Forensic investigator Essay Example | Topics and Well Written Essays - 4000 words

Forensic investigator - Essay Example The report is composed in response to a request from the investigation unit. 1. James Murray allegedly worked as a team head of numerous drug dealers on small scale level. The culprit had sensitively plotted and worked on the whole scheme of drug dealing. The co-conspirators were corresponded through a laptop hence leading to no physical proofs to the forensic unit. The culprit was first reported by one of his classmates, Walter Thom, declaring that he had heard the culprit conversing about the deal over the cell phone, offering the bureau an opportunity to generate his phone records for the proceedings of this case. 2. After the statement from Thom (witness), Murray (culprit) was put under surveillance. His internet connection and phone records were under continuous observation of the investigation bureau. Surprisingly, for over more than two weeks time, there was no obvious evidence of the culprit being engrossed in any of the drug dealing crime. Neither his phone records showed any suspicious calls or text messages. On further evaluation, it was noticed that during 10 PM until the midnight, for two weeks, no data was received from the culprit although the connection was sustained. The testing concluded that the culprit exploited a high technology hacking system which would facilitate his data to be transmitted to his co-conspirators through a profoundly secured portico. The hacking experts took two days to access his system. And the flow of receiving the data alleviated. After that, there was no reply to this e-mail. The other culprit might have discussed it in person or through some other mean. The e-mail was a significant source of the other two names engaged in this crime. Investigations on Job Rhett, aged 24, with rather a considerable criminal record and Robin White, aged 19, a college student debarred due to disgraceful leisure pursuits and conduct. The email also gave a hint that the culprits used a code word for the drugs: spoon. The ‘car’ was

Create Your Own School Essay Example for Free

Create Your Own School Essay A public schools’ job is to create a standardized environment for students of the general population; however, public schools don’t always meet the needs of the students. Charter schools exist to meet the needs of the students and are more open to parental involvement and local control over state and bureaucracies’ control. However, â€Å"charter schools may deter some minority, poor, and working families from seeking enrollment by requiring them to complete volunteer hours and failing to provide transportation and free lunches to eligible students† (Schnaiberg 2000). My school I create will take the benefits of public schools and the benefits of charter schools to create an emphasis on individual learning and respect for cultural diversity. My school offers students in preschool through twelfth grade, an extended school day and longer school year, because most of December is off. My secular school is founded on respecting and encouraging other religions thus the school works around religious holidays, creating all secular and religious holidays off days. School is in session September 3rd through June 20th. Students in early childhood education program and kindergarten are in class Monday-Friday 7:30am-12:30 pm. Students in first through fifth are in class Monday-Friday 7:00am-4:45 pm. Students in sixth through eighth are in class Monday-Friday 6:45am-4:45 pm. Students in ninth through twelfth are in class Monday-Friday 6am-12:30 pm. Students in ninth through twelfth grade are required to have a Monday-Friday work experience internship; students under sixteen have an on-campus internship (1-4pm), while students over sixteen have an off-campus internship (1:30-4:30pm). My school’s goals are to have students by the end of twelfth grade be able to understand and comprehend at or near college level. In addition, students will learn three languages (English, Spanish, and another), read music sheets, be able to play a musical instrument or sing, have life skills, and have a knowledge of the diverse world we live in. All students pre school through twelfth grade will learn English composition, math, science, grammar, social sciences, geography, reading, literature, foreign languages, visual/performing arts (music, art, theatre, and dance), cultural diversity, U.S. government/economy, and physical education. Middle school students will learn speech: interpersonal communication, small group communication, argumentation, intercultural communication, public speaking, and forensics/debate. Middle school and high school students will learn required electives: basic life skills, introduction to computers, cultures of the world, nutrition/health/safety/careers, life skills, philosophy/religions/cultural anthropology, and human sexuality/anatomy/physiology. My school’s goals are to have students prepared for college and/or having a job as well as serving in the community. In addition to a work experience internship, high school students are required to take personal electives, which are any additional high school electives taken through the local community college or 30 units of college units though AP, CLEP, Dantes, etc. Middle school students are required to take personal electives, which are any additional middle school electives that are high school level. All students sixth through twelfth are required to complete community service to graduate and achieve units (10 units=20 hrs). Middle school students are required to complete at least sixty hours of community service and high school students are required to complete at least eighty hours of community service to graduate. Middle school students are required 360 units to graduate including personal electives and community service; high school students are required 520 units to graduate including personal electives, work internship, and community service. Summer school is required for middle school and high school students. Students are required at least twenty units. Repertory and accelerated classes available. My school holds a high sta ndard for the teachers as well for the students. Students are expected to behave, strive for excellence, respect others, have a good character, and be willing to learn, while the faculty is expected to do the same. â€Å"Most charter schools do not require their teachers to be certified† (Borsa 1999). However, my school requires all teachers K-5th to hold a Teaching Credential and a Masters Degree and teachers 6th-12th are required to hold a Masters or Doctoral Degree in the area they teach. My school promotes a healthy life style, school uniforms, and parent involvement. Parents are required to pay one fee that covers all school material, lunches, schools uniforms, field trips, and other necessary items. The food at my school, which is free, and healthy, that means no soft drinks, cookies, candy, chips, or any other junk food; all birthdays at school will be celebrated without unhealthy food. Parents are encouraged to eat healthy and show students healthy life styles. Students are required to wear a school uniform, a short-sleeved tee shirt with school logo and black pants/shorts/dress/skirt or for formal attire is long-sleeved shirt and black pants/shorts /dress/skirt. The shirt will have a color to represent a grade: Pre-K: Pink, K: Purple 1st: Blue, 2nd: Turquoise, 3rd: Green, 4th: Light Green, 5th: Yellow, 6th: Orange, 7th: Red, 8th: Maroon, 9th: Brown, 10th: Black, 11th: Gray, and 12th: White. Like the school uniform, backpacks will be in the color of the school uniform and have the students name on it. My school has no state standardized tests, but the use of state standards. Instead students are required to test into each grade through a test that measures their cognitive and behavioral level. The complete cognitive test has twenty-seven essays and 2030 multiple choice/true-false questions, which is two essays and 140 or 150 questions per grade. The cognitive test measures what the student should know by the end of each grade. Students can challenge an exam if they feel the grade or class they are in doesn’t reflect their abilities. In addition, students are required to take a test out exam in each subject. It serves as a measure for student learning, and an evaluation for teachers and parents. This exam is compared to the â€Å"test in exam† and options for tutoring/after school help for struggling students. If student doesn’t score higher than 80 percent on an exam, they won’t be promoted to the next class or grade unless they successfully retake the exam. The exam can be retaken twice before the student must repeat a grade of class. My school doesn’t use the Standard Letter Grade, but gives students the option for it . Instead of standard letter grades, students in K-5 will have a grade of Pass (B- or higher in Standard Letter Grade) or No Pass (C+ or lower in Standard Letter Grade). Then 6-12th grade students will have the option of keeping their grades in Pass/No Pass or having standard letter grades. (Students will be put on Academic Probation if their GPA reaches 2.99 or below.) Behavior, class participation, in-class work for students K-12 will be graded in O=Outstanding, E=Exceeds Expectations, A=Acceptable, P=Passing, N=Needs Improvement. Each week behavior and participation reports are sent home so parents can see how their student’s behavior and participation improves or becomes a problem. Teachers and parents go over the childs portfolio, which includes tests, papers, art, quizzes, and other in-class material each quarter. At the end of the year students evaluate their own work and other’s work in the portfolio. The student, the teacher, other students, and the parent grade the portfolio like pieces of art are evaluated at an art gallery. My school gives students the option of independent study or regular classroom learning in middle school and high school. All preschool through twelfth grade students are put in their cognitive level and in small classrooms of twenty students of less; however, middle school and high school students have the option of regular class or packets. In regular class students participate in in-class assignments, quizzes, and tests; students must earn homework and extra credit. Students must have at least 240 points out of 300 to pass each quarter; otherwise the quarter will be repeated in packets. In a packets class or independent study students come to class participate and take in-class quizzes and tests; however, class work is done in packets. Students must have an A- or higher to move on to the next packet. Packets are allowed to be taken home and are equivalent to one week of regular class in-class work; only Physical Education, Speech, Science Lab, and Visual/Performing Arts are not allowed to be taken in packets. The packets are recommended for students who are ill, on religious holidays, etc., which prevent them from attending class. In addition, all students on holiday (December) have the option of completing packets for credit and completing quizzes and tests online with a proctor; the packet requires an A- or better to move on. Overall, my school focuses on creating an emphasis on individual learning and respect for cultural diversity; however, there are intuitional and individual barriers. Intuitional barriers will arise when parents who aren’t secular will try to implement their beliefs into the curriculum, but this school offers a well-rounded approach to learning not faith-based learning. In addition, problems may arise when parents try to control what the child learns and what they become; parents are encouraged to let their children be good at what they are good at. Small class sizes and indivualized learning can cause problems for students and parents who want a more mainstreamed education. Students may feel it is too hard for them, but this school is meant to be challenging in academics, but not in socializing. Since there will be intuitional and individual barriers, parents and teachers are encouraged to be open and discuss any problems and look for what is in the best interest of the child. My belief is that education should offer students prepare students for life outside of education. I provided a school that offers students an extended school day and longer school year and summer school to keep kids out of trouble and respect religious beliefs. My school has educated students prepared for college and/or having a job as well as serving in the community. In addition, I provided a school that promotes a healthy life style, school uniforms, individual learning, good behavior, options in learning, and parent involvement. The goal of my school is to prepare and educate students to learn and be the best they can be in whatever they are good at. This charter school will create an emphasis on individual learning and respect for cultural diversity and more. Although this charter school will have intuitional and individual barriers, the school will provide more positive learning than a negative one. References Borsa, J., Ahmed, M., Perry, K. (August 1999). Charter School Goverence. Paper presented at the annual meeting of the National Council of Professors of Educational Administration, Jackson Hole, WY. ED 436 856. Schnaiberg, L. (2000). Charter schools: Choice, diversity may be at odds. Education Week, 19(35), 1, 18-20.

Case Study - Early Alzheimers Essay Example for Free

Case Study Early Alzheimers Essay This paper reviews the use of cognitive rehabilitation treatment of early stage of dementia Alzheimer’s type. The case study examines a 72 year old male patient diagnosed with early stage dementia of Alzheimer’s Type. This study used visual imagery, as well as cues and expanding rehearsal during the cognitive rehabilitation. The evaluation of cognitive rehabilitation treatment included the psychological, physiological, neurological assessments and self-reports. Results suggested that extended use of cognitive rehabilitation treatment ensued longer lasting improved cognitive functioning.  With the results of the study discussed, implications suggest that combining longer treatment of cognitive rehabilitation could help reduce the progression of early onset dementia of the Alzheimer’s Type. Case Study Clare, Wilson, Carter, Hodges, and Adams (2001) studied a 74-year old single man, named â€Å"VJ† who lived with his sister in a single case study. VJ was formerly employed in the construction industry. VJ started to attend the memory clinic in 1993. He was then diagnosed having an early stage of dementia of Alzheimer type (DAT). His sister joined him at the clinic. The researchers started with a process called, cognitive rehabilitation (CR) intervention. Cognitive rehabilitation (CR) focuses on memory functioning. Although CR was at first developed for patients with traumatic brain injuries, it was proven to be efficient for people experiencing cognitive difficulties (Savage, 2009, p. 31). In order to define CR, it is necessary to define cognition. Katz and Hadas (1995) quote Lidz in defining cognition, â€Å"†¦as the individuals capacity to acquire and use information to adapt to environmental demands† (p. 9). Sigelman and Rider (2012) say that cognition is, â€Å"the activity of knowing and the process through which knowledge is acquired and problems solved† (p. 210). Cognitive rehabilitation is quoted by Katz and Hadas (1995) â€Å"†¦the therapeutic process of increasing or improving an individuals capacity to process and use incoming information so as to allow increased functioning in everyday life, this includes both methods to restore cognitive functioning and compensatory techniques (p. 29). Interventions aimed in CR are divided into remedial and adaptive/functional strategies (Katz Hadas, 1995). The main aim of the remedial strategy is the individuals impaired capabilities. The functional strategies are aimed to enhance the strengths of the individual for functioning. The assumption these two strategies are built upon is, â€Å"†¦that functional activities require cognitive perceptual skills†¦Ã¢â‚¬  (Katz Hadas, 1995, p. 30) and cognitive impairments can be modified and treated in the adult dysfunctional brain which will enhance reorganisation or recovery of the brain. Based on these assumptions the remedial strategy is directed towards functional abilities by retraining perception skill components of behaviour, while the functional strategy in contrast assumes that the affected adult brain has limited recovery potential and that retraining of the brain should be focused on specific activities as required (Katz Hadas, 1995). The unique feature of all occupational therapy models, are the emphasis that treatment is based on purposeful activities that are analyzed and adapted to the patients cognitive and functional ability level. This therapy is not without controversy. As the critics of CR indicated, memory training for people with DAT increases frustration for the patients, because the improvement in cognition is short term (Clare et al. , 2001). Sigelman and Rider (2012) agree by saying, â€Å"†¦over time, individuals cannot recall even with the aid of cues and become increasingly frustrated† (p. 541). Neuroplasticity is possible before or in the early stages of AD, but diminishes in later phases of AD. Clare et al. 2001) found empirical research to prove that CR is an effective method of slowing the decline of cognitive functions in early AD. Questions about CR which remain to be answered include impact of CR on well-being and life quality, the ability to sustain longevity of gains in cognitive therapy and what type of contributions can CR make in AD? (Clare et al, 2001). Lately, â€Å"identifying cognitive markers of a preclinical phase of Alzheimer’s disease (AD) has been a major research focus in neuropsychology† (Jacobson et al. 2009, p. 278). Cognitive Rehabilitation Intervention Clare and colleagues, (2001) predicted in theory, that the possibility cognitive rehabilitation may be responsible for the maintenance of memory gains over time. The researchers set to prove through long-term follow-up data that memory retraining had lasting effects and showed gains beyond the treatment sessions as demonstrated by previous cognitive rehabilitation studies. The researchers used 11 Polaroid photos of VJ’s club members to teach the face-name associations. This was performed by the method of combining visual imagery, vanishing cues, and expanding rehearsal (Clare et al. , 2001). The researchers took VJ to the familiar environment of the club to do generalisation sessions using the photos and found the initial recall was 20% and raised to 98% over time and became 100% at the one, three, six and nine months follow-up sessions. VJ practiced every day using the photographs. â€Å"In the early stages of Alzheimer’s disease, free recall tasks are difficult but memory is good if cues to recall are provided†¦Ã¢â‚¬  (Sigelman Rider, 2012, p. 41), like the photos in this case study. After the ninth months, the researchers took the photos away to use them only once a month, at the club with VJ. VJ was to recall the first names of the people in the photos with zero feedback given to VJ. After the first and second year, magnetic resonance imaging (MRI) was completed. At the same times neuropsychological assessment were completed to evaluate the results of changes in cognitive functioning compared to the initial and post-intervention assessments. Several tests were used in the neuropsychological assessment such as the Mini-Mental State Examination (MMSE); National Adult Reading Test (NART); Standard Progressive Matrices (SPM); Speed and Capacity of Language Processing (SCOLP); Visual Object and Space Perception Battery (VOSP); Unfamiliar Face Matching; Digit span, forwards and backwards; Rivermead Behavioural Memory Test (RBMT); Doors and People; Famous Faces and Famous Names. Self-report measures were used as well to assess VJ’s perceptions of memory problems, behaviour, affect and VJ’s sister on caregiver strain. The following measures were used: Memory Symptoms Questionnaire; Hospital Anxiety and Depression Scale (HADS); Caregiver Strain Index (CSI) VJ’s sister rated herself on strain experienced (Clare et al. , 2001). The initial and post-intervention neuropsychological assessments shown VJ’s general cognitive abilities before he contracted DAT were in the high average ranges, his post-intervention scores were above average, though speed of processing was slower. VJ’s perceptual skills and processing of unfamiliar faces were in normal ranges. Memory was severely impaired, having difficulty recalling names of famous people. Overall there was not much of a change between the initial and post-intervention assessments, but only a mild decline in abstract reasoning and speed of processing information. While some of VJ’s cognitive functions remained the same, â€Å"†¦a gradual decline in abstract reasoning, speed of information processing, working memory, episodic memory, and semantic memory over the study period was evident. MMSE scores, too, showed a mild decline†¦assessment of coronal T1 images (MRI) revealed mild, but definite, bilateral hippocampal atrophy as indicated by enlargement of the temporal horn of the lateral ventricle and reduction in height of the hippocampal formation† (Clare et al. , 2001, p. 486-487). After all the results were taken in consideration it seems that this case study provides the evidence that long-term maintenance of specific gains can be achieved with a CR procedure. The use of CR in dementia was criticised as not being an intervention that can assure any gains beyond the treatment sessions. It is clear from the results of this study that this claim is untrue. Another case study in 2003 was done with the same interventions. The same results were found and support the finding that CR maybe a valuable comprehensive intervention for persons with early identified dementia of the Alzheimer type (Clare, Wilson, Carter, Hodges, 2003). Conclusions The results of this case study indicate the importance of length in cognitive rehabilitation for individuals diagnosed with early staged dementia of the Alzheimer’s type. The use of cognitive rehabilitation over an extended period of treatment allowed the researchers to evaluate the importance of visual imagery, recall and extended rehearsal strategies in treatment. The positive results indicated possible development in the treatment of diagnosed patients, as well as duration and techniques applied. Future studies will need to focus on the exact parameters of duration for treatment with cognitive rehabilitation in patients diagnosed with early stage dementia of Alzheimer’s Type. Implications arrived from the longevity of treatment could also improve the overall quality of treatment, evidence to substantiate financial support/funding for treatment and improve motivation and expectations from patients and family members. The importance to involve cognitive stimulation with patients diagnosed with early stages of Alzheimer’s disease is apparent in subsequent research and continues to be implicated in other similar cognitive dysfunctions.

Clinical case scenario assignment

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

Hindu Rituals Essay -- Hinduism Hindu Religion Essays

Hindu Rituals The model worshiper for the Hindu religion would be one that expresses one's devotion in every action that they take. Though the this is true in most religion's the Hindu religion is different in that rituals, festivals and other such type of practice are not the same as worship in the Hindu religion. Worship only occurs at a special time, place and occasion. As in the religion's like s worship and ritual are performed mostly at the same time. The Hindu religion has many different types of rituals that are performed for different occasions. Some of the rituals can only be performed by certain social classes. Many of the rituals that take place can be found in the Vedic literature. The majority of the rituals are centered around sacrificial fires which are called yajna. Since the Hindu religion does not have a specific place nor time to worship many of them are done at temporary altars, there are not any types of deities, though there must be Brahmin priests to perform the ceremony. Majority of the rituals only involve the caste system, which is one of the highest social classes. The yajna ritual can be for two purposes, the first type is for the general welfare of a kingdom or for the world as a whole. The second purpose for the yajna is for the good of the household. Though the rituals can also mean different things for example the person who may want the ritual done for the good of his household may also want there to be good for the world as well. The only real difference between these two types of rituals is that the ritual for welfare of the world, or for the general public is more complex, longer and more expensive then that of the good of the household ritual. Another type of ritual that takes ... ...ey need to participate in the sacred power. Hinduism has many different types of rituals that serve for different purposes, social system and occasion. Some rituals like the yajna are for that of the general good of the world or their households. There is the puja in which a devotee finds strength in that of a god or goddess. Others are there to help the deceased get to that of the world of the dead. There are pilgrimages in which worshippers go to a destination and become a being of sacred power or become closer to it. Many Christians do not agree with the Hindu religion though if you look closely at their rituals and belief system it really is not that far off from that of Christianity. Hindu's believe that there should be good for the world, they believe in some form of god and they take pilgrimages just as many Christian people believe or participate in.

Why Young Individuals Commit Crimes? Essay -- juvenile delinquency, juv

Firstly, what does it mean when someone uses the term juvenile delinquency? Juvenile delinquency can also be referred to as juvenile offending is when a young person under the age eighteen who in which has repeatedly committed a crime or offense. In the United States and other countries, juvenile crime is one of the most serious problems. The reason why juveniles commit crimes is sort of complicated and difficult to explain. There have been several disparate theories to better help with understanding juvenile delinquency. All of these theories are categorized and are placed under three different groups: biological, psychological, and sociological theories. Biological theories all are based on the concept that people are prearranged to commit crimes. An Italian criminologist, Cesare Lombroso created Positive Theory or Positivism which is the major biological theory. The positive theory stated that people are born criminals and are not made. The positive theory also explained criminal behavior by centering on the biological and psychological factors. Cesare used the corpse of criminals who were executed to compare physical features to determine were criminals different from non-criminals. His conclusion was that criminals shared facial features. Sheldon a criminalist idea was that people behaved differently because of the different body types. He believed that a physically fit human was more likely to commit a crime than an out of shape or over weight human. XYY theory is another biological theory that has come into consideration. The XYY theory disputes that an abnormal chromosome are found in violent male criminals. This theory states that this abnormality in individuals is associated with criminal activity and aggressivene... ...w up committing crimes. (McDavid and McCandless, 1962) Works Cited "Cesare Lombroso". Encyclopedia Britannica. Encyclopedia Britannica Online. Encyclopedia Britannica Inc., 2014. Web. 10 Mar. 2014 . Boyd R. McCandles, John McDavid. â€Å"Psychological Theory, Research, and Juvenile Delinquency.† The Journal of Criminal and Police Science 54.1 (1962):1-14. JSTOR. Web. 9 Mar 2014. Champion, D.J. (2004). The Juvenile Justice System: Delinquency, Processing, and the Law. 4th Ed. Upper Saddle River, NJ: Pearson Prentice Hall Inc. Ellwood, Charles A. "Lombroso's Theory of Crime." Journal of the American Institute of Criminal Law and 2.5 (1912): 716-723. JSTOR. Web. 9 Mar 2014. Siegel, Larry J , and Brandon C Welsh. Juvenile Delinquency, Theory, Practice, And Law. Wadsworth Pub Co, print.

8th grade graduation speech -- essays research papers

My fellow classmen, as we look back on our years here at school we should remember the meaningful words of a fellow class member of mine when she said, "Dude, where's my iPod?" It's hard for me to think of a better way to describe the many layers of adolescence, because deep down aren?t we all "dudes?" Do we not all have our inner "iPods", and are we not constantly searching for them? Now, we're leaving our childhood behind to study the vast sphere we call planet Earth, into the notorious world of high school, where things will be so much different. Of course we will still have our varied studies, Geometry, Biology, maybe even Forensics or an Accelerated English class here and there. We will still struggle with the daily setbacks formed by peers and strict teachers and principals. But so much of our lives will change. The cars in the parking lot will be driven by, well, students. Our male friends will grow a little fuzzy around the face, and of course, our day will most likely begin with a bell that actually works. As we face our freshman year with excitement and maybe even fear, l...