Orlando Garcia, Jr. vs. Ranida and Ramon Salvador Essay

Orlando Garcia, Jr. (Community Diagnostics Center) vs. Ranida and Ramon Salvador G.R. No. 168512 March 20, 2007 FACTS: Respondent Ranida Salvador underwent a medical examination at the Community Diagnostics Center (CDC) as a prerequisite for regular employment. Garcia, a medical technologist, conducted the HBs Ag (Hepatitis B Surface Antigen) test. On October 22, 1993, CDC issued the test result indicating that Ranida was â€Å"HBs Ag: Reactive.† The result bore the name and signature of Garcia as examiner and the rubber stamp signature of Dr. Castro as pathologist. When Ranida submitted the test result to Dr. Sto. Domingo, the Company physician, the latter apprised her that the findings indicated that she is suffering from Hepatitis B, a liver disease. Thus, based on the medical report submitted by Sto. Domingo, the Company terminated Ranida’s employment for failing the physical examination. It was later determined that there was an error in the previous examination and that the respondent was not suffering from Hepatitis B. Respondent was rehired by the company. ISSUE: Whether Garcia (CDC) is liable for damages to the respondents for issuing an incorrect HBsAG test result. HELD: The Court held that CDC was negligent because there was no licensed physician in CDC as required by law. CDC is not administered, directed and supervised by a licensed physician as required by law, but by Ma. Ruby C. Calderon, a licensed Medical Technologist. In the License to Open and Operate a Clinical Laboratory for the years 1993 and 1996 issued by Dr. Juan R. Naà ±agas, M.D., Undersecretary for Health Facilities, Standards and Regulation, defendant-appellee Castro was named as the head of CDC. However, defendant pathologist is not the owner of the Community Diagnostic Center nor an employee of the same nor the employer of its employees. Defendant pathologist comes to the Community Diagnostic Center when and where a problem is referred to him. Castro’s infrequent visit to the clinical laboratory barely qualifies as an effective administrative supervision and control over the activities in the laboratory. â€Å"Supervision and control† means the authority to act directly whenever a specific function is entrusted by law or regulation to a subordinate; direct the performance of duty; restrain the commission of acts; review, approve, revise or modify  acts and decisions of subordinate officials or units. Moreover, Garcia conducted the HBsAG test of respondent Ranida without the supervision of defendant-appellee Castro. Lastly, the disputed HBsAG test result was released to respondent Ranida without the authorization of defendant-appellee Castro.

Can money buy happiness Essay

Happiness is a feeling we have for many reasons. Many objects and materials can provide the happiness many humans desire. Money can and have fulfilled that happiness which one lacks for many years. There are many ways I think money does buy happiness. Money increases quality of life in which buys happiness. This is only true if one lives within his means, lives a modest lift style and pursues happiness the right way. I think most people believe happiness is bought in a store. People overestimate how much pleasure they’ll get when they buy luxurious things. We really don’t need all these extravagant luxuries around use. Are they necessities of life? Are they just things to show one’s vanity? Or are they just trying to keep up with the Jones sort of speak. There are different classes of people; welfare, working, middle, and upper class. The welfare classes are not working or can’t find work; their bare minimal needs might be met. Do you think there is any quality of life for that family? Yes there is some food on the table and they may all live in a small apartment. What about the quality and quantity of those conditions? The working classes are working so hard sometimes 2 and 3 jobs struggling just to get buy. The whole time hoping that some day they could make enough to enjoy some of the good things life has to offer; time with family and friends, traveling, health, quality food and shelter. So yes I believe money can buy happiness if managed the right way. All things considered, does it make good sense for people in society to pursue monetary income or wealth? I believe it makes sense for people to pursue monetary income first; the wealth will come later. â€Å"Happiness is an ongoing project, not something that can be accomplished once and for all by earning more money, marrying the love of your life, having wonderful children (Dunn & Gilbert, 2011). But people adapt too quickly to the benefits that come with wealth and take them for granted. They must continuously pursue happiness of making more money to buy more things. Happiness is the psychological condition that results from the achievement  of one’s values. Values are ends that a person acts to gain and or keep. They are those things that a person cares about having or doing â€Å"cares† in the robust sense that he or she is willing to act to secure them. Values can be material or spiritual. Food, clothes, eye wear, a car, a house all of these would be material values. â€Å"Spiritual† values are those that pertain to a person’s consciousness. Spiritual values encompass things like knowledge, beauty, self-esteem, mental health or rewarding work. While spiritual values may take material form, their value depends primarily on their relation to the needs of a person’s consciousness. Money is an opportunity for happiness in today’s society. Many people use money to meet many of their needs. Vanity is now a major factor in the world. Buying materialistic things is an instant feeling of happiness. Money’s power to expand a person’s options is the heart of its contribution to happiness. An individual might value spending one’s life as a writer but unable to sustain an acceptable income writing. More money and the time it buys, makes a pursuit a greater possibility. A person might value being engaged with their children while they are young, or peace of mind about their retirement; more money makes these possibilities easier. One of the things these examples make plain is that money is important not only to fulfill physical desires or to acquire material goods. It is also critical for the spiritual values. Money facilitates the achievement of all values, spiritual as well as material. Money buys good and money buys time. Money buys autonomy to mold one’s life in the image of one’s ideal. Money nourishes happiness by helping a person to achieve the values that happiness is made of. Like many things, money can be put to poor uses. Yet money can also be put to wonder uses, including the greatest: experiences joy in living. That fact has got to be acknowledging if people are to embrace money unapologetically, as they must if they are to attain sufficient control over their lives to realize their ends and fulfill their dreams. The truth is clichà © that money can buy happiness is that happiness is not easy. Money does not offer short cuts around this fact. It is important to appreciate the danger of how money can’t buy happiness, however. On one level it is simply bad advice, which is counterproductive to individual’s happiness. Economists use the term utility to represent a measure of the satisfaction or happiness that individuals get from the consumption of goods and services. Because a higher income can allow one to consume more goods and services, we say that utility increases with income. But does greater income and consumption really translate into greater happiness? However consumption effect tells us that more consumption of goods and services will increase happiness. At least to a degree, we see that money can buy happiness. Based on research I found that money does not increase the happiness because as income increases the person behavior of preferences or satisfaction changes and will result is diminishing income. Research also showed that the more money one earned in an annual salary, one will spend more for the desires in which one has. Happiness can be easily out weighted by the loss of a family member, or cancer that may not be cured or removed. Money brings people happiness in numerous ways. I believe that money can provide one with live. Some people say that without love there is no happiness. On the contrary there is love in money. Others might involve themselves into one life only because the person has money, but they are expressing their love none the less. For example like when a woman falls in love with a man’s personality or anything else she may like about him. The man with a lot of money can lose all his wealth at any time, just like he can lose his personality, a career, looks or even a hairstyle. What people fail to realized is that money can bring happiness, whether or not its material objects. People tend not to like the phrase â€Å"money can bring happiness† not everyone can have a lot of money. Only about 3% of Americans make over $250,000 a year searching happiness through money is not the easiest route. So people  tend to simply deny the phrase, by saying that being rich makes people greedy and heartless. People are often frustrated with the rich because while they work diligently, they view the rich as those who sign a couple of papers and can continue to sit in their gold encrusted chairs, resting with their feet in the air. Because of this, the other 97% of the world say that the rich are miserable, as a way to feel better about themselves. Truth is money does bring happiness, one way or another. In conclusion, evidences suggest that an increase in income and consumption does not appreciably increase happiness. However, due to relative income effect, people still engage in the rat race for making more money. But as a person’s income increases over time, a person’s expectations increase as well, therefore they aspire to having higher incomes. To the extent that satisfaction is tied to whether those aspirations are met, satisfaction may not increase as income grows over time. It is possible that the relationship between income and satisfaction goes two ways; although higher income generates more satisfaction, greater satisfaction offers greater motivation for individuals to work hard and generate a higher income.

Domestic Bathtubs Lab Report Example | Topics and Well Written Essays - 1500 words

Domestic Bathtubs - Lab Report Example According to Wright, (1980), today, 62% of bathtubs, 28% of lavatories and 92% of whirlpool baths are made of plastic. According to Mazzurco (1986), the American National Standards Institute has set standards that manufacturers should observe when designing bath tubs. They may use enameled cast steel or iron besides plastic. Consumers are however taking into account the aesthetic features, safety, durability and environmental aspects when choosing bathtub materials. Customers and manufactures are now taking advantage of enameled or plastic bathtubs to design one-unit bathtubs. Safety, being an important factor to consider, is ensured in modern bathtubs by the use of prefabricated slip-resistant surfaces. The bath tabs should be leak free, the potential problem being solved by the provision of a moisture barrier between the subfloor and the bathtub, or ensuring that the base and the wall are integral parts of the bathtub. Bathtub Materials It is very important to choose the best mater ials for making bath tubs, just as it is important to consider its functions (Mazzurco 1986, pp.57). A wide range of materials that can be used to make bath tubs are readily available. However, they all have their own cons and pros of use. Other factors to consider in material selection are their cleanliness as well as longevity. These materials are in most cases available for spas, basic bath tubs and whirlpools. Examples of materials that are used to manufacture bath tubs are acrylic, cast iron, porcelain/ ceramic tiles, concrete, copper, cultured marble, fiberglass, granite, and porcelain on steel. Acrylic bath tubs normally chip and crack. Therefore, this material is reinforced by fiberglass to make it resistant. However, it is cost effective and light in weight thus allowing easier mass production. Bath tubs made of cast iron are very costly and heavy in weight. Manufacturing bath tubs with cast iron involves creating a mold according to the desired design, and then melting iro n and pouring it into the mold. Though they are expensive, they have two big advantages: many chemicals will not destroy the surface, and they firmly withstand abuse because it is nearly impossible to dent or scratch a bath tub made of cast iron. In its construction of porcelain or ceramic tile bath tubs, a wood form is produced and then covered in concrete. A gentle slope is essential as it ensures the right drainage. A water proof adhesive is used to glue the tiles to the concrete while cracks are sealed with grout. Unfortunately, they are often prone to small cracks that can cause leaks as a result of shifting of the whole house or form. Concrete is not a common material in the manufacture of bath tubs because of its high cost of labor. Concrete is either created in the factory or molded on site and then the finished product is delivered and placed in position. The biggest advantage of constructing bath tubs using tiles is that different textures and colors can be applied on the concrete. Furthermore, the material can conceive almost any color and shape. For a bath tub, copper is very costly to use. Another material that is normally used to manufacture bath tubs is cultured marble. Cultured marble is created by mixing polyester resin with limestone together and then coating it with gel. It is less expensive than cast iron but more

Revealed Religion Essay Example | Topics and Well Written Essays - 1000 words

Revealed Religion - Essay Example (Gatiss2005) Judaism, Christianity and Islam are examples of revealed religions. Revelation may be direct (insertion of meaning directly into the heart of the prophet), behind a veil (as spoken to Moses), or through an agent — the angel Gabriel. In Christianity, the revelation is direct. â€Å"It is a union between the Soul of man and God to convey the mind of God to man to be revealed in the Holy Bible.† Jesus was born at the height of Roman power, when Augustus Octavian was the emperor. Judea was by then a part of the Roman Empire, which being secular, required that the Emperor be looked on as divine. Judaism is a monotheistic religion, and its followers could not accept this. Apart from this, the Rabbis were divided on the issue of interpretation of the Scripture. Some also predicted the arrival of a messiah. Not much is known of the historical figure, Jesus. The Gospels of Matthew, Mark, Luke and John are dated around forty years after the death of Christ, and although they emphasize the events leading to Christ’s death, they also talk about the revelations by God to Christ. Christ was against the highly ritualistic practices of Judaism. He was against the accumulation of too much of wealth, stating that this came in the way of a person’s readiness to embrace the after-life. He preached the message of unconditional love — a lofty ideal indeed. After Christ, his apostles sought to spread his word.... Paul, the decline of the Roman Empire, and the abject poverty of many of its subjects was one of the factors that led to the popularity of Christianity. A religion that offered succor (everlasting life) from the daily grind, and did not subscribe to elaborate and costly practices appealed to the common man. In the latter half of the third century, Christians were persecuted, and many martyrs went willingly to their death. In 313 AD King Constantine issued the Edict of Milan, which not only stopped the persecution of Christians, but encouraged the consolidation and spread of the religion, and the evolution of a distinct Christian identity. The first Ecumenical (worldwide) Council (called for by Constantine) held in Nicaea in 325 AD laid the basis for a uniform Christian dogma like the virgin birth, resurrection and the concept of the 'Trinity' (a union of the Holy Father, the Son and the Holy Spirit in Godhead) By the end of the fourth century, Christianity was established as the most important religion in Rome. The Bishop of Rome gained primacy in the Catholic Church, and Latin, the local language became the language of worship. The Roman legal system also became the basis for Church canon (law). In the western part of the Empire, the Roman Catholic Church established itself, and in the eastern, the Greek Orthodox Church gained strength. By the end of the 6th Century, Christianity had established its elf as a powerful force, under the control of a powerful church. (Fiero) A monastic order evolved in Christianity. The first order was set up in Southern Italy -sometime towards the close of the fifth century - by Benedict of Nursia. The doctrines of simplicity and poverty, celibacy, and the barring of women were established. Women were barred from holding

Robert F. Kennedy's Assassination Essay Example | Topics and Well Written Essays - 1750 words

Robert F. Kennedy's Assassination - Essay Example In one of the speeches that Robert Kennedy in 1962, he was quoted, "The future is not a gift: it is an achievement. Every generation helps make its own future. This is the essential challenge of the present.†1 It is truly a tragedy for the American government to lose leaders with advocacies like the 2 Kennedy’s. Robert Francis Kennedy (RFK) was filled with not just emotion but passion towards leading and serving the country and its people. Yet, just like his older brother John, RFK was assassinated. The will within the person to live is so strong that RFK only died more than 24 hours after the assassination.2 RFK was said to be just like his older brother to have both the brains, the heart and the capabilities to assume the presidency. Bobby, as RFK is fondly called, failed to achieve the coveted post despite the credentials that he has under his belt. The odds are very much going his way and Bobby was just a few more steps towards becoming the next American president. A ll was shattered a couple of minutes past midnight on the 5th of June 1968. His life was ended during his presidential campaign at the Ambassador Hotel in Los Angeles, CA by a gun shot. A man with a very promising future was killed by an assassin identified as the Palestinian-American Sirhan Bishara Sirhan.3 Since it was the period for the presidential campaign, media was all over the place. ... All of the 3 assassinations were highly publicized. However, RFK’s assassination seemed to be more traumatic since it was the 2nd Kennedy assassination in less than half a decade. In the filed video coverage of RKF’s presidential campaign in 1968, the crowd’s jubilation was turned into panic and fear as the sound of the gunshot echoed in the atmosphere. According to Melanson et al: Cameras captured the frenzied struggle to subdue the attacker. They showed us the terrible vision of Robert Kennedy lying on the floor and bleeding profusely. To this day, many people believe that these same cameras captured the actual shooting (as the Zapruder film had done in President Kennedy’s assassination); some are insistent to the point of anger that it’s all in film†¦No photographic record of the actual shooting is known to exist.5 The picture of the blood-covered RFK lying on the floor is truly quite disturbing and heartbreaking. It is disturbing because of the graphical representation of a man respected and eyed to be the next president of a very powerful nation. One can think that the photo being published and circulated in media can be considered as an invasion of privacy. Even if the person involved in the picture is a public servant, such situation should be kept private as to reserve the dignity and respectability of the person. The picture of a dying man lying on the floor covered with his own blood can trigger so many emotions within a nation.6 Since the assailant was identified, the assassination case was considered closed. That is what the public was made to believe. People from different walks of life might agree or disagree with the previous

The History of Affirmative Action Research Paper

The History of Affirmative Action - Research Paper Example n the schools, denied equal chance at acquiring good jobs and rejected from housing areas all reserved exclusively for the pale-skinned dominant culture of the west Europeans. This separation was made possible because of an ideology that believed white people were of a higher, more refined nature than those who had not yet been ‘cleansed’ of their barbarism. In many cases, minority members of society were restricted to slave or near-slave status even after the conclusion of the Civil War in 1865. Through a variety of tactics, the prevailing opinion of the ‘less civilized’ minority people of color was perpetuated by existing legislation and unfair practices that prevented these people from achieving the same kinds of success discovered by white people. Even after legislation now collectively referred to as the Jim Crow laws were abolished, inequality prevailed through shady or evasive business practices, finally forcing the enactment of countermeasures now kn own as Affirmative Action. Although controversial, this legal action was required in order to try to equalize the opportunity for all, extending the right for all free people to reach the potential they are willing to work for. Without affirmative action to help ensure equality, the balance in this country would still be heavily in favor of the ethnic majority and segregation would be much more blatant than it is today. Social evolution depends on widespread social acceptance of differences. It is a process that doesn’t seem to occur naturally in this country without the benefit of affirmative action polices. Since its enactment, affirmative action has succeeded in balancing the opportunities available to men and women of all ethnicities. Although the majority ethnic group, the white people, may now feel they are being treated unfairly simply because they have lost their stranglehold on the economic high ground, affirmative action has been successful in distributing opportuni ty on a more equal basis. A

Causes and impacts of the War of 1812 Essay Example | Topics and Well Written Essays - 2000 words

Causes and impacts of the War of 1812 - Essay Example remained neutral. In 1805, the British defeated a combination of French and Spanish fleets near Cape Trafalgar, confirming its status as the world’s most powerful naval power. The main strength of the French, on the other hand, lay in its strong ground forces. Since the two opponents could not directly pit their strengths against one another, they resorted to economic strangulation methods. This was the first reason why Britain resorted to unfair maritime practices. The second reason was the perception that the American merchant marine was unfairly benefiting greatly from the European war, while also growing at a rapid pace thus posing a threat to Britain’s naval dominance and its commercial shipping (Harney). The British Orders in Council of 1807 decreed that all neutral ships should pass through British ports. France’s Berlin decree of 1806, and Milan decree of 1807 proclaimed Britain as commercially isolated, and condemned neutral nations whose ships adhered to the British decree. America perceived that both countries were disregarding its neutral rights, but British maritime practices were opposed more because Britain controlled the seas (Gateway New Orleans). Impressment refers to the right to search for deserters of a nation’s armed forces. Britain started stopping and searching American ships for British deserters – an act looked upon as a breach of sovereignty. American displeasure was exacerbated by the arrogant power entrusted by the British to their naval officers whereby they made unilateral, on-the-spot judgments about the nationality of any man on the boarded vessel Britain resorted to impressment because an increasing number of its sailors were deserting the navy due to discouraging factors like poor food, hard work and excessive discipline and preferring to work in the American merchant marine that itself faced a shortage of sailors and could afford to offer British deserters a wage treble of what

Cultural Relativism and Improving the Lives of Women Essay

Cultural Relativism and Improving the Lives of Women - Essay Example However, as demonstrated by the overwhelming number of reservations to CEDAW there is an underlying reluctance to part with social and cultural traditions.4 This study assesses the problem of cultural relativism as a barrier to improving the lives of women by reference to the weakness of the implementation and enforcement mechanisms of CEDAW. Cultural relativism takes the position that there is no universally accepted standard for judging all cultures. This is especially unfair to feminists who attempt to draw attention to all forms of gender discrimination and oppression among diverse cultures.5 Cultural relativism is characterized as a â€Å"doctrine† that recognizes that there are some moral codes and social institutions are different and are â€Å"exempt from legitimate criticism by outsiders† and such a doctrine is â€Å"supported by notions of communal autonomy and self-determination†.6 There are two diametrically opposed views on cultural relativism. One view is referred to as radical cultural relativism and this view holds that culture provides the only validity for proffering a moral rule. The other view is radical universalism which takes the position that culture is not relevant for validating moral rules because they are â€Å"universally valid†.7 †¦people are categorized and identified by social identity, especially as it is expressed in religious, ethnic, or tribal terms. These group-based identities often help determine our position in the social and political hierarchy of a society and also condition people’s attitudes and perceptions toward us as we go about our daily business.8 For a number of women, they derive their respective identities from their experiences within specific settings that are dominated by males. Even so, the way that they perceive themselves emanates from how women are treated and quite often they confront levels of discriminatory treatment within their social settings.

Summarize & Critic on Torah (Pentateuch) Essay Example | Topics and Well Written Essays - 1250 words

Summarize & Critic on Torah (Pentateuch) - Essay Example The saga moves from beyond external conflicts- Noah, Abraham, Jacob, Issac and Moses to resolving internal conflicts - following covenants and commandments and resolving age hold human dissatisfaction with what is available, rebellion and ultimate salvation by entering the promised land. The compilation of Pentateuch was done by multiple authors and over a period of six centuries. Friedman presents evidence why he believes this is so; for instance Friedman provides evidence of "Doublets", which are variations of the same story with some facts similar and others paralleling the other instance of same story. Friedman cites specific couplets and verses where such synchronicity has occurred. On the other hand terminology used parallel that of the doublet which it has followed - same set of names fall into same doublet. Thus the text of the Pentateuch can be demarcated into following discrete divisions: J (Jahwistic), E (Elohistic), P (Priestly) and D (Deuteronomic). Within these divisions common names and sequence, presence or absence of events can be clearly identified. Even linguistic parlance within the above divisions is strongly indicative of separate authorships for each of the divisions. The events as presented within each of the div... Historical references within each of the divisions identify the approximate time frame and time period in which they were compiled or written. Friedman has exhaustively listed specific references from where the time frame can be elicited, he proclaims that Priestly text dates back to (715-687 B.C), whereas Deuteronomic dates to the era of reign of Josiah the great grandson of Hezekiah. The linguistic classification and analysis has also reiterated that Jahwistic and Elohistic belong to an earlier era than Priestly and Deuteronomic. As far as the relationships between the divisions are concerned parallels of events are so close between Jahwistic and Elohistic indicating that were probably edited together. In Priestly stories the differences between it and Jahwistic Elohistic report a contradiction of one event by the other presentation as possibly an attempt to explain the consequences after event has happened. Deuteronomic includes references to passages in other divisions indicating that it is more dated than others. Another factor determining completeness is cohesion of Jahwistic Elohistic - both together form a nearly complete and continuous story where as separately each is incomplete. Similarly Priestly also forms a nearly complete section on its own. This indicates merging of Jahwistic Elohistic earlier with addition of Priestly at a later date. It also shows different mindsets of the editors who combined the separate texts as heavy editing of the Jahwistic Elohistic sources seems to have been done in order to ensure good fit while Priestly's addition was without heavy source editing. There are also theories that such explicit divisions are

The global issues of healthcare management Research Paper

The global issues of healthcare management - Research Paper Example The advent of new client technology is bringing in even more issues or reintroducing older ones to the fore. This disruptive technology enhances better patient power. The most supple and advanced health economies have the change to revolutionize the manner in which care is delivered, and in doing this, in order to change their societies (Hall, 2011). This article outlines issues that face the global healthcare management, as well as some of the trends that scholars think greatly impact healthcare for the better or maybe worse. Among the global challenges that affect healthcare include: (1) rising costs, (2) changing demographics, (3) filling the resource gap, (4) easy access, (5) focus on quality and (6) becoming customer-driven. Spending on healthcare basically invariably increases faster compared to GDP. Its growth rate has surpassed that of GDP ever since national record keeping started. In addition, economic recession and spending closely related (Kongstvedt, 2013). Experts claim that we can see the growth rate of healthcare spending in continents such as Europe and Asia outshine the GDP growth considerable during these financially challenging times. Macroeconomic aspects such as aging populaces or inadequate public funding among others are challenging both providers and receivers or healthcare (Kongstvedt, 2013). Penetration and adoption rates of clinical information systems differ greatly. In reality, the number, as well as size of buyers, differs from nation to nation, plus it is not vitally reliant on the size of the nation, but instead on the healthcare system structure. In addition, people’s purchasing behavior is changing towards a more coordinated and joint purchasing from what researchers have seen in the past (Kongstvedt, 2013). There is rising demand on the healthcare delivery institutions, and this is occurring in every nations. Peoples’ immortality rates have increased all

The Spirit Catches You and You Fall Down by Anne Fadiman Essay Example for Free

The Spirit Catches You and You Fall Down by Anne Fadiman Essay 1st chapter reflections: This chapter which introduced me to Lia’s family was interesting. I was shocked to read that in her mother’s country of Laos, Lia would have been born by her mother squatting on the floor! They also used special created remedies to solve health issues without relying on hospitals or clinics. It was also interesting to read how important the Hmong people believed in sprits and how their life decisions where decided around the sprit actions. For example, they believed that male sprit’s held up their house roof, if the male’s placenta was buried near the central pillar of the house. Lia was even blessed by the elders because her parents believed that it was a way of protecting her from ever getting sick. If anything, reading this chapter quickly gave me a quick preview of the clash that Lia’s cultural beliefs will have with the American doctors when she gets sick in the future chapters. However, I’m hoping that this book will pick up a little faster and have less history moving forward (being honest lol) 2nd chapter reflections: This chapter started in a class at college; it continued to explain how a Hmong student spent extra time on his speech to talk about how people make fish soup in his culture. Once I finished the first page in this chapter, I understood that the young man was trying to explain to his class that we as humans should be more careful about how we select our foods because we are all connected in different ways. However, I didn’t pick up whether his class was interested after he was done with his speech. This chapter preceded to dig deeper into the Hmong history by detailing their live in north China; N. China was were the Hmong people was subjected to wars, because they did not like to be told what to do or how to behave as a people. However, the Chinese did not like the Hmong people and called them degrading names because they wanted to overrule them. In response to this, the Hmong had to migrate many time and the Chinese finally applied enough pressure to overtake them. Even with the takeover, the Hmong people refused to show any respect to the Chinese emperor. Besides all of this history, I have yet to see how this will tie into Lia’s future health issue. 3rd chapter reflections: This chapter starts to now focus on Lia and detail her first epileptic seizure that started when she was three months old. It was interesting to read that Lia’s parents blamed her seizure on their older daughter slamming the apartment’s front door. They believed that the front door slamming caused Lia’s soul to become frightened and lost from Lia’s body which triggered the seizure. I soon realized the book’s title â€Å"The spirit catches you and you fall down† is associated with the word epilepsy. It was also interesting to read that Lia’s parents saw her illness as a high distinction and a sign that Lia will grow up to heave a healing sprit within her. It was sad to read that Lia had over twenty seizures before her parents became scared enough to take her to an emergency room at MCMC. At first this hospital had a hard time communicating with Lia’s parents because they only had a few interpreters and the doctors quickly concluded that Lia’s illness was because her parents were giving her veterinary medicine. The doctor’s conclusion was heighted when the baby came to the hospital twice coughing badly and showing signs of pneumonia during which the doctors prescribed antibiotics. Lia was seen the third time by chance with a visiting doctor named Dan Murphy and during this visit he wrote a report that stated he did not feel that her parents were not that frightened. Dr. Murphy and his wife quickly became interested in the Hmong people and worked on reviewing Lia previous documented visits.  This chapter showed how cultures seen Lia’s illness differently; the American doctors wanted to give medication to cu re or control the issue, while her parents thought it meant something special. 4th chapter reflections: This chapter showed how the Hmong people viewed the American medical system because they did not understand why certain doctor procedures such as blood drawing had to be done. It was funny to read that they asked one Hmong women that returned to Laos about why American doctors ate people livers, kidneys, and brains! If anything, I read and understood that there was a HUGE difference between how American and Hmong people saw medical. The Hmong people believed that doctors done nothing but made people worse by invading their body sprits with all the test and medication. 5th chapter reflections: This chapter returned to Lia’s illness and explained that she was sent to the hospital seventeen times before he was even five years old! It was sad for me to read how worse the illness was getting and how Lia started to become aware of when she was about to experience one. This chapter also highlighted the fact that doctors believed that her obesity contributed to her epilepsy events and it made her intravenous access difficult. However, her parents focused on making Lia fat because they believed that this showed that a child was healthy and extremely taken care of. The hospital staff was also upset because Lia’s parents would move her in the hospital bed when they were previously requested not to for health reasons. The relationship between Lia’s parents worsen because the doctors felt that her parents were not giving her the proper needed medication and felt that they were part of the reason why Lia’s health continued to decline. After many attempts to get the parents on board, to give medication, Lia was placed in a foster care. This chapter was heartbreaking for me because I felt and understood both sides that wanted to care for Lia. 6th chapter reflections: This chapter explained in detail about how the Hmong people living in camps, shared horrible news about living in America and dealing with the medical system. In my opinion, this chapter confirmed how bad the cultural differences split people apart from seeing a common ground and added stress on her US healthcare system because Hmong people only came into the ER when they were gravely ill and not for prevention. 7th chapter reflections: This chapter explained how much of a power trip people had when it came to offering the best option for Lia’s health. It was noted that Lia did not do well in a great foster home and her developmental skills decreased more as she stayed. Her seizures also increased and the only time she started to show so signs of improvement was when she admitted to a hospital in Turlock where the people she was staying with lived. Receiving care in Turlock casued a decrease her medication requirements and her allowed her to return home. However, I felt that if anything, everyone involved in her health care was guessing and using Lia as a test dummy at her expense. 8th chapter reflections: This chapter was interesting because I was surprised to read that the doctors at the MCMC told the author not to look into Lia’s case because her parents were not friendly. I also thought that the hospital was trying to protect themselves by keep the author in the dark about certain information regarding the handling of Lia’s health. For example, the hospital kept a close eye by setting up a community meeting with the author and the Hmong people through their own nurse’s aide (who also was Hmong). If my opinion, the author was doomed to begin with because the Hmong people resented the MCMC and any staff that communicated with them. This is why I believe that the author had such a hard time during this meeting with them and a more welcoming one when she went and was introduced by Ms. Waller. This meeting is where the Hmong people opened up and tried to explain their culture to her without bring angry. This chapter proved that being from a different culture is fine ; people not respecting other cultures besides their own is what causes these deep miscommunications. 9th chapter reflections: This chapter was sad. I thought that Lia’s health was going to continue to improve after the doctor mentioned that the parents were giving her the correct medicine. However, I wasn’t surprised that the Lee’s thought that the doctor’s took Lia because they were angry at them. I was shocked to read that she fell off the swing and went back into having bad seizures. I dont think I would have allowed my child to even be on one if he or she had health issues like Lia. Sad to think that her parents thought that their child’s troubles were over and that she was going to live a productive and happy life up until this fall. Like everyone else in this chapter, after the tubes and everything, I also saw death coming later on. I’m just hoping that she doesn’t suffer. 10th chapter reflections: Ok. This is (again) is one of the things I did not enjoy about the book. I dont understand why this extensive history about the Hmong people and Vietman/ American war has anything to do with the previous chapter on Lia’s health condition. Only thing I learned from this chapter was that the Hmong people really resented the American culture which includes why the Lees has trouble trusting the doctors treating Lia. 11th chapter reflections: This chapter was the saddest part of the book that I have read thus far. I had to stop midway through the pages because it reminded me so much of my mother’s last struggle when lung cancer ( I cried reading this). I felt every page of this chapter because Lia’s parents and everyone else that loved her wanted to try everything instead of allowing her to pass peacefully. I also can relate to how Lia parents were treated in the hospital because I was in their position where I did not understand what was going on with my mom†¦ but the doctors were pressuring me to turn off her breathing machine. I noticed that Lia’s parents got to a point where they did not care that there were â€Å"issues† between them and the American staff†¦ they just wanted their child saved.. I felt the same way during my mother’s last rush to the ER because she couldn’t breathe. This girl wasn’t going to have a long happy life and I’m hoping she did n’t suffer because of everyone else stubbornness! 12th chapter reflections: Another history chapter and after the previous chapter, I was drained. I understand that hardship that this culture had to endure and I hope that our entire health care system has learned from this little girl’s mistreatment amongst all parties involved. 13th chapter reflections: So I started reading this chapter believing that Lia was going home from the hospital in Fresno. I was surprised to read that she was sent back to the MCMC and placed in the pediatric unit. In my opinion, there was nothing left they could do that would not require the poor child to suffer. I wasn’t shocked to read that Lia’s father tried to steal his child out of the hospital; the attitudes of the hospitals staff, nurses, and Lia’s parents were so negative that this craziness was bound to happen. Sadly, even with the little girl not functioning, the doctors and her parents enter another struggle to control the fate of Lia. Even though the doctors said she would die soon after leaving the hospital, I’m glad that the lee had personal time for closure at their own house because she didn’t die yet. I refuse to get into the â€Å"who was more right†. 14th chapter reflections: Another chapter on their Hmong history; This chapter details the issues they had with adjusting to American life and how no one wanted to be on welfare. No comments on my part.. Besides I didn’t enjoy this section lol. 15h chapter reflections: This chapter picked me up, made me sad and made me smile all at the same time. Reading through this made me think how differently her life could have been if everyone around her were open-minded when she first entered the hospital for treatment. Her current condition is considered a â€Å"persistent vegetative state† but how her parents treated her has not changed. This chapter showed that she is highly still loved and cared for even though she is not aware of anything. But she had a lot of potential to be a much healthier child if both cultures (American Hmong) would have been willing to accept each other†¦ her health decisions got lost in their hardheadedness! 16h chapter reflections: This chapter discuses history again but focuses on how the Hmong people ended up living in Merced; I’m not shocked that they created their own community here and cling to each other because I would of done the same thing if I was displaced. 17h chapter reflections: This chapter refocused Lia’s case and talked about how much could have been done differently to change her outcome and I agree. I ashamed of the hospital staff that believed that the lees should be grateful because they allowed them $200,000 of free medical cost( that should never be on a person mind when you talking about saving someone’s life) and I wish the parents would of learned how to be more open after their child’s health issue†¦ I see that people STILL want to place blame on Lia’s condition instead of accepting the fact that everyone placed a role in creating her current health state. 18h chapter reflections: This chapter shared a lot of my own opinions about Lia’s case. I do understand that some cultural difference will never be resolved because of the history of mistreatment that has occurred within that person’s culture. Our race issues in American is no difference, some people will always see things and their interactions with people as a â€Å"race† problem and nothing more. However, if you work in a hospital helping other people, you need to be able to look beyond that, not take things personally, not judgmental, and be open to learn about the different people that enters the doors for help. 19h chapter reflections: This chapter showed that despite Lia’s current condition, her family still believes that she will change and become a full functioning child again once her soul returns. Finishing this chapter, and reading the author notes throughout the book, I now see that Anne Fadiman started the story sort of believing that the doctors at Merced done everything they could to help Lia. However towards the end I felt that the author wanted people to understand the lee family and their hardship with adjusting to living in America and dealing with our health care system.

Minimal Intervention Minimally Invasive Dentistry Health And Social Care Essay

Minimal Intervention Minimally Invasive Dentistry Health And Social Care Essay Dentistry has very much shifted from an invasive to a more conservative approach over the years. This is due to an extended understanding of the nature of the disease and its process and discovering more effective methods of treatment instead of the traditional cut, drill and fill technique. Hence, the concept of minimally invasive and minimal intervention dentistry is now gaining popularity in modern dentistry. Minimal intervention is a modern medical approach to the treatment of caries focusing on prevention and detection of dental diseases at the earliest stage to avoid invasive treatment. When surgical intervention is necessary, minimally invasive techniques are being used widely to conserve as much tooth structure as possible and reduce risk of tooth fracture and pulpal problems. The minimally interventive approach involves reduction of cariogenic bacteria. It uses preventive measures such as topical fluorides, fissure sealants and patient education on oral hygiene. Early lesions are remineralised by non-interventive management, such as fluoride ions in saliva. The surgery carried out if necessary is minimally invasive and uses adhesive materials such as glass ionomer cements and adhesive composite systems. Innovative, modified cavity designs are used with possibly no drilling such as ART techniques. The resurgence of air abrasive technology with newer restorative materials has given a new dimension to minimally invasive dentistry. The micro-mechanical bonding of the restoration to the tooth structure through maximum preservation of healthy tooth structure negates the need to follow conventional G.V. Black cavity design parameters. Firstly, the difference between minimal intervention dentistry and minimally invasive dentistry need to be pointed out. Minimal intervention can be defined as a philosophy of professional dental care, with emphasis on early detection and earliest possible cure of the carious disease. This is followed by minimally invasive dentistry, which is the conservation of healthy tooth structure by using techniques that are patient friendly and cause minimal damage to the dental tissue and focuses on repair of irreversible damages caused by the disease and remineralisation.1 The concept of minimally invasive treatment emerged in dentistry in the early 1970s. One of the early examples of this is the application of diamine silver fluoride, which arrests the carious process and prevents the formation of any new caries. The silver ions in the diamine silver fluoride kill pathogenic organisms. Application is simple, cost effective and does not require any complex training to carry out.2 Several other examples are the development of preventive resin restorations (PRR) that were introduced in the 1980s, atraumatic restorative treatment (ART) which is the treatment of caries using only hand instruments and restoring with an adhesive filling material such as glass ionomer cement, and Carisolv in the 1990s which is a chemo-mechanical method that is efficient at removing carious dentine.3 The fundamental components of minimally invasive dentistry are the risk assessment of the disease; paying particular attention on early detection and prevention of caries, remineralisation of the enamel and dentine, use of a wide range of restorative materials and techniques that cause minimal intervention and resorting to surgery only if absolutely necessary. The following definition can be used to summarise the different aspects of minimally invasive dentistry: the maintenance and monitoring of oral health through continuous care, comprising comprehensive preventive management, a longitudinal approach to risk assessment and diagnosis of chronic disease, and a minimally interventive approach to any necessary operative intervention.4 Minimally invasive dentistry is not only restricted to the management of caries. The concept can be used in various dental applications such as the treatment of periodontal conditions, wear of teeth through erosion and attrition and management of chronic oral mucosal diseases such as xerostomia. The patient is very much involved in this type of approach to preserve and maintain their dentition and oral health. The patient takes responsibility for the daily care of their mouth and to control and prevent the risk of developing disease or progression of existing disease to the best of their ability. To do this, patients must have a good understanding of the disease process and know what to do to maintain good oral health and should be consistently motivated by members of the dental team. (REWORD FULLY)Minimal intervention suggests remineralisation of any enamel margin that is not yet cavitated as well as remineralisation of the lesion floor to avoid irritation of the pulp. Demineralised enamel around the margin of the lesion will be restored during the stabilisation phase of treatment aimed at elimination of the disease through application of fluoride. The floor of the lesion will be remineralised through the placement of a glass-ionomer cement for the restoration and this, at the same time will seal the margins against microleakage.14 The minimally invasive approach has been described by Tyas and co-workers as follows: Early caries diagnosis The classification of caries depth and progression using radiographs An assessment of individual caries risk Reduction in cariogenic bacteria, in order to decrease the risk of further demineralisation The arresting of active lesions The remineralisation and monitoring of non-cavitated arrested lesions The placement of restorations with minimal cavity designs Repair rather than replacement of defective restorations Assessment of disease management outcomes at regular intervals13 Patient Motivation (CUT EDIT COMPLETELYYYYYY) Preventive care is the foundation for minimally invasive dentistry. Preventive care is an essential factor of the minimal invasion technique, but is reliant on the patient carrying out effective oral hygiene techniques. The motivation for this is most likely to stem from educating the patient about the carious process so that they understand the importance of maintaining good oral health. The most active method of doing this is likely to be actual demonstration of the carious process to patients as such stimulation is likely to show them the full effects, and encourage them to take part in preventive care on their own. An important factor to take into account is that each patient will have a different caries risk and assessment of this risk is necessary before treatment can take place. Caries risk is much more significant if there has been previous history of caries risk. In fact the best way of addressing treatment, in my opinion is to use the risk score assessment method, treatment by this method ensures that management of the disease is specialist to the patient, so that the results are the most successful. A risk score is worked out and used to manage the disease in a specialised way based on the individual patient. Several different caries treatment techniques will be discussed. Firstly, Caries Management by Risk Assessment (CAMBRA), developed by Featherstone in university of San Francisco, This tool provides not only the assessment mechanism but also a set of interventions tailored to the disease level predicted.- havent changed words around!! Secondly, the technique of DIAGNOdent is lesion specific and detect lesions Some types of caries detection tools are lesion-specific and detect lesions at their earliest stages. DIAGNOdent is very useful in detecting demineralisation on certain surfaces, particularly the occlusal surfaces of teeth. Prevention stems from patient motivation to carry out effective oral hygiene techniques at home and maintain good oral health. Educating patients about dental caries in addition to talking about cavities is an important factor in motivating the patient as when they have a better understanding of the carious process they are more inclined to maintain good oral health to prevent such disease. The ability to demonstrate the caries process to patients might be the best motivational tool. If patients could see the process actually happening before cavitation occurs, they might be more likely to practice appropriate oral hygiene methods at home. It is first necessary to assess the patients caries risk. One of the most important predictors of caries risk is the history of caries. Featherstone and colleagues at the University of California, San Francisco have developed and tested a caries assessment tool called. This tool provides not only the assessment mechanism but also a set of interventions tailored to the disease level predicted. Some types of caries detection tools are lesion-specific and detect lesions at their earliest stages. DIAGNOdent is very useful in detecting demineralisation on certain surfaces, particularly the occlusal surfaces of teeth. DIFOTI which stands for digital imaging fibre optic transillumination uses visable light between and through the teeth to see shadows that might be indicative of caries or other defects in the tooth structure. Quantitative light-induced fluorescence (QLF) scans the entire surface of the tooth and detects caries lesions at their earliest phases. By superimposing the lesion at two separate stages, it can assess the status of remineralisation. This is an example of psychological effect of caries management by risk assessment and early detection. A technology such as QLF allows the patient and practitioner to work together to achieve remineralisation. This empowers the patient and shows them the important of their role combined with professional recommendations in reversing the process before its cavitation stage. (Motivation is key hence patient more likely to follow and successful outcome). An increase in patient awareness of treating disease has developed a new kind of dentistry. Only at such an early stage can the patients focus shift from restorative dentistry to disease management.15 GV Blacks Approach(REWORD REARRANGE ORDER) In 1895, G.V Black introduced the concept of extension for prevention. The principle of extension for prevention is that not only must the lesion be included in the outline, but any adjacent areas not at present carious but likely to do so in the near future should also be included to reduce the risk of subsequent carious recurrence near the cavity margin. The principles of cavity design, as described by G.V. Black underpinned operative dentistry for almost a century. As a consequence of adhesive techniques and new understanding of carious process, Blacks principles have been revisited. Eg: Blacks concept of extension for prevention has been replaced by prevention of extention.17 The preparation of a retentive lock or key in the occlusal aspect of posterior teeth in order to prevent displacement of non-adhesive amalgam restorations result in substantial loss of tooth structure, weakening the tooth. The purely surgical approach to caries control as taught by Black is now recognised as being too invasive and destructive. It is inefficient as it does not eliminate the cause of the disease and also leads to a continuing process of replacement dentistry, enlarging the cavity further. The restoration is subjected to an increasingly heavy load and the tooth gets weaker. The cavity designs proposed by Black required geometric precision with sharp line angles, flat floors and removal of all signs of demineralised tooth structure. The fundamental problem with Blacks classification is that it proposes a cavity design regardless of the size and extent of the lesion. Therefore, there will be a standard amount of tooth structure removed whether it is involved with the disease or not. This results in the cavity preparation being larger that it needs to be. Also extension for prevention increases the areas for access of microbes, resulting in even more tooth structure being removed to remove the secondary caries.18 New Cavity Classification The concept of minimal intervention cavity designs is now being used as a replacement to the traditional Blacks classification. The new classification will identify both the position of a lesion on the exposed crown of a tooth and the extent to which it has progressed. It is not needed to specify a particular design for the cavity that needs to be prepared. (Table 1: Mount GJ, 2009) The above table shows a new cavity classification that has been developed by Graham Mount which takes into account the changes in caries activity so is classified by size as well as site: Site 1 lesions are similar to pit and fissure class I restorations and other defects on smooth enamel surfaces. Site 2 lesions are those at contact areas between any pair of teeth. Site 3 lesions are those originating close to the gingival margin including exposed root surfaces. 13, 14 As the size of the lesion extends so does the complexity of the restoration. The sizes that can be identified are as follows: Size 0 the initial lesion at any site that has not yet had surface cavitation so may be possible to heal it. Size 1 the smallest minimal lesion requiring operative intervention. Size 2 a moderate sized cavity. There is still adequate sound tooth structure to maintain integrity of the remaining crown. Size 3 cavity needs to be modified and enlarged to provide some protection for the remaining crown from the occlusal load. Size 4 cavity is now extensive following loss of a cusp from a posterior tooth or an incisial edge from an anterior.14 Cavity preparation One of the most important aims of minimally invasive techniques is to preserve as much sound tissue as possible. The smaller the cavity preparation, the better the performance of the restoration placed within it. It is important to excavate only the irreparable, diseased enamel and dentine, keeping the cavity as small as possible. The cavity walls have to be modified in order to restore the cavities with a suitable adhesive material that can strengthen and support the remaining tooth structure, promote remineralisation and ideally have antibacterial activity. Any remaining bacteria need to be sealed off so that their nutrient supply is cut off and the carious process is arrested. When carrying out the stages of caries removal, it is imperative to follow a minimally invasive approach, and for this to be successful a good knowledge of the chemistry and handling of dental materials is essential. There are many different approaches for proximal cavity preparation, with focus on preserving as much tooth substance as possible.5 Several techniques will be discussed as followed. Sonic Techniques The sonic oscillating, SONICflex system is used in minimally interventive occlusoproximal preparations. It was developed to cut small proximal cavities and used a high frequent oscillating preparation instruments in an air-driven oscillating handpiece. Damage to adjacent teeth is minimised by the use of safe-sided diamond coated, round ended preparation tips. SONICflex can be used in situations where access is difficult, such as proximal sections. The SONICflex PrepGold and SONICflex PrepCeram instruments are designed for minimally interventive gold and ceramic inlay preparations. Figure 1 preparation with SONICflex Prep Ceram (Wilson NHF, 2007) Figure 2 Preparation with SONICflex Prep Gold (Wilson NHF, 2007) Sonic instrumentation allows proximal beveling with limited risk of damage to the adjacent tooth surfaces.4 Air Abrasion Bioactive Glasses The air abrasion technology was developed by Dr Robert Black in 1945 and was successfully introduced in 1951 with the Airdent air abrasion unit by S.S. White. Air abrasion can be described as a pseudo-mechanical, non-rotary method of cutting hard dental tissue where the tooth surface is bombarded with high velocity desiccated abrasive particles, transferring kinetic energy to the tooth surface, which is micro-chipped away. (REWORD) Studies have shown that bonding of enamel and dentine surfaces that have been prepared with air abrasion are much better than those prepared with conventional carbide burs or acid etching.6 Air abrasion produces no heat, vibration, pressure, pain or noise and extent of hard tissue damage is far less than that accomplished using rotary instruments, therefore making air-abraded hard tissue surface more favourable to adhesive bonding. It works by using a stream of aluminium oxide particles produced from compressed air. The abrasive particles strike the tooth with high velocity and removes a small amount of the tooth structure. Efficiency of removal is relative to the hardness of the tissue or material being removed and the operating parameters of the air abrasion device. (REWORD) A number of parameters such as air pressure, operating distance, powder flow rate, particle size, diameter of the nozzle tip and time of exposure vary the amount of hard tissue removal and depth of penetration. The safety for clinical use of alumina was supported by the fact that the particles are large enough to exceed the upper limit for respirable airborne pollutants.4 Air pressure usually varies from 40 to 160 psi and most common particle sizes are 27 or 50 micrometres in diameter. A high powder flow rate will allow more particles to abrade the tooth faster. Operating distances from the tooth range from 0.5 to 2 mm. Applications of air abrasion include caries removal, removal of superficial enamel defects, detection of pits and fissures, removal of pit and fissure surface stain, preparation of tooth structure for the placement of composites and ceramics, surface preparations of abfractions and abrasions, removal of existing restorations and as an adjunct to the conventional handpiece bur.7 Air polishing is an alternative type of air abrasion that removes plaque and surface stains effectively by using sodium bicarbonate powder instead of alumina. Advantages of air abrasion include majority of patients do not need local anaesthetic, discomfort can be managed by reducing air pressure and patients are less anxious with the sound of air abrasion compared to a turbine drill. Air abrasion has a large number of indications but several contraindications are that it cannot be used to remove large amalgam restorations and is not efficient for removal of gross caries because it does not cut substances that are soft. It also produces a round cavity that is not suitable for preparations requiring sharp margins.13 Bioactive glass particles are recognised for their bone inductive properties and there is evidence that shows that bioglass particles can interact with dentine through the formation of a hydroxyl carbonate apatite layer which can provide an effective interactive seal. Bioglass particles can be used for extrinsic stain removal, desensitisation of exposed cervical dentine, removal of selective demineralised enamel and composite removal. They have the ability of discriminating incipient lesions from sound enamel, treating them selectively and minimally. Chemomechanical Treatment Chemomechanical treatment is a gel-based dentine caries removal system and remains the least interventive approach to the removal of carious dentine. Carisolv gel is used with this system and has the advantages of limiting the need for anesthesia, preserves dental tissues, reduces the use of rotary instruments and is effective in controlling patient anxiety. Carisolv gel is applied into the cavity and subsequently the carious tissue is removed using specially designed hand instruments. The Carisolv hand instruments scrape away the material dissolved by the gel, hence preserving remineralisable layers of dentine and underlying sound dentine. Carisolv gel consists of a 0.1% hypochlorite-based alkaline gel with amino acids. The mechanism of the gel is that it dissolves infected dentine that has undergone proteolytic breakdown of collagen, causing further collapse of the collagen network for easy removal with hand instruments. The gel has no detrimental effect on healthy, hard dental tissue. Indications include the treatment of anxious patients, root caries and deep lesions of caries.4 Chemomechanical methods of caries removal is considered to be less painful compared to the use of rotary instruments.8 It is a well-accepted method by patients, despite the prolonged time taken to carry out the treatment. It is a self-limiting technique only removing infected dentine so it is not possible to cut away too much of the tooth structure.13 Polymer Cutting Instruments Metal and diamond burs are not able to discriminate between infected and healthy dentine. Polymer instruments have been designed to differentiate between these two structures as it is able to remove softened dentine but cannot cut the hard, healthy dentine. These instruments have the potential to prepare selected cavities without the need for local anaesthesia.9 Sound enamel has a Knoop hardness of approximately 400 and for dentine is 70-90. Carious dentine has a much lower Knoop hardness between 0-30. This allows a cutting instrument with a Knoop hardness of around 50 to be developed, which is halfway between carious and sound dentine. The polymer instrument remains largely intact when removing carious dentine but when it hits sound dentine, it is visably worn away therefore cannot remove or damage the sound dentine. This also means that it does not operatively expose vital odontoblasts and therefore has a limited capacity to cause pain and discomfort. Consequently, it may be possible to complete caries removal without having to use local anaesthesia.10 Stepwise Excavation Atraumatic Restoration Technique (ART) Stepwise excavation and ART are modern applications of the minimally invasive approach of managing deep cavitated carious lesions. Both techniques use simple hand instruments such as excavators to remove the necrotic caries-infected dentine and also some caries-affected dentine.5 The reasons for using hand instruments instead of electric rotating handpieces is that it requires minimal cavity preparation that conserves sound tooth tissues and cause less trauma to teeth. Also, the need for local anaesthesia is reduced as the patient will not have to endure as much pain. The stepwise excavation technique involves at different intervals. Carious tissue was removed and a thin layer of calcium hydroxide was placed followed by a temporary restoration. The calcium hydroxides primary purpose is to act as a protective seal of exposed dentine surface. It is a strong alkali so stimulates secondary dentine formation in very deep cavities. No final excavation is performed in the first visit. Re-entry and final excavation is made at a later date. There are several variations to the stepwise excavation technique such as Magnusson and Sundell placed a zinc oxide-eugenol cement temporary restoration and carried out the final excavation four to six weeks later. In 1962, Law and Lewis placed calcium hydroxide and an amalgam restoration and re-entry was made six months later. More recently developed ART techniques restore the cavity with chemically adhesive GIC which forms a better seal, instead of the traditional amalgam and also releases fluoride which prevents and arrests caries.5 When the restoration is removed, arrested caries-affected dentine which is darker and harder is exposed and tertiary dentine is also deposited. In the excavation procedure, all the undermining enamel has to be removed to allow easy access to the carious dentine along the enamel-dentine junction. 1 mm of carious dentine is left behind on the pulpal wall and re-entry takes place after a year and the final excavation is carried out. By removing infected dental tissue in deep cavities, excavation is at a very close level to the pulp. By using the stepwise excavation, pulpal exposure is avoided and any pulpal complications are minimised.11 (Figure 3: Bjorndal L, 2008) Figure 3 show the less invasive stepwise excavation procedure. The red zones indicate where plaque is found. A closed lesion environment before first excacation (a) and after (b) followed by application of calcium hydroxide material and a provisional restoration(c). During the treatment interval the demineralized dentine has clinically changed into signs of slow lesion progress, seen by a darker demineralized dentin (d). After final excavation (e) the permanent restoration is made (f).11 Restorative Materials At present there are several restorative materials that are compatible with a minimal interventive philosophy such as resin composites, giomers, ormocers, compomers, resin-modified and traditional glass-ionomer cements. The use of adhesive techniques such as resin composites removes the need of occlusal keys and undercuts, therefore conserving more tooth substance.13 Amalgam (REWORD) Amalgam is one of the oldest direct restorative materials still in use. It is an alloy of several metals including silver, tin, copper, zinc and a small amount of mercury. Amalgam is not compatible with the minimal intervention philosophy despite its proven durability. It requires an undercut to retain the restoration macro-mechanically; hence more tooth structure is removed or damaged, ultimately weakening the remaining tissue. Consequently amalgam is not recommended for the initial management of lesions of caries and where a minimally interventive approach is indicated.(REWORD) It is possible for the amalgam to be bonded to teeth with dentine adhesive systems, reducing the need for undercuts. These are called bonded amalgam restorations. Modern techniques for cavity preparation such as air abrasion are not well suited for the removal of amalgam and there is concern for the levels of mercury released when amalgam is abraded. Air abrasion of amalgam for one minute released mercury vapour four times in excess of the OSHA standard.12 Resin Composites (REWORD COMPLETELY) Resin composites are glass filler particles in a resin matrix. Composites for anterior and posterior teeth require different properties. Materials with a higher filler: resin ratio are recommended for posterior restorations, whereas materials with more resin matrix are used for anterior restorations. This is because materials with a higher filler: resin ratio tend to be stronger, more wear resistant and shrink less when cured. A high concentration of filler particles makes the material more opaque and is more difficult to finish. On the other hand, materials with a higher filler: resin particle ratios are more easily finished and translucent so better suited for anterior teeth restorations. However they shrink more when cured. All resin systems contract on curing. The concept of soft-start polymerisation has been shown to produce better marginal adaptation which may lead to reduced interfacial leakage. Also the net overall shrinkage is less. Composite restorative materials follow the minimally invasive concept as they can be used in conjunction with a dental adhesive system with minimal tooth preparation. Another advantage is that light-curing provides command cure which allows for immediate finishing and polishing. The restoration, if placed correctly in suitably prepared teeth, seals the tooth restorative interface, reducing interfacial leakage. It is possible to add material to cured increments, which allows for incremental build-up and further additions at a later date. Disadvantages include shrinkage typically 2-3% which can disrupt the marginal adaptation of the restoration. Bonding to dentine still remains problematic and water absorption with surface and marginal staining may occur after some years. Flowable composites are used in the repair of marginal defects in restorations and as a liner. They have a low filler: resin ratio and suffer relatively large percentage shrinkage when they are cured, but have the advantage of easy of adaptation to preparations. Compomers Compomers are made predominately from resin composite with the addition of a polyacid-modified molecule, which makes the material more hydrophilic. Compomers are initially light-cured, but subsequently absorb water, allowing for an acid-base reaction to set the polyacid-modified molecule. Initially the material shrinks due to polymerisation contraction but expands subsequently as water is absorbed. Compomers are easy to handle and release fluoride. they are resin-made so a dentine bonding agent is required. Properties are similar to composites but wear and fracture resistance are less than for composite. Glass-Ionomer Cements (GICs) and resin-modifed GIC (RMGICs) GICs are used for cervical restorations, fissure sealants and proximal lesions in anterior teeth. RMGICs are indicated for bonded-base restorations, temporary restorations especially between appointments in endodontic therapy. They are also used in high caries risk patients and atraumatic restoration treatments. GICs not indicated for definitive restorations in adult dentitions expect for the treatment of root caries. The advantages include self-adhesion to the tooth tissue through bio reacting with the tooth surface and the release of fluoride and other ions. They perform well in low-stress areas. It can also be rechargeable, therefore taking up fluoride from the environment.20 The disadvantages of GICs include poor fracture strength and wear rates. They are also quite difficult to handle but this can be overcome by adding resin to create resin-modified glass ionomer cements which is easier to place and has improved aesthetics. Traditional GICs are more opaque and less aesthetic than RMGICs and also cause more marginal chipping. Exogenous stain build-up is common with traditional GICs.20 Giomers Giomers are a relatively new type of restorative material. The name giomer is a hybrid of the words glass ionomer and composite. They have properties of both glass ionomers such as fluoride release and recharge, and of resin composites such as aesthetics and biocompatibility. Therefore the material combines advantages of both materials. The material is composed of prereacted glass-ionomer particles within a resin matrix. Ormocers Ormocer stands for Organically Modified Ceramic. It is a three dimensionally cross-linked copolymer. Their chemistry is based on a polyvinylsiloxane backbone. Ormocers are fully polymerised materials. Ormocers undergoes 1.97% volume shrinkage which is lowest value recorded so far for a resin based filling material. Due to their cross-linking and chemical nature, Ormocers ensure that it is a highly biocompatible filling material. Their advantages compared to conventional composites are outstanding biocompatibility, minimal shrinkage, resistance to masticatory loading and aesthetics resembling natural teeth. Examples of minimally invasive procedures Sealants A Dental sealant is a thin protective covering made of resin that is applied to the chewing surfaces of posterior teeth to prevent the formation of cavities. It is a primary preventive procedure. If the sealant is placed properly it does not require any cutting of the tooth structure. Placement of sealants in suspect teeth within s

The Consequences Of Passive Listening English Language Essay

The Consequences Of Passive Listening English Language Essay Passive listening occurs when a person is fully aware of a lecture, Conversation, or something audio that is going on in his or her presence but the person does not react to it. This essay is going to attempt to explain in details the consequences of passive listening. A passive listener does not interrupt the speaker or perform any action whatsoever at the same time in which the speaker is delivering his or her speech. In most cases, a passive listener does not nod his or her head, make appropriate facial expressions, and make eye contacts with the speaker or any other action that indicates whether a person is paying attention or not. When a person concentrates on making non-verbal cues (nodding, eye contacts and so on), then he or she is probably not paying much attention in other words, listening passively because those actions come naturally to a person who is actively listening i.e. he or she does not have to concentrate on doing them. In some cases, passive listening is associated with students in the class room. A student who is listening passively to a lecture barely pays attention to details but at the end of the lecture, the student tends to remember 10% or less of the information passed through during the lecture session. This is because although the student was not paying much attention to the details, the student will zone in and out of his or her mind at regular intervals and in the process accidentally take in some valuable information. Usually, passive listening in students is caused by a dull lecture or an interruption in which a student is attracted to for example, cell phones. It is not always the fault of the lecturer because some topics are uninteresting by nature. Despite all the reasons and excuses a student might have for his or her lack of interest during lectures, the consequences for this action will have to be put into consideration because it can adversely affect a persons academic participation and result. Listening passively without checking in on a conversation to verify whether or not you have correctly received the message often leads to deviation from accuracy in communication. By merely being in a conversation without insinuating questions or active accounts that divulge the speakers real message, a persons personal ideas might begin to mold about the probable implication of the message instead of the tangible meaning. An example is when an apprentice technician joins the audience in an inaugural lecture. If he listens passively, he will only superintend to get wind of the sounds, he will be unable to meaningfully identify the spoken cues, talk less of correctly interpreting what has been said. This will result in errors in the p ersons solutions or answers. If a person is listening passively, then the person is not speaking. Effective communication allows both the message sender and the receiver to express themselves in an even exchange of ideas. A passive listener positions an indirect comparison to a cobblestone, you can see it and you know it is there, but it seems incapable of absorbing anything that you are saying. The reason why passive listening is mostly associated with students is because it occurs mainly with teenagers. Passive listening requires a lot of focus because a passive listener severely focuses on what he or she is listening to but is not doing anything apart from listening meaning he or she is not absorbing any information. The strain on unmonitored focus affects a persons ability to understand. A person can store information correctly in the brain only when both the mind and brain of the individual are relaxed. Straining the brain to listen without any interest on details therefore results in a persons lack of understanding, wastage of time and possibly head ache or brain clogging. Some other practitioners of passive listening techniques are those attempting to learn a foreign language the audio way that is through an mp3 player or an audio CD player. This is common because when advertising these products, the marketing team make promises of satisfying results to whoever uses them. They include attractive slogans like learn French the easy way just by listening to this audio CD while finishing your chores. If a person is performing a task while listening to something, then the person is listening passively. The shocking truth is that passive listening cannot get a person to fluency in a language because it ever rarely produces any good results. What is even worse is that it will not help the ability of the person to understand the language he or she is attempting to learn. It is a fact that a passive listener is unable to correctly store, interpret and recall information, this fact also applies to a language learner who is listening passively. In plain words, a language learner who is listening passively will not be able to store, interpret and recall what has been said because language learning needs some amount of focus and understanding. In some cases, a person does not deliberately listen passively to a lecture or speech, passive listening can occur due to absent mindedness. In this situation, the source of this action is either the speaker or the listener. The speaker can be the cause of passive listening in an individual if his or her voice volume is too low and the listeners will have to strain their ears to listen. There will come a point in time when the listeners will finally give up on listening to the lecture because they are tired of straining their ears and the rest of the valuable information the speaker has to deliver will pass by the listeners ears and go to waste. There is also the case of complexity. When the speaker is using too many complex words or unnecessary issues and details, the listener tends to zone out and start to imagine all sorts of consequences for the discussion at hand and in the process missing out on some of the important key points. The listeners can also be at fault because at tim es, they focus on passing judgment on the speaker, topic or lecture so much that they forget the currently important speech they are supposed to be actively listening to and as a result they listen passively and miss out on the most important parts of the lecture. In my research I have learnt that the word consequence means outcome. The outcome of an event can be both good and bad since everything that has an advantage has a disadvantage. Everything I have mentioned on passive listening so far has been negative but it also has its own advantages. People have a medley of reasons to listen passively by due deliberation, in other words, by choice. Passive listening by choice does not occur amongst teenagers only; it is a mode of listening adopted by a lot of people in this world since an era before now. The positive thing about the variety of people that adopt the passive listening mode is that most of them use it in their leisure hours not when they are supposed to be listening to something important. For instance, after a long days studying and sports, a teenage high school girl finally freshens up to go to bed. As she lay on her bed, it is possible that the sleep does not come to her eyes immediately. This is an appropriate time to adopt passi ve listening. The girl can play a slow music that makes her feel relaxed and comfortable to assist her exhausted mind in getting some rest and sleep. Judging from the intention behind playing the slow music, the appropriate mode of listening is passive. This is because the girl might be very well into the music but she will only listen to the soothing waves of sounds the music is producing without making an attempt to pay attention to the lyrics. Another instance is when a house wife is struggling with the daily household chores while her husband is away at work and her kids in school. She can play any type of music she sees fit while she works and she will get the job well done in no time because her attention on both the work and music will be passive. The positive results that passive listening produce here is that it will help the girl get some sleep without stressing her mind about it since she will not be paying attention, and it will help the house wife to get the job done wi thout feeling bored and lonely. In conclusion, the main points mentioned above is that if passive listening is adopted when listening to lectures or something important, it is considered to be a bad habit because it produces negative results. If passive listening is adopted when listening to an mp3 or radio then it is positive and even recommended.

The Drosophilia Hydei Essay -- Biology, Fruit Fly

Drosophila hydei, commonly known as the fruit fly, is about 3mm long and typically found near unripe or rotted and fermenting fruit. Its body is segmented into 3 different sections and covered in an exoskeleton. It has six legs, two small antennae, one pair of wings (which extend slightly over its rear), and large, red compound eyes. The complex, compound eyes permit D.hydei to see in many directions, allowing it to sense food or potential dangers (Miller 2000). Its eyes are sensitive to light intensity, therefore when shadows approach, signaling danger, the fly will flee or take flight (Demerec 1950; Miller 2000). Its body is a gray-brown color and shaped like an oblong oval, being larger in the front and narrowing toward the back. Tiny hairs cover the entire body, which allow the fly to sense movements in the air. These hairs alert them of disturbances such as approaching predators (Demerec 1950; Miller 2000). The pupae from which the Drosophila hydei hatch are orange-brown in color and are slightly larger than the adult fly. Males and females are differentiated by the stripes on the back of the males, as well as size. Males have broader stripes and tend to be smaller, whereas the stripes on a female are narrower and they will be larger in size (Miller 2000). In order to thrive, a food source of yeast and sugar must be present, as is the case with fermenting fruit. The mouth of D. hydei is specifically shaped in order to take up liquid food sources (Miller 2000). The range of Drosophila hydei is broad and it exists in many different habitats, ranging from temperate to wet forests (Bateman 1972). Since very cold temperatures are found to have negative effects on insect survival, Drosophila hydei is not found near th... ...fested by wasp parasites and other harmful microorganisms. Ants also pose a threat to the D. hydei, often carrying away the larvae, destroying their ability to survive (Bateman 1972). The predatorial relationship between ants and D. hydei larvae has a negative effect upon the fly, as they are being used as a food source, whereas the ant benefits, as it is getting a food source. Since Drosophila hydei is prey for so many species, its removal would be detrimental to the many species that prey upon it. Overall, Drosophila hydei is a unique species, capable of residing in a large range of habitats, temperature and light conditions. Much research has been done to determine the affect of abiotic factors upon these organisms. Differences in temperature and light in particular are shown to affect the behavior, growth and reproduction of the species.

No Sugar by Jack Davis: Exposes the Mistreatment of Australian Aborigi

Today, in the 20th Century, it is a commonly known fact in Australia, and throughout the rest of the world, that Aborigines were mistreated from since western culture first settled, and for many years after that. It is the main purpose of stage dramas to bring issues, such as the one mentioned above, and ideas about these issues to life through dramatic performances and the use of a number of various techniques. No Sugar, a revisionist text written by Jack Davis in 1985, is one of these stage dramas. Jack Davis brings issues and even expresses his own ideas about issues such as the injustices of Aboriginal treatment during the 1930's, to life in No Sugar very well because No Sugar is a revisionist text, and therefore offers a new perspective of an Aboriginal point of view, on events which occurred during the time of the issue at hand. No Sugar, the revisionist stage drama written by Jack Davis, is about the mistreatment of Aborigines in Australia during the 1930's. More specifically, it is about the Millimurra family, and their struggle against white ‘protection' and being treated like objects in their own land. The stage drama is mainly set in Northam, and Moore River, in Western Australia. Davis explored issues surrounding the treatment of Aborigines during this period, and reflects his own ideas about these issues. One issue that is highlighted about this period in No Sugar is how Aborigines were discriminated against, for no reason other than having coloured skin. An example of this is in Act One, Scene One, when Cissie is complaining because when her and her brother go to buy apples they get given bad, shrivelled up ones, and the white children get big, juicy ones. "Aw Mum, Old Tony the ding always sells us little s... ...f the depression and that many people are suffering from hunger and deprivation of many essential elements which make for a contended existence. But you in this small corner of the Empire are fortunate enough in being provided for with adequate food and shelter." Act IV. Sc. (v) Page 97. Using dialogue, Davis again shows to the highest degree the amount that Aborigines were disregarded and marginalised in society. Because the reader knows that Aborigines are underprovided, and have to steal and hunt for sufficient food, they see that, as stated by Jimmy, A.O. Neville is "talkin' outa his kwon" and completely disregarding the Aborigines as citizens of Australia. In his revisionary stage drama No Sugar Jack Davis has manipulated narrative and theatrical elements such as characterisation, symbolism and dialogue to present the plays many issues throughout the text.

The Great Mystery of the Pyramids Essay -- History, Building and Const

The Great pyramids of Egypt are undoubtedly one of the most recognized and admired landmarks in the world. Built to pay tribute to gods and pharaohs, the pyramids were of great importance to the Egyptians, and the mystery of their construction continues to amaze us today. Many theories pertaining to how the pyramids were built have been suggested, however, none are as well supported or intelligible as the heave-ho method of quarrying and cutting limestone. Joseph Davidovits’ theory disproving this, in which states the pyramids were moulded, is not plausible. Substantial physical evidence which is consistent with the Egyptologists’ portrayal of the heave-ho method has been found. The entire process of building a pyramid with this method is possible, as demonstrated by thorough experiments and analysis of the Egyptian culture. Indisputably, the Great Pyramids of Giza were constructed by quarrying limestone, and the use of ramps, sleds, and cutting tools, owing to the inge nuity and strength of highly organized Egyptian workers. Joseph Davidovits, a French chemist, has proposed that the pyramids were formed using a special concrete mixture, and then poured into wooden moulds where it hardened (Alt. theory #3).While Davidovits claims to have explained aspects of pyramid construction which the heave-ho theory could not, the mould theory has many faults, rendering it weak and improbable. Firstly, the stones used in building the pyramids were of diverse shapes (Article 5). The shape of the stones would be uniform if they were created in moulds of exact dimensions. If each stone was created in a uniquely fashioned mould, it would account for the diversity in shape. However, building thousands, or even hundreds, of moulds would have been e... ...gods they worshiped. In spite of the efforts of other theorists trying to refute this process, there is a very low number of faults in the heave-ho method. Most of the improbabilities and doubts can be explained with proven experiments, as well as examining the Egyptian lifestyle. In conclusion, the heave-ho method is the strongest and most practical theory of pyramid construction, due to the weakness of other theories, significant physical evidence, and how possible it is to achieve. This method irrefutably shows how the hardworking and inventive Egyptians used abundant resources to create magnificent pyramids, by working in highly organized teams, and using tools and machines such as chisels, hammers, and ramps. The actual process of how the pyramids were built may never become known to us; however, the heave-ho method is the closest idea we have to the truth. The Great Mystery of the Pyramids Essay -- History, Building and Const The Great pyramids of Egypt are undoubtedly one of the most recognized and admired landmarks in the world. Built to pay tribute to gods and pharaohs, the pyramids were of great importance to the Egyptians, and the mystery of their construction continues to amaze us today. Many theories pertaining to how the pyramids were built have been suggested, however, none are as well supported or intelligible as the heave-ho method of quarrying and cutting limestone. Joseph Davidovits’ theory disproving this, in which states the pyramids were moulded, is not plausible. Substantial physical evidence which is consistent with the Egyptologists’ portrayal of the heave-ho method has been found. The entire process of building a pyramid with this method is possible, as demonstrated by thorough experiments and analysis of the Egyptian culture. Indisputably, the Great Pyramids of Giza were constructed by quarrying limestone, and the use of ramps, sleds, and cutting tools, owing to the inge nuity and strength of highly organized Egyptian workers. Joseph Davidovits, a French chemist, has proposed that the pyramids were formed using a special concrete mixture, and then poured into wooden moulds where it hardened (Alt. theory #3).While Davidovits claims to have explained aspects of pyramid construction which the heave-ho theory could not, the mould theory has many faults, rendering it weak and improbable. Firstly, the stones used in building the pyramids were of diverse shapes (Article 5). The shape of the stones would be uniform if they were created in moulds of exact dimensions. If each stone was created in a uniquely fashioned mould, it would account for the diversity in shape. However, building thousands, or even hundreds, of moulds would have been e... ...gods they worshiped. In spite of the efforts of other theorists trying to refute this process, there is a very low number of faults in the heave-ho method. Most of the improbabilities and doubts can be explained with proven experiments, as well as examining the Egyptian lifestyle. In conclusion, the heave-ho method is the strongest and most practical theory of pyramid construction, due to the weakness of other theories, significant physical evidence, and how possible it is to achieve. This method irrefutably shows how the hardworking and inventive Egyptians used abundant resources to create magnificent pyramids, by working in highly organized teams, and using tools and machines such as chisels, hammers, and ramps. The actual process of how the pyramids were built may never become known to us; however, the heave-ho method is the closest idea we have to the truth.

A Case of Digital Divide in Bangladesh Essay

A case of Digital Divide in Bangladesh Anisur Rahman Senior Asst. Director and Head Library and Information Division Northern University Bangladesh Anisur Rahman, â€Å"Access to Global Information—A case of Digital Divide in Bangladesh. † Proceedings of the IATUL Conferences. Paper 25. http://docs. lib. purdue. edu/iatul/2007/papers/25 This document has been made available through Purdue e-Pubs, a service of the Purdue University Libraries. Please contact epubs@purdue. edu for additional information. Access to Global Information—A case of Digital Divide in Bangladesh Md. Anisur Rahman Senior Asst. Director and Head Library and Information Division Northern University Bangladesh 3/18 Iqbal Road, Asad Avenue Mohammadpur, Dhaka 1207 Bangladesh Email: anisdacca@gmail. com Abstract. ICTs can reduce communication costs and break down geographical borders. In the developed nations government policies are being established which attempt to ensure that all citizens will get the opportunity to access the effective use of ICTs in order to enable them to participate in the educational, social and economic activities and democratic processes. Developed countries are getting much benefit from the advancement of ICTs. There is digital divide between developed and developing countries. The term digital divide has been applied to the gap that exists in most countries between those with ready access to the tools of ICTs, and those without such access or skills. In other words, it is the gap between the have’s and the have not’s. The digital divide around the world is usually measured through statistical indices such as the number of telephone lines, personal computers, websites and Internet users and their ratio to the total population. This paper reviews the papers on issues related to digital divide that are affecting so many citizen in developing countries especially in Bangladesh and the factors that alienate people from enjoying the benefits of ICTs. The author recommends possible strategies that can be implemented in developing countries to reverse the widening gap of digital divide. Keywords: Digital divide, ICT, Internet, Bangladesh 1. Introduction Computers, modern telecommunication and the Internet all reduce communication costs and break down geographical borders. Information and communication technologies serve as powerful tools for empowering people, benefit business and virtually link people around the world to share their views, ideas and innovation. 2. Concept of Information Technology Information technology today handles information in every conceivable form, whether music, video, graphics, speech, data, text. It also embraces an increasing range of technologies. Information technology is the use of modern technology to aid the capture, processing, storage and retrieval, and communication of information, whether in the form of numerical data, text, sound, or image. IT has a great impact on the societies. IT has impact on employment, education and training, commerce, at home, arts (music, animation and visual effects, writing, games), and all aspects of public administration and national defense. 3. Digitization The globalization and localization of information and cultural values are basically predicated on digital technology. The invention of e-mail and the WWW leading to digital transmission 1 is the certainly the second digital revolution. Digital scanners and cameras can now be used to capture digital images for importation into computer systems. In the current information revolution, almost everything is digital TV, radio, air-conditioned, cars, airplane, refrigerators, industrial plants and telecommunication systems. 4. Digital divide This digital revolution has created a brand new economic sector that simply did not exist before. Computers, modern telecommunication and the Internet all reduce communication costs and break down geographical borders. In addition, ICT can be an important driver in poverty reduction and assure sustained conomic growth, better public welfare, and strong social solidity and democratic forms of government. In the developed nations government policies are being established which attempts to ensure that all citizens will get opportunity to access the effective use of ICTs in order to enable them to participate in the educational, social and economic activities and democratic process. Developed countries are getting much benefit from the advancement of ICT. So, there is a digital divide between deve loped and developing countries. The concept of the digital divide has been used to highlight difference in electronic access to information based on economic, race, ethnic or social group and/or geographical location. The term digital divide has been applied to the gap that exists in most countries between those with ready access to the tools of ICTs, and those without such access or skills. It is â€Å"a gap, which tends to deepen, is produced between those individuals that can access new information and communication tools such as phones, TV sets or the Internet, and those who are too poor to get them between the have’s and the have nots† (de Munster, 2004). Population residing in developing countries or in low-income countries may be unable to gain access to IT because of the inability to purchase the required equipment, Internet provider service or other necessary resources. It may not be possible to bridge the divide, but it is important to prevent it from deepening, as a minimum, and to attempt to narrow it as much as possible. According to Reuter’s reports at Berlin on Wednesday, April 26, 2006 â€Å"the digital divide is narrowing as citizens in emerging markets get online via computers and mobile phones, with some regions now on a par with developed nations† (Reuters, 2006). Peter korsten, European director at IBM’s Institute for Business value said â€Å"within China and India, regions like Shanghai and Bangalore have almost the same level of Internet and mobile phone connections as developed nations† (Reuters, 2006). 5. ICT status in Bangladesh The ICT status of Bangladesh is not remarkable without some favorable initiatives by the Government and by private entrepreneurs. Computer use in Bangladesh started with a mainframe computer in 1964.