Cost of delivery Essay Example for Free

Cost of delivery Essay 1. The chain stores’ request to reduce cycle time by shipping directly to the stores would seriously affect the service model and delivery costs for BKI. Because, the proposed model would mean that BKI would have to process more number of deliveries in smaller quantities and transport them separately to each store. Cost of delivery will increase due to smaller quantities to be delivered directly to stores resulting in more trips, farther distances and lower economies of scale. This is in complete contrast to the more structured and systematic current model of weekly deliveries of standard quantities to the stores’ warehouses. 2. In my opinion, Joe Rutner’s proposal of establishing a set of six company-owned facilities to act as regional DCs seems to be a step in the right direction for taking on the supply chain requirements of BKI’s customers in the future. Rather than dismissing this store’s request as a one-off case and handling it on a temporary basis, Rutner has proposed a solution that is likely to take the company forward into the future. He understands that the retail stores are themselves are looking to cut costs by improving their inventory and supply chain management and such requests would become common from most if not all of the existing customers. Moreover the new retail stores mushrooming in the market are likely to have less regional facilities and would need the proposed arrangement from BKI. 3. The matter of ownership of these facilities is very important for the success of this proposed supply chain arrangement as the management of BKI needs to study the long term impact of the costs involved. In the long term it would be better if BKI goes for direct ownership of the facilities as it would benefit the profitability of the operations by keeping the costs of maintenance lower than those involved in the alternatives such as co-owned or franchisee structure. However, the management will have to consider the availability of capital resources if it opts for direct ownership. The capital required for the facilities could be lowered to an extent by going for rented building rather than constructing new premises. This would decrease the time required to implement the new proposal also.

Refractory Monosymptomatic Nocturnal Enuresis Treatment

Refractory Monosymptomatic Nocturnal Enuresis Treatment Role of Posterior Tibial Nerve Stimulation in the Treatment of  Refractory Monosymptomatic Nocturnal Enuresis: A Pilot Study Ali Abdel Raheem,* Yasser Farahat, Osama El-Gamal, Maged Ragab,  Mohamed Radwan, Abdel Hamid El-Bahnasy, Abdel Naser El-Gamasy  and Mohamed Rasheed Purpose: We evaluated the early clinical and urodynamic results of posterior tibial  nerve stimulation in patients with refractory monosymptomatic nocturnal enuresis. Materials and Methods: We randomly assigned 28 patients with refractory  monosymptomatic nocturnal enuresis to 2 equal groups. Group 1 received a  weekly session of posterior tibial nerve stimulation for 12 weeks and group 2 was  the placebo group. Evaluation was performed in each group at baseline and after  posterior tibial nerve stimulation to compare clinical and urodynamic findings. Another clinical assessment was done 3 months after the first followup. Results: The 2 groups were comparable in baseline clinical and urodynamic data. Overall, 13 patients (46.4%) had detrusor overactivity and 14 (50%) had decreased  bladder capacity. After treatment 11 group 1 patients (78.6%) had a partial or full  response to posterior tibial nerve stimulation but only 2 (14.3%) in group 2 had a  partial response (p 0.002). Also, the average number of wet nights in group 1 was  significantly lower than at baseline (p 0.002). All urodynamic parameters significantly  improved in group 1. In contrast, the number of wet nights and urodynamic  parameters did not change significantly in group 2. At 3-month followup the number  of patients with a partial or full response in group 1 had decreased from 11 (78.6%)  to 6 (42.9%). No change was evident in group 2. Conclusions: Posterior tibial nerve stimulation can be a viable treatment option  in some patients with refractory monosymptomatic nocturnal enuresis. However,  deterioration in some responders with time suggests the need for maintenance  protocols. Key Words: urinary bladder, nocturnal enuresis, transcutaneous electric  nerve stimulation, urodynamics, treatment outcome  NOCTURNAL enuresis is usually associated  with severe psychological and social  distress to children and their families. 1 In recent years several treatment  modalities emerged to treat NE, such  as behavioral therapy,2 alarm treatment,  3 medical therapy with desmopressin,  oxybutynin and imipramine,  and combination therapy.4–6 However,  none has been completely successful and  the relapse rate of all of them is significant. 7–9 Therefore, there is a great need  to find other treatments that could be  more effective and durable than current  therapy.  The pathogenesis of refractory NE  was discussed in many studies and attributed  to decreased bladder capacity  and/or PTNS was introduced with early  promising results as neuromodulative  therapy for diseases that involve the  lower urinary tract and for refractory conditions in  adults and children.15–19 These beneficial effects of  PTNS for controlling various bladder disorders led  us to try it in patients with refractory primary MNE.   MATERIALS AND METHODS A total of 28 patients were included in this prospective,  randomized, placebo controlled, single blind study from  January 2010 to March 2012 at the urology department at  Tanta University Hospital. The study protocol was reviewed  and approved by the Tanta University institutional  review board. Informed consent was obtained from  all participants or from parents if the patient was younger  than 18 years. We recruited patients with severe (3 or more wet nights  per week) primary MNE at least 6 months in duration in  whom available conventional and combination therapies  had failed, including desmopressin, anticholinergics and  an alarm. We excluded those with secondary NE, nonMNE,  nocturnal polyuria and any neurological abnormality. All patients provided a detailed history and underwent  complete physical examination, urinalysis, x-ray of the  lumbo-sacral spine and ultrasound of the urinary system.   All patients were asked to keep a nocturnal enuresis diary  for 2 weeks, which included the time of sleep and arousal,  and whether they had a dry or wet bed in the morning. Nocturnal urinary output was measured as the total urine  volume collected in the diaper after voiding during the last  night (assessed by weighing the diaper in the morning)  plus the first morning urine volume. Nocturnal polyuria  was defined as nocturnal urine output 130% or greater of   EBC for age.20 The Arabic version of a 2-day frequency-volume chart  (adapted from the Pan Arab Continence Society, www.pacsoffice.com) was obtained from all patients to confirm  that the problem was MNE. Daytime functional bladder capacity was considered the recorded MVV. EBC for age  was calculated by the formula, 30 _ (age in years _ 30). Children with MVV less than 65% of EBC for age were  considered to have a small bladder.20 All patients also underwent urodynamic tests, as performed  by the same urodynamicist using a Delphis-KT  device (Laborie, Toronto, Ontario, Canada), including  1) uroflowmetry with PVR estimation by ultrasound for at  least 2 voids and 2) cystometrogram, including 1 filling  cycle using an 8Fr double lumen urethral catheter with  the patient supine and a slow filling rate of 10 ml per  minute. Patients were randomly divided into 2 equal groups by  method. Randomization was done blindly by having an  independent nurse randomly take a card from an envelope  containing 14 cards for group 1 and 14 for group 2. Group  1 received active PTNS treatment sessions using the  Urgent ® PC Neuromodulation System, while group 2 underwent  a sham procedure. Treatment Protocol We applied the technique described by Stoller.21 The patient  lay supine with the soles of the feet together, and the  knees abducted and flexed (frog position). A 34 gauge  needle was inserted percutaneously approximately 2  inches (5 cm) cephalad to the medial malleolus and 1 cm  from the posterior margin of the tibia at an angle of 60  degrees from the skin surface and the lead wire attached  to it. The surface electrode was placed on the same leg  near the arch of the foot over the calcaneus bone. The  device was turned on and amplitude was slowly increased  until the largest toe of the patient began to curl, the digits  fanned or the entire foot extended, indicating proximity to  the nerve bundle (see figure). If this response was not  achieved or pain occurred near the insertion site, the  device was turned off and the procedure was repeated. When the needle was inserted in the correct position, the  current was set at a tolerable level (pain threshold) and  the session continued for 30 minutes. For the sham procedure we tested only the foot response  to the electrical impulse and then turned off the  apparatus during the whole session. To avoid patient  identification of the type of procedure all participants  were informed that they may or may not feel a sensory  stimulus in the lower extremities during the treatment  sessions. Groups 1 and 2 underwent 12 weekly outpatient treatment  sessions. All participants were advised to stop all  medical treatment for NE at least 1 month before starting  PTNS but to continue behavioral therapy, including fluid  A, neuromodulation system. B, system in use with flexion of left largest toe.   restriction at night, complete bladder emptying before  sleep and awakening 2 hours after sleep to void. Patient Assessment The first patient evaluation was done in the first 2 weeks  after the last session. This evaluation involved repeating  the clinical and urodynamic assessments. The clinical part  included a nocturnal enuresis diary for 2 weeks in which  the number of wet nights/week was reported as well as a  2-day frequency-volume chart. The clinical response to treatment was assessed as  outlined by the International Children’s Continence Society,  including no response—less than a 50% decrease in  the total number of wet nights, partial response—50% to  89% decrease, response—90% or greater decrease and full  response—100% decrease.20 Urodynamic assessment included  uroflowmetry, PVR measurement and cystometry. The second evaluation was done 3 months after the last  session. It involved clinical evaluation using nocturnal  and voiding diaries only. Statistical Analysis All statistical analysis was performed using SPSS ® 17.   Data are shown as the mean SD unless otherwise specified. The Student t and paired sample t tests were used  for comparison between groups and in the same group,  respectively. Nonparametric data were compared by the  Wilcoxon signed ranks or Mann-Whitney U test. Statistical  significance was considered at p 0.05. RESULTS Recruited for this study were 28 patients with refractory  NE who met inclusion criteria. Initial assessment  and baseline characteristics of each group  showed no significant difference in clinical and urodynamic  parameters (table 1). Overall, in the 2  groups DO was present in 13 patients (46.4%) and  14 (50%) had decreased bladder capacity.   The procedure was performed easily with no adverse  effects in all cases. No patient discontinued  the planned sessions. At the end of the PTNS sessions clinical assessment  revealed significant improvement in the average number  of wet nights per week in group 1 (decrease from  4.7 to 2.6, p 0.002, table 2). Compared to the placebo  group, the number of wet nights after treatment was  significantly lower in group 1 (p 0.041, table 2). At  that time 4 group 1 patients (28.6%) had a complete  response to PTNS, 7 (50%) had a partial response and  3 were nonresponders. However, in group 2 there were  2 patients (14.3%) with a partial response, while the  remainder did not respond. When we compared the 2  groups, the difference in this response rate was statistically  significant (p 0.002, table 2). At first evaluation after the end of treatment, the  active group showed significant improvement in all  urodynamic parameters compared to baseline, including  first and strong desire to void, and MCC  (p 0.002, 0.01 and 0.000, respectively, table 2). In  group 2 these parameters did not significantly differ  compared to baseline (table 2). Also, DO disappeared  in 2 of 7 group 1 patients but this improvement was  not noted in the sham treated group (table 2). Statistical  analysis revealed that the difference be- Table 1. Patient characteristics Active Placebo p Value No. boys/girls 8/6 9/5 1 Mean SD age (yrs) 13.7 2.8 14 2.8 0.8 Mean SD body mass index (kg/m2) 24.95 4.40 26.27 4.23 0.43 Mean SD max urine flow (ml/sec) 26.85 6.74 23.28 5.49 0.13 Mean SD PVR (ml) 6.21 7.11 5.86 5.48 0.9 Mean SD daytime frequency 3.9 0.67 4.29 0.64 0.07 Mean SD MVV (ml) 266.57 82 288.93 106.29 0.27 Mean SD No. wet nights/wk 4.7 1.3 5.1 1.4 0.42 No. detrusor overactivity: Present 7 6 1 Absent 7 8 — Mean SD void desire (ml): 1st 148.46 25.89 153.50 21.65 0.59 Strong 260.43 84.18 271.79 75.43 0.71 Mean SD MCC (ml) 291.21 86.82 322.21 76.04 0.32 Table 2. Intragroup and intergroup comparisons of clinical and urodynamic findings after PTNS at first evaluation Active Placebo Baseline After Treatment p Value Baseline After Treatment p Value Posttreatment p Value Mean SD void desire (ml): 1st 148.46 25.89 177.71 35.48 0.002 153.50 21.65 154.14 20.71 0.59 0.041 Strong 260.43 84.18 283.64 72.03 0.01 271.79 75.43 271.6 72.8 0.94 0.67 Mean SD MCC (ml) 291.21 86.82 322.5 65.89 0.000 322.21 76.04 323.57 77.44 0.57 0.97 No. detrusor overactivity: Present 7 5 0.44 6 6 1 0.7 Absent 7 9 8 8 Mean SD MVV (ml) 266.57 82 280.14 71.81 0.022 288.93 106.29 291.07 96.84 0.73 0.6 Mean SD No. wet nights/wk 4.7 1.3 2.6 2.2 0.002 5.1 1.4 4.7 2.1 0.08 0.041 No. response: — — — — Full 4 0 0.002 Partial 7 2 None 3 12 1516 POSTERIOR TIBIAL NERVE STIMULATION FOR REFRACTORY NOCTURNAL ENURESIS tween the 2 groups in this regard was not statistically  significant (p 0.7, table 2). Furthermore, in  this evaluation urodynamic parameters showed that  bladder volume at first desire to void was significantly  higher in group 1 than in group 2 (p 0.041). On the other hand, bladder volume at strong desire  to void and MCC did not significantly differ between  the groups (p 0.67 and 0.97, respectively, table 2). Five of the 8 group 1 patients with decreased EBC  showed improved capacity. MVV also significantly  increased after treatment from a mean of 266.57  82 to 280.14 71.81 cc (p 0.022, table 2). When we studied the relationship between the response  to PTNS and initial urodynamic findings, we  noted that all 10 group 1 patients with small bladder  capacity and/or DO showed a good response to treatment,  including 4 and 6 with a full and partial response,  respectively. However, when we compared the type of  response in those with normal vs abnormal urodynamic  results, the 4 patients with normal urodynamic findings  in this group had a poor response to the sessions, including  3 with no response and 1 with only a partial response. This difference was significant (p 0.007). Clinical results at 3 months after the last session  showed some deterioration in early results in the  active group. In this group the number of patients     ith a full response decreased from 4 to 2 and the  number of those with a partial response decreased  from 7 to 4. No change was detected in the other  group. However, when we compared the response  rate in the 2 groups at this time, we detected no  significant difference (p 0.13). In addition, the  average number of wet nights per week at that time  was 2.9 in group 1 and 4.2 in group 2, which did not  significantly differ (p 0.07). DISCUSSION This study demonstrates that PTNS could be of value  in some patients with primaryMNEin whom previous  conventional therapies failed. To our knowledge this  treatment modality has not been tried before in such  cases but it has been successfully used for overactive  bladder syndrome,22,23 lower urinary tract dysfunction  in adults and children,15,18 refractory overactive bladder,  16 refractory vesical dysfunction19 and refractory  nonneurogenic bladder sphincter dysfunction.17   Absent daytime lower urinary tract symptoms in  patients with NE does not necessarily mean that the  bladder functions well because DO and/or decreased  bladder capacity was previously reported in such  patients.10,11 The clinical response to desmopressin  therapy is less satisfactory when NE is associated  with decreased bladder capacity and/or DO.12–14 In  our study we detected DO and decreased bladder  capacity in 46.4% and 50% of patients, respectively,  although patients with MNE only were included in  analysis. These values agree with previous reports  showing bladder overactivity24 and small bladder  capacity25 in 49% and 50% of children with MNE,  respectively. These findings may partially explain  the mechanism of resistance to the previous treatment  trials in our patients. Our results and those of others reveal that PTNS  can be applied easily and safely in children.18,19  After the 12 PTNS sessions in our series, patients  showed a significant increase in MVV and urodynamic  parameters, including first and strong desire  to void, and MCC, compared to the placebo group. These results agree with those in previous reports  demonstrating that PTNS increased cystometric capacity  from 197 to 252 cc26 and from 243 to 340 cc,27  and increased MVV by 39 cc, which was statistically  significant.23 However, at 3-month followup we detected some  deterioration in the response rate compared to early  results. The overall number of full and partial responders  decreased from 11 (78.6%) to 6 (42.9%) in  group 1. This deterioration during followup suggests  that PTNS may have temporary efficacy and its effect  decreases gradually with time. This finding was also  noted in patients with overactive bladder treated with  PTNS. van der Pal reported that 7 of 11 patients with  an initially good response had evidence of subjective  and objective deterioration after PTNS.28 They suggested  the need for maintenance treatment. The early promising results of this study encouraged  us to suggest that PTNS might be effective  in patients with refractory primary MNE in  whom nocturnal polyuria is not an etiological factor  but in whom the main underlying pathological  condition is decreased bladder capacity and/or DO. However, the exact mechanism that could explain  the mode of action of this treatment modality is  still unknown. PTNS may induce some inhibitory  effects on DO. The existence of this functional  abnormality in the bladder implies that the detrusor  is not completely relaxed between voids.   Therefore, the capacity of the overactive bladder is  usually smaller than that of the bladder with a  normal detrusor. Consequently, the clinical response  usually occurs when bladder capacity increases  and DO improves after PTNS. This explanation  may be supported by the improvement in  bladder capacity (functional and cystometric) and  the disappearance of DO in patients who responded  to PTNS in our study. The main limitations of this study are the small  sample size and the short 3-month followup. In  addition, we did not repeat urodynamic tests at  the second followup at 3 months to avoid patient  discomfort but depended only on the patient clinical  response. However, this information could be important for assessing the cause of the deterioration in PTNS efficacy after treatment was  stopped. CONCLUSIONS PTNS appears to be a viable treatment option in  some patients with refractory primary MNE. However,  deterioration in the response rate with time  raises important questions about the long-term  efficacy of this therapy and the need for further  maintenance sessions. More studies are needed to  support our findings and select patients who  would be good candidates for this therapy.

Impact of Chronic Pain on Suicidal Thoughts

Impact of Chronic Pain on Suicidal Thoughts Abstract This research paper discusses the impact of chronic pain on the suicide attempts. It includes the prevalence and risk of suicidal ideation associated with chronic pain. The paper implicated the selection of work which identifies the psychological processes which are implicated in both the suicide literature and pain in relation to increased rate of suicidality. Although, this paper investigates impact of chronic pain on suicide[H1]; there is an immense need of programmatic research for the investigation of both pain and general specific factors of risk for examining the processes of psychology associated with it, and for the development of enhancing intervention to facilitate the patients in pain. How Does Chronic Pain Impact Suicide Victims Introduction The paper is intended to research the impact of chronic pain on suicide attempt. Throughout the world, suicide is endemic with varying methods and rates. The World Health Organization estimated the recorded suicide deaths in all over the world which represents 1.8% of all the deaths and is approximately 873000 per annum[1]. Rates of prevalence for suicidal ideation and fatal suicide attempts are very high. In a survey conducted in USA, the population indicated that 13.5 percent of respondents have had some kind of suicidal ideation experience in past, and 4.6 percent attempted suicide. These statistics give both the indication of the major issue of management and the index of distress. It signifies the increased consumption of health care, the economic costs related to the lives which are lost, and the immense personal suffering. The risk factors of suicide associated with pain and the behavior of suicide are remained difficult to differentiate as which one is most vulnerable. It is due to the fact that individuals completing and attempting suicide are represented by heterogeneous group which encompass to those with some disorders related to psychiatry like schizophrenia or depression, those with personality disorder or substance abuse issues, and those depilating and experiencing physical and chronic illness[2]. For maximizing the potential identification of the impact of chronic pain on suicide and preventing the deaths which could be avoidable, it is required to study not only the commonalities but also the risk factors which contribute to the suicidal ideation development across suicidal individuals. Chronic pain One out of every five adults, who attend basic medical care during any stage of a year, has been found suspected of having chronic non-malignant pain and it has been a common health related problem[3]. This problem is associated with lack of physical fitness, lower health conditions and poor quality of life. This problem has also been linked with the risks of increasing depression. After negative results of all medical treatments, the impact of chronic pain affect patients’ lives drastically, therefore, the patients of chronic pain convince themselves for committing a suicide attempt as they feel limited or no other choice. The suicide attempt concerning with these patients has been one out of seven solutions to their problem that are conceivable. Unluckily these facts have some truth. Some suggestions have been reviewed in the existing literature and these suggestions have proposed that the ideation of suicide is common in people who suffered from chronic pain. The occurrence of suicidal ideation has been found three times higher in chronic pain patients as compared to those who did not suffer from chronic pain[4]. There are a number of studies that avoid collective explanation of the findings due to the varied samples and suicide assessment methods. But some studies have indicated the existence of suicidal ideation at the rate of 7% in individuals having chronic pain, who were observed during a multi-disciplinary rehabilitation program in a hospital[5]. The researchers also observed the out-patients of hospital and recorded between 5 to 24 percent rate among chronic pain patients. The lifetime existence of suicidal ideation has been observed in 20 percent of patients, which shows no major difference between a community sample and treatment seeking individuals’ results. Another study revealed more significance and observed a group of members of a chronic pain self-help organization. The study resulted that around 50% individuals of that group had serious consideration of suicidality. Four different studies have recorded the existence of suicidality among chronic pain patients. These existing inadequate and limited data related to suicidality in chronic pain patients reveals that contribution of pain has been 4% of all the deliberate self-harm patients in UK’s general hospitals. The data also reveals that 60% of the patients were those who had been suffering from pain for the last six months or more[6]. The lifetime existence of suicidality has been observed from 5% in patients with musculoskeletal disorder, up to 14% in patients with chronic abdominal pain. The rate of suicidality has been recorded as high as double in patients with chronic pain, as compared to those who did not have chronic pain. According to a pain centre in the United States, the prevalence of suicidality was calculated and recorded with a rate of 23 patients out of every one hundred thousand people every year[7]. This rate does not seem to be as high as has been in psychiatric patients, but it is 2 to 3 times higher the rate found in general public. Two different studies related to suicidality have related the pain with the existence of high risks of suicidality in patients who had pain. The first study that was based on a ten year longitudinal observation of farmers revealed that patients of back pain had nine times higher risk of committing suicide as compared to those who did not have back pain. The results remain unchanged even after controlled usage of smoking, social status and getting older[8]. The second study that was based on an eight year longitudinal observation, revealed that patients with wide spread body pain or complex regional pain syndrome (CRPS) had twice the risk of suicidality, violence and accident. Impact of Chronic Pain in Suicide Attempts Family History of Suicide A number of studies related to suicidality have recognized a strong relationship between the existence of suicidality and family history in patients[9]. Another study revealed that the there was 7 to 8 times high risk of occurrence of suicidal ideation in patients with chronic pain who had a family history of existence of suicidality as compared to those chronic pain patients who did not have a family history of suicidality and this remained unchanged even after significant adjustments in other covariates such as depression. Despite this relationship, the suicidality has not been significantly evaluated in other studies, in connection with the affects of family history[10]. The available data about suicidality has been unsuccessful towards the assessment of family history of suicidality which is another risk element for completed and attempted suicidality in patients with chronic pain. Previous Suicide Attempt A number of studies have confirmed that previous attempts of suicidality have played a major role in the development of consequent risk of suicidal attempts in chronic pain patients, in addition to depression’s effects or other covariates. The results observed converse results in depressed patients who did not have chronic pain. The studies established the outcome by stating that depressed patients who had chronic pain were twice as likely to have attempted suicide at least once in the past[11]. Different available studies related to suicidality have confirmed that previous suicidality attempts might be the cause of motivation towards further suicidality attempts and completed suicidality. However the available data has not been successful in assessing the patients with chronic patients. Being Female According to two different studies, female chronic pain patients have been more risks of suicidal ideation than male chronic pain patients[12]. These findings have been surprising because of the fact that ratio of suicidal attempts have been more found in men than women in the western world. However two different studies with comparatively smaller data samples have presented no significant statistical difference in data during the observation of suicidality in both genders[13]. Another possibility of higher occurrence of suicidality in females might be because of the fact that these data samples of population had overrepresentation of female with pain or rheumatoid arthritis disorder. Presence of Co-Morbid Depression According to four different studies, depression has played a major role in developing the risk of suicidal ideation in patients who had chronic pain[14]. In fact, the high co-morbidity between depression and pain; and between depression and suicide has not been a surprising finding because the depression has not always been helpful in predicting the suicidality in chronic pain patients[15]. Studies have also revealed that some of the patients with chronic pain, who also had depression, did not have suicidal ideation. Pain Specific Risk Factors Location and type of pain Location and type of pain might increase the risk of suicidality in patients. Several studies have confirmed that location of pain such as presence of back pain or widespread body pain have been among several causes of higher risk of suicidality as compared to those who did not have pain. Different types of pain with diverse characteristics and level of severity have been recognized as convincing in predicting the suicidal ideation. Patients who had migraine with aura have been found to be twice at risk of having suicidal ideation as compared to those who had migraine without aura, regardless of the existence of co-morbid depression[16]. Patients with abdominal pain have more risk of having suicidal ideation while patients with neuropathic pain were less vulnerable in terms of suicidal ideation. A study based on a mixed group of chronic pain patients revealed higher suicidal risk when compared with controls. But the data presented no difference between fibromyalgia patients and contr ols when each one of the group was separately examined[17]. The available data confirm the vitality of the studies in relation to the effects of different subtypes of pain on suicidality of patients. High Pain Intensity There has been a reasonable assumption that the high intensity of pain has a relationship with the degree of suicidality. Two different studies have observed the pain intensity in relation with suicidality. The first one revealed a significant relationship in both of them, while the other study found no relationship between pain severity and suicidal ideation[18]. Therefore, this shows the need of more clearer and helpful research so that the relationship between pain intensity and suicidality could better be understood. Long Pain Duration Long pain duration in a patient is likely to increase the risk of suicidal ideation. Patients with longer than three months duration of pain were examined against another group of patients with less than three months duration of pain on a range of psychological variables such as patients’ likelihood of suicidal ideation[19]. The study revealed that the risk of suicidality was higher in patients who had prolonged rheumatoid arthritis whereas those with less than three months of rheumatoid arthritis were comparatively at lesser risk of suicidality. Presence of Co-Morbid Insomnia Insomnia has been one the significant factors towards existence and absence of suicidality in patient with chronic pain[20]. The study also confirmed that patients with severe insomnia along with associated daytime dysfunction and greater pain intensity were more vulnerable to suicidal ideation. The severity of sleep-out insomnia has been found with 67% of the variance. The studies have been consistent in confirming the earlier researches that presented higher existence of insomnia and sleep disorders towards suicidality and give extra weight to the significance of the study of interaction present between the non pain specific and pain specific factors of risk while suicidality is investigated among patients of chronic pain[21]. Conclusion Patients who have suicidal ideation generally utilize primary health care services at a higher rate than those who have psychosocial health problems without suicidal ideation. Some health problems specific to patients with suicidal ideation are sleep disorder, bad smoking habits and more psychiatric symptoms than those who have not suicidal ideation but have psychosocial stressors. All of these associated problems and habits tend to contribute towards more discomfort in patients and more repeated visits. This research paper has given an overview of the features and the prevalence of the inter relationships existed between mental ill health and physical ill health along with suicide. It is clear that the chronic pain has a significant impact of suicide attempts therefore greater attention of policy is required and the provision of service is needed for the improvement of condition. Chronic pain has been identified as a major risk factor for patients towards suicidality, causing 13% of patients to have suicidal ideation. Around 19% of patients were those who reported non-suicidal morbid ideation. There is an urgent necessity of programmatic research to investigate both the pain and general specific factors of risk for examining the processes of psychology associated with it, and for the development of enhancing intervention to facilitate the patients in pain. Result In relation to controls, the risk of reaching to death by suicide is found to be doubled at least in the cases of chronic pain. There was life time prevalence of suicidal attempts between 5 percent and 14 percent of individuals which have experienced chronic pain, and suicidal ideation prevalence is about 20 percent. There are eight factors of risk for suicidalty in the chronic pain, inclusive of duration, intensity and type of pain and the sleep on set insomnia associated with pain, hence it is pain specific. References Courtenay E. Cavanaugh, Jill Theresa Messing, Melissa Del-Colle, Chris O’Sullivan and Jacquelyn C. Campbell. Prevalence and Correlates of Suicidal Behavior among Adult Female Victims of Intimate Partner Violence. Suicide and Life-Threatening Behavior, 2011. 372-383. Igor Elman , David Borsook, and Nora D. Volkow. Pain and Suicidality: Insights from Reward and Addiction Neuroscience. Progress in Neurobiology, 2013. 1-27. Afton L. Hassett, Jordan K. Aquino, Mark A. Ilgen. The Risk of Suicide Mortality in Chronic Pain Patients. Current Pain and Headache Reports, 2014. 1-7. Johannes Krause. Tim,Bogerts. Bernhard, andGenz. Axel. Risk Factors for Suicide–An Alternative View. CNS Neurological Disorders-Drug Targets (Formerly Current Drug Targets-CNS Neurological Disorders), 2013. 936-940. Kowal. John, Wilson Keith G., Henderson. Peter R., McWilliams Lachlan A. Change in Suicidal Ideation After Interdisciplinary Treatment of Chronic Pain. Clinical Journal of Pain, 2014. 463-471. Amy R. Murrell, Rawya Al-Jabari, Danielle Moyer, Eliina Novamo, Melissa L. Connall. An Acceptance and Commitment Therapy Approach to Adolescent Suicide. INTERNATIONAL JOURNAL OF BEHAVIORAL CONSULTATION AND THERAPY, 2014. Emilie Olià ©, Hilario Blasco-Fontecilla, Philippe CourtetTop of Form Bottom of Form . Pain in Suicidal Ideations and Behaviors. In Mental Health and Pain. Springer Paris, 2014. 183-190. Michael R Philips, and Hui G Cheng. The Changing Global Face of Suicide. Lancet, 2012. 2318-2319. [1] Emilie Olià ©, Hilario Blasco-Fontecilla, Philippe Courtet. Pain in Suicidal Ideations and Behaviors. [2] Afton L. Hassett, Jordan K. Aquino, Mark A. Ilgen. The Risk of Suicide Mortality in Chronic Pain Patients. [3] Kowal. John, Wilson Keith G., Henderson. Peter R., McWilliams Lachlan A. Change in Suicidal Ideation After Interdisciplinary Treatment of Chronic Pain. [4] Igor Elman , David Borsook, and Nora D. Volkow. Pain and Suicidality: Insights from Reward and Addiction Neuroscience. [5] Michael R Philips, and Hui G Cheng. The Changing Global Face of Suicide. [6] Amy R. Murrell, Rawya Al-Jabari, Danielle Moyer, Eliina Novamo, Melissa L. Connall. An Acceptance and Commitment Therapy Approach to Adolescent Suicide. [7] Courtenay E. Cavanaugh, Jill Theresa Messing, Melissa Del-Colle, Chris O’Sullivan and Jacquelyn C. Campbell. Prevalence and Correlates of Suicidal Behavior among Adult Female Victims of Intimate Partner Violence. [8] Johannes Krause. Tim,Bogerts. Bernhard, andGenz. Axel. Risk Factors for Suicide–An Alternative View. [9] Afton L. Hassett, Jordan K. Aquino, Mark A. Ilgen. The Risk of Suicide Mortality in Chronic Pain Patients. [10] Igor Elman , David Borsook, and Nora D. Volkow. Pain and Suicidality: Insights from Reward and Addiction Neuroscience. [11] Courtenay E. Cavanaugh, Jill Theresa Messing, Melissa Del-Colle, Chris O’Sullivan and Jacquelyn C. Campbell. Prevalence and Correlates of Suicidal Behavior among Adult Female Victims of Intimate Partner Violence. [12] Michael R Philips, and Hui G Cheng. The Changing Global Face of Suicide. [13] Emilie Olià ©, Hilario Blasco-Fontecilla, Philippe CourtetTop of Form Bottom of Form . Pain in Suicidal Ideations and Behaviors. In Mental Health and Pain. [14] Michael R Philips, and Hui G Cheng. The Changing Global Face of Suicide. [15] Amy R. Murrell, Rawya Al-Jabari, Danielle Moyer, Eliina Novamo, Melissa L. Connall. An Acceptance and Commitment Therapy Approach to Adolescent Suicide. [16] Johannes Krause. Tim,Bogerts. Bernhard, andGenz. Axel. Risk Factors for Suicide–An Alternative View. [17] Afton L. Hassett, Jordan K. Aquino, Mark A. Ilgen. The Risk of Suicide Mortality in Chronic Pain Patients. [18] Michael R Philips, and Hui G Cheng. The Changing Global Face of Suicide. [19] Johannes Krause. Tim,Bogerts. Bernhard, andGenz. Axel. Risk Factors for Suicide–An Alternative View. [20] Kowal. John, Wilson Keith G., Henderson. Peter R., McWilliams Lachlan A. Change in Suicidal Ideation After Interdisciplinary Treatment of Chronic Pain. [21] Emilie Olià ©, Hilario Blasco-Fontecilla, Philippe Courtet. Pain in Suicidal Ideations and Behaviors. [H1]How the heck does pain struck suicide?

Essays --

Rachel Toby 1/14/14 Research Paper â€Å"Homelessness In America† ‘Homelessness’ is when an individual or family cannot afford permanent housing. Homelessness is a common problem in human history. There are many reasons why people reached the state of homelessness such as; physical, economic, social and political. These problems continue to interfere with people’s lives. In the early stages of the American colonial settlement, homelessness became a huge problem in America. Most recently homelessness has been caused by the high cost of housing, alcoholism and drug addictions, mental health issues, joblessness and military veterans coming home. Many people who have jobs here in America still cannot afford permanent housing because the minimum wage which is $7.25 is not enough money to make a good living. The people who gets pay $7.25 an hour struggles because by the time they’re done paying all their bills they have very little to buy groceries, so most of the times people buy food for them and their family which means even tually they’re going to owe a lot of money for rent, which is going to lead to eviction. The United States needs a comprehensive plan to end homelessness in the richest country in the world once and for all. Homelessness in the United States has been a problem for at least 200 years. â€Å"In the early 1800s, the rank of homelessness increased for many reasons such as; Migration to the frontiers, displacement caused by the Civil War, immigration from Europe, seasonal employment patterns in agriculture, construction and mining, and severe economic slumps in the 1870s and 1890s† ( Macmillan). This shows that homelessness started to become a huge problem in the 19th century. To help the situation, â€Å"Cities developed shelt... ...step up to take care of their responsibilities, then a lot of young women wouldn’t be homeless. Also there’s not enough affordable daycares. The solution require strong government action and the help of private enterprises. The government can help by building low cost housing for poor people. Veterans need jobs when they return from serving for their country. The government can help with job training. Businesses can help by making the hiring of vets a priority. We also need more centers for treating drug addicts and alcoholics. Homelessness is a huge problem in the United States. The richest country in the world should solve this problem. Low-cost housing, jobs for veterans, centers for addicts and alcoholics and low-cost daycares are all plans that would allow the young women to work or go back to school. If America had the will, we could fix this growing outrage. Essays -- Rachel Toby 1/14/14 Research Paper â€Å"Homelessness In America† ‘Homelessness’ is when an individual or family cannot afford permanent housing. Homelessness is a common problem in human history. There are many reasons why people reached the state of homelessness such as; physical, economic, social and political. These problems continue to interfere with people’s lives. In the early stages of the American colonial settlement, homelessness became a huge problem in America. Most recently homelessness has been caused by the high cost of housing, alcoholism and drug addictions, mental health issues, joblessness and military veterans coming home. Many people who have jobs here in America still cannot afford permanent housing because the minimum wage which is $7.25 is not enough money to make a good living. The people who gets pay $7.25 an hour struggles because by the time they’re done paying all their bills they have very little to buy groceries, so most of the times people buy food for them and their family which means even tually they’re going to owe a lot of money for rent, which is going to lead to eviction. The United States needs a comprehensive plan to end homelessness in the richest country in the world once and for all. Homelessness in the United States has been a problem for at least 200 years. â€Å"In the early 1800s, the rank of homelessness increased for many reasons such as; Migration to the frontiers, displacement caused by the Civil War, immigration from Europe, seasonal employment patterns in agriculture, construction and mining, and severe economic slumps in the 1870s and 1890s† ( Macmillan). This shows that homelessness started to become a huge problem in the 19th century. To help the situation, â€Å"Cities developed shelt... ...step up to take care of their responsibilities, then a lot of young women wouldn’t be homeless. Also there’s not enough affordable daycares. The solution require strong government action and the help of private enterprises. The government can help by building low cost housing for poor people. Veterans need jobs when they return from serving for their country. The government can help with job training. Businesses can help by making the hiring of vets a priority. We also need more centers for treating drug addicts and alcoholics. Homelessness is a huge problem in the United States. The richest country in the world should solve this problem. Low-cost housing, jobs for veterans, centers for addicts and alcoholics and low-cost daycares are all plans that would allow the young women to work or go back to school. If America had the will, we could fix this growing outrage.

Understanding Culture Essay -- Sociology

Culture, is defined by Merriam-Webster's Online Dictionary, as "the integrated pattern of human knowledge, belief, and behavior that depends upon man's capacity for learning and transmitting knowledge to succeeding generations." People learn about culture through interaction rather than through the memorization of a text. To become fluent in any one culture you have to experience it and become involved. There are many ways that a culture can be shared among people without them being fluent in it such as through: food, customs, clothing, language, beliefs, and behaviors. With the increase of technology and new discoveries about the world developing daily it makes it impossible for cultures to remain stagnant; therefore, they must learn how to adapt in order to survive. Some people argue that complete cultural fluency in more than one culture is impossible. However, culture is a learned behavior therefore people should be able to learn and become fluent in more than one. Culture is distinctly human and is transmitted through learning traditions and customs that govern behavior. Cultural anthropologists study human society and culture through describing, analyzing, interpreting and explaining social and cultural similarities and differences. To study and interpret cultural diversity they engage in two activities which are ethnography and ethnology. Ethnography is based on fieldwork while ethnology is based on cross-cultural comparisons of the information collected through ethnography. The studies done on culture can be shared in two ways: first through theoretical or academic anthropology and second through practical or applied anthropology. An example of academic anthropology, which teaches us about culture, is a textbook ... ...nity. An example is the way they raised and slaughtered animals rather than buying them packaged at a store. Although a year may not be enough time to become fluent in a culture, the stories of the students living abroad prove that a person can learn and become part of more than one culture. Culture is what defines the difference between humans and animals. We grow up in a culture which influences who we are and how we live. Through studying different cultures we learn more about our own culture, ourselves, our strengths, and weaknesses. Yet to become fluent a person cannot simply study a culture, rather they must be on an interactive level and experience the culture first hand. Sources Cited http://www.merriam-webster.com/ Kottak, Conrad "Cultural Anthropology: Appreciating Cultural Diversity." McGraw-Hill Education; 15 edition, October 11, 2012

Charlotte Brontes Jane Eyre - Miss Temples Influence on Jane Eyre :: Jane Eyre Essays

Miss Temple's Influence on Jane Eyre "Jane Eyre" is set during the Victorian period, at a time where a women's role in society was restricted and class differences distinct. A job as a governess was one of the only few respectable positions available to the educated but impoverished single women. Not only is "Jane Eyre" a novel about one woman's journey through life, but Brontë also conveys to the reader the social injustices of the period, such as poverty, lack of universal education and sexual inequality. Jane's plight and her "dependant" status is particularly emphasized at the beginning of the novel. Miss Temple is the kind and fair-minded superintendent of Lowood School, who plays an important role in the emotional development of Jane Eyre. Miss Temple is described by Helen as being "good and very clever" and "above the rest, because she knows far more than they do". This description is more significant because it has been said by Helen, and she herself is extremely mature. One of Miss Temple's most outstanding qualities is her ability to command (perhaps unconsciously) respect from everyone around her, "considerable organ of veneration, for I yet retain the sense of admiring awe with which my eyes traced her steps". Even during their first encounter Jane is "impressed"... "by her voice, look and air". Throughout Jane's stay at Lowood, Miss Temple frequently demonstrates her human kindness and compassion for people. An Example of this is when after noticing that the burnt porridge was not eaten by anyone, she ordered a lunch of bread and cheese to be served to all, realising their hunger. This incident is also evidence of her courage, of how she is not afraid to stand up to her superior, when she feels that too much unnecessary suffering has been inflicted on the children Miss Temple's Christianity contrasts with that of Mr Brocklehurst, where instead of preaching restrictive and depressing doctrine, which he then proceeds to contradict, she encourages the children by "precept and example". After the incident involving Mr Brocklehurst announcing to the whole school that Jane is a liar, the reader becomes aware of Miss Temple's sense of natural justice, where before accepting what Mr Brocklehust has said, she inquires from Jane her version. It is of no coincidence that Brontë choose to coincide Miss Temple's arrival into the schoolroom with the moon's light "streaming in through a window near".

Water Pollution Contamination

POLLUTION INTRODUCTION Pollution is the act of environmental humiliation and contamination with artificial waste. Air, water, and soil pollution is a serious complication, which affects everyone in the world. Some of the main causes of pollution is the lack of laws to new industries as well as a poorly educated society. Due to environmental pollution, the society has put pressure on the government to create and carry out diverse policies to the control of environmental pollutants. LAND POLLUTIONLand pollution is the deposition of waste materials be it liquid or solid state either underground or the land that could pollute the natural resources like the soil, underground water. Land pollution also threatens public health and is the root of further Causes: land pollution takes place when unwanted materials of all kinds like garbage, rubbish and trash from different places are disposed to the land. Materials consist of moist food, paper, and glass, plastic, Etc. Also material such as ce ment, metals, rubble concrete are buried in the ground. Furthermore, factories eliminate hazardous chemicals and liquids into the grounds.Contaminated effluent from subsurface sewage disposal can also be a cause of land pollution. Garbage left in open dumps often has breeding of animals such as rats, cockroaches, mosquitoes and other disease carriers. They also root the cause of bad smell, windblown debris and other irritants. Windblown debris could cause contamination of lakes, rivers or wells nearby leaving more room for diseases. Methane, a hazardous gas is given out by decomposing garbage. Misusing of land like deforestation and use of pesticides and chemical fertilizers further pollute the land Effects: Climate: Due to land pollution, the forest cover on earth is decreasing which affects the climate. This results in less rain which leads to fewer pure water resources. Therefore, all living things: the flora and the fauna that rely on fresh water for life are affected. Land poll ution also leads to acid rains, greenhouse effect and global warming. †¢Extinction: Land pollution leads to deforestation resulting in many species losing their habitat which is one of the main causes of extinction. †¢Bio magnification: this process takes place when a particular non-biodegradable substance accumulates in the food chain.This puts not only the specie consuming it in danger, but all the species connected to the food chain. Overall results in affecting the food pyramid †¢Biodiversity: extinction will result in unbalanced and disturbed biodiversity. For example, if a species goes extinct the specie it feeds on will see a number of increase.! WAYS TO REDUCE LAND POLLUTION: †¢Reduce Product packaging: as the consumer market grows, more elaborate and fine packaging is used. This increases the waste produced every year and leads to further land pollution. A way companies have started to go green is make reusable and recycled packaging that attracts the co nsumers. Recycle: Using materials that are recycled. Stop wasting paper and using recycled paper. Give away old books and newspapers to recycle companies. Avoid using materials such as plastic. Recycling helps in reducing the amount of waste dumped in dump fills. Cans and metals could be recycled. †¢Composting: According to scientists, it takes about a decade for a land fill to decompose. Composting helps in decomposition due to its design which helps in flow of air. Yard trimmings and food that are decomposed help in reducing the land pollution AIR POLLUTIONAir pollution is one of the major problems that our planet is suffering from , its affecting our daily life without our notice as its content of poisonous gases and acid rain and many other gases from the burned fossil fuel and transportation and industries, we inhale without our notice it may damage our lungs and affects our health. Air pollution is defined as â€Å" the introduction of chemicals, particulate matter, or b iological materials that cause harm or discomfort to humans or other living organisms, or cause damage to the natural environment or built environment, into the atmosphere. (wikipedia, 2012) Causes of air pollution:- The causes of air pollution are many like as I previously mentioned, it could be because of the burning of fussel fuels such as gasoline , oil, coal and natural gas, the daily usage of electricity , the exhaust gas of cars and vehicles specially and not to forget the main natural cause of air pollution is dust. â€Å"We also cause air pollution indirectly, when we buy goods and services that use energy in their production and delivery. (Air pollution, 2011) The pollutents are those substances which causes the air pollution , it could be gases, liquid droplets or solid substances sometimes like lead and mercury. I’ll mention some important primary pollutants which are carbon monoxide, carbon dioxide, nitrogen and sulphur oxides . -Sulpher oxides: usually obtained from the industries and is widely spread in paper manufacture industries and combine with rain droplets and produces acid rain , alsoâ€Å" is produced by volcanoes and in various industrial processes. â€Å"(Wikipedia, 2012) -Nitrogen oxides: the main source of nitrogen oxides are cars and vehicles. nitrogen dioxide are emitted from high temperature combustion, and are also produced naturally during thunderstorms by electrical discharge† (wikipedia, 2012) -Carbon dioxide: â€Å"a colorless, odorless, non-toxic greenhouse gas also associated with ocean acidification, emitted from sources such as combustion, cement production, and respiration. † (wikipedia, 2012) -Carbon monoxide: caused in the burning of coal, fossil fuels and wood , it’sâ€Å" a colorless, odorless, non-irritating but very poisonous gas. It is a product by incomplete combustion of fuel such as natural gas, coal or wood.Vehicular exhaust is a major source of carbon monoxide. † (wikipedi a, 2012) Effects of air pollution:- Air pollution causes a lot problems and has a lot of impact on us as humans , talking about its effects I will mention three major point to discuss, ‘ the effects of air pollution on our health, enviroment and ecominc life. First, talking about the effect of it on our health, the enhaling of these gases is very harmful and poisonious as it causes permenant damage to the lungs , it also affects the brain and the nervious system and makes us suffer from breathing problems and respiratory illness.Carbon Monoxide is considered as the most dangerous gas , because it â€Å"Reduces ability of blood to bring oxygen to body cells and tissues. † (Air pollution, 2011) . Sulphur oxides when combined with the rain droplets , it forms acid rain which â€Å"causes buildings, statues, and monuments to deteriorate. † (Air pollution, 2011) these gases when enhaled into the human body it can cause a lot of damage and may lead to serious situation s and could cause death sometimes, therefor we need to be careful and not to expose our bodies to such gases.Second, the effects of air pollution on our environment, it may lead to the melting of the polar ice caps, can affect the weather distractions which leads to tornadoes , floods , hurricanes and droughts. In addition to that it causes an increase in the sea level . also, it affects the environment in an indirect way through the spread of new diseases which can be hardly cured and it affects the agriculture which is mostly our source of food. Moreover, acid rain can damage buildings, forests, soil, lakes and it affects the aquatic life.Finally, its effect on the economy, it has an impacts in relation to its effect on the human health and the environment. WATER POLLUTION Contamination of water bodies such as lakes, rivers, oceans, groundwater is called water pollution. Water pollution takes place when pollutants are dumped or discharged into these water bodies. Water pollution l eads to the sea life and other living organisms depending on them in danger due to the contaminated water hazardous nature. Biological communities are affected due to water pollution and it keeps growing every yearCAUSES OF WATER POLLUTION Water pollution is one kind of most dangers pollution it contamination the of water bodies (e. g. lakes, rivers, oceans, aquifers and groundwater). Water pollution occurs when pollutants are discharged directly or indirectly into water bodies that will kills the marine life and oceans. It comes from factory wastes, sewer systems and oil spills that cause harmful effects in all environments because water is a very necessary for animals and human life (causes of water pollution, 2006). SIDE EFFECTS OF WATER POLLUTIONThere are many side effects that water pollution like killing marine life, spreading diseases in human and animal by contamination of heavy metals and harmful bacteria. it kills green areas like forests and farms by using Pesticides that contaminant ground water which feed plants also it same in sewer system that goes in ground or goes in seas and rivers. the most common thing is oil and lubrication liquids , because of increasing using and west that comes from it, it effect the water environment directly by get rid of it in sea or in ground (Jeantheau, 2005) MEASURES THAT COULD BE TAKENThere are many ways to reduce the pollution in water like recital the old lubrications and avoid throwing it in ground or water surfaces. Also we can use things that not effects the water by reduce the pesticide in farms. Making shipment of oil ship more safety by develop the safety system in transferring of oil and chemical products also repair and replacement of leaking and malfunctioning equipment (Control of pollution, 2006). Survey A survey was conducted by the group members on 50 students from Abu Dhabi Al Ain Campus, both male and female.The following were the results collected: †¢All 50 students knew about different kin ds of pollution †¢48 students thought immediate measure was required to stop pollution †¢41 students admitted to have polluted in one way or other (either land, air or water) †¢33 students said they would be a part of â€Å"going green† †¢29 students thought pollution is a problem in UAE Conclusion All in all, pollution of any kind, be it land, water, or air is dangerous and Is affecting the earth and species living on it in harmful ways.It increases every year and the toll gets higher. We as humans have the duty to save our planet for a better tomorrow. Different awareness campaigns and drives could be carried out to promote the dangerous effects of pollution. â€Å"Going green† should be focused on and living healthy should be promoted. The changes will not take place overnight but we all can start from now. Bibliography Air Pollution. (2012). Retrieved from en. wikipedia. org/: http://en. wikipedia. org/wiki/Air_pollution Land Pollution. 2012). R etrieved from en. wikipedia. org: http://en. wikipedia. org/wiki/Land_pollution Nathanson, J. A. (2012). Land Pollution. Retrieved from www. britannica. com: http://www. britannica. com/EBchecked/topic/329175/land-pollution Pillai, P. (2012, january 16). Causes and Effects of Land Pollution. Retrieved from /www. buzzle. com: http://www. buzzle. com/articles/causes-and-effects-of-land-pollution. html Ryan, D. B. (2010, july 03). WAYS TO OVERCOME LAND POLLUTION. Retrieved from www. ivestrong. com: http://www. livestrong. com/article/164542-ways-to-overcome-land-pollution/ causes of water pollution. (2006, 4 19). Retrieved 5 22, 2012, from http://en. wikipedia. org: http://en. wikipedia. org/wiki/Water_pollution#Causes Control of pollution. (2006, 4 19). Retrieved 5 22, 2012, from http://en. wikipedia. org: http://en. wikipedia. org/wiki/Water_pollution#Control_of_pollution Jeantheau, M. (2005, 9 6). side effect of water pollution. Retrieved from http://www. grinnin