Cognitive Impairment Screening in Senior Citizens

I told you three times yesterday you had a doctor's appointment and that I was going to come pick you up. † Judy shuffled back to the kitchen to double check her calendar, followed by her daughter. Both of them stopped in their tracks, taking in the ransacked kitchen. Her daughter asked what had happened in here, but Judy couldn't answer her. She was beside herself. Who could have possibly broken into her home and torn her kitchen apart? Dementia has reared its ugly head. Phil Just wanted to pay for his Reuben. He had been out and about running errands and was very hungry.The young man behind the counter had tried to charge his debit card more than a few times, but to no avail the card was denied each time. Phil began to recant his day to himself. Then It dawned on him, he had closed his bank account only a few hours before. Phil was getting ready to move down to Texas with his son due to his recent diagnosis of Alchemist's. Phil was a regular at the dell and the manager gave h im the Reuben on the house. â€Å"One of the worse things about this rotten disease Is losing the ability of taking care of myself† (Phil Rolled, 2010). Just frustrating for me, not to remember what I need to do to Just feel like I still can live and take care of myself. † This Is a common frustration expressed by those suffering diseases like dementia and Dementia is a costly disease; for the five million people like Phil and Judy living tit the disease in the United States, for Phil and Judy family, and for the government. Earlier detection and intervention of dementia would provide Phil and Judy the time to plan for the future and get the utmost benefit from available treatments.Earlier detection and intervention of the disease would lessen the future financial burden on health care. Cognitive impairment screening would ascertain if early intervention is needed. Cognitive impairment screening in senior citizens must become practice. Dementia is used as an umbrella te rm; describing a wide range of symptoms that include a progressive decline in mental ability severe enough to interfere with daily life. Dementia slowly robs Phil and Judy of their memories. At first, they experience problems with their short-term memory such as remembering an appointment.As time passes, the disease steals more and more of the brain. Phil and Judy eventually will not be able to respond to their environment, nor will they be able to express when they are in pain, or hungry, or thirsty, or when they have to go to the bathroom. A true diagnosis is rare, because dementia affects everyone differently. There is no ere. Dementia is considered an old person's disease. It's normal to forget where you left your keys when you're 65 years old or to forget where you parked the car. Contrary to popular belief, dementia is not a normal part of aging.Alchemist's is the most common type of dementia, but there are many other types. One of the biggest risk factors in developing dement ia is a person's age. Unless someone has stumbled onto the fountain of youth, no one can change or hide from their age. Persons age 65 and older have a greater risk of suffering from dementia. Every five years those Hansen double, so by the time Judy is 85 years old – her chance is nearly 50 percent. Today, there is an estimated five million people living with a dementia related disease in the United States. (What is Dementia, n. D. With the first wave of Baby Boomers already at age 68, the cost of dementia in 40 years is expected to exceed $1. 2 trillion (Alchemist's Fact and Figures, n. D. ). In 2010, the worldwide costs associated with dementia equaled one percent of global GAP. One percent doesn't seem like much on a global scale. However, if dementia care was a company; Dementia Inc. Loud be considered the world's largest by annual revenue. (GE Healthcare, 2014) The Alchemist's Association predicts the total number of dementia-related cases in the United States will reac h 14 million in the year 2050.Our healthcare system and the Medicare program are already strained. As the Baby Boomers get older, are we going to be able to weather the suffocating financial squeeze this disease is going to create? Phial's family is lucky to catch the disease before it has progressed too far, his son will be able to take care of him at home until the disease progresses further. The average cost for caring for someone at home is $12,500 per year. As the disease robs Phil of more brain function, more skilled care is required. Families can be billed anywhere from $42,000 to $72,000 per year.Victims and their families can easily deplete their savings on medical care and then turn to Medicare/Medicaid and tax payers to help with the remaining costs. Judy may have already passed the opportune time to either stay at home with her daughter or have in-home care and ultimately needs to go live either in an assisted living or nursing themselves for the price of skilled care. S enator Tom Harkin stated â€Å"The only way we are truly going to save Medicare from bankruptcy when the baby boomers retire is to reduce the length and incidence of expensive illnesses like Alchemist's. Harkin, Chairman of the Appropriations Subcommittee on Labor, Health and Human Services, and Education, and Related Agencies recently held a hearing in February of 2014 to inspect the financial impact of Alchemist's in America (Bethlehem, 1998). But how do we reduce the length of disease that has a difficult diagnosis and no cure in the foreseeable future? We need to be looking at intervention opportunities. All things considered, some will argue that dementia-related diseases are only a small part of a much bigger problem, dismissing the idea that the disease could bankrupt Medicare. Projections of the frequency of a disease 30 years from now should be taken with a grain of salt,† said Gail Wiliness, chairman of the federal Physician Payment Review Commission (Bethlehem, 199 8). â€Å"We don't know how the frequency of other disease will rise or fall, and how that will affect longevity. † She went on to commend the fact that medical research has allowed people to live longer lives and improve quality of fife. However, she questioned whether the research has saved us any money.Wiliness almost sounds like she is agreeing with another rarely expressed view that concludes if we devote more money and effort into finding a cure for dementia; that will only prolong the life of the elderly by a few more years. Crudely put, if you don't die of complications from dementia, you'll still die of something else. Understandably, we can't avoid death. That is an inevitable fact of life. If we as a community could act early, if we as a community could provide intervention, what kind of standard would e set for the rest of the nation?Earlier detection of dementia could provide earlier intervention, delay the impact of the disease, and prevent significant health ev ents in the future. Does that process sound familiar? In 2013, The United States Preventive Services Task Force recommends women get a mammogram every 2 years starting at age 50 to keep proactive about breast cancer (Mammograms Fact Sheet). Furthermore, the same task force recommends oscilloscopes in adults beginning at age 50 and continuing until age 75 (at different intervals depending on family history) o prevent colon cancer.Curious, I went to the U. S. Preventive Services Task Force website on Recommendations for Adults. I found preventative information on 19 different cancers and 11 different types of heart disease. I found nothing on dementia or Alchemist's. Nothing. Alchemist's disease is the 6th leading cause of death in the United States (Leading Causes of Death, 2011). The top five include heart disease, cancer, chronic lower respiratory disease, and stroke. All five of those diseases all have preventative measures and are routinely screened for in our annual heck-ups wit h our doctors.What needs to be addressed though is why there is more prevalence on detecting cancers and heart disease? John Morris, professor of neurology and co-director of the Alchemist's disease research center at Washington University's School of Medicine, believes we should find a way to distinguish between the normal aging process and early dementia and build more interest (Bethlehem, 1998). This is where a cognitive assessment could help bridge that gap. A cognitive assessment is an examination that is used to determine someone's level of cognitive function.A group of 2,719 elderly residents in Almagest County, Minnesota were 2014). The doctors conducting the case knew from earlier studies that elderly residents would sometimes have a cognitive assessment that indicated some impairment, but when examined again later, the impairment had lessened or completely gone away. During this trial, 40% of people with a mild cognitive impairment reverted back to a more normal state. At the end of the study, the doctors found that 65% of those â€Å"reverts† went on to develop dementia (Berliner, 2014).While this study shows that not everyone who has cognitive impairments may o on to develop dementia, the doctors were certainly more aware of any changes. Unfortunately, there isn't one type of assessment test that is better than the others. However, the Alchemist's Association website has recommended several cognitive assessment tools that can be performed in less that or around five minutes in a primary care or community setting. Not only are there patient assessment tools, there are informant tools for family members and close friends to use as well. Utilizing these assessments Just once isn't going to do the trick.Then again, imagine f the U. S. Preventative Services Task Force recommended a cognitive assessment screening every two-three years starting at age 65. Cognitive impairment screening must become practice for senior citizens. The assessments may n ot garner conclusive data, but over time we will be able to create a clearer picture as to how dementia slowly progresses. From that picture, we will develop earlier intervention techniques to help ease not only the financial strain on Phil and Judy and their families, but ease the frustration felt by dementia's victims.

Chemistry Lab Experiment: The Flame Test Essay

Flame test: AIM: To determine which part of the salt is responsible for the characteristics in the flame. HYPOTHESIS: If we introduce a metal salt in the blue flame of the Bunsen burner, then the colour given off by the flame is due to the metal part of the salt. METHOD: (1)With a heat proof mat under the Bunsen burner, turn the gas on and light up the Bunsen burner with matches. (2)Pour enough Hydrochloric acid into a beaker. (3)Using your wire, dip it into the beaker containing Hydrochloric acid (4)Place it into the flame for a few seconds; this is the cleaning method to avoid contamination of other solutions. If the Bunsen burner flame does not change colour, then your wire is clean and you can proceed to dip it into a metal salt. (5)Dip your wire into a metal salt either the nitrate or chloride and place the wire onto the tip of the blue flame. (6)Observe the change in colour of the Bunsen burners flame and record the observations as you go. (7)As long as you clean the wire as directed in step 3-4 you can proceed into testing the other metal salts. QUESTIONS: Q1: Were there any main difference between the chloride salts and the nitrate salts? If there was please comment on what it was Yes, I had observed some difference between the colour produced from the chloride and nitrate salts present in one flame test. The strontium flame admitted both a similar orange colour, but the strontium nitrate has a much more vibrant dark orange than the strontium chloride. Q2: Suggest reasons why the experiment tested both nitrate and chloride salts? The experiment tested both nitrate and chloride salts to allow us to compare which part of salt is responsible for the colour change of the flame. Q3: Suggest why flames on gas stove burn orange-yellow when a small amount of water boils over onto them? This is due to the chemicals present in the water; such as sodium chloride, calcium ion. The orange-yellow flame admitted could also be due to the ingredients added to the water such as salt. Discussion: When the metal salt is introduced to the flame, the electrons absorb heat energy and can jump into a higher energy level. Because the electrons are now at a higher and more energetically unstable level, they fall back down to their original shell, by doing so visible light is emitted due to the energy release. Name a possible source of experiment error and suggest at least one way to reduce the effect: A possible experimental error that could have effect the result is contamination of metal salts. As directed in the steps you must clean the wire using hydrochloric acid. By doing this you are removing any traces of the previous metal salts that could alter the true colour of the flame produce by a different metal salt. By reusing the same wire at each metal salt, you could reduce the effect. Each wire will be completely free of contamination of other metal salts as it will be exposed to only one metal salt. CONCLUSION: Data collected from the flame test identified that both chloride and nitrogen tested were identical, meaning metal is responsible for the colour produced in the flame. This is evidence that strongly supports my hypothesis; therefore I accept my hypothesis on that basis.

Garbology Assignment Essay Example | Topics and Well Written Essays - 250 words

Garbology Assignment - Essay Example ermined person with a strong belief in my cause, which is why I have managed to stick to what I think is right despite the many temptations that I may see or even smell in daily life. Considering all that, it would not be a big step to assume that I have a soft spot for animals and may be an animal rights activist, that I may be the type to be following organizations such as PETA which help out the creatures. This may also lead one to think that I do not own any products for which an animal may have been sacrificed. These could be minks or anything made of leather like jackets, boots and bags. The next thing that one may notice are the white, disposable cups, plates and even the cutlery: forks and spoons. This could either mean that I do order take out despite the vegetable and fruit peels seen earlier perhaps when I am, supposedly, too tired to cook. Or it could also mean that I do not like washing dishes which is why I have bought the disposable items. Maybe I am allergic to the contents of the washing liquids. One may even assume that I have enough money to be doing that on a daily purpose. Buying and throwing away paper utensils when I could have just spent some money on some china, which would be durable and save me money in the long run and is just so much more sensible. Next, there are lots of empty wrappers of some kinds of candies and even chocolates. But, one cannot see any packets of crisps or any other savory eatable, which are usually so very popular, particularly amongst the youngsters. This is a dead giveaway about me having a sweet tooth and not caring much about the salty or spicy food that is available is such abundance everywhere. Most of the wrappers are red and yellow colored, which shows how much of a fan I am of Reese’s in particular. There are also several crumpled balls of paper – all stained with blue ink – peeping out from under the rest of the rubbish. One can see tiny writing on some of them instead of the black, printed text,

Marketing Strategy & Planning Assignment Example | Topics and Well Written Essays - 3000 words

Marketing Strategy & Planning - Assignment Example reet from Port Clinton Square, which is home to numerous events throughout the year, and in the midst of a number of fine restaurants, 50% of our business each day is usually after dinner. In addition, The Company is fortunate to have tremendous landlords whom bring partnerships. (Liebebenson, 2014) The place is strategically chosen due to the population traffic and the availability of consumers. The firm deals in the provision of authentic Italian Gelato, ice cream products, provision of coffee and other products. The main include gelato and other, creameries, cakes and drinks. They also deal with shop fitting restaurants, designing and also deal with specialized events actions agency. (Villareal, 2011) The company serves mostly artisan gelato and sorbet (24 gelato flavors; 12 sorbet flavors) made fresh daily in their kitchen on site. They also serve specialty products made from dairy, including cakes, Frostbites (small balls of gelato/sorbet hand dipped in chocolate), milkshakes, sorbettinis (sorbet and Pellegrino), the worlds finest root beer floats and assorted coffee drinks. (Liebebenson, 2014) The business is growing steadily across the content. Over the last years the turnover has increased significantly. This has enabled the profitability of the company to also increase as the company opens other branches in UK, US and other Europeans countries. The upward trend has enabled the company to strategies in expansion. The ice cream in the US has saturated mature markets with 92% of household consumption. The ice cream sells about $25.1B in 2012 and its growth is 2.4% annually. (Corper, 2013) Frost gelato operates in a competitive environment. It lies within the perfect competition market where there is free entrance and exit of customers. There is perfect competition from Nestle and Uniliver who have about 24% and 18% respectively of market share. The ice cream in the US has saturated mature markets with 92% of household consumption. The ice cream sells

Why the current third level colleges are not using emerging technology Essay

Why the current third level colleges are not using emerging technology in the classroom to teach students - Essay Example Additionally, the studies done by Becker, and by Bonk and Fischer, show the significant effects that using online instruction and other forms of technological interaction can have on the learning of primary and elementary students. If students are learning to use emerging technology at a young age, and have attuned their minds to the high levels of visual stimulation that come from a computer screen, how can they be expected, once they emerge from secondary school and enter a third-level institution, to turn their attention to an auditory presentation? Bednar, Duffy and Perry’s paper about converting theory into practice is an instructive look at the ways in which the idea of technological instruction can be made practical. Instructional modules and online presentations can take the information from an auditory presentation and make it appear in a completely different medium to students used to watching their instruction. Jonassen’s study of the ways that students use the Internet has come to demonstrate the ways that the Internet is now used to solve problems. One example of this, of course, is the fact that the word google has become a commonly used verb in the English language. The card catalogues that were in every library thirty years ago have long since been superseded by the computer terminal, which sends students not only to print resources in that particular library, but to resources that are available on the World Wide Web to print anywhere. Research has become a much faster, less burdensome process, although the former drudgery of the card catalogue has, in some sense, been replaced by the need to vigilantly make sure that sources are reliable and valid. Finally, Duit’s research on the proper limits to put on student creativity is instructive. His analysis of the ways in which science students learn shows how free-ranging their studies should be permitted to

Conflict in America Legalizing Marijuana Research Paper

Conflict in America Legalizing Marijuana - Research Paper Example During the previous government, this drug was illegal; however, when Obama’s government took power, it legalized marijuana and several states followed suit. This did not amuse the federal government, who were opposed to the move; it criticized the act and even went forth to pronounce legal action on those states and people found trading marijuana. Since this is an issue that may threaten national stability in the United States, it can be resolved by having the two bodies harmonize and come up with the best solution, rather than living with disputes. Keywords: Marijuana, State Laws, Federal Laws Every new government in the US comes with its own laws that favor it; the laws made reflect the promises of the new government and its political party. During the reign of President George W. Bush between the years 2001 to 2009, the government had enforced laws against marijuana. It took actions against those who dealt with the drug. However, when the government of President Obama took office, there was a different approach on marijuana; the government no longer took actions against those who were trading on the drug. According to Morgan (2011), the attorney general announced that the government was no longer going to deal with issues of marijuana peddling anymore. The announcement caused a lot of uproar from those who did not support the idea. The memorandum by the attorney general acknowledged the presence of conflict on marijuana between the federal and the state laws. As at present, the federal laws prohibit all deals on marijuana and according to the US drug enforcement administration, marijuana lacks a safe way of using it and has a high potential of becoming abused (Morgan, 2011). On the other hand, the state laws do not conform to the federal laws. An example of this is California, which became the first state to legalize marijuana, and 15 other states soon followed it. The many conflicts surrounding marijuana are not only found at federal and state domain s. This issue is also present in the medical domain; there are two contrasting arguments of medics concerning marijuana, with one group arguing that the use of marijuana has no effect to the body and the other arguing that it has effects. The American thoracic society reported that most marijuana users had no increased lung infections, while the British lung foundation had filed a report in 2002 citing the adverse effects of marijuana in the human body (Morgan, 2011). Conflict on marijuana is a major issue and of great concern. The greatest effect to Obama’s government is in the political arena. This is because most of those who are opposed to the move could use this chance to ambush an attack to the government, especially given that during the reign of the Republican Party, Marijuana was banned. Democrats’ risk losing their popularity among anti-marijuana citizens and organizations. Most international organizations and nations classify marijuana as a drug and in most countries, its use and trade is prohibited and punished by law. Permission by American government to its citizens to trade and use marijuana offers risks to the country; these include risks of losing reputation amongst international communities among others. In the New York Times, Savage (2012) informs that, â€Å"Several had cautioned that the issue had raised several legal and complex issues†. The complex issues were based on international antidrug

The Internal Auditor, Management, and the Forensic Accountant Essay

The Internal Auditor, Management, and the Forensic Accountant - Essay Example These measurements are carried out by continuous auditing mechanisms practiced by Internal Auditors such that timely alerts can be raised against negative trends or non-compliances within the system. Such auditing can continuously evolve quick fixes in the form of corrective actions that can be taken on a fly and also evolve long term effective preventive actions. Moreover, if data integration is carried out effectively by applying effective integrated frameworks like Balanced Score cards and using corporate governance tools like Business Activity Monitoring or Business Performance Monitoring, then continuous monitoring of risks and fraud become a reality. In this paper, we review literature pertaining to roles and responsibilities of Internal Auditors and their responsibilities to consider Fraud in audit of Financial Reports. First Literature: Understanding Internal Audit by Rickard, Peter, pages 30 to 34; Journal published by Australian Accountant, Melbourne in April 1994. This Journal has been included herewith because it presents a comprehensive discussion on role of Internal Auditors and the expectations from them from a legacy perspective and Peter Rickard is an Accountant specialized in Audit and Fraud Control along with being the member of Performance Management International. As per Peter, the management of an organization expects that the Internal Auditor would keep a close watch on the actual implementation of their instructions & policies in the organization and provide feedback on who is not performing in the organization. In addition, he argues that the Internal Auditors are expected to ensure compliance with Government Policies, Legislations and Regulations. He explained the management expectations from an Internal Auditor under three categories - Functional, Personal and Other. Under funct ional, it is argued that an Internal Auditor is expected to serve as the eyes & ears of the management and under personal, it is argued that the internal auditors should be well qualified, trained, certified & possesses high ethics & integrity. Under the category other, it is argued that the audit findings & fraud detection should be timely & proactive such that effective corrective actions can be taken without delay. The author argues that Internal Auditors cannot be made scapegoats for everything going wrong in the organization because they primarily work on audits based on samples which may not be the true representation of the actual problems. As per the Author, the primary tasks of internal auditors are - Audit Planning, Audit Reporting, Measuring Audit Performance, and bridging the gaps by taking corrective & preventive actions. They should not be taken as "negative informers" who always report "bad news". The perspective of this author is to save an Internal Auditor from over expectations of a Management. However, in the modern world the businesses drive what the

Classroom Management and Discipline to Accommodate the Needs of a Research Proposal

Classroom Management and Discipline to Accommodate the Needs of a Diverse Student Population - Research Proposal Example Instead, the changing demographics of students require teachers to engage in continuous professional development. The introduction will give an overview of the structure of the essay. Apart from the Introduction, there are three major parts of the essay that builds on the argument that I wish to present. The final part is the conclusion, which summarizes the points I will raise to emphasise my argument. The second section will give a comparative analysis of major theories and philosophical issues in learning and its relationship with classroom management. This discussion with then highlight effective classroom management, specifically those that minimise disruptive behaviours while optimizing learning. This section will examine the relationship of learning theories and classroom management. It will draw out from major philosophical trends that manifest in the relevant literature discussing classroom management. It will touch on behavioural management techniques and learning theories. Based on the previous discussion, I will present what are the contemporary strategies and techniques on classroom management. The strategies will be compared based on the objectives that they aim to address. I will then discuss the impact of context in lesson planning and classroom management. I will discuss the importance of socio-cultural background and justify the need to incorporate these factors in the learning environment. I will discuss the common practices to accommodate and adapt instruction to the diverse needs of the students. This section will provide a critical analysis of the issues relating to addressing the challenge of teaching a diverse population. The conclusion will re-introduce the purpose of the essay and provide a summary of the issues discussed. It will then give a comprehensive overview in support of the argument that I wish to

Why is old world wine dropping down in uk Essay - 3

Why is old world wine dropping down in uk - Essay Example During the same period the author find that the New World wine has grown by 3.4%, whereas Old World wine has lost the market share by around 2%. xliv The wine market in UK has been the central hub of wine collection from all over the world. Until recently the Old World economies have been leading in the UK wine market for supplying the classic wines. However, with the emergence of the New World wine producers offering a huge array of wine to choose from along with aggressive promotional strategies have overpoweringly grabbed the market from the hands of the Old World wine manufacturers. The Old World countries like France which used to enjoy monopoly for decades in exporting its tradition-rich wines to the UK markets are now being dominated by the New World economies like Australia with incredible marketing techniques. Factors like poor branding, restricted labelling, inconsistent quality and inept promotional strategy have together led to the decline of the Old World wine producers in the UK wine market. To combat this severe threat an intensive reviewing of attitudes towards brands is exactly what is required for the Old World wine producers to recapture the wine market in UK from the hands of the New Wold wine manufacturers. Understanding the consumers’ needs in today’s modern wine market, adopting clear labelling, recognizing the increasingly stylish wine supply chain, filling the huge information gaps is exactly what is required from the manufacturers of Old World wines. Hence, it is only through the union of innumerable small Old World wine producers reviewing their entire branding strategy that the possibility of their sustainability in the UK wine market prevails. Various European wine producing economies are undergoing tough times in UK wine market (Harrop, 2006). France, Spain, Italy and Portugal, the leading wine producers of the world are gradually losing their

Price Elasticity of Demand Essay Example | Topics and Well Written Essays - 1000 words

Price Elasticity of Demand - Essay Example With changes in market dynamics, burgeoning population, increasing competition in job markets, and rapid technological changes that out phase odd manual jobs, demand for formal education has skyrocketed over the last decade. This happens as people strive to better their competitiveness in securing formal employment. Placing the  high value on academic certificates as an essential aspect in securing any employment has led to an increased demand for further education across  the  board, which in turn creates high demand for colleges and universities, giving way to the proliferation of many institutions offering bachelor degrees and masters as well. A study on income levels among employees with different academic qualifications reveals that there are wide disparities in salaries of diploma, the  degree, and masters degree holders. Salaries increase with  the  increase in academic qualifications with master’s degree holders earning twice as much as degree holders who i n turn earn twice what high school diploma holders earn on average. Those with no formal education form the bulk of unemployed population across the country, often performing poorly paid manual jobs in homesteads, municipal councils and mining zones among other similar places. Office jobs are a preserve for the highly qualified in  the formal education, especially those with bachelor degrees and above. Management jobs are common with master’s degree holders and those with many certificates in support courses.... Other factors that affect the elasticity of demand include changes in income levels, persistence of price changes, and product demand patterns among others. With changes in market dynamics, burgeoning population, increasing competition in job markets, and rapid technological changes that out phase odd manual jobs, demand for formal education has skyrocketed over the last decade. This happens as people strive to better their competitiveness in securing formal employment. Placing high value on academic certificates as an essential aspect in securing any employment has led to an increased demand for further education across board, which in turn creates high demand for colleges and universities, giving way to the proliferation of many institutions offering bachelor degrees and masters as well. A study on income levels among employees with different academic qualifications reveals that there are wide disparities in salaries of diploma, degree and masters degree holders. Salaries increase with increase in academic qualifications with master’s degree holders earning twice as much as degree holders who in turn earn twice what high school diploma holders earn on average. Those with no formal education form the bulk of unemployed population across the country, often performing poorly paid manual jobs in homesteads, municipal councils and mining zones among other similar places. Office jobs are a preserve for the highly qualified in formal education, especially those with bachelor degrees and above. Management jobs are common with master’s degree holders and those with many certificates in support courses relevant to their field of occupation. This state of affairs places high value

Fetal Alcohol Syndrome Essay Example for Free

Fetal Alcohol Syndrome Essay Fetal alcohol syndrome (FAS) is a set of physical and mental birth defects that can result when a woman drinks alcohol during her pregnancy. When a pregnant woman drinks alcohol, such as beer, wine, or mixed drinks, so does her baby. Alcohol passes through the placenta right into the developing baby. The baby may suffer lifelong damage as a result. FAS is characterized by brain damage, facial deformities, and growth deficits. Heart, liver, and kidney defects also are common, as well as vision and hearing problems. Individuals with FAS have difficulties with learning, attention, memory, and problem solving. Fetal Alcohol Spectrum Disorders (FASD) is an umbrella term describing the range of effects that can occur in an individual whose mother drank alcohol during pregnancy. These effects may include physical, mental, behavioral, and/or learning disabilities with possible lifelong implications. The term FASD is not intended for use as a clinical diagnosis. FASD covers other terms such as: Fetal alcohol syndrome (FAS) the only diagnosis given by doctors. Alcohol-related neurodevelopmental disorder (ARND) reserved for individuals with functional or cognitive impairments linked to prenatal alcohol exposure, including decreased head size at birth, structural brain abnormalities, and a pattern of behavioral and mental abnormalities Alcohol-related birth defects (ARBD) describes the physical defects linked to prenatal alcohol exposure, including heart, skeletal, kidney, ear, and eye malformations Fetal alcohol effects (FAE) a term that has been popularly used to describe alcohol-exposed individuals whose condition does not meet the full criteria for an FAS diagnosis What are the Statistics and Facts about FAS and FASD? FASD is the leading known preventable cause of mental retardation and birth defects. FASD affects 1 in 100 live births or as many as 40,000 infants each year. An individual with fetal alcohol syndrome can incur a lifetime health cost of over $800,000. In 2003, fetal alcohol syndrome cost the United States $5. 4 billiondirect costs were $3. 9 billion, while indirect costs added another $1. 5 billion. Children do not outgrow FASD. The physical and behavioral problems can last for a lifetime. FAS and FASD are found in all racial and socio-economic groups. FAS and FASD are not genetic disorders. Women with FAS or affected by FASD have healthy babies if they do not drink alcohol during their pregnancy. Can I drink alcohol when I am pregnant? No. Do not drink alcohol when you are pregnant. When you drink alcohol, such as beer, wine, or mixed drinks, so does your baby. Alcohol is a substance known to be harmful to human development. When it reaches the blood supply of the baby, it can cause permanent defects to the major organs and central nervous system. Is there any kind of alcohol that is safe to drink during pregnancy? No. Drinking any kind of alcohol can hurt your baby. Alcoholic drinks can include beer, wine, liquor, wine coolers, or mixed drinks. What if I am pregnant and have been drinking? If you drank alcohol before you knew you were pregnant, stop drinking now. Anytime a pregnant woman stops drinking, she decreases the risk of harm to the baby. If you are trying to get pregnant, do not drink alcohol. You may not know you are pregnant right away. What if I drank during my last pregnancy and my baby was fine? Every pregnancy is different. Drinking alcohol may hurt one baby more than another. You could have one child that is born healthy and another child that is born with problems. What if a friend, partner, spouse or family member is drinking while pregnant? Many women are unaware of the consequences of drinking during pregnancy. Some women believe wine or beer is not alcohol. In many cases, she may be suffering from alcoholism. She may need to know what effects alcohol can have on the baby. She also may need help getting into treatment. In such cases, you should contact a treatment professional at a local addiction center for advice on how to help. http://www. nofas. org/faqs. aspx? id=5 Copyright 2001-2004 National Organization on Fetal Alcohol Syndrome An individuals place, and success, in society is almost entirely determined by neurological functioning. A neurologically injured child is unable to meet the expectations of parents, family, peers, school, career and can endure a lifetime of failures. The largest cause of neurological damage in children is prenatal exposure to alcohol. These children grow up to become adults. Often the neurological damage goes undiagnosed, but not unpunished. Fetal Alcohol Syndrome (FAS), Fetal Alcohol Effects (FAE), Partial Fetal Alcohol Syndrome (pFAS), Alcohol Related Neurodevelopmental Disorders (ARND), Static Encephalopathy (alcohol exposed) (SE) and Alcohol Related Birth Defects (ARBD) are all names for a spectrum of disorders caused when a pregnant woman consumes alcohol. There are strategies that can work to help the child with an FASD compensate for some difficulties. Early and intensive intervention and tutoring can do wonders, but the need for a supportive structure is permanent. Studies on addiction in Ontario have shown about a 10 12% alcohol addiction rate among adults, with another 20% drinking to a level that places them at high risk. Legally intoxicated is defined as a Blood Alcohol Level of . 08%. A 100 lb (45 kg) female consuming 5 standard drinks (A drink equals a 12 oz. regular beer, 1 oz. shot of 100 proof liquor, 1. 5 oz. shot of 80 proof liquor, or 4 oz. glass of regular table wine) will reach a BAL of . 25% three times the legal limit. BAL reduces . 01% per hour. The Statistics Canada, Canadian Community Health Survey, 2000/01 found that: 6. 8% of girls ages 12 to 14 19. 8% of girls age 12 to 19 26. 0% ages 20 to 24 19. 9% ages 20 to 34 consumed 5 or more drinks on each occasion 12 or more times per year. An additional: 32. 2% ages 15 to 34 13. 8% of girls ages 12 to 14 consumed 5 or more drinks on each occasion 1 to 11 times per year. Copyright  © 2005 Journals and Procedural Research Branch Office of the Legislative Assembly of Ontario, Toronto, Ontario, Canada. Most girls are 2 to 3 months pregnant before they find out. Given the prime childbearing age range, the odds are very high that about 20% of babies have been exposed to multiple binges in high levels of alcohol in the first trimester, before the girl even knew she was pregnant. It is Party Hearty Time. The vast majority of these girls are NOT alcoholics. About 50% of pregnancies are unplanned. If you are drinking, stay out of the backseat as well as the drivers seat! Maternal prenatal alcohol consumption even at low levels is adversely related to child behavior. The effect was observed at average exposure levels as low as 1 drink per week. The Canadian Centre for Childrens Research at McMaster University Hospitals (Hamilton Ontario) states that 20% of Canadian children have serious mental health issues. Typical of school boards in Canada, a major southwestern Ontario School Board (urban / rural mix) with 28,000 Elementary and Secondary School students, has 6,000 students receiving services from the Special Education Department. Of the 6,000, only 250 are classified as Gifted with the balance having significant disabilities (20. 6%). While not all the individuals with disabilities are identified as the disabilities having been caused by prenatal exposure to alcohol, the vast majority of the disabilities are of types known to be caused by prenatal alcohol exposure. FASD is so grossly under-reported that the FAS statistics are almost meaningless. There are very few doctors who have received any training in diagnosing FASD and most prefer to use non-judgmental diagnoses such as ADD, ADHD, LD, MR, RAD, ODD, Bi-Polar, Tourettes, etc.. These diagnoses dont imply the mother has done something that could have affected her baby during pregnancy. However, they can also lead to inappropriate treatment and a lifetime of pain. Failure to identify the real source can lead to more children being born with the same issues to the same mothers and the cycle continuing into the next generation FASD children having FASD babies. Alcohol, hormones, a twitch in the kilt, poor impulse control and inability to predict consequences are a deadly combination. Accidents cause people. FASD is not a threshold condition. It is a continuum ranging from mild intellectual and behavioural issues to the extreme that often leads to profound disabilities or premature death. Denial is not just a river in Egypt. Alcohol as a Teratogen on the Baby ? http://www. acbr. com/fas/. Problem: Fetal Alcohol Syndrome (FAS) is a pattern of mental and physical defects which develops in some unborn babies when the mother drinks too much alcohol during pregnancy. A baby born with FAS may be seriously handicapped and require a lifetime of special care. Some babies with alcohol-related birth defects, including smaller body size, lower birth weight, and other impairments, do not have all of the classic FAS symptoms. These symptoms are sometimes referred to as Fetal Alcohol Effects (FAE). Researchers do not all agree on the precise distinctions between FAS and FAE cases. Cause of the Problem: Alcohol in a pregnant womans bloodstream circulates to the fetus by crossing the placenta. There, the alcohol interferes with the ability of the fetus to receive sufficient oxygen and nourishment for normal cell development in the brain and other body organs. Possible FAS Symptoms: Growth deficiencies: small body size and weight, slower than normal development and failure to catch up. The fact sheets below were developed by many different authors. In some cases, the fact sheets were placed on the web by a different organization than the one that wrote the document. However, all of the fact sheets are in the public domain to encourage wide distribution. You are free to copy and use these fact sheets. The following list of abbreviations was used to indicate the source of the document in the links provided on this page. Many of the sites listed contain additional information beyond the fact sheets that are listed on this page. We encourage you to explore each site. http://www. well. com/user/woa/fsfas. htm RSmith:02-15-94 MISSOURI DEPARTMENT OF MENTAL HEALTH Division of Alcohol and Drug Abuse 1706 East Elm; P. O. Box 687 Jefferson City, Missouri 65102 The following Fetal Alcohol Spectrum Disorders (FASD) are caused by drinking alcohol during pregnancy: FAS: Fetal Alcohol Syndrome Symptoms include small head/body, facial characteristics, brain damage FAE: Fetal Alcohol Effects Symptoms usually not visible, such as behavior disorders, attention deficits ARBD: Alcohol Related Birth Defects. Anomalies such as heart defects, sight/hearing problems, joint anomalies, etc. ARND: Alcohol Related Neurodevelopmental Disorders Disorders such as attention deficits, behavior disorders, obsessive/compulsive disorder, etc. FASD: Fetal Alcohol Spectrum Disorders All of the disorders named above are contained in the spectrum. Full FAS comprises only about 10% of the spectrum. The other 90% may have fewer physical symptoms but are at greater risk for developing serious secondary conditions later. (Streissguth, 1997) FAS is the leading cause of mental retardation in western civilization. But Most persons with FAS have an IQ in the normal range. (Streissguth, 1997). The incidence of Fetal Alcohol Syndrome in America is 1. 9 cases per 1,000 births (1/500). Incidence of babies with disabilities resulting from prenatal alcohol exposure: 1/100! FAS/FAE is a major health issue in western civilization today. More American babies are born with FAS than with Down Syndrome, MD, and HIV combined. Alcohol causes more neurological damage to the developing baby than any other substance. Lecture Summary Fetal alcohol syndrome is among the most common known causes of mental retardation and as such, it is a major public health problem. The purpose of this lecture is to provide a basic overview of what we know about the effects of prenatal alcohol exposure. It is certainly not meant to be comprehensive but rather to give a broad overview of current knowledge in the area, and of ongoing human and animal research in the area. Heavy prenatal alcohol exposure can result in the fetal alcohol syndrome and both changes in brain structure and behavior have been reported in these children. Importantly, current data indicate that individuals exposed to heavy doses of alcohol in utero, but without the facial characteristics of FAS, can also suffer from similar brain and behavioral changes. Animal models have proven to be an excellent research tool in this field, as there appears to be good concordance between the animal and human data. The animal models provide a means to examine mechanisms of alcohol damage, to control for factors not possible in most human studies, and to help answer important clinical questions. Fetal alcohol effects are preventable, and every child born with a defect related to prenatal alcohol exposure indicates a failure of the health care system. Lecturer Dr. Ed Riley http://rsoa. org/lectures/07/index. html Background Fetal alcohol syndrome is among the most common known causes of mental retardation and as such, it is a major public health problem. The purpose of this lecture is to provide a basic overview of what we know about the effects of prenatal alcohol exposure. It is certainly not meant to be comprehensive. For more detailed overview, the following references might be helpful. It is important to remember that as the mother consumes alcohol and her blood alcohol level rises, that alcohol is freely crossing the placenta and the embryo or fetus is being exposed to the same blood alcohol levels. References Stratton, K. , Howe, C. , Battaglia, F. (1996). Fetal alcohol syndrome: Diagnosis, epidemiology, prevention, and treatment. Washington, DC: National Academy Press. Streissguth, A. P. (1997). Fetal Alcohol Syndrome: A Guide for Families and Communities. Baltimore: Paul H. Brookes Publishing Co. Background Fetal alcohol syndrome is among the most common known causes of mental retardation and as such, it is a major public health problem. The purpose of this lecture is to provide a basic overview of what we know about the effects of prenatal alcohol exposure. It is certainly not meant to be comprehensive. For more detailed overview, the following references might be helpful. It is important to remember that as the mother consumes alcohol and her blood alcohol level rises, that alcohol is freely crossing the placenta and the embryo or fetus is being exposed to the same blood alcohol levels. References Stratton, K. , Howe, C. , Battaglia, F. (1996). Fetal alcohol syndrome: Diagnosis, epidemiology, prevention, and treatment. Washington, DC: National Academy Press. Streissguth, A. P. (1997). Fetal Alcohol Syndrome: A Guide for Families and Communities. Baltimore: Paul H. Brookes Publishing Co. Background What each of these papers described was a common set of features that could occur in the offspring of mothers who drank heavily during their pregnancies. This constellation of features was named the Fetal Alcohol Syndrome in 1973 by Jones and colleagues. In order to be diagnosed as having FAS, the individual MUST meet all three criteria. There is a specific pattern of facial anomalies, which will be shown shortly. There is pre and or postnatal growth deficiency. Usually the children are born small (7drinks/week 5 or more drinks per occasion). The data on the left side of the slide come from Louise Floyd of the CDC. The first four studies were sponsored by the CDC and the other two estimates on the left side come from the IOM report (Stratton, 1996). AI/AN stands for American Indian/Alaska Native. The numbers on the right side are from a recent study by Sampson et al. , (1997). They demonstrated rates of FAS of at least 2. 8/1000 live births in Seattle, 4. 6/1000 in Cleveland, and between 1. 3 and 4. 8/1000 in Roubaix, France. Interestingly, in this study they estimate the prevalence in Seattle for FAS and ARND at 9. 1/1000 births. This would mean that nearly 1 in every 100 children is affected by prenatal alcohol exposure. The last number from South Africa is from recent work done by Phil May and colleagues. References Egeland G, Perham-Hester KA, Gessner BD, Ingle D, Berner JE,Middaugh JP. Fetal Alcohol Syndrome in Alaska, 1977 through 1992: An administrative prevalence derived from multiple data sources. American Journal of Public Health. 1998. 88(5): 781-786. Aberdeen IHS Area (1995) MMWR. vol 44(#):253-261. BDMP (1995): MMWR Vol. 44(13):249-253. Atlanta, Ga. (1997) MMWR Vol. 46(47): 1118-1120. Sampson, P. D. , Streissguth, A. P. , Bookstein, F. L. , Little, R. E. , Clarren, S. K. , Dehaene, P. , Hanson, J. W. , Graham, J. M. , Jr. (1997). Incidence of fetal alcohol syndrome and prevalence of alcohol-related neurodevelopmental disorder. Teratology, 56(5), 317-326. Stratton, K. , Howe, C. , Battaglia, F. (1996). Fetal alcohol syndrome: Diagnosis, epidemiology, prevention, and treatment. Washington, DC: National Academy Press. Institute of Medicine: 1996 Clinic-based (page 89), American Indian/Alaskan Native (page 88) May, P. , Viljoen, D. , Gossage, J. , Brooke, L. , Croxford, J. (1999). An epidemiological analysis of data from children with fetal alcohol syndrome and controls in Wellington, South Africa. Alcoholism: Clinical and Experimental Research, 23 (5), 110A. May, P. , Viljoen, D. , Gossage, J. , Brooke, L. , Croxford, J (1999). An update on the maternal risk factors associated with the prevalence of fetal alcohol syndrome in Wellington, South Africa. Alcoholism: Clinical and Experimental Research, 23 (5), 91A Background It must be stressed that the facial characteristics basically define FAS. Without these facial features, one cannot be diagnosed with FAS. In particular, the discriminating features are short palpebral fissures (the length of the eye opening), a flat midface, an indistinct or flat philtrum (the ridge under the nose), and a thin upper vermilion (lip). While each of these can occur in a variety of disorders, the combination of these features appears to be consistent with heavy prenatal alcohol exposure. Children with FAS can also have other facial features, such as epicanthal folds (tiny folds of tissues along the eye opening), a low nasal bridge, an underdeveloped jaw and minor ear anomalies. These individuals can also have a variety of associated features. Heart defects, skeletal anomalies, altered palmar creases (those creases on your hands), and urogenital anomalies are among the anomalies found more frequently in FAS. Reference Streissguth, A. P. (1994). A long-term perspective of FAS , Alcohol Health Research World (Vol. 18, pp. 74-81). image Facies in fetal alcohol syndrome Background The brain on the left was obtained from a 5-day-old child with FAS while the brain on the right is a control. The effects are obvious. The brain on the left suffers from microencephaly (small brain) and migration anomalies (neural and glia cells did not migrate to their proper location in the brain, but instead many of them simply migrated to the top of the cortex). Although it cannot be seen here, there is also agenesis of the corpus callosum and the ventricles are dilated. The corpus callosum is the major fiber tract connecting the two hemispheres of the brain (more on this later). Major findings of other autopsies of children with FAS have found microcephaly, hydrocephaly, cerebral dysgenesis, neuroglial heterotopias, corpus callosum anomalies, ventricle anomalies, and cerebellar anomalies. It must be pointed out, however, that these autopsies have typically been conducted only on the most severe cases, since these children often have enough problems that they do not survive. The interested reader on the pathological changes that occur in FAS is referred to the following articles. References Clarren, S. K. (1986). Neuropathology in fetal alcohol syndrome. In J. R. West (Ed. ), Alcohol and Brain Development (pp. 158-166). New York: Oxford University Press. Roebuck, T. M. , Mattson, S. N. , and Riley, E. P. (1998). A review of the neuroanatomical findings in children with fetal alcohol syndrome or prenatal exposure to alcohol. Alcoholism: Clinical and Experimental Research, 22 (2),339-344. Image brain damage resulting from prenatal alcohol Background The image on the left is a normal midsaggital MRI scan of the human brain with the cerebrum and cerebellum pointed out. The data on the right show the reduction in size of the these two areas in children with FAS and PEA. PEA stands for Prenatal Exposure to Alcohol, and includes children with known histories of heavy prenatal alcohol exposure, but who lack the features necessary for a diagnosis of FAS. As can be seen, the extent of reduction in the volume of both the cerebrum and cerebellum is significant. While the PEA group shows a reduction in volume, with these sample sizes, this is not a significant difference. Other brain imaging studies indicate disproportionate size reductions in the basal ganglia, cerebellum, and corpus callosum. The data are presented as percent of normal matched controls. References Mattson, S. N. , Jernigan, T. L. , Riley, E. P. (1994a). MRI and prenatal alcohol exposure. Alcohol Health Research World, 18(1), 49-52. Archibald, S. L. , Fennema-Notestine, C. , Gamst, A. , Riley, E. P. , Mattson, S. N. , and Jernigan, T. L. (submitted, 2000). Brain dysmorphology in individuals with severe prenatal alcohol exposure. image change in brain size Background One anomaly that has been seen in FAS is agenesis of the corpus callosum. While not common, it occurs in FAS cases (~6%) more frequently than in the general population (0. 1%) or in the developmentally disabled population (2-3%). In fact it has been suggested that FAS may be the most common cause of agenesis of the corpus callosum. In the top left picture, is a control brain. The other images are from children with FAS. In the top middle the corpus callosum is present, but it is very thin at the posterior section of the brain. In the upper right the corpus callosum is essentially missing. The bottom two pictures are from a 9 year old girl with FAS. She has agenesis of the corpus callosum and the large dark area in the back of her brain above the cerebellum is a condition known as coprocephaly. It is essentially empty space. Most children with FAS do have a corpus callosum, although it may be reduced in size. The reduction in size occurs primarily in the front and rear portions (genu and splenium). One interesting item is that this same pattern of reduction in the genu and splenium has been found in ADHD children. The behavioral problems seen in FAS frequently are similar to those seen in ADHD. References Mattson, S. N. , Jernigan, T. L. , Riley, E. P. (1994a). MRI and prenatal alcohol exposure. Alcohol Health Research World, 18(1), 49-52. Mattson, S. N. , Riley, E. P. (1995). Prenatal exposure to alcohol: What the images reveal. Alcohol Health Research World, 19(4), 273-277. Riley, E. P. , Mattson, S. N. , Sowell, E. R. , Jernigan, T. L. , Sobel, D. F. , Jones, K. L. (1995). Abnormalities of the corpus callosum in children prenatally exposed to alcohol. Alcoholism: Clinical and Experimental Research, 19(5), 1198-1202. Background There have been over a dozen retrospective studies of children with FAS (total N = 269). Overall, these studies, such as the Seattle studies or studies out of Germany, reported an overall mean IQ of 72. 26 (range of means = 47. 4-98. 2). The data presented here were collected in San Diego, CA as part of a project at the Center for Behavioral Teratology. The mean IQ performances of children with FAS were compared to alcohol-exposed children with few if any features of FAS. All children in this study were exposed prenatally to high amounts of alcohol, however only the FAS group displayed the craniofacial anomalies and growth deficits associated with the diagnosis. The other group was designated as having prenatal exposure to alcohol (PEA) and had documented exposure to high levels of alcohol but were not dysmorphic, microcephalic, or growth-retarded. In comparison to normal controls, both groups of alcohol-exposed children displayed significant deficits in overall IQ measures as well as deficits on most of the subtest scores. While the PEA subjects usually obtained marginally higher IQ scores than those with FAS, few significant differences were found between the two alcohol-exposed groups. These results indicate that high levels of prenatal alcohol exposure are related to an increased risk for deficits in intellectual functioning and that these deficits can occur in children without all of the physical features required for a diagnosis of FAS. Our PEA subjects may be somewhat similar to individuals identified by other groups as having FAE, however individuals with PEA display few if any of the facial features of FAS, and are not growth retarded or microcephalic. References Streissguth AP, Aase JM, Clarren SK, Randels SP, LaDue RA, Smith DF (1991). Fetal alcohol syndrome in adolescents and adults. Journal of the American Medical Association 265:1961-1967. Mattson, S. N. , Riley, E. P. , Gramling, L. , Delis, D. C. , and Jones, K. L. (1997). Heavy prenatal alcohol exposure with or without physical features of fetal alcohol syndrome leads to IQ deficits. Journal of Pediatrics, 131 (5), 718-721. Mattson, S. N. and Riley, E. P. (1998). A review of the neurobehavioral deficits in children with fetal alcohol syndrome or prenatal exposure to alcohol. Alcoholism: Clinical and Experimental Research, 22 (2), 279-294. image general intellectual performance Background. This was a study of a broad range of neuropsychological tests, such as: The Wide Range Achievement Test- which assesses academic skills, the Peabody Picture Vocabulary Test and the Boston Naming test-both assessment of basic language functioning, the California Verbal Learning Test-a list learning and memory test, the Visual-Motor Integration Test which measures basic visual-perceptual skills, the Grooved Pegboard test-a test of fine-motor speed and coordination, and the Childrens Category Test-a measure of nonverbal learning. Along the x-axis are the tests included in the battery; for comparison purposes, all scores were converted to standard scores with a mean of 100 and an SD of 15. Children with FAS or PEA showed deficits in comparison to controls and they were very similar to each other. There does seem to be some indication that the nonverbal measures (on the right of the slide) are not as impaired as the verbal and academic measures, which are on the left and center of the slide. The take home message is that children with FAS and those exposed to high amounts of alcohol, but without the characteristics required for a diagnosis of FAS, are similarly impaired. The FAS children tend to be a bit worse than the PEA children, but the pattern of behavioral deificits is fairly similar over a wide range of tests. References Mattson, S. N. , Riley, E. P. , Gramling, L. , Delis, D. C. , Jones, K. L. (1998). Neuropsychological comparison of alcohol-exposed children with or without physical features of fetal alcohol syndrome. Neuropsychology, 12(1), 146-153. image neuropsychological performanceBackground In addition to the abilities already discussed, a few studies have documented other specific neuropsychological deficits in individuals with FAS. Children with prenatal alcohol exposure, with and without FAS, have demonstrated various deficits on measures of executive functioning. These measures have revealed problems in areas such as planning (tower task-shown above), cognitive flexibility (trails test), inhibition (stroop test), and concept formation and reasoning (word context tests). Generally, performance on these measures is characterized by increased errors and more difficulty adhering to rules. Therefore, children are less successful overall. For example, on the tower measure shown above (Tower of California-similar to Tower of London), children with FAS and PEA passed fewer items overall and made more rule violations than controls. The only two rules were to never place a larger piece on top of a smaller one and to move only one piece at a time. As can be seen the alcohol exposed children had many more rule violations. In addition, deficits have been found on the WCST (Wisconsin Card Sort Test), a nonverbal measure of problem solving. The WCST test requires both problem solving and cognitive flexibility and has been proposed to be sensitive to frontal system dysfunction. This test is a gold standard in the measure of executive functioning in neuropsychology. Children with prenatal exposure to alcohol made more errors and had more difficulty with the conceptual nature of the task than controls. New data indicate that they have trouble identifying and defining concepts. Finally, tests of planning ability are also thought to be sensitive to frontal systems dysfunction although few such studies have been done in individuals with FAS. On the Progressive Planning Test which is similar to the Tower of London test children with FAS/FAE had difficulty with planning ahead and tended to perseverate on incorrect strategies. So far the results could be summarized as: 1) Heavy prenatal alcohol exposure is associated with a wide range of neurobehavioral deficits including visuospatial functioning, verbal and nonverbal learning, and executive functioning 2) Heavy prenatal alcohol exposure causes microcephaly and disproportionate reductions in the corpus callosum, basal ganglia, and cerebellum 3) Children with and without physical features of the fetal alcohol syndrome display qualitatively similar deficits References Carmichael O. H. , Feldman JJ, Streissguth AP, Gonzalez RD: Neuropsychological deficits and life adjustment in adolescents and adults with fetal alcohol syndrome. Alcoholism: Clinical and Experimental Research 16:380, 1992 Kodituwakku PW, Handmaker NS, Cutler SK, Weathersby EK, Handmaker SD: Specific impairments in self-regulation in children exposed to alcohol prenatally. Alcoholism: Clinical and Experimental Research 19:1558-1564, 1995 Mattson, S. N. , Goodman, A. M. , Caine, C. , Delis, D. C. , Riley, E. P. (1999). Executive functioning in children with heavy prenatal alcohol exposure. Alcoholism, Clinical and Experimental Research, 23(11), 1808-1815. Background Secondary disabilities are those disabilities that the individual is not born with, and hopefully with appropriate intervention could be ameliorated. This slide illustrates the extent of these secondary disabilities as a function of age. These are individuals with FAS and FAE. As can be seen over 90% of these individuals have mental health problems and about 50% of those over the age of 12 have disrupted school experiences, trouble with the law, which is frequently severe enough to require confinement. They also engage in relatively high rates of inappropriate sexual behavior and a significant number have alcohol and drug abuse problems. Interestingly, the factors that are protective against these secondary disabilities are: Being raised in a stable, nurturant home, diagnosis before the age of 6, no sexual or physical abuse, not changing households every few years, not living in a poor quality home, and receiving Developmental Disabilities services. References Streissguth, A. P. , Barr, H. M. , Kogan, J. , Bookstein, F. L. (1996). Final Report: Understanding the occurrence of secondary disabilities in clients with fetal alcohol syndrome (FAS) and fetal alcohol effects (FAE). Seattle, WA: University of Washington Publication Services. Image secondary disabilities Background. Much of what we know about FAS and the effects of prenatal alcohol exposure is the result of work on animal models. After FAS was identified it became important to demonstrate that the effects were indeed the result of alcohol exposure and not due to factors such as other drugs, maternal conditions, or nutritional variables. The development of appropriate animal models was very important in this regard. Models were developed for assessing physical features of FAS as well as the behavioral, neuroanatomical, and neurochemical profiles of prenatal alcohol exposure. The ideal test animal would absorb, metabolize and eliminate alcohol similar to human, transport alcohol and metabolites across.

Evaluating Strengths and Weaknesses of Reason as a Way of Knowing Essay Example for Free

Evaluating Strengths and Weaknesses of Reason as a Way of Knowing Essay This paper that I am writing on is a piece of paper; that is undeniable fact. Hundreds of years of development and definition also back up this statement as do any scientific experiments carried out upon it in an effort to prove that this piece of paper is indeed a piece of paper. Yet through reasoning the fact that this is a piece of paper can be disputed and even proved wrong. Reason seems like an excellent way to work out the world around us. It uses all of the facts available to come up with a suitable hypothesis which can be tested and either proved or disproved through experimentation. This is the foundation of science, which is what the majority of people would trust. So anything proved through scientific means is therefore and irrefutable fact. Of course, in every experiment write up there is an acknowledgement that the data collected might not be completely accurate or that the interpretation of results might be wayward but again this is perfectly reasonable. It is reasonable to assume that despite your best efforts you may have got the answer wrong and another answer, no matter how unlikely, may be correct. As well as reason being proved by scientific experiment it can also be proved by historical fact. For example, it is undisputable fact that on 30th May 1431 Joan of Arc was burned at the stake. That cannot be argued with, it was that date and will always be that date no matter what happens in the future and every history text or website would agree with that fact. So it is therefore illogical to start claiming that Joan of Arc died last week as historical facts, which are perfectly reasonable, tell us otherwise. However, does reason really help us in our quest for knowledge or is it a poor way of finding out about the world? Despite much scientific investigation and historical knowledge there are many questions in the world that are left unanswered and unexplained. These questions are sometimes fundamental to life itself. For example, how are we conscious beings that can interact with the world beyond purely animal instincts? This question could possibly be explained by the electrica l impulses in the brain that form our thoughts but how can we have developed into any kind society purely through electrical impulses? In this case, using reason to explain what is happening almost seems unreasonable as the potential answer seems not to be able to completely cover the question. After all, if it is only electrical impulses, then what need is there for a person to be able to be able to create a symphony with an orchestra? As well as reason not being able to answer some questions there are some problems with following logical arguments. Logical fallacies are the main example of this. This is where through looking at two or more facts a conclusion is drawn which is false. For example: Cake is food, food is tasty, and therefore cake is tasty. However, this is obviously not true as whilst some cake may be tasty, perhaps even the majority; this does not mean to say that all cake is tasty. After all a burnt cake is not that tasty! Also not only is the conclusion false the two facts through which the conclusion is derived can also be said to be false. After all, any cake that I bake should not be classed as food and not all food is tasty. This statement is far too general and is a large problem with logical fallacies as they generally come to a wrong conclusion, both through the ignorance of other factors as well as the fact that often the facts are not completely accurate in the first place. Lateral thinking is also something which at first seems illogical yet (often) in hindsight becomes logical. It is creative thinking which does not merely follow the most logical steps to reach an answer. For example a suggested solution to the Arab-Israeli conflict in the Middle East was to ship vast amounts of Marmite to the area. This seems utterly senseless, as surely holding talks and making agreements between the two sides would be the best steps forward. However, on examining the idea further it becomes logical, if creative! In the typical diet of people in the Middle Eastern area there is a lack of zinc due to the main diet of unleavened bread. This lack of zinc creates aggression. Marmite contains a lot of zinc and therefore could be used to solve the problem in the Middle East. Whilst this solution does not seem reasonable it would work and so shows that reason is not always the best policy. There is also a difference in opinion between what people may think is logical and illogical. Many people in the world take illogical decisions and believe illogical knowledge. Or they seem to do so. Religion is a major factor in many people’s lives and it affects many of the things that they think and do. Due to this people may make a decision that seems illogical to secular people which is perfectly logical to religious people. This brings up the question of; what is reason? After all if two different decisions about the same thing are made and are both reasonable to those people it begs the question of whether or not reason itself can be defined. Is reason just a matter of opinion or is there a yardstick by which all reasonable decisions can be made. If we look back at the British Empire one of the purposes of that was to; â€Å"Make the world England† rather then to respect what other cultures thought and did. In many small islands in the Far East a warrior culture was common and often tribes would fight each other for prestige rather then for anything else. However, to the British this seemed barbaric, yet without it the culture fell apart. For them it was reasonable for this to take place, the knowledge they had seemed to point to the fact that this was a good thing. But not for the British who had a very different opinion through the knowledge that they had acquired. To conclude reason as a way of knowing has both strengths and weaknesses. The weaknesses are that a difference of opinion means that people will reason differently too making it an irregular method of making decisions and acquiring knowledge. Reason may also not be the best policy as more creative solutions may be better which can be derived through latera l thinking. Also logical fallacies call into question the validity of reason as they produce false results through logical steps. As well as this we cannot answer some fundamental questions through reason. However, reason is often the best way that we can make decisions in the world. Scientific experiment and historical knowledge are two very good examples of how reason cannot be changed and is therefore very valuable as it allows us to have consistency with our knowledge. Of course religion means that some inconsistency comes into play with our knowledge but on the whole reason is often the best policy.

Popular Religion And Popular Culture Religion Essay

Popular Religion And Popular Culture Religion Essay Popular religion and popular culture in the late twentieth and early twenty-first centuries can also be understood by the way in which individuals and groups belonging to the mainstream religion engage their faith. Expressions of popular religion can often be at considerable variance from what is officially supposed to be deemed as sacred. In this respect, popular religion absorbs many attributes of human experience that might be looked down on by purveyors of traditional religion. Amongst various aspects of American life, contemporary popular religion can be best identified in regards of Hollywood films, pop music, popular literature, comic books, and the Internet. The evolution of Hollywood films involving religious themes has been rooted largely in the biblical epic. As a popular genre during the 1950s and 1960s, key examples of these epic religious films include The Robe (1953), The Ten Commandments (1956), Ben-Hur (1959), King of Kings(1961), and The Greatest Story Ever Told (1965) among others. These films usually had huge cinematic scale, massive production budgets and box-office celebrities such as Richard Burton, Jean Simmons, Max Von Sydow, Charlton Heston, Deborah Kerr, and Yul Brynner. In the late 1960s and early 1970s, there were numerous horror films with religious themes, most notably Rosemarys Baby (1968), The Exorcist (1973), and The Omen (1976). In Rosemarys Baby, a young, innocent Manhattan housewife is deceived by a coven of witches into giving birth to the eponymous child who is actually the son of Satan. The Exorcist was a horror film that dealt with a young girls demonic possession and her wealthy mothers desperate attempts to rescue her daughter through an exorcism by two Catholic priests. Serving as the pinnacle of the demon child movies of the era, The Omen is the story of a wealthy diplomats family unknowingly adopting a child who is actually the Antichrist foretold in the Book of Revelation. Representing an interesting blend of story elements from both Rosemarys Baby and The Exorcist, The Omen spawned several sequels as well as a remake. There are a great variety of Jesus movies that have made their way to the silver screen. In 1961, MGMs release of King of Kings (a remake of Cecil B. DeMilles 1927 film of the same title) was the first attempt by a major film studio to produce a religious epic in which the Christ Event was its main focus. That movie was followed years later other cinematic renditions of Jesus such as The Greatest Story Ever Told (1965), the musical Jesus Christ Superstar (1973), The Last Temptation of Christ (1988), The Passion of the Christ (2004), and most recently The Color of the Cross (2006). By illustration, Martin Scorseses The Last Temptation of Christ (1988) portrays the last days of Jesus Christ as he is tempted by Satan by glimpses of what life might have been like had Jesus not been crucified including marrying and making love with Mary Magdalene. Based on Nikos Kazantzakis 1960 novel of the same name, the movies main point is that Jesus, while free from human sin, might have still been v ulnerable to all manners of temptation that humans face, including doubt, fearful reluctance, lustful yearning, and regret. By confronting and ultimately conquering all of humanitys weaknesses, Jesus struggled to do Gods will while never surrendering to earthly temptations. At the films end, Christ finally rejects all temptations and the film concludes with the crucifixion. As can be imagined, this film generated a considerable deal of controversy due to its subject matter. The Passion of the Christ (2004) is a film co-written, co-produced and directed by Mel Gibson. According to Gibson, the films primary source material is derived from the Christs passion narratives found in the four synoptic Gospels despite taking creative liberties of incorporating quotes and images from both the Hebrew Bible and New Testament. While deliberately mirroring traditional representations of the Passion in visual art, the film recounts depiction of the last 12 hours in the life of Jesus of Nazareth, particularly the arrest, trial, torture, and crucifixion of Jesus. In spite of criticism regarding the extreme violence, historical inaccuracy, and perceived anti-Semitic references, the overwhelming success of the studios marketing campaign amongst Catholics and evangelical Christians helped the film set numerous box-office records simultaneously. Having earned roughly $400 million, The Passion of the Christ holds the record for the most pre-release ticket sales and the highe st-grossing R-rated film in U.S. history as well as the highest-grossing religious film worldwide. Furthermore, because the films dialogue is entirely spoken in Aramaic, Latin, and Hebrew with English subtitles, The Passion of the Christ is also the highest grossing non-English language film to date. While many religious films since the 1950s were typically based on Christian stories, other films have been based in other religious traditions. For instance, The Message (Mohammed: The Messenger of God) (1976) based upon Islamic history and stirred great controversy upon its release. The film depicts the historic moment when the prophet Mohammed receives the Word from Allah during the 7th century A.D. in the Middle East still dominated by polytheism. After this fateful event, Mohammed begins sending his messengers to proclaim the basic teachings and tenets of Islam throughout the Middle East. The films production was complicated by the fact that, according to the teachings of the Quran, neither any likenesses can be shown of the prophet Mohammed and his extended family nor the image and voice of God ever be depicted in any medium. To overcome this challenge, the lead role of Mohammed was as an absent protagonist while the character of Mohammeds uncle served as a replacement for Moha mmed who alternately uttered lines and listened off-screen to a voice the audience never heard to avoid the heresy of depicting images of either Allah or Mohammed. Filmmakers Joel Coen and Ethan Coen have wrestled with issues of Jewish film representations. Two of the Coen brothers films, Barton Fink (1991) and The Big Lebowski (1998), are especially noteworthy for their diverse abundance of overtly albeit offbeat Jewish characters. The Coens brothers have been accused of depicting anti-Jewish ethnic stereotypes in their numerous films such as Bernie the Shmatte, a cravenly duplicitous hustler, in their third feature film, Millers Crossing (1990). However, their film A Serious Man (2009) is a remarkably provocative and poignant portrayal of Jewish American experience during the 1960s culled from their childhood memories of growing up in St. Louis Park, a suburban Jewish community south of Minneapolis, Minnesota. Drawing heavily from the cultural tradition of Ashkenazic Judaism, the film centers on the Job-like professional and private plights of Larry Gopnik, a physics professor undergoing a crisis of faith. Struggling to make sense of his ruin ed life, Gopnik desperately seeking metaphysical advice and spiritual guidance from three rabbis to become a person of substance. Ultimately the film grapples with theological issues pertaining to the human suffering in ways that strive to reconcile the spiritual and the absurd. Popular Religion and Popular Music The emergence of popular music is one of Americas greatest cultural achievements and since the mid-20th century has had several inspired practitioners whose lives and recordings in the music industry that helped energize the American society by defining a new outlook where the sacred and the secular coexisted within the mainstream. For example, Aretha Franklin was born in Memphis, Tennessee as one of five children belonging to Rev. C. L. Franklin, a famous Baptist minister, and Barbara Siggers Franklin, a singer and pianist. Franklins parents had a troubled relationship and separated for the final time when Aretha was six, leaving her and her siblings to be raised by their paternal grandmother, Rachel Franklin. During her childhood, the home was regularly visited by many of her fathers famous friends including Clara Ward, Sam Cooke, and Mahalia Jackson. In the presence of such gospel music legends, Franklins talents both as a self-taught piano prodigy and a gifted singer with an extr aordinary vocal range became apparent by the time she entered her teens. As noted in her autobiography, Franklin stated that her early gospel singing was patterned after Albertina Walker. Although early motherhood nearly derailed Franklins gospel career, once she decided to return to singing professionally as a pop musician rather than a gospel artist. When she signed a contract with Atlantic Records and began working with legendary RB producer Jerry Wexler to incorporate a more gospel element into Franklins evolving musical sound. By the end of the 1960s, Franklins designation as the reining Queen of Soul was clearly established. Although most of her albums were best sellers during this era, the release of Amazing Grace (1972) eventually sold over two million copies in the United States and has been hailed as the best-selling gospel album of all time. Marking a triumphant return to her gospel roots, the songs on Amazing Grace were recorded live at New Temple Missionary Baptist Chur ch in Los Angeles, California alongside her father as well as gospel legend and family friend Rev. James Cleveland with backing vocals by the Southern California Community Choir in January 1972. In the late 1970s, Bob Dylan became a born-again Christian and released two albums of Christian gospel music: Slow Train Coming (1979) and Saved (1980). When working on Slow Train Coming with Jerry Wexler, the veteran RB producer, Dylan had started to evangelize to him during the recording. Wexler replied: Bob, youre dealing with a sixty-two-year old Jewish atheist. Lets just make an album. The album won Dylan a Grammy Award as Best Male Vocalist for the song Gotta Serve Somebody. When touring from the fall of 1979 through the spring of 1980, Dylan would not play any of his older, secular works. Realizing that there was considerably vocal backlash to his embrace of Christianity by some of his fans and fellow musicians, Dylan frequently delivered declarations of his faith from the stage. Another iconic figure in the realm of popular music that underwent deep religious conversion was the country music legend Johnny Cash.  Rediscovering his Christian faith in the early 1970s, Cash recalled taking an altar call at Rev. Jimmy Rodgers Snows Evangel Temple, a small church in Nashville, TN because, unlike many larger churches, he said that the pastor and congregation treated like just a regular parishioner and not a celebrity. His friendship with famed Christian minister Billy Graham led to the production of The Gospel Road, a film about the life of Jesus, that Cash both co-wrote and narrated. The decade saw his religious conviction deepening, and he made many evangelical appearances on Billy Graham Crusades around the world. In 1986, Cash published his only novel, Man in White, a book about Sauls conversion into the Apostle Paul. In 1990, Cash also recorded Johnny Cash Reads The Complete New Testament. Matisyahu is an American Hasidic Jewish reggae musician renowned blending traditional Jewish themes within reggae, alternative rock, electronica, and hip hop sounds. Matisyahu was born in West Chester, Pennsylvania as Matthew Paul Miller on June 30, 1979. His family eventually relocated to White Plains, New York where he was raised as a Reconstructionist Jew. While Matisyahu was an ardent music lover, he attended Hebrew school at Bet Am Shalom, a synagogue located in White Plains. At the age of sixteen, Matisyahu participated in a semester-long immersion program at the Alexander Muss High School in Hod Hasharon, Israel that allowed him deeper exploration of his Jewish heritage. This overall experience affected his feelings towards Judaism so greatly that he eventually adopted Orthodox Jewish lifestyle by becoming a Baal Teshuva by 2001. Initially he found his way to the Carlebach Shul on the West Side of Manhattan. Matisyahu then found his way to Chabad of Washington Square. From 200 1 until 2007, Matisyahu was affiliated with the Chabad-Lubavitch Hasidic community in Crown Heights, Brooklyn, New York. Shortly after his embrace of hasidism, Matisyahu began studying Torah at Hadar Hatorah, a yeshiva for returnees to Judaism As one example of his devotion, he will not perform in concert on Friday nights in faithful observance of the Jewish Sabbath. He later recounted such diverse influences as Phish, Bob Marley and the Wailers, God Street Wine and Rabbi Shlomo Carlebach among his musical inspirations. There is a proliferation of musical genres that represent a variety of religious backgrounds from Stryper (a Christian heavy metal band) to Creed (a Christian alternative / hard rock band) to the Kominas (a Punjabi taqwacore-Islamic hardcore punk rock-group) to A Tribe Called Quest (an African American hip-hop group predominantly composed of Sunni Muslim converts). In the 1980s,  Stryper was a Christian heavy metal band from Orange County, California, USA. The name Stryper derives from Isaiah 53:5 (KJV):But he was wounded for our transgressions, he was bruised for our iniquities: the chastisement of our peace was upon him; and with his stripes we are healed. The scriptural reference is also part of Strypers logo on most of their releases. (They also incorporate stripes into most of their outfits and their logo.) Once the band embraced the name of Stryper, drummer Robert Sweet created a acronym which is: Salvation Through Redemption, Yielding Peace, Encouragement, and Righteousness. Not only did Stryper enjoy great mainstream success during the latter half of the 1980s, they are pioneers in the mainstream popularization of Christian metal music and even achieved a Grammy Award nomination. Stryper eventually broke up in 1992, which also marked the waning popularity of heavy metal as a musical genre. In the late 1990s and early 2000s, Creed was a popular, multi-platinum selling American alternative / post-grunge rock band from Tallahassee, Florida often identified as a Christian rock band. The band was never signed to a contemporary Christian music label, did not perform in Christian music venues and never got any widespread regular play on Christian radio, Creeds first three albums focused on themes of Christian faith and spirituality. Themes within their song titles such as Higher, My Sacrifice, Whats This Life For, My Own Prison, With Arms Wide Open, and One Last Breath the bands lyrics allude to Christian theology although they frequently refuted the Christian label. Similar to the Christian rock movement, The Kominas (whose name means bastards in Punjabi) are a Taqwacore punk band hailing from the suburbs of Boston, Massachusetts. The Muslim punk trio consisting of Basim Usmani, Shahjehan Khan, and Adam Brierly rock out with songs titles of Dishoom, Baby or Sharia Law in the USA. One of the Kominas best known songs, Rumi was a Homo, a protest song against homophobia within the American Muslim community, was featured in Skidmore Colleges Music Against Hatred concert. Written mainly by Usmani, the bands lyrics are clever, sometimes thought-provoking commentaries on racial profiling, foreign policy, and religious faith. The Kominas critically acclaimed debut album, Wild Nights in Guantanamo Bay, was released in March 2008.As a fusion of punk, metal, and Bhangra folk music The band uses the term Bollywood Muslim punk in order to describe their sound. The music and imagery typically draws from anti-colonial movements, Moghul art, American related to Islam, such as Moorish Science Temple, Five Percenters (an offshoot of the Nation of Islam), and Desi culture, Punjabi folklore, Sufi saints from Punjab, Hinduism, and Bollywood cinema. Formed in the late 1980s, A Tribe Called Quest was an African American hip hop group consisting of rapper/producer Q-Tip (Kamaal Ibn John Fareed, formerly Jonathan Davis), rapper Phife Dawg (Malik Taylor), and DJ/producer Ali Shaheed Muhammad that explored Sunni Islam. They released five albums in ten years, the first three of which were both critically acclaimed and commercially successful. By 1996, lead rapper Q-Tip underwent a deepy religious awakening and, upon spiritual guidance from his friend, Ali Shaheed Muhammad, soon converted to Islam. While on tour, Q-Tips friend introduced him to a talented young producer from Detroit named Jay Dee (also known as J Dilla). Immediately taking the newcomer under his wing, Q-tip and the rest of Tribe agreed to form a production unit with Jay Dee. The group named their production company The Ummah (meaning community, nation, or brotherhood in Arabic) because Q-Tip and Ali Shaheed Muhammad were devout Muslims. In addition to producing A Tribe Called Quests final two studio albums, the Ummah served as a music production collective that provided backing tracks for a wide array of RB and hip hop artists. Although the group officially disbanded in 1998 and Jay Dee death in 2006of a blood disease, their innovative blend of hip hop and jazz has left an indelible imprint upon hip hop music. Popular Religion in Popular Literature In the late 1990s and early 2000s, Tim LaHaye and Jerry B. Jenkins novel Left Behind: A Novel of the Earths Last Days officially launched a best-selling fictional series of 18 Christian-themed thrillers. It was narrative form to a specific apocalyptic reading of the Bible, particularly the Book of Revelation. This novel has received largely favorable reactions from the late Jerry Falwell and other leading figures in the Evangelical Christian community who generally approved of how the authors represented the millennial / apocalyptic themes within Christian theology in a worldly language that was also commercially viable within the entertainment industry. The interpretation of Revelation, as presented in the Left Behind series, also encourages a largely individualistic approach to eschatology and salvation that eschews any responsibility for performing good deeds or evangelizing. Regardless of such criticism, the overall sales for Left Behind series has surpassed 65 million copies and has also inspired several movies, graphic novels, CDs, a video game and a Left Behind series for teenagers. Similarly, author Dan Browns best-selling novels also include historical themes and Christianity as recurring motifs, and as a result, have generated controversy. Browns first novel, Angels Demons (2000) is bestselling mystery-thriller novel focused on fictional Harvard University symbologist Robert Langdons quest to uncover the mysteries of the Illuminati and to unravel a plot to destroy Vatican City by detonating antimatter. The book portrays a historical conflict between the Illuminati and the Roman Catholic Church as a contest between science and religion. Browns subsequent novel, The Da Vinci Code (2003) also examines ancient history, conspiracy theories of secret societies, religious symbolism, and classic architecture. Combining the detective, thriller, and conspiracy fiction genres, The Da Vinci Code provoked popular interest in speculation concerning the historic roots of Christianity. Despite being flatly denounced by many Christian denominations as a dishonest attack on t he Roman Catholic Church rife with historical and scientific inaccuracy, The Da Vinci Code is a worldwide bestseller that had sold roughly 80 million copies that has been translated into 44 languages. Popular Religion in Comic Books There are numerous examples of popular religion being utilized in the world of comic books and graphic novels. For instance, the DC Vertigo Comic book series Preacher chronicled the fictional exploits of Jesse Custer, a small town pastor in Annville, Texas who is experiencing an extraordinary crisis of faith. After Genesis, a creature described as the supernatural spawn of the inexplicable coupling between an angel and a demon, accidentally takes possession of him, Custer becomes a hybrid human-divine being that potentially wields enough power to ultimately rival even God. Inhabited by this spiritual force composed of both pure goodness and pure evil, the comic book portrays the title character of the comic book arguably becomes the most powerful being in existence. Tragically, this realization results in a disaster that turns his church to rubble and killed his entire congregation. Spurred by his highly developed sense of morality and a strong sense of purpose, the comic book illust rates Custers paranormal adventures as he treks across the United States in a quest to find God for himself both figuratively and literally. Following a trend within American comic books during the 1960s and 1970s very much akin to the Death of God theological movement, Preacher alludes to a God that has abandoned creation and thus has left humanity to its own devices for better or worse. During its publication from 1995 to 2000, Preacher was a controversial comic book series renowned by some and reviled by others for both its dark and frequently violent humor as well as its unabashed treatment of religious and supernatural themes. Since the 1970s, there have been several characters that accentuate various dimensions of spiritual practices prevalent throughout the African diaspora. A particularly notable example of an African American supernatural superhero named Brother Voodoo who appeared in a variety of comic books published by Marvel Comics during the 1970s. Returning to his native Port-au-Prince, Haiti after more than a decade of education and practice as a psychologist in the United States, Jericho Drumm assumes the alter ego of Brother Voodoo possesses numerous superhuman and mystical powers such as easily entering into a trance-like state in which his skin becomes impervious to burning and other forms of pain as well as being able to control flame and lower life forms; these are all power that the comic book creators attribute to the characters mastery of mystical rituals derived from the loa, the spirit-gods of Haitian vodou. As an attempt to introduce a character with a very unique ethnic, cultural, a nd religious background, Brother Voodoo was later followed by other figures in the Marvel pantheon of characters such as the female Captain Marvel whose alter ego, Monica Rambeau, hailed from the Creole religiosity of contemporary New Orleans or the character of Storm (aka Ororo Monroe) from the X-Men series whose backstory harkens to being an East African hailed as a demi-goddess because of her mutant ability to control the weather. While these are certainly not the first or only comic book characters of African descent to be introduced, these creations were attempts to merge issues of race and religion in interesting ways. Moving in a considerable different vein, the central figure in DC Vertigo Comics series Hellblazer is a character named John Constantine who pursues a mysterious life as a streetwise detective who frequently crosses the supernatural boundaries between heaven and hell in order to confronting various dangers of an occult nature in the ordinary world. As a foul-mouthed, chain-smoking, hedonistic cynic arguably working for the greater good, Constantine usually triumphs through guile, deceit and misdirection. At the end of his exploits, he typically makes more enemies in the process of resolving a particular conflict than the opponents he originally intends to defeat. Even though depicted as a duplicitous individual, the narrative shows Constantine to be a well-connected person who is supremely adept at making friends and has a wide array of otherworldly contacts and nefarious allies at his disposal. Consequently, the overarching narrative reveals Constantine to be a compassionate and occ asionally heroic figure struggling to overcome the influence of heaven and hell upon an otherwise unsuspecting humanity. In other words, the protagonist of Hellblazer serves as a fictional incarnation of the humanist anti-hero as a trickster of sorts. As such, this book is highly indicative of a trend in mainstream comic books that has been quite popular amongst comic book creators and fans alike wherein the mortal characters such as Constantine are imbued with an agnostic spiritual worldview over and above a sense of moral ambiguity as they unapologetically grapple with seemingly insurmountable hazards both mundane and arcane. On the whole, while there is no dearth of evidence of popular religion at work in comic books and graphic novels, there is presently a shortage dearth of academic research and discussion on the matter. Popular Religion and the Internet One of the most exceptional transformations in the emergence of popular religion in the latter half of the twentieth century has been the burgeoning presence of religion appearing on the Internet. From the mid-1990s to present, an exponential number of churches, synagogues, mosques, and temples have a firm foothold within cyberspace. Towards this end, there are numerous websites such as Streaming Faith.com and Beliefnet.com connect innumerable Christian communities nationally and internationally via the Internet with the increasing prospect of connecting with other religious groups in a virtual fashion. Since the inception and widespread use of the Internet in the 1990s, online Christian resources have tended to dominate religious themed content to date. This has been of particular importance given the presumption that most Internet users hailed from North America or Western Europe, regions deemed predominantly Christian. This assumed dominance has shifted due to the increasing level of Internet access and literacy by populations in the developing nations of the global South, most notably in Asia, Africa, and Latin America. Even though it is highly unlikely that the worlds religions ever will be fully and equally represented in cyberspace, the democratic impulse of the World Wide Web will cause the demographics to begin reflecting the religious diversity among a growing array of internet users worldwide. Moreover, for those members of faith communities that are relatively small and geographically isolated from a traditional house of worship, the World Wide Web provides these practitioners an alternate means of interaction and connection. By virtue of having Internet access, adherents of such faith traditions can receive update information about their religion, obtain latest spiritual resources, and engage in communications with other faithful believers. There are a variety of religious websites such as Torah Net (www.torah.net), Allaahuakbar Net (www.allaahuakb ar.net), Gospel Communications Network (www.gospel.com), Gateways to Buddhism (www.dharmanet.org) and The Witches Voice (www.witchvox.org) are religious oriented news and networking web resources that serve as lively examples of popular religion. See also Celebrity Culture; Electronic Church; Internet; Literature; Contemporary; Lived Religion; Pluralism; Popular Religion and Popular Culture entries; Radio; Spirituality: Contemporary Trends; Television; Visual Culture entries. Juan Floyd-Thomas