Female Reproductive System free essay sample

At the point when a young lady arrives at the age of 13-15, she starts to ovulate or begins her period. This is the age of her sexual development, the time of sexual development in both male and female is called pubescence. The female regenerative framework is a perplexing and significant framework. The framework serves three principle capacities: to store ova, to deliver ova, and to keep a treated egg until it is prepared to live all alone. What occurs in this age? Adolescence is set apart by changes in the body for instance, in the female the bosoms begin creating, pubic hairs likewise develop and you become much progressively cranky. The principal monthly cycle in the life of a young lady is called menarche. In the female, the interior private parts are the ovaries, the fallopian tubes, the uterus and the vagina. The ovary it is a combined organ. Every ovary of the grown-up female is an oval body and weight 2-8 grams. We will compose a custom article test on Female Reproductive System or on the other hand any comparative theme explicitly for you Don't WasteYour Time Recruit WRITER Just 13.90/page The ovum drops into the body hole. The procedure is called ovulation; the ovum which is discharged in to stomach cavity is pushed towards the oval channel. The ovum at long last enters the channel and starts descending the pipe. The ovum is extremely little the size of a pinhead. The ovary discharges one ovum like clockwork. Next comes the uterus or belly, it is an empty, pear-molded strong structure. Its upper more extensive part is known as the corpus uteri and the limited segment is the cervix. The depression of the belly is 7-8 centimeter long. The outside genital pieces of the female incorporate the external and the inward lips and the clitoris. The external and internal lips close the openings of the vaginal cylinder, the vestibule. The clitoris is found in the pubic parted. In feminine cycle eggs will never be embedded in the uterus in the unfertilized state. After around fourteen days of ovulation the uterus starts to contract. This sign is of fixing the arrangements it had made to get to have an infant. Upon the compression of uterus, the blood vessels break, and the blood streams out through the vagina. The blood alongside tissue flotsam and jetsam is called menses. Monthly cycle goes on for 3-4 days. Monthly cycle happens 14 days after the ovulation. Again 14 days after period, there is new ovulation. Both these procedures stop once pregnancy had set in. There are post-preparation changes like, mplantation after treatment the conceptive organs are coordinated towards an alternate arrangement of exercises. As the treated egg goes down the oviduct, it experiencing mitotic cell division, it is a relentless procedure, however for our benefit we partition the post-preparation occasions in to various stages. At the point when the phone shapes a mass of cells there is no space inside the gathering, it’s called the morula stage. The ce lls of morula modify in a way to leave some space. This stage is called blastula; accordingly it is blastula which is inserted in the uterus. This procedure is called implantation. The mass of the uterus is thick and its divider has muscles, organs and blood vessels. As the prepared egg dissolves into the uterine divider, there is some disintegration of blood hairlike. Subsequently the blood comes out and the blastula gets nourishment from that blood. This will create in to hatchling lastly an infant. At the point when the blastula embedded in the uterus of the mother, it keeps on developing by cell division. There significant layers of cells create. These are the germ layers. Films are created and the peripheral layer of the incipient organism is framed and now called chorion. The second covering of the incipient organism is amnion, which promptly encompasses the embryo and secures it. Inside this covering there is an amniotic liquid which shields the incipient organism from stuns just as any significant injury. There is a close contact between the veins of the uterus and that of the hatchling through the placenta. Umbilical line fills in as a connection between the embryo and maternal dissemination. At the point when the early stage improvement is finished, the infant is conceived. The infant is pushed out by the constriction of the uterine muscles; this is called birth. Somewhere close to 45-55 years the ovary quits discharging the egg. We can say that the ovary has gotten nonfunctional. Menopause is an ordinary piece of a womans maturing process. The ovaries quit discharging eggs, and menstrual periods stop. Most ladies experience menopause around age 50. Before to menopause, menstrual cycles frequently become off. The ovaries are less dynamic to invigorating hormone and luteinizing hormone. To attempt to compensate for the diminished reaction, the body delivers MORE of these hormones. The degree of these hormones will diminish. The hormones created by the ovaries incorporate the various types of estrogen, progesterone, and prolactin. The ovaries keep on creating modest quantities of testosterone and some estrogen. The hormones delivered by the pituitary organ are likewise diminished. Since hormone levels fall, changes happen in the whole regenerative framework. The vaginal dividers become less flexible, more slender, and less inflexible. The vagina decreases and shorter. At the point when period stops in a lady, it is underestimated that she won't have the option to have a kid any more. Completion of feminine cycle is called menopause.

The Return: Shadow Souls Chapter 38

â€Å"Talon! Uh †heel!† Elena yelled and started to race as quick as possible to escape the room. This was procedure. Would the owl become considerably littler to get past the entryway or would it decimate its haven so as to keep steady over Elena? It was a decent system, yet it didn't add up to much at long last. The owl shrank to shoot through the entryway, and afterward continued massive size to assault Elena as she ran down the steps. Indeed, ran. With every last bit of her Power diverted to her eyes, Elena jumped from venture to step as Damon had previously. Presently there was no time for dread, no time for deduction. There was just time to turn over in her fingers a little, hard, sickle molded article. Shinichi and Misao †they made it into her home. There must be a stepping stool or something made of glass that even Damon couldn't see, in the flowerbed where Saber had halted and yapped. No †Damon would have seen it, so they more likely than not brought their own stepping stool. That is the reason their path finished there. They climbed straight up into the library. What's more, they demolished the blossoms in the bed, which is the reason the new blossoms weren't doing so well. Elena knew from Aunt Judith, from her adolescence, that transplanted blossoms took for a little while to restore and liven up once more. Leap†¦jump†¦leap†¦I am a feeling of fire. I can't miss a stage. I am a fire essential. Leap†¦leap†¦leap. And afterward Elena was seeing level ground, doing whatever it takes not to jump into it, yet a detainee to her body which was at that point jumping. She fell hard enough to numb one side, yet she kept hold of the valuable sickle grasped in a deathgrip in her grasp. A huge bill crushed into glass where she had been a second prior to she slid. Claws raked her back. Bloddeuwedd was still after her. Sage and his gathering of durable youthful male and female vampires went at the pace of a running pooch. Saber could lead them, yet just as quick as he himself could go. Luckily scarcely any individuals appeared to need to impel a battle with a canine that weighed as much as they did †that gauged more than a large number of the bums and kids they experienced as they arrived at the bazaar. The youngsters swarmed around the carriage, easing back them further. Sage set aside the effort to trade a costly gem for a tote loaded with little change and he dissipated the coins behind the carriage as they went, permitting Saber free rule. They passed many slows down and going across roads, however Saber was no normal hunting dog. He had enough Power to frustrate most vampires. With maybe just a couple of the key particles adhered to his nasal film he could chase down his objective. Where another pooch may be tricked by one of the several comparable kitsune trails they were going through, Saber inspected and dismissed every one of them as being not exactly the correct shape, size, or model. There came a period, however, when even Saber appeared to be vanquished. He remained in the focal point of a six-way junction, paying little mind to traffic, limping somewhat, and going around and around. He was unable to appear to pick a way. Also, nor might I be able to, old buddy, Sage idea. We've overcome much, yet it's unmistakable they went on more remote. No real way to go up or burrow down†¦Sage faltered, checking out the blood red hued wheel of streets. And afterward he saw something. Legitimately opposite him, however to one side was a perfumery. It must sell many aromas, and billions of fragrance atoms were intentionally being discharged into the air. Saber was visually impaired. Not visually impaired in his sharp fluid dim eyes. Yet, where it made a difference he was desensitized and blinded by the billions of aromas that were being exploded his nose. The vampires in the carriage were calling to go on or return. They had no feeling of genuine experience, them. They simply needed a decent show. Furthermore, without a doubt many had slaves who were recording the whipping for them so they could appreciate it at relaxation at home. At that point a glimmer of blue and gold chose Sage. A Guardian! Eh, bien†¦ â€Å"Heel, Saber!† Saber's head and tail hung as Sage arbitrarily picked one of the headings and had him race close by the forcing vampire to get the opportunity to leave the avenue and onto another road. In any case, at that point, wonderfully, the tail went up once more. Sage evaluated that there couldn't be even one atom of the kitsune's aroma left in Saber's noses now†¦ †¦but the memory of the scent†¦that was still there. Saber was indeed in chasing mode, with head down, tail straight, all his Power and insight focused on one objective and one objective just: to discover another atom that coordinated the three-dimensional memory of the one in his brain. Since he was not blinded by the singing smell of each one of those diverse concentrated scents, he had the option to think all the more unmistakably. Also, thinking made him aware of slip in the middle of avenues, causing an upheaval behind him. â€Å"What about the carriage?† â€Å"Forget about the carriage! Try not to dismiss that person with the dog!† Wise, attempting to stay aware of Saber himself, knew when a pursuit was going to end. Tranquillit! he thought to Saber. He additionally scarcely murmured the word. He had never been sure if his creature companions were clairvoyant or not, however he got a kick out of the chance to accept that they were, while carrying on as though they were definitely not. Tranquillit! he let himself know. Thus, when the colossal dark pooch with the sparkling dull eyes and the man ran up the means to one specific unsteady structure, they did it quietly. At that point, as though he'd had a lovely walk around the nation, Saber sat and took a gander at Sage in the face, chuckling gasping. He opened and shut his mouth in a quiet farce of a bark. Sage trusted that the youthful vampires will find him before be opened the entryway. Also, as he needed the component of shock, he didn't thump. Rather he crushed a clench hand with the Power of a heavy hammer through the entryway and grabbed for locks and chains and jolts. He could feel none. He felt a handle. Prior to opening the entryway, and going into who comprehended what hazard, he said to those behind him, â€Å"Any plunder we take is the property of Master Damon. I am his foreman and it was distinctly through my canine's abilities that we have made it so far.† There was understanding, running from protesting to impassive. â€Å"By the equivalent token,† Sage stated, â€Å"whatever risk is in there, I face first. Saber! NOW!† They burst into the room, about taking the entryway off its pivots. Elena shouted out automatically. Bloddeuwedd had quite recently done what Damon would not, and fixed her back with grisly wrinkles from her claws. Be that as it may, even as Elena figured out how to discover the glass entryway to the outside, she could feel different personalities flooding to help continue her, to lift and offer a portion of the torment. Bonnie and Meredith were sifting through enormous shards of glass to get to her. They were shouting at the owl. Furthermore, Talon, nobly, was assaulting from above. Elena couldn't stand it any more. She needed to see. She needed to realize that this metallic-feeling thing that she'd chose from Bloddeuwedd's home wasn't some piece of messy refuse. She needed to know now. Scouring the small piece of metal against the doomed red dress, she paused for a minute to look descending, to see blood red daylight shimmer against gold and jewels and two collapsed back little ears and two brilliant green alexandrite eyes. The copy of the primary fox key half, yet confronting the other way. Elena's legs nearly gave path underneath her. She was holding the second 50% of the fox key. Briskly, at that point, Elena raised her free hand and dove her fingers down into the painstakingly made little pocket behind the precious stone supplement. It hid a minuscule pocket, uncommonly sewn there by Lady Ulma herself. In it was the principal half of the fox key, supplanted there when Saber and Talon had gotten done with it. Presently, as she pushed the subsequent half-key into the pocket with the main, she was unsettled to feel development in the pocket. The two bits of the fox key were †what, getting one? A dark bill hammered into the divider close to her. Without speculation, Elena dodged and moved to get away from it. At the point when her fingers flew back to ensure that the pocket was tied up and secure, she was dumbfounded to feel a recognizable shape resting inside. Not a key? Not a key! The world was turning fiercely around Elena. Nothing made a difference; not the item; not her own life. The kitsune twins had deceived them, had tricked the bonehead people and the vampire who had set out to look up to them. There was no twofold fox key. All things considered, trust wouldn't kick the bucket. What was it Stefan used to state? Mai desperate mai †never state never. Recognizing what a possibility she was taking, realizing she was an imbecile for taking it, Elena push her finger again into the pocket. Something cool slipped onto one finger and remained there. She looked down and for a second was captured by the sight. There, on her ring finger, shined a gold, precious stone encrusted ring. It spoke to two dynamic foxes twisted together, one confronting every way. Each fox had two ears, two green alexandrite eyes, and a sharp nose. Furthermore, that was all. Of what utilize was a knickknack like this to Stefan? It looked to some extent like the twofold winged keys appeared in the photos of kitsune holy places. As fortune, it was without a doubt worth a million times not as much as what they had just spent to get it. And afterward Elena saw something. A light shone from the eyes of one of the foxes. In the event that she wasn't gazing at it so intently, or on the off chance that she wasn't at this point in the White Waltz Ballroom, where hues demonstrated valid, she probably won't have seen it. In any case, the light was sparkling straight in front of her as she turned her hand sideways. Presently it was sparkling from four eyes. It was sparkling in precisely the heading of Stefan's jail cell. Expectation ascended like a phoenix in Elena's heart, and took her taking off on a psychological excursion out of this maze of glass rooms. The music playing was the three step dance from Faust. Away from the sun, profound into the core of the city, that was the place Stefan was. What's more, that was the place

New Student Series Part 9 Ruchita Brajabasi COLUMBIA UNIVERSITY - SIPA Admissions Blog

New Student Series Part 9 Ruchita Brajabasi COLUMBIA UNIVERSITY - SIPA Admissions Blog Today marks our final installment of the New Student Series. Weve been introduced to some extraordinarily talented people, and everyone here in the Admissions Office knows theyll accomplish great things at SIPA.  Ive truly enjoyed getting to know some of our incoming students, and I hope you have too!  After youve read about Ruchita Brajabasi, whos a Teach for India fellow, take a look back at the eight  other students featured on the blog this summer. Im sure youll be just as inspired as we were! Full Name:  Ruchita Brajabasi Program:  Master of Public Administration Concentration: Urban and Social Policy Specialization:  International Organization UN Studies Anticipated Graduation Year:  2017 Hometown: Kolkata, India Undergraduate university, major and graduation year: Manipal University, Biomedical Engineering, 2011 What’s your professional background? I started my career with Accenture, where I worked on designing project management tools. It was a great learning experience because I had to understand the methodologies of product development and management to design tools for it! So I learned best practices of the entire processfrom gathering stakeholder expectations till deployment. My next career stint changed my life in more ways than I can express. I worked as the class teacher for 90 sixth-grade students in an affordable private school in the slums of Mumbai as a Teach For India Fellow. I started with the audacious dream of transforming lives; I think I came out more transformed myself! Did you apply to SIPA to change careers or to gain experience in a career path you already have experience in? While working in the community, I developed empathy for the grassroots perspective. I applied to SIPA to further my understanding of development problems and the means to solve them. What was your reaction when you found out you were accepted to SIPA? I cried. Why did you say yes to SIPA? A number of reasons: I truly believe we learn the most from our peers, and SIPA has the most eclectic mix of students! SIPA’s courses and opportunities cover almost everything under the (development) sun.  One can come out with the precise skills, knowledge and networks one needs to meet his/her vision. NYC. What do you most look forward to as a graduate student at SIPA? Engaging with the 3 Ps (Peers, Professionals and Professors)! Do you have any apprehensions about starting graduate school? It’s a mix of apprehension and excitement: I’ll be leaving behind all that is familiar, and head on to the crazy unknown! But being a math lover, I work best with variables and unknowns,  so it should be fun! What are your goals after SIPA? My vision is to create an equitable society through collaborative educational policy making. After SIPA I would like to work with Governments and International Organizations to develop, implement, and monitor schemes that lead to equity in society. If you could change one small thing about your community, country or the world, what would it be? I would make everyone a better listener. Tell us something interesting about yourself: I have studied in seven different schools and have lived in 14 cities all across India!

Restricted Cell Phone Areas - 896 Words

In the article From Stone Age To Phone Age , author Barbara Ehrereich argues that all cell phones serve as a status symbol, thus presenting mankind s selfish attempt to showboat their level of importance. By publicly engaging in meaningless conversations individuals are able to obtain admirer s jealously; thus portraying that the on-lookers are lonely because of their absence of a cellular phone or lack of received calls. In fact since primal times it has been a tendency of humans to compete with one another over similar status symbols from shrunken-heads to the best place of residence. Cell phones are both misused and overused instead of serving its original purpose for emergencies it is used to gossip, take pictures and compete†¦show more content†¦Makers have added several features to cell phones over the past year or so; theses features include: radios, mp3 players, video cameras, picture cameras, recorders, internet, pc applications, video games and so on. All this feat ures contribute to users not wanting to ever put their cell phones down. That is, if users aren t talking on their cell phones, their taking pictures, text messaging or downloading music on them. Some people have gotten so attached to their cell phones that can t ever leave home without it. It s ironic how some people will march to their local cell phone provider and purchase the latest phone with the newest features every time an upgrade comes out; spending anywhere from one hundred to six hundred dollars on a phone. There motives, keeping up with the latest phone and features, to fit in and to in time stand out and be the envy of all. They want to be that person that everyone comes up to and says, cool phone, where did you get it? I never seen that one before, it is here that people get the jealously stares that they anticipate on. Those who disagree might argue that people should be free to use their cell phones wherever they please, after all they do pay the monthly bill. To res trict users to the usage of their phones only in certain areas would be depriving them of getting their moneys worth. The problem with thisShow MoreRelatedAdvantages and Disadvantages Between a Cellular Network and Land Line Network1095 Words   |  5 Pages When using a cell phone network you will have a choice between two types of phones, GSM or CDMA. Both are a great choice but each have their uses. When a company choses to go with an all cellular network they should pick one of the above two based on the needs of the company. GSM offers the ability to be completely integrated into other networks around the world. All you would need to do is change out the SIM cards in the phones. You might even get a lower rate on your phone when you changeRead MoreCell Phone Coverage: More Important Than The Gadget Essay1695 Words   |  7 Pagesa rare occasion that you do not see a cell phone when walking down the street. These days everyone has a cell phone and if you do not, then the public looks at you in shock. The cell phone has upgraded communication from the typical party line to the wonders of wireless freedom. Cell phone providers entice people with their hands-free, unlimited text and voice, 4G, mp3, Internet, and video capabilities. Children, as young as kindergarten age, have a cell phone and the older retirement generation isRead MoreTexting in Class to Enhance Learning Essay918 Words   |  4 Pagesand Power Points were even added to give visuals to lessons. Cell phones on the other hand have been given the cold shoulder, and even completely banned by some schools. 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Police proceeded to arrest Riley for the possession of loaded firearms. The arresting officer also found and seized a cell phone in Riley’s possession along with items associated with the â€Å"Bloods† street gang. Photographs and videos accessed on the cell phone connected Riley to the â€Å"Bloods† street gang as well. Upon further investigation of the cell phone’s contents police found photographs of Riley in front of a car that had been involved in a shooting. 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Italian Preposition Da - Preposition Da in Italian

In its simplest form, the Italian preposition da means from in English. It’s used in time expressions, in which case you may translate it as since or for. Here are the most common ways to use â€Å"da† in Italian. Common Ways to Use â€Å"Da† 1) To indicate an an action that began in the past and is still going on in the present. You would use the construction of present tense da time. Da quanto tempo leggi questa rivista? - How long have you been reading this magazine?Leggo questa rivista da molto tempo. - Ive been reading this magazine for a long time. 2) To express the equivalent of the English phrase at the house of: Vado da mio fratello. - Im going to my brothers house.Vado da Filippo. - Im going to Filippos house.Andiamo dai signori Rossi. - Were going to the Rossis house.Arrivo subito da te. - I’ll be right over to your place. 3) To indicate origin or source Vengo da Torino. - I come from Torino.Vengo dalla Francia. - I come from France.È tornato dalle vacanze. - He’s back from vacation.È tornato dagli zii. - He’s back from his aunt and uncles house. This also occurs In surnames: Francesca da Rimini; Leonardo da Vinci In correlation with the prepositions a and : si à ¨ trasferito da Roma a Firenze (movement); cadere dalla padella nella brace (figurative) 4) To indicate the worth or price of something: Voglio un francobollo da cento lire. - I want a 100 lire stamp.È una casa da poco prezzo. - Its a house of little worth.Unautomobile da dieci milioni - A ten thousand million dollar car 5) To indicate a location, place (stato in luogo) Ti aspetto dallavvocato. - I’ll wait for you at the lawyer’s office. 6) To indicate cause, reason (causa) Piangeva dalla gioia - To cry from joy 7) To indicate time Non lo vedo da molti anni. - I haven’t seen him in years. In correlation with the preposition a: lavorare dalla mattina alla sera - to work from the morning until the evening Other Ways to Use â€Å"Da† Here are some other ways to use â€Å"Da† 1) To indicate movement through a particular point (moto per luogo): Sono fuggiti dalluscita di servizio. - They escaped through the service exit. 2) To indicate separation (separazione, allontanamento): I Pirenei dividono la Spagna dalla Francia. - The Pyrenees divide Spain from France.Non riesce a staccarsi da quegli amici. - They can’t get away from those friends. 3) To indicate means, method (mezzo): Giudico le persone dai fatti, non dalle chiacchiere. - I judge people from facts, not from gossip. 4) To indicate purpose, ending (fine): Carte da gioco - Playing cardsSala da pranzo - LunchroomSpazzolino da denti - ToothbrushAbito da sera - Evening dress 5) To indicate an attribute (qualità  ): Una ragazza dagli occhi azzurri - A girl with blue eyesUn uomo dal cuore doro - A man with a heart of gold 6) To indicate a way, matter, mode (modo): Agire da galantuomo - To act like a gentlemanTrattare da amico - To treat as a friend 8) As a predicative (predicativo): Fare da padre - To act as a fatherFungere da presidente - To serve as president â€Å"Da† With Infinitives Followed by a verb in the infinitive, the preposition da introduces the following clauses:  » consecutive clause (proposizione consecutiva): Ho (una) fame da morire. - I’m starving.Fa (un) caldo da impazzire. - It’s so hot!  » final clause (proposizione finale): Dammi un libro da leggere. - Give me a book to read.Che cosa vuoi da bere? - What do you want to drink? Phrases Using â€Å"Da† The Italian preposition da is used to form prepositional and adverbial phrases, such as: Da parte di - A part ofFuori da - Outside ofDi qua da - Further on from/This side ofDi là   da - On the other side of/BeyondDa vicino - Close/CloselyDa lontano - From afar/From far awayDa capo - Start over (from the top)/Start anewDa parte (from somebody) -  Of youDa parte (to save something) - (Put) AsideDa meno - For less...Dappertutto - Everywhere Prepositional Articles With Da When followed by a definite article, da is combined with the article to give the following combined forms known as prepositional articles (preposizioni articolate: Le Preposizioni Articolate Con Da PREPOSIZONE ARTICOLO PREPOSIZIONI DETERMINATIVO ARTICOLATE da il dal da lo dallo da l' dall' da i dai da gli dagli da la dalla da le dalle

The oral effect of fluorides and acids Free Essays

string(113) " the Use of Fluorides The â€Å"Centres for Disease Control† \(CDC\) published the graph shown by figure 4 above\." Introduction Overview Fluorides and acids are synonymous with dental hygiene. They are marketed across the world as being beneficial or detrimental. In this report, I shall explore the many views concerning the effects of fluorides and acids in the mouth. We will write a custom essay sample on The oral effect of fluorides and acids or any similar topic only for you Order Now This includes their effects on teeth and gums as well as other relevant areas that concern human oral anatomy. Below is a brief outline of the topics that shall be discussed within this report: Fluorides: What are fluorides Why are fluorides important for oral hygiene The chemical action of fluorides on teeth. How do fluorides bind with enamel to strengthen and protect it What are the ways in which fluorides can be administered Is â€Å"Fluoridation† good or bad Acids: What are acids Why are acids importantWhy are they bad The chemistry of acids – what makes them acidic The genetic and lifestyle factors that could alter oral acidity. What is the chemical action and effect of acids on teeth What is the effect of acids on gums for tooth support Evaluation: Are the relationships between fluorides and cavities reliable and/or valid What issues of safety concerning the use of fluorides arise as a result of this project Are the sources used in this project reliable and/or valid Fluorides Topics that shall be covered in this section: What are Fluorides Why are fluorides important for oral hygiene The chemical action of fluorides on teeth. How do fluorides bind with enamel to strengthen and protect it What other chemicals are needed to strengthen teeth What are the ways in which fluorides can be administered Is â€Å"Fluoridation† good or bad What are Fluorides? Fluorides are formed from the reduction of the element fluorine – the 17th most abundant element in the earth’s crust.[1][2] Fluorine is highly reactive, and only exists as a combination of other elements in a fluoride compound. Fluoride compounds can be found in rocks and soil. Fluoride ions are generally produced when water passes over rocks that contains the fluoride minerals.[2] Why are Fluorides Important for Oral Hygiene? Fluorides are widely used in toothpaste, mouthwash and supplementary products to help reduce the risk of dental cavities.[6] In the UK, fluorides are mainly administered topically to the teeth through the process of brushing. However, only around five million people in cities across the West Midlands and North East England fluoridate (see fluoridation section) their water, so the fluorides have both topical and systemic administrations.[5] According to the British Dental Health Foundation, â€Å"Children who have fluoride when their teeth are developing tend to have shallower grooves in their teeth, so plaque can be more easily removed†.[3] Moreover, the U.S. Centre for Disease Control lists water fluoridation as one of the â€Å"ten greatest public health achievements of the 20th century†.[4] These methods of exposing the teeth to fluoride also increase the concentration of fluoride in the saliva. The fluoride ions interact with molecules of broken down (demineralised) enamel due to acid erosion.[7] This produces a similar enamel-like compound that can then remineralise the tooth enamel. When the rate of demineralisation is greater than the rate of remineralisation, dental caries begin to form. From this, the administration of fluorides work to increase the rate of remineralisation of tooth enamel, thus offsetting the rate of demineralisation reducing the risk of dental decay.[7][8] It is through the promotion of enamel remineralisation in the remineralisation/demineralisation cycle that fluorides have such an important role in maintaining healthy tooth enamel for good oral hygiene.[8][9] The Chemical Action of Fluorides on Teeth Tooth decay is an infectious disease, involving an increase in the plaque formation of oral bacteria such as Streptococcus mutans and Lactobacillus.[10] These facultative bacteria respire anaerobically. Therefore, organic acids are produced when carbohydrates, such as sugar, are used up.[11] As more acid is produced the pH of the saliva decreases.[14] The pH scale generally ranges from pH 1 (the most acidic) to pH 14 (the most alkaline). The recommended saliva pH is said to around 7.2 to 7.4.[13] Therefore, saliva is just slightly alkaline. According to the ‘Manual of Dietetic Practice’ (2002), at a pH below 5.5, acid reacts with and breaks down the crystalline calcium hydrogen phosphate (hydroxyapatite) – the main component of tooth enamel – in a process known as demineralisation.[12] However, when the food source is depleted, the tooth enamel can be remineralised, where the saliva can provide the mineral ions lost for remineralisation. When the oral pH is greater than 4.5, available fluoride ions in the fluid surrounding teeth react with the dissolved crystalline calcium hydrogen phosphate ions forming a fluorapatite layer. This layer binds itself to the enamel surface. Moreover, the fluoride ions can react with the non-dissolved hydroxyapatite enamel, to substitute the hydroxyl group of the hydroxyapatite compound for fluoride ions. This process eventually forms a fluorapatite coating on the outside layer of the teeth.[8][16] The process to produce this remineralised veneer is much quicker than that to produce the normal hydroxyapatite coating.[8][40] Moreover, it is much harder to demineralise the fluorapatite coating by acid than it is for its hydroxyapatite counterpart.[40] This is because the fluoride group, which was substituted for the hydroxyapatite hydro xyl group, inhibits biological systems in the bacteria, so they cannot produce acids as effectively.[40] All of these factors concerning the formed fluorapatite, make this newly formed tooth enamel less likely to undergo acid erosion.[8] In this way, fluorides can function to reduce the risk of cavities forming in the teeth by its topical effects.[17] However, some fluorides function within the body by interacting with the teeth. In these cases, the fluorides can become incorporated into the blood plasma and impregnated into the developing teeth by its blood supply.[17] This in-built fluoride makes the concerning teeth much more resistant to decay.[19][40] The Chemical Equation for the Production of Fluorapatite: Crystalline calcium hydrogen phosphate (hydroxyapatite) reacts with fluoride sources, such as calcium fluoride – CaF2 to produce a fluorapatite compound (calcium halophosphate).[20] Ca10(PO4)6(OH)2 +CaF2 ? Ca10(PO4)6(F)2+ Ca2+ hydroxyapatite + calcium fluoride ? fluorapatite + calcium Studies Supporting the Use of Fluorides The â€Å"Centres for Disease Control† (CDC) published the graph shown by figure 4 above.[37] From figure 4 above, it can be seen that as the percentage of people drinking fluoridated water increases, the mean number of permanent teeth lost, filled or decayed due to cavities decreases. It has also been shown that the fluoridation of water has reduced the risk of caries by 40-60%.[3] This, therefore, supports the evidence behind the mechanisms of fluorides to reduce the risk of developing cavities. However, it should be noted that these links do not signify a causal relationship between fluoride administration and the risk of developing cavities. This is because many other factors can also reduce the risk of cavities, and so one is not fully certain whether the fluorides are the reason for increased enamel strength. Other Chemicals Needed Naturally Stronger and Whiter Teeth As the surface of the tooth enamel begins to breakdown, the tooth itself begins to discolour. This is mainly due to years of chewing and general use, where staining agents become adsorbed to the teeth and the yellower dentine underneath becomes more exposed. Stains can be caused by smoking, eating, drinking and over grinding of teeth. The stronger one’s teeth, the lesser the likelihood that it would become stained by these methods. When tooth enamel has a strong structure, it is more easy to maintain its naturally white appearance. Strong tooth structure results from eating foods high in certain minerals and vitamins. In this way, stronger tooth enamel is less likely to undergo erosion by acid or undergo tooth decay.[21] The list below states and briefly describes some of the recommended nutritional supplements to take for stronger and whiter teeth:[29] Phosphorus: Phosphorus is involved in strengthening the teeth and the bones in the body. Vitamin C and Vitamin D : Vitamin C and vitamin D aids calcium absorption in the body. Magnesium: Magnesium aids the formation of tooth enamel Calcium: Calcium is needed for the body to develop durable bones and teeth. The more calcium absorbed, the greater the rate of calcification of the bones and teeth to a point. In this way, the teeth are stronger and less susceptible to acid-erosion. As calcium is naturally white, calcified teeth are thus whiter in appearance. Interestingly, the calcium deposited in the bones and teeth can be utilised by the blood to help provide the necessary minerals for the body. These minerals and vitamins have a greater systemic function in the body than fluorides for the prevention of cavities. It is, therefore, through the greater mineralisation of the teeth that these dietary supplements have the greatest effect on increasing tooth density to lower its permeability to acid absorption and breakdown.[22] In this way, both the systemic and topical methods of cavity-prevention are together vital to ensure good oral hygiene.[17] Safe Fluoride Levels Fluoride Dietary Reference Intakes Recommended by the Institute of Medicine:[29] 0.01 mg per day for those aged up to 6 months. 4 mg per day for men aged 19 years upwards. The Tolerable Upper Intake Level: 0.10 mg per day for those aged up to 8 years. 10 mg per day for those aged 8 years and upwards. Background Information: The effects of consuming fluorides depend on the total daily intake of fluoride.[24] According to a publication by Fawell, J.K., et al. (2006), an adult living with unfluoridated water in a temperate climate would have a total daily fluoride intake of 0.6 mg/day, compared to one with fluoridated water, who would intake 2 mg/day of fluoride.[23] However, these intakes are different for different regions in the world, due to differing water compositions, cultures and climates. Requirements: All personnel should report, inspect and monitor all processes involved in fluoridation to help prevent cases of overfeed of fluorides into drinking water. Organisations should also train staff to adhere to safety and good practice regulations. They should also produce audits and reports pertaining to the technical requirements for the safe and efficient usage each major compound used fluoridation.[25] These requirement have been set by the â€Å"The Centres for Disease Control and Prevention†. What are the Ways in which Fluorides can be Administered? Diet Fluorides are naturally found in many of the foods that we eat today. It can be found in fruits, vegetables and even in other organisms. Some of the most common sources containing particularly large fluoride concentrations are listed below:[23 Barley Cassava Rice Yams Potato Raisins Fish Shellfish Taro Fluoride Therapy Fluoride therapy encompasses the use of toothpastes, mouthwashes, fluoridated water, dietary supplements and other means to deliver fluoride ions systemically or topically. Some of these methods shall be discussed below: Fluoridation What is it Water fluoridation is a technique used to administer fluorides via the public water supply. Although fluorides can be naturally occurring in our water, fluoridation specifically concerns the issue of adding more fluorides, so as to be of specific medical benefit to the public. Fluoride compounds are used to fluoridate water supplies. Sodium fluoride is the most common compound to use, due to its greater convenience, lower costs and greater associated safety.[27] Sodium fluoride (NaF): A white crystal or powder with no distinct scent that was the first chemical to be used in fluoridation.[27] Generally, the crystallised form is preferred when the compound is being handled, as there is less potentially toxic dust formed.[28] Because of this, NaF is generally used by smaller water companies. Further Information: Fluoridated drinking water has the greatest contribution to one’s daily fluoride intake.[23] In the United States of America, a census was carried out in 1992. The census found that found that fluorosilicic acid (63%) had the greatest population reach out of all those that received water fluoridation, followed by sodium fluorosilicate (28%) and sodium fluoride (9%) respectively.[31] Some Facts about Water Fluoridation Facts are from the source, â€Å"Fluorides†, produced by the ‘World Health Organisation’.[41] Out of all fluorides ingested, 70% to 90% of it is absorbed. When ingested, it can then form the acid HF (hydrogen fluoride), which makes up 40% of the total absorption. When the carried by the blood, the fluorides can then travel around the body. For those of 0 – 1 years of age, 80% to 90% of the fluorides that are absorbed remain. The rest is then removed by excretion (e.g. urine and faeces) 60% of the fluorides absorbed in adults remain in their body. The large majority (99%) of fluorides that remain are stored in bones and teeth. Excessive amounts of fluoride deposits in these regions can cause fluorosis. Notes: In the United States of America, the optimal level of fluoride range from 0.7ppm to 1.2ppm[32], although the ‘WHO’ states that the absolute upper bound for fluorine in water should be 1ppm.[23] In the UK, the recommended and optimal concentrations of fluoride in water are 1ppm and 1.5ppm respectively.[33] However, the fluoride concentration in water depends on the mean maximum atmospheric temperature in that area. This is because, in hotter regions, inhabitants would consume more of the fluoridated water, and thus less fluorides should be present in it.[32] Toothpaste Method of Administration: Toothpaste is applied topically to teeth through brushing. Notes: On average, toothpaste contains 1000-1500ppm of fluoride, usually in the form of NaF. Further Information: Parents should supervise their children’s tooth brushing to ensure that they do not swallow any toothpaste, which is a major cause of dental fluorosis in children under 7.[3][39] Mouthwash Method of Administration: Mouthwashes are rinsed in the mouth for generally 30-40 seconds before being spat out. Further Information: Typically, mouthwashes contain fluorides by the addition of NaF (sodium fluoride). One can easily buy mouthwashes with 225 ppm of fluoride at local supermarkets without prescription. Notes: Alcohol mouthwashes should not be given to children, due to their increased risk of them swallowing it. This is due to children having greater difficulty in overcoming the swallowing reflex.[3] Moreover, allowing children to swallow fluoride mouthwashes may increase their risk of dental fluorosis.[35] Fluoridation: The Big Debate The issue of fluoridation has always raised big questions regarding its effectiveness, safety and usage. Some of the main pros and cons of fluoridation shall therefore be explored. Pros: Large Reach: All members of the community would have access to regular fluorides doses, regardless of income, education or dental access. It many be particularly beneficial to children, as studies have shown that they do not brush as regularly as they should. Therefore, the omission of this administration fluoride can be compensated through water fluoridation, which all children should and would drink. Advantageous for the Elderly: As you get older, one’s saliva flow would generally decrease. This would mean that the elderly have less salivary fluorides that could access, remineralise and strengthen tooth surfaces. Moreover, the elderly have decreased manual dexterity to brush effectively and reach all surfaces. Therefore, all of these issues increase the risk of root surface decay for the elderly, but fluorides would help prevent this from occurring. Evidence: Many studies have been carried out to show that fluoridation of water does have a positive impact on oral hygiene and helping to prevent dental decay. Support: The fluoridation of water is supported by large health bodies such as: The British Dental Association; The World Health Organisation; The British Medical Association; and the British Fluoridation Society. Cost Effective: The use of fluorides reduces the risk of dental caries, and so potentially saves money for a patient who otherwise would have had to have payed for fillings. Reduces the Risk of Dental Caries: A recent study has concluded that adding fluorides to drinking water supplies can lower the risk of dental caries by 40-60%. Acid Resistance and Speed: The compound formed when the broken down enamel reacts with fluoride is more acid resistant and forms more quickly than the original enamel coating. Natural: Fluorides, derived from the natural element, Fluorine, are non-artificial ions. They are regularly used by the body to carry out many other metabolic processes, so its addition into the body would not be unusual. In this way, we have a better understanding of the systemic interaction of fluorides in the body. Cons: Dental Fluorosis: Dental fluorosis is probably the biggest issue surrounding the fluoridation of water. It is a conditions where an excessive consumption of fluorides can potentially cause white spots or brown stains to appear on the tooth enamel. Poison: An excessive consumption of fluorides is toxic and potentially fatal. However, one would have to regularly consume a volume of water far greater than that recommended for fluorides to have such a harmful effect. Concern: This idea that we are always drinking something potentially toxic could lead to much media attention. For example, the media may frighten the public with just one case regarding a patient with dental fluorosis. In this way, public attention that such stories would attract could lead to exploitation of the water fluoridation topic. Law: A patient contracting a condition where fluoride consumption is a risk factor could sue the water-board/government for unwillingly supplying them with fluorides. Therefore, there could be a vast potential liability in nationalising fluoridated water, and its media coverage may encourage even more to sue. Ethics: Some people may not wish to have further chemicals added to their water, as they cannot choose to drink unfluoridated water in a fluoridated community unless they buy bottled (distilled) water, which may be prohibitive for certain social backgrounds. Necessity: It is not yet completely certain whether fluorides are necessary to ensure that one can live. Fluorides work to reduce the risk of the formation of dental caries by counteracting some of the detrimental effects of acids and the associated oral microbes brought about from the consumption of carbohydrates. Therefore, it could be argued that some people do not need fluorides, since they do not consume much carbohydrates. Resources: Many pieces of equipment and additional resources are needed to carry out the process of water fluoridation. This can be costly, as improper pipework may have to be replaced to avoid health risks regarding overexposure of fluorides, such as fluorosis. All sources for the pros and cons are listed in the bibliography Acids Topics that shall be covered in this section: What are acids What are the different types of dental decay Why are acids harmful The chemistry of acids – what makes them acidic The genetic and lifestyle factors that could alter oral acidity. What is the chemical action and effect of acids on teeth What are the different types of dental decay What is the effect of acids on gums and for tooth support What are Acids? An acid is a substance that has a pH value lower than 7, with the lowest and therefore the most acidic pH value being 1.[14] An acid is conventionally described as a substance that donates protons (hydrogen ions). The greater the ability of an acid to donate these protons, the stronger the acid.[14] Why are Acids Harmful to the Teeth? Just hours after brushing, oral bacteria, such as streptococcus mutans, form a thin coating over your teeth called plaque.[10] When foods or beverages that contain carbohydrates (for sucrose, fructose and glucose) enter the mouth, the bacteria within the plaque rapidly convert these carbohydrates (sugars) into lactic acid through anaerobic respiration. It is the hydrogen ions contained within this produced compound that acts and reacts as the acid.[11] Moreover, the acid can be kept in contact with the tooth for up to 2 hours due to the plaque coating. This time frame allows the acid to breakdown the components of the enamel (hydroxyapatite) to eventually result in cavities.[40] The most common areas that can accumulate plaque are the molars and premolars, due to their deep depressions.[41] The outermost layer of the tooth is called the enamel. The enamel of the tooth is commonly known to be the hardest in the human body, due to its highly dense mineral structure. The main mineral in enamel is known as hydroxyapatite, which is a calcium phosphate lattice.[42][43] As the bacteria produce more acid, the conditions in the mouth become more acidic, reducing the pH. When the pH is lowered to 5.5, the rate at which the tooth is demineralised is greater than the rate for remineralisation. This results in an overall loss of phosphate and calcium ions from the enamel, which over time would lead to dental cavities.[12] The demineralisation reaction in enamel involving the constituent phosphate and calcium ions: Ca10(PO4)6(OH)2(s)+ 8H+(aq) ? 10Ca2+(aq) + 6HPO42-(aq) + 2H2O(l) hydroxyapatite + hydrogen ? calcium+ hydrogen phosphate + water From the equation above, the hydroxyapatite (crystalline calcium phosphate) reacts with the hydrogen ions to dissociate into calcium and hydrogen phosphate ions plus water.[20][42] Therefore, this primary mineral of the enamel has broken down and become absorbed into the saliva. However, once the plaque acid has been diluted and neutralised (mostly due to the saliva) the tooth enamel can then be remineralised, recovering the ions dissolved in the salivary fluid.[44] Throughout the day, your mouth is trying to maintain this continuous balance of demineralisation and remineralisation. Eventually over time, an overall loss of ions from the enamel would lead to tooth decay. Since enamel goes clear in the presence of light, the acids can break it down further to expose the softer and yellower dentine tissue below. The dentine is much more susceptible to acid-erosion, as it is less mineralised – it contains fewer minerals. In this way, fewer reactions need to take place to remove these minerals, so the rate of demineralisation is quicker than that for enamel. Dentine has nerves running through it, whereas enamel does not. Therefore, caries extending to the dentine can cause painful sensations especially when consuming hot or cold substances.[45] 5 things required for remineralisation of tooth enamel[36] The correct minerals (containing Ca2+, PO43- and Fl– ions) must be present in one’s saliva. Carbonic acid must then be produced (naturally produced from carbon dioxide and water) and close to the minerals, so it reacts with and dissociate them into their constituent ions. This process must take place near the tooth area affected. The affected demineralised area of hydroxyapatite must be clean and accessible. Complementary shaped ions formed from the minerals can then attract to oppositely charged ions within the hydroxyapatite lattice. Carbonic acid must then reform carbon dioxide and water, which precipitates the complementary ions that were dissolved in it into the area of demineralised enamel. In this way, remineralisation of the tooth enamel has occurred. What are the Different Types of Dental Decay? Dental decay involves the breakdown and weakening of the tooth structure by oral bacteria. This is normally through acidic conditions in the mouth. However, patients with untreated caries would have a greater risk of cavities continuing to form regardless of acidic conditions. Pit and fissure caries are amongst the most common forms of dental decay.[47] Currently, â€Å"tooth decay is one of the most common disorders† in the world.[46] Pit and Fissure Cari Pits and fissures are typical characteristics of molar and premolar teeth, where the inwardly-folding enamel meet. Fissures are the result of undeveloped grooves, where the two folds of enamel have not fully joined. Therefore, it is in these areas where bacteria can most easily accumulate, increasing the risk of caries forming in these regions. Pits and fissures are also notoriously difficult to clean, so this only propagates the process of dental decay further. The deep grooves, called fissures, occur mainly on teeth at the far back of the mouth. These teeth are known are occlusal teeth, as they are involved in chewing. According to the website, DentalIQ, â€Å"Occlusal surfaces account for 12.5% of all tooth surfaces but will experience over 50% of all decay†.[49] They also state that, â€Å"Pit and fissure caries account for 88% of total caries in children†.[47][49] Pits are different to fissures, as they are only small holes naturally found in the teeth, usually at the points where the fissures themselves meet (in posterior teeth).[48] The reason why there are such a high cases of dental decay associated with these types of tooth surfaces is because the indents in the enamel mean that bacteria can accumulate in the sheltered conditions easily. In this way, if one does not properly clean these surfaces, the bacteria (e.g. streptococcus mutans) can thrive and destroy the nearby enamel. According to a study by the ‘Centres for Disease Control and Prevention’, â€Å"approximately 90% of caries in permanent teeth of children occur in tooth surfaces with pits and fissures†.[50][52] To reduce the risk of dental cavities forming in these pit and fissures regions of the teeth, dentists employ an innovative technique, known as ‘fissure sealing’. This involves filling the pits and fissures with a ‘sealant’, so that they form smooth surfaces that are much easier to remove plaque and food remains. According to the website, DentalIQ, â€Å"Sealants are 100% effective in preventing pit and fissure caries if they are completely retained†.[49] Therefore, acids may not have as harmful effects on the posterior teeth if these preventative measures are taken. Over time, decay breaks down the enamel. The decay typically favours the breakdown of the enamel rods, which are highly ordered and mineralised basic unit of enamel structure. Therefore, x-rays of decayed teeth generally show a very distinct pattern, since the enamel rods are also of a very specific shape. This pattern can be seen by white markings from x-ray to the left.[63] When the enamel rods have fully decayed, the bacteria and acids then begin to break down the much softer dentine underneath, which would require more intensive dental treatment to be carried out, in the form of root canal surgery. Common Tooth Regions where Caries can Form: Definitions from the eNotes nursing encyclopaedia.[38] Facial: Outside surface of anterior tooth, adjacent to the face. The term includes buccal (cheek) and labial (lips) areas. Lingual: Inside surface of tooth, adjacent to the tongue. Occlusal: Biting surface of posterior tooth. Incisal: Biting edge of anterior tooth. Mesial: Proximal surface of tooth closest to the midline. Distal: Proximal surface of tooth farthest from the midline. What are the Genetic and Lifestyle Factors that could Alter Oral Acidity? Foods and Drinks pH Values[53] Gooseberries2.8 – 3.1 Grapes 3.4 – 4.5 Raspberries 3.2 – 3.7 Strawberries3.0 – 3.5 Oysters4.8 – 6.3 Golden Delicious3.6 Lemons2.2 – 2.4 Limes1.8 – 2.0 Sorrel 3.7 Carrots4.9 – 5.2 Rhubarb 3.1 – 3 Pork 5.3 – 6.9 Olives (Green) 3.6 – 3.8 Coca-Cola 2.52 The following risk factors for increased oral acidity have been taken from the website, iloveindia.com.[56] Diseases: Esophagitis or Gastro-Oesophageal Reflux Disease (GERD) can increase oral acidity as the conditions involve acidic juices from the stomach refluxing into the mouth. Salivary Glands: Decreased secretion of saliva, so the rate of acid neutralisation too decreases. Thus, acids are retained in the mouth for longer periods of time. Foods: Excess consumption of foods high in acid (e.g. fizzy drinks and sour sweets) can lead to acid reflux, increasing oral acidity. Diets: Some studies promote following a high carbohydrate diet, which would encourage oral acidity due to its anaerobic breakdown. Eating Intervals: Eating sweet foods over short intervals is far worse than eating the same amount in one sitting. This is because acidic conditions are continually returning to the mouth, due to the anaerobic metabolisation mechanism of bacteria. Eating Disorders: Those suffering from bulimia nervosa reflux consumed food, creating extremely acidic conditions in the mouth What is the Effect of Acids on the Gums and Bone? Gingivitis: â€Å"Gingivitis is an inflammation of the gums surrounding the teeth†.[54] In its early stages, bacteria begins to accumulate in the plaque around the teeth and gums, usually due to a lack of oral hygiene. This causes an excess of acid to be produced, irritating the gums. Over time, the gums become increasingly irritated and broken down, leading to reddening, or inflammation. It is quite common in these circumstances that the gums would also bleed easily when irritated further, such as when brushing. However, in gingivitis, the damage is solely to the gums, and if treated soon enough, is wholly reversible.[54] †¦when gingivitis is left untreated, it can advance to periodontitis: According to the Medical encyclopaedia of the University of Maryland, â€Å"Periodontitis is the inflammation and infection of the ligaments and bones that support the teeth†.[34] Gingivitis is usually a precursor to periodontitis, as the inflammations in the gums, form pockets between the gums and teeth. Plaque, containing the acid-producing bacteria, can then accumulate and become sealed in these formations due to the further swelling of the surrounding damaged gum line. The bacteria is now in closer proximity to the supporting tissues of the teeth. The acids released by these bacteria then begin to breakdown these tissues and ligaments, weakening the attachment of the tooth to the bone. Abscesses (swollen area containing pus) are also very common in patients with periodontitis, since the pockets of plaque contain bacteria that secrete toxic liquids. These abscesses also increase the rate of bone destruction.[34] Over time, the structure holding the tooth in place is broken down, and loss of the affected tooth is much more likely. In fact, periodontitis is the leading cause of tooth loss in adults.[18] Evaluation of Project There have been various strengths and weaknesses of some of the conclusions made within this project. Like many scientific analyses, it is very difficult to try and state a causal relationship between certain variables. For example, from figure 4, which demonstrates a link between fluorides and cavities, it is only suggested that there may be a link between them. However, there are many other factors that could also lead to a reduced risk of cavities, so stating that these effects are solely due to fluorides would be considered an invalid conclusion. However, there are many studies that support these links between fluoride exposure and cavity development, so the inclusion of this relationship is not just a means of convenience. Moreover, fluorides have been used in many countries across the globe for many years, and their theoretical effects have been validated and corroborated, increasing the reliability of the administration methods. In turn, many large companies have utilised fluorides within their oral care products, such as toothpastes and mouthwashes. There are also various social and ethical issues surrounding the use of fluorides, especially when concerned with the fluoridation of water. Since fluorides are a derivative of the highly reactive and potentially toxic element, fluorine, there may be quandaries as to whether fluorides are safe for use. This public anxiety has extended to the point of anti-fluoridation societies being created to outlaw the addition of fluorides to the public water supply. This dilemma has been seen particularly in America, where a majority of the population receive fluoridated water. In turn, by producing this report that supports the use of fluorides, some people may protest against it. All these issues are weaknesses of the report that should be considered. However, fluorides have been extensively studied prior to their use in the water supply. When used correctly, they have been found to be of such beneficial to oral health that the BDA (British Dental Association) and the ADA (American Dental Association) both highly recommend them. Many high-powered governments have considered fluorides to be beneficial for oral health, and they even save their citizens money, as they typically have to pay for less dental work, as a result of a reduced risk of developing cavities. The sources used in this investigation can be considered sufficiently reliable and valid. The source, â€Å"Dental caries: a dynamic disease process†, can be considered reliable, as it has been cited by 17 other independent studies.[8] In this way, the information used in this source has been reviewed and accepted by professional scientists. Since, dental caries are relevant to my studies, the information regarding them can also be considered valid for inclusion within this report concerning the effects of fluorides on the risks of developing cavities. Moreover, ‘dentalhealth.org’ states that â€Å"Fluoride can greatly help dental health by strengthening the tooth enamel. The reliability of this information is increased, as it is supported by the source, ‘tips4dentalcare.com’, which states that, The main positive effect of fluoride is increasing durability of tooth enamel. However, some may consider that certain sources are biased, since they are published by organisations that have certain interests in favour of a particular conclusion. For example, the source detailing the advantages of fluorides on oral health by the â€Å"British Dental Health Foundation†, could be biased towards supporting council fluoridation initiatives. However, these organisations are highly respected, and work on behalf of the public, not private, sector. Therefore, issues of outside interests could be considered invalid, and so the information provided and used within this report can be considered valid for use. Bibliography Greenwood, Norman N.; Earnshaw, A. (1997) Chemistry of the Elements, 2nd ed. Oxford: Butterworth-Heinemann, p. 804. Just Think It. (2008). Fluoride. Available: http://www.just-think-it.com/f008.htm. Last accessed 10th Oct 2010. British Dental Health Foundation. (2005). Fluoride. Available: http://www.dentalhealth.org.uk/faqs/leafletdetail.php?LeafletID=17. Last accessed 10th Oct 2010. Division of Oral Health, National Center for Chronic Disease Prevention and Health Promotion, CDC. (1999) Achievements in public health, 1900–1999: Fluoridation of drinking water to prevent dental caries. MMWR Morb Mortal Wkly Rep. 1999;48(41):933–40. The Times Online. (2008). Minister orders fluoride to be added to water. Available: http://www.timesonline.co.uk/tol/news/uk/health/article3295310.ece. Last accessed 10th Oct 2010. National Fluoride Information Centre. (2008). Toothpaste. Available: http://www.fluorideinformation.com/guide_to_fluoride/toothpaste. Last accessed 10th Oct 2010. Pizzo, G; Piscopo, MR; Pizzo, I; Giuliana, G. (2007). Community water fluoridation and caries prevention: a critical review. Clin Oral Investig. 2007;11(3):189–93. 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Communication Skills Training For Oncology -Myassignmenthelp.Com

Question: Discuss About The Communication Skills Training For Oncology? Answer: Introduction Social work consists of many processes, which pay attention to the relationship among individuals and the improvement in the quality of life of people. Individuals have various social roles and how effectively they perform those determine the social relationships. Social work intervenes in this junction of performing the duties and improving lives of people. Helping process is one of the many functioning of the social works. Social functioning comprises of the activities, which are necessary to satisfy the relationships in the experiences of the social living (Fox, 2013). The basic functions of the helping process are restoration of social functioning, provision of resources for development and prevention of social dysfunction. In simple words, helping process in social work is the set of activities to assist the people to identify and cope up with their problems through relationship building, assessment of the problem, setting of the goals, interventions and termination (Miller Rol lnick, 2012). The stages of helping processes will be discussed in the following essay. Discussion Helping process is sometimes defined as the counseling process. Communication skills are extremely important for effective helping process. There are five stages of helping process, namely, Rapport and relationship building, Assessment or problem defining, goal setting, initiating the interventions, and termination of the problem. In each of the stages, Communication plays an important role, as relationships are always determined through effective communication (Egan, 2013). Relationship building Relationships are always based on trust. Thus, laying the foundations for trust by designing a structure and form, voluntary or involuntary, and the roles of articulating is the primary factor for building relationships. Firstly, rapport needs to be developed between the counselor and the client, through introduction, clear description of individuals roles, purpose and active listening to the client. Thus, through effective communication, a relationship is built. Empathy, unconditional positive regard, and congruence are essential in this stage (Shulman, 2012). In this stage, drilling down to the problem is important. The counselor must ask simple and detailed questions to the client to know the exact problem and its source. There should be some basic questions and detailed inquiry on life functions and stress factors. After that, the focus should be on getting more detailed information about the problems through trust (Crowe et al., 2012). Goal Setting In a helping process, once the problems are identified, goals should be specific and clear. Its the duty of the counselor to talk to the client tactfully and find out his or her objective or goal (Brandler Roman, 2015). It has to be mutually agreed upon. In this process, the trust and relationship between the counselor and the client becomes more strong and the client confides into the counselor about his or her perspectives. Thus, effective communication by the counselor is very important not only for conversing with the client, but also to find out the goals for the process (Shulman, 2012). Initiating Intervention Interventions are the perspectives to find out new ways to approach the issue. How to accomplish the goals and solve the problem is addressed through intervention. Communication again plays a crucial role to define the achievable goals and motivate the client to follow the process. The intervention plans are usually positive and action oriented, and can be adapted with time. Termination This is the last stage in the helping process. In this stage, the dependency of the client on the counselor is tactfully reduced, the client is made prepared for the ending of the sessions, and plans are made for possible needs in the future. Termination is also considered earlier if the counselor feels that the process is not helpful for the client. This is done through a systematic process, so that the client can mentally prepare himself or herself. For example, the counselor sets an advance date for the last session, then gradually reviews the progress and makes future plans accordingly. This process empowers the client to think independently (Arnold Boggs, 2015). Thus, it can be said that, communication is extremely powerful tool in helping process. It is a sensitive issue for all the clients and only through supportive attitude, active and attentive listening and comforting words, the helping process can be successful. Barriers to communication Communication is a process of transferring of information through speaking, listening, writing, reading and observing. Thus, during the helping process, communication takes many forms, such as, speaking, listening, observing etc. (Austin Pinkleton, 2015). There can be many barriers to effective communication in the helping process. Those are as follows: Emotional barriers or taboos: Sometimes people feel shy to express their emotions. Again sometimes, due to social taboos, they do not open up. Cultural and language differences: Social norms often determine the way of expression and these vary across different cultures. For example, the definition of personal space varies among different cultures. Along with that, language difference also impede communication. Sometimes, unfamiliar accents create barriers in understanding. Use of jargons: Sometimes the counselor use jargons, which becomes difficult to understand for the client. Prejudices and expectations: Due to cultural differences, people often have preconceived notions and prejudices. They do not make the effort to think beyond that. Hence, they keep the same expectation from the counselor. However, these prejudices seldom meet the expectation and people cannot accept the helping (Kissane et al., 2012). Non-verbal communication and physical barriers: If the counselor cannot understand the body language, facial expressions, gestures, postures and other non-verbal cues, then the communication becomes less effective. Lack of attention: If any one of the counselor or client is not attentive to the sessions, and gets distracted easily, then the helping process would not be effective. Apart from all these, the differences in the view points and perception, physical disabilities, such as speech problems or hearing problems, lack of flexible attitude of the client also create barriers to communication in the helping process (Berge, 2013). Recommendation for overcoming the barriers in communication In the helping process, the barriers to communication, especially interpersonal barriers, are a common issue. It is a challenge for the counselor to build a trusting relationship with the client and find out the precise problems and solve them. Hence, effective communication is extremely important. As there are barriers to communication, there are also ways to overcome those challenges. Those are as follows: Use of simple language: The counselor must not use jargons and use simple language while communicating to make the client comfortable. The client can understand the process if it is communicated in a simple language with easy accent. Even if the perceptions are different, still it has to be conveyed through easy understandable language (Gratis, 2017). Active listening: The counselor must have high level of patience and the practice of active listening. He must listen to everything attentively that the client has to say. Similarly, the client must also listen to what the counselor is instructing respond accordingly. Clarity in the thoughts: It is very important to know about the topic or subject to be discussed with the client and clear thoughts about that. The Counselor must be very clear about the objectives of the helping process and must design his way of dealing accordingly. After the client expresses his thoughts, the counselor must be able to understand that and find out a solution to help the client (Egan, 2013). Staying calm and patient: Both the parties involved in the helping process must be very patient and must control own emotions and frustrations while communicating through the process. If the conversation needs more time, it should be given and must not be hurried. Avoid too much information in one session: People would feel overloaded if they are asked to process too much information in one session. Hence, the counselor must understand the receiving capacity of each client and plan accordingly as per the needs. Providing feedback: Feedbacks should always be given by both the parties to make the process effective. It helps in personal development as well as contributes in effectiveness of the session. Understanding the body language: Counselors must be able to read the gestures, expressions, general body language and non-verbal cues of the client during the helping process. It helps to get many aspects of the clients nature, which he is not being able to say verbally (Ray, 2014). Conclusion Helping process is an integral part of the social work. Many people need help in many ways and counseling is one of the ways to help them. Through counseling people can overcome many challenges and can live a better life. Helping process is heavily dependent on effective communication. In all the five stages of helping process, communication plays the major role, which lays the foundation of trust and relationship. Although there are many barriers to communication in the helping process, there are ways to overcome them also. Both the counselor and the client must put effort for easy communication, understanding, keeping patience and cooperating with each other for making the process successful. With effective communication, helping process can yield the best results. References Arnold, E. C., Boggs, K. U. (2015).Interpersonal Relationships-E-Book: Professional Communication Skills for Nurses. Elsevier Health Sciences. Austin, E. W., Pinkleton, B. E. (2015).Strategic public relations management: Planning and managing effective communication campaigns(Vol. 10). Routledge. Berge, Z. L. (2013). Barriers to Communication in Distance Education.Turkish Online Journal of Distance Education,14(1), 374-388. Brandler, S., Roman, C. P. (2015).Group work: Skills and strategies for effective interventions. Routledge. Crowe, M., Whitehead, L., Carlyle, D., McIntosh, V., Jordan, J., Joyce, P., Carter, J. (2012). The process of change in psychotherapy for depression: helping clients to reformulate the problem.Journal of psychiatric and mental health nursing,19(8), 681-689. Ray, D. (2014). Overcoming cross-cultural barriers to knowledge management using social media.Journal of Enterprise Information Management,27(1), 45-55. Egan, G. (2013).The skilled helper: A problem-management and opportunity-development approach to helping. Cengage Learning. Fox, R. (2013).Elements of the helping process: A guide for clinicians. Routledge. Gratis, B. (2017).Overcoming Interpersonal Barriers to Communication.Nulab. Retrieved 9 October 2017, from https://nulab-inc.com/blog/typetalk/overcoming-interpersonal-barriers-communication/ Kissane, D. W., Bylund, C. L., Banerjee, S. C., Bialer, P. A., Levin, T. T., Maloney, E. K., D'Agostino, T. A. (2012). Communication skills training for oncology professionals.Journal of Clinical Oncology,30(11), 1242-1247. Miller, W. R., Rollnick, S. (2012).Motivational interviewing: Helping people change. Guilford press. Shulman, L. (2012).Brooks/Cole empowerment series: The skills of helping individuals, families, groups, and communities. Cengage Learning.