Dove: Advertising and Body Odor

When considering the product Dove it is a deodorant which gives extra protection for people who have body odor and it helps when a person needs it to protect from getting body odor, therefore Dove deodorant won't make the move, the tag line that Unilever use for Dove will be used by unity Consultant to promote the product by using a new promotional campaign. Basically Dove has wide range of antiperspirant deodorants to protect people from getting body odor and it gives 24 hours protection, further, it gives physically freshness and mentally confident, even in the toughest moments. . 1 Target Market The promotional campaigns of Dove was mainly focused on it’s primary consumers who were young adult females involved in sports, and of course the working population of women and not-working women 16-45 who want to stay fresh and have an active life style and have the confidence to spend the rest of the day without having to worry about body odor. . 4. 2 Communication Objectives â₠¬ ¢Increase Dove brands market share by 10% within one year. Create awareness among the target group within one year to 30%. †¢Create positive feelings about the brand among 30% and preference among 15% of the target audience. †¢Communicate key benefits of the Dove deodorant that appeal to the target market. (www. uniliversrilanka. lk) 4. 3 Campaign Idea †¢ Increase brand awareness. †¢ Build brand image. †¢ Increase customer traffic. †¢ Increase inquiries from end users. †¢ Provide information Increasing consumption of an established brand They followed IMC tools as follows, 4. 4 Advertising The main objective in advertising this was to create awareness and provide information about Dove and to make Dove the best product in the deodorant industry. Every major medium had been used to deliver these messages, including television, radio, magazines, newspapers, the Internet, carrier bags and billboards.

ABC Analysis for Inventory Management Essay

In supply chain, ABC analysis is an inventory categorization method which consists in dividing items into three categories, A, B and C: A being the most valuable items, C being the least valuable ones. This method aims to draw managers’ attention on the critical few (Aitems) and not on the trivial many (C-items). Prioritization of the management attention Inventory optimization is critical in order to keep costs under control within the supply chain. Yet, in order to get the most from management efforts, it is efficient to focus on items that cost most to the business. The Pareto principle states that 80% of the overall consumption value is based on only 20% of total items. In other words, demand is not evenly distributed between items: top sellers vastly outperform the rest. The ABC approach states that, when reviewing inventory, a company should rate items from A to C, basing its ratings on the following rules: A-items are goods which annual consumption value is the highest. The top 70-80% of the annual consumption value of the company typically accounts for only 10-20% of total inventory items. C-items are, on the contrary, items with the lowest consumption value. The lower 5% of the annual consumption value typically accounts for 50% of total inventory items. B-items are the interclass items, with a medium consumption value. Those 15-25% of annual consumption value typically accounts for 30% of total inventory items. The annual consumption value is calculated with the formula: (Annual demand) x (item cost per unit). Through this categorization, the supply manager can identify inventory hot spots, and separate them from the rest of the items, especially those that are numerous but not that profitable. The following steps will explain to you the classification of items into A, B and C categories. 1. Find out the unit cost and and the usage of each material over a given period. 2. Multiply the unit cost by the estimated annual usage to obtain the net value. 3. List out all the items and arrange them in the descending value. (Annual Value) 4. Accumulate value and add up number of items and calculate percentage on total inventory in value and in number. 5. Draw a curve of percentage items and percentage value. 6. Mark off from the curve the rational limits of A, B and C categories. eCommerce example The graph above illustrates the yearly sales distribution of a US eCommerce in 2011 for all products that have been sold at least one. Products are ranked starting with the highest sales volumes. Out of 17000 references: Top 2500 products (Top 15%) represent 70% of the sales. Next 4000 products (Next 25%) represent 20% of the sales. Bottom 10500 products (Bottom 60%) represents 10% of the sales. Inventory management policies Policies based on ABC analysis leverage the sales imbalance outlined by the Pareto principle. This implies that each item should receive a weighed treatment corresponding to its class: ï‚ · A-items should have tight inventory control, more secured storage areas and better sales forecasts. Reorders should should be frequent, with weekly or even daily reorder. Avoiding stock-outs on A-items is a priority. Reordering C-items is made less frequently. A typically inventory policy for C-items consist of having only 1 unit on hand, and of reordering only when an actual purchase is made. This approach leads to stock-out situation after each purchase which can be an acceptable situation, as the C-items present both low demand and higher risk of excessive inventory costs. For C-items, the question is not so much how many units do we store? but rather do we even keep this item in store? B-items benefit from an intermediate status between A and C. An important aspect of class B is the monitoring of potential evolution toward class A or, in the contrary, toward the class C. Splitting items in A, B and C classes is relatively arbitrary. This grouping only represents a rather straightforward interpretation of the Pareto principle. In practice, sales volume is not the only metric that weighs the importance of an item. Margin but also the impact of a stock-out on the business of the client should also influence the inventory strategy. Procurement and Warehouse Applications The results of an ABC Analysis extend into a number of other inventory control and management processes: 1. Review of stocking levels – As with investments, past results are no guarantee of future performance. However, â€Å"A† items will generally have greater impact on projected investment and purchasing spend, and therefore should be managed more aggressively in terms of minimum and maximum inventory levels.Obsolescence review – By definition, inactive items will fall to the bottom of the prioritized list. Therefore, the bottom of the â€Å"C† category is the best place to start when performing a periodic obsolescence review. 2. Cycle counting – The higher the usage, the more activity an item is likely to have, hence the greater likelihood that transaction issues will result in inventory errors. Therefore, to ensure accurate record balances, higher priority items are cycle counted more frequently. Generally â€Å"A† items are counted once every quarter; â€Å"B† items once every 6 months; and â€Å"C† items once every 12 months. 3. Identifying items for potential consignment or vendor stocking – Since â€Å"A† items tend to have a greater impact on investment, these would be the best candidates to investigate the potential for alternative stocking arrangements that would reduce investment liability and associated carrying costs. 4. Turnover ratios and associated inventory goals – By definition, â€Å"A† items will have greater usage than â€Å"B† or â€Å"C† items, and as a result should have greater turnover ratios. When establishing investment and turnover metrics, inventory data can be segregated by ABC classification, with different targets for each category. Definition of ‘Inventory Turnover’ A ratio showing how many times a company’s inventory is sold and replaced over a period. the Periodic Review To make the most effective use of ABC classifications, the analysis should be completed at least on an annual basis, and more often as necessary. Other Inventory Classification Techniques HML Classifications The High, medium and Low (HML) classification follows the same procedure as is adopted in ABC classification. Only difference is that in HML, the classification unit value is the criterion and not the annual consumption value. The items of inventory should be listed in the descending order of unit value and it is up to the management to fix limits for three categories. For examples, the management may decide that all units with unit value of Rs. 2000 and above will be H items, Rs. 1000 to 2000 M items and less than Rs. 1000 L items. The HML analysis is useful for keeping control over consumption at departmental levels, for deciding the frequency of physical verification, and for controlling purchases. VED Classification While in ABC, classification inventories are classified on the basis of their consumption value and in HML analysis the unit value is the basis, criticality of inventories is the basis for vital, essential and desirable categorization. The VED analysis is done to determine the criticality of an item and its effect on production and other services. It is specially used for classification of spare parts. If a part is vital it is given V classification, if it is essential, then it is given E classification and if it is not so essential, the part is given D classification. For V items, a large stock of inventory is generally maintained, while for D items, minimum stock is enough. SDE Classification The SDE analysis is based upon the availability of items and is very useful in the context of scarcity of supply. In this analysis, S refers to scarce items, generally imported, and those which are in short supply. D refers to difficult items which are available indigenously but are difficult items to procure. Items which have to come from distant places or for which reliable suppliers are difficult to come by fall into D category. E refers to items which are easy to acquire and which are available in the local markets. The SDE classification, based on problems faced in procurement, is vital to the lead time analysis and in deciding on purchasing strategies. FSN Analysis FSN stands for fast moving, slow moving and non-moving. Here, classification is based on the pattern of issues from stores and is useful in controlling obsolescence. To carry out an FSN analysis, the date of receipt or the last date of issue, whichever is later, is taken to determine the number of months, which have lapsed since the last transaction. The items are usually grouped in periods of 12 months. FSN analysis is helpful in identifying active items which need to be reviewed regularly and surplus items which have to be examined further. Non-moving items may be examined further and their disposal can be considered.

World civilization Coursework Example | Topics and Well Written Essays - 250 words

World civilization - Coursework Example tremendous zeal in supporting the crusades aimed at recovering the Holy Land and thereby succeeded in bringing in a measure of political unity in Christendom under the aegis of the Catholic Church (Moore 24). As a Pope he was very tough on the pagans and heretics and took a series of measures aimed at annihilating all sorts of heresies and paganism existent in Europe (Moore 24). This further strengthened the domain of the Church over Europe and made the leading European monarchies pledge subservience to the Pope and hence to the Catholic Church. He centralized the Church’s administration and extended sanctions to the varied Catholic mendicant orders with the sole objective of doing away with the rot and corruption existent in the Catholic Church. One of his biggest achievements was the usage of the Fourth Lateran Council to consolidate the Church’s hold over the ecclesiastical and political proceedings in Europe (Moore

Week One Individual Assignment Essay Example | Topics and Well Written Essays - 500 words

Week One Individual Assignment - Essay Example An ADR is considered a pragmatic approach to dispute resolution that can save money and time and help find the best solution for everyone (Inta, 2010). Our ADR consist of several simple mechanisms that must be used to solve conflicts. If a member of the team is not happy about what is going on in the team setting the person must file a complaint in new post title ADR implementation. The post goes up and each team member must read the issue. After everyone reads on the matter, then a meeting must be setup within 36 hours of the post. In the meeting the each team member must provide a reply to the original post in the team player must provide constructive feedback about the issue. The feedback constitutes an alternative solution. Everyone including the person that filed the complaint must provide an alternative solution. After all solutions are posted in the learning team forum the member of the team must vote on their preferred alternative. The alternative that is going to be implemented is the one with the majority of the votes. If there is a tie then the team leader must chose the solution to solve the conflict among the most popu lar alternatives. ADR have become more frequently used in the 21st century due to time and money savings that are associated with the use of alternative dispute resolution

Argument - the Aeneid was a pro-Augustan work which can be seen Essay

Argument - the Aeneid was a pro-Augustan work which can be seen through the themes, arguments, and specific scenes of the Aeneid - Essay Example Associations with Augustus The associations with Augustus in the work of â€Å"The Aeneid† are first seen through the direct quotes that describe the political scene of the time and how Augustus was meant to be a powerful leader. Virgil states this by associating Augustus with the line of Caesar while showing how this automatically leads to him being an exalted leader. He states â€Å"Caesar himself, exalted in his line; / Augustus promis’d oft, and long foretold, / Sent to the realm that Saturn rul’d of old; / Born to restore a better age of gold, Africa and India shall his pow’r obey; / He shall extend his propagated sway / Beyond the solar year, without the starry way† (Virgil, 192). The direct reference in this quote shows Augustus as the promised leader, not only for Greece, but also as ordained with the time, planets and alignment of the stars. This creates a belief system from the direct reference to the leader, showing him as a natural leade r that was meant to rule over other countries and to become one of the most powerful and influential individuals of the time. Actions throughout the Aeneid The direct reference pointed out with â€Å"The Aeneid† is followed by specific actions and situations that show the same political propaganda. The first six books of the journey are written as a part of the Underworld in which all men are in. The hellish state is one which becomes symbolic of how life has been to this point in the ancient city. In book 6, there is a specific shift that leads to the belief that the situation will be overcome. The actions which follow after the journey lead to the Trojan War and the victory of the land. The beginning of this is when Aeneas is given the golden bough and is told to leave the underworld. The propaganda is based on Aeneas leading the city out of a state of hell and into a sense of life giving and an end to human suffering. The references of these actions throughout the plot lin e are known to relate directly to the celebration of the new political leadership of the time as well as the overthrow of the old government and the desire to have Augustus in power to overcome the darker ages of the city (Minson, 48). There are several moments which point to the happiness of the city and what can be after changes occur. More important, the author points to the ideals of victory which he believes are most important to the bringing in of Augustus as a leader. The main association is with the Trojan War and how this led to the rightful place of the city mentioned. Virgil refers to this with the past state and how the time was better because of the triumph and the alterations in leadership which occurred. He states â€Å"Relate what Latium was; her ancient kings! / Declare the past and state of things, When first the Trojan fleet Ausonia sought, / And how the rivals lov’d, and how they fought. / These are my theme, and how the war began / And how concluded by t he godlike man† (Virgil, 198). The recounting of the Trojan war then leads to an understanding that this was led first by politicians and was followed by those who moved according to the strategies desired by the land. The propaganda of the war then leads to one referencing the Augustan leadership while showing that this was the main reason why the victory occurred among the land. Themes of Politics The actions which

Performance Appraisal Essay Example | Topics and Well Written Essays - 750 words - 1

Performance Appraisal - Essay Example The performance appraisals are used to give feedback to the employee on the performance rating and the need for improvements. This also expresses the need for trainings, promotion, demotion, retention or firing. The performance appraisal is among the critical factors of a manger or a leader to provide employee with the feedback and clarify the job expectations. An effective performance appraisal enables employees to know about themselves and understand the management values. The performance appraisals make use of evaluations as feedback in order to improve the performance of employee and reduce the turnover. It increases motivation and instills a feeling of equity among the employees. The appraisals act as a linkage between the rewards and performance. This enhances performance as employees are told about their performance and related strengths and weaknesses. This makes the employees become proud of whatever they are doing well and enables them focus their efforts on areas that require improvement. In overall, organization will benefit when the performance of the employees improves. Every organization is interested in witnessing their employees advance in the company and get other better and well paying positions. This is normally brought about by performance appraisal. For instance, when an employee is told to improve personal skills to be eligible for the following promotion may act as a driving force to that employee to enable them improve their per formance (Goswami, 2013). The performance appraisals are used by the management in making important decisions by the management. These decisions include promotions, demotions, firing and remunerations among many others. Efficient organizations must have established means through which they can make their decisions. The decisions depend on appraisal data. The appraisals can be considered as efficient tools in documenting the organizational decisions. This

Minsheng bank Essay Example | Topics and Well Written Essays - 500 words

Minsheng bank - Essay Example The regulation of various industries by the government is intended to influence the manner in which an economy is run. The banking industry in China is highly regulated by the Chinese government, but this does not rule out the coexistence of both public and private sectors in the Chinese economy. Minsheng bank operates alongside state-owned banks which constitute the basis in which Minsheng and other private commercial banks are regulated in China. The effects of government regulation impact differently on different enterprises, companies, or organizations. Government regulation has its benefits and shortcomings. On the positive side, the imposition of regulations by the government does not only protect consumer interests, but also the interests of all players and stakeholders in the industry. The consumer is safeguarded from exploitation by the operating enterprises. On the other hand, government regulation creates cohesion in the industry, making it possible for the markets involved to exhibit fair competition. Such moves treat all players in the industry equally, thereby enhancing economic growth and development in regard to the contribution of all operational firms in the industry. On the other hand, government regulation curtails the full potential of an enterprise. It limits the expansion capacity of a company, in the event that the company’s expansion strategies are not consistent with the government’s provisions at that time. Government regulation also interferes with market autonomy and free market activities, thus limiting the liberalization factor in the global arena. In this respect, the public sector appears to be relatively favored by the government due to the priorities it is accorded within the regulation process. In the light of government regulation, another significant business strategy emerges in the global banking industry; acquisition. The substantial regulation of Chinese markets and

Government's role in healthcare markets Research Paper

Government's role in healthcare markets - Research Paper Example And today developed nations are striving to establish comprehensive plans to serve people in various aspects. In recent times, health care concerns are increasing due to ever increasing complexity of ambiance people live in. Pollutants, Genetic Modification, Environmental degradation and Global warming are making things a mesh of problems. In spite of galloping advancements in bioinformatics and medicine, deaths are becoming increasingly terminal. This statement can be supported by discussing various types of cancers, increasing obesity and even more complex psychological problems in highly urbanized areas. Keeping in view these concerns United States government has been in the phase of transition which has Health care services as one of the major moot points. Investments in the development of effective medicine, attempts to promulgate health care schemes and finding cost effective all inclusive health care facilities are apparently important for the government. This research is an attempt to delve into the details of US health care industry. It is aimed at finding comprehensive facts and figures about the health care services and the econometrics that are proving to be the driving force of this sector. Distinct organizations have emerged during recent times in order to serve and do business related to health care. The cost and access to health care facilities is the bottom line of this research. As a big picture the health care facilities in US are largely private sector business, whereas government facilities come next to the private sector. These statistics are one of the major concerns for health care policy makers and operators who reside in the echelons of power. About 65% of the health care spending for people below 67 years comes from programs like Medicare, Children’s Health Insurance Program (CHCP) and Tricare. Average US life expectancy is 78 years which ranks her 27th among 34 highly industrialized countries

European Colonization of the Caribbean Essay Example for Free

European Colonization of the Caribbean Essay The Spanish conquests in the Americas encouraged other European countries to expand their domains in the New World. In the latter half of the 16th century, Portugal conquered Brazil in the hope of upsetting Spain in South America. Between 1690 and 1650, the French, Dutch, and English made unsuccessful attempts to occupy the northern coasts of Brazil and the neighboring islands of St. Kitts and the Leeward Islands. However, with the onset of the Thirty Years War, Spain began to weaken. His colonial possessions in the Caribbean were occupied by the English, French, and the Dutch. Spanish and Portugal Conquests Checked Generally, the arrival of other European countries in the New World (with the thought of conquest) forced Spain and Portugal to limit their conquest. For example, in 1621, the Dutch attacked several Spanish colonies in the Caribbean and succeeded in occupying the islands of Curacao, St. Martin, and Araya. The acquisition of vast mount of gold by the Spaniards in the New World attracted the attention of other powers. To their minds, God does not wish the world to be divided only between Spain and Portugal (Treaty of Tordesillas). They wanted a significant share in the wealth of the Americas. The Political and Economic System in Europe The Thirty Years War (to which Spain was heavily involved) forced Spain to cut expenditures at home and raise taxes and quotas in the Caribbean (Cuba, Puerto Rico). In addition, the Spaniards began to implement the plantation system to increase revenues (to finance her wars in Europe). Trade was limited to Spain and he American colonies. The reason is clear: if trade was opened to other European countries, the prospect of a unidirectional prosperity would be prevented (other nations would benefit from the trade). This system is called the ‘mercantilist system. ’ Impact of Mercantilism in the Caribbean and the Outcome Precious metals (gold, silver) became the basis of the mercantilist system. It served as the medium of exchange between the colonies and the mother country. Mines were established all throughout the Caribbean in order to maintain the flow of metals to the mother country. To fasten the procurement of precious metals, the Spaniards (and other Europeans) utilize slave labor (African slaves). In some sense, Spanish wealth (based on precious metals and product quotas) was essentially created by slave labor (which was very oppressive and unchristian). The wealth Spain accumulated from the New World also attracted the attention of pirates. They were of two types: buccaneer and marooner. Buccaneer is a group of pirates that had bases in the Caribbean (in a sense, they were considered the most powerful type of pirate). Marooner is a generic term applied to Spaniards who deserted the Spanish Navy to harass Spanish shipping lines in the Caribbean. The Caribbean Society and European Influences Caribbean society was modeled after European society. Some of the influences are as follows: 1) adoption of Catholicism as the main religion (in the case of Spain), 2) Baroque and Gothic architecture, 3) European city planning, and 4) the plantation system. At the top of the plantation system was the landowner. The manager (usually a relative of the owner) was in the middle position. At the bottom were the slaves and the serfs (local population serving in the plantation). The slaves were often treated harshly by the Europeans. They perceived them as members of an inferior race destined to serve white men’s greed. The same case (though not as oppressive as that of slaves) could be said about women. Women were confined to households, serving their masters with much dedication (by force) as that of serfs. Racial Hierarchy in the Caribbean Race played an important role in Caribbean society. Race served as the determining factor of administration; a form of societal control. The Europeans were at the top of the racial hierarchy. At the bottom were the slaves, the local population, and Chinese traders (which were seen with contempt by the Europeans). The European themselves were racially categorized. The peninsulares were Europeans born in their mother countries. The insulares were pure Europeans born in the colonies. The mestizos were of European and Indian descent. Women played a minor role in Caribbean society. They were confined to household chores (like cooking and child rearing). Maroonage strained Spain’s resources in the New World. The revenues derived by Spain from plantations (the same case with other Europeans) were taken by the maroons (on the way to Spain). The oppressive policies of the Spaniards in Cuba led to the Ten Years War. The slaves and the local population rose in arms against Spanish rule. Reference Toynbee, Arnold. 1989. History of the World. New York: Macmillan Publishing Company.

Smoking Is Bad for Our Health Essay Example for Free

Smoking Is Bad for Our Health Essay Almost 50 years ago, evidence began to accumulate that cigarette smoking poses an enormous threat to human health. More than 30 years ago, initial reports was made began meticulous documentation of the biologic, epidemiologic, behavioral, pharmacologic, and cultural aspects of tobacco use. The present report, an examination of the methods and tools available to reduce tobacco use, is being issued at a time of considerable foment. The past several years have witnessed major initiatives in the legislative, regulatory, and legal arenas, with a complex set of results still not entirely resolved. This report shows that a variety of efforts aimed at reducing tobacco use, particularly by children, would have a heightened impact in the absence of countervailing pressures to smoke. Besides providing extensive background and detail on historical, social, economic, clinical, educational, and regulatory efforts to reduce tobacco use, the report indicates some clear avenues for future research and implementation. It is of special concern to derive a greater understanding of cultural differences in response to tobacco control measures. Since racial and ethnic groups are differentially affected by tobacco, elimination of disparities among these groups is a major priority. Perhaps the most pressing need for future research is to evaluate multifocal, multichannel programs that bring a variety of modalities together. For example, school-based education programs are more effective when coupled with community-based initiatives that involve mass media and other techniques. As pointed out in our report, a combination of behavioral and pharmacologic methods improves the success rate when managing nicotine addiction. Synergy among economic, regulatory, and social approaches has not been fully explored, but may offer some of the most fruitful efforts for the future. It also provides the preliminary data on new statewide, comprehensive tobacco control programs, which offer great promise as new models for tobacco control and combine multiple intervention modalities. Although all aspects—social, economic, educational, and regulatory—have not been combined into a fully comprehensive effort, it is exciting to contemplate the potential impact of such an undertaking to eventually ensure that children are protected from the social and cultural influences that lead to tobacco addiction, that all smokers are encouraged to quit as soon as possible, and that nonsmokers are protected from environmental tobacco. ACKNOWLEDGEMENT It is our great privilege to express our gratitude to our creator Allah (SWT) for such great opportunity to be in touch with this report and came to know the present condition of smoking in these following days. We also have to put our heartened feelings and gratitude for the kindness and assistance that was provided to us to complete our assigned report as on the topic and such way you assigned us.In preparing the proposed report we have taken great assistance support and guidance from the persons of our group, the information you gave as our faculty and website. Table of Content 1. Introduction 2. Real situation 3. Real situation of Bangladesh 4. Tobacco Smoking Prevalence, Total and by Gender Bangladesh, 1995-2010 5. Given statistics 6. Show a table 7. A chart 8. Tobacco Production in Bangladesh 9. Smoking Damage 10. Quitting statistics 11. Economic and Opportunity cost 12. Social cost 13. Recommendations 14. Conclusion Introduction: Smoking is the inhalation of the smoke of burning tobacco encased in cigarettes, pipes, and cigars. Casual smoking is the act of smoking only occasionally, usually in a social situation or to relieve stress. A smoking habit is a physical addiction to tobacco products. Many health experts now regard habitual smoking as a psychological addiction, too, and one with serious health consequences. Real Situation in all over the world: About 2.0 billion people smoke all around the world. The World Health Organization states that global prevalence is 48% for adult males and 12% for adult females, about 1/3 of the adults worldwide, making about 2.0 billion smokers around the world including child smokers. Percent of Population that Smokes by Gender: 22.3 percent are male smokers. 17.4 percent are female smokers. Smoking Statistics by Age: Ages 18 to 24 years 22 percent, ages 25 to 44 years 22.8 percent, ages 45 to 64 years 21 percent, ages 65 and over 8 percent. Smoking Statistics by Race: Blacks are 19.8 percent, American Indians are 36.4 percent, Asians are 9.6 percent, Hispanics are13.3 percent and Whites are 21.4 percent. Smoking Statistics by Education Level: 44 percent of adults with a GED diploma, 33 percent of adults with 9 to 11 years of education, 11 percent of adults with an undergraduate college degree, 6 percent of adults with a graduate college degree Smoking Statistics by Poverty Status: 28.8 percent of adults who smoke live below the poverty level and 20.3 percent of adults who smoke live at or above the poverty level. Number of People Who Start Smoking Each Day: Even with what we know today about the health effects of smoking and the dangers associated with it people continue to start smoking. There are many reasons people start smoking and none of them are good. Each day, nearly 1,000 kids under the age of 18 will start smoking on a daily basis. Eighteen hundred adults, 18 and over, will also start smoking on a daily basis. Smoking situation in Bangladesh: Smoking is an increasingly prevalent habit in Bangladesh, particularly among men. In the past 10-15 years cigarette consumption has more than doubled. In Bangladesh 43.3% of adults (41.3 million) currently use tobacco in smoking and 44.7% of men, 1.5% of women, and 23.0% overall (21.9 million adults) currently smoke tobacco. 26.4% of men, 27.9% of women, and 27.2% overall (25.9 million adults) currently use smokeless tobacco. BDHS 2007 found 60 percent of Bangladeshi men smoke cigarettes and 20 percent consume other forms of tobacco. Although rural men are more likely (62 percent) to smoke cigarette than urban men (54 percent), urban smokers tend to smoke more cigarette per day (42 percent)smoke 10+ cigarette in the past 24 hours) than their rural counterparts (21 percent smoke 10+ cigarette in the past 24 hours). Population (Million) Population(Age Limit)| 1975| 2000| 2025| 2050| All adults, ages 15+ Female adults| 73.115 35.210| 84.249 40.127| 151.428 74.103| 207.054 100934| All youth, ages 0-14 Female youth| 50.457 24.523| 53.190 25.855| 59.344 28.965| 58.368 28.561| Tobacco Smoking Prevalence, Total and by Gender Bangladesh, 1995-2010 Tobacco Production in Bangladesh: Cigarette production and consumption patterns in Bangladesh were examined and the health, nutritional, and economic consequences of these patterns was assessed. Consumption of cigarettes and biri, hand-made tobacco rolls, is increasing. Annual per capita consumption of cigarettes, taking into account all males and females over the age of 15, is 350 cigarettes. Previously conducted surveys of 2 villages indicated that 67% of the males and 1% of the females, over the age of 15, smoked 1 or more cigarettes or biri each day. Cigarette, bidi, chewing, hookah, cigar, cheroot, snuff, natu, burley etc. are the various types of tobacco grown in different parts of the country. Each month approximately 1500 million cigarettes and 3000 million biri are produced. 57% of all commercially produced cigarettes are manufactured by 1 company, which is affilated with the British American Tobacco interest group. Biri are generally produced in cottage industries. Cigarette production is expected to increase by 40%. The cigarette industry is not labor intensive and it provides only a small number of jobs for the population. 123,000 acres of land are currently devoted to the production of tobacco. This constitutes a serious loss of land which might otherwise be used to raise needed rice. It is estimated that the annual rice production loss attributable to the use of land to raise tobacco is equal to 1/2 of the countrys yearly food grain deficit. Regional variation is also notable in men’s cigarette smoking: 73 percent in Sylhet division to 45 percent in Barisal division; 66 percent in Dhaka, 62 percent in Chittagong, 57 percent in Rajshahi and 52 percent in Khulna. Cigarette smoking in men found to have an inverse co-relation with education attainment: 73 percent with no education to 39 percent with secondary complete and higher; 63 percent in primary incomplete and 53 percent in secondary in complete. Similarly wealth quintile reversely influences men’s cigarette smoking: 71 percent in lowest quintile and 46 percent in highest quintile; 65 percent in second, 62 percent in middle and 60 percent in fourth quintiles. Area | Number of Company Card holders | Number of other growers in tobacco cultivation| Total number of growers in tobacco cultivation | Kushtia (Daulatpur upazila) | 11689 (90%) | 1266 | 12955 | Kushtia (Mirpur Upazilla | 8437 (91%) | 796 | 9233 | Bandarban (Lama upazila) | 5754 (98%) | 79 | 5833 | Bandarban (Ali Kadam upazila) | 1149 (97%) | 37 | 1186 | Cox’sbazar (Chakaria Upazilla) | 3008 98%) | 65 | 3073 | Market Share by Cigarette Manufacturer, 1999-2010: BAT Bangladesh 60% Other domestic 32% Imports 8% Health Effects of Smoking Statistics: Smoking is the leading cause of many different health issues within our society. Many types of cancers, heart disease, and lung diseases have been directly linked to smoking. For every person who dies from a smoking related disease, 20 more suffer from at least one serious illness related to smoking. 1 out of 5 people die each year from smoking. Over 400,000 people die each year from smoking related illnesses. Nearly 50,000 nonsmokers die annually from secondhand smoke exposure. Cigarette smoke contains about 4,000 different chemicals which can damage the cells and systems of the human body. These include at least 80 chemicals that can cause cancer (including tar, arsenic, benzene, cadmium and formaldehyde) nicotine (a highly addictive chemical which hooks a smoker into their habit) and hundreds of other poisons such as cyanide, carbon monoxide and ammonia. Every time a smoker inhales, these chemicals are drawn into the body where they interfere with cell function and cause problems ranging from cell death to genetic changes which lead to cancer. Risk factors of smoking: People take up smoking for a variety of reasons. Young people are especially vulnerable because of pressure from their peers and the image that smoking is clever, cool or grown-up. Just trying a few cigarettes can be enough to become addicted. Many people say that smoking helps them to feel more relaxed or cope with stress but nicotine is a stimulant not a relaxant, so it doesn’t help stress. What people are describing is more likely to be relief from their craving or withdrawal symptoms. Smoking Damage: There are hundreds of examples and volumes of research showing how cigarette smoking damages the body. For example, UK studies show that smokers in their 30s and 40s are five times more likely to have a heart attack than non-smokers. Smoking contributes to coronary artery disease (atherosclerosis or hardening of the arteries) where the heart’s blood supply becomes narrowed or blocked, starving the heart muscle of vital nutrients and oxygen, resulting in a heart attack. As a result smokers have a greatly increased risk of needing complex and risky heart bypass surgery. Smoking also increases the risk of having a stroke, because of damage to the heart and arteries to the brain. If someone smokes for a lifetime, there is a 50 per cent chance that your eventual death will be smoking-related half of all these deaths will be in middle age. Smoking and Lung problem: Smoking does enormous damage to the lungs, especially because these tissues are in the direct firing line for the poisons in smoke. As a result there is a huge increase in the risk of lung cancer, which kills more than 20,000 people in the UK every year. US studies have shown that men who smoke increase their chances of dying from the disease by more than 22 times. Women who smoke increase this risk by nearly 12 times.Lung cancer is a difficult cancer to treat long term survival rates are poor. Smoking also increases the risk of the following cancers: * Oral * Uterine * Liver * Kidney * Bladder * Stomach * Cervical * Leukemia Even more common among smokers is a group of lung conditions called chronic obstructive pulmonary disease or COPD which encompasses chronic bronchitis and emphysema. These conditions cause progressive and irreversible lung damage, and make it increasingly difficult for a person to breathe. Harm to children from Smoking: Smoking in pregnancy greatly increases the risk of miscarriage, is associated with lower birth weight babies, and inhibits child development. Smoking by parents following the birth is linked to sudden infant death syndrome, or cot death, and higher rates of infant respiratory illness, such as bronchitis, colds, and pneumonia. Smoking and young people: Smoking is particularly damaging in young people. Evidence shows people who start smoking in their youth aged 11 to 15 are three times more likely to die a premature death than someone who takes up smoking at the age of 20. They are also more likely to be hooked for life. Nicotine, an ingredient of tobacco, is highly addictive – it takes on average on about six cigarettes before nicotine receptors in the brain are switched on, generating a craving for nicotine which may continue for the rest of the person’s life. In less than one packet of cigarettes, a person’s brain can be changed forever from that of a non-smoker to a nicotine addicted smoker. Although the health risks of smoking are cumulative, giving up can yield health benefits, regardless of the age of the patient, or the length of time they have been smoking. Quitting Smoking Statistics: Nearly 70 percent of smokers want to quit smoking altogether. Approximately 40 percent of smokers will try to quit this year. About 7 percent will succeed at quitting smoking their first try. That may sound like a small number but it is over 3 million people. 3 to 4 percent of people who quit smoking will do it cold turkey. If we join a proper smoking-cessation service, using all available help including medication and counseling, your chances of quitting may be as high as one in three (compared to just three per cent if you go it alone). Many smokers are lead to believe that quitting smoking is impossible. That is ridiculous! We have it in our right now to quit smoking we just need to believe. Yes, it is going to be tough and we will face challenges but thats true for anything worth obtaining in life. No one starts smoking to become addicted to nicotine. It isnt known how much nicotine may be consumed before the body becomes addicted. However, once smoking becomes a habit, the smoker faces a lifetime of health risks associated with one of the strongest addictions known to man. About 70% of smokers in the United States would like to quit; in any given year, however, only about 3.6% of the countrys 47 million smokers quit successfully. Although specific genes have not yet been identified as of 2003, researchers think that genetic factors contribute substantially to developing a smoking habit. Several twin studies have led to estimates of 46-84% heritability for smoking. It is thought that some genetic variations affect the speed of nicotine metabolism in the body and the activity level of nicotinic receptors in the brain. Causes and Consequences of smoking: Tobacco usage accounted for 4.1% of the global burden of ill-health in 2000. Much of this burden was due to an increase over the previous decade of tobacco-related illnesses in developing countries. Almost 4.9 million deaths in 2000 were attributed to tobacco usage (Ezzati et al., 2002). According to a recent study on smokers, the average loss of life expectancy per tobacco related illness in India was estimated at 20 years, with middle-aged smokers having twice the death rates than non-smokers (Gajalakshmi et al., 2003). Thus, tobacco usage results in loss of life – and in turn productivity – during the active years of experienced workers. Economic and Opportunity cost: The study in Bangladesh identifies and compares the economic costs and opportunity cost of tobacco consumption with a view to providing economic data to frame tobacco control policy. More specifically it provides an estimation of opportunity costs (costs necessitated by tobacco usage that could otherwise have yielded greater benefit) incurred because of ill-health attributable to tobacco usage. Accounting includes the costs borne by the health system to treat tobacco-related illnesses, and out-of-pocket costs borne by the household of the person afflicted by these illnesses. These two items make up the direct costs. To this is added the cost to the economy due to premature death and disabilities, or the indirect costs. The initial task was to identify the types of illnesses that can be attributed to tobacco usage, although the etiology of the illnesses is not exclusive to tobacco. The list of illnesses varies from country to country due to different habits for tobacco usage (Peto et al., 1992). In this study, eight illnesses were selected as they are consistent with tobacco usage in all regions of the world. These are given below: * lung cancer, cancers of the mouth and larynx * stroke and ischemic heart diseases (IHD) * chronic obstructive pulmonary disease (COPD) (Murray and Lopez, 1996). Studies in the People’s Republic of China and India have shown that tobacco contributes to the incidence of pulmonary tuberculosis. Buerger’s Disease occurring primarily among heavy smokers. Here, tobacco-related illnesses are all those that have been associated with tobacco usage. A portion of the prevalence of the illnesses can be attributed to tobacco usage. Thus the main interest of this study is to estimate the opportunity costs imposed by occurrence of illnesses directly caused by tobacco usage are poor and work bare feet in wet soil condition, has been shown to be a source of disease burden in Bangladesh and other developing countries. Having identified the illnesses, the study compared the total cost of tobacco usage to zero usage. The difference between these costs would represent the magnitude of the problem. The calculation of annual costs followed the cross-sectional, or prevalence-based, approach for cost of illness studies. This estimates actual costs as a function of all illnesses related to current and past smoking. Costs were calculated using standard guidelines on economic â€Å"cost benefit† analysis. All costs attributable to tobacco-related illnesses were deemed excess medical costs Consumption of tobacco is addictive and can therefore be seen as an unwarranted cost. The opportunity costs of tobacco-related illnesses included: * private expenditures (out-of-pocket or insurance) of patients on medical care, e.g., drugs, medical examination, hospitalization, and transportation to health centers * cost of the public health care system * loss of potential income and investment opportunities due to illness and consequent working disability or termination of working life by premature death. * The first two components are the direct costs to the patients and the health care system. * The third component constitutes the indirect cost of illness to individuals and society. The measurement of the total annual cost of tobacco-related illnesses to the economy involves the estimation of: * the relative risk of the eight selected diseases with respect to tobacco the proportion of tobacco users having any of the diseases; * the prevalence rates of the eight diseases attributable to tobacco usage–the probability that one of them would befall a tobacco consumer, derived from the ratio of tobacco users having any of the eight illnesses compared to the proportion of tobacco users in the economy; * the average cost of private treatment of individual patients; * the average hospital cost (inpatient and outpatient) of treatment of individual patients; * the average indirect cost from the loss of working days and income of both the patient and the attendant family members due to the treatment; * average indirect cost from the loss of income owing to disability or early demise caused by the illness. * Methods and analytical framework * Impact of Tobacco-related Illnesses in Bangladesh * The sum of the average costs , weighted by the rate of prevalence of tobacco-related illness, yields an estimate of the expected average cost of illnesses attributable to tobacco usage. To obtain the expected total cost of illness, the average cost needs to be multiplied by the total population. Thus the following basic economic cost structure for each illness will be calculated for each year. Objectives: The objective of the study was to obtain information on the economic costs of illnesses resulting from tobacco usage in Bangladesh. It entailed calculating the opportunity costs borne by the government attributable to tobacco related illnesses, and an analysis of the extent to which these may frame tobacco control policy. The specific objectives were to determine: * the prevalence of tobacco usage; * the prevalence of tobacco-related illnesses; * utilization of health services (in a partial way); * hospital costs borne by the health system due to tobacco-related illnesses; * out-of-pocket expenditure of households, either when(6) deaths and disabilities due to tobacco-related illnesses; * the impact of second-hand smoking; and * benefit of tobacco consumption for the economy. Using the above criteria we attempted to test the following hypotheses: * tobacco-related illnesses impose substantial costs to the society; * total expenditure (household out-of-pocket, health system and indirect costs) exceeds total income (public and private) earned from, domestic consumption of tobacco; and * the cost of tobacco usage is disproportionately high for the poor. The prevalence of tobacco-related diseases and the average private and public costs of treating them were estimated using data collected in 2004 from various sources, including a national household survey, hospital costs and patient surveys (from three public medical college hospitals and one private one), and an expert survey that determined the survival rate and quality of life after occurrence of the diseases attributable to tobacco. These data were supplemented by others from the institutes that provide specialized care for the diseases. On the other hand, a major reason that tobacco consumption has not been considered as a cost has been the concern of policy-makers in poorer countries of losing tax revenues from sales of tobacco products (including surpluses which are normally seen as benefits in welfare economics), as well as wages earned through the production of tobacco. The study therefore adopted a mixed approach while the tax and wages associated with tobacco consumption and production were seen as benefits the producer and consumer surpluses from domestic consumption were discounted as they stem solely from addictive consumption and cause damage to health. In the United States of America, the direct costs of treatment of illnesses directly attributed to tobacco usage accounted for 0.46% to 1.15% of gross domestic product (GDP). This is the actual expenditure in a given year. In the United Kingdom, these costs amounted to 0.13% of GDP, while those in Canada ranged from 0.12% to 0.56% of GDP. Similar ranges were found in Australia. The only comprehensive study from any developing country , carried out in China, showed that direct costs amounted to 0.43% of GDP. Social cost: Social costs included the indirect costs of morbidity and premature mortality, as well as direct medical costs. While social costs averaged 1.4% to 1.6% of GDP in the USA and Canada, the China study showed a higher figure of 1.7% (In 2000) While directly not accounted in the cost calculations in any of the studies mentioned above, the effects of tobacco consumption on poor populations are significantly higher than for other income groups. Taking education as proxy for income levels, data from both developed and developing countries suggest that poor people consume more tobacco products than people in higher income groups in nearly all regions of the world. In the United Kingdom, the least educated people smoke three times more than the highest educated group, and this rate is up to seven times more in some developing countries. The risk of death from tobacco usage is also related to income. A study in Canada determined the risk of death attributable to smoking to be 5% for high-income earners, rising to 15% for the poorest population group. The effects of high consumption of tobacco in developing countries is compounded by the opportunity costs of consuming other essential items. Studies in several countries observed that up to 17% of household income was being spent on tobacco products (de Beyer et al., 2001). A study in Bangladesh estimated that 10 million people currently malnourished could have an adequate diet if money spent on tobacco were spent on food instead. In developed countries, considerable efforts have resulted in a lower number of smokers, often as a result of banning direct and indirect tobacco advertising, high taxes on tobacco products, the enforcement of laws requiring tobacco-free public and work places, and clear graphic health messages on tobacco packaging. Developing countries, on the other hand, are not only witnessing an increase in tobacco usage; they are also lacking effective legislation, often for the socioeconomic arguments stated above. Based on these arguments, some policy-makers conclude that amount gained as revenue from tobacco exceeds the cost to society due to tobacco use. This study seeks to assess the validity of this view in Bangladesh, a pioneer among countries considering legislation to control tobacco consumption. Household survey: The household survey allowed us to estimate the prevalence of tobacco usage, construct a population disease profile for the age group of 15 years and above, determine out-of-pocket costs incurred for tobacco-related illnesses, and diagnose associated health-seeking behavior. Sampling and cluster selection: The household survey took place from May to July 2004. A representative sample of 2467 households was drawn from six divisions. We made sure that the districts selected had different degrees of accessibility to tertiary health care Facilities: Districts within a 25 kilometer radius from a tertiary health-care facility were considered near and those 25 to 50 kilometers were considered far. Unions or Wards (clusters) were selected randomly from the districts. A total of 59 clusters were selected from 6 divisions that included 11985 young and adult individuals. Impact of Tobacco-related Illnesses in Bangladesh: The household sample is representative of the Bangladeshi population in terms of urban–rural composition, distribution of household expenditure, as well as age composition. For example, youth and infants (those aged below 30) accounted for 63% of the total sample, while the national figure is 64%. The distribution of sample population by age group is shown in. The present study focused on adults aged 30 years and above, who constituted 37% of the sample, because tobacco-related illnesses are observable primarily among people of this age group. Impact of Tobacco related Illnesses in Bangladesh are, * Ischemic heart disease (IHD), stroke or transient ischemic attack (TIA), oral cancer, lung cancer * laryngeal carcinoma, chronic obstructive pulmonary disease (COPD) * pulmonary tuberculosis * X-ray: A chest X-ray was performed on any suspected case of lung cancer, COPD or tuberculosis. * Carbon Monoxide Monitor (CO-monitor): In order to corroborate the use of tobacco, a CO monitor was used to measure the ambient air quality and individual CO level. A conversion table was used to determine the CO level in blood (hemoglobin). Recommendations: Despite dissemination and availability of the recommendations on smoking cessation, few countries had taken sufficient action. Therefore, in June 2002, the WHO Tobacco Free Initiative organized a meeting to develop ‘Policy Recommendations for Smoking Cessation for governments, non-governmental organizations and health professionals interested in making public health gains in the short and medium term. The policy recommendations were published in June 2003 and launched during the 12th World Conference on Tobacco or Health in Helsinki, Finland. The recommendation chart is given below: pressure| Companies| People| Government| 1.Adhunik2.Bangladesh 2nd Sub-National Smoke-Free Project organized a Workshop. 3. PROGGA organized a workshop on 17th May,20124. YPSA(Young Power In Social Action) organized a program on May,20105. Bangladesh 2nd Sub-National Smoke-Free Project Workshop† held in Chittagong on 17th to 19th May, 20106. WHO(World Health Org.), BAT, BATA, other Non-governmental org.7. The Anti-tobacco advocacy and campaign. 8. The World No Tobacco Day has been celebrated throughout Bangladesh in befitting manner on 31 May| 1. Banglalink campaign on 15th June, 2012.2. Nokia-Banglalink joint campaign named ‘Ovijaan’ and Ovi internet against smoking.3.Grammenphone4. The Daily Star and Kaler kontho.5. Prothom Aloo organized Anti Tobacco campaign, Bandhushava with the help of DIU.6. Google and anti smoking campaign against tobacco.7. Samsung Electronics leads other companies in the campaign against smoking. 8. The Truth About Tobacco Times of India campaign and workshop against tobacco.9. Radio Today, Bangladesh Betar and other radio TV channel also working against Tobacco.| 1.We should avoid smoking for our own health and environment.2. We should stop smoking among nonresidential area and public places.3. We should avoid smoking before children and young generations.4. We should not smoke too much and encourage other for smoking.5. We should not smoke in school. Colleges and universities. 6. We should follow the tobacco control campaign and avoid smoking.7. We should encourage others to avoid smoking.8. We should follow the rules and regulations of Govt. and other organization against smoking.9. We should avoid smoking in offices and public places.10. We should try to avoid smoking with the help of health agencies and doctors.11. We should aware the local people.12. We can aware the urban and rural people about the consequences of smoking.| 1.Govt. should fund state tobacco control activities at the level recommended by the CDC.2. excise tax rates below the level imposed which states excise tax rates should be indexed to inflation.3. States and localities should enact complete bans on smoking in all nonresidential indoor locations. 4. All health care facilities should meet or exceed JCAHO standards in banning smoking in all indoor areas.5. Colleges and universities should ban smoking in indoor locations.6. State health agencies, health care professionals, and other interested organizations should undertake strong efforts to encourage parents to make their homes and vehicles smoke free.7. All states should license retail sales outlets that sell tobacco products.8. All states should ban the sale of tobacco products directly to consumers.9. Congress should ensure that stable funding is continuously provided to the national quit line network.10. Can increase the high level of prices for tobacco products is an important factor in preventing people.11. Govt. can aware the people about the effect of smoking. 12. Govt. can increase tax among the sales of tobacco.| Recent changes to legislation: In July 2009, further provisions of the Public Health (Tobacco) Acts 2002 and 2004 were commenced. These included * ban on all in-store/point-of-sale advertising of tobacco products. * ban on the display of tobacco products in retail premises. * introduction of a closed container / dispenser provision. * tighter controls on the location and operation of tobacco vending machines, introduction of a retail register. The recommendations propose a broad framework for addressing treatment of tobacco dependence. In this framework, Governments can progressively choose minimal, expanded and core recommendations as they strengthen their resources and capacities. The recommended framework includes a mix of three main strategies: * A public health approach that seeks to change the social climate and promote a supportive environment. * A health systems approach that focuses on promoting and integrating clinical best practices (behavioral and pharmacological) which help tobacco-dependent consumers increase their chance of quitting successfully. * A surveillance, research and information approach that promotes the exchange of information and knowledge so as to increase awareness of the need to change social norms. These are recommendations from WHO and social welfare organization for people and Government also working for prohibiting tobacco. Conclusion: As countries prepare to develop national policy guidelines for the treatment of tobacco dependence, the international community can help by providing a forum for sharing and distributing information, writing up guidelines, reviewing best practices, raising funds and establishing partnerships.

Cone Beam Computed Tomography (CBCT) to Assess Bone Density

Cone Beam Computed Tomography (CBCT) to Assess Bone Density INTRODUCTION Implantology has witnessed an explosive growth during the last few years, from a technique practiced on the fringe of acceptability to one embraced by the mainstream dentistry and dental implants have emerged as a widely accepted form of teeth replacement. Implants are bio-acceptable materials with an inherent capacity to osseointegrate into the jaw bone to support a dental prosthesis to restore adequate function and esthetics without affecting adjacent hard and soft tissue structures. The Success of any implant procedure depends on a series of patient related and procedure dependent parameters, which include general health conditions, biocompatibility of the implant material, feature of the implant surface, surgical procedure and the quality and quantity of the local bone1. Careful recording and analysis of clinical and radiological information, interdisciplinary communication and detailed planning play an important role in determining the final successful outcome. Bone density is a key factor to take into account when predicting implant stability2 Clinical studies show greater implant survival in the mandible than in the upper maxilla, due to the bone characteristics. This survival is influenced by bone quality i.e. bone density2 .The bone density is an important determining factor in implant treatment and can be assessed fairly using different imaging techniques3. The quality of bone in the proposed implant site in terms of relative proportion and density of cortical and medullary bone has frequently been assessed by using a grading scheme proposed by Lekholm and Zarb, which is applicable only to cross sectional images. This classification system has been utilized worldwide because it is easy to use without considerable investment. Misch (2008) used computed tomography (CT) to objectively classify bone density into 5 types based on Hounsfield units (HU). This method allows for a precise and objective assessment of bone quality2 Several imaging techniques are currently available for presurgical and postsurgical examination, including devices developed specifically for dental implant imaging. Computerized tomograms are one of the best available radiographs for determining the bone quality. With the advancement of radiographic technology, computed tomography (CT), as well as cone- beam computed tomography (CBCT) are increasingly being considered essential for optimal implant placement , especially in the case of complex reconstructions4 Unlike conventional two-dimensional  radiographs, techniques like CBCT offer 3-D views of the mouth, face, and jaw from any direction. The cone beam configuration is ideal for the maxillofacial region because the dimensions of the beam allow for a panoramic view, sparing patients the radiation exposure of separate scans of the maxilla and mandible5.The overall advantages of CBCT are in its high resolution, potentially lower radiation dose and reduced cost compared with standa rd Computerized Tomography2 The past two decades have seen continual efforts by manufacturers, researchers and clinicians to improve the success of implant treatment outcomes through evolution in implant designs, materials and clinical procedures6. One such aspect is co-relation of available bone density with primary implant stability. Primary implant stability denotes the stability of a dental implant immediately after placement. Implant stability can be evaluated objectively, noninvasively, and easily by the insertion torque test.7 The insertion torque measurement technique, which records the torque after the implant has been placed, provides information on the local bone quality8. A High initial stability may be an indication for immediate loading with prosthetic reconstruction. A low primary stability following implantation, can cause the implants mobility leading to failure. Bone density and implant stability are important factors for implant osseointegration, and has been widely demonstrated by several au thors3. The insertion torque measurement technique, which records the torque during implant placement, provides information on the local bone quality.1 A number of studies have shown the relationship between bone density based on CT and primary implant stability 9,10. However, there are few studies about the relationship between bone density estimated by CBCT and primary implant stability. The possibility of predicting the primary implant stability and bone quality during the pre-surgical assessment of the implant placement site may produce an implant treatment protocol with higher predictability. The bone density and Implant stability can be evaluated using CBCT and the insertion torque test which records the torque during implant placement and provides information of the local bone quality6, 8. Keeping in mind the aforesaid goals the present study was designed to compare and evaluate the relationship between the bone density estimated by CBCT and the primary implant stability of t he dental implants by measurements of the insertion torque and to determine their correlation. MATERIALS AND METHODS Twenty out- patients with missing single/ multiple teeth who visited the Department of Oral Maxillofacial Surgery, Dayananda Sagar College of Dental Sciences, Bangalore and who were suitable for implant rehabilitation were considered and taken up for the study. Patients with uncontrolled systemic/ psychiatric illness, previous history of undergoing radiotherapy or chemotherapy, pregnant patients, cases of post implant removal and implants placed in sinus lift and immediate extraction sites were excluded from the study. pre-operative assessment: Patients selected based upon the above criteria underwent a thorough clinical examination, and the details were recorded using custom-made case proforma. A written informed consent was obtained from all patients and a standardized pre-surgical and surgical protocol was followed for all the patients. Pre-operative bone density of implant sites were evaluated using cone beam computerized tomographic scans. Bone density measurements were derived using 3DiagnoSys version 4.1 Software (3DIEMME Bio imaging Technologies). 3Diagnosys ® is a diagnostic imaging, analyses and 3D simulation software, tailored for the Clinician. 3Diagnosys ® software helps to interact with the 3D-model of the Patient, which is obtained by importing TC/CBCT/RM images in DICOM format, in a simple and intuitive way. The tools included in this software are not bound to morphological reconstructions but are also able to extract from the DICOM data the densitometric values for a bone funct ional evaluation.)Pre-operative evaluation of bone height and bone width was done using Cone Beam Computed Tomographic scan and appropriate implants were selected to be placed. The bone height and width measurements were achieved using the â€Å"Carestream Dental Imaging Software v6.13.3.3 CS imaging software†(Fov-15x9cm)† .All CBCT scans were obtained using the â€Å"KODAK 9500machine† (10ma 90 Kvp, 200 micron resolution, 10.9sec exposure, 605mgy per cm2). STATISTICAL ANALYSIS The statistical analyses were performed using SPSS version 16.0 software (SPSS Inc., Tokyo,Japan). Spearman’s correlation coefficient (rs) was calculated to evaluate the correlation among density values and insertion torques. A value of P RESULTS The density value ranged from 209.91 to 667.13Hu. The mean density value and insertion torque of all implants were 464.69 + 135.74 Hu and 49.0 + 8.20 respectively. There was highly significant correlation between bone density and insertion torque (rs 0.89, P DISCUSSION Over the last decade, there has been significant changes in reconstruction with dental implants. Rather than merely focusing on the tooth or teeth to be replaced, today’s implant practitioner considers a broad and complex set of interwoven factors before formulating an implant treatment plan4. Proper treatment planning comprises of pre – operative depiction and quantification of accurate bone height and contour which can be established by radiographic examination.11 The success of dental implants relies heavily on both the quality and the quantity of available bone for implant placement3. Studies have shown higher failure rates for implants placed in bone of poor quality and quantity.3 Bone density is a key factor to take into account when predicting implant stability2 Clinical studies show greater implant survival in the mandible than in the upper maxilla, due to the bone characteristics. This survival is influenced by bone quality i.e. bone density2 The bone density is an important determining factor in implant treatment and can be assessed fairly using different imaging techniques5. The quality of bone in the proposed implant site in terms of relative proportion and density of cortical and medullary bone has frequently been assessed by using a grading scheme proposed by Lekholm and Zarb, which is applicable only to cross sectional images. This classification system has been utilized worldwide because it is easy to use without considerable investment. Misch (2008) used computed tomography (CT) to objectively classify bone density into 5 types based on Hounsfield units (HU). This method allows for a precise and objective assessment of bone quality3 Several imaging techniques are currently available for presurgical and postsurgical examination, including devices developed specifically for dental implant imaging.12 They are used to visualize the internal anatomy of the jaws in 3-dimensional perspectives, including the proximity of  nasal fossae, neurovascular bundles, pneumatization of the maxillae, soft tissue morphology and bone quality. Computerized tomograms are one of the best available radiographs for determining the bone quality. Periapical and panoramic radiographs are the least viable options as the subtle changes between the different bone types can’t be quantified using them, also the lateral cortical plates tend to obscure the trabecular density . With the advancement of radiographic technology, computed tomography (CT), as well as cone- beam computed tomography (CBCT) are increasingly being considered essential for optimal implant placement , especially in the case of complex reconstructions 13. Unlike conve ntional two-dimensional radiographs, techniques like CBCT offer 3-D views of the mouth, face, and jaw from any direction.1 The cone beam configuration is ideal for the maxillofacial region because the dimensions of the beam allow for a panoramic view, sparing patients the radiation exposure of separate scans of the maxilla and mandible14. The overall advantages of CBCT are in its high resolution, potentially lower radiation dose and reduced cost compared with standard Computerized Tomography15 The past two decades have seen continual efforts by manufacturers, researchers and clinicians to improve the success of implant treatment outcomes through evolution in implant designs, materials and clinical procedures2. One such aspect is co-relation of available bone density with primary implant stability. Primary implant stability refers to the stability of a dental implant immediately after implantation. Implant stability can be evaluated objectively, noninvasively, and easily by the insertion torque test.16 The insertion torque measurement technique, which records the torque after the implant has been placed, provides information on the local bone quality. High initial stabilization may be an indication for immediate loading with prosthetic reconstruction. If primary stability is not high enough following implantation, the implants mobility is high and can cause failure. A number of devices and techniques have been developed to assess implant stability, including cutting torque resistance analysis, the reverse torque test, the insertion torque test, the mobility measurement test, and resonance frequency (RF) analysis2. Implant stability can be evaluated objectively, noninvasively, and easily by the insertion torque test and RF analysis.17 The insertion torque measurement technique, which records the torque during implant placement, provides information on the local bone quality1. A number of studies have shown the relationship between bone density based on CT and primary implant stability .9,10However, there are few studies about the relationship between bone density estimated by CBCT and primary implant stability.In a study conducted by Isoda k et al; The bone quality evaluated by specific CBCT showed a high correlation with the primary stability of the implants.8 CBCT is one of the significant imaging modalities that can be used to assess the relat ionship between primary implant stability and bone density which can further give an insight into the prognosis of the implant treatment. Implant stability can be evaluated objectively, non-invasively and easily by using the insertion torque test which records the torque during implant placement and provides information of the local bone quality 1. Keeping in mind the aforesaid goals the present study was designed to compare and evaluate the relationship between the bone density estimated by CBCT and the primary implant stability of the dental implants by measurements of the insertion torque. It also aims to determine the correlation between bone density and primary stability of implant by insertion torque value. In all cases Implants were placed under local anesthesia. Different implant systems were used and all were root form implants. Surgical preparation and isolation of surgical field was accomplished according to standard operative protocols. A Crestal incision was placed and Mucoperiosteal flap was reflected and alveolar bone was exposed, and the implant placement site was identified by the marking made with the aid of the surgical probe. Osteotomy site preparation was done with a Reduction gear hand piece (1:16/64) with an external Irrigation attached to the handpiece. Implant osteotomy was performed using standard sequential drill bits as per the dimensions of the implant. The osteotomy was proceeded till the desired depth as per the selected implants. The Implant was driven into the osteotomy site using the manual torque wrench till the final depth was reached. All Implants placed were of tapered design and their lengths ranging from 8 to 16 mm and diameters from 3-5 mm. After placi ng the implant, the implant stability was measured manually using the insertion torque test by a torque wrench with calibrations .The insertion torque reading was measured and recorded at the maximum torque resistance achieved. The cover screw over the implant was then placed and Flap closure was done. Post-operative OPG and IOPA was taken. Routine Antibiotics and anti-inflammatory drugs were prescribed along with oral hygiene maintenance instructions. Patients were recalled for regular follow ups. Permanent prosthesis was given after 3 months. SUMMARY CONCLUSION The study assessed the bone quality with density values obtained by cone beam computed tomography (CBCT) pre-operatively and determined their correlation with the insertion torque values recorded during the Implant placement procedure.From the observations and results obtained ,We can conclude that, the present study demonstrates the relationship between the bone density values derived from Cone Beam computerized tomography (Hu), located in the maxilla and mandible , and bone quality according to the Lekholm Zarb classification. The primary implant stability measured with the insertion torque test (ITV) depends on bone density values, bone quality and implant location. Implants Placed in location with higher bone density have more stability, and we can probably predict the implant insertion torque based on the bone density values (Hu) and the implant location. Finally, with higher bone density values (Hu) and higher primary implant stability measured in ITV values; Hounsfield units can be used as a diagnostic parameter to predict possible implant stability. The results of our study indicate that CBCT can be used to assess the bone quality. Also attaining a good insertion torque and thereby enhancing the implant stability aids successful osseointegration and prosthetic rehabilitation. Hence CBCT can be used as a predictor diagnostic tool for implant success. We suggest that a larger number of patients with a larger follow up might help a conclusive determining factor that pre-operative CBCT is a predictor for primary implant stability.

Pagan and Christian Rituals in Beowulf :: Epic Beowulf christbeo paganbeo

Pagan and Christian Rituals in Beowulf      Ã‚  Ã‚  Ã‚  Ã‚   Beowulf was written in a time when Christianity was a newly budding religion in England. Throughout the book there are obvious references to both Christian and Pagan rituals.   The characters in the epic are newly found Christians who are trying to remain true to their new faith but are weak and hence, in times of great trouble, they resort back to their Pagan traditions and gods out of fear.   Pagan rituals in the book are usually present only as reflections of the past or in times of the characters's greatest turmoil. Otherwise, in times of happiness and rejoicing, they worship their one, almighty, Christian God.   Ã‚  Ã‚  Ã‚  Ã‚   When Grendel is attacking Herot, and its people think they are in their greatest danger, the people of Herot "sacrificed to the old stone gods / Made heathen vows / hoping for Hell's Support, the Devil's guidance in driving their affliction off." (175-178).   With the use of the word "old" in this section, it can be inferred that the stone gods are things of the past.   The rest of the passage shows that it was because of the doubt and fear, instilled in the people by Grendel, that the people of Herot regressed back to their old gods.   The use of the word "heathen" shows that the soldiers were already Christian and reverted back to their old ways.   Ã‚  Ã‚  Ã‚  Ã‚   Soon after this statement, the poem reads:   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Beware, those who are thrust into danger,   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Clutched at by trouble, yet can carry no solace   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In their hearts, cannot hope to be better!   Hail   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   To those who will rise to God, drop off   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Their dead bodies and seek our Father's peace!      Ã‚  Ã‚  Ã‚  Ã‚   This says that the people whose fear consumes them to the point that they lose faith that, after death, their souls will not be granted eternal peace by the Father, God.  Ã‚   This illustrates that the soldiers who have fallen from faith in their worship are doing so only because of great fear, but that they are looked down upon by God and good Christians.   It says that only those who will sacrifice themselves and trust in God will be let into Heaven.   These

Multicultural Education Means Mediocre Education, Part II :: miscellaneous

Multicultural Education Means Mediocre Education, Part II I had taught high school and middle school English and social studies in a public school system for thirty-four years, retiring from the teaching profession in July of 1999. Any observations, opinions and conclusions I make about Multicultural Education are not theoretical: they are pragmatically based on experience and my interactions with over four thousand students. And I have been scrutinizing and studying Multicultural Education for four decades now and have heard too-many-times the lackluster educational jargon originating from college professors and from misguided advocates of M.E., and quite frankly those â€Å"elitist arguments† have become rather redundant, hackneyed and monotonous, and to think that I once wholeheartedly espoused those ethereal Multicultural Education principles as an idealistic teacher beginning my career back in September of 1965. Despite the â€Å"Happy Face† that supporters of Multicultural Education are attempting to promote and propagandize, one distinct adjective comes to mind whenever I think about Multicultural Education and that particular word is â€Å"insidious.† To the unsuspecting layman or college student â€Å"Diversity through M.E.† is a nifty catch phrase that sounds awfully noble and pleasant to the ears upon hearing its utterance, but the process known as Multicultural Education is actually quite detrimental to the implementation of effective American education. I deliberately describe the scourge as insidious because over the past forty years M.E. has imperceptibly and very cunningly been introduced, advanced and perpetuated by its militant proponents without the American public realizing exactly how harmful, how treacherous and how detrimental the seemingly benign terminology appears to be. First of all, Multicultural Education never clearly defines and identifies itself to the American public for what it really is. U.S, citizens automatically equate and associate M.E. with Bilingual Education and ESL (English as a Second Language), which the clever campaigners for M. E. never lucidly delineate and differentiate. Bilingual Education and ESL are indeed definite, positive, beneficial and necessary programs in our American public schools. Those two activities encourage and facilitate the cultural â€Å"Melting Pot† ideal whereby immigrant and certain minority students learn English and ESL and are hopefully successfully assimilated into American society after two-to-four years of exposure to a new language and a new culture. But Multicultural Education is the complete opposite and inverse of Bilingual Education and ESL. M.E. deceitfully and deliberately does not accurately distinguish itself from Bilingual Education and ESL to the unwary American public.

THE NATIONAL TOBACCO STRATEGY

Facts about harm associated with tobacco and contact information for quit programs provide access to information and support School education programs that focus on assertiveness skills, academic success and developing a negative attitude to smoking all help young people to modify personal behaviors and enhance skills that will be protective against smoking in future Quitting service Creating Supportive environments: Promotion of smoke free messages and regulation of place creates a variety of physical and social support structures accessible to individuals Frightening media campaigns â€Å"every cigarette is doing you damage† maintained powerful antismog attitude in the with advertising of pharmaceutical products, such as nicotine patches, the urgency to quit is implemented by the sense of having a solution readily available. Most indoor and public places are smoke free, providing safe physical and social environments for people to work and interact socially.Non-health initia tives like housing, counseling and anti-violence strategies reduce stress and anxiety that might lead to smoking. Employment and training programs to reduce boredom associated with unemployment-?address socio-cultural and socioeconomic determinants which influence tobacco use. Regulation of place of sale aims to eliminate the sale of tobacco products to minors and aka them less visible: hidden behind counters Strengthening Community action Local educational strategies such as peer support and mentoring programs improve self-esteem and the sense of worth among students which can be protective factors against harm from tobacco use.Families and parents provided with safe places for children to avoid tobacco smoke-?parks Reorienting Health services: ‘Lifestyles' prescription pads are tools used by Gaps to initiate discussions with patients about lifestyle behaviors-?help doctors introduce preventative assuages and recommendations for improving lifestyle behaviors. Building Healthy Public Policy. High levels of taxation on tobacco ensure cigarettes are less affordable, reducing access for younger people in particular Imposition of laws that prevent smoking in most public and indoor environments I. E. No smoking in pubs and clubs Place of drug education in all Australian schools an important cornerstone of public policy. Delivery of anti-smoking messages and development of anti-smoking attitudes as young as possible is critical.

Eating Disorders Research paper Essay

Eating disorders are considered critical attitudes, emotions, and eating behaviors. Minimized food intake, overeating, and the perceptions of body image, weight, and shape are some examples. There can be contributing factors and influences that develop the idea of an eating disorder. There are three types of eating disorders, binge eating disorder, anorexia nervosa, and bulimia nervosa. The two most common forms are anorexia nervosa and bulimia nervosa. According to the National Eating Disorder Association, â€Å"25% of girls 12-18 years old were reported to be engaged in problematic food and weight behavior† And in men and boys, according to the website nimh.nih.gov, â€Å"one in four preadolescent cases of Anorexia occurs in boys, and binge-eating disorder affects females and males about equally†. While the causes aren’t concise, some contributions can be cultural, personal characteristics, stress events or life changes, family, peers, and media. Individuals of low self-esteem or feeling useless can be a big contribution. For most adolescents they tend to compare themselves to others and they can develop an eating disorder because of this aspect. For example if their friends have an eating disorder they may develop one because they want to fit it. Some adolescents can develop an eating disorder from a stressful event such as; teasing, transition from middle school to high school, or a more traumatic event like rape. Families can even contribute to a teen developing an eating disorder. If parents are fighting a lot or may be considering divorce, this can be stressful and some adolescents handle it by not eating or induce vomiting as a means to obtain control over their parents in the household or gain back the attention. If the adolescent seems to feel like their life is spiraling out of control, they may feel like an eating disorder is a way to gain that control back. Also family studies show that anorexia nervosa, bulimia nervosa, and binge eating disorders do run in families. The heritability of anorexia nervosa is around 60%, and of bulimia nervosa can be 28 and 80%. For binge eating disorder currently it is 41%. According to some studies conducted across  countries eating disorders can be influenced by genetic factors. Another large contribution to eating disorders is our societal views. According to the National Eating Disorder Association, we develop these ideas, beliefs, and attitudes about what is acceptable according to our culture. To put this into perspective if our culture says your beautiful when you skinny, then some people believe that if they’re not skinny, they aren’t beautiful. Essentially since girls are generally valued for their appearance, they are likely the ones to internalize this idea into their thought process. The media also plays a role in the cultural and societal acceptance. A couple of examples that are very common are models and movie stars. Most often models are in every magazine, on every billboard, and in most commercials. Even T.V. shows like America’s Next Top Model gives children at a young age what the idea of â€Å"beautiful† is. Most movie stars aren’t overweight, which generally can contribute to both males and females being self-conscious about what the ideal appearance should be. There are three kinds of aspects that deal with the development of an eating disorder; behavioral, mental, and physical. The National Eating Disorder Association explains the more we focus on thoughts and feelings of our weight and how we look the more we may be missing out on life overall. When we focus on weight and body image, it can become an obsession, which can contribute to emotional and physical issues. The mental aspect of an eating disorder focuses on the opinion of yourself or your self- esteem. Self-esteem and body image both go hand in hand when it comes to one’s body. Eating disorders not only deal with the mental and behavioral aspects, but those of physical as well can contribute. Anorexia and Bulimia can lead to serious health problems such as kidney failure, heart problems, dehydration, and in excessive cases malnutrition, which can lead to death. A study by the National Association of Anorexia Nervosa and Associated Disorders reported that, â€Å"The mortal ity rate associated with Anorexia nervosa is twelve times higher than the death rate associated with all causes of death for females 15-24 years old.† Anorexia nervosa is an eating disorder in which results in thinness through starvation. It has the highest mortality rate of any psychological disorder, although we know little about the causes of this disorder. Generally the standard cause of death includes both  effects of starvation and suicide. This is disorder is also known as a visible eating disorder, because most are noticeably thin, although some hide their thinness with big clothes or wearing layers. During this time this individual is not maintaining a normal or healthy weight for their age, height, or gender. Anorexia nervosa tends to have two forms first being starvation or restricting. These individuals reduce their caloric intake and increase physical activity to maintain an abnormally low weight. When your body goes into starvation mode, it can alter your body. The second form is either binge eating, purging, or can be both. When anorexia nervosa is in its early stage these behaviors were seen in over half of the individuals. During anorexia nervosa a person can come to weigh less than 85% of the ideal body weight. Anorexia tends to occur during early adolescence or 10-12 years old. People who suffer from anorexia suffer from not only physical illness, but psychiatric too. Some include cognitive impairment, body-checking, low self-esteem, self-absorption, ritualistic behaviors, extreme perfectionism, and self-consciousness. The two most common psychiatric illnesses with anorexia are depression and anxiety. Some physical symptoms that may occur or develop over time are electrolyte imbalances (sodium and potassium levels), osteoporosis (decreased bone density), lanugo hair, dry brittle hair, low body temperature, low blood pressure, slowed heart rate, growth retardation, bloating, constipation, fidgeting, and loss of tooth enamel and dentin, and dehydration. However, the official diagnosis of anorexia nervosa in females requires the absence of menstruation (amenorrhea), for at least three consecutive months. The deficiency of menstruation is a normal response to starvation and weight loss and the body will then shut down the reproductive functions. Treatment plans of Anorexia nervosa often depend on the individual’s needs which may include medical care and supervision, nutritional counseling and therapy. If they have had severe weight loss, hospitalization is essential to get them back to an appropriate weight. This individual will need assistance in developing new patterns of thought process in their eating patterns. The earlier detected the less treatment necessary. Depending on the individual and the amount of time they have had the eating disorder; treatment can take a short or long period of time. Each person varies in the recovering process of the disorder. According to the National  Association of Anorexia Nervosa and Associated Disorders, â€Å"Only 1 in 10 men and women with eating disorders receive treatment. Only 35% of people that receive that treatment for eating disorders get treatment at a specialized facility for eating disorders.† Bulimia nervosa is an eating disorder that is characterized by a binge and purge pattern. Unlike Anorexia, people who have Bulimia can be at a normal weight range, but still have that fear of weight gain and they are generally very unhappy with their body image, shape, and size. It is also an invisible eating disorder, because individuals are usually of normal weight or over-weight. It can be difficult to place a caloric intake on a binge, but most agree around 1,000 calories is the minimum; however it can be up to 20,000 calories. Bulimia, unlike Anorexia, usually occurs during late adolescence or early adulthood, about 18-22 years old. These individuals persistently follow the pattern of binging in combination with some form of compensatory behavior, which is intended to reverse the effects of the binge or prevent weight gain. Compensatory behaviors include actions such as; self-induced vomiting, misuse of laxatives, diuretics, or other agents, fasting, and excessive exercise. The behavior of Bulimia may not be obvious because they do it in secrecy, because they feel a sense of shame and sickness of what they did. This pattern of binging and purging most likely occurs several times a week. Some data addresses a theory that individuals born after 1960 are at greater risk for the disorder, because it is more of a â€Å"modern occurrence† than anorexia. Usually more common in urban areas which suggests that environmental exposure and social learning play a role in the development of this disorder. This disorder is 9 times more common in females than males. Coincidentally, people with Bulimia also have psychiatric and physical aspects. It is estimated that 80% of individuals with bulimia have another psychiatric disorder. The psychiatric features are depression, anxiety, low self-esteem, extreme perfectionism, self-consciousness, irritability, impulsive spending, shoplifting, and may or may not have substance abuse problems, although the most common are anxiety disorders, major depression, substance use, and personality disorders. The two most common personality features those similar to those who have anorexia nervosa, perfectionism and low self-esteem. People with bulimia are likely to be more impulsive and have higher stimulus or sensation-seeking behavior. They also have a  tendency to exhibit more erratic and impulsive traits. Some physical symptoms of bulimia include; dehydration, electrolyte imbalance, kidney problems, inflamed sore throat from purging, acid reflux, swollen parotid glands, gastrointestinal complications, irregular menstruation, constipation, bloating, sensitive and decaying teeth and tooth enamel from stomach acids. Like Anorexia the treatment for Bulimia is essential for the individual’s health. For Bulimia there are a few more options such as; reducing or ending the binging or purging pattern, nutritional counseling, and cognitive behavioral therapy, prescribing medication, and accessing reasons for the illness. About 70% of people who have the disorder of Bulimia recover from it. According to the DSM the criteria is specific for anorexia nervosa and bulimia nervosa. However, most people who have eating disorders do not meet the criteria. There is a different way of diagnosing these particular individuals which is by the Eating Disorder Not Otherwise Specified (EDNOS). According to the textbook, Abnormal Psychology the â€Å"DSM-IV lists six examples of how the symptoms of EDNOS differ from those of the other disorders. Patients may have: 1. all features of anorexia nervosa except amenorrhea. 2. all features of anorexia nervosa except drastic weight loss. 3. all criteria for bulimia nervosa except frequency of binge eating or purging or duration of 3 months. 4. regular, inappropriate compensatory behavior after eating small amounts of food. 5. chewing and spitting out food (purging disorder). 6. binge eating disorder (binging without compensatory behavior.† Binge eating disorder is characterized by regular binge eating behaviors, but without the compensatory behaviors. Binge eating disorder or BED is a recent addition to the DSM, and is not yet an official psychiatric disorder. Since it was a recent addition little is known about its morbidity and mortality. Some research indicates that a person can be ill with BED for approximately 14.4 years which may suggest that BED is not just a temporary stage. The two most common forms of psychiatric disorders are depression and anxiety like most other eating disorders. Of females 3.5% meet the criteria of BED and of males 2%. BED is also found in approximately 5 to 8% of obese individuals. Eating disorders in females and males as discussed are not generally similar. In anorexia nervosa women and girls are more common to have this disorder than men and boys, essentially the ratio being 9 to 1. Many different theories  have been presented as to why it affects women more than men. The most effici ent theory is believed to be the increased pressure on females to have the ideal appearance or the â€Å"perfection† of the female body. Even though bulimia nervosa is also approximately 9 to 1, women to men can be somewhat sex-biased. Men tend to rely on nonpurging forms of compensatory behavior after binge eating, rather use excessive exercise. It is male athletes that feel pressured to remain thin and fit and focus on their weight and body shape excessively. For binge eating disorder the sex ratio is equally balanced. The developmental factors of eating disorders can assist in determining the causes as well. In anorexia nervosa it generally uncommon during childhood, although it is occurring increasingly. Bulimia nervosa is usually seldom conveyed before puberty. In anorexia nervosa the disorder itself and the associated symptoms can lead to isolation from peers and family. It can also have negative effects on the family emotionally and financially. The parents especially undergo extreme anxiety and struggle to understand why their children are doing this to themselves and their body. All this stress and financial difficulties with the expense of treatment can weaken or ruin a family’s functioning. For bu limia girls who develop mature figures earlier than their peers may develop disappointment, which can lead to earlier experimentation to design controlled eating and weight, which could very well increase the risk of an eating disorder. Binge eating generally begins in late adolescence or early adulthood. There are many treatments for eating disorders, the treatment goals for individuals with anorexia nervosa, bulimia nervosa, and binge eating disorder differ somewhat, although there are some aspects in common. The treatment goal of anorexia nervosa are increased caloric intake and weight gain so later treatments for psychological aspects of this disorder can be dealt with more effectively. For bulimia nervosa the focus is on the normalization of eating, elimination of binge eating and purging, and improvement of the psychological aspects of the disorder as well. For binge eating disorder individuals who are overweight the goal is to elimination of binge eating and normalization of eating. Also either weight stabilization or weight loss can be effective. In anorexia nervosa inpatient treatment can be accomplished by having a disciplined team to succeed. The first and most important step is weight restoration. Weight is generally not the only  factor to consider some other crucial factors such as medical complications, suicide attempts or plans, failure to improve with outpatient treatment, interference with school, work, or family, and pregnancy. Inpatient treatment is very difficult for the patient and the family as the patient is feared of giving up the symptoms, essentially the patient could have developed a phobia of food. It is important for the doctor to create a safe environment to make the patient feel safe and to also obtain the patients trust to make the hospitalization a success. Biological treatments include medications to assist in the cure of the disorder or assist in decreased symptoms of the disorder. Medications prescribed for anorexia nervosa have shown to be ineffective currently. In bulimia nervosa fluoxetine (Prozac) has been known to decrease the core symptoms of binge eating and purging and associated psycho logical features such as depression and anxiety. The FDA approved the treatment of fluoxetine for the treatment of bulimia nervosa, but for no other eating disorders. Although fluoxetine reduces the symptoms it is still not found to reduce or have permanent remission on long-lasting effects. A treatment that is necessary but not a sufficient intervention for all eating disorders is nutritional counseling. An additional treatment that helps individuals change their thinking patterns that contribute to their problem is cognitive-behavioral therapy or (CBT). Recovery rates with CBT wavy from 35-75% at five or more years of follow-up. For anorexia nervosa some evidence suggests that CBT may reduce relapse in adults after weight has been restored. However it’s unclear how effective CBT is with individuals who are extremely underweight. For bulimia nervosa the basis of CBT is self-monitoring. The individuals keep track of what they eat, the situation they were in, and their thoughts and feelings. CBT focuses extensively on relapse prevention for all eating disorders. It is also an effective treatment for a binge eating disorder. Binge eating disorders may first be offered a help-book or an online cognitive-behavioral program online to use at their own pace. For the family theories of anorexia nervosa a family-based intervention is directed to change the dysfunction of the family. This therapy can assist the family in being around healthier and a place to have open communication. Some modern approaches to family therapy for anorexia nervosa include conjoint family therapy, separated family therapy, parent training, and the Maudsley method,  which focuses on parental control of the initial stages of renutrion. The seven values include working with experts who know how to help you, working together as a family, to not blame your child or yourself for the problems you are having, focusing on the problem before you, not debating with your child about eating or weight-related concerns, knowing when to begin backing off, and taking care of yourself because you are the child’s best hope. In conclusion I have discussed and explained the three types of eating disorders; anorexia nervosa, bulimia nervosa, and binge eating disorder. I explained what factors can contribute to the development of an eating disorder. I deliberated three aspects of eating disorders such as the mental, behavioral, and physical. The analyzed the three eating disorders and gave a definition for each. I gave various personalities and other psychological dysfunctions that can come along with eating disorders. I expressed the sex ratios and developmental factors of eating disorders and explained the contributing factors for each. Also in discussing the symptoms of eating disorders lastly I identified some treatments that can assist in reducing symptoms and essentially preventing relapse. Some treatments that were acknowledged are inpatient treatment, biological treatments, nutritional counseling, cognitive-behavioral therapy, and family-based interventions. Works Cited About eating disorders. (n.d.). Retrieved from National Association of Anorexia Nervosa and Associated Disorders website: http://www.anad.org/â€Å'get-information/â€Å'about-eating-disorders/â€Å'bulimia-nervosa/ Body Image: Loving Yourself Inside and Out. (n.d.). Retrieved from The National Women’s Health Information Center website: http://www.womenshealth.gov/â€Å'bodyimage/â€Å'eatingdisorders/ Eating Disorders. (2008). Retrieved from National Eating Disorder Information Centre website: http://www.nedic.ca/ Eating Disorders: anorexia nervosa, binge eating, and bulimia nervosa. (n.d.). Retrieved from U.S. Library of Medicine, U.S. Department of Health and Human Services, National Institutes of Health website: www.nlm.nih.gov/â€Å'medlineplus/â€Å'eatingdisorders.html Eating disorder statistics. (n.d.). Retrieved from