Analysis of Black Reconstruction Essay - 2741 Words

Analysis of Black Reconstruction Prior to the Civil War and Reconstruction, the main goal of the African American population was to be granted freedom. African Americans had been enslaved since 1619 in America, when the first slaves were sold on the auction block. However, their concepts of freedom were extremely romanticized and highly unrealistic as a direct result of the atrocities they witnessed and endured in the institution of slavery. They visualized the abolition of slavery to be comparable with the coming of Jesus Christ. Yet when politics made that day become reality on January 1, 1863, the newly freed men and women were utterly disappointed and in disarray. After living their lives under the institution of slavery,†¦show more content†¦Survival was a key element for the lives of African Americans during slavery. Its guiding principle was the ability to endure the oppression to secure the continuation of the race. Slaves recognized that adaptation to the new environment and culture in the New World would be the main factor for their ability to stay alive. They began this adaptation process, called survival faith, by creating a sub-culture which merged traditional African practices with those the slaves were forced to adopt from their masters. The African slaves brought with them all of their African traditions but were suppressed from utilizing them in their original fashion. Therefore, they merged remnants of African cultures including  ¡Ã‚ §the great Bantu tribes from Sierra Leone to South Africa; the Sudanese, straight across the center of the continent, from the Atlantic to the Valley of the Nile; the Nilotic Negroes and the black and brown Hamites, allied with Egypt; the tribes of the great lakes; the Pygmies and the Hottentots; and in addition to these, distinct traces of both Berber and Arab ¡Ã‚ ¨ (DuBois, 3) with those remnants of European and Native American cultures. This new culture was comprised of dance, rhythmic music, folk traditions and value s, religious beliefs,Show MoreRelated Three Plans For Reconstruction Essay1043 Words   |  5 Pages Analysis of the Three Plans for Reconstruction The American Civil War, lasting from 1861-1865, was the most severe military conflict the country had seen; it involved the United States of America (the Union), and eleven secessionist Southern states (the Confederate States of America). The war was the upshot of decades worth of political, social, and economic conflict between the agricultural South, which produced mainly cash crops such as cotton, tobacco, and sugarcane, and the industrialRead MoreReconstruction Document Analysis1256 Words   |  6 Pages2012 Document Analysis: â€Å"Reconstruction: Clashing Dreams and Realities, 1865-1868† The Civil War brought with it destruction in the South, over 600,000 fatalities, economic devastation, and a nation hanging together by the thread of the hopes of those who believed that the nation of Washington would not â€Å"perish from the earth.† Those living in the losing side had to face the harsh realities that their lives would never be the same, both for the white slave owners and for the black, newly-liberatedRead MoreThe End Of The Civil War1577 Words   |  7 Pagesdebated and crucial topic in this time period was the rights of the free black men to vote. â€Å"The goal of Reconstruction was to readmit the South on terms that were acceptable to the North –full political and civil equality for blacks and a denial of the political rights of whites who were the leaders of the secession movement† (â€Å"Reconstruction†). The Republican party was segregated due to different opinions regarding black civil rights into the anti-slavery Congressmen, known as Radicals; and PresidentRead MoreKilling Reconstruction : American Exceptionalism And The North s Rise1094 Words   |  5 PagesKilling Reconstruction; American Exceptionalism and The North’s Rise to Power Pulitzer Prize holding biographer of president Woodrow Wilson’s biography, Scott Berg, described the future foreign policy of southern diplomats and federalists such as Wilson, to have been formed by the trauma experienced during the course of The Civil War. The Confederate south was left in a state of constant ruin, with infrastructure and the economy in recession, morale and dignity torn, and in a racial transgressionRead More C. Vann Woodwards The Strange Career of Jim Crow Essay1719 Words   |  7 Pagesspecifically the Jim Crow laws he equates with the segregation of races. 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The proclamation was made by Abraham Lincoln in 1863 and stated â€Å"That on the 1st day of January, A.D. 1863, all persons held as slaves withinRead More Failure of Democracy Essay870 Words   |  4 PagesAccording to David Herbert Donald in the article Why They Impeached Andrew Johnson, â€Å"Rarely has democratic government so completely failed as during the Reconstruction decade.† As voiced by Lincoln in his Gettysburg Address, the nation is a â€Å"government of the people, by the people, and for the people.† However, during the period of reconstruction, the government was far from this philosophy. Public opinion was all but ignored, and all matters were decided by either President or Congress. SouthernRead MoreReconstructi on Of The Civil War1541 Words   |  7 Pagesabout Reconstruction what comes to their minds first is the rebuilding of the Union. For all intents and purposes, the years between 1865 and 1877 following the Civil War were about the reunification of the Northern and the Southern states and the government’s attempt to return everything back to normalcy. This time was about letting the southern states join the United States again. However the issue that was also happening at the time was the issue of emancipation. After the Civil War, black slavesRead MoreAnalysis Of Nicholas Lemann s The Battle Of The Civil War 1567 Words   |  7 PagesNicholas Lemann’s aim of writing this book is to look at the brutal campaign of fraud and violence during the mid-1870s that ultimately led to the restoration of conservative, white governments in some southern states. The author focuses on the reconstruction of Mississippi. He stirs memories of the murderous Southern resistance and to civil rights movements 90 years later. Lemann writes at an era when neo-Confederate sympathies have cropped up again in southern politics, and amid several reports ofRead MoreBlack Leadership, Politics, and Culture in Uplifting the Race by Kevin Gaines1225 Words   |  5 PagesBlack Leadership, Politics, and Culture in Uplifting the Race by Kevin Gaines Uplifting the Race is a rather confusing yet stimulating study that goes over the rising idea and interests in the evolution of racial uplift ideology from the turn and through the twentieth century. In the first part of the book, Gaines analyzes the black elite obsession with racial uplift ideology and the tensions it produced among black intellectuals. Gaines argues for the most part that during the nineteenth-century

Cost Accounting 14th Edition Problem 15-35 Free Essays

COST ACCOUNTING P 15-35 Required: 1. Using selling prices, allocate the $1,000 gateway-package revenue to the three divisions using: a. The stand-alone revenue-allocation method | Selling Price| Rev. We will write a custom essay sample on Cost Accounting 14th Edition Problem 15-35 or any similar topic only for you Order Now Allocation| Precio por cuarto para dos personas 2 noches| $800| $581. 82| Dos â€Å"rounds† de golf con precio de | 375| 272. 73| Una cena para dos| 200| 145. 45| | $1,375| $1,000| b. The incremental revenue-allocation method | Selling Price| Rev. Allocation| Dos â€Å"rounds† de golf con precio de | $375| $375| Precio por cuarto para dos personas 2 noches| 800| 625| Una cena para dos| 200| 0| $1,375| $1,000| 2. What are the pros and cons of the two methods in requirement 1? Pros sobre el â€Å"stand alone†: 1. Cada elemento en el â€Å"bundle† recibe una porcion del ingreso. 2. Es un metodo simple para implementar. Contras sobre el â€Å"stand-alone† 1. Este metodo puede ignorar la importancia que le da el cliente a cada elemento del â€Å"bundle†. Por ejemplo, algunos clientes pueden estar interesados en el golf y no en la cena y viceversa. Pros sobre el metodo incremental: 1. Una vez se determina que secuencia utilizar para asignar, la im plementacion es automatica. Contras sobre el metodo incremental: 1. Algunos productos no van a recibir asignacion de ingresos. Aun cuando se incurran los costos, no recibe asignacion de ingresos. 3. Because the recreation division is able to book the golf course at 100% capacity, the company CEO has decided to revise the Gateway package to only include the lodging and food offerings shown previously. The new package will sell for $900. Allocate the revenue to the lodging and food divisions using the following: 1. The Shapely value method. Incremental-Revenue Allocation Method|   | Weighted Shapely Value| Primary Product 1st| Unit SP| Allocation| W| Lodging| Food| Lodging|   |   | $800 | $800 | 1| $800 |   | Food|   |   |   | 200 | 100 | 1|   | $100 | | | | | | $1,000 | $900 | |   |   | | | | | | | | |   |   | Primary Product 1st| Unit SP| Allocation| |   |   | Food|   |   |   | $200 | $200 | 1|   | 200 | Lodging|   |   | 800 | 700 | 1| 700 |   | | | | | | $1,000 | $900 | |   |   | | | | | | | | | $750 | $150 | | | | | | | | | | | 2. The weighted Shapely value method, assuming that lodging is three times as likely to sell as the food. Incremental-Revenue Allocation Method|   | Weighted Shapely Value| Primary Product 1st (1)| Unit SP| Allocation| W| Lodging| Food| Lodging|   |   | $800 | $800 | 3| $2,400 |   | Food|   |   |   | 200 | 100 | 3|   | $300 | | | | | | $1,000 | $900 | |   |   | | | | | | | | |   |   | Primary Product 1st (2)| Unit SP| Allocation| |   |   | Food|   |   |   | $200 | $200 | 1|   | 200 | Lodging|   |   | 800 | 700 | 1| 700 |   | | | | | | $1,000 | $900 | |   |   | | | | | | | | | $775 | $125 | | | | | | | | | (1) Lo mas probable sucedera 3 de 4 veces. (2) Lo mas probable sucedera 1 de 4 veces. How to cite Cost Accounting 14th Edition Problem 15-35, Essay examples

The Earthquakes Of 1811 And 1812 In free essay sample

The Mississippi River Valley Essay, Research Paper When one thinks of temblors, the Mississippi river vale ( MRV ) , does non often come to mind. One normally thinks of one of California # 8217 ; s legion mistakes or someplace in Alaska. However, small known to the general populace, there were two monolithic temblors in the MRV, which rank among the top three in the immediate United States and in the top 10 for the full United States ( hypertext transfer protocol: //wwwneic. cr.usgs.gov/neis/eqlists/bigten.lis ) . Get downing in the early forenoon hours of December 16, 1811 a violent shaking of the Earth began, which continued on for three months, bring forthing two of the three largest temblors in the immediate US, this peculiar temblor registered an 8.0 in magnitude on the Richter graduated table. There was a 2nd temblor on February 7, 1812 which registered 8.2 ( hypertext transfer protocol: //wwwneic.cr.usgs.gov/neis/eqlists/ bigten.lis ) . The home base which is responsible for this activity is named the New Madrid Seismic zone, it is named for the lone populated metropolis that was in being in the clip and the country of these temblors, New Madrid, Missouri. The New Madrid Seismic zone lies in the cardinal MRV, get downing in southern Illinois and stoping in sou-east Missouri, western Tennessee. Normally an temblor consists of a principal daze and so the aftershocks, the 1811-1812 temblors didn # 8217 ; t follow the usual form. There was the first primary daze, at and so it # 8217 ; s aftershocks, nevertheless the aftershocks from the first temblor hadn # 8217 ; T subsided before the 2nd chief daze hit. Following suite, the aftershocks from the 2nd temblor had non terminated when the 3rd and largest chief daze hit ( hypertext transfer protocol: //www.eas. slu.edu/Earthquake_Center/Nuttli.1973/intensity.html ) . It is hard to bet on the existent strength of the temblors due to the deficiency of engineering, nevertheless, the strength can be estimated by the harm caused by the temblors and besides by the diaries of the people settling this portion of the state. Fortunately, a adult male by the name of Jared Brooks, who was a occupant of Louisville KY, kept a diary of the seismal activity from December 16, 1811 to May 5, 1812. He had devised his ain system of mensurating strengths with a set of horizontal pendulums from 1 to 6 inches in length and a set of perpendicular spring- mass systems. Inventing his ain instruments, he besides created his ain classs of strengths, with six degrees. The first is comparable to an eight on the Modified Mercalli graduated table, 2nd degree is a five to a six, third is a four to five, 4th is a three, the 5th degree is comparable to a two on the MM, the 6th is a 1 ( hypertext transfer protocol: //www.slu.edu/Earthquake_Center/ Nuttli.1973/Magnitudes.html ) . With the aid of these measurings scientist have been able to invent approximative strengths of these temblors. The followers is a map with the MM strength values for the December 16, 1811 temblor. Map ( hypertext transfer protocol: //www.eas.slu.edu/Earthquake_Center/Nuttli.1973/Intensity.html ) Through some in depth research about land gestures and strengths of these temblors, if has been concluded that the epicentre of the first temblor ( December 16, 1811 ) was closer to the nor-east Arkansas near the southern terminal of the lake formed by the St. Francis River. The lake in the country was raised every bit much as 12 ft. up higher than the encompassing state. The H2O in the lake was drained and replaced by white sand. It was stated by the Louisiana Gazette that the river itself rose every bit much as 25 to 30 pess above it # 8217 ; s Bankss ( hypertext transfer protocol: //www.eas.slu.edu/Earthquake_Center/Nuttli.1973/Intensity.html ) . There are several published personal histories of these temblors, the following is an aggregation of extracts from a missive found in a book entitled, # 8220 ; Lorenzo Dow # 8217 ; s Journal, # 8221 ; published by Jos Harkat-ul-Mujahidin Martin, printed by John B. Wolff, 1849, on pages 344-346. On the 16th of December, 1811, approximately two O # 8217 ; clock, A.M. , we were visited by a violent daze of an temblor, accompanied by a really atrocious noise resembling loud but distant boom, but more hoarse and vibrating, which was followed in a few proceedingss by the complete impregnation of the atmosphere, with sulphurious vapours, doing entire darkness. The shriek of the affrighted dwellers running to and fro, non cognizing where to travel, or what to make # 8211 ; the calls of the poultry and animals of every species the snap of trees falling, and the boom of the Mississippi # 8211 ; the current of which was retrogade for a few proceedingss, owing as is supposed, to an irruption in its bed # 8212 ; formed a scene genuinely atrocious. There were several dazes of a twenty-four hours, but lighter than those already mentioned until the 23d of January, 1812, when one occurred as violent as the severest of the former 1s, accompanied by the same phenomena as the former. From this clip until the 4th of February the Earth was in continual agitation, visibly beckoning as a soft sea. On that twenty-four hours there was another daze, about every bit difficult as the proceeding 1s. Following twenty-four hours four such, and on the 7th about 4 O # 8217 ; clock A.M. , a concussion took topographic point so much more violent than those that had proceeded it, that it was dominated the difficult daze. The atrocious darkness of the ambiance, which was once saturated with sulphurious vapour, and the force of the stormy thundering noise that accompanied it, together with all of the other phenomena mentioned as go toing the former 1s, formed a scene, the description of which would necessitate the most sublimely notional imaginativeness. At foremost the Mississippi seemed to withdraw from its Bankss, and its Waterss garnering up like a mountain, go forthing for the minute many boats, which were here on their manner to New Orleans, on bare sand, in which clip the hapless crewmans made their flight from them. It so lifting 15 to 20 pess sheer, and spread outing, as it were, at the same minute, the Bankss were overflowed with the retrogade current, rapid as a downpour # 8211 ; the boats which earlier had been left on the sand were now torn from their moorages, and all of a sudden driven up a small brook, at the oral cavity of which they laid, to the distance in some cases, of about a one-fourth of a stat mi. The river falling instantly, every bit rapid as it had risen, receded in its Bankss once more with such force, that it took with it whole Grovess of immature cotton-wood trees, which ledged its boundary lines. They were broken off which such regularity, in some cases, that individuals who had non witnessed the fact, would be difficultly persuaded, that is has non been the work of art. A great many fish were left on the Bankss, being unable to maintain gait with the H2O. The river was literally covered with the wrecks of boats, and # 8217 ; Ti said that one was wrecked in which there was a lady and six kids, all of whom were lost ( hypertext transfer protocol: //www.hsv.com/genlintr/newmadrd/ accnt1.htm ) . This is a really powerful history of the first and 2nd primary dazes. Having neer been in an temblor I can non conceive of # 8220 ; the Earth visibly beckoning as a soft sea # 8221 ; . There are several other published histories, nevertheless, none as descriptive and powerful as this one. Mentions hypertext transfer protocol: //www.eas.slu.edu/Earthquake_Center/NewMadrid/General.html hypertext transfer protocol: //www.eas.slu.edu/Earthquake_Center/Nuttli.1973/Intensity.html hypertext transfer protocol: //www.eas.slu.edu/Earthquake_Center/Street/rstreet.html hypertext transfer protocol: //www.hsv.com/genlintr/newmadrd/accnt1.htm hypertext transfer protocol: //www.slu.edu/Earthquake_Center/ Nuttli.1973/Magnitudes.html hypertext transfer protocol: //wwwneic.cr.usgs.gov/neis/eqlists/bigten.lis

Vindenergi Essays - , Term Papers, Research Papers

Vindenergi Vind energi er den energien som finna s t i lu fta som er i rorsle. Vinden vil alltid finnast, sa leng e sola ski n. Vindkraft er en fornybar energ ik jeld e som vi har brukt i fleire tusen ar. Vindmylner : Menneska har brukt vindmylne i ca. 4000 ar. Vi brukar vindmylne f o r a fang e vind energi. I Noreg kom vindmylne ne pa 1800-talet, i land med mykje vind som Nederland og Danmark er vindkrafta e i godt utnytta energikjelde. F or a utnytta energikjelda mest mule set man fleir e vindmylner ved sida av kvarandr e . V indkraft blir plassert i omrada med my kj e vind , det vi l si pa kysten og i typiske flate land. K ossen fungerer vindmylner: D et er l ufta som bevegar rotorblada . L ufta blir fort vidare til ein generator som ligg i maskinrommet. Der i fra overfore energien til kablar i form av elektrisk Strom . Vindmylna dreiar seg alltid mot vinden , slik utnyt t ar dei vinden best . Klimaet: V indenergien er klimaven n leg, men ikkje naturlegvis naturven n leg. Kvar form for energiproduksjon vil paverke miljoet i s torre eller mindre grad. Positive ting for klimaet med vind energi er at det er e n fornyba r res s urs. Vind energi vil heller ikkje forureine . Negative ting er at det er farleg for fuglane. Sjolv om vind er gratis, er det ikkje gratis a produser vindenergi . Det er dyrare en n fossilt brenn stoff . K var egnar det seg med vindkraft: S jolv om land som Tyskland og Nederland har bygd ut meir vindenergi, har Noreg my kj e stor re vind res s u rsar pa grunn av var lange kyst linje. Europas beste vindres s ursar fi nn ein i Storbritannia og Noreg. Kvifor er fornybar energi viktig: D en fornybare energien er miljoven nleg. Det kan brukast utan at det blir noko co2 utslepp i atmosfaren. Co2 kan fore til global oppvarming som igjen kan for e t il ein av disse alvorlege konsekvensane: - mangel pa drikke vatn - mangel pa mat - drama tiske oydelegging: stormar, flau mar, skogbrann osv. - mange menneska ma flykt Det a satsa pa fornybar energi er lurt. Vi brukar meir ikkje -fornybar energi , Forn ybar betyr jo at det kan brukast opp og opp igjen. Eksemplar pa ikkje fornybar energi er kol, olje a gass. E i n gong kjem detta til a ta slutt , mens den forn ybare energien berre fortsette a fortsette . Kjelder: Geographica - atlas og kunnskapsverk om jorda, folk og land. Nova 9 (vindmylner) http://www.wwf-norge.no/fadder/lofoten/index.php?p=lofotenutm_source=1000utm_source=1400gclid=EAIaIQobChMI6_y4yOWv1wIVxkQYCh3hPA91EAAYASAAEgJGjvD_BwE https://no.wikipedia.org/wiki/Fornybar_energi http://www.fornybar.no https://snl.no/fornybare_energikilder http://www.renewableenergyworld.com/index.html https://www.youtube.com/watch?v=T_ulKgp6-KY http://ungenergi.no/energikilder/vindkraft/hva-er-vindkraft/ http://www.fornybar.no/vindkraft http://www.vindenergi.no

Inundating and Drowning

Inundating and Drowning Inundating and Drowning Inundating and Drowning By Maeve Maddox I heard a reporter on NPR refer to something that had been â€Å"inundated by water.† Looking online, I found this headline: Family of Five Inundated by Water No Assistance Provided- Belize News In each example, â€Å"by water† is redundant. As a transitive verb, inundate means â€Å"to overspread with a flood of water.† It does make sense to add a prepositional phrase if something other than water- or a specific kind of water- is doing the overflowing. For example, Potatoes and sweet potatoes- when harvested conventionally- are inundated with pesticides  at three levels. The Neuse was not only inundated with urine and feces, but the nutrient loading from the spill caused an algal bloom of toxic  Pfiesteria  that caused a massive fish kill.    Following Hurricane Ike (Sept. 2008), significant forage and row crop acreage was inundated by saltwater for 12 to 240 hours. For stylistic reasons, â€Å"by water† works in the following examples because the compound object of the preposition includes another substance: The subways leading to Brooklyn are all  inundated with water and  floating debris.   The streets and roads, which two days ago were  inundated with water and  mud, are now as dry as in summer. When inundated is used figuratively to mean flooded or â€Å"filled with abundance,† then whatever is doing the flooding is identified. For example, Houston Mayor Annise Parker’s office has been inundated with bibles following her decision to subpoena pastors’ sermons to check for anti-gay rhetoric. British PM inundated by flooding criticism from leaders to the north [The criticism relates to flooded conditions in the north of England.] Get ready to be inundated by tech ads Officers say they are inundated with complaints from internet users complaining about online abuse being directed at them. The following headline from Philly-dot-com combines the literal and figurative senses of inundate: Alls Not Well In Dublin Bucks Borough Inundated By Water And Money Problems Another word that usually incorporates water in its meaning is drown. To drown is â€Å"to suffer death by submersion in water.† It is, of course, possible to drown in a liquid other than water. I watched a television drama in which someone drowned in a vat of molten chocolate. In a literal sense, when a person drowns, death is understood to be the outcome. The use of â€Å"to death† in the following examples is redundant: A mother and her 7 children drowned to death in illegal immigration trip from Turkey to Greece on November 29 TV actor Mohsin Khan drowned to death The tiger star in Life Of Pi almost  drowned to death  during filming. A boy drowned to death  in the pool which lies in the basement of the school. The verb drown can also be used in the context of covering something with water: Some corn and soybean  plants were drowned. Drowned corn crops may hurt farmers, rest of nation The crops in many  fields  of the neighborhood  were drowned  by the continuous rains.    To slow the German army, Flanders  fields were drowned. When people drown, they die. When fields are drowned, they are filled with water. When fields or streets are inundated, it’s almost always with water. Note: The past form drowned is pronounced as one syllable (drownd). Want to improve your English in five minutes a day? Get a subscription and start receiving our writing tips and exercises daily! Keep learning! Browse the Expressions category, check our popular posts, or choose a related post below:100 Words for Facial ExpressionsHomonyms, Homophones, Homographs and HeteronymsComma Before Too?

Go Ahead and Wallow in These Depressing Love Quotes

Go Ahead and Wallow in These Depressing Love Quotes Love can make you soar with happiness. Or love can leave you sore with sorrow. Sometimes love can leave you heartbroken. You might be so much in pain from  unrequited love that you never want to love again. Such depression can take a toll on your health. The antidote to heartbreak  just might be depressing love quotes   misery loves company might be a cliche, but its also true. So go ahead and wallow in it for just a bit, knowing that what you are feeling is part of lifes journey and an experience shared by many through the ages. W. Somerset MaughamThe love that lasts the longest is the love that is never returned. Love is only a dirty trick played on us to achieve continuation of the species. BoethiusA man content to go to heaven alone will never go to heaven. For in all adversity of  fortune  the worst sort of misery is to have been happy. Francois de La RochefoucauldAbsence diminishes mediocre passions and increases great ones as the wind extinguishes candles and fans fires. Julie AndrewsAll love shifts and changes. I dont know if you can be wholeheartedly in love all the time. Judy GarlandFor it was not into my ear you whispered, but into my heart. It was not my lips you kissed, but my soul. OvidFortune and love favor the brave. Mother TeresaThe hunger for love is much more difficult to remove than the hunger for bread. Mignon McLaughlinHate leaves ugly scars, love leaves beautiful ones. Albert EllisThe art of love ... is largely the art of persistence. Thomas FullerThe greatest hate springs from the greatest love. Edmund SpenserAnd painful pleasure turns to pleasing pain. Thomas MooreTo love you was pleasant enough. And, oh! Tis delicious to hate you! George Bernard ShawLove is a gross exaggeration of the difference between one person and everybody else. Federico Garcia Lorca, Blood Wedding and Yerma â€Å"To burn with desire and keep quiet about it is the greatest punishment we can bring on ourselves.†Ã‚   Betty Smith, A Tree Grows in Brooklyn â€Å"I know thats what people say youll get over it. Id say it, too. But I know its not true. Oh, youll be happy again, never fear. But you wont forget. Every time you fall in love it will be because something in the man reminds you of him.†Ã‚   Dylan Thomas â€Å"Though lovers be lost, love shall not; And death shall have no dominion.†Ã‚   George R.R. Martin â€Å"When the sun has set, no candle can replace it.†Ã‚   Lana Del Ray â€Å"No one compares to you, but theres no you, except in my dreams tonight.†

Case Study Analysis Essay Example | Topics and Well Written Essays - 2500 words - 2

Case Study Analysis - Essay Example For a long time, public administration has reluctantly been viewed as a science by several other disciplines. Perhaps, this is attributable to the idea that public administration theories rely on other disciplines in predicting and explaining relationships among elements articulated in its administrative functions. Nevertheless, public administration system entails studying human beings in an organizational setting, but which operates in a political environment (Rabin et al 2006). In this regard, public administration theory is derived from other disciplines, but studied as a single entity due to its unique traits of enjoining different dynamics to have an effective administration. In a broader sense, public administration is explained by two theories; universal design theory and situational design theory (Farazmand, 2001). In universal design theory, scientific management, classical and bureaucratic theories explains the structuring the public administration. Situational theory deno tes on the human aspect of the organization. Common theories that emphasize on this theory include behavioral approach, system approach and human relations theory among others. In the United States, the public administration can be argued to have utilized theories of public administration effectively. However, Milakovich & Gordon (2012) argued that it is indispensable for the public administration to consider exploring all available ways of bridging the existing gaps. For instance, with the increase in the number of migrants in the United States, the department of homeland security has been face with the challenge of controlling foreigners streaming to the United States. Going by the scientific management theory, Fredrick Winslow Taylor emphasized on the need to have social prosperity between the workers and the management. This aims at developing science of each element of man’s work and

American Type(s) Essay Example | Topics and Well Written Essays - 250 words

American Type(s) - Essay Example Trompenaars seconds the power dimension using the hierarchy dimension of culture. All individuals ought to understand the positions they hold to adopt effective interaction skills. In addition, human interaction cuts across the social, political, and economic spheres. It is better to adopt a polychronic culture where human interaction is valued over the activities in the modern day world. Edward Hall presents the three common dimensions that separate the American culture from the rest of the world. He analyses cultures through time, context, and space. He places Americans within the dimensions of low context, monochronic time, and high territoriality dimensions. Americans fall under the low context dimension due to their attention to detail. They acknowledge that time is for the essence to obtain a holistic view of life. However, Hall rules out the fact that Americans fail to attach value to human interaction. The social aspects of the American culture are highly influenced by human interaction. Shwalbe, (1996) explains that individuals invent the social world from the patterns of belief and action. There exists an American type that views the social world in form of a human artifact. For example, in America, foreign cultures are viewed as being bound by irrational accounts such as gender bias yet such bias is ignored in the local culture. The American type is bound by patterns of belief that seem natural and must be religiously

The relationships between happiness and money Essay Example for Free

The relationships between happiness and money Essay The Relationship between Money and Happiness If money doesn’t buy happiness, what does? Many people believe that having more money is going to make them happier in life, but does money really provide true happiness? After reading the passage â€Å"Yes, Money can buy happiness,† by John Tierney, explains that people are more often to be happier when they spend money on others rather than spend money on themselves. In my opinion many people believe having more money will make their lives happier and free of all worries. In my life money has provided food, clothing, and shelter our basics needs in life but I came to a conclusion where my satisfactory is not enough. I complain that I need more money and that it will solve all the solution to my problems. But in reality money is never going to be enough to buy my happiness in life, because the more we have the more we need and want. For example, I went shopping to the citadel outlets with my family, less than a few hours I spend about four hundred dollars. I looked at other people and I wish I had more money to spend in order to feel enjoyment and more satisfaction. Then, I look into my partner eyes and say to him, I realize with money you can become selfish, destructive and greedy but on the other hand it can help you discover a world you never knew because we all know money can open the doors to many objects in life. Such as, having the opportunity to explore the world, to have all the materials in life. Furthermore, I do agree that buying does bring happiness to everybody in that moment. After, that I disagree it would bring 100% happiness in life because money does not buy love, passion, pureness, and what life is all about. In the end it all depends on your approach to life and how you see money and the relationship with it.

The Big Lie(about Theism) :: essays research papers

The Big Lie I have been going to church since I was three years old. I also attended Sunday school since I was three. Since then I have been confirmed as a member of the church and have actively participated in the senior high youth program at my church. All of these years I figured that I would "grow into god", well at least that is what my pastor said. I think of myself now, at seventeen years old, and I still have not "grown into god". I have many reasons why I chose atheism. First I think of church as a bunch of hogwash. When I take a step back to look at the church, here is what I see. I see a god that has not shown any proof for that last 2000 years (if even then), I also see a god that has left no evidence, except for the cross. Lets talk about the cross for a moment. Jesus was supposed to have carried this huge cross only to be nailed to it and hung among thieves. First off, if Jesus was this big threat to a king and supposed to be the Son of God would not one think that he would go out with a bigger ceremony. I do not think that the king would just hand him among thieves. Second, on the third day he was supposed to move this huge stone and "rise". What is rising anyway did he just magically lift into the air without making a sound and no one seeing him. Or was it more of a fade away into nothing, if that was so why did he move the stone? I see many similarities between the church and a cult. What is a cult? A cult as I see it is people who blindly dedicate time and money to a higher power in which they have never seen evidence of, same as the church. The main difference between a church and a cult as I see it is the church has history. Many cults can be self-destructive, hence the church is thought to be stronger. The people of the church also have this book they cling to, the bible. This bible was supposed to be written thousands of years ago and supposed to have actual quotes from Jesus himself. First how could a book last this long? The Big Lie(about Theism) :: essays research papers The Big Lie I have been going to church since I was three years old. I also attended Sunday school since I was three. Since then I have been confirmed as a member of the church and have actively participated in the senior high youth program at my church. All of these years I figured that I would "grow into god", well at least that is what my pastor said. I think of myself now, at seventeen years old, and I still have not "grown into god". I have many reasons why I chose atheism. First I think of church as a bunch of hogwash. When I take a step back to look at the church, here is what I see. I see a god that has not shown any proof for that last 2000 years (if even then), I also see a god that has left no evidence, except for the cross. Lets talk about the cross for a moment. Jesus was supposed to have carried this huge cross only to be nailed to it and hung among thieves. First off, if Jesus was this big threat to a king and supposed to be the Son of God would not one think that he would go out with a bigger ceremony. I do not think that the king would just hand him among thieves. Second, on the third day he was supposed to move this huge stone and "rise". What is rising anyway did he just magically lift into the air without making a sound and no one seeing him. Or was it more of a fade away into nothing, if that was so why did he move the stone? I see many similarities between the church and a cult. What is a cult? A cult as I see it is people who blindly dedicate time and money to a higher power in which they have never seen evidence of, same as the church. The main difference between a church and a cult as I see it is the church has history. Many cults can be self-destructive, hence the church is thought to be stronger. The people of the church also have this book they cling to, the bible. This bible was supposed to be written thousands of years ago and supposed to have actual quotes from Jesus himself. First how could a book last this long?

Biographical Analysis of John Mcwhorter

Han Bin Kim Comp II, Class B Assignment 2, Draft 1 February 23, 2013 John McWhorter Interview Over the years I have interviewed a good number of people, but there has never been anyone quite like John McWhorter. Upon reading the article â€Å"The Cosmopolitan Tongue: The Universality of English† as published in the 2009 Fall edition of World Affairs, I found myself delighted by the mellow but powerful tone and the writer who could use it with such ease. Here was a man with brains, consideration, and humor.Lost in my reveries about what McWhorter would be like, I didn’t quite realize that I had somehow dialed his office number until a deep voice filtered through the receiver. â€Å"Yes? McWhorter speaking. † With a tingling sense of nervousness I had forgotten since my rookie days, I introduced myself and asked if he could spare time for a brief interview. He replied, â€Å"Interviews, my dear sir, are rarely brief,† and I could almost hear his smile. There was that brilliant wit which had inspired him to state that there were â€Å"no feminine-gendered tables that talk like Penelope Cruz. (McWhorter, 251) After a turn or two of friendly wrangling, he gently suggested meeting Saturday afternoon at a quiet cafe we both knew. I agreed to the designated rendezvous and, unable to control the temptation, asked, â€Å"How long have you said cafe like that? † The way McWhorter pronounced the word was this: the ‘c’ was sweeter and lighter, in the way Italians and Spaniards speak, and the ‘f’ was said like a soft ‘p’—sounding simply foreign. He said simply, â€Å"Since I was very young. I already knew that he had â€Å"taught himself languages as a hobby since childhood† (McWhorter, 247), and unsatisfied as I was with his answer, I vowed that Saturday would be a new day. On Saturday afternoon I drove down a peaceful country road and walked silently into the cafe. A tall man stood wi th his back to me, gazing out the large French window, and without prologue asked, â€Å"Isn’t that a beautiful poem right in front of us? Anne Shirley said it a century ago, but I’ll take the liberty to repeat it.The lines and verses are only the outward garments of the poem; the real poem is the soul within them†¦ and that beautiful scene is the soul of an unwritten poem. † I smiled quietly at his analytical but sensitive analogy, reminded immediately of his description of the word ‘al— â€Å"an evergreen branch, a word whose final sound is a whistling past the sides of the tongue that sounds like wind passing through just such a branch. † (McWhorter, 247) I later asked him what his childhood nickname had been, and laughing, he confessed that he had most often been called â€Å"poet†.Small wonder for a man who could condense a long, everyday sentence—say, for example, â€Å"there are an innumerable number of books that c ould have summed up to no mean weight†Ã¢â‚¬â€into three pithy, creative, imagery-filled words: â€Å"Bookstore shelves groan. † (McWhorter, 247) He folded his long self into the armchair, crossing his legs, and leaning slightly forward he told me to sit down. As I sat, I remarked, â€Å"You look a great deal like I imagined you to be. † His quiet question and intelligent gaze compelled me to elucidate.I had gathered much of the premises from his writing. The contrasting thoughts â€Å"I hardly rejoice when a language dies† (McWhorter, 247) and â€Å"Would it be inherently evil if there were not 6,000 spoken languages but one? † (McWhorter, 252) could hardly have revealed themselves in a single piece of writing unless the writer was a man of exceptionally precise, cold logic. Thus I had already envisioned the deep-set, handsome eyes that flashed fire from under his brow, and the firmly set mouth. I had also imagined him to be a handsome man, and he was that, too.Humor saved the chin from tapering too sharply, the mouth from being dour: â€Å"Spanish speakers do not go about routinely imagining tables as cooing in feminine tones. † (McWhorter, 249) McWhorter laughed at my analysis, wryly telling me that I should have gone out for professional work in physiognomy, and handed me the menu which the waitress had left by his side. These little considerate actions which I had noticed during the phone call and the three minutes I had met him, inspired me to ask if he had always been so considerate. He looked surprised. I have never thought myself considerate,† he said slowly, â€Å"I am often told that I am too frank with my words. Before I make my opinion on something, I look at it from all perspectives to check that it is perfectly reasonable and logical. But once I make it, I say it without stopping to think if people who think otherwise will be hurt by my words. † I protested. I had already known that he was a considerate person just by reading his article; namely, the welcoming way with which he drew his readers in: â€Å"Most Americans pronounce disgusting as â€Å"diss-kusting† with a k sound. Try it—you probably do too. )† (McWhorter, 248) The tall man leaned back in the armchair and laughed. â€Å"My dear friend, every writer is obligated to welcome his readers. Readers are the laziest species that ever drew breath, and if they don’t feel welcomed, they won’t read. As for being patient in littler things—well, I don’t know if this is very relevant or not, but I read five versions of the Talmud, each one progressively harder, when I was in middle school. I’m pretty sure junior high was when my interest in Hebrew peaked.The Talmud was a pretty good source of linguistic and cultural knowledge, and some of the moral standards made pretty logical sense, so I adopted them as my own. † It was relevant. Being considerate in a gent lemanly way, however, was different from the deferential attitude that McWhorter always took on when dealing with other cultures. More curious was how completely he seemed to understand each language, from its origin to how the people felt about it—â€Å"Native American groups would bristle at the idea that they are no longer meaningfully â€Å"Indian† simply because they no longer speak their ancestral language. (McWhorter, 249) McWhorter looked a trifle annoyed at first, but gradually his well-shaped face took on more complacent, amused lines. â€Å"I am a writer, and I am a linguist,† he said. â€Å"Both have to do with words—their denotation, connotation, nuance, and power. Knowing the power each word can wield automatically inspires you to feel a certain reverence for the English vocabulary in general—I’m sure you’ll agree with me there, sir—and knowing the power each language can wield brings you on your knees before th e altar of all languages. † â€Å"But you don’t worship something you know absolutely nothing about,† he aid, gazing out at the sunlit scene again. â€Å"You first make sure that whatever it is, it is something that deserves to be worshipped. So you study the language. From then on, it’s rather like jumping into a river. Jump into the heart of the current, and you will be swept away like a stray autumn leaf. If you give yourself wholeheartedly up for the language to mold, the culture starts to mold you too. And as for the fact that I feel this way towards all languages,† and here a small frown creased his brow as he turned to me again, â€Å"well, it is a shame that this should be surprising, that is all.Each language has a rich legacy, albeit a legacy very different from our own, and they should be respected. † McWhorter’s eloquence touched me, and we talked for two more hours, vacillating from common everyday things I caught glimpses of from his article to fascinating facts I had never dreamed about him. I learned that he had mastered Socrates’ syllogisms at the age of six and Hegelian dialectics at the age of twelve, and that the value he respected most in humanity was its reason.Judging by the cold shoulder he gave his so beloved minority languages in his concluding paragraph—â€Å"We must consider the question in its pure, logical essence† (McWhorter, 252)—it was hardly surprising. More interesting was the fact that he had no less than four dogs at home, each named after a rare language he had specially enjoyed. The latest addition to the family was a darling slender little Chihuahua named Ket, with triple the uncertain grace of awkwardness found in dogs of his species. In the middle of hearing about Ket’s antics, I asked rather abruptly, â€Å"What art form is your favorite?Modernist? † McWhorter looked at me, surprised. â€Å"How did you guess? † I laughed. McWhorter, for a man of such clear-cut logic, enjoyed impossibilities as far as reality allowed— â€Å"The Ket language of Siberia is so awesomely irregular as to seem a work of art. † (McWhorter, 250) It was only natural that he should enjoy Picasso, whose pictures showed sharper intellectual insight, over David or Michelangelo, whose works were but excellent facsimiles of life’s appearance copied onto canvas and marble.Four hours passed by in the blink of an eye and time came for McWhorter to leave. He stood up and cordially shook my hand. â€Å"It was an honor meeting you, sir, though I dare say the interview was not short. † I shook my head. â€Å"No, it was an excellent interview. Thank you very much, Mr. McWhorter. † â€Å"Please, John,† McWhorter smilingly said. â€Å"If there’s one thing I learned from studying languages, it is that names are the essence of culture. I’ve seen many languages that are creative and fiendi shly difficult and random—but no language is ever simpler than the other.Each has rich names for the things they treasure most. Native Americans sometimes have odd names; did you know that they have to earn it? But in our culture, we place identification foremost—and thanks be, my name is John McWhorter; John for friends and Mr. McWhorter for editors who don’t like my articles. † â€Å"Aren’t there many Johns here? † I teased, laughing, as I pulled on my coat. McWhorter shook his head. â€Å"None like me, John McWhorter,† he smiled, and treaded lightly out the door.

Hume and his contemporaries Essay

Live art performances, marked by an overture of spirituality, consciousness, physical introductions to pain, drawn further on to include specific rituals, symbolisms, varied states of emotions brought by self-inflicted hurt and eventually, culminating in a wild display of frenzy and shocking images, are less likely to please the uninitiated audience than it will provoke a sense of awe and wonderment among performance art critics. In a similar situation, Marina Abramovic’s attempts to upend the static discourses of physicality, mental states of mind and art that pervade current Western hegemony, understandably, can only be regarded in the extremes by people steeped firmly into formal traditions. Either her method of performance will elevate its spectators to a heightened degree of appreciation, therefore merit a thunderous welcome to a novel brand, sui generis, of art of our time at the end of each scene; or her gruesome didactics on the body’s threshold for pain, simply fails to pass muster. Her performance practice, a risk more than anything else, certainly inspire debates on whether or not to set moral, perhaps even social limits to art in order to determine, in precise and concrete terms, at which point creativity and imaginative art themes and performances become either delightful to the senses or noxious to the sensitivities of the general public. The idea of drawing the line along and between different shades of extremes, although already evinced clearly in the works of Marina Abramovic, seems to fit the consensus on the idea of censuring the bold and burlesque, stripping it off its material enunciation and expression to mitigate the horror and revulsion inherent in the exposition, or in the worst case, totally ignore it until the novel yet misunderstood facade fades from inattention. However, thanks mainly to Marina Abramovic’s unwavering desire to reach her audience, despite the sometimes hostile reception during her performances itself, in ways that continually push the envelope of spectator tolerance, did she carry her work from the esoteric art circles to mainstream. To wit, in one of her collaborative performances with Ulay, entitled Incision (1978), while purposively eliciting reaction, probably direct participation, from their audience, one of the spectators primed the climactic resonance of the work by jumping into the stage to kick Marina Abramovic as she was lying prostate right in the middle of the act. In her biographical work, she writes that although she expected the attack to happen any moment during the performance, she did not realize the immediacy and steeled resolution of that man who assailed her (Abramovic, 1998). Photographs of the show caught the man with a leg lifted, jumping into the air. â€Å"The next photograph shows Abramovic lying on the floor, and the man seems to be landing from a kicking action [†¦] the audience’s interrogation manifested in a spontaneous physical attack (Tang, 2005). Ethical and moral questions, as well as aesthetic controversies have been discussed quite animatedly as early as the 18th century. Philosophers, like David Hume, have started to addressed the tough issues about morality, art and taste—the chief concerns that pervaded his era. Cynthia Freeland, introducing the notions of Taste and Beauty, in a book about defining the slippery strands of art, writes that Hume and his contemporaries â€Å"would not have approved of blasphemy, immorality, sex, or the use of body fluids as appropriate in art† (Freeland 2001). As a caveat to this general statement, it must be understood that even though 18th century consciousness all the way up to the present have not been too open in giving cognizance to art that smack of Marina Abramovic’s own brand of carnal art expressions, there are already extant cultural and social systems which places importance into shamanistic and ritualistic gestures. Among art critics and historians, some pursue a theory of art as ritual: â€Å"ordinary objects or acts acquire symbolic significance through incorporation into a shared belief system† (Freeland, 2001). In the same vein, Freeland further digs deep in history to provide evidence in varied cultural rituals that depict blood and physical pain. She avers that â€Å"when a Mayan king shed blood before the multitude in Palenque by piercing his own penis and drawing a thin reed through it three times, he exhibited his shamanistic ability to contact the land of the undead† (2001). Other modern artists try to recreate a similar sense of art as ritual, just as much as Marina Abramovic has had for the last three decades. Diamanda Galas, for instance, â€Å"fuses operatic wizardry, light shows and glistening blood in her Plague Mass† (2001), supposedly to exorcise pain in the era of Aids. Herman Nitsch, Viennese founder of the Orgies Mystery Theater, promises â€Å"catharsis through a combination of music, painting, wine-pressing, and ceremonial pouring of animal blood and entrails† (Nitsch, n. d. in Freeland, 2001). As it turns out, these very rituals are ingrained in Western traditions. Illuminating examples of which are the amount of blood depicted in European’s, and verily much of the cultures in the modern world today, two main belief discourses: that of the Judeo-Christian and the Greco-Roman. By taking a cursory review of religious and classical texts of Western traditions, we are able to immediately uncover a plenitude of blood representations and ritualistic sacrifices. In the Old Testament, Yahweh is seen to require â€Å"sacrifices as parts of His covenant with the Hebrews† (Freeland, 2001). Similarly, Agamemnon â€Å"faced a divine command to slit the throat of his own child [†¦] the blood of Jesus is so sacred that it is symbolically drunk to this day by believing Christians as promising redemption and eternal life† (2001). Such myths and religious stories are rather germane to Western art. We read of Homeric heroes wining the favors of their gods and goddesses by sacrificing animals. Likewise, the tragedies of Lucan and Seneca â€Å"piled up more body parts than Freddy Krueger in A Nightmare on Elm Sreet† (2001). Not surprisingly, likewise, Renaissance paintings are never without a hint of blood draped at the canvassed in hard red-acrylic paint whilst Shakespeare’s tragedies typically concluded with swordplay and stabbings. The preceding examples of ritualistic performances which involves blood and sacrifices, death and disease, murder and trials, are very instructive with regards to our penchant for the macabre and the dreadful. It is in these premises that Marina Abramovic draws much of her inspiration to create an art, pro forma, that bespeak of our capacity to endure scenes of gore and violence—if only on a less exacerbated state. Her performance, for the most part, certainly places importance on the symbolic values of ceremonies, gestures and artifacts. Albeit appearing random and spontaneous, her methods establish a logical connection between her consciousness while performing and her body’s means of coping with the strength of self-infliction. In the nascent days of her art, she has performed controversial after controversial explorations into the limitations of the mind and the body. Rhythm 10, in 1973, was the first in a series of abject surrender to the inevitability of suffering. Alone in the stage, she prepared a set of knives to be used as piercing objects in a risky game of Russian hand roulette. Without signs of hesitation, she proceeded to stab the spaces between her fingers in a rough yet determined fashion. Each time she made the mistake of cutting her flesh; she dropped the knife and took out another one to repeat the process all over again until she made use of all ten knives (Abramovic, 1998). The following year, in the performance entitled Rhythm 5, she sought to re-evoke the energy of extreme body pain by constructing a huge star soused with combustible petroleum liquid. At the onset, the structure as lit to flames, and while she was standing right outside the contraption, she religiously clipped her fingernails, cut her hair and them inside the burning star. The denouement of the program was when she danced around and then flew across the flames into the center of the burning star. Serious and life-threatening complications ensued when the smoke that engulfed her from inside asphyxiated her to the point that she no longer had control of her actions. The medical team and the audience, who were all there to watch, started to suspect that something was terribly amiss. Fortunately, the quick responses from the stand-by technicians saved her from an untimely death caused by severe smoke inhalation (Abramovic, 1998). In the same year and the years that followed, Marina Abramovic designed similar art experiments that were meant to test the limits of herself and her body, and later the audience and their tolerance for vicarious agony through her body. Rhythm 2 and Rhythm 0, were performed with the hopes of proving that the consciousness can go beyond the rubric of psychological triggers in mind. The sole aim of both was to uproot the inherited tendencies of the mind to reel from stark images and provocative gestures. She sought to cultivate in the audience a sense of indifference in order that one may reach a virtual catharsis what with all the sharp and strong representations between the body and suffering. For artists like Marina Abramovic, it is clear to them that what they are performing, and while in the act of performing, there is a higher purpose that they wish to achieve regardless of the methods by which these are made possible. They have a firm understanding and appreciation for every act and gesture that they make. None of such are done without rhyme and reason. For artists like Marina Abramovic, everything that happens during any performance, in spite of the harsh opinions of critic that meet them right afterwards, makes a lot of sense. However, audiences who see and react to these artists do not enter, much less share the beliefs and values, or with prior knowledge of what will transpire, with that of the artist. When asked about the origins of her creativity and ideas for her art performance, Marina Abramovic happily recalls her childhood memories with her parents. As if to show indeed that her style was a result of previous life experiences that may be susceptible to a psychoanalytical reading, she narrates: â€Å"A long time ago I made a piece called Art Must Be Beautiful, Artist Must Be Beautiful. At that time, I thought that art should be disturbing rather than beautiful. [†¦]My life is full of such contradictions. [†¦] My father and mother are divorced. As an adult, I recently wanted to go back to help them because of the war. With the embargo, there is nothing in the stores. [†¦] I called my father to ask him what he needs, and he dictates a long list – antibiotics, bandages, penicillin, toilet paper, coffee, sugar, powdered milk, all these basic things for survival. Then I call my mother and ask what she needs. She says, â€Å"I need Chanel lipstick, Absolute Red, Number 345, and hair spray. † I am between these two. † (Abramovic, 2005) Most modern art, in this case, within the context of theatre, videos and live performances, fail to provide ample background reinforcement against the dominant traditions and systems of belief. What invariably happens is that the audiences will remain ignorant to, consequently, unappreciative of the complexities and undertones of the supposedly artful, meaningful and profound gestures. The audience, instead of sharing that same degree of catharsis, sacrifice and initiation, will shy away. They themselves are alienated from the performance so much that they are brought far afield the community, forcing them to abandon the art because of pure shock and horror, largely as a result of their ineligibility to feel as the artists do (Freeland, 2001). Damien Hirst, the ‘Britpack’ artist who sparked controversy in the 1990s with his motley display of macabre high-tech exhibits of â€Å"dead sharks, sliced cows, or lambs in glasses of formaldehyde, [†¦] has parlayed his notoriety into success with his popular Pharmacy restaurant in London† (Freeland, 2001). By no means, therefore, are the works that revolve around symbolisms, spirituality, humanity and fatalism seldom reflects the nature of most of our ritualistic traditions. Symbols of pain and suffering that are central to many religions, cultural systems, political and social units, may come off to the lay person as undesirable and may even cause the same panic as had the man in Marina Abramovic’s performance. Art performance that utilizes imageries that hint at violence, torture and distress, when it is performed in the public who has no inkling of its context, meaning and history are in danger of misconstruing art for capricious display of filth and tripe. As with all in theatre, the performer must work â€Å"against mutual projection between audience and performer†, the identification in which â€Å"[we] believe so readily in the other as the keeper of our treasure and our disease† (Tang, 2004). Valie Export, a similarly omnipresent and provocative figure in the world of art performance, shares the same problems of audience interaction, although not as much as Marina Abramovic. Beside art performance, her repertoire includes film, text, painting and photography to name a few. These avenues of artistic expression gravitate towards her criticisms for feminism and gender. A staunch activist and a progressive performer, she has oftentimes been called a woman living an anachronistic life. This is due to her revolutionary ways to present her ideas that even her colleagues, who without proper notice of her intentions to perform, usually end up dismissing her as too fanciful and idealistic. Her works on ‘Asemie or the Inability of Expressing Oneself Through Facial Expressions’ (1973) and ‘Touch Cinema’ (1968) garnered both fame and distress. Chief of the reasons that contributed to an admixture of reception from the critics and audience is the fact that her ideas do not create strong meaningful associations that the people can readily identify with. Humor and parody may be part and parcel of her work as a performer, but these effects are not what she contemplated to be so. Indeed, while she wanted to catch the attention of her spectators, her ultimate goal is to instruct them of the subtle messages regarding feminism, modernism and ritual art. Export, along with the controversial artists at the turn of the 21st century, became (in-)famous in the recent decades because of her startling presentations of objects and her body (Mueller, 2004). Of her earlier works, ‘Aktionshose: Genitalpanik’ or ‘Action Pants: Genitals in Panic’ (1968), Export engaged the audience, piquing their imagination and belief, with a series of photographs, simultaneously permitting them to engage her as the tangible representations of the images presented in the collage. In an art theater in Munich, dressed to the nines, with the crotch cut out of her pants, Valie Export threaded each row person-to-person, showed her outfit thereby giving the film-viewing public with a palpably visual representation with a real female body. In doing so Export tackled the pornographic reduction of women in static representations just when ideas of feminism and gender were starting to develop during that time. Her message is commensurate to a direct, unapologetic, political affront to the abstract objectification of the female body as a fetish. She moved an aesthetic gesture beyond the representational context of the safe boundaries of art into an actual encounter with a public. Export effectively brought to the fore the various dimension of simple, albeit arresting, bodily gestures â€Å"both to produce and to represent action [. . . ] by stressing the moment and the process of its own production† (Stiles, n. d. ). Export repudiated the representational static sign and discharged an interventionist act by revealing her yonic-self to the public vis-a-vis the photos on the display. Art performance, in the recent decades since its entrance in the mainstream, has, and is continuing to encompass a wide field of human proclivities which spans across a whole, comprehensive range of emotions, symbols and design. Although traditional views on aesthetics and taste still influence much of the productions in the art, more and more innovative, socially-informed, stunningly beautiful works of art performance are being (re-)invented and (re-)discovered every time. It doesn’t matter whether these newly created art forms subscribe to tradition or to the taste of the general public. What matters most is the never-ending quest to plumb the full extent of our humanity as individuals and as a community. Art performance is yet to supplant, at least equal the popularity of video-films, cinema, photography and painting in terms of the instances that these are demanded by the public. But with the works of Marina Abramovic, Ulay, Damien Hirst, Valie Export et al and their boundless passion to break the mold and stun the public to enlightenment, art performance can be considered as a significant cornucopia of art studies and of artistic expression. A number of critics do give favorable comments to Marina Abramovic’s performances and ingenuity, Valie Export’s live photography sessions, Hirst’s â€Å"gleaming vitrines with suspended animals inside† (Freeland, 2001). However, it must be noted that even if the critics find them beautiful and artful still its startling content warrants full attention; nothing short of shallow and pedantic in all respects of praise and criticism. Freeland writes, perhaps disinterestedness has some small and specific role in approaching difficult art by enabling us to try harder to look at and understand something that seems very repugnant to the senses (2001). The work’s content and the artist performing are just as crucial as the theories that surround art performance. It is not so much as merely an arbitrary act done through the caprice of a strange art performer. It is instead, a manifestation of our natural tendencies, our history, our sense of taste and what is beautiful, our entire spirituality and lastly, our consciousness set against the body as a tool to perceive reality. Art performance as practiced by these artists is a celebration of the body and of our community. An excellent performance and performer do more than take the audience to elevated heights, but also give them a sense of being truly and undeniably alive. And such, makes all the difference. References Abramovic, M. (2005). Marina Abramovic: the biography of biographies. New York & London: Charta Publishers. Abramovic, M. (1998). Artist body: performances 1969-1998. New York & London: Charta Publishers. Freeland, C. (2001). But is it art? : blood and beauty. New York: Oxford University Press, Inc. Mueller, R. (1994). Valie Export: fragments of imagination. Bloomington and Indianapolis: Indiana University Press. Stiles, C. (n. d. ). Aktionshose: genitalpanik (action pants: genital in panic). Retrieved January 15 2008, The Galleries at Moore database. Tang, A. (2005). Gazing at horror: body performance in the wake of mass social trauma. (Masters of Arts program, Rhodes University 2005). .

Society and Teen Drug Use †Health Essay

Society and Teen Drug Use – Health Essay Free Online Research Papers Society and Teen Drug Use Health Essay People rarely escape the topic of drugs because they are everywhere in society; from television to magazines, from movies to radio and from social issues to public concerns. Teens are the ones most bombarded by drugs and drug paraphernalia because they are the ones targeted by dealers and traffickers. The dealers and traffickers get the leader of a group of teenagers hooked on drugs and use him/her to steer other teens towards drugs. The leader embraces anyone who does drugs and shuns anyone who does not, which forces teens to think that they need drugs to be popular. The dealers and traffickers also seek out unpopular teenagers and convince them that drugs are a quick answer to their social problems. To add to the pressure, many admired musicians place drugs into their songs, and several well-liked actors and actresses have roles in movies that contain drug usage. In fact, some of the musicians and actors are addicts themselves, which just furthermore impairs teens about making the right choices in relation to drugs and persuades them to do drugs to be â€Å"cool† like the actors. We as a society must put and end to drug use and abuse. It ruins the user’s life by forcing the user to spend all their money on their horrible addiction. Once the user is out of money, they resort to stealing which boosts up the crime rates and makes our society an unsafe place to live and work. Drugs that are injected into the user’s body via a needle help the spread of sicknesses such as the AIDS virus and Hepatitis B. To put an end to the flow of drugs, the government should raise the consequences on trafficking, possession and dealing drugs. To stop the increase of drug addicts the government should thoroughly educate teens on drug use and abuse, what drugs can to do a user’s body and how drugs consume a user’s life. Therefore peer pressure should be stopped because it can manipulate teenagers into drugs which will ruin their lives. Introduction Teens all over the world face hardships and obstacles that they must overcome in order to succeed in life. These obstacles can come in any form, but for teens in Canada, it comes as peer pressure. Peer pressure is the problem of many teenaged Canadians for it can control the actions of unwilling teenagers and force them to make bad decisions that will haunt them for the rest of their lives. To let teens succeed in life peer pressure must be stopped. Conclusion Peer pressure must be stopped because it causes the problems of numerous teenagers all over Canada, everywhere in North America and around the world. If peer pressuring someone into a bad lifestyle could be put to an end, then the world would be a better place because there would be a lot less negative influence on developing minds. Peer pressure turns perfectly good, intelligent people into drug addicts, criminals, bullies and gang members. How would you feel if peer pressure turned your child into a drug addict? Research Papers on Society and Teen Drug Use - Health EssayThe Relationship Between Delinquency and Drug UseThe Effects of Illegal ImmigrationPersonal Experience with Teen PregnancyRelationship between Media Coverage and Social andQuebec and CanadaHip-Hop is ArtEffects of Television Violence on Children19 Century Society: A Deeply Divided EraCapital PunishmentMarketing of Lifeboy Soap A Unilever Product

Cardiovascular Diseases

Thanks to the rising health awareness and government programmes this number significantly reduce during last 30 years. Coronary heart disease and cardiovascular disease Cardiovascular diseases are diseases of the heart (cardiac muscle ) or blood vessels (vasculature). Cardiovascular disease (CVD) means all the diseases of the heart and circulation (blood vessels disease) including coronary heart disease (angina and heart attack) and stroke, as well as coronary and periphery blood vessels disease (problems with circulation). Diseases from this group are the biggest killer in Europe and USA, but developing and non-develop countries too. The final and most tragic consequence of different types of heart disease is heart attack with tragic consequences. Heart diseases are caused by atherosclerosis, a disease of arterial blood vessels resulted from atheroma i. . plaques accumulated (forming; sticking) on artery walls which makes the blood vessels nonelastic and narrowed and leads to decreased blood flow. For the atherosclerosis doctors very often use alternative name chronic cardiovascular disease. The opposite group acute heart disease made group of diseases which are dangerous for patients lives. Acute heart diseases include conditions or illnesses wh ich usually have a rapid onset of symptoms and may resolve within days with or without treatment. A condition or illness that is sudden or severe. On the other hand a condition or illness that arises slowly over days or weeks and may or may not resolve with treatment made a group of chronic heart disease. Both of them are caused by atheroma and the most known are next: a) Acute heart disease Heart attack is caused by lack of O2 in heart muscle cells. Very often it is caused by rupture of â€Å"hard plaques† patches which result in blood clots and partially or completely block blood flow and cause a heart attack. When a fiber cap becomes thin, these â€Å"hard plaques† can suddenly rupture, spilling their contents, resulting in blood clots that partially or completely block blood flow and cause a heart attack http://www. authorstream. com/Presentation/nitin-35423-heart-diseases-science-technology-ppt-powerpoint/ Cholesterol glossary. http://www. mybwmc. org/library/28/000225 Stroke Stroke is death of brain cells caused by obstructed blood flow to parts of the brain. Since the level of LDL cholesterol is main cause of narrowed of blood vessels, it is necessary control it. If not treated properly, high LDL cholesterol can cause a stroke. Cholesterol glossary. http://www. mybwmc. org/library/28/000225 b) Coronary heart disease Heart disease (coronary heart disease), When the plaque build up in th conorary arteries heart does not get sufficient blood, the condition is called coronary artery disease or coronary heart disease. Atherosclerosis is a disease of arterial blood vessels in which plaques form on artery walls. This is a consequence of different substances circulating in the bloodstream (inflammatory cells, proteins, cholesterol and calcium) sticking inside the vessel walls. Plaque patches influence on narrowing blood flow in the artery. ttp://www. bodybuilding. com/fun/gastelu5. htm Peripheral artery disease (reduced blood flow in the limbs, usually the legs Coronary plaque Coronary plaque is a term which use in practice as a synonym for atheroma or atherosclerosis. Patches of atheroma are formed from substances that circulate in the bloodstream. They consist of lipid, or fat, cores covered by collagen fiber cap s which are sticking to the inside of the vessel walls. Over time plaque or patch of atheroma increases making an artery narrower and the blood flow through the artery is reducing. We can see the changes in blood vessels caused by plaque in the Figure 1. Figure 1 Artery with the patches of atheroma – plaque Preventing Cardiovascular Diseases. Patient. co. uk. emis www. patient. co. uk/health/Preventing-Cardiovascular-Diseases. htm (March 13, 2013) http://medicineworld. org/blogs/heart/blog/permalinks/Jan-2006/coronary-plaque-detection-by-molecular-imaging. html (March 13, 2013) Mature plaques typically consist of two main components: soft, lipid-rich atheromatous â€Å"gruel† and hard, collagen-rich sclerotic tissue. Lipid-rich and soft plaques are more dangerous than collagen-rich and hard plaques because they are more unstable and rupture-prone and highly thrombogenic after disruption. Researchers have found that many people who have heart attacks do not have arteries narrowed by plaque. Many heart attacks are now known to be caused by soft or vulnerable plaques, located on an inflamed part of an artery. This plaque can burst, leading to the formation of a blood clot that can cause a heart attack. The 2009 issue of â€Å"The American Journal Pathology† edited explanation of those relations discovered by Olga Ovchinnikova and er colleagues. They found that inflammation results in the formation of soft (vulnerable) plaque which is filled with different cell types that promote blood clotting. This leads to a reduction of mature collagen, resulting in thinner caps that are more likely to rupture, even in the cases when total level of plaque isn’t extremely high. The authors advocate d ifferent viewpoints about relations between the plaque level and structure, i. e. its influence on heart attack. The first group claims that described types of blockages cause only about 30 percent of heart attacks. On the other hand, some sources state that more than two-thirds of acute coronary events result from rupture of coronary plaques. However problems that plaque creates are extremely dangerous for people’s life and it is very important to prevent and monitor its appearance and changes. Graphs of vulnerable plaque and rupture of plaque which causes a heart attack is presented below. Figure 2 Vulnerable atherosclerotic plaques. Vulnerable atherosclerotic plaques. A. Atherosclerosis in a chronic disease that leads to plaque rupture and vascular occlusion. B. Cross-section of a lethal coronary plaque rupture. Adapted from Heistad D. Unstable coronary-artery plaques. N Engl J Med. 2003. Atherosclerosis Modeling In-vitro. http://www. remedi. uzh. ch/research/disease. html Figure 3 Plaque Rupture and Heart attack http://hon. nucleusinc. com/generateexhibit. php? ID=30468A=1027 Factors influencing plaque growth and stability Based on everything mentioned above and medical experience the conclusion about relations between heart attack and other cardiovascular disease and the level of plaque increasing are found. The higher the level of plaque the higher risk of heart disease will be. The level of plaque will increase as the result of high level of cholesterol, type LDL, so called â€Å"bad cholesterol† in blood. When the level of LDL is normal, blood can pass in and out of the blood vessels without problems, but if it significantly increase particles of the blood will accumulate and sooner or later provoke trigger (cause) heart attack. Other very important factors influencing plaque level increasing are high blood pressure and cigarette smoking. Both factors accelerate the plaque formation changing (damaging) artery walls and even more, helping cholesterol forming. Medical experience proved that plaque composition and vulnerability (hard or soft plaque) is more responsible for the conversion of a stable disease to a life-threatening condition than the plaque size. Except the plaque vulnerability the risk of plaque disruption is are consequence of rupture triggers (extrinsic forces). Soft plaque – lipid-rich one is more dangerous because of its instability and higher probability for rupture. Even (IAKO) Although â€Å"hard plaque† that one having higher level of calcium influence on the blood vessels walls and their â€Å"hardness† experience show that heart attacks are mostly caused by soft plaque disruption. Figure 4 Plaque rupture and its consequences in the form of heart diseases http://www. nature. com/nrg/journal/v7/n3/fig_tab/nrg1805_F2. html Risk factors of coronary heart disease Risk factors influencing cardiovascular disease we can group based on their stability into the three groups: a) Modifiable risk factors In this group hypertension is the most dangerous risk factor for heart attacks, but even more for stroke. It is forming as the result of abnormal blood lipid levels which means high total cholesterol, high levels of triglycerides and high levels of low-density lipoprotein or low levels of high-density lipoprotein (HDL). Smoking, physical inactivity, Type 2 diabetes, and a diet full with saturated fats are risk factors strongly influencing the heart disease. All of them are treatable and patients (individuals) belonging into the different types of risk customers’ groups should avoid practice them. b) Non-modifiable risk factors The factors from this group mostly are constant, like the case in gender or family history. Others are changing when time is passing, like age and lifestyle and personal habits. Older people have more chance to get heart attack and the man, especially those having â€Å"bad medical history†. Ration between man and woman are changing when women past the menopause. After that the level of risk is similar as the men’s one. As I’ve presented there is direct correlation between cardiovascular disease and condition and health of blood vessels, more precisely of developing atheroma, means level and structure of plaque in vessels. On the other development of plaque and its level is directly influenced by level of cholesterol and some other elements which are connected with individual person and his/her life and genetic predispositions. As with the other diseases everybody has some risk of developing atheroma, but some risk factors increase the risk level for several categories. Those risk factors include: fn 12 †¢Fixed risk factors – factors that person cannot change: oA strong family history which means close relatives who developed heart disease or a stroke before they were 55 (for males) or 65 (for female). Severe baldness in men at the top of the head. oAn early menopause in women. oAge. Older people have more risk to develop atheroma. oEthnic group. Medical data show that people from different ethnic group have different risk for heart diseases. †¢Treatable or partly treatable risk factors include different health problems caused basically by the same causes as the: oHypertension (high bl ood pressure). oHigh cholesterol blood level. oHigh triglyceride (fat) blood level. oDiabetes. oKidney diseases causing diminished kidney function. All factors from this group have to be controlled and monitor. Any kind of their complication probably will trigger more serious problems such as heart attack or stroke. †¢Lifestyle risk factors that can be prevented or changed. Actually these factors PRETHODE precede to those belonging to the second group. Except the genetic factors way of life and daily habits are the more responsible for different kind of heart diseases. Those factors are: oSmoking (Smoking cigarette increase blood pressure, decrease HDL; damages arteries and blood cells and increases heart attacks. Passive smoking is also a risk factor for cardiovascular disease ) oLack of physical activity. Obesity (People who are overweight (10-30% more than their normal body weight) have 2 to 6 times the risk of developing heart disease. ) oAn unhealthy diet and eating too much salt. oExcess alcohol. Looking on those three groups one can easily conclude that people with â€Å"bad predisposition† having high fixed risk factors have to think about their lifestyle risk factors ev en more, in order to try to decrease the second group of factors (treatable or partly treatable risk factors). On the other hand some of risks are more dangerous than the others; for example smoking increases risk for heart disease more than obesity. And of course combination of two or more risk factors increases significantly the level of risks; older man (or woman) who smokes, without physical activity and with bad eating habits has more chance to get some of previously explained disease than the one who have â€Å"just one of bad habits†. The more risk factors someone has the greater is the likelihood that he/she will develop cardiovascular disease, unless taking action to modify his/her risk factors and working to prevent them compromising his/her heart health. That doesn’t mean that people with â€Å"good genes† can be irresponsible and ZANEMARITI risk factors from other groups. With or without genetic predisposition modern life significantly increases a risk of heart disease for everybody. Hormones impact on lipids and other risk factors Different numbers of man and women died from heart attack initiated a lot of research about hormones’ influence on the risk factor and heart disease development. Number of men died from the heart attack outnumbered the number of women in pre-menopause period, but in the post-menopause data show completely opposite situation. A percentage of women in post-menopause having heart disease and dying from heart attack increase dramatically and now outnumbered the men. The main reasons for those changes are connected to the level of hormones and their influence on level and structure of cholesterol and consequently on risk factors and heart disease. As mentioned before total cholesterol actually is made of two different types of cholesterol: LDL – low density lipoprotein (LDL), so called bad cholesterol and high density lipoprotein (HDL). High levels of LDL cholesterol lead to atherosclerosis increasing the risk of heart attack and ischemic stroke. HDL cholesterol reduces the risk of cardiovascular disease as it carries cholesterol away from the blood stream. http://www. walgreens. com/marketing/library/careguides/careguide. jsp? docid=000225=28=High%20Cholesterol Estrogen, a female hormone, raises HDL cholesterol levels, partially explaining the lower risk of cardiovascular disease seen in premenopausal women. But after menopause (natural or surgical) when a level of estrogen significantly decreases total cholesterol rises, low density lipoprotein (LDL) cholesterol rises, and high density lipoprotein (HDL) cholesterol does not change or decreases slightly. This is the reason why negative hormones’ effect after menopause increasing more than proportionally. Some authors argue that even influence of estrogen on LDL and HDL level is proved it is yet unclear whether increase in risk is caused, at least partially, by increased level of androgen (the other of hormones belong to steroid as estrogen too), which is characteristics of menopause too. This sexual dimorphism means a lower incidence in atherosclerotic diseases in premenopausal women, which subsequently rises in postmenopausal women to eventually equal that of men. These observations point towards estrogen and progesterone playing a lifetime protective role against CAD in women. As exogenous estrogen and estrogen plus progesterone preparations produce significant reductions in low-density lipoprotein (LDL) cholesterol levels and significant increases in high-density lipoprotein (HDL) cholesterol, this should in theory lower the risk of CAD. UKLOPITI U ONO GORE Among estrogen’s positive effects on the heart are: †¢Reducing the LDL (â€Å"bad†) cholesterol in the blood. †¢Increasing the HDL (â€Å"good†) cholesterol in the blood. †¢Helping to keep blood vessels open. †¢Lowering blood pressure at night. †¢Reducing blood viscosity (how sticky the blood is), a property that may cause blood clots which could result in a heart attack or stroke. Estrogen’s effects on clotting are complicated, however, since there also is an increased risk for thromboembolism (a blood clot that blocks a vessel) in women taking estrogen. Possibly enhancing fibrinolysis, which is the body’s natural process for breaking down blood clots. Read more: http://ehealthmd. com/content/what-are-benefits-hrt#ixzz2NbWR3MxY http://ehealthmd. com/content/what-are-benefits-hrt#axzz2NbW1GJJN Nutrition guidelines As presented before three different groups of risk factor exist. Some of them people can cha nge but the other are fixed, non-changeable because they caused by genetic heritage ( ) influences. Controllable factors are connected to the lifestyle of person. Lifestyle changes can prevent or slow the development of coronary plaque and heart disease. In order to prevent a disease development one have to keep track of his/her blood pressure and cholesterol levels. Choosing a heart-healthy diet is vital in controlling weight, which helps keep blood pressure and cholesterol levels down. Foods high in cholesterol and saturated fat should be avoided, and quitting smoking is imperative. Regular exercise and an increased overall activity level contribute to heart health and help reduce stress. The risk of cardiovascular disease is possible to reduce following recommendation for lifestyle changing: Cessation of smoking and avoidance of second-hand smoke. Nutrition should ensure a healthy diet wiht total diet no more than 8% of saturated + trans fatty acids of total energy intake. All people, especially ones with high risk factors should lower alcohol consumption As the prevention physical activities are recommended – at least 30 minutes of moderate intensity physical activity per day or three days week (i. e. 150 mins/week minimum). Currently practiced measures to prevent cardiovascular disease include: †¢A low-fat, high-fiber diet including whole grains and plenty of fresh fruit and vegetables (at least five portions a day)[29][30] †¢Tobacco cessation and avoidance of second-hand smoke;[29] †¢Limit alcohol consumption to the recommended daily limits;[29] consumption of 1-2 standard alcoholic drinks per day may reduce risk by 30%[31][32] However excessive alcohol intake increases the risk of cardiovascular disease. [33] †¢Lower blood pressures, if elevated, through the use of antihypertensive medications[citation needed]; †¢Decrease body fat (BMI) if overweight or obese;[34] Increase daily activity to 30 minutes of vigorous exercise per day at least five times per week;[29] †¢Decrease psychosocial stress. [35] Stress however plays a relatively minor role in hypertension. [36] Specific relaxation therapies are not supported by the evidence. [37] Routine counselling of adults to advis e them to improve their diet and increase their physical activity has not been found to significantly alter behaviour, and thus is not recommended. [38] http://www. news-medical. net/health/What-is-Cardiovascular-Disease. aspx http://www. barnesandnoble. om/w/prevent-halt-and-reverse-heart-disease-joseph-piscatella/1100260037 Primary and secondary prevention of heart disease It is necessary start with prevention from heart disease as early as possible. Changes in the number of people killed by heart attack in developed countries show that prevention and awareness about this group of disease help to http://circ. ahajournals. org/content/123/20/2274/F2. expansion. html health plans must continue to drive cardiovascular care further along the continuum toward primary prevention of cardiovascular disease (CVD). CVD risk factors should be managed not only after a coronary event has occurred, but also before the onset of such and event. Ideally, health lifestyles should be promoted with all patients so that risk factors for CVD never develop. In this way, CVD care can be moved from the inpatient setting to the outpatient setting. Sidney C. Smith Jr, MD. Focus on Cardiovascular Disease; A Word About the Quality of Care in Cardiovascular Disease. Director, Center for Cardiovascular Science and Medicine University of North Carolina at Chapel Hill. http://www. qualityprofiles. rg/leadership_series/cardiovascular_disease/cardiovascular_introduction. asp Key priorities for implementation Primary prevention of CVD †¢For the primary prevention of CVD in primary care, a systematic strategy should be used to identify people aged 40–74 who are likely to be at high risk †¢People should be prioritised on the basis of an estimate of their CVD risk before a full formal risk assessment. Thei r CVD risk should be estimated using CVD risk factors already recorded in primary care electronic medical records †¢Risk equations should be used to assess CVD risk People should be offered information about their absolute risk of CVD and about the absolute benefits and harms of an intervention over a 10-year period. This information should be in a form that: opresents individualised risk and benefit scenarios opresents the absolute risk of events numerically ouses appropriate diagrams and text (See www. npci. org. uk) †¢Before offering lipid modification therapy for primary prevention, all other modifiable CVD risk factors should be considered and their management optimised if possible. Baseline blood tests and clinical assessment should be performed, and comorbidities and secondary causes of dyslipidaemia should be treated. Assessment should include: osmoking status oalcohol consumption oblood pressure (see ‘Hypertension’, NICE clinical guideline 34) obody mass index or other measure of obesity (see ‘Obesity’, NICE clinical guideline 43) ofasting total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides (if fasting levels are not already available) ofasting blood glucose orenal function oliver function (transaminases) thyroid-stimulating hormone (TSH) if dyslipidaemia is present †¢Statin therapy is recommended as part of the management strategy for the primary prevention of CVD for adults who have a 20% or greater 10-year risk of developing CVD. This level of risk should be estimated using an appropriate risk calculator, or by clinical assessment for people for whom an appropriate risk calculator is not available or approp riate (for example, older people, people with diabetes or people in high-risk ethnic groups) †¢Treatment for the primary prevention of CVD should be initiated with simvastatin 40 mg. If there are potential drug interactions, or simvastatin 40 mg is contraindicated, a lower dose or alternative preparation such as pravastatin may be chosen. Secondary prevention of CVD †¢For secondary prevention, lipid modification therapy should be offered and should not be delayed by management of modifiable risk factors. Blood tests and clinical assessment should be performed, and comorbidities and secondary causes of dyslipidaemia should be treated. Assessment should include: osmoking status oalcohol consumption oblood pressure (see ‘Hypertension’, NICE clinical guideline 34) obody mass index or other measure of obesity (see ‘Obesity’, NICE clinical guideline 43) ofasting total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides (if fasting levels are not already available) ofasting blood glucose orenal function oliver function (transaminases) othyroid-stimulating hormone (TSH) if dyslipidaemia is present. Statin therapy is recommended for adults with clinical evidence of CVD †¢People with acute coronary syndrome should be treated with a higher intensity statin. Any decision to offer a higher intensity statin should take into account the patient’s informed preference, comorbidities, multiple drug therapy, and the benefits and risks of treatment †¢Treatment for the secondary prevention of CVD should be initiated with simvastatin 40 mg. If there are potential drug interactions , or simvastatin 40 mg is contraindicated, a lower dose or alternative preparation such as pravastatin ay be chosen †¢In people taking statins for secondary prevention, consider increasing to simvastatin 80 mg or a drug of similar efficacy and acquisition cost if a total cholesterol of less than 4 mmol/litre or an LDL cholesterol of less than 2 mmol/litre is not attained. Any decision to offer a higher intensity statin should take into account informed preference, comorbidities, multiple drug therapy, and the benefit and risks of treatment http://www. eguidelines. co. uk/eguidelinesmain/guidelines/summaries/cardiovascular/nice_lipid_modification. php How to lower the risk of cardiovascular disease The risk of cardiovascular disease is possible to reduce following recommendation for lifestyle changing: Cessation of smoking and avoidance of second-hand smoke. Nutrition should ensure a healthy diet wiht total diet no more than 8% of saturated + trans fatty acids of total energy intake. All people, especially ones with high risk factors should lower alcohol consumption As the prevention physical activities are recommended – at least 30 minutes of moderate intensity physical activity per day or three days week (i. . 150 mins/week minimum). Cessation of smoking The aim of this measure is complete cessation of smoking and avoidance of second-hand smoke. Patient and their families need to stop smoking. Those who are unable to quit may need professional help in form of counselling, behavioral therapy and even pharmacological therapy. Nicotine replacement therapy (NRT) is the first line choice of medication. Nutrition The aim of thi s measure is to ensure a healthy diet. Total diet should have no more than 8% (of total energy intake) of saturated + trans fatty acids. All patients are advised to take approximately 1g Eicosapentaenoic acid (EPA) and Docosahexaenoic acid (DHA) and more than 2g Alpha Linolenic Acid (ALA) daily. Diet should have vegetables, fruits and legumes, grain-based foods, moderate amounts of lean meats, poultry, fish and reduced fat dairy products. EPA and DHA can be obtained from oily fish and marine n-3 (fish oil) capsule supplements. Alcohol consumption All patients should be advised to lower alcohol consumption. Men should drink no more than 2 standard drinks per day and women no more than 1 standard drink per day. Physical activity The aim of this measure is to raise physical activity and exercise to the recommended goal of at least 30 minutes of moderate intensity physical activity on most, if not all, days of the week (i. e. 150 mins/week minimum). Maintaining a healthy body weight The aim should be to achieve a waist measure of less than or equal to 94 cm in men and less than or equal to 80 cm in women. The body mass index (BMI) should be maintained at 18. 5–24. 9 kg/m2 Lowering blood cholesterol The aim of therapy should be to maintain blood cholesterol at: †¢Low density lipoprotein (LDL) at – less than 2. mmol/L †¢HDL – more than 1. 0 mmol/L †¢Triglyceride (TG) less than 1. 5 mmol/L The blood cholesterol can be maintained with the use of pharmacotherapy. Statins are commonly used lipid lowering drugs. Those with diabetes and atherosclerosis need stringent blood cholesterol control as well. Other lipid lowering drugs include fibrates like gemfibrosil, clofibrates etc, Eze timiber and niacin. Lowering blood pressure High blood pressure is one of the important risk factors for cardiovascular disease. Those with coronary heart disease, diabetes, kidney disease or stroke need tight blood pressure control. The aim should be a blood pressure of less than 130/80 mm of Hg. Diabetes and blood sugar control Those diagnosed with diabetes need stringent blood sugar control to prevent cardiovascular damage. HbA1c levels should be maintained at less than 7%. Other drugs to lower risk of cardiovascular disease Other drugs used to lower risk of cardiovascular diseases include: †¢Antiplatelet agents – this includes Aspirin and Clopidogrel. These drugs when given to patients with risk of heart attacks may prevent such attacks and events. †¢ACE inhibitors like Enalapril, Captopril, Lsinopril and Cardiovascular Diseases Thanks to the rising health awareness and government programmes this number significantly reduce during last 30 years. Coronary heart disease and cardiovascular disease Cardiovascular diseases are diseases of the heart (cardiac muscle ) or blood vessels (vasculature). Cardiovascular disease (CVD) means all the diseases of the heart and circulation (blood vessels disease) including coronary heart disease (angina and heart attack) and stroke, as well as coronary and periphery blood vessels disease (problems with circulation). Diseases from this group are the biggest killer in Europe and USA, but developing and non-develop countries too. The final and most tragic consequence of different types of heart disease is heart attack with tragic consequences. Heart diseases are caused by atherosclerosis, a disease of arterial blood vessels resulted from atheroma i. . plaques accumulated (forming; sticking) on artery walls which makes the blood vessels nonelastic and narrowed and leads to decreased blood flow. For the atherosclerosis doctors very often use alternative name chronic cardiovascular disease. The opposite group acute heart disease made group of diseases which are dangerous for patients lives. Acute heart diseases include conditions or illnesses wh ich usually have a rapid onset of symptoms and may resolve within days with or without treatment. A condition or illness that is sudden or severe. On the other hand a condition or illness that arises slowly over days or weeks and may or may not resolve with treatment made a group of chronic heart disease. Both of them are caused by atheroma and the most known are next: a) Acute heart disease Heart attack is caused by lack of O2 in heart muscle cells. Very often it is caused by rupture of â€Å"hard plaques† patches which result in blood clots and partially or completely block blood flow and cause a heart attack. When a fiber cap becomes thin, these â€Å"hard plaques† can suddenly rupture, spilling their contents, resulting in blood clots that partially or completely block blood flow and cause a heart attack http://www. authorstream. com/Presentation/nitin-35423-heart-diseases-science-technology-ppt-powerpoint/ Cholesterol glossary. http://www. mybwmc. org/library/28/000225 Stroke Stroke is death of brain cells caused by obstructed blood flow to parts of the brain. Since the level of LDL cholesterol is main cause of narrowed of blood vessels, it is necessary control it. If not treated properly, high LDL cholesterol can cause a stroke. Cholesterol glossary. http://www. mybwmc. org/library/28/000225 b) Coronary heart disease Heart disease (coronary heart disease), When the plaque build up in th conorary arteries heart does not get sufficient blood, the condition is called coronary artery disease or coronary heart disease. Atherosclerosis is a disease of arterial blood vessels in which plaques form on artery walls. This is a consequence of different substances circulating in the bloodstream (inflammatory cells, proteins, cholesterol and calcium) sticking inside the vessel walls. Plaque patches influence on narrowing blood flow in the artery. ttp://www. bodybuilding. com/fun/gastelu5. htm Peripheral artery disease (reduced blood flow in the limbs, usually the legs Coronary plaque Coronary plaque is a term which use in practice as a synonym for atheroma or atherosclerosis. Patches of atheroma are formed from substances that circulate in the bloodstream. They consist of lipid, or fat, cores covered by collagen fiber cap s which are sticking to the inside of the vessel walls. Over time plaque or patch of atheroma increases making an artery narrower and the blood flow through the artery is reducing. We can see the changes in blood vessels caused by plaque in the Figure 1. Figure 1 Artery with the patches of atheroma – plaque Preventing Cardiovascular Diseases. Patient. co. uk. emis www. patient. co. uk/health/Preventing-Cardiovascular-Diseases. htm (March 13, 2013) http://medicineworld. org/blogs/heart/blog/permalinks/Jan-2006/coronary-plaque-detection-by-molecular-imaging. html (March 13, 2013) Mature plaques typically consist of two main components: soft, lipid-rich atheromatous â€Å"gruel† and hard, collagen-rich sclerotic tissue. Lipid-rich and soft plaques are more dangerous than collagen-rich and hard plaques because they are more unstable and rupture-prone and highly thrombogenic after disruption. Researchers have found that many people who have heart attacks do not have arteries narrowed by plaque. Many heart attacks are now known to be caused by soft or vulnerable plaques, located on an inflamed part of an artery. This plaque can burst, leading to the formation of a blood clot that can cause a heart attack. The 2009 issue of â€Å"The American Journal Pathology† edited explanation of those relations discovered by Olga Ovchinnikova and er colleagues. They found that inflammation results in the formation of soft (vulnerable) plaque which is filled with different cell types that promote blood clotting. This leads to a reduction of mature collagen, resulting in thinner caps that are more likely to rupture, even in the cases when total level of plaque isn’t extremely high. The authors advocate d ifferent viewpoints about relations between the plaque level and structure, i. e. its influence on heart attack. The first group claims that described types of blockages cause only about 30 percent of heart attacks. On the other hand, some sources state that more than two-thirds of acute coronary events result from rupture of coronary plaques. However problems that plaque creates are extremely dangerous for people’s life and it is very important to prevent and monitor its appearance and changes. Graphs of vulnerable plaque and rupture of plaque which causes a heart attack is presented below. Figure 2 Vulnerable atherosclerotic plaques. Vulnerable atherosclerotic plaques. A. Atherosclerosis in a chronic disease that leads to plaque rupture and vascular occlusion. B. Cross-section of a lethal coronary plaque rupture. Adapted from Heistad D. Unstable coronary-artery plaques. N Engl J Med. 2003. Atherosclerosis Modeling In-vitro. http://www. remedi. uzh. ch/research/disease. html Figure 3 Plaque Rupture and Heart attack http://hon. nucleusinc. com/generateexhibit. php? ID=30468A=1027 Factors influencing plaque growth and stability Based on everything mentioned above and medical experience the conclusion about relations between heart attack and other cardiovascular disease and the level of plaque increasing are found. The higher the level of plaque the higher risk of heart disease will be. The level of plaque will increase as the result of high level of cholesterol, type LDL, so called â€Å"bad cholesterol† in blood. When the level of LDL is normal, blood can pass in and out of the blood vessels without problems, but if it significantly increase particles of the blood will accumulate and sooner or later provoke trigger (cause) heart attack. Other very important factors influencing plaque level increasing are high blood pressure and cigarette smoking. Both factors accelerate the plaque formation changing (damaging) artery walls and even more, helping cholesterol forming. Medical experience proved that plaque composition and vulnerability (hard or soft plaque) is more responsible for the conversion of a stable disease to a life-threatening condition than the plaque size. Except the plaque vulnerability the risk of plaque disruption is are consequence of rupture triggers (extrinsic forces). Soft plaque – lipid-rich one is more dangerous because of its instability and higher probability for rupture. Even (IAKO) Although â€Å"hard plaque† that one having higher level of calcium influence on the blood vessels walls and their â€Å"hardness† experience show that heart attacks are mostly caused by soft plaque disruption. Figure 4 Plaque rupture and its consequences in the form of heart diseases http://www. nature. com/nrg/journal/v7/n3/fig_tab/nrg1805_F2. html Risk factors of coronary heart disease Risk factors influencing cardiovascular disease we can group based on their stability into the three groups: a) Modifiable risk factors In this group hypertension is the most dangerous risk factor for heart attacks, but even more for stroke. It is forming as the result of abnormal blood lipid levels which means high total cholesterol, high levels of triglycerides and high levels of low-density lipoprotein or low levels of high-density lipoprotein (HDL). Smoking, physical inactivity, Type 2 diabetes, and a diet full with saturated fats are risk factors strongly influencing the heart disease. All of them are treatable and patients (individuals) belonging into the different types of risk customers’ groups should avoid practice them. b) Non-modifiable risk factors The factors from this group mostly are constant, like the case in gender or family history. Others are changing when time is passing, like age and lifestyle and personal habits. Older people have more chance to get heart attack and the man, especially those having â€Å"bad medical history†. Ration between man and woman are changing when women past the menopause. After that the level of risk is similar as the men’s one. As I’ve presented there is direct correlation between cardiovascular disease and condition and health of blood vessels, more precisely of developing atheroma, means level and structure of plaque in vessels. On the other development of plaque and its level is directly influenced by level of cholesterol and some other elements which are connected with individual person and his/her life and genetic predispositions. As with the other diseases everybody has some risk of developing atheroma, but some risk factors increase the risk level for several categories. Those risk factors include: fn 12 †¢Fixed risk factors – factors that person cannot change: oA strong family history which means close relatives who developed heart disease or a stroke before they were 55 (for males) or 65 (for female). Severe baldness in men at the top of the head. oAn early menopause in women. oAge. Older people have more risk to develop atheroma. oEthnic group. Medical data show that people from different ethnic group have different risk for heart diseases. †¢Treatable or partly treatable risk factors include different health problems caused basically by the same causes as the: oHypertension (high bl ood pressure). oHigh cholesterol blood level. oHigh triglyceride (fat) blood level. oDiabetes. oKidney diseases causing diminished kidney function. All factors from this group have to be controlled and monitor. Any kind of their complication probably will trigger more serious problems such as heart attack or stroke. †¢Lifestyle risk factors that can be prevented or changed. Actually these factors PRETHODE precede to those belonging to the second group. Except the genetic factors way of life and daily habits are the more responsible for different kind of heart diseases. Those factors are: oSmoking (Smoking cigarette increase blood pressure, decrease HDL; damages arteries and blood cells and increases heart attacks. Passive smoking is also a risk factor for cardiovascular disease ) oLack of physical activity. Obesity (People who are overweight (10-30% more than their normal body weight) have 2 to 6 times the risk of developing heart disease. ) oAn unhealthy diet and eating too much salt. oExcess alcohol. Looking on those three groups one can easily conclude that people with â€Å"bad predisposition† having high fixed risk factors have to think about their lifestyle risk factors ev en more, in order to try to decrease the second group of factors (treatable or partly treatable risk factors). On the other hand some of risks are more dangerous than the others; for example smoking increases risk for heart disease more than obesity. And of course combination of two or more risk factors increases significantly the level of risks; older man (or woman) who smokes, without physical activity and with bad eating habits has more chance to get some of previously explained disease than the one who have â€Å"just one of bad habits†. The more risk factors someone has the greater is the likelihood that he/she will develop cardiovascular disease, unless taking action to modify his/her risk factors and working to prevent them compromising his/her heart health. That doesn’t mean that people with â€Å"good genes† can be irresponsible and ZANEMARITI risk factors from other groups. With or without genetic predisposition modern life significantly increases a risk of heart disease for everybody. Hormones impact on lipids and other risk factors Different numbers of man and women died from heart attack initiated a lot of research about hormones’ influence on the risk factor and heart disease development. Number of men died from the heart attack outnumbered the number of women in pre-menopause period, but in the post-menopause data show completely opposite situation. A percentage of women in post-menopause having heart disease and dying from heart attack increase dramatically and now outnumbered the men. The main reasons for those changes are connected to the level of hormones and their influence on level and structure of cholesterol and consequently on risk factors and heart disease. As mentioned before total cholesterol actually is made of two different types of cholesterol: LDL – low density lipoprotein (LDL), so called bad cholesterol and high density lipoprotein (HDL). High levels of LDL cholesterol lead to atherosclerosis increasing the risk of heart attack and ischemic stroke. HDL cholesterol reduces the risk of cardiovascular disease as it carries cholesterol away from the blood stream. http://www. walgreens. com/marketing/library/careguides/careguide. jsp? docid=000225=28=High%20Cholesterol Estrogen, a female hormone, raises HDL cholesterol levels, partially explaining the lower risk of cardiovascular disease seen in premenopausal women. But after menopause (natural or surgical) when a level of estrogen significantly decreases total cholesterol rises, low density lipoprotein (LDL) cholesterol rises, and high density lipoprotein (HDL) cholesterol does not change or decreases slightly. This is the reason why negative hormones’ effect after menopause increasing more than proportionally. Some authors argue that even influence of estrogen on LDL and HDL level is proved it is yet unclear whether increase in risk is caused, at least partially, by increased level of androgen (the other of hormones belong to steroid as estrogen too), which is characteristics of menopause too. This sexual dimorphism means a lower incidence in atherosclerotic diseases in premenopausal women, which subsequently rises in postmenopausal women to eventually equal that of men. These observations point towards estrogen and progesterone playing a lifetime protective role against CAD in women. As exogenous estrogen and estrogen plus progesterone preparations produce significant reductions in low-density lipoprotein (LDL) cholesterol levels and significant increases in high-density lipoprotein (HDL) cholesterol, this should in theory lower the risk of CAD. UKLOPITI U ONO GORE Among estrogen’s positive effects on the heart are: †¢Reducing the LDL (â€Å"bad†) cholesterol in the blood. †¢Increasing the HDL (â€Å"good†) cholesterol in the blood. †¢Helping to keep blood vessels open. †¢Lowering blood pressure at night. †¢Reducing blood viscosity (how sticky the blood is), a property that may cause blood clots which could result in a heart attack or stroke. Estrogen’s effects on clotting are complicated, however, since there also is an increased risk for thromboembolism (a blood clot that blocks a vessel) in women taking estrogen. Possibly enhancing fibrinolysis, which is the body’s natural process for breaking down blood clots. Read more: http://ehealthmd. com/content/what-are-benefits-hrt#ixzz2NbWR3MxY http://ehealthmd. com/content/what-are-benefits-hrt#axzz2NbW1GJJN Nutrition guidelines As presented before three different groups of risk factor exist. Some of them people can cha nge but the other are fixed, non-changeable because they caused by genetic heritage ( ) influences. Controllable factors are connected to the lifestyle of person. Lifestyle changes can prevent or slow the development of coronary plaque and heart disease. In order to prevent a disease development one have to keep track of his/her blood pressure and cholesterol levels. Choosing a heart-healthy diet is vital in controlling weight, which helps keep blood pressure and cholesterol levels down. Foods high in cholesterol and saturated fat should be avoided, and quitting smoking is imperative. Regular exercise and an increased overall activity level contribute to heart health and help reduce stress. The risk of cardiovascular disease is possible to reduce following recommendation for lifestyle changing: Cessation of smoking and avoidance of second-hand smoke. Nutrition should ensure a healthy diet wiht total diet no more than 8% of saturated + trans fatty acids of total energy intake. All people, especially ones with high risk factors should lower alcohol consumption As the prevention physical activities are recommended – at least 30 minutes of moderate intensity physical activity per day or three days week (i. e. 150 mins/week minimum). Currently practiced measures to prevent cardiovascular disease include: †¢A low-fat, high-fiber diet including whole grains and plenty of fresh fruit and vegetables (at least five portions a day)[29][30] †¢Tobacco cessation and avoidance of second-hand smoke;[29] †¢Limit alcohol consumption to the recommended daily limits;[29] consumption of 1-2 standard alcoholic drinks per day may reduce risk by 30%[31][32] However excessive alcohol intake increases the risk of cardiovascular disease. [33] †¢Lower blood pressures, if elevated, through the use of antihypertensive medications[citation needed]; †¢Decrease body fat (BMI) if overweight or obese;[34] Increase daily activity to 30 minutes of vigorous exercise per day at least five times per week;[29] †¢Decrease psychosocial stress. [35] Stress however plays a relatively minor role in hypertension. [36] Specific relaxation therapies are not supported by the evidence. [37] Routine counselling of adults to advis e them to improve their diet and increase their physical activity has not been found to significantly alter behaviour, and thus is not recommended. [38] http://www. news-medical. net/health/What-is-Cardiovascular-Disease. aspx http://www. barnesandnoble. om/w/prevent-halt-and-reverse-heart-disease-joseph-piscatella/1100260037 Primary and secondary prevention of heart disease It is necessary start with prevention from heart disease as early as possible. Changes in the number of people killed by heart attack in developed countries show that prevention and awareness about this group of disease help to http://circ. ahajournals. org/content/123/20/2274/F2. expansion. html health plans must continue to drive cardiovascular care further along the continuum toward primary prevention of cardiovascular disease (CVD). CVD risk factors should be managed not only after a coronary event has occurred, but also before the onset of such and event. Ideally, health lifestyles should be promoted with all patients so that risk factors for CVD never develop. In this way, CVD care can be moved from the inpatient setting to the outpatient setting. Sidney C. Smith Jr, MD. Focus on Cardiovascular Disease; A Word About the Quality of Care in Cardiovascular Disease. Director, Center for Cardiovascular Science and Medicine University of North Carolina at Chapel Hill. http://www. qualityprofiles. rg/leadership_series/cardiovascular_disease/cardiovascular_introduction. asp Key priorities for implementation Primary prevention of CVD †¢For the primary prevention of CVD in primary care, a systematic strategy should be used to identify people aged 40–74 who are likely to be at high risk †¢People should be prioritised on the basis of an estimate of their CVD risk before a full formal risk assessment. Thei r CVD risk should be estimated using CVD risk factors already recorded in primary care electronic medical records †¢Risk equations should be used to assess CVD risk People should be offered information about their absolute risk of CVD and about the absolute benefits and harms of an intervention over a 10-year period. This information should be in a form that: opresents individualised risk and benefit scenarios opresents the absolute risk of events numerically ouses appropriate diagrams and text (See www. npci. org. uk) †¢Before offering lipid modification therapy for primary prevention, all other modifiable CVD risk factors should be considered and their management optimised if possible. Baseline blood tests and clinical assessment should be performed, and comorbidities and secondary causes of dyslipidaemia should be treated. Assessment should include: osmoking status oalcohol consumption oblood pressure (see ‘Hypertension’, NICE clinical guideline 34) obody mass index or other measure of obesity (see ‘Obesity’, NICE clinical guideline 43) ofasting total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides (if fasting levels are not already available) ofasting blood glucose orenal function oliver function (transaminases) thyroid-stimulating hormone (TSH) if dyslipidaemia is present †¢Statin therapy is recommended as part of the management strategy for the primary prevention of CVD for adults who have a 20% or greater 10-year risk of developing CVD. This level of risk should be estimated using an appropriate risk calculator, or by clinical assessment for people for whom an appropriate risk calculator is not available or approp riate (for example, older people, people with diabetes or people in high-risk ethnic groups) †¢Treatment for the primary prevention of CVD should be initiated with simvastatin 40 mg. If there are potential drug interactions, or simvastatin 40 mg is contraindicated, a lower dose or alternative preparation such as pravastatin may be chosen. Secondary prevention of CVD †¢For secondary prevention, lipid modification therapy should be offered and should not be delayed by management of modifiable risk factors. Blood tests and clinical assessment should be performed, and comorbidities and secondary causes of dyslipidaemia should be treated. Assessment should include: osmoking status oalcohol consumption oblood pressure (see ‘Hypertension’, NICE clinical guideline 34) obody mass index or other measure of obesity (see ‘Obesity’, NICE clinical guideline 43) ofasting total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides (if fasting levels are not already available) ofasting blood glucose orenal function oliver function (transaminases) othyroid-stimulating hormone (TSH) if dyslipidaemia is present. Statin therapy is recommended for adults with clinical evidence of CVD †¢People with acute coronary syndrome should be treated with a higher intensity statin. Any decision to offer a higher intensity statin should take into account the patient’s informed preference, comorbidities, multiple drug therapy, and the benefits and risks of treatment †¢Treatment for the secondary prevention of CVD should be initiated with simvastatin 40 mg. If there are potential drug interactions , or simvastatin 40 mg is contraindicated, a lower dose or alternative preparation such as pravastatin ay be chosen †¢In people taking statins for secondary prevention, consider increasing to simvastatin 80 mg or a drug of similar efficacy and acquisition cost if a total cholesterol of less than 4 mmol/litre or an LDL cholesterol of less than 2 mmol/litre is not attained. Any decision to offer a higher intensity statin should take into account informed preference, comorbidities, multiple drug therapy, and the benefit and risks of treatment http://www. eguidelines. co. uk/eguidelinesmain/guidelines/summaries/cardiovascular/nice_lipid_modification. php How to lower the risk of cardiovascular disease The risk of cardiovascular disease is possible to reduce following recommendation for lifestyle changing: Cessation of smoking and avoidance of second-hand smoke. Nutrition should ensure a healthy diet wiht total diet no more than 8% of saturated + trans fatty acids of total energy intake. All people, especially ones with high risk factors should lower alcohol consumption As the prevention physical activities are recommended – at least 30 minutes of moderate intensity physical activity per day or three days week (i. . 150 mins/week minimum). Cessation of smoking The aim of this measure is complete cessation of smoking and avoidance of second-hand smoke. Patient and their families need to stop smoking. Those who are unable to quit may need professional help in form of counselling, behavioral therapy and even pharmacological therapy. Nicotine replacement therapy (NRT) is the first line choice of medication. Nutrition The aim of thi s measure is to ensure a healthy diet. Total diet should have no more than 8% (of total energy intake) of saturated + trans fatty acids. All patients are advised to take approximately 1g Eicosapentaenoic acid (EPA) and Docosahexaenoic acid (DHA) and more than 2g Alpha Linolenic Acid (ALA) daily. Diet should have vegetables, fruits and legumes, grain-based foods, moderate amounts of lean meats, poultry, fish and reduced fat dairy products. EPA and DHA can be obtained from oily fish and marine n-3 (fish oil) capsule supplements. Alcohol consumption All patients should be advised to lower alcohol consumption. Men should drink no more than 2 standard drinks per day and women no more than 1 standard drink per day. Physical activity The aim of this measure is to raise physical activity and exercise to the recommended goal of at least 30 minutes of moderate intensity physical activity on most, if not all, days of the week (i. e. 150 mins/week minimum). Maintaining a healthy body weight The aim should be to achieve a waist measure of less than or equal to 94 cm in men and less than or equal to 80 cm in women. The body mass index (BMI) should be maintained at 18. 5–24. 9 kg/m2 Lowering blood cholesterol The aim of therapy should be to maintain blood cholesterol at: †¢Low density lipoprotein (LDL) at – less than 2. mmol/L †¢HDL – more than 1. 0 mmol/L †¢Triglyceride (TG) less than 1. 5 mmol/L The blood cholesterol can be maintained with the use of pharmacotherapy. Statins are commonly used lipid lowering drugs. Those with diabetes and atherosclerosis need stringent blood cholesterol control as well. Other lipid lowering drugs include fibrates like gemfibrosil, clofibrates etc, Eze timiber and niacin. Lowering blood pressure High blood pressure is one of the important risk factors for cardiovascular disease. Those with coronary heart disease, diabetes, kidney disease or stroke need tight blood pressure control. The aim should be a blood pressure of less than 130/80 mm of Hg. Diabetes and blood sugar control Those diagnosed with diabetes need stringent blood sugar control to prevent cardiovascular damage. HbA1c levels should be maintained at less than 7%. Other drugs to lower risk of cardiovascular disease Other drugs used to lower risk of cardiovascular diseases include: †¢Antiplatelet agents – this includes Aspirin and Clopidogrel. These drugs when given to patients with risk of heart attacks may prevent such attacks and events. †¢ACE inhibitors like Enalapril, Captopril, Lsinopril and Cardiovascular Diseases