Patient Protection And Affordable Care Act - 1259 Words

Maxcine Bakhshizad Mr. Todd Mod â€Å"H† Patient Protection Affordable Care Act Everest University What Is Affordable and What Isn’t? The healthcare industry in America has definitely changed over the last few decades. Our federal government has tried to mold and shape our country into a place where healthcare can be affordable for all families, not just the wealthy and those below the poverty line. The Patient Protection and Affordable Care Act was created to bring about changes and healthcare reform for especially your average American middle-class family. The Obama Administration worked very diligently to ensure some type of change was made in present-day America that would last and finally be the reform that†¦show more content†¦These are some of the immediate changes that have been made. Immediate Changes Without a doubt, for the past few years the healthcare industry has been asking for healthcare reform. â€Å"In 2010, two new healthcare laws were enacted, The Patient Protection and Affordable Care Act (Public Law No. 111-148), hereafter referred to as the Affordable Care Act) and the Health Care and Education Reconciliation Act (Public Law No. 111-152). These acts cover a number of issues and represent significant changes in America’s healthcare industry.† (Elsevier, 2016) President Obama and his administration made it their business that as soon as he got elected, he would make sure that America had some type of healthcare reform. Changes needed to be made and kept. There were several laws put in place, but with these two specific laws put in place had made an immediate effect on our country and the previous healthcare laws that were set in stone were no more. For example, one of the first immediate changes to go into effect is that the insurance co mpanies couldn’t deny coverage to children with pre-existing illnesses. This was a big one because there are so many children out there with all types of ailments. You have children with cancer, diabetes, asthma you name it. Furthermore, with the ObamaCare in place it puts more security on having healthcare for your children. Speaking of which, in addition to the first immediate law, the second is that

Sport, Education, and the Meaning of Victory Essay examples

Sport, Education, and the Meaning of Victory Sport was included in ancient educational systems because it was thought to promote aretà ª or human excellence which could be applied to almost any endeavor in life. The goal of most modern scholastic athletic programs might be better summed up in a word: winning. Is this a sign that we have lost touch with the age-old rationale for including sport in education? I argue that it need not be by showing that we value winning precisely for the virtues associated with it. I then take Platos traditional parts of aretà ª: piety, sophrosunà ª, courage and justice and show how they are manifest in modern athletic ideals of self-knowledge, discipline, courage and justice. To the extent that scholastic†¦show more content†¦The best way to tell is to ask a simple yet crucial question in the style of Socrates: What is Winning? One reason this question is seldom asked may be that, on the face of it, the answer is absurdly obvious. Sports, after all, are essentially sets of rules constructed by human beings, and winning is clearly defined within each of these sets of rules. Analytically, a winner is simply the athlete or team who accumulates the most points, crosses the finish line first, jumps the highest, throws the farthest, or whatever superlative the sport designates. The definition of winning in sport is clear and quantitatively measurable — unlike winning in other areas of life, such as love or happiness, where success is not so easily measured. Perhaps this precision is one of the reasons we value an athletic victor so much, but certainly there is more to it. Ben Johnson crossed the finish line first in the 100 meter dash at the Seoul Olympics in 1988, but few consider him the winner of the race. Even victors who win fair and square sometimes see the moral victory and the lions share of admira tion awarded to a losing competitor. Our conception of a winner runs much deeper than the ability to fulfill the analytic definition of victory in sport. In Homers Iliad (XXIII, 823-880), there is an account of a foot race at Patroclus funeral games in which the goddess Athena chooses her favorite Odysseus as the winner of the race and ensures his victory byShow MoreRelatedThe Fascists’ Control of Italy and their Social and Economic Policies1398 Words   |  6 Pagesargued some of these were of more value to the Fascist domination than others. The social policies implemented by the Fascists secured their control of the lives of every person, young or old, in Italy in particular through education and the Dopolavoro. Education was heavily manipulated to only teach the youth a positive view of the Fascists. It became necessary for all teachers and lecturers to swear loyalty to Mussolini. 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The Importance of Gender Representations in Spanish Cinema Free Essays

The different works of art – from paintings to literary pieces – present prevailing themes in the society. They act as small fragments of a comprehensive historical narrative. These fragments, though fictional, are still able to reflect true scenarios, real life stories from which they are based upon. We will write a custom essay sample on The Importance of Gender Representations in Spanish Cinema or any similar topic only for you Order Now To a certain extent, films serve the same purpose as any work of art – they present the artist’s feelings, thoughts, and reflections on whatever is happening in the society at the time of its creation. The different elements in any film – the social setting and the gender representations do not only bring life to its plot. Rather, these thematic elements of the film contribute fully on its general appeal and overall impact to its audiences. In this paper however, the researcher will only focus on one of these elements – gender representation. Putting a specific focus on this study, this paper will only explore the importance of these representations in Spanish cinema. To perform this purpose, common gender representations in some Spanish films will be revealed in relation to: how it reflects the prevalent issues in Spanish society; how it adds to the film’s appeal to local audiences; and how it provides an imagination of Spanish identities to local and international movie goers. 1st Assumption: Gender representations grant the films the ability to reflect the prevailing issues in the Spanish Society In the past few years, domestic violence has been a prevalent social problem in Spanish communities. Reports show that there is a high count of women who are suffering from the violence and physical abuse posed by their husbands and partners. Based on the report of Emma Daly in Christian Science Monitor, the Spanish society is suffering from a â€Å"machismo culture† where women are treated as inferior to men. (Daly, 1998) In relation to this important social issue, many films also carry domestic violence as significant thematic components in their plots. In such films, women are portrayed as the victims of their husbands’ consummation of their masculinity in a largely patriarch society that equates women to second-class citizens. Solo mia (2001) is one of the films which reflect this social issue. The movie puts into film a typical story that takes place not only in Spain but also in many societies where a once loving and tender relationship goes wrong. As shown in the movie, the relationship gradually transforms into a tale of obsession which prompts the husband to repeatedly subject his wife to domestic violence. (Saenz, 2009) The same social issue envelopes the film â€Å"Princesas† (2005) and El Bola (2000). In the first film, a prostitute suffers from the violence introduced by her lover while in the latter shows that children can also become victims of what is known in Spain as â€Å"Terrorismo Familiar†. Basically, Spanish cinema reflects not just the fact that domestic violence prevails in the real Spanish community. Rather, gender representations in the film also show that such type of violence affects women of all ages, and in different social classes. With the men presented mostly as the perpetrator of the violence, the films further shows that men in Spain often act adversely against the inferior women. nd Assumption: Gender representation increases the film’s appeal to local audiences by reinforcing nationalism and providing greater grounds for linkage and identification. Since Spanish cinema reflects prevalent values, ideas, and practices in the Spanish community, it gives the film a more localized appeal. The tendency to magnify one’s identification with t heir culture further increases the movies’ appeal to the local moviegoers. Basically, most of the Spanish films pose a generic thematic distinction from the mainstream Hollywood movies. While most Hollywood movies take the themes of liberal women who are posed as office workers and even successful professionals, most Spanish movies reflect on the importance of motherhood – a local theme that is common in many traditional patriarchal societies. Solas is one of the most famous films that glorify maternity as the only way for a woman to achieve real fulfillment and happiness. The film revolves around the story of Rosa and her daughter Maria. The two, both victims of domestic violence, are reunited after several years of being apart. Rosa has become a passive victim to her husband’s abuse but Maria refuses to surrender to the despotism and instead, decides to live in the city. However, Maria inevitably ends up in the same situation as that of her mother – being physically and emotionally abused by her boyfriend. To a certain degree, the portrayal of motherhood in the story works in two contrasting ways. Rosa retains the profile of the typical mother. She is portrayed as the submissive and self sacrificing woman who is willing to endure overwhelming hardships – the abuse of her husband – in order to potentially â€Å"save† her family from falling apart. However, she fails as Maria separates herself from the threat that her father poses. Fortunately, in line with Rosa’s angelic qualities as a mother, she is able to â€Å"save† her daughter from leading a devastating lifestyle through her captivating and unrestrained love and care. Following these implications, motherhood is presented in the story as a self-denying role which women must embrace not only to provide a certain sense of accomplishment but also to gain the ability to â€Å"save† people whom they care for. Motherhood is also presented as a Spanish woman’s way toward salvation and recovery as depicted in Maria’s character. Maria’s relationship with his boyfriend reflected a destructive scenario which led to her alcoholism. However, as Maria became pregnant, that signaled her positive transformation from an angry and hostile character to another motherly figure that’s kind, passionate, loving, and forgiving. In essence, Maria’s motherhood became her escape from the destructive factors that formerly consumed her life. Such gender representation embedded in the plot of the movie allows the local audiences – particularly women – to relate to characters and watch the film. 3rd Assumption: Gender representation in Spanish films offers both local and international audiences with an imagination of Spanish identities Gender representation forms a significant part of the local Spanish cultures and traditions. As films carry gender representation which is reflective of a distinct cultural identity, they then achieve significance as cultural accounts. The fact that the movies provide both local and international audiences with an idea of what comprises a real Spanish community qualifies them as relevant educational and enriching artifacts. In addition to that, these artifacts not only promote an imagination of Spanish identities. Rather, the Spanish movies also help people of other cultures in learning, appreciating, and understanding Spanish culture. For example, in the film â€Å"Coma agua para chocalate (1992) or ‘Like water for chocolate’†, the gender representations mirror how important must both men and women adhere to old superstitions and traditions. The film shows that marriage and love are restricted by old Spanish traditions as a young couple – Pedro and Tita – could not get married simply because Tita’s oldest sister has to get married first and because Tita had to first fulfill her domestic roles and â€Å"responsibilities† to her mother. Gender representation in La casa de los espiritus (1993) or â€Å"The House of the Spirits† also offers a glimpse at Spanish culture. This film shows the importance of social class as a local rags-to-riches patriarch does everything to prevent his daughter from marriage a lower class worker who fights for socialism. The same theme inspires the film, The Dog in the Manger (1995). In the movie, a Countess falls in love with his secretary. However, social status stands on their way. Furthermore, this gap in social position increasingly widens as the Countess, as a woman is expected to be submissive to societal expectations. Conclusions Gender representations become important elements to Spanish cinema mainly because they reflect prevailing issues and themes in a natural Spanish community. As these themes are reflected and portrayed, the films gain the local audience’s attention through the formation of linkages and character identification. Gender representations embedded in the plot also qualify the films as cultural artifacts that offer audiences with a glimpse of Spanish culture. On the whole, gender representation promotes the appreciation of not just Spanish movies, but of the Spanish culture as well. Through the gender roles promoted in the films, both local and international audiences learn how Spanish culture must be understood and appreciated. How to cite The Importance of Gender Representations in Spanish Cinema, Papers

Digestion and Food free essay sample

Digestion is the breakdown of large insoluble food molecules into smaller molecules so they can pass though the intestinal wall into the bloodstream and be transported throughout the body. There are seven different food groups in a balanced diet which should include Carbohydrate, fat, water, protein, fibre, vitamins and minerals. Although most foods contain these in some shape or form the foods that contain most of one type fall into that category, a chicken fillet for example would fall under the protein category because it contains more protein per hundred grams than any other nutrient. This assignment will explain the systems and processes necessary for the digestion of a Beef sandwich and a chicken Tikka Masala with rice. In the digestion of a beef sandwich containing sliced Beef, bread, butter and a chicken Tikka Masala there are different stages of where food is broken down. Enzymes are added at different times to ensure the food is absorbed properly. Digestion technically starts in the brain. Even before food touches your lips the stomach is already preparing for the food about to be ingested. The ingestion process starts with taking food into the mouth (eating and drinking). The purpose of this is so the food can be cut into smaller pieces and saliva is added before it is swallowed. This is where the first enzymes start work. There are two enzymes found in the saliva of the mouth, salivary amylase and lingual lipase. Amylase breaks down dietary carbohydrates such as monosaccharides, disaccharide sugars and complex polysaccharides (starch). Monosaccharide’s can be easily absorbed into the bloodstream so the others need to be broken down into these before they can be absorbed (Derrickson, Tortora 2006 p906). The salivary amylase starts to break down the polysaccharide starch found in the bread of sandwich and the rice in the chicken Tikka meal while it is being chewed. Once the food has been swallowed it slides down the throat which extends into the esophagus. The smooth muscle, mucus and secretions in the esophagus enable the food to slide down easily into the stomach. At the end of the esophagus is the lower esophageal sphincter which connects to the stomach. The stomach is a j-shaped organ where food is mixed with gastric juices secreted by the lining. The gastric juices consist of water, enzymes and hydrochloric acid to kill any harmful bacteria (Parker 2007 p176). The main enzyme in the stomach is called pepsin which specialises in the break down of protein. Gastric pepsin breaks proteins into polypeptides, pancreatic trypsin, chymotrypsin and carboxypeptidase which change the polypeptides into peptides (Lippincott, Williams, Wilkins 2005 p224). The proteins in the beef part of the sandwich and chicken part of the Tikka Masala are broken down by theses enzymes in order to extract the essential amino acids found in the peptides so that they can be easily absorbed in the small intestine where the food moves to after the stomach has done its work. The intestinal mucosal peptidases in the small intestine break the peptides down into amino acids allowing this to happen. As the carbohydrate (rice and bread from the two meals) enters the stomach the salivary amylase is deactivated by the ph level. As the food then enters the duodenum which is the first part of the small intestine, another type of amylase is then added from the pancreas which changes the carbohydrates into simple sugars (Parker 2007). The simple sugars are maltose lactose and sucrose. As these are pasted further into the small intestine ‘the enzymes maltase, lactase and sucrase chop maltose, lactose and sucrose into smaller bits, more easily absorbed, which are eventually converted to glucose and absorbed through the intestinal walls into the bloodstream’ (Collins 2007). Once this has happened the glucose is transported to the liver where it can be where it can be stored or distributed to cells throughout the body (Collins 2007). Fats fall under three categories, saturated (mainly found in animal products); Unsaturated (fish, nuts) and Trans fats which are mainly found in vegetable oils and processed foods made from hydrogenated vegetable fats. Fats or lipids as there also known ‘are diverse compounds that are grouped together because they are insoluble in water, but soluble in nonpolar solvents’ (Bailey 2008). This means lipids take longer to digest than carbohydrates and proteins. The fat content of the two meals comes mainly from the butter of the beef sandwich and the cream of the Masala sauce. The Short chain triglycerides found in these are digested by gastric lipase in the stomach. The majority of fat digestion though is done in the small intestine where pancreatic lipase and bile salts are added. The bile salts emulsify fat into droplets which makes them water soluble allowing them to be absorbed more easily. The pancreatic lipase ‘breaks down fats and phospholipids into a mixture of glycerol, short and long-chain fatty acids, and monoglycerides’ (Lippincott, Williams, Wilkins 2005 p224). Small finger like projections on the small intestine called Villi give it a large surface area making it easy for the absorption allowing the fatty acids and monoglycerides to pass through into the blood stream. Nearly all vital nutrients from food are absorbed in the small intestine and the left over waste that passes into the large intestine afterwards is known as the chyme. The chyme descends through three main regions of the large intestine called the caecum, colon and rectum. During this journey sodium, chloride, and water are absorbed through the lining of the colon into the blood making less watery faeces to be excreted out of the anus.

The Effect of the Crisis on Schools

world bank essays

world bank essays The World Bank is a lending organization used by developing nations in need of finances to help provide relief from financial difficulties. Some would say that the World Bank helps countries by giving them valuable finances which developing countries need in order to bring about financial reforms. Others argue that that the World Bank has another agenda and that it only lends money to the developing nations in order to push the countries into policies of trade liberalization and privatization. This essay will examine the argument that despite claiming to reduce poverty in poorer nations the World Bank actually adds to the destabilization of the developing countries. In particular this essay will look closely at the new World Bank policy called the Highly Indebted Poor Countries Initiative and how this initiative is again being used as bargaining power over the developing world rather than helping to alleviate debt problems which was its original purpose. This topic is of particular r elevance as this new initiative has only recently been implemented and the way in which it used will be of great importance to developing nations as they struggle to recover from growing debt in the next few years. The World Bank was first established during World War II at Bretton Woods, New Hampshire. The emphasis in the early stages of the World Banks development was post war rebuilding. The first loan made by the World Bank was to France in 1947 for $250 million to help it recover from the devastations of war. The World Bank (03) states that despite lending to countries post conflict or in other similar humanitarian emergencies, it has evolved into a lending institution whose main agenda involves relief to third world poverty. The World Bank describes itself as a specialized agency rather than a bank. It states that its aim is to bridge the gap between rich and poor nations by turning rich country resources into poor country growth. The World Ban...

An Overall Analysis of Various Aspects of Islam Research Paper - 1

An Overall Analysis of Various Aspects of Islam - Research Paper Example Unlike Islam as a set of beliefs Hinduism is a collection of different intellectual or idealistic points of view, as Gavin Flood says in this regard that it does not have "unified system of belief encoded in declaration of faith or a creed" (Flood 34). In spite of Hinduism’s numerous traditions and versions including Shaivism, Vaishnavism and Srauta, a common philosophy of Hinduism is founded on the concepts of â€Å"karma, dharma, and societal norms† (Georgis 62) The Islamic faith in the oneness of God fundamentally originates from the Holy book, Quran, which the Muslim believes to be direct revelation or guidance of God descended upon Prophet Muhammad. Etymological Roots of Islam and Hinduism The term â€Å"Islam† derives from the root ‘salaam’ or ‘s-l-m’, where the term â€Å"Hindu† has its root in the word ‘Sindhu’ a local Sanskrit appellation, of the Indus River. Indeed the word, â€Å"Hindu† was incorpora ted in English from the Arabic term â€Å"Al Hind† used to refer to the Indian Subcontinent and the people living in this area. Later the term â€Å"Al-Hind† gets changed into Persian articulation as ‘Hindu’. On the other hand, the etymological root of Islam literally means ‘wholeness and completion’. But a number of other Islamic scholars consent that Islam as a religion has a broader meaning, â€Å"submission to the will of God†. ... But drawing references to the textual evidences in the holy Quran, scholars claim that Islam begins from the birth of Adam, the first man and prophet of Islam. In this way, Abrahamic religions are supposed to be the ancient versions, of Islam, which God Himself annulled because the distortions of His message brought about man. (Nasr 45) But other scholars believe that since God has repealed other religions as well as other versions such as Christianity (the religion preached by Zesu, a prophet of high respect in Islam), Judaism (preached by Moses, another revered prophet) and other religions, the real Islam for modern people is to be considered the one that Muhammad founded in the Seventh Century in Arab peninsula. Unlike Islam’s self-acclamation about its origin in Adam’s the first man’s age, the religious texts o Hinduism do not verify its origin. Rather anthropological researches show that the origin of Hinduism in India dates back to a period between 5500BCE and 2600BCE, commonly known as the late Neolithic age (Thapar 77). Indeed from this period up 500BCE Hinduism prevails as a Vedic religion depending on the religious texts called Vedas. The Vedas is a collection of several versions, of which the Oldest is the Rig Veda. The Vedas advocates the worship of gods such as Agni, Indra, and Varuna. This Vedic religion had undergone lots of changes over the century before the modern Hinduism emerged after the Muslim conquest of India in the early seventh century. Along the protracted path of addition, inclusion and reduction, the early first century texts Ramayana and Mahabharata began to be influential in this religion. Beliefs in

Skydiving Essay Example | Topics and Well Written Essays - 500 words

Skydiving - Essay Example The reason behind this is the force of gravity. This gravity results in an acceleration of 9.8 m/s^2. Given this acceleration, the following formula determines how far the skydiver will travel in a given time: Air resistance is the force that acts against the gravity while the skydiver is accelerating downward. Air resistance acts upwards against the gravity which acts downwards. In the beginning, the push provided by air resistance is much smaller than the pull of gravity; therefore, the skydiver continues to accelerate downwards. However, as the skydiver falls faster and faster, the value of air resistance increases because of which the acceleration starts to decrease. Eventually, the force of air resistance becomes equal to that of the force of gravity. At this point, the skydiver stops accelerating and attains a constant speed. This constant speed is known as the terminal velocity. Terminal velocity is the maximum velocity that a particular body can reach when falling through the air. (Gordon et al 2000; Lenaker 2002) The cross-sectional area of the skydiver plays a very important role in how quickly or slowly the skydiver will reach their terminal velocity. This is because the cross-sectional area determines the amount of air resistance that will act on the skydiver. Greater the cross-sectional area, greater will be the force of air resistance. For example, a skydiver who falls in a spread eagle position will encounter a greater air resistance than one who falls head, or feet, first. This is where the role of parachutes comes in. As soon as the skydiver opens their parachute, their cross-sectional area increases, leading to an increase in the air resistance. This air resistance becomes greater than the gravity. The upward net force causes the skydiver to slow down. As the speed of the skydiver decreases, so does the air resistance, until the skydiver reaches terminal velocity again. (Gordon et al. 2000). Gordon, J. R.,

The Saudi Arbitration Law 1983 Essay Example | Topics and Well Written Essays - 6000 words

The Saudi Arbitration Law 1983 - Essay Example However, the SAL 1983 was considered inadequate, considering that it is a brief law, containing only 25 Articles. It only addresses some important aspects of arbitration. Therefore, in 1985, the Implementing Regulations (IR1985) was enacted with more comprehensive arbitration provisions. The law had not clearly dealt with international commercial arbitration, which raised a lot of doubts whether it was limited to domestic arbitration or could be applied to international arbitration as well. Its Articles did not mention international arbitration, whether commercial or otherwise. Only in Article 18, the IR1985 addressed the method of notifying foreign companies which have a branch or agent in the Kingdom. During the practice period, the Law had been widely criticized regarding various aspects of the arbitration process. This chapter will address the most important features of the law analytically. The legal legitimacy of arbitration is derived from the agreement of arbitration between the parties. The SAL 1983 recognized two types of agreeing on arbitration. One of these is the arbitration clause; which means stipulated in the original contract. This is the between parties includes a provision referring to a part of or all disputes arising between them from this contract to arbitration. The other type is the submission of the agreement which agreement, which is the agreement expresses the desire of both parties to present a standing dispute between them to arbitration.10 In practice, the Saudi court has recognized both two types as legally binding, providing that a defense with the existence of any of the two types should be presented before any other defense or request. In case No 10/1416,11 between Danish and Saudi companies, it was claimed by the plaintiff that the Saudi company purchased medicines without paying. The case was rejected by the Commercial Department due to th e presence of an arbitral agreement. The claimant raised an appeal on the ground that the respondent did not initially request for arbitration in the first hearing. This appeal was rejected by the Examination Committee which approved the judgment of the Commercial Department pursuant to that the first hearing was an exchange of documents and information regarding the case and did not contain any defenses or requests by the respondent. It is useful to point out that the SAL 1983 and the succeeding Implementing Regulations did not provide for writing as a condition of validity of arbitration or confirmation. Although the provision of Article 5 of the SAL 1983 stated that the arbitration instrument shall be filed to the authority originally competent to hear the dispute, as well as signed by the parties or their representatives.12 With consideration to these two issues, it seems that writing is not a condition of arbitration,13 but a condition of enforcement. Therefore, the arbitration agreement can be confirmed with  various means  such as recognition and  testimonial  or presumption based on the general provisions of Sharia. The Principle of Separability is considered  of the most important guarantees of the effectiveness of arbitration clause.  It means the independence of the arbitration clause contained within the contract

Adult Education During The Industrial Revolution History Essay

Adult Education During The Industrial Revolution History Essay The purpose of this paper is to highlight five influential factors that contributed to the development of adult education in the United States during the Industrial Revolution. Discussion will begin with the American Model of University Extension including the concepts developed by William Harper and Charles Van Hise, and the role they played in the development of extension education. Next in discussion will be womens rights highlighting a few female role models and their contribution to the push for womens freedoms and education. Education for work, details the demand for education as America shifted from the Antebellum era into the fast pace era of the Industrial age, followed by a discussion on how the U.S. Department of Agriculture campaigned to improve agriculture in the south. This paper will conclude with African American Adults and how after becoming freed slaves they began the journey of education. American Model of University Extension According to Stubblefield and Keane (1994), in 1887 Herbert Baxter Adams, professor of history at Johns Hopkins University, gave a speech at the convention of the American Library Association that inspired the creation of the American lecture programs. The American lecture programs were modeled after the English University extension program. Moreover in 1891, the American Society for the Extension of University Teaching held a conference to promote extension activities which led to the private and state universities involvement in extension. Furthermore, in 1885 the University of Wisconsin developed the farmers institute. In 1892 William Rainey Harper, the president of the University of Chicago, implemented correspondence classes and off-campus courses to further the development of extension education. In addition, in the beginning of the twentieth century, academic scholars worked to promote extension services with the belief that knowledge was essential to progress. In 1915, Charle s Van Hise, president of the University of Wisconsin, created the concept of combining culture, vocation and research information to be the major focus of the extension services. Further, he believed it was the duty of the extension services to inform and educate everyone in the country (Stubblefield and Keane, 1994). Womens Rights The Industrial Revolution was the beginning for womens independence which changed the lives of women when factories began to hire women. Women were often paid less than men but were expected to perform the same type of work (Tilly, 1994). The reasons factory owners preferred women to men workers was because of the pay and labor. Valenze (1995) stated, Factory owners preference for female labor was based not only on its cheapness: many women assumed the yoke of hard labor in the factories without complaint, and this fostered the widespread opinion that female workers were more docile, and therefore less likely to cause trouble than men. Because of women fighting for rights and receiving them, in 1893 there was a week-long celebration of the World Congress of Representative Women at the Chicago World Fair which attracted almost 150,000 people (Stubblefield and Keane, 1994). Some women contributed to improving situations for the working class. Role models such as Elizabeth Cady Stanton, Susan B. Anthony, Lucy Stone, and Elizabeth Blackwell, who were all well-known for their involvement in the womens rights movement, opened the doors of opportunity in education and occupation for women of today. Without their perseverance women could still possibly be extremely limited in career opportunities and unable to do the things that they take pleasure in and benefit from. Education for Work Transitions from the Antebellum Era to the Industrial era brought on new challenges in more ways than economics, technology, and farming; the need for educational changes was taken place as well. During the Industrial era manufacturing was at a high with new innovations such as textile plants, therefore vocational education was on the rise. Vocational education was a shift from a reliance on natural resources to a reliance on human resources and the skilled workforce (Stubblefield and Keane, 1994). In 1917 the Hughes Act backed the idea that industrial education should be taught in public schools along with home economics and several courses geared towards the changing era. An increase in student participation in the classroom rose from 86 % in 1919 to 92% within five years. Adults also sought out training through private trade schools and apprenticeships studies. Adults who were unable to attend were often offered education via correspondence study. The largest and most well known c orrespondence school was located in Scranton Pennsylvania which enrolled over two million students between 1892 and 1920 (Stubblefield and Keane, 1994). Despite the setback of some schools trying to exploit their students to gain a buck, employers who had established apprenticeship programs also taught their students the value, integrity and or hard work. Agriculture The Department of Agriculture provided an institute method of teaching by offering lectures and farming classes to the local farmers. While the institute method of teaching covered a lot of material there was no sure way to determine if the knowledge received from the farmers was actually going to be implemented in their every day farming techniques (Stubblefield and Keane, 1994). Not only was it rooted in the survival of the population, agriculture was also an essential source of raw materials for the textile business. In 1887, the federal government made the experiment station a national institution through the Hatch Act, which granted each state $15,000 per year to assist in the aid of agricultural education. By 1900, the adult farming school was accepted as part of the education of rural adults. In 1902, Seaman Knapp, a special agent for the U.S. Department of Agriculture (USDA), was in charge of the campaign to improve agriculture in the south and he set up a local farmer for su ccess by using his farm as a demonstration point on the effects of agricultural education has on farming (Stubblefield and Keane, 1994). In doing so he eased the minds of the hesitant farmers and opened their eyes to new farming methods which reassured them that innovation was a positive thing. In 1904, Knapp accepted African Americans as demonstrators and cooperators of farming, and in 1906, he teamed up with the Tuskegee Institute in Tuskegee, Alabama (Stubblefield and Keane, 1994). Wool and cotton production for the making of cloth increased each year, as well as the yield of food crops. Marketing and production provided enough food to continue an adequate work force. African American Adults Post Civil War left the country in disarray and a lot of uncertainty when it came to the issue of slaves making the transition over to freedom. There was not a plan for changeover which left a lot of free blacks without jobs and an education. In 1865, the Freedmens Bureau began a reshaping by General Howard to better suit the educational needs of freed slaves. The bureau selected several groups and societies to begin educational development; the American Missionary Association focused on assisting blacks in their transition from slaves to free people. The Missionary established schools that were dedicated solely to the educational development of blacks where they also began training blacks to be educators themselves. The intent was to produce enough qualified teachers who would educate other freed blacks. The end state was to hopefully encourage blacks to pursue careers to be lawyers, teachers, doctors, or preachers (The American Missionary Association, n.d.). Even though the Freedme ns Bureau was disbanded in 1872 and blacks were on their own so to speak, the education that blacks received for that seven year span was instrumental in the continued drive for higher education. Just as the rest of the country was adapting to the new industrial methods, farmers overcame the corporate domination with the help of the Grange and Farmers Alliances. Women took a stand for what they believed was right, and freed slaves were receiving an education to help in their transition. The purpose of this paper was to highlight five influential factors that contributed to the development of adult education in the United States during the Industrial Revolution. They were the American Model of University womens rights, education for work, agriculture and African American Adults.

The History of Math Essay examples -- essays research papers

The history of math has become an important study, from ancient to modern times it has been fundamental to advances in science, engineering, and philosophy. Mathematics started with counting. In Babylonia mathematics developed from 2000B.C. A place value notation system had evolved over a lengthy time with a number base of 60. Number problems were studied from at least 1700B.C. Systems of linear equations were studied in the context of solving number problems. The basic of mathematics was inherited by the Greeks and independent by the Greeks beg the major Greek progress in mathematics was from 300 BC to 200 AD. After this time progress continued in Islamic countries Unlike the Babylonians, the Egyptians did not develop fully their understanding of mathematics. Instead, they concerned themselves with practical applications of mathematics. Mathematics flourished in particular in Iran, Syria and India from 450B.C. Major progress in mathematics in Europe began again at the beginning of the 16th Century. The 17th Century saw Napier, Briggs and others greatly extend the power of mathematics as a calculator science with his discovery of logarithms. Cavalieri made progress towards the calculus with his infinitesimal methods and Descartes added the power of algebraic methods to geometry. Euclid, who lived around 300 BC in Alexandria, first stated his five postulates in his book The Elements that forms the base for all of his later Abu Abd-Allah ibn Musa al’Khwarizmi, was born abo...

Netw360 Week 7 Lab

Kyle Pederson NETW360, Ben Brezinski 4/16/12 Lab #7 Hands on Lab Microsoft Network Monitor Introduction and Wireless Frames When we expanded frame 4 the signal strength was -60dbm, the data rate was 1mbps, and the SSID in the beacon frame was Amory. In frame 5, looking at the Hex Details, the BSSID for this access point was 00 15 E9 D1 48. The authentication status in frame 14 was successful. In frame 15, the Association Response status was in a successful state. When we tried to the Microsoft Network Monitor we were unable to pick up any management packets during our capture. SNMP management We were able to successfully ping 10. 7. 8. 80 to verify we had access to the â€Å"managed† device. The batch file was set up with the 10. 27. 8. 80 address and had commands to get information from that address. The name of the device was NPIF9460B and the status of it was â€Å"ready to print†. After we downloaded the MIB Browser and entered 10. 27. 8. 80 into the address field, we were able to get the sysUpTime which was 830 hours 13 min and 2 sec. Finding rogue access points When using the command â€Å"netsh wlan show networks mode=bssid† in the command prompt we were able to identify 17 access points. Out of the 17 access points 11 were not part of the DeVry wireless network.Using the FindAccessPoints. BAT we were able to identify 18 access points and 12 of them were not part of the DeVry wireless network. Opening the FindAccessPoints. vbs in notepad we were able to see the script and the basis of the script worked around the command netsh wlan show networks mode=bssid. After we set up our Linksys as a rogue access point we had no problem finding it using the batch file. This would be very handy to use at your home network, if you lived in a place where there is many access points, because you could pick up any rogue access points that someone has set up to attempt to capture any of your information.Logging Here is our log file from our Linksys a ccess point. [pic] Linksys Access point maintenance and troubleshooting The current firmware version of our Linksys access point was 1. 5. 01 and the current time was 2012/04/14 15:42:41. The current status of our access point was: †¢ Report Mode- BG-mixed †¢ SSID- net360 †¢ DHCP- enabled †¢ Channel- 1 Next we were able to backup our current configuration to our PC and then we reset the access point to the factory defaults. The factory defaults were set as: †¢ Report Mode BG-mixed †¢ SSID- Linksys †¢ DHCP- enabled †¢ Channel- 6Once set as the factory we were able to restore our original configuration by uploading the file we created earlier. As soon as that file uploaded our access point was set up the same as before. This was very straight forward to do and I feel it is a good idea to back up your configuration, just in case the access point gets reset. Wireshark Introduction and Examining Wireless Frames Lab Lab Report 1. Is Wireshark open s ource or propriety? (7 points) Wireshark is an Open-source program. 2. What is seen in each of the three panes that display the packets seen on a local area network? 7 point) The top pane is the packet list pane that shows each packet on a separate line and has five columns with the following information: the time that the packet came in, source, destination of each packet, the protocol being used with the packet, and information about each packet. The second pane is the tree view pane and it displays the headers of the various protocols captured in the packet and this is displayed in a hierarchal view from physical layer to the application layer. The third pane is the byte view pane that shows the raw data in a hexadecimal format. . What does a display filter do? (7 points) The display filter enables you to filter what you want to view when capturing your packets. So if you wanted to just view the packets that were using the protocol TCP you could filter those out. You can also use expression filters that lets you be more specific in what you want to filter. 4. What does the protocol column show? (7 points) The protocol column shows the highest layer protocol in the frame. 5. How do you expand the details in a layer of the packet in the middle frame? 7 points) To expand the details you must click on the plus sign. 6. In frame 1 what channel is being used? (7 points) Frame 1 is using channel 6. 7. In frame 1 what frequency is being used? (7 points) The frequency being used is 2437MHz. 8. In frame 1 what is the signal level? (7 points) The signal level in frame 1 is 11. 9. What type of frame is frame 1? (7 points) Frame 1 is a broadcast initiation frame to the access point 10. In frame 1 what is the beacon interval in milliseconds? (7 points) The beacon interval is 102. 4ms.

Sapient and Savor

Sapient and Savor Sapient and Savor Sapient and Savor By Mark Nichol Sapient and savor are cognates (words with the same origin)- which shouldn’t be surprising, as they both pertain to being perceptive. These words, and the others discussed below, derive from the Latin verb sapere, meaning â€Å"taste† or â€Å"have a flavor.† Savor, from the same Old French word, is both a noun and a verb, though the former is rare; that form refers to having a good smell or taste or to a quality that makes something enjoyable or interesting, while the verb means â€Å"enjoy for a long time.† The adjectival form, savory, means â€Å"pleasant smelling or tasting† but also applies to foods that are salty or spicy but not sweet. By extension, something savory is morally acceptable; the antonym, unsavory, is more common. A related, though rare, term is sapid; similarly, insipid, its opposite, is more widely employed, though it is more likely to be used to mean â€Å"boring† or â€Å"dull† in reference to a person’s personality rather than â€Å"lacking in flavor.† Savoir faire, adopted into English directly from French, stems from the French verb savoir, meaning â€Å"know†; it means, basically, â€Å"knowing the right thing to do† in the sense of acting appropriately in society. (Faire is derived from the Latin verb facere, meaning â€Å"do,† which is also the source of fact.) A similar French term, savoir vivre (literally, â€Å"knowing how to live elegantly†), likewise made its way into English but is much less well known. A savant is â€Å"a learned person,† which is its definition in the original French. The phrase â€Å"idiot savant† was applied, starting in the late nineteenth century, to someone who has what is now referred to as savant syndrome, a condition in which a person with a mental disability nevertheless demonstrates exceptional skills in mathematics, memory, or art or music. (Idiot, ultimately from Greek, originally referred to an ignorant person but then became a classification of mental ability; it has come almost full circle in meaning.) The term savvy, which refers to practical intelligence (and is employed as a verb meaning â€Å"know† or â€Å"understand†), started out as pidgin developed in parallel from the French phrase savez-vous, meaning â€Å"Do you know?† and the Spanish phrase sabe usted, meaning â€Å"You know.† Sapient, borrowed directly from French, means â€Å"wise†; the binomial nomenclature for the human race is Homo sapiens (literally, â€Å"human being wise†). A neologism, sapiosexual (apparently coined in the late 1990s), refers to someone attracted to highly intelligent people. Sage, descended from an Old French word spelled the same way, was originally an adjective meaning â€Å"wise† but came to be used as a noun as well to refer to a wise person. Want to improve your English in five minutes a day? Get a subscription and start receiving our writing tips and exercises daily! Keep learning! Browse the Vocabulary category, check our popular posts, or choose a related post below:What Is Irony? (With Examples)Do you "orient" yourself, or "orientate" yourself?How to Punctuate Introductory Phrases

Free Essays on Spectroscopy Raman

spectroscopy Spectrograph Spectrophotometer Diffraction Grating Spectrum Analysis Continuous Spectrum Spectrum Lines Work of Niels Bohr Absorption Spectra Applications of Spectrum Analysis Chemical analysis Astrophysical applications In physics and physical chemistry, the study of spectra (see Spectrum). The basis of spectroscopy is that each chemical element has its own characteristic spectrum (see Elements, Chemical). This fact was recognized in 1859 by the German scientists Gustav Robert Kirchhoff and Robert Wilhelm Bunsen. They developed the prism spectroscope in its modern form and applied it to chemical analysis. One of two principal spectroscope types, this instrument consists of a slit for admitting light from an external source, a group of lenses, a prism, and an eyepiece. Light that is to be analyzed passes through a collimating lens, which makes the light rays parallel, and the prism; then the image of the slit is focused at the eyepiece. One actually sees a series of images of the slit, each a different color, because the light has been separated into its component colors by the prism. The German scientists were the first to recognize that characteristic colors of light, or the spectra, are emitted an d absorbed by particular elements. Spectrograph In a spectrograph, the eyepiece is replaced by a camera. Color photography is not necessary to identify the images of the slit, known as the spectrum lines; their wavelengths can be calculated from their positions on the film. Spectrographs are useful throughout the ultraviolet and visible regions of the spectrum, and as far as 1200 m (0.000048 in) in the infrared region. Spectroscopy in the extreme ultraviolet and infrared regions is similar to that in the visible region, except that glass does not transmit such radiations; lenses and prisms are made of quartz, flourite, sylvine, or rock salt. Concave mirrors can also be substituted for lenses. Special p... Free Essays on Spectroscopy Raman Free Essays on Spectroscopy Raman spectroscopy Spectrograph Spectrophotometer Diffraction Grating Spectrum Analysis Continuous Spectrum Spectrum Lines Work of Niels Bohr Absorption Spectra Applications of Spectrum Analysis Chemical analysis Astrophysical applications In physics and physical chemistry, the study of spectra (see Spectrum). The basis of spectroscopy is that each chemical element has its own characteristic spectrum (see Elements, Chemical). This fact was recognized in 1859 by the German scientists Gustav Robert Kirchhoff and Robert Wilhelm Bunsen. They developed the prism spectroscope in its modern form and applied it to chemical analysis. One of two principal spectroscope types, this instrument consists of a slit for admitting light from an external source, a group of lenses, a prism, and an eyepiece. Light that is to be analyzed passes through a collimating lens, which makes the light rays parallel, and the prism; then the image of the slit is focused at the eyepiece. One actually sees a series of images of the slit, each a different color, because the light has been separated into its component colors by the prism. The German scientists were the first to recognize that characteristic colors of light, or the spectra, are emitted an d absorbed by particular elements. Spectrograph In a spectrograph, the eyepiece is replaced by a camera. Color photography is not necessary to identify the images of the slit, known as the spectrum lines; their wavelengths can be calculated from their positions on the film. Spectrographs are useful throughout the ultraviolet and visible regions of the spectrum, and as far as 1200 m (0.000048 in) in the infrared region. Spectroscopy in the extreme ultraviolet and infrared regions is similar to that in the visible region, except that glass does not transmit such radiations; lenses and prisms are made of quartz, flourite, sylvine, or rock salt. Concave mirrors can also be substituted for lenses. Special p...

Public Administration Case Study Example | Topics and Well Written Essays - 500 words - 1

Public Administration - Case Study Example study aimed at answering what are the contributions that leaders need to make in public organizations to motivate their workforce (Wright et al., 2012). The specific purpose of the study was to identify the methods through which leaders following transformational leadership style can use internal and external motivational factors to increase their employee’s focus and attention towards the mission of the organization. In order to conduct this study data was collected through a survey in which the respondents included different senior level managers in the public organization and the total size of those who were surveyed was more than 50,000 senior level managers (Wright et al., 2012). The survey was supplied with the help of the internet and the survey was posted on the website of the study. Out of those individuals who responded to the survey a total of 1,538 were considered as valid for the study (Wright et al., 2012). The majority of the respondents were male and they belonged to the White race and they had attained higher level education. The study was conducted with the help of a statistical tool called correlation and regression and the validity of the responses was analyzed through the statistical tool of Cronbach Alpha (Wright et al., 2012). With the help of the study the researchers identified that leaders who practice transformational leadership style can help in elevating worker’s motivation towards providing public services (Wright et al., 2012). The researchers even identified that this form of leadership provided employees with clearly and well defined goals. The third main finding of the study was that worker’s motivation towards providing public services and clearly defined roles are two important factors that attract employees towards the mission of the organization (Wright et al., 2012). Furthermore the researchers identified that leaders in public organizations that provide their followers with a vision, led by setting an example,

Business Analysis using PESTEL Essay Example | Topics and Well Written Essays - 3500 words

Business Analysis using PESTEL - Essay Example The main part of the report has used PESTLE framework to identify the factors that are important to be considered by the electric car manufacturers. The listed factors are then classified as highly relevant and less relevant. An impact analysis is then performed on the highly relevant factors to arrive at the most important trend to be considered. The trends as identified by the impact analysis are Government spending, Government deficit, Economic Growth, Research spending, Innovations, Safety regulations and Environmental awareness. Based on the analysis of the above factors, it is identified that the main opportunity for the electric car companies in the next 5 years is the increased environmental awareness among the people. Similarly, the main threat for electric car markets is the uncertainty about government policies. Sl. No. Topic Page No. 1 Introduction 4 - 5 2 Main body 2.1 PESTLE Analysis 2.2 Analysis of four trends 6 – 10 10 – 15 3 Conclusion 15 – 16 1. Introduction Developing a powerful battery for electric cars is a challenging task for all electric car manufacturers due to the various challenges associated with it. Those main challenges will be discussed here in this report. The topic is â€Å"A new type of battery that can extend the range of electric cars between charges from about 100 miles to about 500 miles.† This study will deal specifically about the electric car market in UK. The various aspects that are relating to the UK car market are dealt in detail in this report. The objective of the study is to identify and analyse the four key factors that are important for the electric car market in UK. A very comprehensive PESTLE analysis is done in order to identify the key factors affecting the UK electric car segment. Before getting into the core area, it is important to have an idea about the UK electric car market. British automobile industry is one of the most established and fastest growing automobile industries in the world. UK shows good growth figures for all car segments. The trend until some years back has been the small car segment. But now, the trend is getting shifted to the electric cars irrespective of whether it is big or small. The main motivating factors for such a shift in trend is the continued awareness regarding the ill effects caused by vehicle emissions and the low cost of operations. Due to this high potential that exists in the region, companies from across the world are targeting to introduce electric cars for the UK market. This is evident from the fact that the even the super luxury car maker Rolls Royce will unveil the electric version of their Phantom in the 2011 Geneva Motor Show. As of 2008 electric cars represented around 0.004 percent of cars on the UK roads. The committee on climate change then expected this figure to reach around 40 percent by 2020. (Webster, 2008) (Ref. 1). The following chart gives the electric car growth estimate by region. (Reed, 2010) (R ef 22) To make things easier for the car manufacturers as well as the potential buyers, the UK Government is very keen on supporting the segment through their subsidy programme and other policies. The government has planned to provide subsidy of up to ?5000 to those who acquire an electric car in future. (House of Commons, Page 40) (Ref. 2) But when it comes to the sales of electric cars, government support is not the only factor that works out. The practicality of the car is the most important success

Land Law and Criminal Law Essay Example | Topics and Well Written Essays - 2000 words

Land Law and Criminal Law - Essay Example The principle of overriding interests was introduced to assist those whose interests would not reasonably expect to be registered. This includes things such as short term leases, legal easements1, as well as squatter’s rights and the rights of persons in actual occupation2. Overriding interests are covered under s70 of the Land Registration Act 1925, which has now been replaced by the Land Registration Act 2002. Overriding interests are now dealt with under sch 1 and 2 of the 2002 Act. The case of Williams & Glyn Bank v Boland was one of the first cases to adopt this principle. In this case a wife was able to claim an overriding interest in the property on the basis that she had made a substantial contribution to the purchase and was in actual occupation. This shows that in some cases the courts have regarded the actual occupation of the applicant to be treated as an overriding interest3. In situations where a person is in actual occupation and can demonstrate an interest in that property the court are unlikely to interfere with their right to remain in the property. Any attempt to do so would entitle that person to apply for proprietary estoppel on the basis of their contribution to the property4. Proprietary estoppel was established in the cases of Willmott v Barber (1880) 16 Ch D and Ramsden v Dyson (1866) LR 1 HL 129 where five essential elements were highlighted that had to be satisfied before a legal owner would be prevented from asserting his legal rights. These five elements consisted of the plaintiff having expended some money or having done some act on the faith of their mistaken belief that they would acquire an interest in the land5; they must have made some mistake as to their legal rights; the defendant must know of the existence of his own right which is inconsistent with the plaintiffs rights; the defendant must be aware of the plaintiffs mistaken belief of his rights; and lastly the defendant must have encouraged the

Open Method of Coordination Essay Example for Free

Open Method of Coordination Essay 1. Introduction: This paper aims to offer an assessment of OMC performance in relation to its goals and methods. A determination therefore will be made on whether OMC goals are met and what obstacles have been met in attaining said goals. In order to attain this purpose, we will define the Open Method of Coordination (OMC), find its goals and reasons why it was introduced into EU policymaking, followed by a brief overview in academic literature. Secondly, we will analyse the concept of social inclusion/exclusion (according to Atkinson). Thirdly, we will analyse whether OMC’s social inclusion made any improvement since Lisbon through the National Actions Plans and any other possible base. 2. Analysis and discussion 2.1 Define the Open Method of Coordination (OMC) its goals and reasons why it was introduced into EU policymaking.   What is OMC’s overview in academic literature? Summit at Lisbon in March 2000 Hughes, K. (2001) said that at the DOT.COM Summit at Lisbon in March 2000, the EU set itself the strategic goal of creating full employment in a competitive and inclusive knowledge-based economy. The author stated that to reach this goal, EU prime ministers announced the adoption of a new open method of co-ordination, which is based on benchmarking and spreading best practice. Such method the author said is really intended to help member-states converge towards common objectives in areas such as employment, economic reform and social cohesion. The objective of full employment (Grubel, 1977) will always be an objective of every right-thinking state for the fulfilment of which guaranties peace and security among citizens. The four stages of OMC as described by Hughes, K. (2001) includes the following: First, EU ministers agree on policy goals in the area concerned.   Second, member-states translate these guidelines into national and regional policies, with specific targets.   Third, the ministers agree on benchmarks and indicators, to measure and compare best practice within the EU and worldwide.   Finally, through evaluation and monitoring, member-states performances are assessed relative to each other and to their declared goals. Hughes, K. (2001) also posited that advocates of this soft (i.e. not law-based) approach argue that it enables member-states to co-operate closely, yet recognizes their diversity and avoids forced harmonization. The author also opined that the approach allows co-coordinated action in areas where it would be politically difficult, or even impossible, to move forward through a common policy or legal framework.   In addition, the author said that it allows for a concerted EU approach while leaving legal competence and authority with the individual member-states.   Thus, Hughes, K. (2001) concluded that progress can be made through open co-ordination where otherwise there would be none. To balance the claim of OMC, Hughes, K. (2001) noted the fear of the critics, who believe that open co-ordination is at best a talking-shop and at worst a weapon aimed at the traditional Community method of European integration. Thus the author said: â€Å"They view the new approach as a Trojan horse for more inter-governmental decision-making. Whether they are right will become apparent as the targets of the Lisbon summit are met or not over the next few years. The more difficult question is whether it is indeed another tool for integration, or rather a move towards increased, and perhaps less effective, inter-governmentalism.† To produce a set of common but not legally-binding, objectives for tackling poverty and exclusion would seem to be an useless exercise since everything would be based on voluntary decision of the members since whatever may be agreed upon are not legally binding. But this was what happened at Lisbon where the EU leaders suggested that open co-ordination should apply to areas such as social exclusion, enterprise and e-Europe, where most or all powers remain with the member-states. Hence, Hughes, K. (2001) noted that the member-states will produce national action plans for reaching these objectives, on which the Commission will then comment. OMC therefore seems to be a unique way of solving problems among members where the absence of legally binding rules will not hinder the members to act on what is beneficial to them. The members states must really have to rest on the strength of the political pledge to the development, on its professed worth and efficacy, and on peer pressure and public support. The European Economic Integration It would be incomplete to look at OMC if none is mentioned about European economic integration. Wikipedia (2006) acknowledged the fact that thee OMC was first applied in EU employment policy, as defined in the Amsterdam Treaty of 1997, although it was not called by this name at the time. It stated that OMC was officially named, defined and endorsed at the Lisbon Council for the realm of social policy and since then, Wikepedia (2006) said the approach has been applied in the European employment strategy, social inclusion, pensions, immigration, education and culture and asylum. Tsoukalis, L. (1997) in describing the process of European economic integration said: â€Å"It concentrates mainly, although not exclusively, on the more recent phase which started around the mid-1980s and which has been characterized by a continuous expansion of the European agenda, the strengthening of intra-European economic ties, the transfer of new powers to common institutions, as well as the geographical extension of what we may call the European economic system.   †¦.   The process of integration has always been characterized by fits and starts, by bursts of activity which have often been followed by crisis and relative inaction. In the early 1990s, the economic and political climate changed once again, the deterioration of the macroeconomic environment being accompanied by successive crises in the exchange markets and growing scepticism about the future of European integration. Unemployment rates reached dangerous heights, while economic growth receded. And the armies of unemployed began to seriously threaten Europes welfare systems. Yet the process of integration did not stop; far from it. And the plan for EMU has remained on the table with a treaty seal on it. The remaining years until 1999 are therefore most likely to be dominated by preparations for the historic rendezvous with the single currency, a rendezvous which, if it does take place as scheduled, some countries at least are bound to miss.† Tsoukalis, L. (1997) also said that during the same period, the EU has gone through two more rounds of enlargement, with the accession of five new members (without counting the accession of the Eastern Là ¤nder following Germanys unification). Mentioned by the author was also the fact EU has also gone through two major treaty revisions, linked to the internal market program and EMU respectively, while a third one is under negotiation as of 1997 then. The author argues that those developments show hardly any signs of withering away. On the other hand, the same author said that there is the allegedly unstoppable trend of economic globalization which, according to so many experts and laymen, leaves little room for public regulation and effective intervention, citing as examples Ohmae (1990), Hirst and Thompson (1996) and Boyer and Drache (1996). The author also posited that European integration has indeed evolved within the context of growing international economic interdependence, a term still often used instead of globalization by the less exuberant representatives of the economics profession. 2.3 Analysis of the concept of social inclusion/exclusion (according to Atkinson). OMC could not be discussed in isolation with social inclusion/exclusion, hence out understanding of the OMC necessitates us to look more on the concepts of social inclusion (Planning Portal, 2006) and social exclusion (Kerrycdb, n.d.). Atkinson, et. al. (2002) described the concept of social inclusion and exclusion as follows: â€Å"I know there is some scepticism about the open method of coordination given its character of soft law. Yet I am convinced that an effective open method of coordination in the field of social inclusion can play a crucial political role at this stage in European politics. It will create a common understanding of our core social values that goes beyond solemn declarations at the level of heads of state and government, and so should enable us to define in a more precise way the substance of the European Social Model. It has, then, the potential to be a powerful driver.† (Emphasis supplied). The optimism of the authors (Richardson, 1994) is readily evident.   In certain circumstances, a law may have power to demand compliance (Hutter, 1997) but one could hardly limit human freedom to choose (Hill, 1993) and decide for the themselves. On discussing Principles of Indicator Construction in relation to social inclusion/exclusion Atkinson, et. al. (2002) said:   â€Å"†¦ it is an important feature of this process that the policies to achieve social inclusion are the responsibility of member states, under the subsidiary principle. Social inclusion is to be promoted through the method of open coordination, as described above. Member states are to agree on the objectives of policy, but they will be free to choose the methods by which these objectives are realized. One member state may achieve low poverty rates by active labour market policy; another may place greater reliance on social transfers. In one member state transfers may be provided by the state, in another transfers may be private. In one member state training may be associated with apprenticeships; in another, it may be part of the school system. This we have taken to mean that, for the present purpose, the social performance indicators should in principle be concerned with outputs rather than inputs. The aim is to measure social outcomes, not the means by which they are achieved. †¦.† Readily evident is the fact that indicators social inclusion/exclusion be seen in outputs and inputs that Atkinson, et. al. (2002) went further saying: â€Å"While we regard total spending on education, for example, as a measure of the resources being put into education, and hence would prefer a measure of educational attainment, we recognize that the availability of teachers may be an index of educational opportunities. If our concerns are forward-looking, then we may take into account the possibility that one can benefit from a service in the future. Confidence in the future can be improved by the existence of services; they have an option value that is a form of current output. A sense of exclusion may be generated by the absence of educational or health facilities. A person may be over school age but still feel that the absence of a secondary school in his or her town is a factor in social exclusion.† (Emphasis supplied) On discussing Social Indicators from a Member State Perspective, Atkinson, and et. al. (2002) said: â€Å"For a valuable review of both European and national initiatives, predating the National Action Plans on Social Inclusion, readers are referred to Vranken et al. (2001).† The same authors also made comparison of the conceptual frame-works adopted in different countries, the databases employed, and the indicators used. After which they consolidated national reports on poverty and social exclusion that have been formed by official and academic researchers. Further, the same authors said: â€Å"Member states differ in the degree to which they have set explicit targets for combating social exclusion. In some cases there are strategies aimed at promoting social inclusion that already include explicit targets and indicators against which to measure the effectiveness of policy. Some countries, such as Ireland, have set a national objective for the reduction of financial poverty; others have adopted a set of progress indicators by which performance is to be evaluated; and still others monitor the trends in poverty and social exclusion in a less structured manner and without pre-commitment to identified targets.† Based on said premises the author opined that the amount of space allocated to each country varies. He was quick however to mention that in each case, however, a National Action Plan on Social Inclusion (NAPincl) was submitted to the Commission in June 2001 and that the NAPincls were requested to state the progress aimed for by national policies and to list the indicators used to assess progress, and the European Union is to move from that base towards commonly agreed and defined indicators.   (Paraphrasing made) 2.3 Did the OMC social inclusion made any improvement since Lisbon like through National Actions Plans? Although there are several members stated which have adopted jointly the OMC as strategy, what is cited in answer to the question is that one involving U.K. OMC social inclusion made any improvement since Lisbon on different occasions based in the following: a. On National Actions Plans European Commission, Employment Social Affairs, Social Inclusion (2006) on Implementation and update reports on 2003-2005 National Action Plans on Social Inclusion said: â€Å"The second UK NAP (2003-05) maintains the process of developing a broad and comprehensive strategy. Facilitating access to employment for those capable of working is at the centre of the strategic approach and has been helped by continued good economic and employment growth. The strategy also envisages the provision of good income support and high quality social services to those who cannot access work. Among the groups identified as requiring special support are: lone parents; the long-term unemployed; older people; those with few or no qualifications; ethnic minority communities; sick or disabled people; and residents of deprived neighbourhoods. The strategy involves commitment to a number of targets, supported by national indicators, most notably the aim of eradicating child poverty by 2020.†Ã‚   The Commission also noted that an important measure to help meet this target has been the provision of high-quality, integrated early-years education and health, family support and childcare services in the most disadvantaged areas. Hence, the Commission believes that these services will now be extended to cover all areas of England over the next ten years and it’s thus noted that the European Social Fund has a key role in support of the National Action Plan to help people develop their employability and skills, with a particular focus on unemployed and socially excluded people. b. On how open a member state to the process Armstrong, K. (2005) in concluding the paper â€Å"Implementing The Lisbon Strategy: â€Å"Policy Co-Ordination Through ‘Open’ Methods: How Open Is The United Kingdom To The OMC Process On Social Inclusion?† stated among other things, that his study has found examples of domestic adaptation to the OMC process on inclusion. He cited that these examples relate in particular to the mobilisation of anti-poverty networks and the willingness of central government civil servants to develop new working relationships with such networks. He thus mentioned that DWP and NGOs have joined forces to develop a participation tool-kit for the next round of NAPincls is an indication of a desire to break out of traditional bureaucratic routines and at least gives the appearance of a commitment to the NAPincls. The author further said that attitudes towards the NAPincls from the devolved administrations is more ambivalent, although the idea that the EU process might serve as a model for recasting the Northern Ireland anti-poverty strategy suggests a stronger adaptation dynamic at work here. Nevertheless, the author admitted the difficulty, that it is that it is hard to escape the conclusion that notwithstanding the elaboration of new processes, the UK NAPincl remains primarily a report and not a plan. He thus noted that to be sure, it has filled a gap between the central and devolved government social exclusion and anti-poverty reports and acts as an overview of the UK as a whole. The author also noted that the lack of synchronisation between the EU co-ordination processes and the domestic cycle of budget-planning and target-setting results in a reinforcement of the domestic arena as the key driver of social inclusion objectives, indicators and targets. This he believes undercuts the ability of the UK NAPincl to do more than report on what has already been agreed. (Paraphrasing made) Armstrong, K. (2005) also said that the research reported here also highlights two different political visions of the future of OMC. Particularly he noted the evidence of domestic adaptation – particularly at the level of central government – points to the importance of altering domestic mind-sets and routines in order to buttress commitments to political change. The alternative vision, however, the author observed is that is one that looks to EU institutions – in particular the European Council – to deliver high-level messages and to steer the Member States in the desired direction. He thus argued that it may not be a matter of choosing which vision to follow but the evidence of the Lisbon Strategy to date has been that there remains a gap between the big statements of political intention and delivery within the Member States. Thus he recommended that more needs to be done to uncover the domestic mechanisms of adaptation in order to explain the success or failures of the commitments made at Lisbon. (Paraphrasing made) Conclusion: There is evidence for a European to make a statement such as: â€Å"We are we a step closer to European Social Model and is the OMC the right approach.† OMC social inclusion made any improvement since Lisbon on the basis of the following: Although there is no legal compulsion to do things in OMC, there is evidence to say that voluntary actions do accomplish great things. Even in the absence of compelling force on the basis of legislation, people have goods reasons of accomplishing their political and economic purposes. The implementation of the OMC in the United Kingdom is one of the best proofs. Although more concrete proofs are still necessary to really declare that OMC will lead the members states to success, positive developments in the early implementation bears much goods results to further build upon. The power of humanity is not only manifested in having law to force them to move but also making them more willing effort to do things when they believe that right decisions just make many great things, and OMC is the one of these.

The clinical efficacy of salvia officinalis

The clinical efficacy of salvia officinalis An evaluation of the clinical efficacy of Salvia officinalis, Salvia lavandulaefolia and Melissa officinalis for the prophylaxis, management and amelioration of cognitive dysfunction: with particular reference to Alzheimers disease and non-Alzheimer-type senile dementias. 1. Introduction Dementia is a collection of symptoms caused by a chronic, global deterioration of cognitive function. It can occur at any age but is most prevalent in the elderly and increases with age (Beers et al. 2006: 1811). Around 5% of people over 65, 25% over 80 and 45% over 85 have some form of dementia (Knapp et al. 2007: 10; Collins 1997: 185). The population is aging and whereas today there is an estimated 700,000 people in the UK suffering from dementia, this number is set to increase to more than a million by 2025. The huge impact dementia has on society, devastating families and costing around  £17-18 million annually cannot be overstated (Knapp et al. 11). Early identification and safe, effective, intervention is therefore important. Dementia may be classified as Alzheimers or non-Alzheimer-types (Beers et al. 2006: 1811). The most common dementia is Alzheimers disease (AD) (Grossman et al. 2006: 985), affecting around 20 million people worldwide (Akhondzadeh et al. 2003: 53) and accounting for around 62% of dementias (Knapp et al. 2007: 11). Non-Alzheimer-type dementias typically affecting those over 60 include vascular dementia (27%), Lewy body dementia and fronto-temporal dementia (Knapp et al. 29). Cognitive disorders are treated allopathically with drugs that have yet to show real benefits and have a number of side-effects and contraindications. The need for safer, more effective treatments has led to increasing interest in the use of herbs for their management (Akhondzadeh and Abbasi 2006: 117). A variety of herbs, for example Salvia officinalis, Rosmarinus officinalis, Mellissa officinalis, Ginkgo biloba (Heinrich et al 2004: 234), Withania somnifera (Howes et al. 2003: 12), Centella asiatica (Chevallier 1996: 78) and Panax ginseng (Mantle et al. 2000: 207) have long-standing traditional use as memory-enhancing herbs. Consequently a number of clinical studies have been conducted to assess the efficacy of some of these herbs, most notably Ginkgo biloba, Salvia spp. and Mellissa officinalis, in the treatment of cognitive disorders. Of these, only clinical trials of Gingko biloba have been extensively reviewed (Birks and Grimley Evans 2002; Ernst et al. 1999; Oken et al. 1998). This present review aims to fill this gap by providing up-to-date information on whether clinical studies of Salvia spp. and Mellissa officinalis support their traditional use as cognition enhancers. To inform herbal practice it will evaluate clinical studies to assess whether the results have determined safe, effective herbal strategies and prescription for prophylaxis, management and amelioration of cognitive decline. 2. The literature review 2.1. Background: clinical presentation and pathology Although much scientific progress has been made since 1907 when Alois Alzheimer first described a case of dementia with â€Å"peculiar patches† disseminated throughout the cerebral cortex (Collins 1997: 185), there is still much to learn about the aetiology and pathogenesis of Alzheimers disease and other dementias (Knapp et al. 2007: 11). The onset of dementia is insidious, often beginning as mild cognitive impairment (MCI) and progressing to severe dementia over time (Loveman et al. 2006: 4). In the early stages, episodes of mild forgetfulness or misplacing possessions are often attributed to normal aging. Patients commonly suffer from anomic aplasia and agnosia but retain language comprehension (Collins 1997: 186). Dementia becomes more apparent when sufferers are unable to learn new information, to register the content of a conversation, or to recall recent events or the names of family members. Unlike those with benign forgetfulness, dementia patients are unaware of their amnesia. Frequently, there are mood changes, depression and other psychologic disturbances. Language comprehension fails (aphasia) and eventually patients may simply repeat what they hear or be unable to speak at all. Visuospacial deficits usually occur at a late stage (Collins 1997: 186). Those affected have difficulty in copy drawing simple obj ects. Differential diagnosis between MCI subtypes of various and complex aetiologies is challenging (Kidd 1999: 145). As some MCI subtypes are reversible (Levey et al. 2006: 992) prophylaxis for dementia could potentially encompass a range of varied or unknown aetiologies and risk factors. Knowledge of these and an awareness of differing clinical presentations are therefore important (Levey et al: 991). Additionally, an understanding of current orthodox treatment strategies and key neurochemical impairments in dementia can inform herbal practice of the most likely therapeutic actions of herbs. 2.1.1. Alzheimers disease As clinical studies have indicated that mild to moderate Alzheimers disease (AD) responds better to allopathic drugs than severe AD (Levey et al: 2006: 993), to prevent transition of MCI to AD early diagnosis is important. Evidence suggests that MCI associated with memory loss most commonly leads to AD (Levey et al. 991) and results of a clinicopathologic study of 80 subjects with MCI through to autopsy suggest that depression is one of the first features of AD (Galvin et al. 2005: 763). Formation of diffuse neuritic senile plaques in the brain is characteristic of AD but as these can only be determined from biopsy (Collins 1997: 186) probable diagnosis is made by clinical neuropsychological testing (Grossman et al. 2006: 986) such as the Mini Mental state Examination (MMSE) (Alzheimers Society 2002: 436), while magnetic resonance imaging can corroborate diagnosis by identifying areas of temporal neuronal loss (Vandenberghe and Tournay 2004: 347). Progression of AD is unremitting for around 5-10 years until death ensues. In the final stages sufferers may develop apraxia, with difficulty in performing familiar tasks. A common cause of death is pneumonia when patients eventual difficulty with eating results in aspiration pneumonia (Collins 1997: 186). The loss of faculties has been ascribed to both structural and neurochemical abnormalities (Perry et al. 1996: 1063). Senile plaques in the brains of AD patients contain amyloid and tau protein (microtubule associated protein) (Collins 1997: 188). Since isolation of b-amyloid peptide from cerebral vessels in AD patients (Wong et al. 1984: 8729), the accepted hypothesis for the pathogenesis of AD has been the ‘amyloid hypothesis, which proposes that AD is due to excessive formation of extracellular b-amyloid (Ab?) from amyloid precursor protein (APP), a membrane protein in neurons (Grossman et al. 2006: 986). It is thought that Ab molecules initiate a toxic cascade long before plaque forms by causing an inflammatory reaction, disrupting synaptic function and causing neurons to degenerate (Grossman et al. 986) with a loss of cholinergic fibres in the basal forebrain. In vitro results suggest that Ab enters mitochondria and induces free radical damage (Reddy 2006: 9). Intracellular neurofibrillary tangles are believed to be formed by abnormal phosphorylation of tau proteins (Tanzi and Bertram 200 5: 545), particularly in the hippocampus and neocortex, areas of the brain involved in memory (Mantle et al. 2000: 202). To date, thirteen genes have been implicated in AD (Bertram et al. 2007: 17). Of sporadic late onset Alzheimers up to 40% of cases may be due to a faulty gene on chromosome 21, ApoE4, an isoform of the ApoE gene that encodes for apolipoprotein, an astrocytic protein that may play a role in the reparative process in the brain. ApoE4s pathogenetic mechanism may be to enhance amyloid deposits within tissue by accelerating cleavage of b-peptide (Collins 1997: 189). Possession of a gene implicated in AD does not necessarily result in its development, the likelihood of which is further complicated by the potential role of environmental factors such as viruses and toxins in combination with genetic factors (Bird 2005: 864). 2.1.2. Vascular dementia Vascular dementia (VaD) is any type of dementia caused by cerebral blood vessel disease (Micieli 2006: S37). Onset of VaD is usually abrupt. Imaging may reveal areas of multiple infarcts (Collins 1997: 191) but their presence does not necessarily imply dementia (Grossman 2006: 987). According to Looi and Sachdev (1999) it is not possible to differentiate between AD and VaD with neuropsychological testing. Speech and language difficulties associated with vascular dementia may be mild or there may be a more pronounced aphasia as in multi-infarct VaD (Collins 1997: 191). 2.1.3. Frontal lobe dementia Frontal lobe dementia or Picks disease is uncommon and is characterised by neuronal loss and gliosis. Rarely, there are fibrillary inclusion bodies in the neurons. Presentation of frontal lobe dementia differs from AD in that the first symptoms are a change in personality rather than memory loss (Collins 1997: 193). 2.1.4. Lewy body dementias Dementia with Lewy bodies may differ to AD in its presentation in that patients suffer from marked visual hallucinations. Additionally, cognition tends to fluctuate between normality and confusion. Parkinsonian features such as shuffling gait, tremor, bradykinesia and rigidity are prevalent. Sleep behaviour disorder, such as acting out attacking themes, may appear years before other signs of the disease (Grossman et al. 2006: 989). 2.2. Risk factors Factors believed to pose a risk for developing dementia include cardiovascular disease, being female, a family history of dementia, Downs syndrome, older age, head trauma, diabetes and lower educational standards (Collins 1997: 186, 188; Lebson et al. 1997: 301). 2.2.1. Cardiovascular disease: Patients may have more than one type of dementia concurrently (Beers et al. 2006: 1811). This is compounded by results of a number of epidemiological studies suggesting that cardiovascular disease increases the risk of developing AD (Stampfer 2006: 12). Using transcranial Doppler ultrasonography Sun et al. (2007: 152) demonstrated diminished cerebral blood flow velocities in MCI patients who also carried the ApoeE4 allele. Risk factors for VaD are believed to include artherogenic factors such as hypertension, hyperlipidaemia, diabetes, and cigarette smoking (Micieli 2006: S38). Conversely, there are indications from clinical trials that nicotine has a protective effect for AD (Breteler et al. 1992: 71). Results of a randomised, double-blind, multicentred trial in which subjects with hypertension were treated with antihypertensives or placebo suggest that hypertension is a risk factor for developing both AD and VaD. Antihypertensives reduced risk by 55%. The results were significant as subjects had similar characteristics, the sample size was large (3228) and equally divided into placebo and treatment groups. Median follow-up was 3.9 years (Forette et al. 2002: 2047). 2.2.2. Head trauma: A meta-analysis by Fleminger et al. (2003: 858) replicated earlier findings by Mortimer et al. (1991) that head injuries pose a risk for AD but only in males, thought to be due to an early protective effect of oestrogens in females (Fleminger et al. 860). Bias may have been introduced into both studies as informants recalled the injuries. 2.2.3. Diabetes mellitus: Given that diabetes mellitus (DM) is a known risk factor for vascular disease it is not surprising that most studies on the development of vascular dementia in DM patients have shown a positive association (Biessels 2004: 10). Studies on DM as a risk factor for AD, however, have yielded conflicting results, possibly due to study limitations such as small sample sizes and selection bias (Leibson et al. 1997: 301). Large longitudinal studies may be more reliable. A population-based historical cohort study of 1,455 cases followed over 9,981 person years found a statistically significant positive association (Leibson et al. 304). According to results from the Framlingham Study, diabetes may not be an independent risk factor for developing AD but risk is strongly associated with possession of the ApoE4 genotype (Akomlafe et al. 2006: 1551). 2.2.4. Hormones: Women are twice more likely than men to suffer from AD. Although this may be partly due to women having a longer life expectancy (Beers et al. 2006: 1814) there is evidence to suggest that a decline in endogenous oestrogen in later life plays a role in its pathogenesis. Oestrogen is believed to stimulate cholinergic activity, reduce oxidative stress related cell damage, reduce vascular risks, reduce Ab formation and promote synaptic activity (Zandi et al. 2002: 2123; Hoskin et al. 2004: 141). Evidence from studies to determine whether oestrogen-containing hormone replacement therapy (HRT) in women has a protective effect on the brain, however, is conflicting (Colucci et al. 2006: 1376) but this may be due to differences in methodology and confounding factors (Resnick and Henderson 2002: 2171). For example, in one large prospective study that found a positive correlation between HRT use and a significant reduction in AD development, patients with dementia were asked q uestions regarding previous use of HRT (Zandi et al. 2124) yet accurate recall in a dementia sufferer cannot be guaranteed. Results of a retrospective case-control study suggesting the likelihood of women developing AD increases with number of pregnancies (Colucci et al. 2006: 1375) could be of little value. Cases with previous head injuries, low educational standards, both considered risk factors for AD (Collins 1997: 186; Fleminger et al. 2003: 858), and those who had used HRT, were not excluded from the study. There is evidence to suggest testosterone may delay AD onset in men. Men over 32 years of age who were free from AD at baseline (n = 574) were followed for a mean of nineteen years (Moffat et al. 2004: 188). Long-term free testosterone levels were significantly lower in men who developed AD. Due to conflicting results and confounding factors in the research the clinical evidence for risk factors for dementia is inconclusive. However, although more research is needed the results can assist in informing herbal practice. 2.3. Orthodox treatment strategies As cholinergic neurotransmitters are believed to have a role in memory function (Grossman et al. 2006: 985) symptomatic treatment for subtypes of dementia is similar and focuses on acetylcholinesterase (AChE) inhibition with drugs such as donepezil, rivastigmine and galantamine (Loveman et al. 2006: 8). According to Delagarza (2003: 1366) loss of cholinergic neurons causes a decrease in acetylcholine and subsequent drop in AChE with a compensatory rise in butylcholinesterase (BChE). Nicotinic receptors also decrease. Rivastigmine also inhibits BChE; galantamine also acts on nicotinic receptors. Depression in dementia is treated with non-anticholinergic antidepressants as anticholinergic drugs exacerbate symptoms (Beers et al. 2006: 1814). Another drug, memantine, a N-methyl-D-aspartic acid (NMDA) receptor antagonist (Grossman et al. 987), licensed to treat moderate to severe AD, acts by modulating the action of the neurotransmitter glutamate, which is believed to be associated with c holinergic damage and neurodegeneration when secreted in excess (Loveman et al. 2006: 8). Dizziness, diarrhoea, headaches, nausea and vomiting were found by a meta-analysis of dementia drugs to be common adverse events with anti-cholinesterases and memantine (Loveman et al. 2006: 49). Furthermore, their long-term benefits are inconclusive (Loveman et al. 145). Similarly, their use for vascular or Lewy body dementia is controversial as a review of clinical trials data deems there is insufficient evidence for their efficacy. Trials were of generally poor quality and with inconsistent findings (Maggini et al. 2006: 457). Other potential drugs for AD include 70 new compounds formulated to interfere with the toxic amyloid cascade or to target inflammation, oxidation or apoptosis (Grossman et al 2006: 987). As g-aminobutyric acid (GABA) agonists can impair memory GABA antagonists are also being developed (Association of the British Pharmaceutical Industry). 2.4. Potential herbal treatment strategies In view of the hypothesised pathological sequelae, risk factors and current orthodox treatment of dementias, efficacious herbs for these conditions could potentially have one or more of AChE-inhibiting or cholinergic, antidepressant, hypotensive, hypoglycaemic, antioxidant, anti-inflammatory, GABA modulator, nicotinic agonist, testosterogenic and oestrogenic actions. According to Kennedy and Scholey (2006: 4614) orthodox AChE inhibitors are not well tolerated by patients as they are toxic alkaloids and European plants traditionally used for cognitive enhancement may therefore provide non-alkaloid safer alternatives. To this end Salvia officinalis, Salvia lavandulaefolia and Melissa officinalis, members of the Labiatae family (Lamiaceae), have been extensively investigated in vitro. 2.4.1. Salvia spp. Salvia is the largest genus in the Labiatae family with over 700 species. The most common European species are Salvia officinalis L (garden or common sage) (Figure 1) and Salvia lavandulaefolia Vahl (Spanish sage), both of which originate on the shores of the Mediterranean (Kennedy and Scholey 2006: 4614). S. officinalis is an aromatic, evergreen shrub up to 75 cm in height with greyish-green oblong to lanceolate opposite leaves covered in a fine down. It has bluish-violet, two-lipped flowers arranged in whorls (Wildwood 1998: 202). S. lavandulaefolia has narrower leaves and a lower spreading habit (Sergei Savelevs Database). Sage was used in medieval Europe as a tisane for prolonging life and is a traditional spring tonic for strengthening weak constitutions (Lipp 1996: 63). According to Culpepper (1826: 147) ‘Sage is of excellent use to help the memory, warming and quickening the senses and an old country remedy, which indicates its efficacy for inflammation: ‘A sunburnt face is eased by washing with sage tea (Page 1978: 41). Other traditional uses are for headaches and migraine (Page: 34). The major active constituents of the leaves of both species are believed to be the volatile oils (1.0-2.8%), containing monoterpenes such as a-pinene, b-pinene, 1-8-cineole, camphor, geraniol and thujone (Kennedy and Scholey 2006: 4615). S. officinalis contains around 50% a- and b- thujone whereas only traces have been found in S. lavandulaefolia. As thujone, a terpenoid ketone, is potentially neurotoxic, S. lavandulaefolia may provide a safer alternative than S. officinalis to orthodox dementia drugs (Perry et al. 1999: 530). However, S. officinalis is toxic only at doses of over 15 g (Grainger-Bissett and Wichtl 2001: 441) but the oil should not be ingested. Both species contain polyphenolic compounds including rosmarinic acid, methyl carnosate, luteolin, luteolin-7-0-glucoside and caffeic acid (Kennedy and Scholey 4615), triterpenes eg oleanic acid and the flavonoids 5-Methoxysalvagenin (Barnes et al. 2002: 408) and hispidulin (Johnston and Beart 2004: 809). 2.4.2. Melissa officinalis M. officinalis L (balm, lemon balm) (Figure 2) originates from the eastern Mediterranean region and western Asia and is now widely cultivated in the west (Grainger Bissett and Wichtl 2001: 329). It is a bushy perennial, about 60 cm high with bright green, lemon-scented leaves in opposite pairs. Small labiate flowers grow in whorls and change colour from pale yellow to white or pale blue. Fresh leaves should be collected when young (Wildwood 1998: 175). It has been in medicinal use as a nervous system restorative for over 2000 years (Kennedy and Scholey 2006: 4617). The London Dispensary (1696 cited in Grieve 1931) states: ‘An essence of Balm, given in Canary wine every morning will renew youth, strengthen the brain John Evelyn wrote: ‘Balm is sovereign for the brain, strengthening the memory and powerfully chasing away melancholy (cited in Grieve 1931). There are no known contraindications or adverse effects (Barnes et al. 2002: 339). M. officinalis contains 0.2-0.3% essential oil (EO) consisting of over 70 components including around 60% monoterpenoid aldehydes and over 35% sesquiterpenes. The principle monoterpenes include citronellol, neral, geranial, methyl citronellate, ocimene; major sesquiterpenes include b-caryophylene and germacrene D. The herb also contains flavonoids, caffeic and chlorogenic glycosides, polyphenolic acids such as rosmarinic acid, and triterpenes (Granger Bissett and Wichtl 2001: 330). 2.5. Possible mode of action of phytochemical constituents in dementia 2.5.1. Antioxidant properties Numerous studies have been conducted on Salvia officinalis in a search for natural antioxidants to use in the food industry. Consequently, results of chemical tests on purified extracts of the herb have suggested that phenolic compounds rosmarinic acid, carnosic acid, carnosol, carnosoic acid, rosmadiol, rosmanol, epirosmanol, isorosmanol, galdosol methyl carnosate, 9-erythrosmanol and luteolin-7-0-glucopyranoside have significant antioxidant activity (Bertelsen et al 1995: 1272; Cuvelier et al. 1994: 665; Pizzale et al. 2002: 1651; Miura et al. 2002: 1848; Wang et al. 1998: 4869). S. lavandulaefolia dried leaf extracts in ethanol, chloroform and water, and various EO monoterpenes were assayed for antioxidant properties in phospholipid microsomes. The extracts and monoterpenes a-pinene, b-pinene, 1-8-cineole, camphor and geraniol and thujone all showed significant antioxidant activity (Perry et al. 2001: 1351). The extracts showed greater antioxidant activity than any individual monoterpenes, which suggested a synergistic effect (Perry et al. 1352). Ferreira et al. (2006: 35) measured the antioxidant properties of EOs, decoctions and ethanolic extracts of M. officinalis and S. officinalis relative to b-carotene. The EO and decoctions of both herbs showed significant antioxidant activity. Lima et al (2007) found methanolic and aqueous extracts of S. officinalis prevented lipid peroxidation in hepatoma cells. As there were more phenolics in the methanol extract it was thought there were other antioxidant compounds in the aqueous extract. Ethanolic EO extract from dried M. officinalis investigated for its ability to inhibit lipid peroxidation in vitro showed a dose-dependent (10-20 mg) 80-90% protection of linoleic acid from peroxyl radical attack. As no rosmarinic acid was detected in the EO the antioxidant action was attributed to squalene (Marongiu et al. 2004: 790). Considering there are potentially 70 constituents in the EO it is unlikely that this would have been the only active phytochemical but composition of the oil varies according to harvesting, origin and climate (Grainger-Bissett and Wichtl 2001: 329). Interestingly, M. officinalis prepared as a tea demonstrated significant antioxidant capacity, which corresponded to high phenolic content, when assayed with the ABTS (2,2/-azinobis 3-ethylbenzothiazoline-6-sulfonic acid) radical decolourisation assay (Ivanova et al. 2005: 147). 2.5.2. Anti-inflammatory activity Chloroform, aqueous and ethanol extracts and monoterpenes of S. lavandulaefolia, were tested for their ability to inhibit formation of pro-inflammatory eicosanoids thromboxane B2 (TXB2) and leukotriene B4 (LTB4) in leucocytes (Perry et al. 2001: 1348). The chloroform and ethanol extracts showed significant inhibition of LTB4. Alpha-pinene and geraniol showed weak selectivity for LTB4 and TXB2 respectively (Perry et al. 1351). The results support the traditional use of S. lavandulaefolia as an anti-inflammatory herb but indicate that it is the sum of the whole plant phytochemicals acting in synergy that are likely to contribute to this action. A standardised ethanolic extract containing 9.9% rosmarinic acid (RA) from the leaves of S. officinalis reduced Ab-induced neuronal cell death, Ab-induced lipid peroxidation, reactive oxygen species formation, DNA fragmentation and tau protein hyperphosphorylation in vitro (Iuvone et al. 2006: 1143). Kimura et al (1987) found rosmarinic acid (RA) had the ability to inhibit pro-inflammatory cytokines in human polymorphonuclear leucocytes (PMNs) in vitro. As both species contain RA these results suggest antioxidant, anti-inflammatory and neuroprotective properties of M. officinalis and the Salvia spp. against Ab-induced neurotoxicity. 2.5.3. Oestrogenic activity A range of concentrations of EO, ethanolic, chloroform and aqueous extracts and isolated monoterpenes of S. lavandulaefolia were assayed in yeast culture for oestrogen-binding properties. The EO showed weak oestrogenic activity at low concentrations. The aqueous and ethanolic fractions and geraniol showed significant oestrogenic activity (Perry et al. 2001: 1352). The results of this experiment support S. lavandulaefolias use as an oestrogenic herb. The effects of S. officinalis in combination with Medicago sativa were assessed on menopausal symptoms related to oestrogen deprivation. Hot flushes and night sweats were completely eliminated in 20 out of 30 women (De Leo et al. 1998: 207). These effects were attributed to dopaminergic actions but it is not clear for which herb. S. officinalis does, however, contain geraniol found to be oestrogenic in vitro (Perry et al. 2001: 1352). 2.5.4. Acetylcholinesterase inhibitory activity M. officinalis EO demonstrated strong AChE inhibition in homogenised human brain tissue but ethanolic extract of the dried leaf had no effect. Ethanolic fresh leaf extract showed a weak effect (Perry et al. 1996: 1064). Conversely, when EOs and ethanolic extracts of M. officinalis were assayed in solution with AChE negligible results were obtained for its inhibition by EO and significant results for its ethanolic extract (Ferreira et al. 2006: 34). Dried, reconstituted ethanolic, ethyl acetate or aqueous extracts of M. officinalis, yielding 10mg/ml, demonstrated weak AChE inhibitory activity when assayed in a chemical system using thin layer chromatography (Salah and Jà ¤ger 2005: 146). The herbs were purchased from local suppliers in the Lebanon so their quality is unknown. S. officinalis EO and ethanolic extract assayed in solution with AChE showed moderate AChE inhibitory activity (Ferreira et al. 2006: 34). Moderate (dose-dependent) AChE and weak BChE inhibition was demonstrated by ethanolic extracts of fresh and dried S. officinalis and S. lavandulaefolia in human brain homogenates. The EOs had significant effects but not the individual constituents (camphor, thujone, cineole, caffeic acid and borneol) (Perry et al. 1996: 1066). The findings suggest a major synergistic effect of the constituents (Perry et al. 2000: 895), which was later confirmed by Savelev et al. (2003: 667). The results for camphor conflict with another experiment in which S. lavandulaefolia EO and isolated monoterpenes a-pinene, 1-8-cineole and camphor demonstrated AChE inhibitory activity in human erythrocytes. Ethanolic extracts of dried S. officinalis, S. lavandulaefolia and M. officinalis were assayed for acetylcholine (ACh) receptor activity in human brain homogenate. All plants demonstrated ACh receptor activity and M. officinalis had the highest nicotinic displacement value (Wake et al. 2000: 108). 2.5.5. GABA modulation Methanol extract from S officinalis leaves revealed the flavonoids apigenin, hispidulin and cirsimaritin functioning as benzodiazepine receptor-active components (Kavvadias et al. 2003: 113), suggesting a potential calming effect for the herb, which may be relevant to AD. 2.6. Evaluation of in vitro studies According to the results all three herbs may have AChE inhibitory, anti-inflammatory and antioxidant properties, and S. lavandulaefolia and S. officinalis may have and oestrogenic properties (Appendix I, Table 1, page 36) and a sedative effect for S. officinalis. Although these results are interesting in vitro systems cannot be extrapolated to humans and clinical evidence is necessary to support findings. For example, they cannot determine effective human dosage or mode of administration. They largely do not account for potential synergistic effects of the herbs nor do they provide an indication of in vivo physiological, pathological and genetic, or environmental, influences. Furthermore, the extent to which phytochemicals in herbs are effective in dementia may depend upon their bioavailability in the brain (Anekonda and Reddy 2005: 371). It is worth noting, however, that as terpenoids tend to be lipophilic they are able to cross the blood brain barrier (Houghton and Howes 2005: 12). Some results are conflicting but they may depend on methodological quality and design. The experiments cited above vary widely in their approach with regard to extraction methods and assay methods. Savelev (2003: 667) has demonstrated how two different methods used for exploring interactions between the same agents may give different results when applied to the same set of data. Consistency of results may also be affected by differences in harvesting times and quality of herbs. Results for M. officinalis are particularly inconsistent but, according to Perry et al. (1996: 1068) most commercial sources of the EO are adulterated. Additionally, variation in media composition is known to affect the outcome of in vitro tests (Maurer and Kuschinsky 2006: 73). Consequently, in vitro experiments can only provide an indication of the clinical efficacy of therapeutic interventions. However, despite the inherent difficulties of in vitro research with herbs, there is considerable consistency with their potential value in dementia prophylaxis and management (Appendix I, Table I, page 36). Promising results in vitro of constituents of plants traditionally used to enhance memory, and subsequent interest in their potential actions in the brains of human patients, has generated clinical trials of M. officinalis and Salvia spp. for dementia. These will be reviewed. 3. Method A computerised literature search was conducted on the Allied and Complementary Medicine Database (AMED) including CINAHL Database, EMBASE, Pascal Biomed, Biological Abstracts, RCN Journals Database and IPA (International Pharmaceutical Abstracts); PubMed, the Cochrane Collaboration, Bandolier, the NHS Centre for Reviews, The National Research Register, ADEAR (Alzheimers Disease Education and Referral Centre database), PLoS (Public Library of Science), Herbalgram and Alt HealthWatch as well as hand-searching in books and journals. Literature searches dated back to 1985 and the final search was in April 2007. Key words in medical subject headings (MeSH) for an initial search in various Boolean combinations were: memory, cognitive dysfunction, dementia, Alzheimers, herbal, botanicals, phytotherapy, complementary and alternative. Also, in a second search these MeSh terms were entered with key herbs: Salvia, sage, Melissa and lemon balm. Inclusion criteria Controlled clinical trials, observational studies and case reports. Herbs for which there are at least two clinical studies in relation to cognitive enhancement. Exclusion criteria Due to the limitations and ethical considerations of animal experiments the review is restricted to human trials. Trials with combined preparations are excluded. Due to time constraints and a restriction to papers in the English language a complete systematic review is not viable at this time. To eliminate