The Human Cost of an Illiterate Society

Response to â€Å"The Human Cost of an illiterate society† 1/30/2011 In â€Å"The Human cost of an illiterate society,† Jonathan Kozol attempts to convince his reader that illiteracy is extremely harmful to a society, and that it is the ultimate destruction of a human being’s life. He explains with great detail how being ignorant (unknown) at something so universal like being able to read the directions on a medicine label, can lead to a lifetime of hardship and long term agony.Kozol develops his reasoning by contributing meaningful but real world examples on how being illiterate is dangerous and fatal. For example He uses not being able to explain where you are if something fatal was to happen, and not being able to understand the dangers of a cigarettes label with a surgeons warning on it. After giving a plenty load of examples, he then brings the discussion back to his central argument on how being illiterate can be costly. When a person does not understand wh at they have wrongfully done it can be difficult to prosecute or judge that person.If he is not able to read then that person might not be aware that giving a child too much aspirin could result in overdose which can ultimately lead to death. The question that still remains is should that person be held accountable. According to today’s society the answer is still unknown but to protect the people of this society from that illiterate person, the answer is yes that person must be limited. What this ultimately means is that, he must be kept from society so that he won’t cause harm for his on ignorant habits.He will have to be watched, fed, and kept in an environment where he will always be stable. This top of living can cost a lot of money and this is the financial burden that cost a society so much money. In a way this is unfair because it is not this person’s fault that he can’t read, understand, and think critically. Illiterate people will always be in t he dark, and they will always struggle with trying to figure out the differences between what’s wrong and what’s right.

Main cause of the Pilgrimage of Grace was a widespread dislike of religious changes Essay

Do you agree with the view that the main cause of the Pilgrimage of Grace was a widespread dislike of religious changes? There were three main rebellions in Henry VIII’s reign as king; The Lincolnshire Rising, The Pilgrimage of Grace and Cumberland Rebellion. These rebellions were all connected because each one triggered off the next one. The three main factors that set off the rebellions were the economic state of the country, the political state and the religious activities at the time. There are evidences that support the view that the main cause of the Pilgrimage of Grace was a widespread dislike of religious changes. Source 6 states that â€Å"†¦ Pilgrimage of Grace was a reaction against the religious changes†. Everything about the rising was to do with religion, the banners that the rebels carried had the five wounds of Christ on it, and all the rebels had to take the pilgrims oath. Where they swore not to carry out violence and that the pilgrimage was all to do with God and not overthrowing the king. This is supported by the evidence in source 7 where it says â€Å"except for the love you bear to Almighty God†. The author for source 7 is Robert Aske, who led the Pilgrimage of Grace to defend the religious houses that were being closed and property seized by the king. This goes to show that religion seemed to be the main cause of the uprisings against the king; the evidence shows that the Pilgrimage of Grace was named due to religion. Source 6 also mentions â€Å"brought to the boil by the dissolution of the smaller monasteries†. The timing of the rebellions started when the smaller monasteries were closed down and while commissioners were in progress of shutting other ones. Many monks and clergymen were now starring at homelessness and unemployment and many felt that standing up to the kings new policy was all they could do-they had nothing left to lose. They didn’t have the skills in the fast paced world and no financial means to survive and were on poor pensions. However, the monks could easily gain the support of the local people as the monks had looked after them, and the fact that the monks would of most probably have come from the surrounding areas. Even though the monks could gain the support of the locals, many of them would join the rebellion as they would lose their place of worship and pray. Source 7 also mentioned â€Å"maintenance of the Holy Church† this suggests that people started to see that Henry VIII was moving away from the traditional Catholic methods and starting to take up protestant views. Robert Aske named this uprising using a religious name. This meant that many more people would join, as all the people in England didn’t agree with Henry VIII’s new religious policy. The audience for source 6 are for the general public most importantly history students however this source was written 400 years after the event and could be argued if the memory of the author is distorted or have the author done an extensive research. On the other hand, there are evidences in the sources to suggest that religion was not the main cause for the Pilgrimage of Grace. Source 8 mentions â€Å"involving many social elements† it can be inferred from source 8 that the rebellions wasn’t only focused on religious activities but also socio-economic factors. England at the time of the Lincolnshire Uprisings was in turmoil, especially in the north of the country. The successful resistance to the amicable grant had stopped the government, but the English people were now weary and didn’t hold complete support for the English government. The north had been in a poor economic situation for a long time, the economy wasn’t the biggest reason for the fights and rebellions, but it would have played a part. This is supported by evidence in source 6 where it states â€Å"those responsible to be punished† suggests religion wasn’t the only thing the rebels were fighting for. Source 8 also mentions â€Å"high taxes, enclosure, the statue of uses†¦.. † the harvest of 1535 had been terrible and 1536 had seen little improvement in the produce. Which then in turn lead to hunger and poverty. What also didn’t help was the introduction of an extra tax. This ‘new’ tax soon aroused suspicion as this use of premium income was only used at a time of conflict for the country. The government also introduced new policies which involved tax being paid to landowners and these caused landowners to cheat and charge extra amounts. This could have really frustrated the common people and might have pushed them or the force behind the Pilgrimage of Grace. Also the introduction of enclosures really affected large populated areas like York due to the shortage of land and this would have caused the people of the north to call for a rebellion. Moreover it can also be argued that there were political reasons for the outbreaks. This is caused due to Henry’s attempt to end his marriage with Catherine of Aragon. This was intensified because of Henry’s idea to centralised power, which meant excluding the north. Thomas Cromwell, who was no important noble family, carried out the centralising of the power to the south, was just a commoner turned king’s main advisor. Many people, especially in the north felt that Cromwell had no right to be advising the king. This is supported through evidence in source 7 where is says â€Å"†¦. bad counsel from his advisers†. In conclusion, it can be argued that most of the reasons for the outbreaks are religious based, but the risings started due to taxes, bad harvest, the introduction of protestant methods in church and the dissolution of the monasteries and the dislike for Cromwell and his new policies. These all surely added up to the triggering of the revolts. However, the amount of people that took part in the rebellion depended on the issue that they weren’t happy about. So for example if some people didn’t like the closing of the monasteries, they would have felt angry and frustrated enough to have to join the ‘Pilgrimage’. The fact the it was named the Pilgrimage of Grace seems to hint that Aske and others that started it only felt it was meant to be purely religious affair and that the other groups that joined in used as a front for their anger.

Quality of Care for Diabetic Patients in a Large Urban Public Hospital Assignment

Quality of Care for Diabetic Patients in a Large Urban Public Hospital - Assignment Example According to the research findings, it can, therefore, be said that Suwattee, Lynch, and Pendergrass relied on hospital records mainly from the quality improvement department to collect data pertaining to patient characteristics and information on their follow up by physicians. They analyzed the data using x2 test, ANOVA, Fisher’s PLSD test to observe categorical and continuous variables, while taking the help of SAS statistical software. They concluded that diabetes clinic provided the highest quality care while clinic staffed by internal medicine residents provided the intermediate and the other clinic staffed by faculty physicians provided the least amount of care. Validity: As it was mentioned by the authors, the research was mainly based on documented reports rather than direct observations. Also, if their pre-existing favorability towards diabetes clinic had made them perform an overlooked biased study with respect to selection and testing of measures, the internal valid ity would have been in question. However, the documentation of their data analysis and the correlation of results and assumptions with relevant published data suggest that the study can be considered as validated. From the data, assumptions and relative measures provided by the authors, it can be stated that the results of this study have content, predictive and concurrent validity, respectively. Applicability: The main point identified in this research was that diabetes clinic having a disease-management process provided highest quality care to patients. It was in spite of the fact that some aspects of the care in the diabetes clinic are provided by least experienced personnel than those in the clinic staffed by faculty physicians. Adherence to standard guidelines for patient care through a system-wide coordination among involved providers is the key for this difference. Though this comprehensive approach seems widely applicable, the fact that even the diabetes clinic’s scor e was also suboptimal indicates that applicability needs long-term commitment and participation of all involved entities.

My personal development plan Coursework Example | Topics and Well Written Essays - 1500 words

My personal development plan - Coursework Example In my life, I have some innate skills that I have obtained in the course of life and which I do not struggle to develop while I am working within an organisation or for my own good. These skills help me to overcome various challenges in life and make it easy for me to implement activities in a very easy way without making any consultation from different people. For example, I have skills in communication, which I acquired through my education and a person interested in different things in the world, I have developed my ability in written and spoken Arab as well as in English. In English, I have developed the skills since birth as I am a native English speaker and can communicate to different people with ease of understanding of their language and forms of communication. In addition, I advanced my skills in English following my study at the University of Buckingham where I attained a certificate in effective communication between 2008 and 2009. This was in my attempt to enhance my com petence in the English language as a language of communication in my endeavours as I practice my skills in marketing and promotion. This was also in understanding that marketing and promotion, in which I major, needs people who are fluent in their modes of communication as one interacts with different people in the market and convincing them to purchase products. My skills in written and spoken Arabic was put in to test when I worked for Coca-Cola Company in Yemen in 2011 from June and September and during my four weeks internship in Egypt.

The concept of stakeholder management Essay Example | Topics and Well Written Essays - 1000 words

The concept of stakeholder management - Essay Example To address the role of stakeholders in governance analysis, the concept of stakeholder management was created. The challenge of stakeholder management, then, is to see to it that the organization's primary stakeholders achieve their objectives and that other stakeholders are dealt with ethically and are also satisfied. This is the classic "win-win" situation. It does not always occur, but it is a legitimate goal for management to pursue to protect its long-term self-interests. Management's second-best alternative is to meet the goals of its primary stakeholders, keeping in mind the important role of its owner investors. Without economic viability, all other stakeholders' interests are lost. Thus, the important functions of stakeholder management are to describe, to understand, to analyze, and, finally, to manage. Reference: Buchholtz, A., & Carroll, A. (1999). Business and society: Ethics and stakeholder management. US: South- Western Educational

MANAGING INNOVATION AND ENTREPRENEURSHIP (Take home exam) Essay

MANAGING INNOVATION AND ENTREPRENEURSHIP (Take home exam) - Essay Example If these are not that effective, then entrepreneurs must have stopped using them for years. According to Porter’s five forces model, there are potential entrants that are able to play as relevant industry competitors. These new entrants are also capable of forming innovation and even imitation. China for instance is known for its low-cost products that at some point similar to existing offerings, which makes imitation not that impossible to take place. Thus, it would make sense that in order to prevent others from imitating a product; barriers to potential entrants should be made. According to Porter, barriers to entry includes economies of scale, product differentiation, capital requirements, switching costs, access to distribution channels, cost disadvantages independent of scale and government policy. We have been immersed mostly in the concepts of economies of scale and product differentiation so I would like to focus on these two as important barriers to innovation, as based on Porter’s five forces model. The economies of scale would force the entrant to face two undesirable options: come in at large scale and risk strong reaction from existing firms; choose small scale and accept cost disadvantage. In either of these choices, a new entrant needs to take the risk of losing his chance to successfully penetrate into the market. The other potential barrier to new entrant is product differentiation. Firms that already have brand identification and customer loyalties are hard to beat. Therefore, firms should therefore increase advertising, customer service, product differences and be the first into the industry in order to prevent potential entrants. Product differentiation therefore could at some point be highly associated with economies of learning, production techniques, production design and more, just to be able to create one-of-a-kind product that could bring competitive advantage and

Marketing - Exam on Marketing Essay Example | Topics and Well Written Essays - 750 words

Marketing - Exam on Marketing - Essay Example The role of integrated marketing communication is to use advertising as a means of creating a sound and meaningful relationship between the business and the specific audience the business is trying to reach. II. While integrated marketing communication is a complex field, there are a number of specific IMC drivers. The primary drivers of integrated marketing communications include message clutter. Another notable driver is the need for consistency in brand differentiation. One considers that in organizations such as Coca-Cola this is evident in that a single logo and advertising campaign that are implemented for set periods. Still, other drivers are evolving technology and forming transaction to relationships. One considers that there are a variety of specific examples where these elements occur. In terms of evolving technology the Internet has presented many news ways companies can improve transaction to relationships and a fusion of entertainment to consumption. Among the most prom inent recent examples include advertising specifically tailored to the customer and email marketing campaigns. Domino’s Pizza, for instance, recently developed an advertising campaign where if individuals clicked on their Facebook page they were eligible for a discounted pizza. There are a variety of different IMC communication tools. Different tools have different uses. These tools creative a hierarchy of effects. Promotional tools are one prominent example. These tools must be developed so the target audience receives a message that is consistent throughout. For example, a business should use similar marketing designs and slogans throughout the organization so the customer comes to identify these elements with the business. This has become a prominent element of major corporations such as Starbucks and Coca-Cola. Other prominent marketing tools include publication relations, personal selling, and sales and promotion. In addition there are internal elements, including accoun tability where the organization considers cost elements. Another important consideration is integrated marketing communication from a managing perspective. Most importantly, IMC can be a challenging management task, as it involves a number of elements within the business. It follows that management must be highly coordinated in instituting these new forms of advertising inline with new forms of technology and communication. Today nearly all major corporate elements, one considers Wal-Mart, have a social media presence. There are a number of barriers to IMC. Many of these can be considered along a spectrum. For instance, talent and skills are potential barriers within the business. Other major barriers include control and coordination issues, business culture challenges, and modification challenges. There are a variety of advantages and disadvantages to IMC. The primary advantage is that IMC implements an approach to advertising that directly targets consumers with specific interests . This allows for more effective communication and a competitive advantage through more efficient marketing. In terms of disadvantages, there is a greater advertising burden placed on the organization. This increased burden also involves bureaucratic procedures and a uniformity of style and message. In conclusion, integrated marketing communication constitutes a new and highly adaptive form of advertising and marketing. The approach involves a comprehensive and customer centric approach to

Better Place Essay Example | Topics and Well Written Essays - 2000 words

Better Place - Essay Example Based on its perception that it could add value to utilities, Better Place was working closely with utilities to develop long term investment plans in renewable and clean energy. Israel, for example, had set a goal to have 10 percent of its electricity sourced from solar power and renewable energy by 2020. Israel Electric Corporation established a committee led by the senior vice president of engineering projects, Yakov Hain, to facilitate ongoing conversations between IEC and Better Place. Hawaii Electric Company announced a non-exclusive agreement with Better Place to invest in renewable energy and establish a recharging network connected to the grid, yet the utility noted its open-mindedness to engaging with similar companies. In Toronto, Canada, Better Place held talks with Bullfrog Power, an electricity provider that provided 100 percent renewable and clean energy sources. Spain and Portugal were also prospective locations as Better Place projected a demand for 50,000 plug-in el ectric cars in the region by 2011. As of early 2010, the company had begun establishing partnerships and carrying out market research to assess the feasibility of entry into regions with fewer boundaries and more factors inhibiting the transition to Electronic vehicles. Industry Analysis and Scenarios Better Place put up its first exhibition centre in Israel, February 2010. It was constructed in the interior of industrial oil storage tanks, which had one and a half kilometer test tracks for the available electric cars. The trade fair centers provided peculiar podiums through which the institution’s ambitious strategies of the industry would be presented, thus bringing to a halt, the domination in the automobile manufacturing industries. The most remarkable and an up to date highlight in the industry’s proofs is the invention of a bazaar, all the way through which it had entered into partnerships with Israel’s nationalized electric venture resources’ firms , services, car manufacturers, battery companies, corporate consumers and the Israeli government to make steady the electric automobiles’ networks nationwide (Better Place, 2010). Better Place organization also made pronouncements beforehand to initiate partnership with Denmark, the United States, and Canada, Australia, and Japan administrations and make proficient engagements in discussions with twenty five other different governments all over the world. In 2007, Better Place, as an organization make a realization of an enterprise-investment-endowments of approximately two hundred million US Dollars in its principal encompassing of businesses, and three hundred and fifty in 2010. These achievements were based on 1.25 billion dollars valuations and made it the second largest get underway in history. As already in the earlier statement, this organization’s mission was thus focused on drastically reducing and eventually eliminating the custom and sole dependency of autom obile industries on oil (Global Progress, 2010). As a mean of forging ahead, Better Place envisaged that its shoppers would be presented with three tiers of services’ fixed monthly payments, which include: plans–all–you–can-drive, and pay–as–you-go. Within this aspect, Better Place had think about automobile drivers being in a position to in most instances prefer service plans with an ERGO in which electricity is virtually put up for sale in miles as opposed to in kilowatt hours. At this rate, it is determined that ERGOs would be in the best position to effectively

Database Design- Dependency Diagram Essay Example | Topics and Well Written Essays - 250 words

Database Design- Dependency Diagram - Essay Example not be necessary to show all the data dependencies among the various modules because some module might be unconnected in a sequence or time and hence these are not illustrated on a dependency diagram. For example, a module might give data that cannot be used by another module until time lasts. In this scenario, the existing dependency among these modules will be left off in the dependency diagram. The dependency diagrams are also vital and useful when there exits’ complex dependency of module in a database system. Otherwise, the effort which is required to complete the dependency diagram is not warranted in complex dependencies. In this case the recommendation is the decomposition of the diagram to a less complex one such as an action diagram or a structural chart which is outlined to form a suitable dependency diagram. Action diagrams might not be used to illustrate further elaborate details such as in the shared accesses to the main storage, which is not illustrated in a dependency diagram. A CRUD diagram might also be used to illustrate dependency among some of the processes that are not shown in the dependency diagram such as the year –end time dependency among

The assignment it is a marketing subject and it a research Paper

The assignment it is a marketing subject and it a - Research Paper Example This research study holds importance since promotion is a common tool utilized by all real world companies. Promotion strategy is also a kind of competency which can be acquired by a firm. The importance of this study lies in analyzing wide arrays of theoretical frameworks related to promotion. Research objectives have been stated below- According to Easwaran, marketing can be defined as an approach that enables direct flow of services or products from manufacturers to end customers. It helps to satisfy customer requirements, involved in exchange process. There are wide set of activities included within the approach of marketing. Marketing mix comprises of four basic elements – product, price, place and promotion. Additional elements in marketing mix are physical evidence, process and people. Hence promotion is one of the significant elements of marketing mix. Any service or product always needs the support of effective promotion scheme. Planning is required before promoting brand through advertisement campaigns, leaflet distribution, etc. There are other decisions which are focused on along with planning promotional activities like determining objectives, selecting target group, outlining promotion budget, distribution, new product launch, etc. Promotion is a medium of spreading awareness about a brandâ€⠄¢s offerings. There are three major purpose of promotion – presenting information to target customers, differentiating a product and increasing market demand. Promotional plan is solely responsible for wide array of outcomes such as brand equity building, increase in sales, positioning, and acceptance of new product, corporate image development and competitive retaliations (Easwaran 112). As per Arens, promotion can be stated as a variable to communicate brand message to target audience and eventually change their behavior or attitude. Market share and sales percentage can only be increased when appropriate promotional strategy

Political Nature Of Music Essay Example for Free

Political Nature Of Music Essay Music has influenced man in a lot of ways and it can be evidently seen in the events that have occurred throughout the years. The vastness of musics capability to create influential concepts and ideas ranges from the smallest of intents to the broadest of intentions. Politics is not an exemption to the scope of musical boundaries. Through the years, music has provided various influential impacts to society and to politics. In the United States, music has become a popular method to promote political intentions. Music and Politics Through the years music has evolved and added up different genres from time to time. This aspect of music provides a wider range of impact on different types of music lovers. From punk to hip-hop, jazz up to pop, these different musical styles possess the influential aspects that determine the concept of music and its ability to affect people. There are various artists and bands who blatantly express their political outcries through the use of their music. There have been the bands from the past until present who showcase their protests to political leaders and their actions. To these bands, their capability to influence people most especially the die hard fans makes them believe that they can make an impact or better yet a change to society. This potential of bands to influence and affect the perceptions of people is a powerful tool that displays musics power. Bands and artists that showcase their political views creates a controversial stir due to the fact that not all people have the same political views. Despite all of this, these bands continue to stand on their opinions and still create music to promote their side. There are also those bands and artists who promote politically but does not display their political side. These artists are the ones who advertise people to vote. Due to the greatness of musics influence especially on the youth of today, artists promote political awareness and help these youth to care for the country and vote. There have been various commercials of bands or artists who display their stand to vote. Years ago, artists started to create the thought of â€Å"vote or die†. This shows their strong stand to help people vote. If there are the musical artists who promote their stand to vote, there are also those who oppose the actions of political leaders. For instance, there are several music artists who display their strong stand against President Bushs actions especially of the decision to send the countrys troops to Iraq. Years ago, there became a nationwide controversy regarding the Dixie Chicks opposing President Bush. This has led to different scenarios. This is just one example of music artists expressing their side. Through the years there are the bands like the notable punk artists such as the Sex Pistols, Dead Kennedys, The Clash and Green Day who have been notorious to utilize controversially political lyrics that bash the administrations. There are so many other bands who make use of their lyrics and catchy sounds to stir up messages that bring forth impact. We already jumped to the present times but the 1960s and 1970s are the decades that have really made expressionistic views through music. From the influential music of the rock bands of that era up to the formulation of the phenomenal rock concert named Woodstock, politics has served as a source of musical â€Å"revolution†. Woodstock, is the whole epitome of music serving as a tool towards political views. It is one of the most phenomenal events of history, a compilation of musical artists who serve for a single and peaceful cause. An expression of peace and a blatant display of care and intent to provide a better resolution to the war during those times, Woodstock became a festival of driven intention to promote peace and somehow express the side of the youth towards the actions of the American government especially pertaining to the Vietnam War then. Jumping back to the present, musics influence stands on different aspects. In the United States, such prominent music icons serve as the most influential artists that can accumulate a larger prospective view. There are those artists who serve for patriotic intentions while there are those who serve for what they think is better for the country. Its hard to count all these artists and specify their political views but the whole point is that the power of music is so great that when people choose to believe in it, their views and principles can be altered by musics life-changing influences. For music lovers and the die hard fans, most of them copy or imitate their favorite artists or bands, and in turn, some of them find it cool to follow their footsteps or even yet their views. Such is the power of music that it can affect political views and principles of people. Music can unite people but it can also segregate people. The genres are the ones which takes care of the segregation part but with the evolution of music today, the genres have become side by side with views and perceptions. All of them serve as the segregating factor. But nonetheless, music still has the power to unite and make people believe in something. Though it is a fact that all people dont possess the similar views, with regards to politics for that matter, there is a magnanimous challenge for music to unite everyone. The socio-economic class of people vary in a lot of ways and music also takes a part on it. As it is widely known, African Americans mostly take the side of Jazz, Hip-Hop and RB due to their history while the Whites take country music, pop, rock and punk. Segregation can also be evidently seen in these types of music which appeal to certain groups of people. All in all, music has served great not only in the United States but also around the world. The contributions of music to the history of the world somehow have created the different impacts on events. Whether be it on the past or today, musics vast power to capture a single persons political point of view is quite underrated. To some it may not look like as a big factor, but to some it also means a lot. Some people love music and that love for music helps them to believe in something. Personally, my political views have been strong from the start. Its not that music has influenced me or something, but seeing my favorite bands and artists taking a stand on what I believe in makes me feel that I am on the right side. Music helped me to become what I am today. It made me realize that someway, somehow I have something to believe in, something to be a fan of, and that I share this feeling with other people around the world. Music is a part of my life. I could not imagine my world without music. Though I know that not all people agree on my views, I still believe that music helps me to believe in something. The poetry of the lyrics, the awesome guitar rifts, the fast pace of the drums or even just the enlightening voice of the artist, these factors are the ones that helps me to create peace of mind and believe in something that has power and influence. Although I may not share the political views of all people, my music helps me take a stand and realize my worth and the worth of the country. Music artists have personally influenced me to vote and take a political stand but on what stand that is, its all up to me. Such is the power of music, it can alter, influence, and unite people.

The Biopsychosocial Model Health And Social Care Essay

The Biopsychosocial Model Health And Social Care Essay In the preceding paragraphs many theoretical models were put forward, but it is now desirable to introduce a holistic model of causation, one that is more naturalistic than the simple linear reductionist models (Borrell-Carrià ³ et al., 2004). A comprehensive literature search showed that the most common and widely accepted holistic framework for treatment and rehabilitation is the biopsychosocial model. The popularity of this model can be seen by the frequency of its occurrence in online sources. A preliminary assessment of the biopsychosocial model was conducted using the Medline database, using the term biopsychosocial in the topics field. It is well recognised that use of the term biopsychosocial does not necessarily indicate an adoption of the biopsychosocial model, but at a minimum, it does reflect a recognition of the perspective (Suls Rothman, 2004). Figure 1.5: Frequency of citation of the term biopsychosocial using the Medline database. 4.1 The Biopsychosocial Model One of the famous landmarks articles, published almost thirty years ago by Engle (1977), questioned the biomedical interventions used in both psychiatry and medicine, and warned of a crisis in the biomedical paradigm (Alonso, 2004). Engle (1977) argued that a true medical approach should consider: (1) the patient; (2) the healthcare system; (3) the social context of the patients life; and (4) the psychological context (Mrdjenovich et al., 2004; Pereira Smith, 2005). The main proposition of the biopsychosocial model is that treatment interventions should be an interlinked system covering multiple dimensions (i.e. diagnostic and causative variables), taking into account biological, social, psychological and macro (e.g. socioeconomic status, cultural, ethnic) issues (Figure 1.6) (Burton et al., 2008). Any defect in one part of the system will affect another part of the system (Keefe et al., 2002). For instance, deterioration of a patient condition (biological effect) can negatively aff ect patients` emotional states increasing stress and anxiety level (psychological effect) affecting his/ her ability to work or perform his/her daily routine activities (social effect), which will then, subsequently, increase pain and/or disability levels (Keefe et al., 2002). Figure 1.6: A pictorial illustration of the biopsychosocial model. Adapted from Finlay (2009). The biopsychosocial model accentuate the importance of interacting and understanding the patient as a unique individual taking onto consideration their belief system in a moderate way that neither concentrate on the biomedical aspects or psychosocial aspects but rather illustrate their relationship together (Jones et al., 2002). In comparison between the biopsychosocial model and the earlier discussed models, it can be seen that the biopsychosocial model posits a much complex, multidimensional and broader approach of clinical care (Hadjistavropoulos Craig, 2004). Engles new paradigm has often been seen as a radical departure for medicine (Salmon Hall, 2003, p.1972). However, Lambert et al. (1997) stated that although the biopsychosocial model is a new approach, it is still conservative. This assessment was based on several perspectives proposed by the model. First, by underlying the need for good clinical decisions to respond to the eccentricities of each individual patient, it re-affirms the patients role, self identity and professional independence (Armstrong, 2002; Salmon Hall, 2003). Secondly, the model extends the responsibility of medical care to go beyond biological complications and encompass non-medical treatments as well (Baer, 1989). Physicians are required to connect with their patients in a relationship that involves not only the patients complaints and symptoms, but also their personalities and psychosocial lives (Salmon Hall, 2003). Conversely, patients are expected to be prepared to respond to the physicians and bring about the required changes in their lives to prevent and/or manage their illness (Salmon Hall, 2003). However, one of the issues that has been discussed in the literature is whether the concepts of the doctor-patient relationship and patient-centredness can affect and threaten the doctors authority. However, if the requirements for patient-centredness and a doctor-patient relationship are applied in a moderate and professional way, they do not threaten either the doctors authority or their responsibility, especially since physicians maintain their authority by virtue of their specialist knowledge and their responsibility for an accurate diagnosis and appropriate treatment (Salmon Hall, 2003). Taking on the considerations mentioned in this section lead to a perceived need for a study to determine the current methods followed in managing lower limb injuries (either in elective or emergency cases) and whether the biopsychosocial model is a better approach of treatment. 4.1.1 To what extent have the medical establishment and different research fields adopted the biopsychosocial model? The biopsychosocial model has been widely adopted and promoted in different domains, including medical schools, major medical organisations, social work departments, public health, counselling, and some fields of psychology (Kaplan Coogan, 2005). For example, the WHOs International Classification of Functioning, Disability and Health (ICF), which is a global framework of disability and rehabilitation, is based on the biopsychosocial model (WHO, 2001). Dowrick et al. (1996) conducted a study to explore whether the biopsychosocial model is based on rhetoric or reality. A semi-structured postal questionnaire was sent to 494 principal general practitioners. The questionnaire sought the practitioners views about what they believed to be relevant and appropriate to a practitioners skills and knowledge in general medical practice, and investigated whether these views are consistent with the biopsychosocial model. Only 41% (207) of the sample responded to the questionnaire, which is considered to be a low response rate (Church et al., 2001). The results showed that general practitioners embrace the view that physicians should incorporate a biopsychological model, rather than a biopsychosocial model, in their general medical practice. However, the results cannot be generalised because the study was conducted exclusively on members of a specific organisation. Therefore, the results can only be only applied to the specific population describ ed in the study. Similarly, Alonso (2004) also investigated the extent to which the biopsychosocial concept has been adopted by medical researchers. Using the Medline database, Alonso examined published articles in the period 1978-1982 (period a) and the period 1996-2000 (period b). Period a was selected because it covers the first five years since Engels conceptualised his new model, and the second period (period b) was determined by the date of Alonsos study (covering the five years before the study). The findings of the previous study showed that the conceptualisation of health in medical research, as characterised in articles written within the past two decades, has not changed. In other words, physicians are still reluctant to incorporate the biopsychosocial model, and often focus solely on traditional methods of treatment. Other studies (Dowrick et al., 1996; Cohen et al., 2000; Alonso, 2004; Kaplan Coogan, 2005) also concur with the findings of Alonsos original study, and conclude that the bi opsychosocial model has not been fully integrated into actual medical practice. Conversely, in an evaluation of published articles between the years 1977-1987 and 1988-1998, Hwu et al. (2001) found a considerable spread of medical research articles that did include social and psychological aspects in their definitions of health and medical care. In addition, a literature search also shows that several behavioural, medical and psychological phenomena have adopted the biopsychosocial concept (Kaplan Coogan, 2005), in areas such as schizophrenia (Kotsiubinskii, 2002; Schwartz, 2000), chronic fatigue (Johnson, 1998), antisocial behaviour (Dodge Petit, 2003), gastrointestinal illness (Drossman,1998), spinal cord injury (Mathew et al., 2001), and pain management (Truchon, 2001; Covic et al., 2003). Clearly, there are conflicting findings in the existing literature regarding the extent to which the biopsychosocial model has been integrated into the medical domain, indicating a need for future research. 4.1.2 Application of the biopsychosocial model in rehabilitation Several authors have argued that there is a considerable gap between the introduction of a new or revised model and the application of the proposed model in clinical practice (Linton, 1998; Muncey, 2000; Jones et al., 2002). The challenging factors surrounding changes in clinical practice have been reviewed by Muncey (2000), two of which are associated with physicians decision-making skills and knowledge. In addition, physicians reluctance, in some cases, to integrate new models into their clinical practice should also be taken into consideration (Silagy, 1998; Jones et al., 2002). Furthermore, because the current medical literature is often introduced at a basic scientific level, it is complicated for non-researchers to understand and transfer new models and theories to clinical settings (Jones et al., 2002). Jones et al. (2002) stated that in order to achieve successful application of a new pattern of behaviour and practice thinking, two elements are required. These are reflective, critical clinical reasoning (i.e. the decision-making process), and a suitable organization of knowledge in which the new model can be implemented. The significance of the biopsychosocial model is based on its capability to show the multitude of interactions between its elements (Jones et al., 2002). in addition, every individual element can then be further explored. However, this means that physicians need to further develop their clinical practice skills in terms of patient assessment and management, either physically or in terms of other factors that contribute to their patient`s illness (Jones et al., 2002). One of the elements that should be considered in the application of the biopsychosocial model is diagnostic reasoning, which mainly depends on the application of the scientific paradigm (or the empirico-analytical model) for decision-making and validation. This form of reasoning attempts to identify and test hypotheses relating to the nature of psychological and physical impairments and their functional disabilities (Jones et al., 2002). Narrative reasoning is another form of reasoning which is used to understand the patients own experience with their pain and illness (Mattingly, 1994; Jones et al., 2002). However, although this sounds like a simple method, in fact it is far more challenging than simply listening to patients own stories (Jones et al., 2002). Finally, it is essential to highlight the fact that the biopsychosocial approach is not only concerned with curing pathological defects, but also with helping people to regain their normal life activities (Burton et al., 2008). In addition, it is acknowledged that there may be a certain amount of reluctance regarding the adoption of the biopsychosocial model because of the hurdles in the way of its clinical application (Burton et al., 2008). Changing the way in which injuries are managed in clinical settings will require further investigation, since little attention has been paid towards identifying the current methods that are used to manage lower limb injuries (either in emergency or elective settings) and whether the biopsychosocial model is a better approach in managing such injuries. From the findings and the studies presented in this literature review, it can be concluded and hypothesised that enough clinical evidence exists to show that the biopsychosocial model is a better approach to managing lower limb injuries. On the other hand, the literature does not answer the basic question to whether the surgery is elective or emergency make a difference to the patient experience after injury, which necessitate the need for further investigate. 5.0 Conclusion Little attention has been given to the patients experience after lower limb surgery for example, comparing and contrasting the experiences of patients who have had elective or emergency surgeries, exploring physical, social and psychological aspects, and looking at whether methods of treatment and follow-ups are applied differently between elective and emergency surgeries. In addition, although various studies had focused on how the physical, social and psychological factors interlink together, no previous study has investigated the outcome of the application of the biopsychosocial model in managing patients after lower limb surgery as a result of injury, compared to those who were treated using other treatment approaches. Therefore, to address these issues, this study aims to explore and report the patients experience of clinical care of lower limb injury after surgery, comparing and contrasting the experiences of patients who have had elective or emergency surgeries, and investigating whether the biopsychosocial model is a better treatment approach for the management of lower limb injuries than other approaches. Thus, the current study is based on the following research questions: 6.0 Research question Primary research question: What are the differences between patients experiences and clinical approaches after elective lower limb surgery as a result of injury, compared with patients experiences after emergency lower limb surgery as a result of injury? Secondary research question: If a difference exists among patients experiences and clinical approaches between elective and emergency lower limb surgeries as a result of injury, how does this difference related to the current care pathway including the biopsychosocial model? 6.1 Aims and objectives The aim of this study is to develop a better understanding of patients experiences after a lower limb injury that is severe enough to necessitate surgery, and to compare medical services (after lower limb surgery) provided in emergency settings vs. elective settings. In addition, the study aims to investigate the efficiency of current methods of treatment and compare them with treatment methods derived from a biopsychosocial approach. Understanding the experience of lower limb injury from the patients perspective is essential for providing guidelines for appropriate and efficient medical services, and in the prevention of future complications for the patient. In addition, such an understanding will form a reference for future research studies. The objectives of this study are to explore and report: The difference in patients experiences of medical services for lower limb surgery provided in emergency settings and elective settings. Whether the current biomedical approach to managing lower limb injuries is efficient enough from the patients perspective. The importance of psychosocial factors for a patient with lower limb injury. The importance of implementing treatment methods derived from a biopsychosocial model approach. 6.2 Statement of null hypotheses The research is based on three null hypotheses: The primary null hypothesis states that there will be no difference in patients experiences in emergency and elective surgery settings for patients with lower limb injuries. The secondary null hypothesis states that there will be no difference between elective and emergency lower limb surgeries as a result of injury, and hence it does not relate to the current care pathway including the biopsychosocial model.

Breastfeeding: Advantages and Disadvantages

Breastfeeding: Advantages and Disadvantages This essay is potentially vast in its scope as the advantages and disadvantages of breastfeeding can vary enormously depending on which authority one chooses to consult. (1) We shall therefore take an overview and present the generally accepted arguments in this area. There is a substantial evidence base for the benefits of breastfeeding for not only the infant, but also the mother, the families and society as a whole. (2). The benefits are not only nutritional, but cover other areas such as development, immunity, psychological well-being, overall health risks, social and environmental areas (3) Human milk is widely recommended as the food of choice for the otherwise healthy full-term newborn. Apart from providing the optimal nutrition it contains a number of cellular and humoral components such as phagocytes, immunocompetant cells, immunoglobulins and hormones and also plays a (as yet, not fully defined) role in promoting intestinal mucosal maturation. (4) Because of these (and other) considerations, the World Health Organisation recommends exclusive breastfeeding for at least the first six months of life. (5) There is widespread evidence that the trend towards universal breastfeeding is increasing (viz. 6) in most of the developed countries, Fewtrell gives a global figure of 2% per year. but studies show that this trend is not equal across all socio-economic and demographic groups. If we specifically consider the UK situation then we can show that the commencement of breastfeeding is equal in the working and non-working mothers groups, although if one considers the situation of how many mothers are still breastfeeding at six months post partum, the incidence in the working mothers group is less than half that in the non-working group. (7) What then is the evidence base for the benefits of breastfeeding? In addressing this question we shall confine our comments to those relevant to the developed world. If we consider the Kramer study, which compared the benefits of continued breastfeeding from 3 months to 6 months, the authors were able to demonstrate that the additional 3 months produced benefits in terms of greater weight gain, greater growth (length) together with a reduced incidence of gastrointestinal infection. (8) In absolute terms however, the benefits of breastfeeding over formula milks (or cows milk) is much greater. A huge number of potential childhood infections have been demonstrated to have a lower incidence in the breastfed child including bacterial meningitis, diarrhoea, respiratory tract infections, otitis media, urinary tract infections (9) as well as less common entities such as necrotising enetrocolitis (10). It is also significant that the all-cause mortality rates are 21% less in breast fed infants. We should note that this figure, although accurate, is misleading, as many high risk babies are not breast fed because of their intercurrent problems. (11) Apart from infections, many other health benefits can be demonstrated. There is a reduction in the incidence in sudden infant death syndrome under the age of 1 yr. (12). Diabetes (Type I and Type II) is less common amongst breastfed babies (in later life) as are the incidences of conditions such as lymphoma, leukaemia and Hodgkin’s disease. (13). Breastfeeding tends to be associated with a lower incidence of obesity, hypercholesterolaemia and asthma. (14) There is a slightly weaker evidence base to support the benefit of breastfeeding in terms of neurological development. Some authorities suggest that it can improve cognitive development. (15) and it may also reduce the perception of some painful stimuli. (16) In addition to benefits for the child, there are also a number of demonstrable benefits for the mother who breastfeeds. If suckling occurs at the time of birth, the resultant release of oxytocin reduces the incidence of post partum haemorrhage and increases the speed of uterine involution. (17). In the period after the birth, breastfeeding reduces both fertility and menstrual loss, it facilitates a return to pre-pregnancy weight, it reduces the risk of both ovarian and breast cancer (18) and may well reduce the incidence of osteoporotic fractured hips (19) In the opening segment of this essay we alluded to the benefits to the community as a whole. These can be defined in terms or reduced health costs to the community by virtue of the protective effects of breastfeeding. There are also less definable benefits in terms of reduced employee absenteeism. Some authorities have gone as far as to point to the environmental benefits of reduction in energy expenditure on production, distribution and disposal of formula feeds and their packaging. (20) Thus far we have considered the positive benefits of breastfeeding but in order to provide a balanced argument, we should also consider the disadvantages. The pre-term infant or severely underweight or ill baby has special needs and there are a number of reasons why they should not be breastfed. The pre-term infant has immature physiological systems and the kidneys may not be able to handle the osmotic gradients that are required to excrete the amount of fluid necessary to remove the amount of nutritional load required for adequate growth. This may result in respiratory problems and exacerbation of any pre-existing cardiac conditions (viz. patent ductus arteriosus). For this reason, most pre-term infant are electively parentrally fed and then weaned onto enteral feeding when their gastrointestinal tract and other physiological systems are mature enough to handle the fluid load. (21) If the mother is ill or has a potentially communicable illness such as HIV/AIDS or TB, then breastfeeding is contraindicated, as it is in conditions when certain drugs (both medicinal and recreational) are taken by the mother. (22). We should also record that the evidence for HIV/AIDS spread is not secure, as some studies have suggested that breastfeeding actually confers a degree of protection against HIV/AIDS for the child. This is still an area of considerable debate. (23) It is also clear from an examination of the literature on the subject, that there is a great deal of misinformation on the subject of breastfeeding in the popular press (and to a lesser extent in the medical press). Breastfeeding is not contraindicated in conditions such as Hepatitis B or C +ve. (24). Most febrile conditions are not a contraindication to breastfeeding as the maternal immune response will be passively given to the child in any event. Some authorities suggest that tobacco smoking is a contraindication to breastfeeding. If we remove considerations of general health from the consideration, there is no reason why tobacco smoke should be considered a bar to breastfeeding as such. (it clearly may be ill-advised however) (25). Some authorities suggest on theoretical grounds that breastfeeding should be suspended during the period of physiological jaundice of the newborn. A number of recent studies have shown that this is not necessary and may cause insurmountable difficulties in rehabilitation-establishing breastfeeding after the event. (26) In essence, within the scope of the exclusions referred to above, healthcare professionals should actively encourage and support mothers in their ability to breastfeed their offspring. In doing so, one should always consider the autonomy of the mother (27) and attempt to provide empowerment and education in order to facilitate the best result rather than compulsion or emotional blackmail. (28). This should help to ensure the maximum possible take up of breastfeeding from mothers who have been able to make a fully informed decision. If direct breastfeeding is not possible, then, generally speaking, expressed breast milk is the preferred substitute. In this essay we do not presume to have covered anything like an exhaustive presentation of the arguments, but there is no doubt, from an overview of the evidence base on the subject, that in the vast majority of cases, both mother and child will derive substantial benefits from being able to breast feed for at least the first six months of life. References (1) Duerbeck N B (1998) Breast-feeding: what you should know so you can talk to your patients. Comp Ther 1998 ; 24 : 310 318 (2) Kramer M S, Chalmers B, Hodnett E D, et al. (2001) Promotion of Breastfeeding Intervention Trial (PROBIT): a randomized trial in the Republic of Belarus. JAMA. 2001 ; 285 : 413 – 420 (3) Schanler R J. (2001) The use of human milk for premature infants. Pediatr Clin North Am. 2001 ; 48 : 207 – 219 (4) Margolis L H and J. B. Schwartz (2000) The Relationship Between the Timing of Maternal Postpartum Hospital Discharge and Breastfeeding. J Hum Lact, May 1, 2000 ; 16 (2) : 121 128. (5) Fewtrell M S , J. B Morgan, C. Duggan, G. Gunnlaugsson, P. L Hibberd, A. Lucas, and R. E Klein man (2007) Optimal duration of exclusive breastfeeding: what is the evidence to support current recommendations? Am. J. Clinical Nutrition, February 1, 2007 ; 85 (2) : 635S 638S. (6) Bonuck K A, K. Freeman, and M. Trombley (2006) Randomized controlled trial of a prenatal and postnatal lactation consultant intervention on infant health care use. Arch Pediatr Adolesc Med, September 1, 2006 ; 160 (9) : 953 960. (7) Kramer M S, Kakuma R. (2001) The Optimal Duration of Exclusive Breastfeeding. Geneva, Switzerland: World Health Organization ; 2001 (8) Kramer M S , Guo T, Platt R W et al. (2003) Infant growth and health outcomes associated with 3 compared with 6 mo of exclusive breastfeeding. American Journal of Clinical Nutrition, Vol. 78, No. 2, 291 295, August 2003 (9) Heinig M J. (2001) Host defense benefits of breastfeeding for the infant. Effect of breastfeeding duration and exclusivity. Pediatr Clin North Am. 2001 ; 48 : 105 –123 (10) Dewey K G, Heinig M J, Nommsen-Rivers L A. (1995) Differences in morbidity between breast-fed and formula-fed infants. J Pediatr. 1995 ;126 : 696 – 702 (11) Chen A, Rogan W J. (2004) Breastfeeding and the risk of postneonatal death in the United States. Pediatrics. 2004 ;113 (5) (12) Horne R S, Parslow P M, Ferens D, Watts A M, Adamson T M. (2004) Comparison of evoked arousability in breast and formula fed infants. Arch Dis Child. 2004 ; 89 (1) : 22 –25 (13) Davis M K. (1998) Review of the evidence for an association between infant feeding and childhood cancer. Int J Cancer Suppl. 1998 ; 11 : 29 – 33 (14) Toschke A M, Vignerova J, Lhotska L, Osancova K, Koletzko B, von Kries R. (2002) Overweight and obesity in 6- to 14-year old Czech children in 1991: protective effect of breast-feeding. J Pediatr. 2002 ; 141 : 764 – 769 (15) Horwood L J, Darlow B A, Mogridge N. (2001) Breast milk feeding and cognitive ability at 7–8 years. Arch Dis Child Fetal Neonatal Ed. 2001 ; 84 : F23 – F27 (16) Carbajal R, Veerapen S, Couderc S, Jugie M, Ville Y. (2003) Analgesic effect of breast feeding in term neonates: randomized controlled trial. BMJ. 2003 ; 326 : 13 (17) Labbok M H. (2001) Effects of breastfeeding on the mother. Pediatr Clin North Am. 2001 ; 48 : 143 – 158 (18) Rosenblatt K A, Thomas D B. (1993) Lactation and the risk of epithelial ovarian cancer. WHO Collaborative Study of Neoplasia and Steroid contraceptives. Int J Epidemiol. 1993 ; 22 : 192 – 197 (19) Paton L M, Alexander J L, Nowson C A, et al. (2003) Pregnancy and lactation have no long-term deleterious effect on measures of bone mineral in healthy women: a twin study. Am J Clin Nutr. 2003 ; 77 : 707 – 714 (20) Jarosz L A. (1993) Breast-feeding versus formula: cost comparison. Hawaii Med J. 1993 ; 52 : 14 – 18 (21) Denne, S. C., Karn, C. A., Ahlrichs, J. A., Dorotheo, A. R., Wang, J. Liechty, E. A. (1996) Proteolysis and phenylalanine hydroxylation in response to parenteral nutrition in extremely premature and normal newborns. J. Clin. Invest 97 : 746 -754 (22) Read J S; (2003) American Academy of Pediatrics, Committee on Pediatric AIDS. Human milk, breastfeeding, and transmission of human immunodeficiency virus type 1 in the United States. Pediatrics. 2003 ; 112 : 1196 – 1205 (23) Coutsoudis A, Rollins N. (2003) Breast-feeding and HIV transmission: the jury is still out. J Pediatr Gastroenterol Nutr. 2003 ; 36 : 434 – 442 (24) Pickering : (2003) American Academy of Pediatrics. Transmission of infectious agents via human milk. In: Pickering LK, ed. Red Book: 2003 Report of the Committee on Infectious Diseases. 26th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2003 : 118 – 121 (25) American Academy of Pediatrics, (2001) Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001 ; 108 : 776 – 789 (26) American Academy of Pediatrics, (2004) Subcommittee on Hyperbilirubinemia. Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics. 2004 ; 114 : 297 – 316 (27) Sines D (1995) Impaired autonomy: the challenge of caring. Journal of Clinical Nursing 4 (2) 109 -115. (28) Marinker M.(1997) From compliance to concordance: achieving shared goals in medicine taking. BMJ 1997 ; 314 : 747 – 8. ############################################################### 12.05.07 PDG Word count 2,183 Polycrystalline Ceramics: Sub Grain Structure Polycrystalline Ceramics: Sub Grain Structure Pure un-doped zirconia is a polymorph which has three allotropes namely: Monoclinic, Tetragonal and finally Cubic. These phases tend to transform into each other when exposed to certain temperature ranges and such transformation is important for the processing and mechanical properties of zirconia. The monoclinic phase of pure un-doped zirconia is stable at room temperature and remains so up to about 11700C, where it then transforms into tetragonal phase. It becomes stable tetragonal at this temperature and remains so up to 23700C, where it turns to cubic. The cubic phase occurs up to the melting temperature of 26800C. Monoclinic phase The monoclinic form also referred to as baddeleyite, is a thermodynamically stable phase at a temperature range between room temperature and approximately 9500C. It contains four ZrO2 molecules per unit cell and has a space group of P21/c. Figure 2.1 shows the lattice parameter of monoclinic form. Its structure is described as a distorted fluorite (CaF2 structure). It is difficult to define the crystal structure of monoclinic zirconia because of its complexity as well as the problem of making a monoclinic single crystal with the satisfactory qualities due to: micro-cracking, low purity, twinning and disproportionate solid solution formation. Tetragonal phase This is a high temperature phase (t) firstly discovered by a group of scientist during its transformation from the lower temperature monoclinic phase over a temperature of about 11500C. Figure 2.1 shows the lattice parameter of tetragonal form. The structure is similar to that of monoclinic polymorph in the sense that it is also distorted CaF2 structure. Hence, tetragonal zirconia (t-ZrO2) can be described using the face centred tetragonal Bravais lattice as oppose to the body centred tetragonal lattice, that contains a unit cell with volume twice the size of the primitive cell. (3) Figure 2.2b shows a simple schematic of a tetragonal unit cell. Its structure comprises of eight oxygen ions surrounding a zirconium ion, with half at a distance of 0.2455nm forming an elongated tetrahedron and the remaining four are at a distance of 0.2065 forming a flattened tetrahedron (the elongated and flattened tetrahedron are rotated 900 to each other). The transformation from tetragonal to monocli nic can start (Ts) and finish (Ts) over a range of temperatures. This reaction can be measured using the following experimental techniques: DTA, XRD and dilatometry. (3) Cubic phase Unlike the other structures, the cubic polymorph is quite easy to explain as it has a fluorite structure (CaF2). Figure 2.2c shows a simple schematic of a tetragonal unit cell. It has a lattice parameter of the order 0.508nm (this however depends on the temperature purity of zirconia that is partially stabilised zirconia at room temperature or pure zirconia at elevated temperature) and a crystal symmetry of Fm3m.   The martensitic transformation For a martensitic transformation to occur, a change in shape is required which must also produce a plane that does not change during transformation. This is so that it is common to the phase produced as well as the parent phase. The phase transformation in zirconia involves a change in volume of between 4 to 5%. The matrix inhibits the transformed particle of zirconia causing a partial shape change. However, the transformation creates a strain which is held in the monoclinic and its surrounding grains. As a result of this, researchers have come up with the idea that transformation stresses are relieved by deformation twinning. When this happens, most of the lattice strain is then restricted to the monoclinic/matrix interface. Micro-cracks can be formed at this matrix/monolithic interface or in the monoclinic particle if this lattice strain increases. The twinning found in monoclinic is caused by deformation twinning, as the researchers have observed using TEM that a section of the st rain related with the transformation happens as a result of a mechanism known as slip. (3) The phase transformation particularly from tetragonal to monoclinic is of great importance, as it attributes the zirconias excellent properties. [from fulltext.pdf] It was firstly discovered by Garvie et al that the transformation of metastable tetragonal phase to monoclinic phase acts as a toughnening mechanism to crack propagation resistance in zirconia. The transformation is quick and results in a 4 to 5 percent increase in volume which leads to formation of micro-cracks and eventually macro-cracks in the material. This process induces compressive stresses and thus toughens the materials. Gupta et al backed this theory up. Studies showed that the transformation mechanism is highly dependent on grain size and by doping the ceramic material with stabilisers. Examples of stabilisers are yttria (Y2O3), magnesia (MgO), calcia (CaO), etc. Y-TZP ceramics is in the family of these toughened materials. Tetragonal zirconia doped with Yttria (Y-TZP) has great strength of over 1000MPa and tou ghness weighing between 6 and 10 MPa.m1/2. This makes it an ideal contender in medical applications, particularly in hip joints. ZrO2 Y2O3 The phase diagram shown in figure 3 was firstly discovered by Scott (1975), this study was agreed and used by many more researchers. The tetragonal phase field is the main aspect of figure 3. It shows that up to about 2.5mol% of Yttria can be produced in solid solution in addition with the low eutectoid temperature leading to the formation of a fully tetragonal ceramic, this will happen as long as the grain is of an appropriate size. The theory of transformation toughening produced some excitement in the materials industry however this excitement came to a halt when Kobayashi et al discovered a flaw in Y-TZP ceramics. Y-TZPs undergoes low temperature degradation during ageing at temperatures ranging from 100 to 4000C, this is particularly enhanced when it is exposed to water or is in humid environments. This degradation is due to the formation of flaws such as micro-cracks and macro-cracks (mentioned earlier) at the surface which gradually goes into the bulk of the material. These flaws are due to the spontaneous transformation from tetragonal phase to monoclinic phase. Material scientists have documented literature regarding the degradation however there have been contradictory views as to the mechanism of this phenomenon. Figure 4 is a graphshowing the low temperature degradation of different types of TZPs. Figure 5 shows ageing temperature against surface monoclinic levels. Some of these researchers focused on the interaction between water (or water vapour) and YTZP, whilst others focused on ways to prevent this from happened. Sato et al came up with a theory where the hydroxyl group from water (H2O) reacts with zirconia from the bonds between zirconia and oxygen (that is Zr-O-Zr bonds) forming Zr-OH bonds at crack tips. This accelerates the rate at which the metastable tetragonal phase transforms to monoclinic at low temperatures. They came up with the conclusion that there is a strain which stabilizes the tetragonal phase, however under certain circumstances it is released and with the combination other pre existing flaws accelerates the transformation. The theory put forward by Yoshimura et al is similar to that of Sato et al in the sense that the Zr-OH bonds are also formed. However, the reaction process which leads to the same outcome is what differentiates the two theories. Their research showed a comparison of the transformed monoclinic phase to the untransformed tetragonal ZrO2. Hydroxyl (OH-) was in the monoclinic ZrO2 whereas there was no trace in the latter. Due to their findings, they came up with the theory that the degradation process occurred in stages: upon exposure to water, Zr-OH bonds are formed as a result of H2O being adsorbed on the YTZP surface. This creates a stress site which builds up as the OH- ions diffuse through the surface and lattice causing the formation of nucleation sites for the phase transformation. This occurs until the stress reaches crack level causing the transformation to occur at the surface leading to the formation of micro and macro cracks all the way through to the bulk. Lange et al [7] witnessed ÃŽÂ ±-Y(OH)3 crystallites of about 20 50 nm in size forming and came up with the idea that the hydroxide formed creates a monoclinic nuclei by removing Yttria from the grains of the tetragonal phase on the surface. As Yttria is being withdrawn, growth of the nuclei continues until a critical size where it will grow spontaneuously, leading to the transformation of tetragonal grains to monoclinic. Micro cracks and macro-cracks begin to occur as the transformed grain gets large enough. This process happens over and over again as the micro and macro-cracks act as a site for water molecules to penetrate into to the grains. This process occurs only if the grains are larger than the critical size. However, if they are smaller, the transformation will be influenced by the diffusion of Yttria on the surface. Other researchers such as Winnubst and Burggraf support this theory, as they found traces of Yttria on surface layer of the YTZP specimen. Their specimen was exposed to temperature of 1770C in a nitrogen environment for over 5hrs and using an auger electron microscope, they found a yttrium rich surface layer. The listed theories were based on YTZPs mechanism during degradation. Whalen et al identified that the reason for this degradation is the spontaneous transformation from tetragonal phase to monoclinic phase at the surface which then eventually spreads to the bulk. They came up with the idea of stabilising the tetragonal phase. This could be done by either of the following two methods: the chemical factor which is increasing the stabiliser content on the surface or the microstructural solution which is reducing the grain size at the surface. The latter was decided upon and this was done by the process of post sintering grinding followed by annealing treatment. 2.45mol% Y2O3/ZrO2 was the material involved in the research. Samples of the material were made using isostatic pressing at pressure of 275MPa and then sintered at a temperature of 15000C for a time period of 2hrs. A 2mm disk was formed of which its two sides had different surfaces treatments, One side being polished and the other being surface grounded. The phase compositions at surfaces were then examined using XRD. The XRD result indicated there was a significant difference in the phase composition of both sides. The ground side showed little transformation change whereas there was 50% increase in monoclinic phase after annealing. This provided evidence that the ground and annealed surface hindered the process of phase transformation from tetragonal to monoclinic at the surface. As a result of this, there were no micro-cracks formed at the surface and hence the expected mechanical properties were achieved. Talk and compare it to mine later (TEM as oppose to XRD, advantages of process) The aim of this project is to provide evidence (if any) of the occurrence of refined grains (recrystallization) in Y-TZP structures as a result of deformation. The ideology used to explain the concept of recrystallization in metals can be used to explain its occurrence in ceramics as this is a new phenomena in the ceramic industry. Grain refinement requires certain conditions in its exposure in polycrystalline ceramics and they are: plastically deforming the material (as a result of applying a stress) and followed by heat treatment. Deformation is basically a change in body shape which occurs as a result of an applied force. Materials may experience either elastic which is impermanent deformation that upon the release of an applied stress is recovered or plastic deformation which is permanent deformation that is non recoverable when a stress is applied. YTZPs recrystallization behaviour can be explained by its ability to plastically deform. The stress and strain behaviour of a material is used to determine the start and the degree of plastic deformation. Figure 6 shows an example of a typical stress and strain curve. Yield tensile strength is the point at which elastic deformation ends and the material begins to plastically deformation. Most polymers and metals undergo elastic followed by plastic deformation but this is not the case for ceramics. They undergo elastic deformation followed by fracture with little or no plastic deformation. YTZP has superplasticity properties and this nature can be used to explain refinement in its microstructure. Plastic deformation is governed by the movement of large numbers of dislocations. Hindering dislocation motion will increase a materials strength. Ceramics are inorganic materials held together by both ionic and covalent bonds. The bonding combination results in hindering the motion of dislocations, hence their high strength but brittle behaviour. Dislocation is an important factor in understanding plastic deformation and so certain elements need to be examined in order to understand the concept. Most materials comprise of an arrangement of atoms referred to as a crystal structure (these can either be single or polycrystalline that is having multiple crystals as the name suggests). This project will focus on polycrystalline zirconia, however understanding single crystals help in explaining the behaviour of polycrystalline materials. All crystal structures have flaws that distort the regular arrangement of the atoms. These flaws can either be point defect (that is they may have vacancies or interstitials), surface, line (dislocations) and volume defects. The activities and effects of all these flaws are interconnected thus the importance in the need to understand them. As the dislocations move, they tend to interact with one another however this interaction is a complex as an amount of dislocations (rephrased from pdf). The collective motion of dislocations leads to gross plastic deformation. http://composite.about.com/library/PR/2001/blmpi1.htm Dislocations can either be screw, edge or a hybrid of both. Edge dislocation: in this dislocation, the line of defect is parallel to the shear stress. The dislocation movement is similar to that of a caterpillar in the sense that the motion is in small amounts at a time. Figure 7shows a typical schematic of the motion of dislocations. A is the extra half plane of atoms. As shear stress is applied, the bond between the upper and lower part of B is broken. The extra atom plane of atom A bonds with the lower part of B converting the lower part to an extra half plane. This motion causes the top half to move with respect to the bottom half. Screw dislocation: this is similar to that of edge in the sense that it also occurs with shear stress however, the defect line is perpendicular to the shear stress as oppose to being parallel. Just like the edge dislocation only a minute fraction of bonds are broken at a given time. Although the motions are different, the overall plastic deformation for both dislocations is the same. The primary mechanism that causes plastic deformation in crystals is called slip. As dislocations move across the crystals, they shear the crystals along their planes of motion. Slip System The degree of ease of motion of dislocations is different with in all crystallographic directions and crystallographic planes of atoms. Normally dislocation motion occurs in a preferred plane and within that plane there are specific directions at also which it occurs. The combination of the plane and direction is referred to as a slip system. The plane at which this motion occurs is referred to as slip plane, and the direction is referred to as slip direction. The slip system depends on the crystal structure of the material. Slip will only occur when the value of applied the shear stress exceeds a certain critical value. The mechanism at which slip occurs is different in single crystals that of polycrystalline materials. Schmid defined the critical shear stress in single crystals as shown in figure 9: Deformation is much more complicated in polycrystalline materials as the crystallography orientations of numerous grains have to be taken into account. This orientation is random and therefore causes the direction of slip to vary from one grain to another. Its complexity extends further more to the grain boundaries which acts as barriers to dislocation motion. Twinning is another mechanism at which plastic deformation can occur. The idea of twinning in plastic deformation is to allow further slip to occur by producing changes in plane orientations. It occurs when a fraction of the crystals adopts an orientation that is correlated to the orientation of the rest of the untwined lattice in an exact proportioned way. Figure 10 shows an illustration of an un-deformed crystal with one undergoing slip and twinning. There is a clear difference between slip and twinning. The crystal orientation in a slip is the same above and below the slip plane whereas in twinning differs across the twin plane. More differences is illustrated in figure 11 Slip Twinning Where it occurs Widely spread planes Every plane of region is involved Occurrence On many multiple slip systems simultaneously On a particular plane for each crystal Time required Milli seconds Micro seconds Size (in terms of inter atomic distance) Multiples Fractions. ANNEALING PROCESS LEADING TO RECOVERY, RECRYSTALLIZATION AND GRAIN GROWTH Annealing is a high temperature process that causes changes in a materials structure, leading to alterations in its properties. When a material is plastically deformed, majority of the energy is dissipated as heat, but a minute fraction is stored in the material as strain energy which is associated with a range of lattice imperfections established as a result of deformation. The deformation process as well as a number of various factors (such as temperature and rate of deformation) determines the amount of energy stored in the material. A reduction in deformation and an increase in intensity of deformation cause a vast increase in the amount of retained energy. The release of stored energy There are two main techniques of releasing the energy retained by a material due to plastic deformation and they are an-isothermal annealing and isothermal annealing. Anisothermal annealing occurs when the material is continuously heated from a lower temperature to that of a higher one (the energy discharged is determined as a function of temperature) whereas, Isothermal annealing occurs when the temperature is constant. The materials microstructure will undergo either or maybe all of these three restoration processes: recovery, recrystallization and grain growth. The extent of plastic deformation can sometimes determine the mechanisms of recovery and recrystallization. These processes require heat treatment to cause rearrangement of grain boundaries and dislocations. Recovery It is the initial stage of annealing that takes place at the low temperature stage of annealing. As a material is plastically deformed, a minute portion of mechanical energy is stored which exists in crystals as stacking faults, point defects (such defects are interstitials and vacancies) and dislocations. When a material is plastically deformed, it is at a thermodynamically unstable state of higher energy. This is converted to lower energy states by the application of annealing leading to a change in microstructure. There are two process involved in recovery: slip annihilating and polygonization. Slip annihilation occurs when dislocations of opposite signs (that is in the case of edge dislocations, the fusion of the positive and the negative edge dislocation or in the case of screw in which the right hand screw merges with the left hand screw) merge together thereby cancelling each other out. Polygonization is the rearrangement of dislocation after annihilation recovery to a lower energy configuration. During recovery, this strain energy built up is relieved to some extent by dislocation motion, due to enhanced atomic diffusion at high temperatures. Recovery leads to physical properties like thermal and electrical conductivities being recovered to their pre worked states. [ggbk] Recrystallization After recovery, grains are not entirely strain free. That is the energy state of the grains is relatively high. New sets of strain free grains having near equal dimensions in all directions with low dislocation densities are formed. This process is known as recrystallization. This mechanism of producing new equaxed grains is driven by the difference in internal energy between the unstrained and strained material. The process of recrystallization can occur after or during deformation. The manner at which recrystallization occurs is of two kinds which vary with materials. Firstly a continuous manner, at which the microstructure gradually evolves into a recrystallized one or a discontinuous manner at which distinct new grains nucleate and grow Recrystallization after deformation is referred to as static whereas the latter is known as dynamic. The extent at which recrystallization occurs is dependent on two factors namely: time and recrystallization temperature. The temperature at which recrystallization is completed in an hour is referred to as recrystallization temperature. It is usually a third to half the materials melting temperature. The rate at which recovery process occurs is inversely proportional to time (that is it reduces with increasing time). Recrystallization has an entirely different kinetic. During the isothermal annealing, recrystallization starts very slowly then builds up gradually up to a certain point where it slows down. This can be shown in figure 13 In some cases it can be as high 0.7th the melting temperature. An illustration of the relationship between recrystallization temperature and percentage cold work is shown in figure 14. It is understood that as the percentage cold work increases, the recrystallization temperature decreases. Other factors affect the rate and occurrence of recrystallization. The annealing temperature is one of a few factors that have an effect on recrystallization. A materials recrystallization temperature reduces annealing time. The stress applied is another factor both recrystallization and temperature, an increase in stress applied means a lower temperature is required to activate the process. Also, the deformation on the material must be enough to allow nucleation and growth. A process known as grain growth occurs in a polycrystalline material after recrystallization provided the annealing temperature is maintained. The restoration mechanism does not require prior deformation or recrystallization and therefore will occur during annealing in their absence in a polycrystalline material. Grain boundary is the driving force for recovery. Stored energy produced as a result of a material being plastically deformed is released during the process of annealing causing a change in microstructure. This energy released is as a result of various mechanisms due to crystal defect interactions: A decrease in crystal defects due to their reactions with each other. Dislocations with opposite signs interacting causing their annihilation and dislocation loop shrinkage. Relocation of dislocations causing the formation of lower energy configurations such as grain boundaries with low angles. The formation of grain boundaries with high angles. These reactions occur during the restoration process of recovery. After this process, the following can occur: Dislocations as well as point defects being absorbed as a result of the migration of high angle grain boundaries. A decrease in the overall grain boundary area. These micro-structural changes occur during the restoration process of recrystallization and recovery. As a result of these micro-structural modifications, an ideal definition of recrystallization is derived: Along with the micro-structural changes, the properties of the specimen also change correspondingly. Thus, deformation and annealing are important processing methods for producing desired properties of the material by controlling its microstructures. Recrystallization mechanism The start of recrystallization is referred to as nucleation and occurs when dislocations are rearranged so as to form low dislocation density sections that have a high angle grain boundary with great mobility and thus is capable of quick movement over the strained region or recovered matrix. Recrystallization has a low driving force and high grain boundary energies; as a result of these characteristics, thermal variations cannot explain regions surrounded by high angle grain boundaries that are free from defects upon annealing. Therefore, the formation of recrystallized grains does not occur during annealing but previously exists in the deformed state. Three methods can be used to describe nucleation and they are: Movement of high angle boundaries that already exist before annealing: this happens when pre existing grain boundaries move into grains that are highly strained as illustrated in figure 16 this process requires a favourable energy balance between an increase in the overall grain boundary surface and a reduction in stored energy as a result of the removal defects triggered by the migration of the boundary. Movement of sub boundaries (that is low angle boundaries): this model is based on the theory of polygonization where stored energy is reduced during annealing as a result of rearrangement and removal of defects. It occurs when sub grain boundaries besiege regions containing low dislocation densities. Upon formation of sub grains, with the help of sub grain boundary movement, they are able to grow at the expense their neighbouring grains. Dislocations are absorbed by migrating sub boundaries and because of this, their mobility, orientation differences and energies are increased until their transformation into high angle boundaries, thus illustrating nucleation. Sub grains coalescence: this occurs when two neighbouring subgrains merge leading to their crystal lattices coinciding. It is regarded as a slow process but when compared to migration of sub grains is favoured for annealing at low temperatures. it is illustrated in figure 17. In this method, stored energy is reduced leading sub boundaries disappearing, sub grains growing and increase in orientation differences between coalescence groups and their neighbouring sub grains. These lead to the formation of high angle boundaries which move at high speeds and cause the process of recrystallization nucleation. It is vital to identify the fact that the total energy balance that takes the disappearance of sub boundaries into account with the increase and orientation difference is favourable (that is it leads to a reduction in total free energy). This mechanism is illustrated in figure 18. The occurrence of these three models is relatively diverse and they will therefore occur under different conditions. The basic requirement for the occurrence of the movement of pre existing grain boundaries that is the existence of differences in large strain between neighbouring grains is well accepted by researchers. However, there is conflict as to when the mechanisms sub grain boundaries migration and the coalescence of sub grains occur. Researchers believed the coalescence of sub grain boundaries are linked with large dispersion of sub grain angles distribution, relatively moderate strain, and reasonably low annealing temperatures. Whereas the mechanism of sub grain migration is linked with high annealing temperatures, strains that are relatively high and large dispersion in the distribution in sub grain size. Growth of recrystallized regions The basic mechanism causing recrystallization and grain growth is the migration of grain boundaries with high angles. However their driving force is what differentiates them from each other. The energy of the high angled grain boundaries is the main driving force for grain growth whether it being abnormal or normal growth. Whereas that for recrystallization is the energy stored during straining appeared as crystalline defects. In defect free regions that are encircled by boundaries with high angle, recrystallization progresses by enlargement of this nucleus over the non recrystallized medium. Grain growth and recrystallizations migrating high angle boundary curvature signal is another important factor that differentiates the two. http://asmcommunity.asminternational.org/portal/site/www/AsmStore/ProductDetails/?vgnextoid=a75a7dcbe4e18110VgnVCM100000701e010aRCRD ASM Handbook Volume 14A, Metalworking: Bulk Forming (ASM International) http://www.accuratus.com/zirc.html http://www.totaljoints.info/ceramic_for_total_hips.htm#2 http://www.azom.com/details.asp?ArticleID=940 http://books.google.co.uk/books?id=eUZw4SgqaPYCpg=PA126lpg=PA126dq=phase+transformation+mechanism+leading+to+microcracks+zirconiasource=blots=fCFhf-satfsig=WNiOjbUtX06mA_d1NkXIEEHcOsshl=enei=r568S9zCKJHFsgaxkd3lCQsa=Xoi=book_resultct=resultresnum=4ved=0CBYQ6AEwAzgK#v=onepageqf=false EXPERIMENTAL PROCEDURE Equipment Three samples of YTZP, 0ne made from 3mol Y2O3/ZrO2 powder and the other two made from the same powder but by two other manufacturers. Focused Ion Beam (FIB): is a technique used by material scientists in the analysis of a materials microstructure. the samples obtained can either be analysed directly using the FIB or transferred and viewed under a TEM or SEM. This process is similar to that of an SEM however ions (particularly gallium ions) rather than electrons. Figures 19a and b show how the FIB operates. The surface of the sample being tested is subjected to primary gallium ion beams. This spits a small part of the material, leading to the formation of either secondary ions (either positive or negative) or neutral atoms on the surface. Secondary electrons (e) are also produced from the gallium beam. This is collected as well as the signal from the split ions to form an image which is either analyzed using the FIB itself, SEM or TEM. http://www.fibics.com/fib/tutorials/introduction-focused-ion-beam-systems/4/ images is from here. GNU image manipulation program (GIMP): is an image editing software used to measure grain sizes. Vickers indentation: is used to form indentations which are viewed and studied under an optical microscope. A square imprint is formed from the Vickers indenter, where the two diagonal lengths are measured. In this project, the Vickers indentation is used to form plastic deformation. The surface defects such as scratches and unevenness need to be controlled, hence the reason for polishing. High temperature furnace: used for sintering and annealing. TEM Cold isostatic pressing Sample preparation Three mol% Y2O3/ZrO2 solid solution powder was used in this experiment. The powder was pressed into a disc at 200MPa, then sintered at 14500C for 2 hours. Two discs were produced, each pressed with loads 7.5 tons and 5 tons respectively. The load was reduced to 5 inorder to reduce the chance of lamination, as it occurred with the 7.5. Measurements and dimensions Sample 1: broken Sample 2 Weight 25.7711g 19.6836g Diameter 39.23 39.11 Height (thickness) 7.1 6.51 Dimensions after sintering<

Permeability Of Hydrophilic :: essays research papers

Permeability of Hydrophilic Supervisors: Vladan Milovic Professor Per Artursson SUMMARY Investigations of the integrity and transport characteristics of 2/4/A1 cells have been done in this report. The cell line was isolated from rat fetal intestinal epithelial cells and transfected with thermolabile SV40 large T antigen. These cells proliferated at 33 Â °C, but eliminated the antigen and ceased proliferating at a non-permissive temperature (39Â °C). At 39Â °C 2/4/A1 cells started to differentiate but simultaneously the cells also underwent massive cell death. When cultured at 37Â °C these cells formed confluent and tight monolayers that seemed to have paracellular transport characteristics similar to that of the human intestine. Transmission electron microscopy confirmed the development of multilayers at 33Â °C, monolayers at 37Â °C and defects in the cell layer due to apoptosis at 39Â °C. Different immunostainings of ZO-1, E-cadherin and vinculin confirmed formation of tight and adherence junctions. Transepithelial resistance reached a plateau of 25-35 Ohm.cm2, which was similar to the small intestine. In transport studies 2/4/A1 cell line monolayers selectively restricted the permeation of hydrophilic permeability markers proportional to molecular weight and discriminated more accurately between the molecules of intermediate molecular weight compared to Caco-2 cells. These results indicated that 2/4/A1 cells could be used as a model for hydrophilic drug absorption. INTRODUCTION The small intestine plays a crucial role in the absorption of drugs and nutrients. Exogenous substances cross a series of barriers during the process of intestinal absorption: (1) the aqueous boundary/mucus layer, (2) a single layer of epithelial cells, and (3) the lamina propria, which contains the blood and lymph vessels that then transport the absorbed drugs to other parts of the body (Artursson 1991). The cell monolayer is comprised of two parallel barriers: the cell membrane and the tight junctions. Most drugs are absorbed by a passive diffusion across the cell membrane by the transcellular route, or across the tight junctions between the cells - the paracellular route. Drug transport can also be carrier mediated, when the drug utilizes transporters located in the cellular membrane. Transcytosis is another kind of active transport, in which macromolecules can be transported across the intestinal epithelial cell in endocytosed vesicles. The hydrophilic and charged drugs are absorbed after passing through the paracellular route, the water-filled channels between the cells (Artursson 1991). Rates and extent of the paracellular transport are, therefore, highly influenced by the structure and size of the tight junctions as well as by the size of the molecules. Only small and hydrophilic drugs can pass between the cells rapidly and completely; permeation of larger molecules can be limited proportionally to their size and lipophilicity (Hillgren et al. 1995). Simple assay methods are needed for drug absorption studies.

US History :: American History

In 1828 Andrew Jackson was elected as President, as a favorite among the United States many view him as the Hero of New Orleans. He is to many the epitome of a gentleman and that he embodies the ideals of many Americans. He views himself as the President of all the people and likes the idea of having those who worked for the government to depend on him. Jackson however, was ignorant to many of the fields that would have been beneficial to him and the United States had he not been so unwilling to accept advice from experts. His lack of knowledge of the banking system was evident; however, he had Nicholas Biddle to thank for keeping the system afloat. Biddle brilliantly maintained the Bank of the United States which in turn ensured that many financial institutions were able to maintain their efficiency. Despite Jackson's efforts to destroy the bank because of the monopoly it allowed, this short-lived veto was reversed. Biddle's efficient means of running the bank ensured a stab le economy for the United States. Jefferson continues to lose favor among Americans because of his tyrannical style of leadership. The creation of the Whig party, led by Henry Clay and John C. Calhoun, demonstrates the patriotic dislike held by many Americans. They aimed to influence President Jefferson and the Jacksonians to face and approach economic problems form a broad national perspective. Unfortunately there was no dominant leader who was able to achieve this goal. Society continues to change and the population within the United States continues to grow. From the span of 1790 to the 1850s the population increased from 3.9 million people to a little over 23 million people. Cities continued to grow and new towns continued to emerge causing an increase in farms and factories. This increase in population and town size was more prevalent in the Northeast in comparison to the South. The South saw its primary growth in Mobile, Charleston, Savannah, and Baltimore. During the Second Great Awakening revivals led by Charles Grandison Finney were being held in towns along the Erie Canal from 1826 to 1831 where he preached that his listeners should take their salvation into their own hands. The abolition of slavery was in the forefront by the 1820s however, there were not many supporters because many felt it could only be abolished through a revolution.