In the end, the Senate voted against removing Clinton from office, but whether that will be the last of this matter, only time will tell. Fifty years from now, when our grandchildren are learning about our 46th President, what will the books say? Will they explain how his moral hypocracy divided a country? As a member of our United States armed forces, I find it hard to respect a man who can so easily lie to his citizens, deny responsibility for his actions, and expect the public to forgive and forget with no real repentance. It is a sad time for our country when parents can’t even use the head of state as a role model for their children. As a result of Clinton’s actions, his every decision is questioned for fear that he is just covering us another lie. Can Americans rely on Bill Clinton to make the best choices for our country when we don’t even trust him?

A Performance Including Education :: Drama

This task was to include education in a performance to be shown to primary school children. This performance needed to reflect on issues understood by children of this age and to be clear and straight forward while explaining the message. Three weeks ago we were set an assignment to last until now. This task was to include education in a performance to be shown to primary school children. This performance needed to reflect on issues understood by children of this age and to be clear and straight forward while explaining the message. My first reaction when I heard of this task was one of excitement and anxiety. I knew this assignment would be challenging which made me very eager to start as soon as possible. However I was worried as I knew that all ideas would have to be adapted for the age group and that there would be censorship issues. There were many ideas put in to a discussion on the first day of the task. Within our group these were our main ideas-Abuse, drugs, smoking, trust issues & bullying. However we knew most of these ideas were not compatible for the age group of the audience so we narrowed it down to three main ideas-smoking, trust issues & bullying. We knew that whatever idea we used we would have to make it humorous to allow the children to enjoy themselves. We also had some ideas on how to portray these ideas allowing the audience to understand and enjoy the humour. These ideas were- Men In Black(spoof), Batman(spoof) & Spider pants (original character made from typical superhero names and character). During the rehearsals we went through the different ideas and at first we decided to act out bullying through peer pressure however when we performed this to the group we found that it was very boring which was not what we were aiming for. So we then changed to trust issues using spider pants (we could not use men in black as we found out it had already been done previously we also could not do batman due to the costumes and props needed to make it realistic),However we were unable to carry out our idea of spider pants due to the unfortunate absents by myself and another person in the group & so when we performed this it did not come out right. We then eventually changed to a play about kidnappers. This entailed the theme of trust issues and was comical. It was not only the ideas that would not work though, we soon found that some members of our group were not prepared to work to the extent

Understanding The Process Of Laundry Detergency Environmental Sciences Essay

Detergency is a procedure where dirts are removed from substrate stuffs. It ever is reviewed and researched because of its commercial importance. Washing and cleansing is a complicated procedure because it involves interactions of much physical and chemical influence. In general, rinsing procedure contains remotion by aqueous surfactant solution of ill solute thing and disintegration of drosss from fabric surfaces [ 1 ] . 2. Preliminaries Before discoursing how detergents work in rinsing procedure, we have to cognize how dirts adhere to cloths and the different types of dirts. In the present, the substrate is a fabric normally, fabricated by knitting, weaving or blending together a batch of fibres which have spun into narrations before incorporation into the fabric. Soil is something present in the matrix of the fabric but differs from the fabric fibres both in composing and form, while characteristically is of a comparable size. Dirt may be liquid or solid. If it is liquid, it must be non-volatile and non-aqueous. The liquid dirt here is termed oily dirt to separate from the solid particulate dirt. These two types of dirts may happen together: an external atom is more possible to adhere to fabrics when the latter already has liquid dirt. There are two chief differences between liquid dirt and solid dirt: form and rheological belongingss. The greasy dirt alterations shape by and large while the particulate dirt holds its initial form all the clip [ 2 ] . No affair liquid or solid, both sorts of dirt adhere to the fabric because of a effect of Van Der Waals and interrelated interactions between the dirt and the substrate. 3. Washing Procedure 3.1 Structures The most important ingredients in detergents are chemicals called wetting agents. The word aa‚ ¬Aâ€Å"surfactantaa‚ ¬A? comes from aa‚ ¬Aâ€Å"surface active agentsaa‚ ¬A? and as defined, the wetting agents are chemical signifiers which tendency to concentrate or better to adsorb at interfaces, or to organize colloidal sums in solution at really low molar concentrations. As shown in Figure 1, it is obvious to bespeak the basic demand of wetting agents is combination of hydrophilic and hydrophobic parts in molecules, i.e. amphiphilic molecules. When the wetting agents dissolved in H2O, they will prefer to hold an orientation that can minimise inauspicious interactions between hydrophobic molecular subdivisions and aqueous stage ( Figure 2 ) . Figure 1 Structure of Wetting agents Beginning: pubs.caes.uga.edu/caespubs/pubcd/B1319/B1319.html Figure 2 Wetting agents dissolved in H2O Beginning: slides of talks Therefore, there are several signifiers when wetting agents are in solutions ( Figure 3 ) . Figure 3 Different signifiers of wetting agents 3.2 Mechanism As the cardinal construction of wetting agents mentioned, the lavation procedure is easy to explicate. To do H2O wash better, surface tenseness has to be reduced so H2O can wet things more uniformly. That is exactly what a wetting agent does. The wetting agents in detergents improve H2O ‘s capableness to wet things, spread over surfaces, and ooze into soiled apparels fibres. Wetting agents do another of import occupation excessively. In the solution incorporating the wetting agents whose molecules adsorb on the surface of dirt and fabrics at the same time, the hydrophobic portion of their molecule is attracted to H2O, while the other portion is adhering to dirt and grease. Neither detergents nor soap accomplish anything except adhering to the dirt until some mechanical energy or agitation is added into the equation [ 3 ] . So the wetting agent molecules help H2O to acquire a clasp of lubricating oil, interrupt it up, and wash it off ( Figure 4 ) . Figure 4 Illustration of the particulate dirt remotion If the dirt is oily, it will scatter in solution as emulsion, while it is particulate, it disperses as suspension. 4 Components Used for wash, the detergents ever contain wetting agents, builders, enzymes, decoloring agents, and other minor additives such as optical brighteners, fabric softeners, and scattering agents [ 4 ] . Among them, wetting agents and builders are the two most of import ingredients. 4.1 Wetting agents As an abbreviation for surface active agent, wetting agents remain the most of import constituents for the development of cloth attention and place attention merchandises [ 5 ] , consisting from 15 % to 40 % of the entire detergent preparation [ 6 ] . Wetting agents used in detersive preparations can be classified into four groups harmonizing to the hydrophilic group: non-ionic detergents, nonionics, cationics, and zwitterionics. In the usage of detergent composings, alkylbenzene sulfonates, alkyl sulphates alcohol ethoxylates, kats, and betaine are popular, and biodegradable wetting agents such as APG and MES will be a development tendency in the detergent composings [ 4 ] . Nowadays, mixed active preparations are popular worldwide because they offer the advantage of good public presentation over a wider scope of wash conditions and let makers flexibleness with regard to surfactant supply and demand [ 7 ] . Besides at the same clip the commixture helps to stay mile to the tegument of custodies. 4.2 Builders A possible builder should fulfill a big figure of demands including sequestering ability, alkalinity, buffer capacity, bleach compatibility, dirt deflocculation, unwritten toxicity, skin soaking up, oculus annoyance, effects on fish and other aquatic animate beings, and other environmental and economic practicableness [ 8 ] . We use builders to take Ca2+ and Mg2+ ions in difficult H2O and in dirts, for ever wetting agents can non work efficaciously in H2O particularly in difficult H2O. And the great sum of wetting agents in the detergent preparations increases the figure of troubles and the costs of sewerage disposal. Figure 5 Structures of polydimethyl siloxanes and their derived functions [ 4 ] We have ionic, organic and polymer builders [ 4 ] . In the Attic, Sodium tripolyphosphate ( STPP ) was the most used in the yesteryear. However, for phosphates can easy do a batch of environmental jobs that later, we use organic builders such as EDTA, NTA, ODA, IDA, and so on as a replacement for STPP. But still question their clean efficaciousnesss, inauspicious ecological or toxicological influences, and the cost. Besides, we use borates and zeolites as ionic builders, and now multifunctional builder is demanded, such as superimposed crystalline silicate ( Na2Si2O5 ) which combines a high public presentation per unit mass with a high grade of multi-functionality [ 9 ] . Polymeric builders have good builder capacity but most of them are non of course biodegradable. So now a bio-based polyester co-builder, which is found to be non-toxic to aquatic life is invented [ 10 ] . 4.3 Enzymes Encapsulated enzymes have been used worldwide for 40 old ages in detergent merchandises, particularly laundry preparations, and for biodegradability and functionality at low temperatures, its importance additions [ 11 ] . Enzymes can assist to better detergence, such as peptidase, amylase, cellulase, and lipase. Alkaliphilic Bacillus strains are frequently good beginnings of alkaline extracellular enzymes to be used in detergents [ 12 ] . Before people think enzymes in detergents ever cause allergy, but now this has been changed and substituted by the recommendation of carefully use by the practician. 4.4 Bleachs We use bleaches to destruct unwanted discolorations on the cloth, and besides dyestuff in solution which causes hemorrhage. Laundry detergents typically contain percarbonate or perborate salts as bleach systems [ 13 ] . The bleach activity ever requires a suited temperature. For the energy economy and other restricts, scientists focus on new accelerators to make the same clean efficaciousness at a comparatively low temperature. However, at the same clip of decoloring discolorations, bleaches besides increase melting degree of the fabric [ 14 ] . As used in day-to-day lavation, we besides have to see the built-in toxicity and toxic by-products of decoloring additives. 4.5 Other Additives Some laundry detergents contain â€Å" optical brighteners † . These are fluorescent dyes that glow blue-white in UV visible radiation which can do yellowed cloths appear white [ 15 ] . Fabric softeners are to cut down the clash between fibres, and between fibres and the tegument. They are frequently a cationic wetting agent, which is attracted to the negatively charged substrates like proteins and many man-made cloths. Scattering capacity is a step of how a liquid stage influences a solid stage [ 16 ] . From some respects it decides the cleansing capableness. We add some scattering agents into the detergents to better the decreasing of the surface tenseness so increase the efficaciousness of detergents. 5. Development Scientists are concentrating on detergents for wash which are biodegradable, effectual, and low toxic to clamber. Biosurfactants are possible the replacements for chemical wetting agents. Compared with chemical wetting agents, they are better in biodegradability and effectivity at utmost temperature or pH and in holding lower toxicity [ 17 ] . However, it is difficult to happen a balance between the hydrolytic and the biodegradability, non merely for the wetting agents, but besides for the enzymes and other additives in the detergents [ 18 ] . Now many biosurfactants are tested for utilizing in laundry preparations, as what Mukherjee AK [ 19 ] and Srokova I [ 20 ] have done. To salvage energy and H2O, there is a tendency of concentrated detergent, and besides it is environment friendly [ 21 ] . And different new sorts of additives are added as softeners, odor-removers, antibacterial constituents, and others which can give detergents multifunction.

Blockade Runners

Blockade Runners. A blockade runner is usually a lighter-weight ship used for evading a naval port. Often blockade running is done in order to transport cargo, for example to bring food or arms to blockade a city. Other times blockade runners would carry mail in an attempt to communicate with the outside world. The blockade runners during the American civil war were seagoing steam ships that were used to make it through the union blockade that extended some 3,500 miles along the Atlantic and Gulf of Mexico coastlines and the lower Mississippi River.These ships had to go undetected they sually traveled at night. If any of the runners were detected by union ships they would simply try to outmaneuver or outrun the union ships. The typical blockade runners were privately owned vessels often operating with a letter of marque issued by the Confederate States. Inbound ships usually brought things that were badly needed supplies and mail, they often carried things like cotton, tobacco and ot her goods for trade. If a blockade was detected they would either be captured or destroyed.There were an estimated 2500-2900 attempts to run the blockade with at east 80% success. Some of the famous blockade runners were; The Bat, The Britannia, The chameleon, The Condor, The Falcon, The Hansa, The Lizzie, The Stag, and The ptarmigan. The Steamer Denbigh. – We are glad to learn that this steamer, reported to be ashore and a wreck in her late attempt to run out of this port in a fog, is not damaged to the extent supposed. She has been relieved of her cargo and is now afloat, and is expected up to-day. The enemy's fleet discovering her unfortunate position tried to vent their spite upon her.They succeeded in hitting her but once in her wheelhouse, doing her no damage. She was defended by the guns of Fort Morgan, which succeeded in putting three shots in one of the blockaders and driving the rest off. The enemy's ship that was struck was sent off in the direction of Pensacola, s upposed to be disabled. The energy of Gen. Higgins and his command in defending the unfortunate ship is highly commended. Word count: 363 Bibliography: Wikipedia, famous blockade runners, newspaper article Mobile Register February 4, 1864. Denbigh runs around near Fort Morgan.