Dementia is a broad category of brain diseases that cause a long-term and gradual decrease in the ability to think and remember, severe enough to affect daily functioning. Other common symptoms include emotional problems, difficulties with language, a decrease in motivation. Consciousness is not affected. A dementia diagnosis requires a change from a person's usual mental functioning and a greater decline than one would expect due to aging; these diseases have a significant effect on caregivers. The most common type of dementia is Alzheimer's disease. Other common types include vascular dementia, dementia with Lewy bodies, frontotemporal dementia. Less common causes include normal pressure hydrocephalus, Parkinson's disease dementia, syphilis, HIV, Creutzfeldt–Jakob disease. More than one type of dementia may exist in the same person. A small proportion of cases run in families. In the DSM-5, dementia was reclassified with degrees of severity. Diagnosis is based on history of the illness and cognitive testing with medical imaging and blood tests used to rule out other possible causes.
The mini mental state examination is one used cognitive test. Efforts to prevent dementia include trying to decrease risk factors such as high blood pressure, smoking and obesity. Screening the general population for the disorder is not recommended. There is no known cure for dementia. Cholinesterase inhibitors such as donepezil are used and may be beneficial in mild to moderate disorder. Overall benefit, may be minor. There are many measures that can improve the quality of life of people with dementia and their caregivers. Cognitive and behavioral interventions may be appropriate. Educating and providing emotional support to the caregiver is important. Exercise programs may be beneficial with respect to activities of daily living and improve outcomes. Treatment of behavioral problems with antipsychotics is common but not recommended, due to the limited benefit and the side effects, including an increased risk of death. Globally, dementia affected about 46 million people in 2015. About 10% of people develop the disorder at some point in their lives.
It becomes more common with age. About 3% of people between the ages of 65–74 have dementia, 19% between 75 and 84, nearly half of those over 85 years of age. In 2013 dementia resulted in about 1.7 million deaths, up from 0.8 million in 1990. As more people are living longer, dementia is becoming more common. For people of a specific age, however, it may be becoming less frequent, at least in the developed world, due to a decrease in risk factors, it is one of the most common causes of disability among the old. It is believed to result in economic costs of US$604 billion a year. People with dementia are physically or chemically restrained to a greater degree than necessary, raising issues of human rights. Social stigma against those affected is common; the symptoms of dementia vary across stages of the diagnosis. The most affected areas include memory, visual-spatial, language and problem solving. Most types of dementia are progressive. By the time signs of the disorder are apparent, deterioration in the brain has been happening for a long time.
Neuropsychiatric symptoms that may be present are termed Behavioural and psychological symptoms of dementia. These can include problems with: Balance Tremor Speech and language Eating/swallowing Memory Wandering or restlessness Visual perception Behavioral and psychological symptoms of dementia always occur in all types of dementia and may manifest as: Agitation Depression Anxiety Abnormal motor behavior Elated mood Irritability Apathy Disinhibition and impulsivity Delusions or hallucinations Changes in sleep or appetite; when people with dementia are put in circumstances beyond their abilities, they may experience a sudden change to crying or anger. Psychosis and agitation/aggression often accompany dementia. In the first stages of dementia and symptoms may be subtle; the early signs become apparent when looking back in time. The earliest stage of dementia is called mild cognitive impairment. 70% of those diagnosed with MCI progress to dementia. In MCI, changes in the person's brain have been happening for a long time, but symptoms are just beginning to appear.
These problems, are not severe enough to affect daily function. If/once they do, the diagnosis becomes dementia. A person with MCI scores between 27 and 30 on the Mini-Mental State Examination, a normal score, they may have some memory trouble and trouble finding words, but they solve everyday problems and competently handle their life affairs. In the early stage of dementia, symptoms become noticeable to others. In addition, the symptoms begin to interfere with daily activities. MMSE scores are between 20 and 25; the symptoms are dependent on the type of dementia. More complicated chores and tasks around the house or at work become more difficult; the person can still take care of themselves but may forget things like taking pills or doing laundry and may need prompting or reminders. The symptoms of early dementia include memory difficulty, but can include some word-finding problems and problems with planning and organizational skills. One good way of assessing a person's impairment is by asking if they are still able to handle their finances independently.
Carboprost is a synthetic prostaglandin analogue of PGF2α with oxytocic properties. Carboprost main use is in the obstetrical emergency of postpartum hemorrhage which reduces postpartum bleeding during these circumstances. Used in postpartum hemorrhage caused by uterine atony not controlled by other methods. One study has shown that carboprost tromethamine is more effective than oxytocin in preventing postpartum hemorrhage in high-risk patients undergoing cesarean delivery. Carboprost is used for the termination of pregnancy in the 2nd trimester. Unlabeled use: Hemorrhagic Cystitis PID Contraindicated in severe cardiovascular and hepatic disease, it is contraindicated in acute Pelvic Inflammatory Disease. Hypersensitivity to carboprost or any of its components is a contraindication Exert caution in asthmatic patients as carboprost may cause bronchospasm. Asthma anemia jaundice diabetes mellitus seizure disorders past uterine surgery diarrhea flushing or hot flashes fever chills nausea/vomiting Carboprost is supplied with its salt derivative tromethamine in 1 milliliter ampules containing a 250 microgram/milliliter solution of the active drug.
The drug must be refrigerated at a temperature between 2 – 8 degrees Celsius. A significant deactivating metabolic transformation of natural prostaglandins is enzymatic oxidation of the C-15 hydroxyl to the corresponding ketone; this is prevented, with retention of activity, by methylation to give the C-15 tertiary carbinol series. This molecular feature is introduced at the stage of the Corey lactone by reaction with methyl Grignard reagent or trimethylaluminium; the resulting mixture of tertiary carbinols is transformed to oxytocic carboprost by standard transformations, including sepoaration of diastereomers, so that the final product is the C-15 analogue. This diastereomer is reputably freeer of porstaglandin side effects than the C-15 isomer. Arbaprostil Carboprost at the US National Library of Medicine Medical Subject Headings
Catasticta nimbice, the pine white or Mexican dartwhite, is a butterfly in the family Pieridae. It is found from Costa Rica north to Mexico. Rare strays can be found as far north as the Chisos Mountains of western Texas; the wingspan is 45–57 mm. The upperside is creamy tan with thick black veins. There is a wide black outer margin surrounding the cream-colored spots. Males perch and patrol for females. Adults are on wing year round in Mexico, they have been recorded feeding on nectar from Fuscia and Senecio species in Costa Rica. The larvae feed including Struthantus species and Phoradendron velutinum, they feed in groups. Pupae look like bird droppings; the following subspecies are recognized: Catasticta nimbice nimbice Catasticta nimbice ochracea Catasticta nimbice bryson Godman & Salvin, Catasticta nimbice ligata Eitschberger & Racheli, 1998
Bull Cove Falls is a waterfall located in the southwestern Appalachian Mountains in North Carolina. Bull Cove Creek rises just north of the border of North Georgia; the creek flows west over the falls merging into Beech Creek, a tributary of the Tallulah River. Bull Cove Falls itself is a two-part cascade. To access the falls, travel on US 76 about 8 miles south from the state line. Turn right onto Persimmon Road and go 4.1 miles to Tallulah River Road. The trailhead for Bull Cove Falls is 7.6 miles up this road. The trail to the falls is a strenuous 1 mile one-way trek, due to the wilderness nature of the area, hikers must be prepared for backcountry travel. High Falls of Beech Creek Big Laurel Falls Mooney Falls
The G8 Climate Change Roundtable was formed in January 2005 at the World Economic Forum in Davos, Switzerland. Its purpose was to address the global climate change issue facing governments and civil society; the first meeting was held in Gleneagles, from 6–8 July 2005, to coincide with the 31st G8 summit. The roundtable was established by twenty-three leading international businesses with the assistance of G8 President and Prime Minister of the United Kingdom Tony Blair, to co-operatively engage in a global plan of action; the aim of the group was to ensure that a long-term policy framework was set up to enable consistent and transparent market-based solutions in mitigating climate change, while addressing issues linked to climate change. Carbon trading is one of the most popular pricing mechanisms used to the reduce greenhouse emissions worldwide; the group devised a Framework for Action which called for technology incentive programs, the establishment of common metrics, for example in energy efficiency, the expansion of emissions trading schemes.
Some of the companies participating include Ford, British Airways, HSBC, EdF and BP. Now, the Climate Change Roundtable has a membership of 150 businesses spread across the globe. Environmentalists raised concerns that the body's statement does not call for targets or include timetables. Friends of the Earth noted that the roundtable represented a major shift by the business community towards efforts to mitigate climate change; the G8 Climate Change Roundtable stated 5 key points to be addressed: Companies must recognize their responsibility in addressing climate change. The issue of climate change requires further international support. Market forces must be considered in the crafting of a solution, consumer support is needed to solve the problem. Specific policies for the mitigation of climate change. Specific policies which should be adopted by G8 members; the G8 Climate Change Roundtable developed 5 key principles for businesses to consider when crafting a climate change mitigation strategy.
These principles are: Strategies should be based on scientific and economic facts. Businesses should adopt market based policy frameworks which are transparent and offer consistent price signals in the long-term. Solutions should be adopted globally. Climate change solutions must not be viewed in isolation from other global challenges, such as ensuring access to energy, expanding availability of clean water, alleviating poverty, achieving economic growth in emerging markets. Businesses should seek a system wide solution, identifying opportunities for CO2 mitigation throughout the supply chain; the G8 Climate Change Roundtable developed 3 key principles for governments to consider when addressing climate change. Governments should: Focus their resources on measuring the effects of climate change on human and environmental health. Increase their understanding of current and future changes taking place within the global environment.. And adopt climate stabilization policies with the goal of mitigating future environmental harm.
The G8 Climate Change Roundtable aimed to create a long-term policy framework, both transparent and consistent. Through market based solutions such as carbon trading, the Roundtable established a policy framework which now encompasses 150 businesses across the globe. By creating long term value, these members established a market based framework extending to 2030 and indicative signals extending to 2050; this policy framework they hoped would take on a global scale, with consistent policies throughout the various states. The framework was meant to not only mitigate climate change but promote sustainable development by addressing issues of poverty and economic growth in emerging markets; the Roundtable recommended encouraging technological innovation through performance based incentives. By commercializing low carbon technologies they aimed to mitigate climate change quickly, they noted that by ensuring that climate change mitigation goals aligned with societal goals, governments would be able to optimize greenhouse gas reductions.
By ensuring that emerging markets, such as China, Brazil, South Africa and Mexico, invest in low carbon economic growth, new technologies can be applied globally while streamlining emerging markets. New investments should align with societal goals, creating partnerships between G8 nations as well as emerging nations. Through such a partnership, members can collaborate on specific projects within countries or rapid dissemination of specific technologies. Members of the new policy framework should establish common metrics. By streamlining greenhouse emissions reporting processes and systems, countries can achieve this goal. Business and G8 governments should use supply chain drivers and the power of procurement to integrate climate change solutions into their global supply chain requirements. By committing to the use of the Roundtable’s policy framework throughout the supply chain, optimal greenhouse gas mitigation can be achieved. ABB, Fred Kindle, CEO Alcan, Travis Engen, President and CEO BP, John Browne, Group Chief Executive British Airways, Martin Broughton, Chairman BT, Ben Verwaayen, CEO Cinergy, James E. Rogers, President & CEO Cisco Systems, Robert Lloyd, Operations, Middle East, Africa Deloitte, John Connolly, CEO, UK and Global Managing Director, Touche Tohmatsu Deutsche Bank, Tessen von Heydebreck, Member of the Board of Managing Directors E.
Friedrich Martius was a German internist, one of the pioneers of constitutional thought in medicine. He was the father of philosopher Hedwig Conrad-Martius, he studied medicine at the Pépinière in Berlin, obtaining his doctorate in 1874. Following graduation, he served as a military doctor, afterwards worked as an assistant in the clinic of Carl Gerhardt in Berlin. In 1887 he received his habilitation, was appointed personal physician to Frederick Francis III, Grand Duke of Mecklenburg-Schwerin. In 1891 he relocated to the University of Rostock as an associate professor and director of the medical clinic. In 1899 he attained a full professorship at Rostock, he was the author of numerous scientific articles, being known for works associated with cardiac and gastric disorders. Die Magensäure des Menschen, kritisch und experimentell, 1892 – Gastric acid in humans, etc. Tachycardie. Achylia gastrica, ihre Ursachen und ihre Folgen. Mit einem anatomischen Beitrage von O. Lubarsch, 1897 – Achylia gastrica, its causes and its consequences, with anatomical contributions by Otto Lubarsch.
Pathogenese innerer Krankheiten, nach Vorlesungen für Studirende und Ärzte, 1899 – Pathogenesis of internal diseases. Neurasthenische Entartung einst und jetzt. Tröstliche Betrachtungen eines Kulturoptimisten, 1909 – Neurasthenic degeneration past and present. Konstitution und Vererbung in ihren Beziehungen zur Pathologie, 1914 – Constitution and inheritance in its relationship with the pathology. Concepts of the Human Constitution in Weimar Medicine, 1918-1933