Informed consent is a process for getting permission before conducting a healthcare intervention on a person, or for disclosing personal information. A health care provider may ask a patient to consent to receive therapy before providing it, or a clinical researcher may ask a research participant before enrolling that person into a clinical trial. Informed consent is collected according to guidelines from the fields of medical ethics and research ethics. An informed consent can be said to have been given based upon a clear appreciation and understanding of the facts and consequences of an action. Adequate informed consent is rooted in respecting a person’s dignity. To give informed consent, the individual concerned must have adequate reasoning faculties and be in possession of all relevant facts. Impairments to reasoning and judgment that may prevent informed consent include basic intellectual or emotional immaturity, high levels of stress such as posttraumatic stress disorder or a severe intellectual disability, severe mental disorder, severe sleep deprivation, Alzheimer's disease, or being in a coma.
Obtaining informed consent is not always required. If an individual is considered unable to give informed consent, another person is authorized to give consent on his behalf, e.g. parents or legal guardians of a child and conservators for the mentally disordered, or consent can be assumed through the doctrine of implied consent, e.g. when an unconscious person will die without immediate medical treatment. In cases where an individual is provided insufficient information to form a reasoned decision, serious ethical issues arise; such cases in a clinical trial in medical research are anticipated and prevented by an ethics committee or Institutional Review Board. Informed Consent Form Templates can be found on the World Health Organization Website for practical use. Informed consent can be complex to evaluate, because neither expressions of consent, nor expressions of understanding of implications mean that full adult consent was in fact given, nor that full comprehension of relevant issues is internally digested.
Consent may be implied within the usual subtleties of human communication, rather than explicitly negotiated verbally or in writing. In some cases consent cannot be possible if the person protests he does indeed understand and wish. There are structured instruments for evaluating capacity to give informed consent, although no ideal instrument presently exists. Thus, there is always a degree to which informed consent must be assumed or inferred based upon observation, or knowledge, or legal reliance; this is the case in sexual or relational issues. In medical or formal circumstances, explicit agreement by means of signature—normally relied on legally—regardless of actual consent, is the norm; this is the case with certain procedures, such as a "do not resuscitate" directive that a patient signed before onset of their illness. Brief examples of each of the above: A person may verbally agree to something from fear, perceived social pressure, or psychological difficulty in asserting true feelings.
The person requesting the action may be unaware of this and believe the consent is genuine, rely on it. Consent is expressed, but not internally given. A person may claim to understand the implications of some action, as part of consent, but in fact has failed to appreciate the possible consequences and may deny the validity of the consent for this reason. Understanding needed for informed consent is, in fact, not present. A person signs a legal release form for a medical procedure, feels he did not consent. Unless he can show actual misinformation, the release is persuasive or conclusive in law, in that the clinician may rely upon it for consent. In formal circumstances, a written consent legally overrides denial of informed consent. Informed consent in the U. S. can be overridden in emergency medical situations pursuant to 21CFR50.24, first brought to the general public's attention via the controversy surrounding the study of Polyheme. For an individual to give valid informed consent, three components must be present: disclosure and voluntariness.
Disclosure requires the researcher to supply each prospective subject with the information necessary to make an autonomous decision and to ensure that the subject adequate understands the information provided. This latter requirement implies that a written consent form be written in lay language suited for the comprehension skills of subject population, as well as assessing the level of understanding through conversation. Capacity pertains to the ability of the subject to both understand the information provided and form a reasonable judgment based on the potential consequences of his/her decision. Voluntariness refers to the subject’s right to exercise his/her decision making without being subjected to external pressure such as coercion, manipulation, or undue influence. Waiver of the consent requirement may be applied in certain circumstances where no foreseeable harm is expected to result from the study or when permitted by law, federal regulations, or if an ethical review committee has approved the non-disclosure of certain information.
Besides studies with minimal risk, waivers of consent may be obtained in a military setting. According to 10 USC 980, the United States Code for the Armed Forces, Limitations on the Use of Humans as Experimental Subjects, a waiver of advanced informed consent may be granted by the Secretary of Defense if a research project would: Directly benefit subjects. Advance the de
Michael Specter is an American journalist, a staff writer, focusing on science and technology, global public health at The New Yorker since September 1998. He has written for The Washington Post and The New York Times. Specter covered local news at The Washington Post in 1985 but became a national science reporter for the Post and the New York City bureau chief. In 1991, Specter transferred to the Times. There, from 1994 to 1998, he was based in Moscow. In 1995, he was appointed co-chief of the Moscow bureau of the Times. While in Russia, he covered stories such as the war in Chechnya, the 1996 Russian presidential elections, the declining state of Russian health care. In 1998, he became a roving correspondent based in Rome covering topics as varied as Europe's demographic crisis, Michelangelo's Florentine Pietà, the spread of AIDS in Africa, his 2009 book, Denialism: How Irrational Thinking Hinders Scientific Progress, Harms the Planet, Threatens Our Lives, explores the ways in which people in the United States and Europe have rejected scientific truths, backed by impressive data.
They instead are embracing what seem to be more comfortable fictions about issues such as the value of organic food, vaccine safety, personal genomics. He delivered a talk titled "The danger of science denial" at TED 2010. At The New Yorker, he has written about the global AIDS epidemic, avian influenza, scientific efforts to resurrect extinct viruses, synthetic biology, genetically modified food, efforts to mine the human genome to fight disease, the world’s diminishing freshwater resources, he has written profiles of many people, including Dr. Oz, Lance Armstrong, Richard Branson, the ethicist Peter Singer, P. Diddy, Manolo Blahnik, AIDS activist Larry Kramer, Ingrid Newkirk. In 1996, Specter was awarded the Overseas Press Club Citation for Excellence for his coverage of the War in Chechnya. In 2002, he won the A. A. A. S. Science Journalism Award, he has twice received the Global Health Council's Annual Excellence in Media Award- for his piece about AIDS in India, “India's Plague” and for one about AIDS and the population crisis in Russia, “The Devastation,“.
In 2009, Specter received the Robert P. Balles Annual Prize in Critical Thinking for his book Denialism; the yearly award is given by the Committee for Skeptical Inquiry to the author of the published work that best exemplifies healthy skepticism, logical analysis, or empirical science. Specter is a son of Eileen Specter, he was married to Alessandra Stanley, now a television critic for The New York Times. They have Emma. Specter is a 1977 graduate of Vassar College. Specter, Michael. Denialism: how irrational thinking hinders scientific progress, harms the planet, threatens our lives. New York: Penguin Press. Specter, Michael. "India's plague". The New Yorker. 77: 74–86. Archived from the original on December 14, 2006. —. "The vaccine". The New Yorker. 78: 54–65. Archived from the original on December 12, 2006. —. "A deadly misdiagnosis". Letter from India; the New Yorker. 86. —. "The operator: is the most trusted doctor in America doing more harm than good?". Profiles; the New Yorker. 88: 40–49. Profile of Mehmet Oz. —.
"The Lyme wars: the Lyme-disease infection rate is growing. So is the battle over how to treat it". Annals of Medicine; the New Yorker. 89: 24–29. —. "The gene factory: a Chinese firm's bid to crack hunger, evolution – and the genetics of human intelligence". Letter from Shenzen; the New Yorker. 89: 34–43. —. "The fear equation". The Talk of the Town. Comment; the New Yorker. 90: 29–30. —. "Rewriting the code of life: through DNA editing, researchers hope to alter the genetic destiny of species and eliminate diseases". Annals of Science; the New Yorker. 92: 34–43. Michael Specter website
Vaccination is the administration of a vaccine to help the immune system develop protection from a disease. Vaccines contain a microorganism in a weakened or killed state, or proteins or toxins from the organism. In stimulating the body's adaptive immunity, they help prevent sickness from an infectious disease; when a sufficiently large percentage of a population has been vaccinated, herd immunity results. The effectiveness of vaccination has been studied and verified. Vaccination is the most effective method of preventing infectious diseases. Smallpox was most the first disease people tried to prevent by inoculation and was the first disease for which a vaccine was produced; the smallpox vaccine was invented in 1796 by English physician Edward Jenner and, although at least six people had used the same principles years earlier, he was the first to publish evidence that it was effective and to provide advice on its production. Louis Pasteur furthered the concept through his work in microbiology.
The immunization was called vaccination. Smallpox was a contagious and deadly disease, causing the deaths of 20–60% of infected adults and over 80% of infected children; when smallpox was eradicated in 1979, it had killed an estimated 300–500 million people in the 20th century. Vaccination and immunization have a similar meaning in everyday language; this is distinct from inoculation. Vaccination efforts have been met with some controversy on scientific, political, medical safety, religious grounds. In the United States, people may receive compensation for those injuries under the National Vaccine Injury Compensation Program. Early success brought widespread acceptance, mass vaccination campaigns have reduced the incidence of many diseases in numerous geographic regions. Vaccines are a way of artificially activating the immune system to protect against infectious disease; the activation occurs through priming the immune system with an immunogen. Stimulating immune responses with an infectious agent is known as immunization.
Vaccination includes various ways of administering immunogens. Most vaccines are administered before a patient has contracted a disease to help increase future protection. However, some vaccines are administered after the patient has contracted a disease. Vaccines given after exposure to smallpox are reported to offer some protection from disease or may reduce the severity of disease; the first rabies immunization was given by Louis Pasteur to a child after he was bitten by a rabid dog. Since its discovery, the rabies vaccine have been proven effective in preventing rabies in humans when administered several times over 14 days along with rabies immune globulin and wound care. Other examples include cancer and Alzheimer's disease vaccines; such immunizations aim to trigger an immune response more and with less harm than natural infection. Most vaccines are given by injection. Live attenuated polio, some typhoid, some cholera vaccines are given orally to produce immunity in the bowel. While vaccination provides a lasting effect, it takes several weeks to develop.
This differs from passive immunity has immediate effect. A vaccine failure is. Primary vaccine failure occurs when an organism's immune system does not produce antibodies when first vaccinated. Vaccines can fail to produce an immune response; the term "vaccine failure" does not imply that the vaccine is defective. Most vaccine failures are from individual variations in immune response; the term inoculation is used interchangeably with vaccination. However, some argue. Dr Byron Plant explains: "Vaccination is the more used term, which consists of a'safe' injection of a sample taken from a cow suffering from cowpox... Inoculation, a practice as old as the disease itself, is the injection of the variola virus taken from a pustule or scab of a smallpox sufferer into the superficial layers of the skin on the upper arm of the subject. Inoculation was done'arm to arm' or less effectively'scab to arm'..." Inoculation oftentimes caused the patient to become infected with smallpox, in some cases the infection turned into a severe case.
Vaccinations began in the 18th century with the work of the smallpox vaccine. Just like any medication or procedure, no vaccine can be 100% safe or effective for everyone because each person's body can react differently. While minor side effects, such as soreness or low grade fever, are common, serious side effects are rare and occur in about 1 out of every 100,000 vaccinations and involve allergic reactions that can cause hives or difficulty breathing. However, vaccines are the safest they have been in history and each vaccine undergoes rigorous clinical trials to ensure their safety and efficacy before FDA approval. Prior to human testing, vaccines are run through computer algorithms to model how they will interact with the immune system and are tested on cells in a culture. During the next round of testing, researchers study vaccines in animal, including mice, guinea pigs, monkeys. Vaccines that pass each of these stages of testing are approved by the FDA to start a three-phase series of hu
Delta Air Lines
Delta Air Lines, Inc. referred to as Delta, is a major American airline, with its headquarters in Atlanta, Georgia. The airline, along with its subsidiaries and regional affiliates, operates over 5,400 flights daily and serves an extensive domestic and international network that includes 304 destinations in 52 countries on six continents, as of October 2018. Delta is a founding member of the SkyTeam airline alliance. Regional service is operated under the brand name Delta Connection. One of the five remaining legacy carriers, Delta is the sixth-oldest operating airline by foundation date, the oldest airline still operating in the United States. Among predecessors of today's Delta Air Lines, Western Airlines and Northwest Airlines began flying passengers in 1926 and 1927, respectively. Delta has eight hubs, with Atlanta being its largest in terms of total passengers and number of departures, it is the world's second largest airline in terms of scheduled passengers carried, revenue passenger-kilometers flown and fleet size.
In 2018, Delta ranked No. 75 in the Fortune 500 list of the largest American corporations by total revenue. Delta Air Lines began as a crop dusting operation called Incorporated; the company was founded on May 30, 1924, in Macon and moved to Monroe, Louisiana, in 1925. They flew a Huff-Daland Duster, the first true crop duster, designed to combat the boll weevil infestation of cotton crops. Collett E. Woolman, one of the original directors, purchased the company on September 13, 1928, renamed it Delta Air Service. Service began on June 17, 1929, with the inaugural flight between Dallas and Jackson, Mississippi; the company recognizes four founders: the principal founder Collett E. Woolman, C. H. McHenery, Travis Oliver, Malcolm S. Biedenharn. Delta moved its headquarters to its current location in Atlanta in 1941, continued to grow through the addition of routes and the acquisition of other airlines, it replaced propeller planes with jets in the 1960s and entered international competition to Europe in the 1970s and across the Pacific in the 1980s.
Delta's more recent history is marked by its emergence from bankruptcy on April 25, 2007, the subsequent merger with Northwest Airlines. The merger was announced April 14, 2008, was set to create the world's largest airline. After approval of the merger on October 29, 2008, Northwest continued to operate as a wholly owned subsidiary of Delta until December 31, 2009, when both carriers' operating certificates were merged. Delta completed integration with Northwest on January 31, 2010, when their reservation systems and websites were combined, the Northwest Airlines brand was retired; as of October 2018, Delta and its worldwide alliance partners operated more than 15,000 flights per day. Delta is the only U. S. carrier that flies to Accra, Dakar, Düsseldorf, Lagos, Ponta Delgada, Stuttgart. It is the only U. S. carrier that has scheduled service to Africa, thereby the only U. S. carrier to serve all six inhabited continents. Delta has eight hubs. Atlanta – In addition to its corporate headquarters, Delta operates its primary hub in Atlanta as well as Delta TechOps, Delta's primary maintenance base.
It is Delta's main gateway to Latin America and the Caribbean, a secondary transatlantic gateway. Detroit – Inherited through the merger with Northwest, Detroit serves as one of Delta's two Midwest hubs, it is the primary Asian gateway for the northeastern United States and it provides service to many destinations in the Americas and Europe. Los Angeles – Delta inherited its LAX hub from Western Airlines, but dismantled it in the mid-1990s, opting to relocate most of those aircraft to the U. S. East Coast. Since it has re-opened the hub, offering service to Latin America, Asia and Europe, as well as major domestic bases and West Coast regional destinations. Minneapolis–Saint Paul – Inherited through the merger with Northwest, Minneapolis–Saint Paul serves as one of Delta's two Midwest hubs. Service includes most major Canadian and American metropolitan areas, a number of regional destinations in the upper Midwest as well as many destinations in Latin America and Asia. New York–JFK, New York City – A major international gateway to Europe.
Inherited from its partnership with Pan Am after Pan Am's collapse in 1991. Offers service on many transcontinental "prestige routes" to west coast destinations Los Angeles, San Francisco and Seattle. New York–LaGuardia, New York City – An important domestic hub created as a result of a slot swap with US Airways. Delta service at LaGuardia covers numerous east coast US cities, a number of regional destinations in the US and Canada. Salt Lake City – Delta inherited Salt Lake City during the Western Airlines merger. Service covers most major US destinations as well as a number of regional destinations in the US and Canada, select cities in Europe and Hawaii. Seattle–Tacoma – Delta announced Seattle's hub status in 2014; the hub serves as an important gateway to Asia. Delta started aggressively building its presence in Seattle in 2011, sparking tensions with Seattle-based Alaska Airlines. Since 2017, due to airport space restrictions, Delta's growth in Seattle has slowed, Delta has been upgauging existing flights rather than adding new ones.
In addition to their eight hubs, Delta operates three smaller focus cities. Boston – Boston was a hub for Delta in the second half of the 20th century through the early 2000s; the present Terminal A was built for Delta's sole use, but following the 2005 bankruptcy, they scaled back operations and leased 11 gates in the terminal. Delta has since regained all the Terminal A gates and
Times Square is a major commercial intersection, tourist destination, entertainment center and neighborhood in the Midtown Manhattan section of New York City at the junction of Broadway and Seventh Avenue. It stretches from West 42nd to West 47th Streets. Brightly adorned with billboards and advertisements, Times Square is sometimes referred to as "The Crossroads of the World", "The Center of the Universe", "the heart of The Great White Way", "the heart of the world". One of the world's busiest pedestrian areas, it is the hub of the Broadway Theater District and a major center of the world's entertainment industry. Times Square is one of the world's most visited tourist attractions, drawing an estimated 50 million visitors annually. 330,000 people pass through Times Square daily, many of them tourists, while over 460,000 pedestrians walk through Times Square on its busiest days. Known as Longacre Square, Times Square was renamed in 1904 after The New York Times moved its headquarters to the newly erected Times Building – now One Times Square – the site of the annual New Year's Eve ball drop which began on December 31, 1907, continues today, attracting over a million visitors to Times Square every year.
Times Square functions as a town square, but is not geometrically a square. Broadway runs diagonally, crossing through the horizontal and vertical street grid of Manhattan laid down by the Commissioners' Plan of 1811, that intersection creates the "bowtie" shape of Times Square; the southern triangle of Times Square has no specific name, but the northern triangle is called Father Duffy Square. It was dedicated in 1937 to Chaplain Francis P. Duffy of New York City's U. S. 69th Infantry Regiment and is the site of a memorial to him, along with a statue of George M. Cohan, as well as the TKTS reduced-price ticket booth run by the Theatre Development Fund. Since 2008, the booth has been backed by a red, triangular set of bleacher-like stairs, used by people to sit, talk and take photographs; when Manhattan Island was first settled by the Dutch, three small streams united near what is now 10th Avenue and 40th Street. These three streams formed the "Great Kill". From there the Great Kill wound through the low-lying Reed Valley, known for fish and waterfowl and emptied into a deep bay in the Hudson River at the present 42nd Street.
The name was retained in a tiny hamlet, Great Kill, that became a center for carriage-making, as the upland to the south and east became known as Longacre. Before and after the American Revolution, the area belonged to John Morin Scott, a general of the New York militia, in which he served under George Washington. Scott's manor house was at what is 43rd Street, surrounded by countryside used for farming and breeding horses. In the first half of the 19th century, it became one of the prized possessions of John Jacob Astor, who made a second fortune selling off lots to hotels and other real estate concerns as the city spread uptown. By 1872, the area had become the center of New York's horse carriage industry; the locality had not been given a name, city authorities called it Longacre Square after Long Acre in London, where the horse and carriage trade was centered in that city. William Henry Vanderbilt ran the American Horse Exchange there. In 1910 it became the Winter Garden Theatre; as more profitable commerce and industrialization of Lower Manhattan pushed homes and prostitution northward from the Tenderloin District, Long Acre Square became nicknamed the Thieves Lair for its rollicking reputation as a low entertainment district.
The first theater on the square, the Olympia, was built by cigar manufacturer and impresario Oscar Hammerstein I. According to Gotham: A History of New York City to 1898, "By the early 1890s this once sparsely settled stretch of Broadway was ablaze with electric light and thronged by crowds of middle- and upper-class theatre and cafe patrons." In 1904, New York Times publisher Adolph S. Ochs moved the newspaper's operations to a new skyscraper on 42nd Street at Longacre Square, on the site of the former Pabst Hotel, which had existed on the site for less than a decade since it opened in November 1899. Ochs persuaded Mayor George B. McClellan Jr. to construct a subway station there, the area was renamed "Times Square" on April 8, 1904. Just three weeks the first electrified advertisement appeared on the side of a bank at the corner of 46th Street and Broadway; the north end became Duffy Square, the former Horse Exchange became the Winter Garden Theatre, constructed in 1911. The New York Times moved to more spacious offices one block west of the square in 1913 and sold the building in 1961.
The old Times Building was named the Allied Chemical Building in 1963. Now known as One Times Square, it is famed for the Times Square Ball drop on its roof every New Year's Eve. In 1913, the Lincoln Highway Association, headed by entrepreneur Carl G. Fisher, chose the intersection of 42nd Street and Broadway to be the Eastern Terminus of the Lincoln Highway; this was the first road across the United States, which spanned 3,389 miles coast-to-coast through 13 states to its western terminus in Lincoln Park in San Francisco, California. Times Square grew after World War I, it became a cultural hub full of theatres, music halls, upscale hotels. Times Square became New York's agora, a place to gather to await great tidings and to celebrate them, whether a World Series or a presidential election. Advertising grew in the 1920s, growing
Los Angeles Times
The Los Angeles Times is a daily newspaper, published in Los Angeles, since 1881. It has the fourth-largest circulation among United States newspapers, is the largest U. S. newspaper not headquartered on the East Coast. The paper is known for its coverage of issues salient to the U. S. West Coast, such as immigration trends and natural disasters, it has won more than 40 Pulitzer Prizes for its coverage of other issues. As of June 18, 2018, ownership of the paper is controlled by Patrick Soon-Shiong, the executive editor is Norman Pearlstine. In the nineteenth century, the paper was known for its civic boosterism and opposition to unions, the latter of which led to the bombing of its headquarters in 1910; the paper's profile grew in the 1960s under publisher Otis Chandler, who adopted a more national focus. In recent decades, the paper's readership has declined and it has been beset by a series of ownership changes, staff reductions, other controversies. In January 2018, the paper's staff voted to unionize, in July 2018 the paper moved out of its historic downtown headquarters to a facility near Los Angeles International Airport.
The Times was first published on December 4, 1881, as the Los Angeles Daily Times under the direction of Nathan Cole Jr. and Thomas Gardiner. It was first printed at the Mirror printing plant, owned by Jesse Yarnell and T. J. Caystile. Unable to pay the printing bill and Gardiner turned the paper over to the Mirror Company. In the meantime, S. J. Mathes had joined the firm, it was at his insistence that the Times continued publication. In July 1882, Harrison Gray Otis moved from Santa Barbara to become the paper's editor. Otis made the Times a financial success. Historian Kevin Starr wrote that Otis was a businessman "capable of manipulating the entire apparatus of politics and public opinion for his own enrichment". Otis's editorial policy was based on civic boosterism, extolling the virtues of Los Angeles and promoting its growth. Toward those ends, the paper supported efforts to expand the city's water supply by acquiring the rights to the water supply of the distant Owens Valley; the efforts of the Times to fight local unions led to the October 1, 1910 bombing of its headquarters, killing twenty-one people.
Two union leaders and Joseph McNamara, were charged. The American Federation of Labor hired noted trial attorney Clarence Darrow to represent the brothers, who pleaded guilty. Otis fastened a bronze eagle on top of a high frieze of the new Times headquarters building designed by Gordon Kaufmann, proclaiming anew the credo written by his wife, Eliza: "Stand Fast, Stand Firm, Stand Sure, Stand True." Upon Otis's death in 1917, his son-in-law, Harry Chandler, took control as publisher of the Times. Harry Chandler was succeeded in 1944 by his son, Norman Chandler, who ran the paper during the rapid growth of post-war Los Angeles. Norman's wife, Dorothy Buffum Chandler, became active in civic affairs and led the effort to build the Los Angeles Music Center, whose main concert hall was named the Dorothy Chandler Pavilion in her honor. Family members are buried at the Hollywood Forever Cemetery near Paramount Studios; the site includes a memorial to the Times Building bombing victims. The fourth generation of family publishers, Otis Chandler, held that position from 1960 to 1980.
Otis Chandler sought legitimacy and recognition for his family's paper forgotten in the power centers of the Northeastern United States due to its geographic and cultural distance. He sought to remake the paper in the model of the nation's most respected newspapers, notably The New York Times and The Washington Post. Believing that the newsroom was "the heartbeat of the business", Otis Chandler increased the size and pay of the reporting staff and expanded its national and international reporting. In 1962, the paper joined with The Washington Post to form the Los Angeles Times–Washington Post News Service to syndicate articles from both papers for other news organizations, he toned down the unyielding conservatism that had characterized the paper over the years, adopting a much more centrist editorial stance. During the 1960s, the paper won four Pulitzer Prizes, more than its previous nine decades combined. Writing in 2013 about the pattern of newspaper ownership by founding families, Times reporter Michael Hiltzik said that: The first generations bought or founded their local paper for profits and social and political influence.
Their children enjoyed both profits and influence, but as the families grew larger, the generations found that only one or two branches got the power, everyone else got a share of the money. The coupon-clipping branches realized that they could make more money investing in something other than newspapers. Under their pressure the companies split apart, or disappeared. That's the pattern followed over more than a century by the Los Angeles Times under the Chandler family; the paper's early history and subsequent transformation was chronicled in an unauthorized history Thinking Big, was one of four organizations profiled by David Halberstam in The Powers That Be. It has been the whole or partial subject of nearly thirty dissertations in communications or social science in the past four decades; the Los Angeles Times began a decline with Los Angeles itself with the decline in military production at the end of the Cold War. It faced hiring freezes in 1991-1992. Another major decision at the same time was to cut the range of circulation.
They cut circulation in California's Central Valley, Nevada and the San Diego ed
Artificial induction of immunity
Artificial induction of immunity is the artificial induction of immunity to specific diseases – making people immune to disease by means other than waiting for them to catch the disease. The purpose is to reduce the risk of suffering. Immunity against infections that can cause serious illness is beneficial. Since Pasteur provided support for a germ theory of infectious disease, we have induced immunity against a widening range of diseases to prevent the associated risks from the wild infections, it is hoped that further understanding of the molecular basis of immunity will translate to improved clinical practice in the future. The earliest recorded artificial induction of immunity in humans was by variolation or inoculation, the controlled infection of a subject with a less lethal natural form of smallpox to make him or her immune to re-infection with the more lethal natural form, Variola Major; this was practiced in ancient times in China and India, imported into Europe, via Turkey, around 1720 by Lady Montagu and others.
From England, the technique spread to the Colonies, was spread by African slaves arriving into Boston. Variolation had the disadvantage that the inoculating agent used was still an active form of smallpox and, although less potent, could still kill the inoculee or spread in its full form to others nearby. However, as the risk of death from inoculation with Variola Minor was just 1% to 2%, as compared to the 20% risk of death from the natural form of smallpox, the risks of inoculation were considered acceptable. In 1796, Edward Jenner, a doctor and scientist who had practiced variolation, performed an experiment based on the folk-knowledge that infection with cowpox, a disease with minor symptoms, never fatal conferred immunity to smallpox; the idea was not new. In 1798, Jenner extended his observations by showing that cowpox could be passed from a lesion on one patient to others through four arm to arm transfers and that the last in the series was immune by exposing him to smallpox. Jenner described the procedure, distributed his vaccine and provided information to help those hoping to establish their own vaccines.
In 1798 he published his information in his famous Inquiry into the Causes and Effects...of the Cow Pox. He is credited with being the first to start detailed investigations of the subject and of bringing it to the attention of the medical profession. Despite some opposition vaccination took over from variolation. Jenner, like all members of the Royal Society in those days, was an empiricist; the theory to support further advances in vaccination came later. Main articles: Pasteur Louis Pasteur. Using experiments based on this theory, which posited that specific microorganisms cause specific diseases, Pasteur isolated the infectious agent from anthrax, he derived a vaccine by altering the infectious agent so as to make it harmless and introducing this inactivated form of the infectious agents into farm animals, which proved to be immune to the disease. Pasteur isolated a crude preparation of the infectious agent for rabies. In a brave piece of rapid medicine development, he saved the life of a person, bitten by a rabid dog by performing the same inactivating process upon his rabies preparation and inoculating the patient with it.
The patient, expected to die and thus was the first person vaccinated against rabies. René Dubos, Louis Pasteur: Freelance Of Science, Little and Company, 1950. Anthrax is now known to be caused by a bacterium, rabies is known to be caused by a virus; the microscopes of the time could reasonably be expected to show bacteria, but imaging of viruses had to wait until the development of electron microscopes with their greater resolving power in the 20th century. Some diseases, such as tetanus, cause disease not by bacterial growth but by bacterial production of a toxin. Tetanus toxin is so lethal that humans cannot develop immunity to a natural infection, as the amount of toxin and time required to kill a person is much less than is required by the immune system to recognize the toxin and produce antibodies against it; however the tetanus toxin is denatured losing its ability to produce disease, but leaving it able to induce immunity to tetanus when injected into subjects. The denatured toxin is called a toxoid.
The use of simple molecules such as toxoids for immunization tends to produce a low response by the immune system, thus poor immune memory. However, adding certain substances to the mixture, for example adsorbing tetanus toxoid onto alum enhances the immune response; these substances are known as adjuvants. Several different adjuvants have been used in vaccine preparation. Adjuvants are used in other ways in researching the immune system. A more contemporary approach for "boosting" the immune response to simpler immunogenic molecules is to conjugate the antigens. Conjugation is the attachment to the antigen of another substance which generates an immune response, thus amplifying the overall response and causing a more robust immune memory to the antigen. For example, a toxoid might be attached to a polysaccharide from the capsule of the bacteria responsible for most lobar pneumonia. Temporary immunity to a specific infection can be induced in a subject by providing the subject with externally produced imm