Environmental Effects on COPD

Environmental Effects on COPD Chronic Obstructive Pulmonary Disease (COPD) is an obstructive airway disorder characterized by the slowly progressive and irreversible decrease in forced expiratory volume in one second (FEV1), accompanied by emphysema and chronic bronchitis (Rabe et al. 2007; Cazzola et al. 2015); it develops with decreasing lung function as a function of age in the normal population (Ito and Barnes, 2009). Despite the heritability of 40-77%, a host of other influences can also exacerbate this condition (Young et al., 2009). Rather the development and progression of COPD involves multiple genes, gene-gene and gene-environment interactions (Ã…Â ½idzik et al. 2008; de Jong et al. 2015). Smoking exposure is considered as the most important risk factor for the development of COPD (Chan-Yeung et al. 2007; Kurmi et al.2015) with mild and moderate COPD cases having a three- fold risk of developing lung cancer within ten years, which increases to a ten-fold risk with severe COPD compared to the smokers with normal lung function (El-Zein et al. 2012). There also however exists COPD-associated increased mortality from lung cancer in non-ever smokers (Turner et al. 2007; Kiri et al. 2010; Aldrich et al.2015). Despite quarrying and mining activities as important occupational set-ups inducing COPD (Jhoncy et al. 2011; Iftikhar et al. 2009), yet work-place identification of this occupational disease has not come to attention on pursuing literature related to COPD. Also there is uncertainty in prognosis of COPD although a number of validated indices exist (Briggs et al. 2008). As these indices require in-puts from patients and the interpretation by the care-giver/physician, these may not be able to cater to disease-identification in the field. In the present study, the on-site disease-identification using the recommended spirometry evaluation (Briggs et al. 2008;Shiota et al. 2015) to recognize COPD cases at stone-crushing units (dust exposure) was carried out. Such an identification at the workplace gains importance as 50-80% of COPD are missed-out on the basis of misdiagnosis/co-current diagnosis due to relying on reported symptoms which are not sufficiently sensitive and / or because of fa ilure of persons to report to the health provider (Levy et al. 2009). The effect of various environmental stressors from occupational exposures needs to be assessed for prediction of cancer outcome(s) (Fenech, 2002) as 90% of cancer is environmental in origin (Hemminki et al. 2006). COPD has also been identified as an independent risk factor for lung cancer with inflammation as the pathophysiologic factor for high risk of its progression (Sin et al. 2006; Hillas et al.2015) and smoking- induced COPD associated with lung cancer has also been documented (Koshiol et al. 2009). While mechanisms governing the risk of developing neoplastic disease are not well known (Barreiro, 2008), of the various theories, oxidative stress may be playing a pivotal role in its manifestation. In COPD, oxidative stress has been observed as ensuing from decreased FEV1 (Kluchovà ¡ et al. 2007), substantial inflammatory response increasing cytokines as triggered by exogenous dust particles (Yang et al. 2011) and decreased antioxidants because of depletions of glutathione peroxi dase, superoxide dismutase (SOD), catalase, ascorbic acid and vitamin E (Borm et al. 2004). The impaired oxidant-antioxidant status can cause cellular damage; DNA damage can result from the action of reactive oxygen species (Jackson and Loeb, 2001) and is the underlying cause of mutations leading to cancer (Bernstein, 2012).Chromosomal damage (increased micronuclei frequency) in peripheral blood lymphocytes has been extensively used for predicting risk of cancer (Fenech et al. 2011) and oxidative DNA damage is also implicated in carcinogenesis, ageing and age-related neurodegenerative diseases (Fortini et al. 2003, Nishigori et al. 2004). The major form of oxidative DNA damage is 8-hydroxy-2`-deoxyguanosine (8-OHdG) resulting from G→T and A→C base substitutions. It may lead to mutagenesis if unrepaired and is directly correlated with lung carcinogenesis (Gackowski et al. 2006). The lesion 8-OHdG is an established biomarker of oxidative stress/oxidative DNA damage and being potentially mutagenic, it is useful as an intermediate marker of a disease end-point lik e cancer (Cheng et al. 1992). Therefore in the present study, 8-OHdG level was assessed as a pre-lesion of neoplasia in peripheral blood leukocytes (PBL) of COPD- identified cases at stone-crushing units. Although the leukocytes are not the direct target of the exposure at this workplace, they may possibly be affected by the accumulated unmetabolized toxic compound(s) in the lung (Gackowski et al. 2003). This hence prompted the assessment of oxidative DNA damage in the peripheral blood leukocytes and also because of the non- accessibility of the target (lung) cells. The biomarkers of exposure and effect, and clinical disease (cancer) may further be influenced by susceptibility genotypes and their gene products as pre-dispositional factors (Their et al. 2003). Also as DNA damage and DNA repair have a major role in carcinogenesis and from occupational settings, the susceptible metabolic genotypes (gene products) may inherently be associated in causing genetic damage. Therefore genotyping of the occupational workforce was carried out for glutathione-S-transferase (GST) gene variants (both for disease susceptibility and genetic damage) since GST alleles have been documented to have an association with COPD (Young et al. 2011). Furthermore, a reduced expression of these alleles has also been observed in the air passage of COPD patients (Imboden et al. 2001; Lakhdar et al. 2011) and hence the expression of glutathione-s-transferases was also estimated. Association of the Val/Ala variants of manganese superoxide dismutase (MnSOD) with lung cancer (Wang et al. 2001) further justified the genotyping of this allele and assessing its expression. Variant forms of these susceptible genes are generally common in the population. Due to their specificities for substrates they interact with during environmental exposures, they can increase the risk for disease-causation (Lan et al. 2000). Incidentally, GST and SOD enzymes are also involved in the metabolic and oxidative stress pathways (Borm et al. 2004), and since stone-crushing is an inflammation-triggering occupation (Vallyathan et al. 1995), the assessment of the amounts of these enzymes was thought appropriate. The purpose of the present study was two-fold. On one hand to identify COPD cases from workplace exposure (occupation-related disease) and hence assist in identifying ‘missing’ COPD cases using recommended (spirometry) measurements (Briggs et al. 2008, Young et al. 2011) and COPD categorizations (GOLD, 2003). The other (main) purpose was to determine the propensity (Prognostic Index/score) for genetic damage and by extension an increased likelihood for carcinogenesis as ensuing from the combined effects/interactions of prognostic (risk) factors in COPD cases (the workers exposed to industrial-type prevalent conditions) at stone-crushing units. This entailed the evaluation for the presence of oxidative stress (GSH and SOD) and oxidative DNA damage in workers at stone-crushing units genotyped for the GST and MnSOD genes.

Outsiders: Gang Members

The need to belong is a fundamental need within all of humanity, and has played a key role in society since the beginning of time. The novel by S. E Hinton, ‘The Outsiders’ conveys this need and the yearning to feel social acceptance within us all. ‘The Outsiders’ comments on this inherent part of humanity through its realistic portrayal of teenage gang life, centering on the dependency of the gang members to feel a sense of inclusion and support from their gang. Insert The Outsiders plot line ‘The Outsiders’ conveys that the need to belong is apparent within everyone through the universality of the needs and views of the gang members.This conveys that finding a place to belong, as the characters do within their own gangs, is a basic aspect of man. These concepts are explored through the archetypal structure of the gangs represented within ‘The Outsiders’ that the audience is able to relate to, with the gangs clear hierarchy and the ir fierce loyalty and dependency present between the gang members. The novel depicts Ponyboy’s awakening to the true similarities between the rival gangs, and that although they brand themselves as polar opposites, both gangs at the heart are the same.It is slowly revealed that both gangs exist in order to give the teenagers a place to deal with society’s expectations and to feel a sense of inclusion, needs that the whole of society can relate to. The rivalry between the gang also signifies the universality of the gangs, as it is common throughout society for groups to bond themselves through a sense of ‘us versus them’, fulfilling the need within humanity for inclusion and camaraderie. There is also a strong tribal element within the gangs, as both gangs are male centered, territorial and resort to violence.This conveys the inherent need within humanity to belong, as tribes have formed since the beginning of time as an answer to this need. The tribal natu re of the gangs also conveys the gang member’s reliance on the gang and the support it offers them, as throughout history rejection from the tribe leads to death. The gangs instinctually resorting to violence also comments on the tribal nature of the gang, as they conform to primitive behavior of uniting against others. Hinton’s employment of point of view conveys to the audience Ponyboy’s personal opinions and discoveries about the true nature of the gangs.Through Ponyboy realizing the similarities between the gangs and questioning the violent nature of the gangs, the audience gains a greater understanding of the universality of belonging within a group and the inherent need to feel accepted within all of humanity. Although there is a universal element present in the gang life, there are also significant differences between the two rival gangs. These differences capture the importance of belonging as it focuses on the greaser’s loyalty, love and dependen cy within the gang that the SOCS don’t have.The Greasers’ need to belong, unlike the SOCS, stems from their alienation and exclusion from mainstream society. As the title conveys, they are ‘outsiders’, so the unity within the gang is much stronger as they have nowhere else to go. The sense of security created by the gang strengthens the relationships and loyalty between the gang members, making them more like a family then a group of friends. This is presented throughout the book, as the different greasers convey their allegiance to the gang and their willingness to put themselves on the line in order to protect a fellow gang member. When you’re a gang, you stick up for the members. If you don’t stick up for them, stick together, it isn’t a gang anymore. ’ Hilton’s employment of vernacular language and symbolism conveys the greaser’s loyalty to their gang as they mark themselves apart from the rest of society throu gh their appearance and slang. The greasers take a special pride in their long hair, a uniform for the gang of outcasts. The Outsiders conveys that more than anything, humanity feels a need to belong, through the range of characters and their different needs and connection to their gang.Hilton’s employment of characterization captures the drive behind man to belong, and what it can compel someone to do. Dally and Johnny are key examples of this, as their dependency on the gang is due to them not having a supportive family or another place to turn to. This is contrasted with the character of Darry, a more peripheral member of the gang who, due to his stable job and his history of athletic achievements, doesn't depend on the gang for self fulfillment and a life purpose. The Outsiders leads the audience to question the significance of belonging through the allegiance of the gang contrasted with biological bonds of family.Throughout the entire novel, Ponyboy struggles to find his place within the gang and within his family unit, as he fights with his brothers and feels alienated and unwanted. As Ponyboy tries to find his place within life, he turns away from his brothers and towards the support of the ‘greaser family’. Ponyboy’s journey is compared with Johnny, who is pushed away by his parents and looks to the greaser gang for family support and comfort. As Ponyboy gains an insight into Johnny’s life he in turn learns to appreciate his brothers and the sense of belonging they offer. It ain’t the same thing as having your own folks care about you† Johnny said simply. The need to belong is also explored in the Outsiders through the breaking up of the gang following the dramatic events that occur. Throughout the novel, the gang slowly collapses into a state of chaos, revealing to the audience the gang member’s dependency on the gang for their self identity and a reason for living. The gang is conveyed to have a s et structure at the beginning of the novel, each member having their own role within the gang.While the three brothers are the foundation of the gang, as they offer safety and hospitality to the other gang members, it is Johnny who is the heart of the gang, as the gang is tied together through their need to protect and love Johnny. As the bonds between the brothers begin to crumble, the fractures of the gang become apparent. It is the death of Johnny that leads to the gang collapsing and Dally’s suicide.This is conveyed through emotive language at the effect Johnny’s death plays on each character, â€Å"Soda looked like he was going to cry, Two-Bit’s eyes were closed and his teeth were clenched†¦ My heart was pounding in slow thumps. Dally’s suicide depicts his need of the gang, as he loses his will to live following Johnny’s death and the disbanding of the gang. Ponyboy enters a state of discord following the death of his friends that eventu ally allows him to move onto a state of reflection and growth as he realizes the significance of his belonging within his family and the importance of caring for the needs of his family and the gang in order to build a sense of solidarity and belonging. Insert Conclusion

Stepping Out of the Comfort Zone

Stepping Out of the Comfort Zone Communications break boundaries and bring connections between people. In â€Å"Some Friends and I Started Talking: Conversation and Social Change,† Margaret J. Wheatley describes communication as â€Å"a timeless and reliable way for humans to think together† (312). As human, communication is an essential need for everyday survival. It also brings people closer as they have a better understanding of each other through communication.For many cases, it takes people a lot of courage to step out of their own comfort zone and start conversations with others. When I came to the United States, the language barrier was keeping me from communicating with everyone around me. I barely spoke any English at the time. I would avoid talking to everybody. In class, I would sit by myself, putting my head down during lectures and avoid to be called on. But being so quite didn’t mean I was invisible to the bullies. During 8h grade, I was bullied by a group of Hispanic boys.They would throw my books into trashcans, made fun of my accent and pushed me as I walk through hallways. I was so afraid to come to school. My grades were dropping as the semester went by. I knew I needed to talk to somebody about it. Stepped out of my comfort zone, I seek my counselor Jane for help. Our conversation lasted for about two hours, but it changed my life completely. Wheatley mentions, â€Å"a simple conversation gave birth to actions that can change lives,†(312) in her essay.I soon found myself confronting the bullies and stopped them from bullying other people that were just like me. My grades also improved as my social life improved. This proves how communication is a â€Å"powerful tool in society† (Wheatley 313). Communication opens up new points of views and changes life for those who take courage and effort to begin a conversation. â€Å"We are hungry for a chance to talk. People want to tell their stories and willing to li sten to yours†(Wheatley 312). Communication is also the key to friendship and relationships.

Setting The Table For Urban Agriculture - 1167 Words

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