The Critical appraisal of two research articles,critically analyse and Essay

The Critical appraisal of two research articles,critically analyse and evaluate the streights and weaknesses - Essay Example Critical appraisal is â€Å"the process of carefully and systematically examining research to judge its trustworthiness, and its value and relevance in a particular context† (Burls, 2009, pp. 1-8). Its practice in medical field is highly relevant to delineate the useful discoveries from the harmful ones. A quality research is not just one that reflects good composure or format rather it is one that has internal validity which is being free from bias. Therefore, the research must be reviewed particularly in the selection, performance, detection and attrition where bias commonly occurs. Analysis must be conducted from data gathering, collation, down to analysis. In this paper, the author aims to clinically appraise two researches on health and social care. The first is entitled â€Å"Efficacy and safety of hyaluronic acid in treatment of leg ulcers: a double-blind randomised controlled trial (Dereure, Czubek and Combemale, 2012, pp. 131-139)† while the other is â€Å"The experience of patients with complex wounds and the use of negative pressure wound therapy in a home-care setting (Moffatt, et al. 2011, pp.512-527).† Both are in pursuit of a reliable and sustainable practice caring for patients with chronic wound. The first is a method to hasten healing of chronic wounds through the use of a topical medicine and the other is regarding the social and psychological needs patients with chronic wound under pressure treatment. Each will be presented separately and both research design and methodology will be critiqued. There will be no comparison between the two researches since they differ completely in design and methodology. After discussions and analysis, conclusion of what transpired will be stated. The author elected these studies on chronic wound care as it poses great demand on the current health care system. With the world directing to an aging population, health problems related to obesity, immobility, chronic illness such as diabetes b ecome rampant. These health problems commonly results to chronic wounds that has poor healing and required vast attention from clinicians. In 2009, it was declare to be a great public threat to health and economy as it results to government expenditure of at least 25 billion dollars per annum (Landro, 2012, par.5). Chronic wounds, particularly on the lower extremity, have high prevalence, high cost, and poor clinical outcome. They are often managed by a non-integrated healthcare system which consequentially resulting in an erratic healthcare arrangement. This challenges scholars and scientist to discover and create better technology and technique to better manage chronic wounds in a more sustainable and cost-effective manner (American Society of Plastic Surgeons, 2007, pp.1-8). For years, several methods have reached popularity in the medical scene of managing these type of wounds such as debridement and other surgical procedures, compression dressing, wound dressing with a variety of topical medicines, negative pressure wound therapy, cultured skin cells, pressure redistribution mattress, oxygen chambers, etc. (Landro, 2012, par.4); all of which acclaims to be effective in the healing process of complex wounds. Efficacy and safety of hyaluronic acid in treatment of leg ulcers: a double-blind randomised controlled trial (RCT) (Dereure, et al.

What Is My Personal Philosophy Of Education Essay

What Is My Personal Philosophy Of Education - Essay Example Students play a vital role in the education process, wherein their responsibility would be to show whether the educational process has been successful or not. The importance of introducing education as a fruitful and enjoyable experience is a challenge that is needed to be overcome by the school, as well as the teachers themselves. If the students were able to have positive experiences with regards to taking their first steps in school, then it is a good thing that happened to them because their instinct of absorbing information has been triggered. However, if these students had the unlikely chance of getting a negative first impression in school, it would stay with them all throughout their lives, and could even affect their attitudes toward education, learning, and life as a whole. In a way, schools become institutions that are able to affect and mold the mindset of the young. Learning institutions as well as the people behind them therefore have the overwhelming task of not just providing education to students in general, but also instilling a set of core values into the young ones, as well as jumpstarting their sense of a continuous se arch for knowledge. Being the representative of the academic institution to students, teachers play a vital role in how students would be responding to the learning process, as well as to education in general.... iding the students with hands-on activities, getting them involved in classroom discussions, as well as giving clear directions and prompt feedback (Martin & Loomis, 2007). By combining the attributes that are exemplified by excellent teaching personality and instructional skills, this makes a teacher effective both in teaching the academic things as well as building character and instilling values among students. Doing so makes the teachers essential components in the effectiveness of the school as an institution that helps in developing the younger generation. Aside from the organization of the school and the traits and characteristics of the teachers, the student also plays a vital role in the education process. While the school could select what and how to teach, it is up to the student on retaining the information that was given (Martin & Loomis, 2007). Students shoulder the responsibility of affirming the effectiveness or lack of it when being taught. At the end of the learning process, the success or failure of this process is dictated by the students’ actions towards education as a whole. For example, in elementary school, students are taught the basics of reading and writing. In order for them to fully understand, the students must also be proactive in retaining what they have learned. They could do this by reviewing the lessons taught for the day, asking teachers for things that they wanted further clarification on, or even trying to answer the study questions found at the end of the chapters of their books. Teachers mostly give examinations in order to assess whether the learning process has been effective or not, and the students have the responsibility of doing their best in examinations, not just to get good grades but also to confirm or disprove the

Oral Erythroplakia Case Study

Oral Erythroplakia Case Study ABSTRACT- Oral Erythroplakia is considered a rare potentially malignant lesion of the oral mucosa. Oral Erythroplakia is a clinical term to describe any erythematous area on a mucous membrane that cannot be attributed to any other pathology. Oral Erythroplakia are very few, only the true, velvety, red homogeneous oral Erythroplakia has been clearly defined while the terminology for mixed red and white lesions is complex, ill-defined and confusing. Oral Erythroplakia is predominantly seen in the middle aged and elderly. The most common affected areas are the soft palate, the floor of the mouth and the buccal mucosa. A specific type of Oral Erythroplakia occurs in Chutta smokers in India. Lesions of Oral Erythroplakia are typically less than 1.5 cm in diameter. Keywords Biopsy, Erythroplakia, Laser, INTRODUCTION- The word erythroplakia means red patch, and is derived from the Greek words ÃŽ µÃ Ãâ€¦ÃŽ ¸Ã ÃŽ ¿Ãâ€š red and πΠ»ÃƒÅ½Ã‚ ¬ÃŽ ¾ plate The World Health Organization defines oral erythroplakia as follows: â€Å"Any lesion of the oral mucosa that presents as bright red velvety plaques which cannot be characterized clinically or pathologically as any other recognizable condition† It has been reported that prevalence of Oral Erythroplakia varies between 0.02%1 and 0.2%2 (adapted from Reichart et al.)3 Clinically, it can be flat or depressed and sometimes it can be found together with leukoplakia (erythroleukoplakia); it pre-dominantly occurs in the floor of the mouth, the soft palate, the ventral tongue and the tonsillar fauces. There are usually no symptoms. However, some patients may complain of a burning sensation and or sore. Heavy alcohol consumption and tobacco use are known to be important aetiological factors. The main purpose of identifying oral premalignant lesions is to prevent malignant transformation by initiating adequate intervention. It is widely approved that the oral premalignant lesions erythroplakia, show a significant tendency to malignant transformation. The differential diagnosis includes: erythematous candidiasis, early squamous cell carcinoma, local irritation, mucositis, lichen planus, lupus erythematosous, drug reaction and median rh omboid glossitis.4 Surgical excision is the treatment of choice though more studies are needed.The treatment5 modalities include change of lifestyle factors such as tobacco and alcohol intake,medication with retinoids or antimycotics,surgical excision,cryosurgery,laser evaporation or laser excision.Laser surgery has become a reliable treatment6 option for oral cancer as well as for precancerous lesions. Widely used lasers in oral and maxillofacial tumor surgery are the CO2 laser, the Er:YAG laser, the Nd:YAG laser and the KTM laser. The use of lasers in tumor surgery has several advantages: remote application, precise cutting, hemostasis, low cicatrization, reduced postoperative pain and swelling, can be combined with endoscopic, microscopic and robotic surgery. Here we report a case of erythroplakia in soft palate region treated with diode laser. CASE REPORT- A, 63 years old, male patient (Fig 1), came to the department of oral and maxillofacial surgery, with the chief complain of red patches at the hard and soft palate region. Patient gave the history of pan, tobacco chewing and smoking since 20 yrs. Medical history was negative for any findings and all the vitals were under the normal limit. No significant findings were noticed on extra oral examination. (Fig-1). On intraoral examination, multiple red patches were seen at the mucosal surface of the palate. All those patches were less than 1.5 cm in diameter. (Fig- 2). On palpation it was soft and velvety on touch. A provisional diagnosis of Erythroplakia, with differential diagnosis Lichen planus , Erythematous candidiasis ,Early squamous cell carcinoma were made. All necessary blood investigation done, and were found under normal limit. To establish a definitive diagnosis, a biopsy was performed using a local anaesthesia. The biopsy specimen was taken from hard and soft palate, and sen t for histopathological examination (Fig 3) which confirmed the final diagnosis of Erythroplakia. The red appearance is due to the thin atrophic epithelium with prominent subepithelial vascularity and inflammation. Almost all erythroplakic lesions contain dysplastic cells. The histopathology may be mild or moderate epithelial dysplasia, severe dysplasia or carcinoma in-situ. Carcinoma in-situ is characterized by a complete disorganization of cells throughout all layers of the epithelium, with no keratin pearls. Laser ablation was planned as the treatment modality under local anaesthesia. (Fig-4) Diode laser was used at 2.5watts (Fig 5). Post operative instructions given and patient was recalled after 24 hours. Patient came for follow-up, reported with slight pain. Healing was uneventful. After that patient was asked to report at weekly interval. Healing was satisfactory after 3 weeks.(Fig 6) DISCUSSION- Erythroplakia and speckled leukoplakia are uncommon lesions of the mouth. Erythroplakia of the oral cavity is a specific disease entity which must be differentiated from other specific or nonspecific inflammatory oral lesions, although this can only be done in most cases by biopsy. The term erythroplakia of the oral cavity as used in this report and as accepted by most authors describes the clinical appearance of a red patch of the mucous membrane which does not represent some specific or nonspecific inflammatory lesion. However, in most cases the clinician cannot distinguish with certainty the true erythroplakia as discussed here and the more innocuous inflammatory lesions, thus mandating biopsy. Most, and probably all, cases of true clinical erythroplakia represent some epithelial atypia, ranging from mild epithelial dysplasia to invasive carcinoma.7 Furthermore; there is no correlation between the clinical appearance of erythroplakia and the histologic findings. Erythroplakia is t he leukoplakia like term used to describe clinically red and well demarcated macules of the oral mucosa which cannot be attributed to inflammatory or traumatic factors, and which have a much higher propensity for progression to carcinoma than leukoplakia8. The histopathological9 feature of erythroplakia includes a marked epithelial atrophy associated with epithelial dysplasia. A relative reduction in keratin production and increase in vascularity accounts for the clinical color of the lesion. Cellular infiltration and capillary distention were remarkable. Nowadays laser surgery has become a reliable treatment6 option for precancerous lesions. Widely used lasers in oral and maxillofacial tumor surgery are the CO2 laser, diode laser, the Er:YAG laser, the Nd:YAG laser and the KTM laser. In our case we use diode laser in erythroplakia. Laser has many distinctive advantages, such as the ability to cut, coagulate, ablate or vaporize target tissue elements, enabling dry-field surgery thro ugh the sealing of small blood vessels (haemostasis) disinfection of the tissue, reduced post-operative edema (through the sealing of small lymphatic vessels) decreased amount of scarring. It contributes to faster and more effective treatment resulting in improved treatment outcome and increased patient comfort and satisfaction. CONCLUSION- Oral cancer is one of the 4 major non communicable diseases leading to Death10. Soft tissue health in the oral cavity is essential for overall dental and medical health and a successful maintenance of any restoration. The clinical and pathological features of the lesions analyzed in our study support the data in other published studies. Although their prevalence is low, histopathological features ranging from epithelial dysplasia to invasive carcinoma. This justifies placing these lesions among the oral lesions with the highest malignant potential. Additionally, regardless of histopathology and therapy, periodic monitoring of these patients and cessation of risk factors are essential measures.

Culture and Technology - Tools to Aid in Survival Essay -- Sociology E

Culture and Technology - Tools to Aid in Survival Culture: â€Å"the predominating attitudes and behavior that characterize the functioning of a group†. Technology: â€Å"the body of knowledge available to a society that is of use in fashioning implements, practicing manual arts and skills, and extracting or collecting materials†. Technology aids in the functioning of a group: it is what enables â€Å"predominating attitudes and behavior† to be acted upon. Therefore, initially, a culture must provide incentive for the development/adoption of a technology. Once adopted, the technology must then be incorporated into the society, requiring cultural adjustments. Always, usefulness is the key determining factor. Cultural adjustments must be worth the effort, the technology must meet a societal need. The technologies that each society chooses to adopt are the ones that they find the most useful. Societies have not developed different technologies by accident: the criteria for determining â€Å"usefulness† is culturally based. The Near East is not a particularly fertile area. Dry land and large rivers that periodically flood characterize the landscape. Obtaining sufficient food was not easy. â€Å"The most vital need of early man in regions of scanty rainfall such as the Near East is water.† (Drower, 520). Because this was the most difficult challenge facing them, from an early stage the people who populated the area must have focused on developing effective farming practices. For them, there was probably little else that was as important as water. Because of this, the cultures of peoples in the area centered around the water. Everything was defined by the river. The oracle of Amen, for example, defined Egypt to be â€Å"The entire tract which th... ...ct. Everyone wants to survive: culture and technology both are merely tools to aid in survival. Usefulness is the governing factor for both. If part of a culture is no longer useful because of a change in the environment, that culture will change. If technologies may be developed to make an environment more hospitable, thus avoiding cultural change, then those technologies are focused on. What is most important to people is the maintenance of their culture. Sources Chant, Colin. Pre-industrial Cities & Technology. London: Routledge. 1999. Drower, M. S. A History of Technology, from Early Times to the Fall of Ancient Empires, Chapter 19: Water supply, irrigation, and agriculture. Edited by Singer, Holmyard, and Hall. Oxford Clarendon Press, 1958. Ehrlich, Paul R. Human Natures: Genes, Cultures, and the Human Prospect. Washington D.C.: Island Press. 2000.

Brian Eno Essay

We all know that everything has started to change in music with the recording technology. What we qualified something really important in music in the past, such as history, time and place etc. , today, in a sense, they start to lose their â€Å"value†. Before explaining the idea of Brian Eno, i want to mention what we discuss before him. Previously, we discussed Benjamin, Gould who supported the opposite sides of one point and i think the main point of these discussions is ‘the aura of the music has started to destroy with the recording technology’, accordingly, ‘time and the place’ have started to lose their value too. Of course, Brian Eno discussed the time line, while he was mentioning his idea. Brian Eno is an English musician, composer, record producer, music theorist, singer and visual artist. On his essay, ‘Studio as a Compositional Tool’, he mentions that an artist can start his composition in a recording studio without having any idea about creating his work. In other words, starting a work in scratch , starting a work without an available idea and at this moment ‘the time line’ appears. If an artist has a specific idea to create his work, this idea evolved slowly. So, music comes into exist. In a way, the artist has got a direction and he knows what he can do, and also he can guess the finished product before he starts his composition. By this way, two things become important; the beginning of the work and the end of the work. Time line becomes important in this style of production. On the other hand, Brian Eno approaches it differently. An artist does not have to have a specific idea before going to recording studio, he does not have to carry his idea to the future. He can start to create his work with observing its transformations at the very moment in studio. For this idea, people are not able to know what the product will be in the end. So, the artist has not any concern to assimilate his work to his idea. The product started progress at the moment and it will end up like that. Trying to create a work with an available idea is different from creating a work without any available idea. According to Brian Eno, people do not have to have a specific idea to create a composition. The beginning of the work can give the artists an idea and they can develop it, transform it while observing its progression. The sounds are changing and when an artist listens them, a new idea can come  into his mind and he can intervene in it. It goes like this. There is a thing people are not able to know: the result of this product, just like life. People born, grow up, while they are growing up, they learn something, they make mistakes and they try to fix them, they try to do not make these mistakes again, these actions continue to happen but they do not know what will happen tomorrow. They do not know what happens next. Time passes, time goes on but where it goes? We do not know. In addition to this, do we have to know? I do not think so. While the classical compositions are formed, the artist has an idea in his mind before forming it and the composition is formed with this direction, this idea. In other words, the artist knows what it is going to be at the end. Apart from that, the artist should know the history of music, he is able to play at least one instrument, he should also know writing scores. So, he should know how to transform his idea into object technically but people do not need this. Of course the artist should know something, he has knowledge about music a little bit, but it is not the only thing to create a composition. The artist also must not have idea about his work before starting his work like how classical compositions work. The artist has no idea about the result of his product when he starts his work without any idea. Because of this situation, he does not have any connection with the past. There are only an artist and a studio and this artist tries to produce a product at the moment contrary to classical composition style. â€Å"Being there at this moment â€Å" is really important. While mentioning to create a work at the exact moment, there is a painter , who is Jackson Pallock. Of course, he might have idea, when he painted his paintings but if you look at his paintings, you can easily see the action and it is not possible to decide these ideas before starting to paint. The exact moment is more important than the idea at his works. Here comes again this situation: â€Å"Being there at the moment.† Just like what Eno is doing. He is also affected by him. In classical composition, we can mention the relation between the artist and the product. There is another thing; when an artist started his work with a specific idea, there is a risk to fail because, you have things to compare ,  you have chance to compare your idea and your product. But according to Brian Eno, there is no place for failure because, the artist does not have enough thing to compare, he does not have an idea, he has only product. When classical composition finishes, the performer and the acoustical environment, the concert hall are also affected the composition. By this way, it is so hard to know exactly the idea of the composer. The performer cannot give the feeling or the environment does not give the same sound. With the recording technology, something has started to change in a good way. In recording studio environment, people have chance to interfere in the acoustic environment. Of course there is certain limits but people are able to do it. Because of this situation, the limits are more larger than the times before the recording. People are able to change the sounds with the recording tech, they do not have this chance to do it with their acoustic instruments. On the other hand, many people, who have not enough ability to play an instrument, have chance to make music and this is really good development. Just like, what Brian Eno said: â€Å" I can neither read nor write music, i cannot play any instruments.† The technology makes it possible, makes the limits more larger, gives a change to come into existence for â€Å"different music†. It is so nice, and it is eccentrical. *Music is all around us, all you have to do is listen. *

Bach (Acorus Calamus) Essay

Bach or Sweet flag is thought to hold originated in Central Asia and likely autochthonal to India. found common in countries that surround the Himalayas. As a consequence of cultivation. it has spread throughout the Earth. found across Europe. in southern Russia. northern Asia Minor. southern Siberia. China. Japan. Burma. Sri Lanka. Australia. every bit good as southern Canada and northern USA. Calamus has long been a symbol of male love. The name is associated with a Grecian myth on Kalamos. boy of the river-god Maeander. In Japan. the works is a symbol of the samurai’s courage because of its crisp sword-like foliages. Teton-Dakota warriors chewed the root to a paste. which they rubbed on their faces. It prevented exhilaration and fright when confronting an enemy. In Penobscot places. the root was cut and hung up. Steamering it throughout the place is thought to bring around illness. hold besides been used as a thatch for roofs. Food and Flavouring: An indispensable oil from the rootstock is used in perfumery and as nutrient flavorer. it has a aroma reminiscent of patchouli oil. An indispensable oil obtained from the foliages is used in perfumery and for doing aromatic acetums. Insect repellant: The indispensable oil is besides an insect repellant and insect powder. It is effe hundred T I ve a tabun I n st house flies. When added to rice being stored in garners it has significantly reduced loss caused by insect harm because the oil in the root has sterilized the male rice weevils. All parts of works can be dried and used to drive insects or to odorize linen closets. Incense: The foliages and the roots have reviewing aroma of cinnamon. They can besides be burnt as incense. Medicine: In Ayurvedic system of medical specialty. the rootstocks of Sweet flag are considered to possess anti-spasmodic. flatus-relieving and anthelminthic belongingss and have been used for a figure of good grounds. Vacha is considered as a ‘sattvic’ herb which provenders and transmutes the sexual ‘kundalini’ energy. It is forms a popular redress for cough and cold and besides the other respiratory upsets like bronchitis. In natural signifier it is used as cough lozenge. Sweet flag provides assistance to the digestive system and Acts of the Apostless against flatulent gripes. indigestion. and purging. Acorus calamus depresses cardinal nervous system and is a good known ingredient in preparation for psycho-somatic upsets like epilepsy. The blues of Sweet flag drive some insects. THE PLANT Sweet flag is a perennial. semi-aquatic and fetid works. found in both temperate and sub temperate zones. It is up to 2m tall. aromatic. ensiform foliages and little. yellow/green flowers with bifurcate rootstock. Plants really seldom flower or set fruit. but when they do. the flowers are 3-8 centimeter long. cylindrical in form. light-green brown and covered in a battalion of rounded spikes. The fruits are little and berry-like. incorporating few seeds. Cultivation It’s a Hardy works found turning from tropical to sub-tropical climes. Plenty of sunlight should be available to the works during its growing and after reaping for drying the rootstocks. This species comes up good in argillaceous loams. flaxen loams and light alluvial dirts of river Bankss. The land should be ploughed twice or thrice prior to the oncoming of rains. Acorus is propagated through rootstocks obtained from earlier planting. The best clip for planting is the 2nd two weeks of June. The river or canal bank where the land is saturated with H2O is really suited for its growing. Timely weeding and hoeing to command the spread of weeds and to obtain good output is indispensable. After each weeding the turning workss are pressed down into the dirt. After 6-8 months. in December. the lower leaves turn xanthous and dry bespeaking their adulthood. The field should be partly dried merely go forthing sufficient wet for deracinating the works. The uprooted rootstock is cleaned after rinsing with H2O and cut into size and hempen roots removed. The cut rootstocks are dried by distributing under the shadiness so that the sum of oil nowadays in it is non harmed. Trade AND COMMERCE Sweet flag has been an point of trade in many civilizations for 1000s of old ages. Sweet flag forms a utile adjunct to other quinine waters and stimulations. Its domestic demand is rather big. As the production is much less in India. the internal market itself is extremely possible. Importers. purchasers within the state. processors. traditional practicians. Ayurvedic and Siddha drug makers throng the markets for procurance of this works every twelvemonth.