Last Sacrifice Chapter Eleven

I BRACED MYSELF, EXPECTING TO see the Dashkov brothers appear again with some last minute â€Å"advice.' Instead I saw– â€Å"Adrian!' I ran across the garden I'd appeared in and threw my arms around him. He hugged me back just as tightly and lifted me off the ground. â€Å"Little dhampir,' he said, once he put me down again. His arms stayed around my waist. â€Å"I've missed you.' â€Å"I've missed you too.' And I meant it. The last couple days and their bizarre events had completely unhinged my life, and being with him–even in a dream–was comforting. I stood on my tiptoes and kissed him, enjoying a small moment of warmth and peace as our lips met. â€Å"Are you okay?' he asked when I broke away. â€Å"No one'll tell me much about you. Your old man says you're safe and that the Alchemist would let him know if anything went wrong.' I didn't bother telling Adrian that that probably wasn't true, seeing as Abe didn't know we'd gone freelancing with some backwoods vampires. â€Å"I'm fine,' I assured Adrian. â€Å"Mostly bored. We're holed up in this dive of a town. I don't think anyone will come looking for us. I don't think they'd want to.' A look of relief spread over his handsome face, and it occurred to me just how worried he was. â€Å"I'm glad. Rose, you can't imagine what it's like. They aren't just questioning people who might have been involved. The guardians are making all sorts of plans to hunt you down. There's all this talk about â€Å"deadly force.† â€Å"Well, they won't find me. I'm somewhere pretty remote.' Very remote. â€Å"I wish I could have gone with you.' He still looked concerned, and I pressed a finger to his lips. â€Å"No. Don't say that. You're better off where you are–and better not to be associated with me any more than you already are. Have you been questioned?' â€Å"Yeah, they didn't get anything useful out of me. Too tight an alibi. They brought me in when I went to find Mikhail because we talked to–‘ â€Å"I know. Joe.' Adrian's surprise was brief. â€Å"Little dhampir, you've been spying.' â€Å"It's hard not to.' â€Å"You know, as much as I like the idea of having someone always know when you're in trouble, I'm still kind of glad I don't have anyone bound to me. Not sure I'd want them looking in my head.' â€Å"I don't think anyone would want to look in your head either. One person living Adrian Ivashkov's life is hard enough.' Amusement flickered in his eyes, but it faded when I switched back to business. â€Å"Anyway, yeah. I overheard Lissa's †¦ um, interrogation of Joe. That's serious stuff. What did Mikhail say? If Joe lied, that clears half the evidence against me.' It also theoretically killed Adrian's alibi. â€Å"Well, not quite half. It would have been better if Joe said you were in your room during the murder instead of admitting he's a flake who doesn't remember anything. It also would have been better if he hadn't said all this under Lissa's compulsion. Mikhail can't report that.' I sighed. Hanging out with spirit users, I'd started to take compulsion for granted. It was easy to forget that among Moroi, it was taboo, the kind of thing you'd get in serious trouble for. In fact, Lissa wouldn't just get in trouble for illicitly using it. She could also be accused of simply making Joe say whatever she wanted. Anything he said in my favor would be suspect. No one would believe it. â€Å"Also,' added Adrian, looking dismayed, â€Å"if what Joe said gets out, the world would learn about my mother's misguided acts of love.' â€Å"Im sorry,' I said, putting my arms around him. He complained about his parents all the time but really did care about his mother. Finding out about her bribery had to be tough for him, and I knew Tatiana's death still pained him. It seemed I was around a lot of men in anguish lately. â€Å"Although, I really am glad she cleared you of any connection.' â€Å"It was stupid of her. If anyone finds out, she'll be in serious trouble.' â€Å"What's Mikhail's advice then?' â€Å"He's going to find Joe and question him privately. Go from there. For now, there's not much more we can do with the info. It's useful for us †¦ but not for the legal system.' â€Å"Yeah,' I said, trying not to feel disheartened. â€Å"I guess it's better than nothing.' Adrian nodded and then brushed away his dark mood in that easy way of his. Still keeping his arms around me, he pulled back slightly, smiling as he looked down at me. â€Å"Nice dress, by the way.' The topic change caught me by surprise, though I should have been used to it with him by now. Following his gaze, I noticed I was wearing an old dress of mine, the sexy black dress I'd had on when Victor had unleashed a lust charm on Dimitri and me. Since Adrian hadn't dressed me for the dream, my subconscious had dictated my appearance. I was kind of astonished it had chosen this. â€Å"Oh †¦' I suddenly felt embarrassed but didn't know why. â€Å"My own clothes are kind of beat up. I guess I wanted something to counteract that.' â€Å"Well, it looks good on you.' Adrian's fingers slid along the strap. â€Å"Really good.' Even in a dream, the touch of his finger made my skin tingle. â€Å"Watch it, Ivashkov. We've got no time for this.' â€Å"We're asleep. What else are we going to do?' My protests were muffled in a kiss. I sank into it. One of his hands slid down the side of my thigh, near the dress's edge, and it took a lot of mental energy to convince myself that him pulling the dress up was probably not going to clear my name. I reluctantly moved back. â€Å"We're going to figure out who killed Tatiana,' I said, trying to catch my breath. â€Å"There's no â€Å"we,† he said, echoing the line I'd just used on Victor. â€Å"There's me. And Lissa. And Christian. And the rest of our misfit friends.' He stroked my hair and then drew me close again, brushing a kiss against my cheek. â€Å"Don't worry, little dhampir. You take care of yourself. Just stay where you are.' â€Å"I can't,' I said. â€Å"Don't you get it? I can't just do nothing.' The words were out of my mouth before I could stop them. It was one thing to protest my inactivity with Dimitri, but with Adrian, I needed to make him and everyone else at Court think I was doing the â€Å"right thing.' â€Å"You have to. We'll take care of you.' He didn't get it, I realized. He didn't understand how badly I needed to do something to help. To his credit, his intentions were good. He thought taking care of me was a big deal. He wanted to keep me safe. But he didn't truly get how agonizing inaction was for me. â€Å"We'll find this person and stop them from doing whatever it is †¦ they want to do. It might take a long time, but we'll fix it.' â€Å"Time †¦' I murmured against his chest, letting the argument go. I'd get nowhere convincing him I needed to help my friends, and anyway, I had my own quest now. So much to do, so little time. I stared off into the landscape he'd created. I'd noticed trees and flowers earlier but only now realized we were in the Church's courtyard–the way it had been before Abe's assault. The statue of Queen Alexandra stood intact, her long hair and kind eyes immortalized in stone. The murder investigation really was in my friends' hands for now, but Adrian had been right: it might take a while. I sighed. â€Å"Time. We need more time.' Adrian pulled away slightly. â€Å"Hmm? What'd you say?' I stared up at him, biting my lower lip as a million thoughts spun through my mind. I looked again at Alexandra and made my decision, wondering if I was about to set new records in foolishness. I turned back to Adrian and squeezed his hand. â€Å"I said we need more time. And I know how we can get it †¦ but †¦ well, there's something you have to do for me. And you, uh, probably shouldn't mention it to Lissa yet †¦' I had just enough time to deliver my instructions to Adrian–who was as shocked as I'd expected–before Dimitri woke me up for my shift. We switched off with little conversation. He had his usual tough face on, but I could see the lines of fatigue etched upon his features. I didn't want to bother him–yet–with my Victor and Robert encounter. Not to mention what I'd just told Adrian to do. There'd be plenty of time for a recap later. Dimitri fell asleep in that easy way of his, and Sydney never stirred the entire time. I envied her for a full night's sleep but couldn't help a smile as the room grew lighter and lighter. She'd been inadvertently put on a vampire schedule after our all-night adventures. Of course, Lissa was on the same schedule, which meant I couldn't visit her during my watch. Just as well. I needed to keep an eye on this creepy collective we'd stumbled into. These Keepers might not want to turn us in, but that didn't make them harmless either. I also hadn't forgotten Sydney's fears about surprise Alchemist visits. When late afternoon came for the rest of the world, I heard stirring inside the house. I gently touched Dimitri's shoulder, and he jerked awake instantly. â€Å"Easy,' I said, unable to hide a smile. â€Å"Just a wakeup call. Sounds like our redneck friends are getting up.' This time, our voices woke Sydney. She rolled over toward us, her eyes squinting at the light coming through the badly screened window. â€Å"What time is it?' she asked, stretching her limbs. â€Å"Not sure.' I had no watch. â€Å"Probably past midday. Three? Four?' She sat up almost as quickly as Dimitri had. â€Å"In the afternoon? † The sunlight gave her the answer. â€Å"Damn you guys and your unholy schedule.' â€Å"Did you just say â€Å"damn'? Isn't that against Alchemist rules?' I teased. â€Å"Sometimes it's necessary.' She rubbed her eyes and glanced toward the door. The faint noises I'd heard in the rest of the house were louder now, audible even to her ears. â€Å"I guess we need a plan.' â€Å"We have one,' I said. â€Å"Find Lissa's sibling.' â€Å"I never entirely agreed to that,' she reminded me. â€Å"And you guys keep thinking I can just magically type away like some movie hacker to find all your answers.' â€Å"Well, at least it's a place to–‘ A thought occurred to me, one that could seriously mess things up. â€Å"Crap. Your laptop won't even work out here.' â€Å"It's got a satellite modem, but it's the battery we have to worry about.' Sydney sighed and stood up, smoothing her rumpled clothes with dismay. â€Å"I need a coffee shop or something.' â€Å"I think I saw one in a cave down the road,' I said. That almost got a smile from her. â€Å"There's got to be some town close by where I could use my laptop.' â€Å"But it's probably not a good idea to take the car out anywhere in this state,' said Dimitri. â€Å"Just in case someone at the motel got your license plate number.' â€Å"I know,' she said grimly. â€Å"I was thinking about that too.' Our brilliant scheming was interrupted by a knock at the door. Without waiting for an answer, Sarah stuck her head inside and smiled. â€Å"Oh, good. You're all awake. We're getting breakfast ready if you want to join us.' Through the doorway, scents of what seemed like a normal breakfast drifted in: bacon, eggs †¦ The bread had gotten me through the night, but I was ready for real food and willing to roll the dice on whatever Raymond's family had to offer. In the house's main section, we found a flurry of domestic activity. Raymond appeared to be cooking something over the fireplace while Paulette set the long table. It already had a platter of perfectly ordinary scrambled eggs and more slices of yesterday's bread. Raymond rose from the fireplace, holding a large metal sheet covered in crisp bacon. A smile split his bearded face when he spotted us. The more of these Keepers I saw, the more I kept noticing something. They made no attempts to hide their fangs. From childhood, my Moroi were taught to smile and speak in a way that minimized fang exposure, in case they were out in human cities. There was nothing like that here. â€Å"Good morning,' said Raymond, carefully pushing the bacon onto another platter on the table. â€Å"I hope you're all hungry.' â€Å"Do you think that's, like, real bacon?' I whispered to Sydney and Dimitri. â€Å"And not like squirrel or something?' â€Å"Looks real to me,' said Dimitri. â€Å"I'd say so too,' said Sydney. â€Å"Though, I guarantee it's from their own pigs and not a grocery store.' Dimitri laughed at whatever expression crossed my face. â€Å"I always love seeing what worries you. Strigoi? No. Questionable food? Yes.' â€Å"What about Strigoi?' Joshua and Angeline entered the house. He had a bowl of blackberries, and she was pushing the little kids along. From their squirming and dirty faces, they clearly wanted to go back outside. It was Angeline who had asked the question. Dimitri covered for my squeamishness. â€Å"Just talking about some of Rose's Strigoi kills.' Joshua came to a standstill and stared at me, those pretty blue eyes wide with amazement. â€Å"You've killed the Lost? Er–Strigoi?' I admired his attempt to use â€Å"our' term. â€Å"How many?' I shrugged. â€Å"I don't really know anymore.' â€Å"Don't you use the marks?' Raymond scolded. â€Å"I didn't think the Tainted had abandoned those.' â€Å"The marks–oh. Yeah. Our tattoos? We do.' I turned around and lifted up my hair. I heard a scuffling of feet and then felt a finger touching my skin. I flinched and whipped back around, just in time to see Joshua lowering his hand sheepishly. â€Å"Sorry,' he said. â€Å"I've just never seen some of these. Only the molnija marks. That's how we count our Strigoi kills. You've got †¦ a lot.' â€Å"The S-shaped mark is unique to them,' said Raymond disapprovingly. That look was quickly replaced by admiration. â€Å"The other's the zvezda.' This earned gasps from Joshua and Angeline and a â€Å"What?' from me. â€Å"The battle mark,' said Dimitri. â€Å"Not many people call it zvezda anymore. It means â€Å"star.† â€Å"Huh. Makes sense,' I said. The tattoo was, in fact, kind of shaped like a star and was given when someone had fought in a big enough battle to lose count of Strigoi kills. After all, there were only so many molnija marks you could cram on your neck. Joshua smiled at me in a way that made my stomach flutter just a little. Maybe he was part of a pseudo-Amish cult, but that didn't change the fact that he was still good- looking. â€Å"Now I understand how you could have killed the Tainted queen.' â€Å"It's probably fake,' said Angeline. I'd been about to protest the queen-killing part, but her comment derailed me. â€Å"It is not! I earned it when Strigoi attacked our school. And then there were plenty more I took down after that.' â€Å"The mark can't be that uncommon,' said Dimitri. â€Å"Your people must have big Strigoi fights every once in a while.' â€Å"Not really,' said Joshua, his eyes still on me. â€Å"Most of us have never fought or even seen the Lost. They don't really bother us.' That was surprising. If ever there was a Strigoi target, a group of Moroi, dhampirs, and humans out in the middle of nowhere would be it. â€Å"Why not?' I asked. Raymond winked at me. â€Å"Because we fight back.' I pondered his enigmatic statement as the family sat down to eat. Again, I thought about the entire community's willingness to fight when we'd first arrived. Was it really enough to scare off Strigoi? Not much scared them, but maybe certain things were too much of an inconvenience to deal with. I wondered what Dimitri's opinion would be on that. His own family had come from a community that separated itself somewhat from mainstream Moroi life, but it was nothing like this. All of this spun in my mind while we ate and talked. The Keepers still had a lot more questions about us and Tatiana. The only one not participating was Angeline. She ate as little as Sydney and kept watching me with a scowl. â€Å"We need some supplies,' said Sydney abruptly, interrupting me in the middle of a gruesome story. I didn't mind, but the others looked disappointed. â€Å"Where's the nearest town that would have a coffee shop †¦ or any restaurant?' â€Å"Well,' said Paulette. â€Å"Rubysville is a little over an hour north. But we have plenty of food here for you.' â€Å"Its not about food,' I said quickly. â€Å"Yours has been great.' I glanced at Sydney. â€Å"An hour's not so bad, right?' She nodded and then glanced hesitantly at Raymond. â€Å"Is there any way †¦ is there any way we could borrow a car? Ill †¦' The next words clearly caused her pain. â€Å"I'll leave the keys to mine until we get back.' He arched an eyebrow. â€Å"You've got a nice car.' Sydney shrugged. â€Å"The less we drive it around here, the better.' He told us we could take his truck and that he â€Å"probably' wouldn't even need to use the CR-V. Sydney gave him a tight smile of thanks, but I knew images of vampires joyriding in her car were dancing through her head. We set out soon after that, wanting to be back before the sun went down. People were out and about in the commune, doing chores or whatever else it was they did with their lives. A group of children sat around a dhampir reading a book to them, making me wonder what sort of education process they had here. All of the Keepers stopped whatever they were doing as we passed, giving us either curious looks or outright smiles. I smiled back occasionally but mostly kept my eyes ahead. Joshua was escorting us back to the â€Å"parking lot' and managed to walk beside me when we reached the narrow path. â€Å"I hope you won't be gone long,' he said. â€Å"I'd wanted us to talk more.' â€Å"Sure,' I said. â€Å"That'd be fun.' He brightened and chivalrously pushed aside a low-hanging branch. â€Å"Maybe I can show you my cave.' â€Å"Your–wait. What? Don't you live with your dad?' â€Å"For now. But I'm getting my own place.' There was pride in his voice. â€Å"It's not as big as his, of course, but it's a good start. It's almost cleaned out.' â€Å"That's really, um, great. Definitely show me when we're back.' The words came easily to my lips, but my mind was pondering the fact that Raymond's house was apparently â€Å"big.' Joshua parted ways from us when we reached Raymond's truck, a big red pickup with a seat that could just barely hold the three of us. Considering the Keepers didn't leave the woods much, the truck seemed like it had seen a lot of miles. Or maybe just a lot of years of disuse. â€Å"You shouldn't lead him on like that,' Dimitri said, when we'd been on the road for about ten minutes. Surprisingly, Sydney had let him drive. I guessed she figured a manly truck deserved a manly driver. Now that we were moving, my mind had focused back on the task at hand: finding the other Dragomir. â€Å"Huh?' â€Å"Joshua. You were flirting with him.' â€Å"I was not! We were just talking.' â€Å"Aren't you with Adrian?' â€Å"Yes!' I exclaimed, glaring at Dimitri. His eyes were fixed on the road. â€Å"And that's why I wasn't flirting. How can you read so much into that? Joshua doesn't even like me that way.' â€Å"Actually,' said Sydney, sitting between us, â€Å"he does.' I turned my incredulity on her. â€Å"How do you know? Did he pass you a note in class or something?' She rolled her eyes. â€Å"No. But you and Dimitri are like gods back at camp.' â€Å"We're outsiders,' I reminded her. â€Å"Tainted.' â€Å"No. You're renegade Strigoi – and queen-killers. It might have all been southern charm and hospitality back there, but those people can be savage. They put a big premium on being able to beat people up. And, considering how scruffy most of them are, you guys are †¦ well †¦ let's just say you two are the hottest things to walk through there in a while.' â€Å"You're not hot?' I asked. â€Å"It's irrelevant,' she said, flustered by the comment. â€Å"Alchemists aren't even on their radar. We don't fight. They think we're weak.' I thought back to the enraptured faces and had to admit that a lot of the people there did have a weathered, worn-out look. Almost. â€Å"Raymond's family was pretty good- looking,' I pointed out. I heard a grunt from Dimitri who no doubt read this as evidence of me flirting with Joshua. â€Å"Yeah,' she said. â€Å"Because they're probably the most important family in town. They eat better, probably don't have to work in the sun as much. That kind of stuff makes a difference.' There was no more talk of flirting as we continued the drive. We made good time to Rubysville, which looked eerily similar to the first town we'd stayed in. When we stopped at what appeared to be the Rubysville's only gas station, Sydney ran inside to ask a few questions. She came back, reporting that there was indeed a cafe of sorts where she could plug in her laptop and try to look up what we needed. She ordered coffee, and we sat there with her, too full from breakfast to order anything substantial. After a couple dirty looks from a waitress who seemed to regard us as loiterers, Dimitri and I decided to take a walk around town. Sydney looked almost as pleased as the waitress about this. I don't think she liked having us hover around. I'd given Sydney a hard time about West Virginia, but I had to admit the scenery was beautiful. Soaring trees, full of summer leaves, surrounded the town like an embrace. Beyond them, mountains loomed, very different from the ones I'd grown up with near St. Vladimir's. These were rolling and green, covered in more trees. Most of the mountains surrounding St. Vladimir's had been stony and jagged, often with snowy peaks. A strange sense of nostalgia came over me, thinking back to Montana. There was a good possibility I'd never see it again. If I spent the rest of my life on the run, St. Vladimir's was the last place I could go. If I was caught, well †¦ then I'd definitely never get to see Montana again. â€Å"Or any place,'I murmured, speaking out loud before I could catch myself. â€Å"Hmm?' asked Dimitri. â€Å"I was just thinking about if the guardians find us. I never realized how much there was I wanted to do and see. Suddenly, that's all at stake, you know?' We moved off to the side of the road as an orange pickup came driving by. Children out of school for the summer screeched and laughed in the back of it. â€Å"Okay, suppose my name isn't cleared and we never find the real murderer. What's the next-best-case scenario? Me: always running, always hiding. That'll be my life. For all I know, I will have to go live with the Keepers.' â€Å"I don't think it'll come to that,' said Dimitri. â€Å"Abe and Sydney would help you find some place safe.' â€Å"Is there a safe place? For real? Adrian said the guardians are increasing their efforts to find us. They've got the Alchemists and probably human authorities looking for us too. No matter where we go, we'll run the risk of being spotted. Then we'll have to move on. It'll be like that forever.' â€Å"You'll be alive,' he pointed out. â€Å"That's what matters. Enjoy what you have, every little detail of wherever you are. Don't focus on where you aren't.' â€Å"Yeah,' I admitted, trying to follow his advice. The sky seemed a little bluer, the birds a little louder. â€Å"I suppose I shouldn't whine over the dream places I won't get to see. I should be grateful I get to see anything at all. And that I'm not living in a cave.' He glanced over at me and smiled, something unreadable in his eyes. â€Å"Where do you want to go?' â€Å"What, right now?' I glanced around, sizing up our options. There was a bait and tackle store, a drugstore, and an ice cream parlor. I had a feeling that last one would be a necessary trip before leaving town. â€Å"No, in the world.' I eyed him warily. â€Å"Sydney's going to be pissed if we take off for Istanbul or something.' This got me full-fledged laughter. â€Å"Not what I had in mind. Come on.' I followed him toward what looked like the bait and tackle store and then noticed a small building tucked behind it. Naturally, his sharp eyes had seen what I missed– probably because I'd been fixated on the ice cream. RUBYSVILLE PUBLIC LIBRARY. â€Å"Whoa, hey,' I said. â€Å"One of the few perks of graduating was avoiding places like this.' â€Å"Its probably air conditioned,' he pointed out. I looked down at my sweat-soaked tank top and noticed a faint pink tinge to my skin. With my tanned complexion, I rarely burned, but this was some serious sun–even so late in the day. â€Å"Lead on,' I told him. The library was mercifully cool, though even smaller than the one at St. Vladimir's. With some uncanny sense (or maybe just a knowledge of the Dewey Decimal System), Dimitri led us over to the travel section–which consisted of about ten books, three of which were about West Virginia. He frowned. â€Å"Not quite what I expected.' He scanned the shelf twice and then pulled out a large, bright-colored one entitled 100 Best Places to Visit in the World. We sat down cross-legged on the floor, and he handed me the book. â€Å"No way, comrade,' I said. â€Å"I know books are a journey of the imagination, but I don't think I'm up for that today.' â€Å"Just take it,' he said. â€Å"Close your eyes, and flip randomly to a page.' It seemed silly, considering everything else going on in our life, but his face said he was serious. Indulging him, I closed my eyes and selected a page in the middle. I opened to it. â€Å"Mitchell, South Dakota?' I exclaimed. Remembering I was in a library, I lowered my voice. â€Å"Out of all the places in the world, that makes the top hundred?' He was smiling again, and I'd forgotten how much I'd missed that. â€Å"Read it.' â€Å"†Located ninety minutes outside of Sioux Falls, Mitchell is home to the Corn Palace.† I looked up at him in disbelief. â€Å"Corn Palace?' He scooted over next to me, leaning close to look at the pictures. â€Å"I figured it'd be made of corn husks,' he noted. The pictures actually showed what looked like a Middle Eastern–or even Russian–style building, with turrets and onion domes. â€Å"Me too.' Reluctantly, I added, â€Å"I'd visit it. I bet they have great T-shirts.' â€Å"And,' he said, a sly look in his eyes, â€Å"I bet no guardians would look for us there.' I made no attempts to conceal my laughter, imagining us living as fugitives in the Corn Palace for the rest of our lives. My amusement brought us a scolding from a librarian, and we quieted as Dimitri took his turn. Sao Paolo, Brazil. Then my turn: Honolulu, Hawaii. Back and forth we passed the book, and before long, we were both lying on the floor, side by side, sharing mixed reactions as we continued our â€Å"global tour of the imagination.' Our arms and legs just barely touched. If anyone had told me forty-eight hours ago that I'd be lying in a library with Dimitri, reading a travel book, I would have said they were crazy. Almost as crazy was the realization that I was doing something perfectly ordinary and casual with him. Since the moment we'd met, our lives had been about secrecy and danger. And really, those were still the dominant themes in our lives. But in those quiet couple of hours, time seemed to stand still. We were at peace. We were friends. â€Å"Florence, Italy,' I read. Pictures of elaborate churches and galleries filled the page. â€Å"Sydney wants to go there. She wanted to study there, actually. If Abe could have managed that, I think she would have served him for life.' â€Å"She's still pretty obedient,' Dimitri remarked. â€Å"I don't know her well, but I'm pretty sure Abe's got something on her.' â€Å"He got her out of Russia, back to the U.S.' He shook his head. â€Å"It's got to be more than that. Alchemists are loyal to their order. They don't like us. She hides it–they're trained to–but every minute with the Keepers is agony. For her to help us and betray her superiors, she owes him for some serious reason.' We both paused a moment, wondering what mysterious arrangement my father had with her. â€Å"Its irrelevant, though. She's helping us, which is what matters †¦ and we should probably get back to her.' I knew he was right but hated to go. I wanted to stay here, in this illusion of tranquility and safety, letting myself believe I might really make it to the Parthenon or even the Corn Palace someday. I handed the book back to him. â€Å"One more.' He picked his random page and opened the book. His smile fell. â€Å"Saint Petersburg.' A weird mix of feelings entangled themselves in my chest. Nostalgia–because the city was beautiful. Sorrow–because my visit had been tainted by the awful task I'd gone there to do. Dimitri stared at the page for a long time, wistfulness on his face. It occurred to me then that, despite his earlier pep talk, he had to be experiencing what I did for Montana: our old, favorite places were lost to us now. I nudged him gently. â€Å"Hey, enjoy where you're at, remember? Not where you can't go.' He reluctantly shut the book and dragged his eyes away from it. â€Å"How'd you get so wise?' he teased. â€Å"I had a good teacher.' We smiled at each other. Something occurred to me. All this time, I'd figured he'd helped break me out because of Lissa's orders. Maybe there was more to it. â€Å"Is that why you escaped with me?' I asked. â€Å"To see what parts of the world you could?' His surprise was brief. â€Å"You don't need me to be wise, Rose. You're doing fine on your own. Yes, that was part of it. Maybe I would have been welcomed back eventually, but there was the risk I wouldn't. After †¦ after being Strigoi †¦' He stumbled over the words a little. â€Å"I gained a new appreciation for life. It took a while. I'm still not there. We're talking about focusing on the present, not the future–but it's my past that haunts me. Faces. Nightmares. But the farther I get from that world of death, the more I want to embrace life. The smell of these books and the perfume you wear. The way the light bends through that window. Even the taste of breakfast with the Keepers.' â€Å"You're a poet now.' â€Å"No, just starting to realize the truth. I respect the law and the way our society runs, but there was no way I could risk losing life in some cell after only just finding it again. I wanted to run too. That's why I helped you. That and–‘ â€Å"What?' I studied him, desperately wishing he wasn't so good at keeping emotions off his face. I knew him well; I understood him. But he could still hide things from me. He sat up, not meeting my eyes. â€Å"It doesn't matter. Let's go back to Sydney and see if she found out anything †¦ although, as much as I hate to say it, I think it's unlikely.' â€Å"I know.' I stood with him, still wondering what else he would have said. â€Å"She probably gave up and started playing Minesweeper.' We headed back toward the cafe, stopping briefly for ice cream. Eating it while we walked proved quite the challenge. The sun was nearing the horizon, painting everything orange and red, but the heat lingered. Enjoy it, Rose, I told myself. The colors. The taste of chocolate. Of course, I'd always loved chocolate. My life didn't need to be on the line for me to enjoy dessert. We reached the cafe and found Sydney bent over her laptop, with a barely eaten Danish and what was probably her fourth cup of coffee. We slid into seats beside her. â€Å"Hows it–hey! You are playing Minesweeper!' I tried to peer closer at her screen, but she turned it from me. â€Å"You're supposed to be finding a connection to Eric's mistress.' â€Å"I already did,' she said simply. Dimitri and I exchanged astonished looks. â€Å"But I don't know how useful it'll be.' â€Å"Anything'll be useful,' I proclaimed. â€Å"What did you find?' â€Å"After trying to track down all those bank records and transactions–and let me tell you, that is not fun at all–I finally found a small piece of info. The bank account we have now is a newer one. It was moved from another bank about five years ago. The old account was still a Jane Doe, but it did have a next-of-kin reference in the event something happened to the account holder.' I could hardly breathe. Financial transactions were lost on me, but we were about to get something solid. â€Å"A real name?' Sydney nodded. â€Å"Sonya Karp.'

Democratic Education in Modern China Essay

Education plays an important role in transforming a society, this follows from its impact on the reasoning of persons, transforming of culture, change of attitude, increased efficiency and also the enhancement of a systematic analysis of some documentations that enable the creation of a new knowledge among other impacts. It enables the transfer of skills from one person to the other and also the sharing of experience that is meant to increase efficiency. Educating society enables the country to develop its human resources. This is enhanced through the imparting of skills that are meant to improve the labour productivity and efficiency in performing varied tasks. Education also impacts communication in a positive manner as the trainees are provided with the skills on how to effectively communicate. Effective communication enables the employees of an organisation to exchange ideas with much easy, hence promoting the sharing of experience that is likely to enhance improved efficiency in some organisation. Education history in China can be traced to have started at the initial stages of the Chinese civilization. It started among the nobles who established educational training for their young ones. The first school that was established in was Shang Hsiang, that was meant to teach the youth and specifically the nobles on some skills as provided by the Chinese culture (Deng, 1). The establishment of Shang Hsiang school can therefore be perceived as the starting point for education in China. Afterwards the government established five national schools that were meant to teach specifically the junior nobles. The national schools thought the six Arts that include rite, mathematics, Calligraphy, Charioteering, Archery and Archery, that formed the six practices of the Chinese culture. Within the same time, hundred schools of thought emerged within the Chinese community having Confucianism as the most popular school of thought. The leader of Confucianism, that is Confucius was perceived as being the originator for the education that was meant to reach the large numbers, that is, educate for the public. Confucius advocated for the provision of education to all the population without discrimination and encouraged the teaching of the students according to their respective ability. The advocating for education for all and according to their ability followed the discrimination that was existing by then in providing educational training because it was only meant for the noble youths, who were the offspring of he nobles. Therefore, this can be perceived as being a setback in the early development of education in China during the Cultural Revolution. The success and the failures of the Cultural Revolution reforms in Education. The success or the failure of the cultural revolution reforms imply the extend to which the educational reforms met the purported purposes as provided by the authority. In the early establishment of schools in China, the process of enhancing education was affected by the political structure, where schools were grouped according to political entities in order to gain favour of social influence. The political structure affected education depending on which school of thought that the leaders of the society regarded as being appropriate as the various schools of thought were in competition. For example, Qin Shi Huang favored for legalism, that is, the Chinese philosophy, and perceived the other schools of thought as being useless (Peterson, 20). Following his attitude, he used to burn books from the other schools of though and buried scholars belonging to the schools of thought that were not preferable according to him. This actions is one of the major setbacks that retarded the development of education in China during the cultural revolution. Confucianism was advocated as the national education doctrine by Emperor Wu of Han. This situation disadvantaged the other schools of thought that never had an upper hand in the Chinese politics, despite their educational content. Otherwise, it was just a matter of the attitude other than the quality of education inherent in different schools of schools of thought. The success of education in China was however boasted by the invention of paper in China. This enabled effective documentation of the educational teachings, and enhanced easy reference and storage. The freedom to access education, that is, the autonomy of education from political influence was enhanced through the defeat of the Chinese empire in the Opium war. This marked the turning point for education standard and access in China. Following the defeat, the modern western education streamed into the country in various languages. It also impacted the various sectors that included the national defence and the technicalities that were used in production. The government also boasted the education by sending numerous students abroad to study varied technical courses. The families also sent their offspring for study in the countries that include the United States of America, Europe and Japan. Towards the end of the 19th Century a number of high learning institutions were established that include the Jiaotong University and also the Peking University. On introducing the western education and deserting the cultural oriented education, the Chinese education system focused in enhancing economic modernisation as the main agenda foe improving the education standard. This direction was provided in 1984 following the designing of laws that were meant to govern the Chinese education system (Hill and Storey, 27). An education plan was also designed in 1985 that was meant to reform the education system. Among the contents on the plan included the five year compulsory education and also the instituting of the State Education Commission. The government devoted funds in the improvement of the education standards and ensuring that more citizens were accessible to education. In China, the policies that have been designed overtime have been alternating between improving the knowledge also the practical application of the knowledge in enhancing national development. This was meant to orient the education system in making it relevant for national development. The government has also been trying to lessen the gaps that exist between the workers and the peasants in terms of literacy. The urban population also seem to be more educated than the rural population, thus the government has also been trying to seal the gap by supplying the rural population with the educational facilities. There has also been an encouragement for the intellectuals to engage in providing manual labour in enhancing national development. Science and technology was offered the first priority in enhancing national development, however social sciences were also perceived as being reinforcing in attaining national development. The vocational training was considered equivalently important. The elite were encouraged to further their capabilities by seeking further training in improving their efficiency and competence. The intellectuals were also encouraged to engage in research that was meant to create new knowledge in integrating it which the knowledge from abroad. The beneficiaries of the criteria that used in selecting students for higher education during the cultural revolution time, where recommendations dependent on political connectivity than merit. The higher education in China can be perceived to have risen following the dynamics in the political policies that have been occurring in the modern China. The need for higher education arose due to the emphasis over professionalisms and the enabling of technical competence. In the early stages of Chinese cultural revolution, a large number of students were enrolled in Red Guard organizations which were the higher learning institutions by then (Williams, 117). In 1970s, according the admission criteria into the Red Guard, one was admitted to the organization only if they were recommended from their work unit and had good political credentials, and on the condition that they were not involved in the manual labour. There were no examinations that were meant to evaluate the ability of the students who were admitted to the University, meaning that there was a possibility for admitting incapable students to the university. Admission into a university heavily depended on political connections of an individual other than merit; therefore one required a political recommendation before joining university. Following the criteria that was used in admitting students into the university, the education standard was reported to had fallen to an extend to which the students were unable to read a book after leaving the university in their respective fields of study. This situation also had an impact of demoralizing the university administrators. The criteria of admission only gave an opportunity to the children of the cadres and the officers who had connections that were to enable them get admission for their children ‘through the back door’. Therefore, following the nature of the criteria that was used to admit students, the students who benefited from the high learning education were the ones who had a political connection that was to enable them secure an admission through the back door. This method of admission disadvantaged the potential students who could have made in better in the university due to lack of political connection. The children of the peasants stood at a disadvantage meaning that the cycle of being politically non-influential was likely to persist, as the politically influential persons were likely to prepare their children to take over after them, hence perpetuating leadership within some families. The Red Guards can be regarded as being naive pawns in an elite struggle other than being rational actors that were to protect their self interests. The criteria that was adapted by the Red Guards in admitting the students into the university portray the Red Guard as being naive pawns in an elite power struggle than rational actors protecting their self interest. This is evident in the situation where the red Guards only engaged in admitting students into the university without any evaluation on whether they have the ability to pursue various courses of their preference. As mentioned early, the graduates never even had the ability to read a book even after graduating from the university. The criteria locked out the children who belonged to his peasant families regardless of their ability to excel in academics. This situation enabled the politically connected persons to reign with fewer competitions from the other members of the society, regardless of their weaknesses because the criteria provided them with a protection against. The aim for the high education was to enable high performance among the students when they are in practice, implying that the admitting of students who do not qualify into the university following their political connections is anti development (Smith and Buckle, 231) The admitting of students who do not qualify for admission will contribute less to national development because the education attained while in the university will have less impact in improving their performance. The red guards were trying to ensure that competition is restrained because of the posts that were to enable them maintain their social classes were likely to be taken by the new elites that were likely to emerge among the peasants, thus it was a strategy over which the peasants were denied the opportunity to compete favorably with the politically connected persons. The dominance was only to be reinforced by restricting the new forces that were likely to emerge from the peasants is they accessed higher education. The Red guards can be regarded as being protecting their interests, but the protecting of their interests was irrational. They can be perceived as being irrational actors following the fact that the criteria was undermining national development, because the graduates were likely to fail meeting the responsibilities entrusted to them with regard to the academic tittles awarded to them. The aim for higher education was to enhance national development, therefore the act of offering education to persons who were certain to contribute less to national development seem to be an irrational act as the purported reasons for offering higher education were never attained. This implies the wasting of resources by the state in educating students whose marginal productivity in contributing to the national development was below the optimal requirements, thus a bogus investment. Thus, making the whole process an irrational. A comparison and contrast between the cultural revolution reforms in education and the educational reforms the were introduced after 1978. Following the failures of the cultural revolution reforms in education in attaining accelerated national development, there arose various reforms after 1978 that were meant to enhance effectiveness in the education system in enabling national development. For instant, during the 1980’s, there were a number of reforms that occurred following the modernization goals that were set by the government. The higher education was regarded as being the foundation for research and training that was meant to enhance national development on doing the application of the knowledge that is created (Jinxia, 219). This is different from the times of cultural revolution where higher education was used for the purpose of prestige and not for enhancing national development. There were also reforms in the management of the higher learning institutions that gave a new focus in terms of the offering opportunity to the students and the content of the courses offered. Following the reforms, the universities were provided with the opportunity of choosing their own curriculum and participation in the various projects. They were also grated an autonomy to hire their staff and manage the funds awarded to them by the government. The university admission criteria also changed, where only the academically able students were to be considered. In making a comparison between the cultural revolution reforms and the reforms after 1978, the reforms during the cultural revolutions were meant to perpetuate education only within the a few individuals in the society in enhancing the reigning of the a few over the majority, therefore, education was used as a strategy to rule. Education was denied to the peasants because offering them education was perceived as being ‘sharpening an iron for oneself’, therefore the reforms in the education system were meant to limit the access to education to a few individuals, that is, the persons who were politically connected. This is contrary to the policy reforms that were enhanced after 1978. After 1978, access to education was made easy, where higher education was meant for the students who were capable (Sakai, 67). That is, everything was done on merit, with less political influence through the enhanced university autonomy. The reforms were guided by the modern development goals that were set, which were supposed to enhance national development through the investing in education. National development was to be enabled through research and development that was to be based on the higher learning institutions. In enabling breakthroughs, the universities were then provided with an incentive of evaluating students before being admitted on ensuring that the education that was offered was to be effective in enhancing national development. The objective of the educational reforms during the cultural revolution was to maintain the societal status held by some families, that is, education was meant only for the nobles. After 1978, the objective of enhancing educational reforms changed from self interest to the realizing of national development through the building of human resources of the country. The results of educational reforms during the cultural revolution is the lagged technological development that was reflected in the retarded national development and also the existence of inequalities within the Chinese community following the nature of reforms that favoured some classes in society at the expense of the rest of the society. The country was also experiencing low labour productivity following the fact that the non-qualified personnels were given the opportunity to lead various institutions or perform some tasks that were entrusted to them. The results for the reforms after 1978 were positively rewarding in enhancing national development (Lu-chai, 93). The country was able to utilize the talents that were inherent in its population non-selectively through the admission to higher learning institutions based on merit. It increased equality in society as all the population later had equal access to education once one’s ability is evident. The country also realized improved labour productivity because the skills attained in higher learning institutions were likely to be applicable in practice following the nature of students admitted to the university. The impact of the dismantling the commune system in China and the return of family farming on the provision and demand for the basic education among the Chinese rural area Education in China was received as the means in which an individual can improve his or her welfare, and this is enhanced through the offering of services using the skills attained through education for compensation. Therefore, education was perceived as being an investment that was meant improve one’s welfare (Price, 311). The commune system in China can be perceived as a factor that contributed to persons in society not to work hard, because they were likely to get an equal share to the ones who did not work. Therefore, people, and more especially the ones who were living in the rural areas and who depended on farming did not see the need for seeking education as all their requirements were met communally. The dismantling of the commune system by the adaptation of the return to family farming affected the perception of persons in the Chinese society and more especially persons staying in the rural areas who heavily depended on farming. The implication of the dismantling is that each family was expected to struggle in satisfying its needs. Following the high population of the the Chinese people, the population never had a reasonable land to do farming on sustaining the population, therefore, the population turned to seeking education as a means of gaining skills that will enable then to earn a living. Therefore, the dismantling of the communism system to family farming can be perceived to have triggered the demand for basic education following the need to attain skills in enhancing an improved welfare. The family setups took the responsibility of ensuring that their children were educated in enhancing an improved welfare of both the family and for their children, thus is was perceived as being a gateway to success. The reasons as to why vocational training was popular during the reform period compared to the Maoist era. There were emphasis during the times of 1949-76 concerning the significance of vocational training in applying education to meet production requirements. The vocational education became popular after the 1978 reforms (Peake, 32). The logic behind vocational training popularity after the 1978 reforms is that during the times, that is, before 1978, the vocational training was perceived as being an inferior education to be offered to the peasant children, thus making it unpopular. During the reform period, vocational training became popular following the agenda for attaining modernization in China, therefore children were encouraged to join vocational training that was meant to equip the population with the skills that were supposed to delver the country into the desired modernization. The popularity of vocational training can also be attributed to the the dismantling of communism system in 1982 that lead to the family based farming. The dismantling of communism provided an incentive over which society members saw the need to acquire the skills that were expected to earn them a living hence an avenue over which vocational training attained popularity. The requirements for getting a university admission were based on merit during the times of the reforms, thus there was a large number of persons who were not likely to attain an entry into the university education. Therefore, as an alternative for attaining skills, the population opted for vocational training that had less requirements for training. The number of vocational training institutions were also many compared to the universities, therefore due to resource scarcity a large number of persons were likely to get vocational training than university education. Despite the large number of vocational training institutions, the institutions were also accessible even to the persons leaving in the rural areas, on the reason that the population is likely to utilize the reasons that are easily accessible than the ones that are far reaching. Work Cited Deng Peng. Private Education in Modern China. Greenwood Publishing Group. 1997. Hill, p. and Storey Colin. Facing Up to China: A Series of Essays from the Making of Modern. Brtistol Polytechnic Library. 1987. Lu-chai Chung. A History of Democratic Education in Modern China. University Publications of America. 1977. Jinxia Dong and Dong Jinxia. Women, Sports, and Society in Modern China: Holding Up More Than Half the Sky. F Cass. 2003. Peake Henderson. Nationalism and Education in Modern China. University of California. 2007. Peterson Glen. The Power of Words: literacy and Revolution in South China, 1949-95. UBC Press. 1998. Price, R. Education in Modern China. Routledge. 2004. Sakai Robert. Politics and Education in Modern China. Harvard University. 1953. Smith Douglas and Bucklew Neil. Middle Education in the Middle Kingdom: The Chinese Junior High School in Modern Taiwan. Praeger. 1997. Williams Michael and Humprys Graham. Citizenship Education and Lifelong Learning: Power and place. Nova Publishers. 2003.

Answer questions Coursework Example | Topics and Well Written Essays - 250 words

Answer questions - Coursework Example There are a number of bones that were analyzed so as to determine the cause of death and possible identity of the victim. The bones are as follows: (A)Chimpanzees do exhibit a social behavior in the sense that they interact in a group setting whereby there are certain activities conducted by different members, this in the long run tend to benefit the whole group. (B)Working in a group setting has an effect on all members as it is mutually beneficial, it lays upon each member a task to perform this can be seen during grooming. (C)The reason for the chimpanzee behaving in this manner is that it makes their lives easier through working as a community to achieve a set goal. (B) The environment in which the animals live in and get there food from forced them into establishing or use of the grip or hands when it comes to picking food, climbing trees, grooming or their involvement in any activities that require the use of

Philosophy Assignment Example | Topics and Well Written Essays - 1000 words

Philosophy - Assignment Example He gets emotional because his son thinks he is a good dad but the society in general doesn’t believe that homosexuals can be good parents. Shaw tries to cheer up the mood. Brady reveals that his marriage is a fraud but he will continue to play along because it is the right thing to do. His wife is expecting another baby. Their conversation ends on a dilemma that if Brady reveals his sexual orientation he might lose his family but if he doesn’t he will abandon a part of himself. The conversation ends and they both depart. The essay is written in the narrative rhetoric, filled with dialogues and history about the characters. Giving insight to an adult homosexual male probably could not have been done with other rhetorical modes. It is more emotional than critical or argument-driven. As the famous philosopher says that one needs three things to convince someone; credibility, logic and emotional appeal. In this case the emotional appeal dominates the rest. It creates empathy in the readers for Brady. Shaw has not touched the philosophical debate on homosexuality as either right or wrong. She has only given an insight to the life a homosexual man who apparently has a wonderful family but his homosexual nature is restless. There are many instances where Shaw gives the narrative. For instance she brings in the comparison between Brady and David. David is mentioned to strengthen the narrative that he is a confident gay male while Brady is shy. Shaw calls him â€Å"very gay† (paragraph 8). Just like a fictional story, the use of dialogues to describe personality has been used extensively. For instance Brady’s own words are quoted to describe what sort of a person he is. On not telling his wife about his homosexuality he says; Had Shaw used any other mode like exposition, argumentation or description it would have either created a debate or it would have lacked the emotional appeal.

To what extent have Standard Charges improved the practice of planning Literature review

To what extent have Standard Charges improved the practice of planning obligations in the United Kingdom - Literature review Example The most common form of Standard Charge in relation to planning is the, so called, ‘roof-tax’, which is a tariff imposed ‘on development’ (Syms 2010, p.206). Despite the initial concerns regarding the role and the value of Standard Charges, it has been proved that the specific measure could help towards the improvement of planning obligations in Britain. The ways in which the above target is achieved are analytically explained in this paper; reference is made to the potential differentiation of Standard Charges from other, similar, approaches of planning obligations practice, such as the negotiated approach. 2. Critical review of planning obligations practice The framework of the planning obligations practice in Britain has been extensively examined in the literature; the contribution of these obligations in community development has been considered as one of the most important causes of this phenomenon. However, the emphasis on the planning obligations prac tice has been also related to various political interests, as analytically explained below. ... In accordance with Ratcliffe et al (2009) in their initial form, planning obligations were considered as ‘land-use/ amenity – related gains and social/ economic – related gains (Debenham et al. 1988 in Ratcliffe et al. 2009, p. 16). Another characteristic of planning obligations system in Britain is that the specific system is based ‘upon negotiation and bargaining’ (Ratcliffe et al 2009, p.16). It is assumed that planning obligations system is not fully standardized, but it can be rather transformed and customized in accordance with the needs of each particular case. In this context, flexibility is an additional characteristic of planning obligations system; it is this characteristic, which can result to problems for the effective operation of the specific system, a gap that is covered through Standard Charges, as they are analytically explained below. The planning obligations practice in Britain has to address a series of issues, the most important of which is the demand for increase of development across the country. In a report published by the House of Commons in 2006 reference is made to the need for urban development in the greater London area (House of Commons, 2006, p.198); furthermore, it is explained that the planning obligations practice could help the efforts of the London borough – and the Councils of the surrounding boroughs also – to support land development across London so that the housing needs of the local population to be covered. In the above context, it is made clear that the planning obligations system in London ‘should ensure that increases in value are captured and used to support infrastructure investment to maximize capacity and sustainability’ (House of Commons 2006, p.198).

Concepts in mental Health Consensus and Controversies Essay

Concepts in mental Health Consensus and Controversies - Essay Example A good understanding of such concept is essentially relevant with mental health care. Origin and Historical Significance of Mental Health Concept The concept of mental health has a polymeric nature, and inaccurate and general borders, which gains from a historical view to be better understood. At present the broadly understood concept of mental health has its origins chased back to advances in public health in different branches of knowledge such as clinical psychopathology and psychological medicine. The origin of the mental hygiene movement can be assigned to the piece of work of Clifford Beers in the United States. A book namely A mind that found itself was published in 1908, which was based on the authors personal experience of admittances to three mental institutions and asylums. Through its origins and in reflecting Beers’ experience in mental hospitals, the mental hygiene movement was chiefly and essentially referred to the betterment of the care of people with mental f olies. In the year 1909 when Beers wrote the book, a Mental Hygiene Society was instituted in Connecticut. Adolf Meyer suggested the term â€Å"mental hygiene† to Beers (Schneck, 1975). This had got tremendous and quick popularity to the initiation of the National Commission of Mental Hygiene. The Beers (1937) states: â€Å"When the National Committee was organized, in 1909, its chief concern was to humanize the care of the insane: to eradicate the abuses, brutalities and neglect from which the mentally sick have traditionally suffered.† The globalization of activities of this Commission led to the administration of some national associations related to mental hygiene in different countries from 1919 onwards. The International... This essay discusses that in a general sense, mental health has established to be a crucial component of the definition of health and also continues to be used both to indicate a state as an attribute of health. It refers to denote to the crusade deduced from the mental hygiene movement, representing the practical application of psychiatry and psychological medicine not only on an individual basis but also to groups such as societies and communities, as is the case with clinical psychiatry. Mental health is, rather unluckily, even so, considered by many as a field of study, either as an equivalent of psychiatry and psychological medicine or any other complementary fields of psychiatry. Above discussed elements can be served as evidence of the importance of mental health cognition as not only a field of study. For psychiatric nurses, the knowledge of mental health and mental illness concepts is particularly important in a way that they are part of the diagnosing of mental disorders an d treatment of mental health patients in outpatient community clinics or inpatient care hospitals. For such a reason, mental health nursing requires specified and specialized training isolated from other segments of care in the field of nursing. Instituting standard concepts of care in mental health nursing ameliorates inter-communication among faculty and the quality of intervention and handling of mental health patients. Dealing with mental health patients interests will better the overall wellness and performance of the patient.

Ecologies and Environments United States Essay Example | Topics and Well Written Essays - 1250 words

Ecologies and Environments United States - Essay Example According to ecologists’ studies, the Rocky Mountains, despite having a snow cover, do have diverse biotic zones that start from tops and extend to the lowlands and plains (U.S. Census Bureau, 2012). The biotic zones usually serve as essential habitats for numerous animals and plants, for instance, Tundra in Rocky Mountains of Colorado. The wildlife available in the Rocky Mountains encompasses elk, mule, pronghorns, black bears, coyotes and grizzly bears. In addition, owing to the fact the U.S. seashores at both the Atlantic and Pacific oceans, the near states usually experience varying climate patterns compared to those of the interior regions (EPA, 2012). In addition, U.S like other industrial states has also experienced the increased predicament of obnoxious gas emissions from its chemical industries. However, as compared to the previous years the emissions have decreased because of the awareness the environmental authorities have created among the citizens to deal with the problem of global warming. For instance, the carbon monoxide emissions dropped from 114,465 in 2000 to 77,685 in 2008 despite minor fluctuations witnessed in between the years (U.S. Census Bureau, 2012). The forest cover occupies approximately one third of the total U.S.’ land; it provides habitats for numerous wild animals, not to mention other organisms. Forests have also benefited the society through the provision of clean water, reaction sites (camping and touring) and absorbing excess CO2, especially that generated by different industries (Rahm, 2010). Presently, the U.S. is experiencing habitat range rifts where numerous species are relocating to the Northern colder latitudes, for example, boreal forests, which are almost replacing Tundra vegetation. (Christiansen, Markstrom & Hay, 2011). This has led to negative impacts on numerous species’ habitats and wildlife that rely solely on Tundra ecosystem like snowy owl, for example. The reason can be found in the fact that temperatures are constantly increasing, especially in the central regions, which have yielded to the extinction of some animal species like American Pika etc (U.S. Census Bureau, 2012). List the specific factors that distinguish your local ecology and environment. 1. Range shifts - species are relocating to the Northern colder regions due to global warming and unpredictable climatic conditions. 2. Food web interruption due to the increasing rate of range shifts. 3. Precipitation, which has led to the increasing of the oceans’ water levels. 4. Forest cover, though it occupies the third of the U.S total land. 5. Rocky Mountains characterized by diverse biotic zones. Discuss how human activities have affected your local ecosystems Mining in US has become a serious threat to both the ecosystem and human life despite diverse state’s environmental agencies implementing strict rules and regulations to control it (Withington, 2012). The main threat lies in the release of obnoxious gases straight into the atmosphere and discharging of heavy metals into the water masses, which affects aquatic life (UGCRP, 2009). These heavy metals include cyanide, lead and mercury, which not only affect aquatic

Entry into Chinese Market Case Study Example | Topics and Well Written Essays - 1250 words

Entry into Chinese Market - Case Study Example When they decide to enter newer countries, firms have to analyze both the opportunities as well as challenges, so that those challenges can be effectively managed. The first aspect they will have to analyze is the entry mode, so they can pick the best entry mode which has minimal risks, and this applicable to retail firms as well. In addition, they have to focus on the economic and legal aspects that could aid as well as impede them. China is one country, which has optimal opportunities for all firms including the retail firms like the fictional firm of Pesco. This paper will discuss the advantages as well as the disadvantages of entering China by the firm Pesco, focusing on the feasible entry modes, and how Pesco can or have to manage the economic and legal aspects. With the onset of globalization and the opening of the Chinese markets in 1990s, foreign firms particularly retail firms are more than eager to enter to tap the large prospective customer base. China being a country whic h runs on Communist principles, for most part of the 20th century, China raised an â€Å"Iron Curtain† and restricted the foreign firms’ entry, thereby protecting the indigenous firms. However, with globalization providing more opportunities to firms, and with its entry into WTO, Chinese government started to allow foreign firms into its territory. â€Å"Indeed, if we can identify a single moment when the  ­Western- ­dominated Globalization 2.0 gave way to Globalization 3.0, it may have been when China acceded to WTO membership on December 11, 2001† (Walker, n. d). Due to these developments, China particularly started lessening its trade restrictions particularly in the retail sector. The foreign firms for their part are enticed by the huge population of China and how they can be tapped as a huge customer base. â€Å"Most of the world’s major global retail firms are desperate to grab a slice of the world’s largest and most rapidly growing emer ging market† (Gamble, 2006). In addition, the sizable sections of this population have high purchasing power. As the Chinese economy as a whole, is improving optimally, it has resulted in the accentuation of its citizens’ purchasing power, and for the retail firms including Pesco, this can be huge advantage. Because of this favorable business environment in China, Pesco can open its retail outlets. When it comes to the entry mode, Pesco can enter in the form of wholly owned subsidiaries. This entry mode can provide many advantages for Pesco, including in the economic and legal sphere. However, there are risks as well, when this mode is adopted. The first advantage Pesco can garner if it uses the wholly owned subsidiary option and not the joint venture option is the benefits from the new tax regime. The main feature of this new tax regime is that foreign firms as well as foreign firms having joint ventures with Chinese entities have to pay land-use taxes, which is equal and even more than the indigenous Chinese companies and foreign firms’ subsidiaries. That is, in under the earlier favorable tax regimes, the foreign firms including joint ventures were given exemptions from the land-use tax, and were also given permission to construct infrastructures on non-taxed lands and function in them. However, in the new tax structure, foreign firms’ tax payments have been even tripled from the old rate. That is, â€Å"in large cities the annual property tax rate will range from 1.5

Music Essay Example | Topics and Well Written Essays - 2000 words - 2

Music - Essay Example dentify his place in the society and makes him realize what role he is actually playing or being a part of the society what role the society expects him to play. However, such perception or gaining of experience is always not very positive, as, a human being, due to various socio-cultural turmoil as well as personal level hostility, perceives the society and its inhabitants essentially hostile. Due to development of such conception he also assumes that the basic requirements to live as a Human Being are not been provided to him by the social institution. Consequently, he rebels against all those systems as well as attempts to assert himself as a separate identity that is engaged in an eternal quest to gain his rights and rightful place in the socio-cultural backdrop. In the eyes of the society he becomes, thus, an outlaw, a misfit but deep inside his heart he believes that what he is doing is right because he is fighting not only for his place in the society as an individual but his rebellion is actually voicing position of several other people who also are engaged in the same quest to recover their rightful place in the society. Judging this position, such a person can be equaled with the character of Satan in Paradise Lost (Book I) where Satan wages immortal battle against God, who becomes representative of the social institutions, restraining basic rights and freedom of the common people. Such essence of hope for a better future, fused with the spirit of rebellion can best be perceived in music. Whenever it has come to social dynamism, radical change into the existing socio-cultural structure, and change into the cultural perspective of the existing social form, music has always voiced the reflection of common people, their perception about society and the spirit to rebel that would finally help in constructing and deconstructing the thought pattern for a better future. Such phenomenon is true in case of every society, if we make an evaluation of music from

HIV (Human Immunodeficiency Virus) Essay Example for Free

HIV (Human Immunodeficiency Virus) Essay HIV (Human Immunodeficiency Virus) causes AIDS (Acquired Immune Deficiency Syndrome) that disables the immune system.  It was discovered in 1983 .HIV enters the body through the bloodstream and duplicates itself rapidly.  The victim is susceptible to infectious diseases that eventually are fatal (1). Statistically, HIV/AIDS is the number one killer of African-American women ages 25 to 34, according to the Centers for Disease Control and Prevention.  Between 2000 and 2003, they were nineteen times more likely than White females and five times more likely than Hispanic females to contract the disease.   African-American men were seven times more likely than White men and three times the rate of Hispanic men to contract HIV/AIDS (2). In 2008, there is still not a cure for AIDS.  Instead, scientists have discovered drugs that can slow down the progression of the disease. Protease inhibitors (PIs) are antiviral drugs that slow down the spread of HIV (1). The virus produces a protein called protease so that it can replicate itself.  Ã¢â‚¬Å"Protease cuts long chains of proteins and enzymes into shorter chains, the first step in the process by which HIV infects a cell† (1).  If this doesn’t happen, replication does not continue. In 1987, AZT was the first anti-HIV medication that was created.   It showed hope and kept people healthier longer.   However, the side effects were very high for men.   Since that time, more HIV medications have evolved.   Antiretroviral therapy usually consists of combinations of nucleoside/nucleotide reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors, protease inhibitors, or fusion inhibitors, which are prescribed in the later stages of HIV (19). Dual protease inhibitor therapy is also being used clinically (3).  They are also associated with improving morbidity and mortality of HIV-positive persons (5).  Although these drugs are expensive, they have proven to be the most successful therapy in managing HIV.   However, some patients don’t comply 100% with their treatments.   This is largely due to the side effects. Sometimes they make a patient feel worse than the actual disease. The most commonly reported ones are abdominal pain, abnormal bowel movements, diarrhea, fatigue, headache, and nausea.   Children usually develop a skin rash. The more serious side effects are liver problems and pancreatitis.   Some patients have also seen large increase in triglyceride ad cholesterol levels.   Diabetics saw an increase in their blood sugar levels.   Other patients developed diabetes while taking protease inhibitors (16). Presently, nine PIs have been approved for use in the United States and Europe:   amprenavir, atazanavir, fosamprenavir, lopinavir, indinavir, ritonavir, saquinavir, tipranavir, and nelfinavir. Three non-nucleoside reverse transcriptase inhibitors (NNRTIs) are used for treatment of HIV:  nevirapine, delavirdine, and efavirenz (7). Drug treatment selection depends on factors such as drug resistance, tolerability, drug interactions, and effectiveness. Therapeutic drug monitoring (TDM) â€Å"has been proposed so that practitioners may better maintain appropriate plasma concentrations of drugs in their patients by identifying interactions with other medications and assessing medication adherence   (7). Figure 1 shows the structures of these compounds. Fig. 1. Chemical structures of protease inhibitors and non-nucleoside reverse transcriptase inhibitors. About 50% of â€Å"treatment-naà ¯ve patients† don’t have continued antiviral response after one year of therapy (18). In some cases, there is a development of drug resistance and metabolic complications.   Also, â€Å"there is increasing evidence that virological treatment failure is correlated with variations in the pharmacokinetic parameters of drugs (20).   This can be due to drug interactions, low bioavailability, and variations in metabolic enzyme activity.   Atazanavir (ATV) has good oral bioavailability and a favorable pharmacokinetics profile (18).   With this in mind, patients can mostly take a once-daily dose. A separate analytical method has been recently published for quantifying ATV in human plasma using solid phase extraction and HPLC with PDA (photodiode array) detection at 201 nm (18).   This method provides excellent separation of ATV from its internal standard, clozapine (CLZ) and the other PIs, thus, obtaining an accurate measurement of the drug (see figure 2). CLZ elutes at 8.9 minutes, and ATV elutes a 24.4 minutes. A 40-ml injection resulted in a recovery yield of 100%. Fig. 2.   Chromatogram of ATV with PIs/NNRTIs (8000 ng/ml) spiked with CLZ Nelfinavir mesylate has been shown in phase III controlled clinical trials to significantly reduce viral load and increase CD4+ cell counts when used with reverse transcriptase inhibitors. It’s prescribed as part of triple drug combination therapy (9). CD4+ are helper T cells.   They are important for immune reconstitution in patients that are receiving antiretroviral therapy (10).   After a large number of these cells are destroyed, AIDS develops (7). Six clinical trials was conducted in the past ten years using 2, 148 HIV-infected children enrolled in the Pediatric AIDS Clinical Trials Group treatment trials (10).   Patient ages varied from 2 to 7 years of age.   The focus was to observe short-term variability of CD4 percentages.   The study found that 49% of patients had CD4 percentages above 25%.   32% of patients had CD4 counts between 15% and 24%; 19% were less than 15%.   Finally, 5.4% had a CD4% of less than 5% (10). In June 2006, Darunavir (DRV) was licensed in the United States.   It is a promising PI that is active against HIV strains that are resistant to the other PIs that currently on the market (17).   It is prescribed in 600-mg doses that are taken twice daily with 100 mg of ritonavir that acts as a booster. Protease inhibitors are associated with unfavorable pharmacokinetics and many side effects such as gastrointestinal disturbances and lipid abnormalities (5).  Four of the most common PIs used are indinavir, ritonavir, saquinavir, and nelfinavir (3).  Ã¢â‚¬Å"Monitoring blood concentration of PIs, which can indicate both therapeutic and toxic levels of the drugs as well as patient noncompliance with the medication, may improve the care of both HIV-infected adults and children† (3). When ritonavir was first introduced, it was given in doses of 600 mg every 12 hours. â€Å"However, patient intolerance of full doses led to its primary use as a pharmacologic enhancer to increase the concentrations in plasma of a second protease inhibitor to improve the convenience of antiretroviral regimens by extending the dosing interval, reducing pill burden, and /or eliminating food-induced reductions in pharmacokinetic exposure† (8).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Researchers used High Performance Liquid Chromatography (HPLC) to determine concentrations of PIs in blood.  Various methods have been used to study the pharmacokinetics and drug interactions. Interpreting plasma levels can be used to â€Å"individualize drug dosage of antiretrovirals (4). Quality control (QC) procedures must be done to ensure that these methods are accurate and precise.  Ã¢â‚¬Å"Such procedures usually include intralaboratory (internal) method validation, intralaboratory QC procedures, and participation in an interlaboratory QC program for antiretroviral drugs† (4). Since the latter hadn’t been done before, it was established so that laboratories can obtain better measurement results of antiretroviral drugs. Nine laboratories participated in the first part of the program.  The first part of the experiment involved the measurement of the protease inhibitors:  indinavir, nelfinavir, ritonavir, and saquinavir.  All had a specified purity of 99% or higher.  QC samples were prepared by spiking blank plasma from HIV-negative volunteers with PI standard. The low concentrated standards ranged from 0.087 to 0.15 mg/L while the intermediate concentrated standards contained ranged from 2 to 3 mg/L of all four PIs.  Finally, the high-concentrated standards contained approximately 5 to 11 mg/L of drug.  All drugs were dissolved in methanol following accurate weighings and diluted with blank plasma (4). High Performance Liquid Chromatography (HPLC) was used to analyze twelve samples.  All laboratories measuring more than one protease inhibitor used as assay for â€Å"simultaneous determination† (4).  Six laboratories used HPLC/UV and three labs used HPLC-MS/MS. Mass spectrometry detection is often recommended for measurement of low concentration levels.  Also, this type of analysis is usually faster and â€Å"does not require complete resolution of drugs for detection and quantification† (5).  Only five laboratories were able to measure all four PIs.  Three laboratories were not able to determine nelfinavir.  One laboratory only measured indinavir (4). Acceptable accuracy results are between 80% and 120%.  Only indinavir resulted in an acceptable accuracy of 80%.  The remaining PIs had between 36% and 74% accuracy.  These results should encourage laboratories to improve their analytical methods and QC procedures.  Other PIs, such as amprenavir and lopinavir, can be analyzed as well (4). HIV-positive plasma samples are heat inactivated before analysis, approximately 58 °C for 40 minutes, to decrease the risk of infection to the operator.  They may also go through a freeze/thaw cycle. As with the QC study, blank plasma was spiked with seven PIs (indinavir, amprenavir, atazanavir, ritonavir, saquinavir, lopinavir, and nelfnavir) at low, intermediate, and high concentrations measured in ng/ml.  Certain assays only require 100  µl of plasma for analysis.  Ã¢â‚¬Å"This is advantageous when measuring PI concentrations as part of clinical studies as they often necessitate hourly sampling to generate complete PK profiles; therefore less blood can be drawn from the patient† (5).  In addition, seven PIs can be quantified in one assay, but impossible to assay all seven in a single preparation. â€Å"The use of liquid chromatography coupled to tandem mass spectrometry (LC-MS-MS) has emerged as the developmental method of choice supporting clinical and pre-clinical pharmacokinetic studies† (13). Recovery for the HPLC-MS/MS methods was above 87% for all seven drugs at all three concentration levels (5).  It was successful in quantifying seven PI concentrations in plasma of HIV positive persons that participated in a run time of nine minutes.  Therefore, the assay may be used for determining PI concentrations in semen, lymphocytes, and cerebrospinal fluid (5). A fast and highly-sensitive LC-MS-MS method was developed that could analyze five protease inhibitors (amprenavir, indinavir, nelfinavir, ritonavir, and saquinavir) in one run using an internal standard.   Sample sizes were small (ng/ml) and run times were approximately 5 minutes.   Recoveries for all five PIs were between 87% and 92%(11). Tipranavir is part of a class of non-peptidic PIs that works against both â€Å"wild-type virus and variants resistant to current PIs†(6).  It also has a high genetic barrier.  Tipranavir is prescribed in a 500-mg dose taken in combination with 200 mg of ritonavir twice daily as part of antiretroviral therapy for patients with HIV-1 strains that are resistant to multiple PIs (6). Fig. 3. Tipranavir chemical structure   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  An HPLC-UV method has been validated and is currently applied when monitoring tipranavir (TPV) plasma levels in HIV patients.  Samples were prepared for solid phase extraction (SPE) by conditioning the cartridges with 0.1% phosphoric acid, pH 7.  TPV stock solutions with a concentration of 5 mg/ml were diluted from with 50% methanol. Samples were spiked with TPV at 1.875, 7.5, 18.75, 37.5, 60, and 75  µg/ml in triplicate. QC samples were diluted with blank plasma and phosphate buffer to 5.625, 22.5, and 67.5  µg/ml.  Clozapine was used as the internal standard (6).  5-ml aliquots of blood samples were obtained from HIV infected patients.  The plasma obtained from centrifugation was heated at 60 ° C for one hour in a water bath. TPV in plasma was measured at a UV absorbance of 201 nm with a retention time of 32.2 minutes. Its internal standard, clozapine (CLZ) has a retention time of 8.3 minutes (6). Figure 4 below shows the chromatogram of TPV, its internal standard, and all other PIs and NNRTIs  present.   Figure 5 shows TPV and its internal standard CLZ only. Fig. 4. Chromatogram of plasma control sample of TVP (22.5 mg/ml) spiked with internal standard and all PIs and NNRTIs. Fig. 5. Chromatogram of calibration sample of TVP (37.5 mg/ml) spiked with internal standard CLZ. Isocratic HPLC methods combined with the use of UV and fluorescence detection produces more sensitivity. Amprenavir is a fluorescent compound.   Its internal standard PR25 can also be seen under fluorescence (see figure 6). Fig. 6.   Blank plasma with 100 ng/ml amprenavir and 1000 ng/ml of PR25 seen under fluorescence. In conclusion, much progress has been made in the development of protease inhibitors and other antiretroviral therapy. HPLC with UV detection has been the most commonly used method of analysis.   It is rapid, simple, and highly sensitive.   LC-MS-MS has been noted at the developmental method of choice for clinical and pre-clinical pharmacokinetic studies (13).   More compounds can be analyzed in less time.   Also, they can be used for methods using other human biological matrices. For the majority of protease inhibitors, all side effects are not known. In 2007, darunavir was the new HIV protease inhibitor with eleven other antiretroviral agents on the market.   They can affect patients that have diabetes, liver problems, and hemophilia; their conditions can worsen as a result of taking PIs. Only a patient’s health care provider can determine the best treatment option REFERENCES Nagel, Rob. 2007. Protease Inhibitors. UXL Encyclopedia of Science; [cited 2008 May 8], Available from http://galenet.galegroup.com/servlet/SciRC?ste=1docnum=cv2644301082. Health Hotline:   HIV and Genital Herpes [cited 2008 May8]; Available from http://www.ebony.com. â€Å"HPLC Assay for Common Protease Inhibitors Developed.†Antiviral Weekly; [cited 2008 May 07; Available from http://galenet.galegroup.com/servlet/SciRC?ste=1docNum=A60069570. Aarnoutse, Rob E., Verweij-van Wissen, Corrien P.W.G.M., van Ewijk-Beneken Kolmer, Eleonora, W.J., Wuis, Eveline, W., Koopmans, Peter P., Hekster, Yechiel A., and Burger, David, M. 2001. International Interlaboratory Quality Control Program for Measurement of Antiretroviral Drugs in Plasma; Antimicrobial Agents and Chemo 46(3): 884-886. Dickinson, Laura, Robinson, Lesley, Tjia, John, Khoo, and Saye, Back, David. 2005. Simultaneous determination of HIV protease inhibitors amprenavir, atazanavir, indinavir, lopinavir, nelfinavir, ritonavir and saquinavir in human plasma by high-performance liquid chromatography-tandem mass spectrometry; J of Chrom. B 829:82-90. Colombo, S., Beguin, A., Marzolini, C., Telenti, A., Biollaz, J., and Decosterd, L.A. 2006.   Determination of the novel non-peptidic HIV-protease inhibitor tipranavir by HPLC-UV after solid-phase extraction; J of Chrom. B 832:138-143. Rezk, Naser L., Tidwell, Richard R., and Kashuba, Angela D.M. 2004.   High-performance liquid chromatography assay for the quantification of HIV protease inhibitors and non-nucleoside reverse transcriptase inhibitors in human plasma; J of Chrom. B 805:241-247. Shelton, Mark J.,Hewitt, Ross G., Adams, John, Dela-Coletta, Andrew, Cox, Steven, and Morse, Gene D. 2003. Pharmacokinetics of Ritonavir and Delavirdine in Human Immunodeficiency Virus-Infected Patients; Antimicrobial Agents and Chemo 47(5): 1694-1699. Zhang, Kanyin E., Wu, Ellen, Patick, Amy K., Kerr, Bradley, Zorbas, Mark, Lankford, Angela, Kobayashi, Takuo, Maeda, Yuki, Shetty, Bhasker, and Webber, Stephanie. 2001.Circulating Metabolites of the Human Immunodeficiency Virus protease Inhibitor Nelfinavir in Humans:   Structural Identification, Levels in Plasma, and Antiviral Activities; Antimicrobial Agents and Chemo 45(4): 1086-1093. Carey, Vincent J., Pahwa, Savita, and Weinberg, Adriana. 2005.   Reliability of CD4 Quantitation in Human Immunodeficiency Virus-Positive Children:   Implications for Definition of Immunologic Response to Highly Active Antiretroviral Therapy; Clinical and Diagnostic Lab Immunology 12(5): 640-643. Chi, Jingduan, Jayewardene, Anura L., Stone, Judith A., Motoya, Toshiro, and Aweeka, Francesca. 2002.   Simultaneous determination of five HIV protease inhibitors nelfinavir, indinavir, ritonavir, saquinavir and amprenavir in human plasma by LC/MS/MS; J of Pharm and Biomedical Analysis 30:675-684. Verbesselt, R., Van Wijngaerden, E., and de Hoon, J. 2007. Simultaneous determination of 8 HIV protease inhibitors in human plasma by isocratic high-performance liquid chromatography with combined use of UV and fluorescence detection: Amprenavir, indinavir, atazanavir, ritonavir, lopinavir, saquinavir, nelfinavir and M8-nelfinavir metabolite; J of Chrom. B 845:51-60. Frerichs, Valerie A., DiFrancesco, Robin, and Morse, Gene D. 2003. Determination of protease inhibitors using liquid chromatography-tandem mass spectrometry; J of Chrom, B 787:393-403. Gangl, Eric, Utkin, Ilya, Gerber, Nicholas, and Vouros, Paul. 2002. Structural elucidation of metabolites of ritonavir and indinavir by liquid chromatography-mass spectrometry; J. of Chrom. A 974:91-101. Turner, Michele L., Reed-Walker, Kedria, King, Jennifer R., and Acosta, Edward P. 2003. Simultaneous determination of nine antiretroviral compounds in human plasma using liquid chromatography; J. of Chrom. B 784:331-341. 2008. Kaletra. [Cited 2008 May 16], Available from http://www.heartandsoul.com. D’Avolio, Antonio, Siccardi, Marco, Sciandra, Mauro, Lorena, Baietto, Bonora, Stefano, Trentini, Laura, and Di Perri, Giovanni.2007. HPLC-MS method for the simultaneous quantification of the new HIV protease inhibitor darunavir, and 11 other antiretroviral agents in plasma of HIV-infected patients; J. of Chrom. B 859:234-240. Colombo, S., Guignard, N., Marzolini, C., Telenti, A., Biollaz, J., and Decosterd, L.A. 2004. Determination of the new HIV-protease inhibitor atazanavir by liquid chromatography after solid-phase extraction; J. of Chrom. B 810:25-34. Weller, Dennis R., Brundage, Richard C., Balfour, Jr., Henry H., and Vezina, Heather E. An isocratic liquid chromatography method for determining HIV non-nucleoside reverse transcriptase inhibitor and protease inhibitor concentrations in human plasma; J. of Chrom. B 848:369-373. Sarasa-Nacenta, Maria, Lopez-Pua, Yolanda, Mallolas, Josep, Blanco, Jose’ Luis, Gatell, Jose’ M., and Carne’, Xavier. Simultaneous determination of the HIV-protease inhibitors indinavir, amprenavir, ritonavir, saquinavir and nelfinavir in human plasma by reversed-phase high- performance liquid chromatography; J, of Chrom. B 757:325-332.

Hepatitis causes and effects

Hepatitis causes and effects Abstract Hepatitis, one of the major incurable diseases, still exists nowadays endangering many peoples lives. It has many types i.e. Hepatitis A, B, C, D, E and G. The nature of Hepatitis is viral which is caught by either through body fluids or improper personal hygiene in addition to other causes which remains unknown. This disease leads into serious physiological effects such as fatigue, jaundice and serious liver complication like liver Cirrhosis. Psychosocial effect which is another outcome of Hepatitis includes social withdrawal, anxiety, depression and suicidal tendency. Despite of the extensive researches to find a cure for Hepatitis, there is still no effective treatment for it so the responsibility of avoiding this infection is both on government and individuals. Hepatitis is one of the most fatal diseases which was discovered in the early eighties; it can be defined as an inflammation of the liver organ. Hepatitis is derived from the Latin words Hepat which means the liver and itis inflammation. The usual cause of Hepatitis is a virus that invades the body through blood stream. This virus could get into the body either through body fluids or improper personal hygiene, leading to serious physiological and psychosocial effects. There are several types of Hepatitis, such as A, B, C, D,E and G. A, B and C viruses are the most common types of Hepatitis and all these viruses can cause similar problems and have similar symptoms, but they spread in different ways and have different effects on the body. There are several modes of transmission including contaminated body fluids, improper personal hygiene in addition to idiopathic causes. Contaminated body fluids include saliva, blood, feces and urine. Blood transfusion is the most common method, where the blood is transferred from an infected patient to another patient what would be called Horizontal Transmission. Another method is the Vertical Transmission which occurs when a pregnant woman pass it to her fetus. Furthermore, contaminated needles shared by the drug abusers or in medical accidents such as needle pricks† is another way emphasized by (Nowak and Handford, 2004, p.379). Having unprotected sex and multi-partners are other ways leading to this disease according to Nowak and Handford (2004) whom reported that Sexual transmission does occur, particularly among the homosexuals. Note also that 20% of infected heterosexuals pass the virus to their spouses.(p.380). All of the above mentioned causes can lead to Hepatitis B a nd C which are the most dangerous ones. The second major cause of Hepatitis is poor hygiene, for instance, personal and general. To start with contaminated water such as sewage lanes, rivers and public toilets are places of great risk for caching Hepatitis A especially to those who live nearby. This type of Hepatitis is usually transferred by feces according to Fiore (2004) HAV is primarily transmitted by the fecal-oral route, either by person-to-person contact or by ingestion of contaminated food or water (p.705-15).Moreover, unwashed vegetables and shellfish, such as clams and oysters may be contaminated by sewage to become sources of infection to humans. Also, personal hygiene is another element for contacting hepatitis and can occur by sharing razors, toothbrushes and towels, and leads to Hepatitis B and C. Despite previously discussed causes of this disease, there is still a great sector of hepatitis which remains unknown. Statistics shows that approximately 30% of hepatitis B infection are of unknown origin.40% of Hepatitis C cases are idiopathic (Nowak and Handford, 2004,p.379-80). Where another article points that sources is unknown but could be considerable; 50% of reported patients with hepatitis A do not have an identified source of infection (Fiore, 2004, p.706). But McHutchison Bacon (2005) emphasized in their diagram of Figure 2: Sources of Infection for Persons With Hepatitis C that only 10 % of Hepatitis C infection are unknown(p.S287). There are many effects of this disease which lie under the two categories: the physiological effects and psychosocial effects. Where the physiological effects contain all the symptoms of Hepatitis, the psychosocial effects indicate the emotional and social consequences of being a Hepatitis patient. The symptoms of the various forms of hepatitis are similar and they are caused by the damage in the liver. The most noticeable symptom is jaundice which causes a yellowing of the skin. Other symptoms associated with hepatitis include fatigue, general body pain, nausea, mild fever, and loss of appetite. As the infection spreads in the liver, the organ becomes enlarged. It may cause pain in the abdomen and in worst scenario can lead to liver Cirrhoses which mean total liver damage and eventually death. It takes seven to eight weeks after exposure to the Hepatitis virus for the symptoms to appear. A patient with Hepatitis is not only predisposed to physical symptoms, but also to emotional and social problems. These complexities include depression and social withdrawal as each one leads into the other, added to that depression and anxiety which commonly occur together. Anybody who suffers from Hepatitis will be anxious and this anxiety may lead in to depression in sever cases, for example when a patient suffers from Hepatitis and he knows it is a serious illness defiantly he will not stop worrying, these worries can make the person preoccupied with his illness and lead him to depression. Moreover, a Hepatitis patient social withdraw as a result of being unable to find a partner who is willing to live with this fatal disease. It is also hard to make people understand the nature of this serious disease and make friends and families accept and accommodate it. All this may drive the patient to be lonely and tempt to be suicidal. To sum up, Hepatitis is still one of our life time mysteries to be solved. The spread of this disease is mostly due to the natural or hygienic causes in addition to some percentage of idiopathic causes which is still unknown. Like any other illness, Hepatitis has many drawbacks which could be listed under two categories physiological and psychosocial. Unfortunately, despite the advanced field of medicine Hepatitis remains un-ended and research continues in order to find the ultimate treatment for it. Until a final cure is found, precautionary steps should be taken by both government and individuals. The government is responsible to ensure infection control awareness over this disease through its health system. But it is a personal responsibility to prevent oneself from this disease as well as any other disease by following the simple rules of hygiene and ensure to get proper health care from reliable health establishments only. References Fiore, E. (2004). Hepatitis A Transmitted by Food. FOOD SAFETY, 38(1), 705-715. McHutchison, J. G., Bacon, B. R. (2005). Chronic Hepatitis C: An Age Wave of Disease Burden. THE AMERICAN JOURNAL OF MANAGED CARE, 11(10), S286-295. Nowak, T. J., Handford, A. G. (2004). Pathophysiology :Concepts and Application for Health care Professionals (Third ed.). NY: Mc Graw Hill. Prevention, C. f. D. C. a. (2009). Disease burden from viral hepatitis A, B, and C in the United States [Electronic Version]. Retrieved 9 Dec 2008 from http://www.cdc.gov/ncidod/diseases/hepatitis/resources/dz_burden02.htm.