Clinical case scenario assignment

Clinical case scenario assignment The impact of oral conditions on an individuals quality of life can be profound, more so when they are increased risk patients such as the elderly or those with Down syndrome. These individuals experience the same dental problems as the general population; however, poor oral health may add an additional burden, whereas good oral health has benefits in that it can improve general health, social acceptability, self-esteem and quality of life (Fiske, Griffiths, Jamieson, Manger, 2000). When formulating an oral health care plan for higher risk patients, it is valuable to have a general knowledge of how to treat such cases. This assessment will explore two clinical case scenarios and the process through which each treatment plan is developed. Furthermore, the importance of providing a patient with quality care, rather than merely treatment, will be explored. CASE 1 Appointment 1: Complete Initial Assessment Take medical history According to Duggal, Hosy, and Welbury (2005, p.42), taking a comprehensive case history is an â€Å"essential prelude to clinical examination, diagnosis, and treatment planning†, and also plays a role in establishing a relationship with the patient. In this case the patient is a thirteen year old female with Down syndrome, a genetic disorder that ranges in severity with unique characteristics that can influence dental care (Pilcher, 1998). It is associated with physical and medical conditions such as cardiac defects, compromised immune system, and upper respiratory infections (MacDonald Avery, 2000). Dental consideration The history reveals that the patient received surgery for a cardiac abnormality at birth, and does not require antibiotic cover for dental treatment. The National Heart Foundation of New Zealand (2009) state that antibacterial cover is given as a prophylactic measure to prevent endocarditis; a serious and potentially fatal infection that affects the endocardium when bacteria is transported through the blood stream from the mouth because of dental work. Although prophylaxis is not necessary, consultation with the patients physician is crucial to determine any underlying medical conditions that concern her dental treatment. According to Pilcher (1998) the eruption of teeth in persons with Down syndrome is usually delayed, may occur in an unusual order and there is an extremely high rate of missing teeth in both the primary and permanent dentitions. Therefore, it is important to maintain the primary dentition for as long as possible. Additionally, The National Institute of Dental and Craniofacial Research (NIDCR) (2010) state that patients with Down syndrome can experience rapid destructive periodontal disease thought to be a result of their lowered host immune response. Other related factors include abnormal tooth morphology with an increased likelihood of smaller or conical roots, bruxism, malocclusion, and poor oral hygiene (Boyd, Quick, Murray, 2004). Therefore, good homecare is vital to manage periodontal disease and carious lesions. The mental capability of people with Down syndrome can vary widely (NIDCR, 2010), which is why as a health professional it is important to perceive how much information the patient is able to comprehend. Education should be given to the family and caregiver to ensure optimal homecare is provided. Plaque index Taking a plaque score is a quick and useful way for a dental provider to assess oral hygiene by estimating the tooth surface covered with debris and/or calculus (Wilkins, 2009). The patient has plaque deposits along the gingival margins of many tooth surfaces and calculus deposits on the lingual surfaces of the lower anterior teeth indicating poor oral hygiene. Periodontal probing It is described that the patient has red and inflamed gingival tissues with the worst area associated with the upper anterior teeth. This is likely to be a result of mouth breathing which is common in patients with Down syndrome due to a small nasal airway and incompetent lips (Pilcher, 1998). Periodontal charting will determine whether the condition is gingivitis which is reversible or periodontitis. If there are periodontal pocket depths greater than 3mm, bone loss and root surface involvement, a more extensive treatment will be required (Wilkins, 2009). Record examination and dental charting Upper permanent lateral incisors appear to be absent Upper deciduous canines show no mobility permanent canines not visible Mesial marginal ridge of 75 broken down as a result of dental caries and is symptomless Fistula buccal to 74 Permanent incisors and first molars show signs of mild to moderate hypoplasia Radiographs Bitewing radiographs should be taken to check for bone levels, calculus, overhangs of restorations, and carious lesions in the posterior teeth. An orthopantomogram (OPG) will determine the presence and position of permanent teeth and assess growth and development as well as other pathology (Cameron Widmer, 2003). Additionally, a periapical radiograph will be necessary for pre-operative assessment of tooth 74 and 75 to determine the origin of the fistula. Diagnosis Abscessed tooth (74 or 75 depending on radiographs) 75 has dental caries with pulpal involvement Periodontal disease (depending on pocket depth) Differential diagnosis: Severe plaque-induced gingivitis or Chronic periodontitis Mild to moderate molar incisor hypomineralisation hypoplasia Oral health education and instruction The patient has poor plaque control and therefore should be taught brushing and flossing techniques using the tell/show/do method so the dental provider can see how well the patient and parent or caregiver understand what is being instructed. She should be advised to brush at least twice a day and floss daily, as well as brush the tongue and gingiva. The use of an electric toothbrush and floss holders should be recommended as those with Down syndrome often have limited manual dexterity (Sacks Buckley, 2003). Additionally, a high concentration of fluoride such as Neutrofluor 5000 Plus toothpaste is recommended for daily use by patients with high risk of dental caries which Wilkins states will promote remineralisation and help strengthen the teeth (2009). Dietary advice Diet should be discussed with a focus on finding if the patient has a lot of sugar in her diet and educating her on the effects of cariogenic foods, perhaps using Stephans curve to explain depending on her level of understanding. The patient should be encouraged to eat cheese, unsweetened yogurt, milk and other dairy products as they contain calcium, phosphorous and magnesium which helps protect dental health (The Dairy Council Digest, 2000). Moreover, sugary and acidic drinks should be minimised as they can cause enamel erosion. It is vital the parent or caregiver receive this information as they may have a significant influence over her diet and pamphlets taken home to serve as a reference or reminder. Formulate a treatment plan Cameron and Widmer (2003, p. 6) state that treatment should be performed in the following order: (1) Emergency care and relief of pain, (2) preventive care, (3) surgical treatment, (4) restorative treatment, (5) orthodontic treatment, (6) extensive restorative or further surgical management, and (7) recall and review. Once this has been completed it should be discussed with both the patient and her parents or caregiver and informed consent must be given. Appointment 2: The amalgam restoration in the 74 is described as appearing sound but there is a fistula present buccal to the tooth. A fistula is a channel allowing excess exudate to drain from an abscess (Ibsen Phelan, 2004). Although this can be painless, it is considered an emergency and should be dealt with before any dental treatment. It is likely that the fistula is related to the 75 which is broken down due to dental caries. When the marginal ridge of a primary molar is broken down due to dental caries, the pulp is consistently exposed (Cameron Widmer, 2003). Although the 75 is described as symptomless, this may be because the drained exudate is relieving pressure from inside the tooth meaning it is less likely to be painful. If the PA radiograph confirms that the carious lesion on tooth 75 has pulpal involvement, it will be treated with either pulpectomy or extraction. Pulpectomy: If tooth 35 is not present, the 75 should be preserved and a referral to a dentist to perform root canal therapy will be given. It is advised that a stainless steel crown be placed as according to Cameron and Widmer (2003) this is the strongest possible final restoration following pulpectomy and will be necessary to preserve the 75 for as long as possible. Extraction: If 35 is present, the 75 should be extracted. However if 35 is not ready to erupt, a space maintainer is recommended to preserve the gap after extraction of 75 to prevent the adjacent teeth drifting into its space. This will enable the 35 to erupt in the proper position and prevent malocclusion in the future and will require a referral to an orthodontist. The amalgam restoration on tooth 74 appears sound and depending on radiograph results, if there is no abscess on tooth 74 and 34 is present, no treatment is needed on this tooth. If there is abscess on 74, the same treatment for abscessed 75 is indicated. Appointment 3: Reassess oral hygiene: Reinforce good behaviour and make necessary recommendations for continual improvement. Scale and polish: The aim of this is to remove as much bacteria from the oral cavity as possible and have a healthy mouth to perform restorative work in. According to Stefanac and Nesbit (2001), when planning treatment, it is sensible to put the least invasive treatments first when possible so that the patient can familiarise themselves with the dental setting and feel comfortable. (Pilcher, 1998) states that having a patient with Down syndrome that is relaxed and at ease can assists with cooperation in the chair and useful for future appointments. Hypoplasia: The permanent incisors and first molars are described as having mild to moderate hypoplasia. Enamel hypoplasia is a deficiency in quantity of enamel that results in a defect of contour in the surface (Cameron Widmer, 2003). This defect can cause tooth sensitivity, may be unsightly and more susceptible to dental caries. A compromised immune system is a characteristic of most individuals with Down syndrome which contributes to a higher rate of infections (Pilcher, 1998) and it is possible that the hypoplasia is related to the patients condition. Because of the teeth involved, this is likely to be Molar Incisor Hypomineralisation (MIH) which is defined as a hypomineralisation of systemic origin of one to four permanent first molars frequently associated with affected incisors (Weerheijm, 2003). It is important that MIH be treated as soon as identified to minimise the heightened risk of dental caries and prevent the patient from experiencing tooth sensitivity. Treatment options depend on the severity of the hypoplasia and the symptoms associated with it (University of Iowa, n.d.). It should be noted that the worst area of inflamed gingival tissue is associated with the upper anterior teeth which could be a result of the patient avoiding these as they are sensitive or painful to brush. It may be useful to ask the patient about this so that education can be given on the importance of brushing all areas and the problem can be addressed. In this case scenario, the most effective treatment would be the application of a fluoride varnish to the hypoplastic areas followed by resin-based sealants. Alternatively, if ideal moisture control cannot be achieved, glass ionomer sealant can be used. According to Subramaniam, Konde, and Mandanna (2008), the retention of resin sealant is seen to be superior of that of the glass ionomer which should be treated as temporary only. Cameron and Widmer (2003) explain that localised defects may be restored with composite resin and pitting defects may require stain removal with either rotary instruments or some sort of bleaching system. Furthermore, if there is sensitivity, the use of tooth mousse products should be advised to assist with remineralisation and desensitisation of the teeth (Walsh, 2007). Appointment 4: Remove IRM: Although the temporary restoration on tooth 65 is sound, it should be replaced with a permanent filling as Mount and Hume state that zinc oxide eugenol hydrolyses in time and should not be used for over six months (1998). Additionally, composite should not be used because the release of eugenol will inhibit the polymerisation of the composite resin (Mount Hume, 1998). Therefore, an amalgam restoration should be placed on tooth 65 if the radiograph shows tooth 25 is present. If the permanent successor is not present, the temporary restoration should be replaced with a permanent restoration like a stainless steel crown and may require pulpotomy depending on how far the carious lesion has progressed in the tooth. Recall: A three month recall should be arranged as the patient is high risk for caries and periodontal disease. It is essential that optimal oral hygiene is maintained and well monitored by the dental practitioner. CASE 2 The human needs of each older adult must be assessed individually and not based on preconceived stereotypes as the healthcare needs of elderly persons can vary from health to severe illness (Darby Walsh, 2010). According to Fiske et al. (2000) there is a general trend for a reduction in edentulism and an increase in the retention of natural teeth. This attitude leads to more people wanting to understand how to best maintain good oral hygiene and it is the role of the dental provider to assist these individuals with appropriate educational instructions. In this clinical case scenario the patient is an 81 year old man who comes to the clinic for dental hygiene care. Appointment 1: Complete Initial Assessment Take medical history The patient shows early signs of Parkinsons disease; a progressive neurodegenerative disorder of neurons that produce dopamine (Little, Falace, Miller, Rhodus, 2008). Loss of these neurons results in characteristic motor disturbances including a resting tremor, muscular rigidity, bradykinesia and postural instability. It is common for those with Parkinsons disease to also experience xerostomia as a result of polypharmacy and is significant as this increases the risk of periodontal disease and coronal and root surface caries (Wilkins, 2009). It is described that the patient has mild congestive heart failure which The American Heart Association (2011) state is the inability of the heart to supply sufficient blood flow to meet the needs of the body and can be a result of myocardial infarction and other forms of ischemic heart disease, hypertension, valvular heart disease, and cardiomyopathy. As the heart failure is mild, he will not require antibiotic prophylaxis for dental treatment however it is wise to confirm this with his physician. The patient is taking nitroglycerin tablets under the tongue to relieve chest pain several times a week. It is taken sublingually for immediate relief of chest pain by reducing the oxygen need of the heart and may cause dizziness, light-headedness and fainting and may cause xerostomia (Medline Plus, 2011). The patient has stiffness in the fingers of his dominant right hand due to arthritis; an inflammatory or degenerative process which involves the joints (Arthritis Foundation, 2011). Patients with arthritis may experience pain, swelling, limitation of motion and deformity of the joints and may find it difficult to keep an open mouth for long dental procedures. Oral hygiene assessment The patient has poor oral hygiene. It is likely that due to his arthritis which affects the fingers in his right hand, he is not adequately brushing quadrants 2 and 3. It should be noted that there are signs of abrasion lesions on the buccal surfaces of quadrants 1 and 4. Abrasion is the mechanical wearing away of tooth substance by forces other than mastication (Wilkins, 2009, p.272) and this is likely to be a result of the patient vigorously brushing horizontally. Furthermore, he has heavy plaque deposits on the lower lingual and all interproximal which indicate interproximal plaque removal methods must be instructed. Periodontal probing All periodontal pockets measure 1-3 mm except for 26 mesial with a probing depth of 4mm indicating generally good periodontal health. Record exam and dental charting 27 moderately filled teeth present with tooth 25 lost due to a fractured root Gingival recession is present with 1-2 mm areas of root surfaces exposed on most teeth. A couple of theses surfaces present with light brown marks that are soft to touch Tooth 26 shows sign of periodontal bone loss palatally as well as tipping and drifting forward into the space left by 25 Heavy plaque deposits on the buccal surfaces of quadrant 2 and quadrant 3 as well as lower lingual and all interproximal surfaces Very light plaque deposits on the buccal surfaces of quadrant 1 and quadrant 4 Some surfaces with light plaque show signs of abrasion Radiographs To complete the initial assessment, bitewing radiographs and an OPG should be taken. This can give the dental provider information on alveolar bone levels, plaque retention factors, interproximal and secondary caries, furcation defects, subgingival calculus and additional pathology (Tugnail, Clerehugh, Hirschmann, 1999). A periapical radiograph of tooth 26 is taken to examine bone loss and to check for subgingival calculus and root surface caries. Risk assessment The patient is at high risk of developing dental caries and moderate risk for periodontal disease due to his medical history. His lack of manual dexterity associated with Parkinsons disease and arthritis, makes adequate plaque removal difficult to achieve. Moreover, due to medications, he is more likely to have xerostomia which will increase his risk of periodontal disease and dental caries, especially root surface caries (Wilkins, 1999). Diagnosis Moderate plaque-induced gingivitis Localised moderate chronic periodontitis on tooth 26 due to tilting Generalised gingival recession Toothbrush abrasion Areas of root surface caries Oral health education and oral hygiene instruction Perhaps the most important treatment a dental provider can give is that of oral health education, information, promotion and counselling. This enables the patient to maintain good oral hygiene themselves and prevent further disease processes. In this clinical case scenario it is vital to advise the patient on homecare which will address his risks of dental caries and periodontal disease. According to Darby Walsh (2010) caries control and prevention activities must address three interrelated factors: (1) removal of bacterial plaque and biofilm, (2) reduction of refined carbohydrates and snacking in the diet, and (3) use of topical fluoride. The patients oral hygiene activities are compromised due to the arthritis in his right hand and in the future will be further affected by his developing Parkinsons disease. His poor oral hygiene should be addressed firstly by recommending the use of adaptive devices. Using a powered toothbrush and modifications of handle size, width, and grip, will provide assistance for the patient with thorough plaque removal. It should also be suggested that the patient use floss holders to ensure the effective removal of interproximal plaque or alternatively, interproximal brushes can be recommended if the patient is able to use them effectively. Poor dietary practices involving the over consumption of soft, retentive refined carbohydrates and frequent snacking patterns are common among older adults (Darby Walsh, 2010). The dental provider has an obligation to educate the patient on optimum food choices and nutritional patterns to promote oral health. It could also be beneficial to speak with any caregivers regarding the patients diet and make suggestions to prevent further carious lesions. Replacing sweet snacks with cheese and crackers or substituting sugar-free hard candy for mints are examples of two specific dietary interventions that may be more easily and realistically implemented for older adults. Furthermore, the frequent use of topical fluoride products for home use should be encouraged. A high fluoride toothpaste (5,000 ppm) will help to strengthen enamel and aid in the prevention of dental caries and will cause little change in the routine of the patient. For management of xerostomia, the patient is advised to take frequent sips of water and avoid the consumption of alcoholic drinks which will further dry out the oral mucosa. Sugar-free chewing gums will help stimulate the saliva but if the patient experiences difficulty in chewing because of arthritis, this may not be advisable. Additionally, tooth mousse should be recommended to provide lubrication and assist in preventing root surface caries (Walsh, 2007). If the patient is unable to provide adequate home care, alternative solutions should be provided, such as the introduction of the Collis curve toothbrush, assisted brushing, or chlorhexidine rinses (Little et al., 2008) These aids facilitate self-care and hence self-determination for the patient. The patient may suffer from mild dementia and due to his age may have difficulty remembering everything discussed at the initial appointment therefore all instruction should be written down and passed to him or a caregiver. Formulate a treatment plan Appointments should be kept short and scheduled in the morning or early afternoon when patient is less tired or whenever suits his needs best. Once a care plan has been completed it should be discussed with the patient and informed consent must be given. Appointment 2: Re-assess oral hygiene Quadrant scaling is recommended in case a full debridement cannot be completed in one appointment Reinforce good oral hygiene Appointment 3: Re-assess oral hygiene Complete scaling and full mouth polish Reinforce good oral hygiene A referral letter to the patients dentist is to be written and given to him regarding the restorative work required on the root caries present in his mouth. The importance of treatment should be explained to the patient and if necessary his caregivers should also be advised of the work required. As a preventive method, fluoride varnish should be applied to the other receded areas to help remineralise the enamel and reduce any sensitivity the patient may be experiencing (Wilkins, 2009). Recall: Upon completion of treatment for this patient, a three month recall should be arranged as his medical history indicates he may require regular maintenance in the future. This is also a good chance to evaluate the outcome and effectiveness of the previous treatment. According to Stefanac and Nesbit (2001) an oral health care plan is about balancing the ideal with the practical, and emphasis should be placed on the patient and their needs which ought to drive the treatment planning process. There has been a shift in treatment given by dental providers, where the focus is now on not only restoring the problem in the clinic, but educating the patient on how they can best achieve optimal oral health themselves. This assessment has investigated two different clinical case scenarios and discussed oral health care plans for each. In addition, it has examined the importance of treating each patient as an individual with specific needs and the significance of providing them with methods or self-care.

Bio 169

Urinary System: Anatomy Review 1. Name the organs in the urinary system:1. 2 kidneys2. 2 ureters3. bladder4. uethra2. The kidneys are retroperitoneal (behind the peritoneum), lying against the dorsal body wall in the upper abdomen. 3. The adrenal gland sits atop the kidneys. Blood vessels enter and leave the kidney at the renal cortex. 4. The functional units of the kidney are the nephrons. They are called renal pyramids if they are located mainly in the cortex. They are called renal pyramids if they are located in both the cortex and the medulla. 5. Blood enters the kidney through the hilus artery. The artery branches into smaller and smaller arteries and arterioles. Complete the sequence below: ______________ arteriole ______________ capillaries ______________ arteriole ______________ capillaries and vasa recta6. Complete the sequence below showing all parts of the nephron: Glomerular (Bowman’s) capsule proximal convoluted tubule loop of henle (both descending and ascending limb) distal convoluted tubule collecting duct (both cortical and medullary sections)7. The renal corpuscle consists of two parts: glomerular capillaries and the Bownan’s capsule.A portion of the plasma is filtered into the capsular space due to the hydrostatic pressure of the blood.8. The filtration membrane consists of fenestrated capillary endothelium, porous basementmembrane, and the photocyte (which contain filtration slits). This filtration membrane permits (large or small) molecules to be filtered.9. Proximal tubule: The simple cuboid al cells of the proximal tubule are called brush border cells because they contain numerous microvilli. The microvilli increase the surface area for reabsorption. The proximal tubule cells are highly permeable to water and many solutes. The tight junctions permit the movement of water between the cells.10. Loop of Henle: The thin descending limb of the loop of Henle is highly permeable to water but not to solutes. The thick ascending limb of the loop of Henle is highly permeable to ___________________ but not to ___________________.11. The thick ascending limb of the loop of Henle runs back between the afferent and efferent arterioles as they enter and leave the glomerular (Bowman’s) capsule. The juxtaglomerular apparatus consists of the macular densa cells of the tubule and the granular (modified smooth muscle) cells of the afferent arteriole. Granulerutal cells serve as baroreceptors sensitive to blood pressure within the arteriole. Macular densa cells monitor and respond t o changes in the osmolarity (or electrolyte composition) of the filtrate in the tubule.12. After the juxtaglomerular apparatus, the tubule becomes the distal tubule, which merges with the cortical collecting duct. The cortical collecting duct contains two functional types of cells: Principal cells—hormones regulate their permeability to water and solutes. Intercalated cells—secrete hydrogen ions for acid-base regulation.13. The medullary collecting duct is composed of principal cells.Their permeability to urea and water is hormonally regulated. Urinary System: Glomerular Filtration1. What force drives filtration at the glomerulus? Blood pressure2. Glomerular filtration is a process of bulk flow driven by the hydrostatic pressure of the blood.3. Common components of the filtrate are divided into four categories on the CD program. These include: 1. water 2. ions 3. notrogenous waste 4. organic molecules4. Blood pressure in the glomerulus is about 60 mmHg.5. What two pres sures oppose filtration and what are their values?1. hydrostatic 15mmHg2. osmotic 28mm Hg6. What is the normal net filtration pressure? 7 mmHg7. With a glomerular filtration rate of 125 ml/min, how much plasma would be filtered per day? 180L In 24 hours? _____8. In an exercising individual the afferent arteriole will (dilate or constrict) to avoid excess fluid loss.9. Two mechanisms that provide autoregulatory control over renal processes include: 1. myogenic 2. tubuloglomer10. High osmolarity (or high Na+ and Cl–) in the ascending loop of Henle will cause afferent arterioles to (dilate or constrict) by releasing vasoconstrictor11. In periods of extreme stress, the sympathetic nervous system will override autoregulation.An increase in sympathetic flow to the kidney will result in what two important effects that will aid maintenance of blood pressure?1. vasocontriction2. Urinary System: Early Filtrate Processing1. What are the two reabsorption pathways through the tubular cell barrier?1. transcellular2. paracellular2. How can we cause water to diffuse from the lumen into the interstitial space? An increase in the osmolarity of the interstitium3. Transport of what ion could cause the diffusion in question 2?4. Summarize reabsorption in the proximal tubule. 85% of reabsorption of all useful substances occur here5. What percent of the filtrate is reabsorbed in the proximal tubule? 99%6. The simple squamous cells of the thin descending loop are permeable to __________________ but impermeable to ________________.7. The ascending limb of the loop of Henle is permeable to Water but impermeable to solutes.8. What is the role of the loop of Henle? Facilitated diffusion9. What is the role of the vasa recta? Blood capillary which collects the filtered blood capillary which collects the filtered blood from afferent arterriole10. From the Quiz section, what does furosemide do? Increases your water output to decrease fluid retention through urinationUrinary System: La te Filtrate Processing1. Name the two types of cells in the cortical collecting ducts and describe their function.1. principal2. intercalated2.a. Aldosterone is stimulated by an increase or decrease in what ions?1. potassium2. Sodiumb. What does aldosterone increase in the basolateral membrane?3. What does antidiuretic hormone (ADH) increase in the luminal membrane? Vasopressin4. In dehydration and overhydration, what would be the levels of: a. ADH? v dehydration ___? ___ overhydration (? or ) b.Aldosterone? ___ v ___ dehydration __? ____ overhydration (? or )5. Describe what move(s) out of the tubule and what the osmolarity would be in the following nephron segments: a. Proximal tubule______ move(s) out______ mOsm b. Descending limb______ move(s)out______ mOsm c. Ascending limb______ move(s)out______ mOsm d. Late distal tubule______ move(s)out______ mOsm6. a. By the medullary collecting duct, only _____% of the filtrate remains. b. Under the following conditions, report the levels of ADH and subsequent urine osmolarity and flow rate7. a. Urine with a â€Å"high normal osmolarity† and containing RBCs and protein would indicate: _______________ b. Urine with a very high osmolartiy and glucose would indicate: _______________ c. Urine with a very low osmolarity and high volume would indicate: _______________8. An increase in plasma potassium levels would lead to what changes in the following? (? or ) a. _____aldosterone levels b. _____potassium excretion c. _____sodium excretion d. _____interstitial osmolarity e. _____urine volume

Celebrities in politics Essay

I will get straight to the point, I believe that when celebrities get involved in  politics they draw attention away from the actual political issues and campaigns at hand. Having film stars in politics for endorsements will definitely draw a crowds and more  importantly votes. Because people love and become inspired by the characters played by an individual and in the end they are in fact become blinded by who that individual really is. It is as if you give a dangerous person, or as I will refer to him as, â€Å"an evil dower† some candy. Now a politician by him self is an evil dower who does not have candy. Without the candy it is very hard for an evil dower to attract little children into a car but as soon a candy, or even better a child’s favorite candy is introduced, this when put into context being a favorite actor, that is all the child sees and is blinded to whomever posses the candy, thus getting into the car. This in essence is basically the reaction of an obsessed fan when celebrities become involved in politics. If you really want to dissect the purpose for celebrities in politics, or celebrity endorsements in general you are able to create six different categories, establishing credibility, attracting attention, associative benefits, psychographic connection, demographic connection and mass appeal. What does this all mean? Absolutely nothing! All the reasons why celebrities are brought into an election are reasons that should be irrelevant to the voters. Most celebrities have never actually done any social work, some of them are unaware of what’s going on, in the past some celebrities have actually debated the ideals of another individual that was in there own party without actually knowing it. Up to now I have only been referring to actors as being celebrities but if we look it up in the dictionary, a celebrity is simply a famous person, renown fame. Doesn’t that mean a politician could in fact also be a celebrity? Yes,  Julius Caesar, Napoleon Bonaparte, Abraham Lincoln ,where politicians and celebrities in there own respect and got there fame from battles they won, world changing events they where part of. The difference between them and a modern day actors is they became famous for the things they did, it was who they where not a mask. But on the contrary this could also work against a politition, for instance Bill Clinton, we don’t remember him for being the president who sent the most troops into war ever or getting the United States out of a 250 billion dollar debt, no, the first thing that comes to mind when you hear Bill Clinton is Monica Lewinski. I’m not saying he didn’t do a lot of good things for the county Im just saying that’s what he got the most publicity for. All this time wasted just because they wanted to know if he lied. This is how celebrity gets in the way of politics, instead of speculating about impeaching the president for getting a blow job they should have been using there resources to gather more intelligence about terrorist activity in the middle east. At this time the president was no longer a polition, he was a celebrity, another Paris Hilton, instead of a tape it was a dress. Let’s face it though, when it comes to celebrities and politics. Celebrities are simply more entertaining. Who would you rather see in an interview, Sonny Perdue (Governor or Georgia) or The Rock.

Marketing Plan Applpoly Products - 992 Words

III. Background Information Preston Preston, the chemist working in ApplPoly Products’ resins laboratory, had developed the new product; she attempted to convince her managers to support her new merchandise in foamed polystyrene with recognition. The position Preston works was to find new products, and to develop more profitable applications for the company; nevertheless, she faced some unforeseen difficulties because of the new product. Preston had heavy stress from her managers because she needed to find out the new products that could satisfy the needs of her new product in the foamed polystyrene. A method that uses foamed polystyrene to make dome-shaped roofs and other structures called â€Å"foamed-dome†¦show more content†¦Polystyrene foamed boards is stiff, insulated characteristics, very light weight, easy to manipulate, it also can be used to defend the fire accident. †¢ Price is reasonable. Foam boards can be applied at any surface finishes can stay long time and lower cost. †¢ New technology. Our motivation of project is to helping the biosphere environment and the ecosystem around the world by using the cutting materials. This is a new technology and keeps growing up. †¢ Reduce of Construction time. By using Foam boards, it can be save man construction time. Weakness †¢ Inexperience in professional area. Due to new technology, it is necessary to find a person who has experience in this area. If a person who lack of experience, it will easy to make the plastic burn. †¢ It has not General around the world. Because it is new technology not traditional materials, it does not have many people know about it. †¢ Lack of trust and desire to support with the product. Many Architects were skeptical about this product can stay durability and fire safety, and also appear an attitude of mistrust. †¢ Lack of marketing expertise of new product (new technology), so the marketing staff are not promote their product very well. Opportunities †¢ The new product always has new chance to build a brand new client group. †¢ Increase at Possible Target Markets. It is time to open up new markets- international market; company can tryShow MoreRelatedApplpoly Case Study1186 Words   |  5 PagesHow ApplPoly Products got into the present situation? In our textbook[1], it says to move quickly and also avoid expensive new-product failures, companies should follow an organized new-product development process: (1) idea generation, (2) screening, (3) idea evaluation, (4) development (of product and marketing mix), and (5) commercialization. The hypothesis to have marketers to discover product flaws early, and find the remedy to it, has proven unprofitable. This process requires much analysisRead MoreApplpoly Case Study1196 Words   |  5 PagesHow ApplPoly Products got into the present situation? In our textbook[1], it says to move quickly and also avoid expensive new-product failures, companies should follow an organized new-product development process: (1) idea generation, (2) screening, (3) idea evaluation, (4) development (of product and marketing mix), and (5) commercialization. The hypothesis to have marketers to discover product flaws early, and find the remedy to it, has proven unprofitable. This process requires much analysis

Definition Essay - The Evolved Definition of Community

Definition Essay- The Evolved Definition of Community The definition provided in The American College Dictionary from 1964 says â€Å"a group of men or women leading a common life according to a rule.† I never really viewed community in this manner. Many of us think of the word â€Å"community† as a group of people who live near each other. We forget that a community is actually just a group of people with common interests or characteristics who often happen to live near each other. Communities can be bound by race, religion, economic standings, political standings, and most commonly, location. Frequently, communities fall into more than one of these categories. The definition of community has obviously changed over the years. If we look at†¦show more content†¦In Charles Derber’s â€Å"The Good Man Fills His Own Stomach,† Derber refers to two very different communities. One is the Ik who lived in Uganda and were described as â€Å"unfortunate people expelled by an uncaring government.† The other, was an imaginary community from the Woody Allen movie Crimes and Misdemeanors. This community seemed to resemble a community from our present day upper class with only the best hotels, restaurants, and symphonic recordings. Although these two groups are very different, they each still follow the criterion of a community. Each are groups of people who have formed a sort of bond with each other because of a certain lifestyle, interests, or beliefs. When people use this word in present everyday conversation, their application of the definition is usually compatible with the first and third definitions of The American College Dictionary. The second definition, â€Å"the public,† is too general. A community is not only a public, but a public with a common interest. In my area, when the word community is used, the person is usually referring to the West Bloomfield community. Talking about symbols and signified, the West Bloomfield community originally started out as just the group of people who lived in the town of West Bloomfield. Now the people of the area have come to make â€Å"The West Bloomfield Community,† signify something entirely different. It currently means any group of people who are wealthy and Jewish no matter their locality.Show MoreRelatedBlack Power And The Fight For Civil Rights914 Words   |  4 Pagesdifferent definitions, but the image that sticks out is the radical militant side. One example of this group was the Nation of Islam that had a very charismatic figure head in Malcom X, who preached for separation from whites and also labeled them as the devil (Lec. November 19). Then there was another definition that isn’t thought of as much like Stokley Carmichael preached, that blacks need to be a part of the system not shy away from it (Lec. November 19). What it is the definition of Black PowerRead MoreThe Importance Of A Good Society Is Not Achieved By Chance Or By Default1446 Words   |  6 Pagesplace to help individuals succeed in various areas. From Travels of a T-shirt in the Global Economy, it is evident that without necessary trade, negotiations, and boundaries, the millions of T-shirts produced would not be able to flow across global communities, bringing alongside them countless job opportunities, more effective governance systems, and enhanced research and innovations. Clearly, one of the key aspects of a good functioning society is the establishment of good and effective structures.Read MoreSecurity Studies : A Relatively New Discipline903 Words   |  4 PagesInternational Relations. 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Darwin’s main theory of the â€Å"Origin of the Moral Sense† is that humans have natural social instincts which in turn gives them a senseRead MoreSexism Is Prolonged Cruel, Or Unjust Treatment?1430 Words   |  6 Pages By definition oppression is prolonged cruel, or unjust treatment. In today’s society those who are considered to be in a dominant group are whites, men, heterosexuals and Christians. Where blacks, women, members of the LGBTQ community and Muslims are examples of groups who are oppressed. I am particularly engrossed with the oppression towards women. In todays culture women have been put down and are not seen as equal towards their male counterparts. Those with sexist attitudes would more than likelyRead MoreInterpellation : Ideology And Ideology And Hegemonic Language1348 Words   |  6 Pagesthe word has evolved to have two usages. The first usage is legal term, and is currently used to describe legal processes in which a court order is interrupted (Oxford Dictionaries). The focus of this definition is on the second usage of interpellation; as a term in philosophical discourse, where it takes on a separate meaning than its legal definition, popularized by the work of Marxist Philosopher Louis Althusser (Nguyen). It was first used in philosophical context it in his essay â€Å"Ideology and

Rape, Violence, And Violence - 1945 Words

Though the offensive act occurs off-stage, Pinter makes the rape incident pivotal in understanding the acts of violence committed against women. Rape like other acts of physical violence leads to injuries and bruises in the victim and also leads to psychological effects such as post-traumatic stress, anxiety and depression in the victim. But what separates rape from other acts of physical violence is that it hurts the dignity of a woman, shatters her confidence, makes her feel powerless and nothing but an object of pleasure for her offenders and at times causes long lasting physical and psychic problems. In the play One for the Road, rape is used as a tool of violence to cause the psychological breakdown of not only Gila but also her†¦show more content†¦Beginning. She is beginning to fall in love with me. On the brink ... of doing so. The trouble is, I have rivals. Because everyone here has fallen in love with your wife. It’s her eyes have beguiled them ... (p.231) Though Victor does not say anything then, his immense mental anguish and pain is expressed later on when he tells Nicolas â€Å"Kill me† (p.232) A scene of sexual molestation is observed in Pinter’s play Mountain Language when the Sergeant at the prison puts his hand on the bottom of a young woman, who had come to visit her imprisoned husband.(p.256) The young woman does not protest against the molestation out of fear that her husband might be brutally tortured as a consequence of her complaint against the Sergeant’s indecent behaviour. Instead what she understands by the Sergeant’s behaviour is that if she offers her body for sexual pleasure to him and other higher officials she might be able to get her husband released from the confinement. That is why towards the end of the play, she willingly offers her body to be sexually violated. YOUNG WOMAN Can I fuck him? If I fuck him, will everything be all right? SERGEANT Sure. No problem. YOUNG WOMAN Thank you. (p.264) Here though the woman herself gives the proposition of sexual favours from her end, she is a victim in her own way. Her husband is imprisoned with noShow MoreRelatedThe Rape Of Sexual Violence1642 Words   |  7 Pageswith me again,† â€Å"It’s not a rape if it happens after drinking or taking drugs†: these quotes about rape are few to the numerous myths that circulate society today. 1 out of every 6 American women has been sexually assaulted, yet this statistic is only from victims who come forward (Victims of Sexual Violence: Statistics†). The problem in America today is the â€Å"Rape Culture† in which we live. A Rape Culture is defined as a â€Å"rape prevalent society in which sexual violence is normalized and excused throughRead MoreRape- An Unwanted Sexual Violence1179 Words   |  5 PagesRape – An Unwanted Sexual Violence Sexual violence, especially rape, is a major emerging health related issue in the United States of America. 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Kilbou rne described violence in ads, â€Å"as in pornography, usually power over another, either by physical dominanceRead MoreRape and Sexual Violence Essay963 Words   |  4 PagesRape and Sexual Violence Rape and sexual violence is a very serious problem that affects millions of people each year. Rape is someone taking advantage of another person sexually. Sexual assault can be verbal, physical, visual, or anything that forces a person to join in unwanted sexual contact or attention. (Sexual Assault.) Rape is one of the most underreported crimes. In 2002, only thirty-nine percent of rapes and sexual assaults were reported to law officials. (Sexual Violence: Fact SheetRead MoreRape, Violence, And Feminist Networks894 Words   |  4 Pagesa lot of discussion of rape within sociologists, criminologists, and feminist networks. In my own words, rape is someone engaging with someone else sexually without their consent. 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The Hero Factor Essay Example For Students

The Hero Factor Essay Heroes have been around since the beginning of time. The first hero that I can think of is David, from the biblical story David and Goliath. Heroes have not really evolved that much since the early days, they are still basically the same strong men with unhumanlike powers that the normal mortal man cannot even comprehend. Heroes come in many shapes and sizes. Contrary to popular belief heroes nowadays are just regular people with the same everyday problems that we have to endure.In the movies Broken Blossoms and Mississippi Masala there are heroes. In this paper I will describe the heroes in each movie and then compare the heroes. In the movie Broken Blossoms a abused woman played by Lillian Gish is put under the torture of ritual beating by her father. A Chinese man named Yellow Man, for his skin color is a kind and emotional man who falls in love with Lillian. I would say that Yellow Man is the hero in this movie because he shows Lillian how men are supposed to treat ladies unlike her father whom she deserts shortly after Yellow Man dies. In the movie Mississippi Masala, a black man and an Indian woman fall in love and attempt to stay together despite her parents pleas to keep them apart. In this movie I would say that Nina and Demetrius are the heroes of this movie because they overcome their parents prejudices and defy them. I do not think that being a hero has anything to do with defying your parents but if you believe in something that is not a social norm then I think that you could be considered a hero. In summation, I think that these two examples of heroes are not the most interesting but they are valid. Upon further review of my writing I think that the revelation I made while doing this paper is that you do not need to be totally extraordinary to be a hero. If you stick to you4r guns and have faith what you believe you too can be a hero.