Salt is a mineral consisting of sodium chloride, a chemical compound belonging to the larger class of salts. Salt is present in vast quantities in seawater; the open ocean has about 35 grams of solids per liter of sea water, a salinity of 3.5%. Salt is essential for life in general, saltiness is one of the basic human tastes. Salt is one of the oldest and most ubiquitous food seasonings, salting is an important method of food preservation; some of the earliest evidence of salt processing dates to around 6,000 BC, when people living in the area of present-day Romania boiled spring water to extract salts. Salt was prized by the ancient Hebrews, the Greeks, the Romans, the Byzantines, the Hittites and the Indians. Salt became an important article of trade and was transported by boat across the Mediterranean Sea, along specially built salt roads, across the Sahara on camel caravans; the scarcity and universal need for salt have led nations to go to war over it and use it to raise tax revenues. Salt has other cultural and traditional significance.
Salt is processed from salt mines, by the evaporation of seawater and mineral-rich spring water in shallow pools. Its major industrial products are caustic chlorine. Of the annual global production of around two hundred million tonnes of salt, about 6% is used for human consumption. Other uses include water conditioning processes, de-icing highways, agricultural use. Edible salt is sold in forms such as sea salt and table salt which contains an anti-caking agent and may be iodised to prevent iodine deficiency; as well as its use in cooking and at the table, salt is present in many processed foods. Sodium is an essential nutrient for human health via its role as an osmotic solute. Excessive salt consumption may increase the risk of cardiovascular diseases, such as hypertension, in children and adults; such health effects of salt have long been studied. Accordingly, numerous world health associations and experts in developed countries recommend reducing consumption of popular salty foods; the World Health Organization recommends that adults should consume less than 2,000 mg of sodium, equivalent to 5 grams of salt per day.
All through history, the availability of salt has been pivotal to civilization. What is now thought to have been the first city in Europe is Solnitsata, in Bulgaria, a salt mine, providing the area now known as the Balkans with salt since 5400 BC; the name Solnitsata means "salt works". While people have used canning and artificial refrigeration to preserve food for the last hundred years or so, salt has been the best-known food preservative for meat, for many thousands of years. A ancient salt-works operation has been discovered at the Poiana Slatinei archaeological site next to a salt spring in Lunca, Neamț County, Romania. Evidence indicates that Neolithic people of the Precucuteni Culture were boiling the salt-laden spring water through the process of briquetage to extract the salt as far back as 6050 BC; the salt extracted from this operation may have had a direct correlation to the rapid growth of this society's population soon after its initial production began. The harvest of salt from the surface of Xiechi Lake near Yuncheng in Shanxi, dates back to at least 6000 BC, making it one of the oldest verifiable saltworks.
There is more salt in animal tissues, such as meat and milk, than in plant tissues. Nomads who subsist on their flocks and herds do not eat salt with their food, but agriculturalists, feeding on cereals and vegetable matter, need to supplement their diet with salt. With the spread of civilization, salt became one of the world's main trading commodities, it was of high value to the ancient Hebrews, the Greeks, the Romans, the Byzantines, the Hittites and other peoples of antiquity. In the Middle East, salt was used to ceremonially seal an agreement, the ancient Hebrews made a "covenant of salt" with God and sprinkled salt on their offerings to show their trust in him. An ancient practice in time of war was salting the earth: scattering salt around in a defeated city to prevent plant growth; the Bible tells the story of King Abimelech, ordered by God to do this at Shechem, various texts claim that the Roman general Scipio Aemilianus Africanus ploughed over and sowed the city of Carthage with salt after it was defeated in the Third Punic War.
Salt may have been used for barter in connection with the obsidian trade in Anatolia in the Neolithic Era. Salt was included among funeral offerings found in ancient Egyptian tombs from the third millennium BC, as were salted birds, salt fish. From about 2800 BC, the Egyptians began exporting salt fish to the Phoenicians in return for Lebanon cedar and the dye Tyrian purple. Herodotus described salt trading routes across Libya back in the 5th century BC. In the early years of the Roman Empire, roads were built for the transportation of salt from the salt imported at Ostia to the capital. In Africa, salt was used as currency south of the Sahara, slabs of rock salt were used as coins in Abyssinia. Moorish merchants in the 6th century traded salt for weight for weight; the Tuareg have traditionally maintained routes across the Sahara for the transportation of salt by Azalai. The carava
"The Call of Cthulhu" is a short story by American writer H. P. Lovecraft. Written in the summer of 1926, it was first published in the pulp magazine Weird Tales, in February 1928. Cthulhu Mythos scholar Robert M. Price claims the irregular sonnet "The Kraken", written in 1830 by Alfred Tennyson, was a major inspiration for Lovecraft's story, as both reference a huge aquatic creature sleeping for an eternity at the bottom of the ocean and destined to emerge from its slumber in an apocalyptic age. S. T. Joshi and David E. Schultz cited other literary inspirations: Guy de Maupassant's "The Horla", which Lovecraft described in Supernatural Horror in Literature as concerning "an invisible being who...sways the minds of others, seems to be the vanguard of a horde of extraterrestrial organisms arrived on Earth to subjugate and overwhelm mankind". It is assumed he got inspiration from William Scott-Elliot's The Story of Atlantis and The Lost Lemuria, which Lovecraft read in 1926 shortly before he started to work on the story.
Price notes that Lovecraft admired the work of Lord Dunsany, who wrote The Gods of Pegana, which depicts a god lulled to sleep to avoid the consequences of its reawakening. Another Dunsany work cited by Price is A Shop in Go-by Street, which stated "the heaven of the gods who sleep", "unhappy are they that hear some old god speak while he sleeps being still deep in slumber"; the "slight earthquake" mentioned in the story is the 1925 Charlevoix–Kamouraska earthquake. S. T. Joshi has cited A. Merritt's novella The Moon Pool which Lovecraft'frequently rhapsodied about'. Joshi says that,'Merritt's mention of a "moon-door" that, when tilted, leads the characters into a lower region of wonder and horror seems similar to the huge door whose inadvertent opening by the sailors causes Cthulhu to emerge from R'lyeh'. Edward Guimont has argued that H. G. Wells' The War of the Worlds was an influence on "The Call of Cthulhu", citing the thematic similarities of ancient, but indifferent aliens associated with deities.
The story's narrator, Francis Wayland Thurston, recounts his discovery of various notes left behind by his great uncle, George Gammell Angell, a prominent Professor of Semitic languages at Brown University in Providence, Rhode Island, who died during the winter of 1926 after being jostled by a sailor. The first chapter, The Horror in Clay, concerns a small bas-relief sculpture found among the notes, which the narrator describes: "My somewhat extravagant imagination yielded simultaneous pictures of an octopus, a dragon, a human caricature.... A pulpy, tentacled head surmounted a grotesque and scaly body with rudimentary wings"; the sculpture is the work of Henry Anthony Wilcox, a student at the Rhode Island School of Design, who based his creation on a delirious dream of "great Cyclopean cities of titanic blocks and sky-flung monoliths, all dripping with green ooze and sinister with latent horror". References to both Cthulhu and R'lyeh are included in letters written by Wilcox. Angell discovers reports of "outre mental illnesses and outbreaks of group folly or mania" around the world.
The second chapter, The Tale of Inspector Legrasse, discusses the first time the Professor had heard the word "Cthulhu" and seen a similar image. At the 1908 meeting of the American Archaeological Society in St. Louis, Missouri, a New Orleans police official named John Raymond Legrasse asked the assembled antiquarians to identify an idol carved from a mysterious greenish-black stone. Legrasse discovered the relic months before in the swamps south of New Orleans, during his raid on a supposed voodoo cult; the idol resembles Wilcox's sculpture, represented a "...thing, which seemed instinct with a fearsome and unnatural malignancy, was of a somewhat bloated corpulence, squatted evilly on a rectangular block or pedestal covered with undecipherable characters". On November 1, 1907, Legrasse led a party of fellow policemen in search of several women and children who disappeared from a squatter community; the police found the victims' "oddly marred" bodies being used in a ritual where 100 men—all of a "mentally aberrant type"—were "braying and writhing" and chanting the phrase: "Ph'nglui mglw'nafh Cthulhu R'lyeh wgah'nagl fhtagn".
After killing five of the participants and arresting 47 others, Legrasse interrogated the men before learning "the central idea of their loathsome faith": "They worshipped, so they said, the Great Old Ones who lived ages before there were any men...and...formed a cult which had never died...hidden in distant wastes and dark places all over the world until the time when the great priest Cthulhu, from his dark house in the mighty city of R'lyeh under the waters, should rise and bring the earth again beneath his sway. Some day he would call, when the stars were ready, the secret cult would always be waiting to liberate him." The prisoners identify the confiscated idol as Cthulhu himself, translate their mysterious phrase as "In his house at R'lyeh, dead Cthulhu waits dreaming". One talkative cultist, known as Old Castro, named the center of their cult as Irem, the City of Pillars in Arabia, referred to a phrase in the Necronomicon: "That is not dead which can eternal lie, And with strange aeons e
Health policy and management is the field relating to leadership and administration of public health systems, health care systems and hospital networks. Health care administrators are considered health care professionals. Health policy and management or health systems management or health care systems management describes the leadership and general management of hospitals, hospital networks, and/or health care systems. In international use, the term refers to management at all levels. In the United States, management of a single institution is referred to as "Medical and health services management" "Healthcare management" or Health Administration. Health systems management ensures that specific outcomes are attained, that departments within a health facility are running smoothly, that the right people are in the right jobs, that people know what is expected of them, that resources are used efficiently and that all departments are working towards a common goal. Social determinants have been shown to influence health.
However, at present, population health receives only five percent of national health budgets. By comparison, 95 percent is spent on direct medical care services, yet medical care only accounts for only 10-15 percent of preventable mortality in the United States. Genetics, social circumstances, environmental exposures, behavioral patterns comprise the bulk of health determinants of health outcomes, considered when creating health policy. At the federal level, policymakers are addressing social determinants through provisions in the Affordable Care Act, in which non-profit hospitals must conduct community health needs assessments and participate in community improvement projects; the creation of public-private partnerships by hospitals has occurred in many states, has addressed social determinants of health like education and housing. Federal and local governments can improve population health by evaluating all proposed social and economic policies for potential health impacts. Future efforts within health policy can incorporate appropriate incentives and tactical funding for community-based initiatives that target known gaps in social determinants.
Needs assessments may be conducted in order to identify the most effective mechanisms for each given community. Such assessments may identify a demand for increased and reliable forms of transportation, which would allow individuals to have continuous resources to preventative and acute care; as well, funding for job training initiatives within communities with low employment would allow individuals to build their capacity to not only earn income, but engage in health-seeking behaviors which are at an elevated cost. Unwarranted variations in medical practice refer to the differences in care that cannot be explained by the illness/medical need or by patient preferences; the term “unwarranted variations” was first coined by Dr. John Wennberg when he observed small area and practice style variations, which were not based on clinical rationale; the existence of unwarranted variations suggests that some individuals do not receive adequate care or that health resources are not being used appropriately.
The main factors driving these variations are: complex healthcare technology, exponentially increasing medical knowledge and over reliance on subjective judgement. Unwarranted variations have measurable consequences in terms of over/under utilization, increased mortality, increased costs. For example, a 2013 study found that in terms of Medicare costs, higher expenditures were not associated with better outcomes or higher quality of care. Medical practice variations are an important dimension of health policy and management - understanding the causes and effects of variations will guide policymakers to develop and improve upon existing policies. In managing practice variations, it is important to perform assessments of the diseases/procedures with high levels of unwarranted variations. Policymakers should take a comprehensive approach to align policies and technology in order to reduce unwarranted variations in care. Effective reduction requires active patient involvement and physician engagement though standardization of clinical care with a focus on adherence to care guidelines and an emphasis on quality based outcomes.
The medical industrial complex is the network of corporations which supply health care services and products for a profit. The term was derived from the language that President Eisenhower had used when warning the nation, as he was retiring, about the growing influence of arms manufacturers over American political and economic policies; the term "medical industrial complex" started to spread from 1980 through the New England Journal of Medicine by Arnold S. Relman who served as an editor of the journal from 1977 to 1991. According to Dr. Relman, American health care system is a profit-driven industry and it has become a accepted theory these days. Since the term was introduced 40 years ago, health care industry has developed into a larger and flourishing industry. Medical industrial complex includes proprietary hospitals and nursing homes, diagnostic laboratories, home care and emergency room services, renal hemodialysis units, a wide variety of other medical services, provided by public or private not-for-profit community-based institutions or by private physicians in their offices.