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Globalisation implies greater access to drug markets with the high circulation of people acting as a key drivers of drug trade and consumption (Spooner & Heatherington discount kamagra super 160mg otc erectile dysfunction and diabetes pdf, 2005) purchase kamagra super no prescription impotence nerve damage. In fact, recent United Nations reports indicate that the population of illicit drug users continues to grow globally, especially as economies rapidly urbanize. Globalisation through encouraging competition, is affecting families and causing children-parent bonding and communication to take a strain. By its very nature globalisation fosters competitive behaviour that discourages social and family cohesion. Sectors in the economy compete rigorously, with workers being forced to work long hours with less job security. Part-time, casual and outsourcing of jobs is becoming the norm, and less and less benefits are accruing to workers, forcing workers to take multiple jobs. Parents are finding it difficult to balance work and family, and more often child care obligations are compromised (Daly, 2004). Parents are spending less time with their adolescent children, leading to boredom, frustration and depression and increased substance use problems (Spooner & Heatherington, 2005) and Ramsoomar, 2015). Table 3 Risk and protective factors for substance abuse by adolescents Risk Factors Individual Family School Community Societal Exposure to public Advertising that Delinquency Parental drug use Deviant peer affiliation drunkenness promotes drug use Abundance of free, Peer Pressure Family conflict Skipping school unstructured time Neighbourhood Availability of drugs in or affirmation of substance Moral and Social Rebelliousness Poverty / Affluence around school premises use Degeneration Rejecting parental Family Context/Structure authority and cohesion Low academic aspirations Few job opportunities Sensation seeking Low Expectation Poor school performance Ease of access to drugs Impulsiveness Aggression Poor sense of well being Protective Factors Good relationship between School policy on substance Community disapproval Self confidence caregiver & child use of substance use Taxation 20 Good communication Access to positive Controlling availability High self esteem between caregiver & child Code of Conduct leisure activities and access to substances Increasing minimum Good Parental monitoring (e. Quality of Educational legal age of alcohol relationships setting rules) Experience consumption Effective policy implementation Source: Department of Basic Education (2013) Missing Evidence Although literature provides a fair understanding of the dynamics surrounding many drugs, our understanding of the determinants of Nyaope remain unexplored. As anecdotal evidence suggests that Nyaope has many causalities, further research is required to understand the incidence (by gender, race and age) and key drivers of this drug usage. Although in South Africa we know much about the negative effects of alcohol and tobacco on individuals, community and society at large, there is still a dearth on knowledge on the effects of other substance such as cannabis, heroin, cocaine, inhalants, nicotine, opioids, and many other drugs. At a theoretical level, drugs affect the individual, community, and society at large. Needless to say, all its negative effects straddle all sectors of the economy, including the health sector. This section reviews literature on the consequences of substance abuse to the individual, household/community and society at large. On the onset it has to be borne in mind that this distinction is only made to frame our analysis, in reality the lines dividing individual, community or societal effects of substance abuse are quite blurred. At the onset, it is critical to point out that literature is clear that the consequences of substance abuse differ between women and men, which implies any treatment or intervention programme has to factor in gender differences. Empirical evidence has also pointed out to a strong association between substance abuse by youth and a number of accidental injuries including traffic, drowning, poisoning, burns and falls, as well as premeditated injuries such as interpersonal violence, suicides, child abuse and sexual violence. Seedat et al, (2009) has demonstrated the link between drug misuse and homicide, abuse of children and partners, as well as rape and other violent acts. Lack of resources to sustain drug addiction has also been singled out as a major cause of many serious crimes, such as murder and robbery. A decade ago, Parry et al, 2004 and Parry et al, 2005 noted that violence was strongly related to use of illicit drugs (45%) and 40% cannabis. Other studies have shown that substance abuse is associated with risky sexual behaviour. In a very recent study, Magidson, et al (2016) tests the association between drug use and sexual activity, violence for both males and females in peri- urban areas. In a sample of 822, 16-18 year olds, and using logistic regression models, Magidson, et al (2016) found that drug use (and alcohol) are strongly associated with violence and sexual activity for both males and females. In a survey of both sexual partners taking drugs and those not, Kalichman et al (2006) found that the psychopharmacological effects of some drugs boosted the sexual activity of drug users, thereby predisposing them to risky sexual behaviour (Morejele, 2006). This is also confirmed in Reddy (2010), where 14% of school going learners reported having drugs before engaging in sex. Many girls have become pregnant as the psychopharmacological effects of drugs compromise their judgements. Other social effects of substance abuse to a youth include poor educational achievements, unemployment, crime, welfare dependence, poverty, social exclusion, marginalisation, and violent behaviour (Bouchery, 2011). Besides these maladies reinforcing each other, they in turn perpetuate substance abuse. Consequences to Household/Family/School There is consensus among all studies reviewed that within a household/family environment, substance abuse has severe negative effects, with violence being the most significant problem. According to Zulu, et al (2004) and Jewkes, et al, (2010), substance use is largely implicated in interpersonal violence (including gender-based violence and sexual assault), school violence, and often lead to a non-conducive teaching or learning environment. At home violence is meted mostly against women partners, wives, siblings or parents, while at school peers and teachers are the prime victims. Drug use often leads to family dysfunctionalities and disintegration, financial losses and distress, increased burdens associated with medical and other treatment services for drug users not able to support themselves. Substance abuse is also associated with poor academic performance and aspirations and prolonged stay at school. Sutherland and Shephered (2001) have shown that drug use is associated with academic difficulties, absenteeism and dropping out of school. For example cannabis use, which is a drug of choice among South Africa youth has been shown that it generally interferes with learning, short-term memory and psychomotor skills. Melisa et al (2014) reported that methamphetamine (“tik”) had “adverse effects on mental, physical, and economic well-being, and limited future opportunities through school drop-out and incarceration” of drug users in the Western Cape Province. The same study implicated tik use to household conflict, with negative consequences on children, “including neglect and poor birth outcomes”. At a community level, respondents linked tik use to increased rates of crime, violence and corruption, which undercut community cohesion. Consequences to Society Substance abuse certainly means the energies, creativity and talents of the youths are not harnessed. Substance abuse is linked to unemployment, crime, physical inactivity and even premature deaths. The National Drug Master Plan (2012-2016) estimates the costs of illicit drugs to the South African economy at 6. Other major costs such as drug related violence, injuries, deaths, disease, law enforcement and lost productivity remain largely unquantified. Melisa et al (2014) noted that at the community level, tik use was 23 associated with “increased rates of crime, violence and corruption, which undercut community cohesion”. Although these statistics do not directly speak to the youth; they point to a serious national burden. Missing connections in Literature Other than the above, literature in South Africa is silent on the harm substance abuse has on others (friends, and colleagues) (Ramsoomar, 2015). Further research is required to establish the effects of substance abuse by young people on the quality of family life, pressures on family finances, family stress levels, family or friend disruptions, emotional and psychological impacts on families, divorces, theft from family and friends, etc 24 Section 6 Approaches to combating drug use among Youth The above review of literature shows that youth substance abuse is a multidimensional challenge that requires a multifaceted and integrated gamut of interventions. Bronfenbrenner’s socio-ecological framework becomes handy when analysing interventions as it allows the targeting of interventions to all risk factors at all levels: be it individual, micro, mesosystem and exosystem. Thwala (2005) has noted that for any intervention to be successful, it should be underpinned by the following set of principles: Principle 1: Interventions should promote protective factors and seek to lessen risk factors.
The term tolerable is chosen because it connotes a level of intake that can generic kamagra super 160 mg fast delivery erectile dysfunction causes symptoms and treatment, with high probability buy cheap kamagra super 160mg online erectile dysfunction otc treatment, be tolerated biologically by individuals; it does not imply acceptability of that level in any other sense. Many individuals are self-medicating with nutrients for curative or treatment purposes. It is beyond the scope of this report to address the possible therapeutic benefits of higher nutrient intakes that may offset the risk of adverse effects. The term adverse effect is defined as any significant alteration in the structure or function of the human organism (Klaassen et al. Any such alteration (referred to as an adverse nutrient–nutrient interaction) is considered an adverse health effect. This does not mean that there is no potential for adverse effects result- ing from high intake. When data about adverse effects are extremely limited, extra caution may be warranted. Like all chemical agents, nutrients can produce adverse health effects if their intake from a combination of food, water, nutrient supplements, and pharmacological agents is excessive. Some lower level of nutrient intake will ordinarily pose no likelihood (or risk) of adverse health effects in normal individuals even if the level is above that associated with any benefit. It is not possible to identify a single risk-free intake level for a nutrient that can be applied with certainty to all members of a population. However, it is possible to develop intake levels that are unlikely to pose risk of adverse health effects for most members of the general population, including sensitive individuals. For some nutrients, these intake levels may pose a risk to subpopulations with extreme or distinct vulnerabilities. Such a model might have several potential advantages, including ease of application and assur- ance of consistent treatment of all nutrients. It was concluded, however, that the current state of scientific understanding of toxic phenomena in general, and nutrient toxicity in particular, is insufficient to support the development of such a model. Scientific information about various adverse effects and their relationships to intake levels varies greatly among nutri- ents and depends on the nature, comprehensiveness, and quality of avail- able data. The uncertainties associated with the unavoidable problem of extrapolating from the circumstances under which data are developed (e. The hallmark of risk assessment is the requirement to be explicit in all of the evaluations and judgments that must be made to document conclusions. The characterization of risk typically contains both qualitative and quantitative information and includes a discussion of the scientific uncertainties in that information. In the present context, the agents of interest are nutrients, and the environ- mental media are food, water, and nonfood sources such as nutrient supplements and pharmacological preparations. Performing a risk assessment results in a characterization of the rela- tionships between exposure to an agent and the likelihood that adverse health effects will occur in members of exposed populations. Scientific uncertainties are an inherent part of the risk assessment process and are discussed below. Risk management decisions depend on the results of risk assessments, but may also involve the public health significance of the risk, the technical feasibility of achiev- ing various degrees of risk control, and the economic and social costs of this control. Risk assessment requires that information be organized in rather specific ways, but it does not require any specific scientific evaluation methods. Data uncertainties arise during the evaluation of information obtained from the epidemio- logical and toxicological studies of nutrient intake levels that are the basis for risk assessments. Examples of inferences include the use of data from experimental animals to estimate responses in humans and the selection of uncertainty factors to estimate inter- and intraspecies variabilities in response to toxic substances. Uncertainties arise whenever estimates of adverse health effects in humans are based on extrapolations of data obtained under dissimilar conditions (e. Options for dealing with uncertainties are discussed below and in detail in Appendix L. The steps of risk assessment as applied to nutrients follow (see also Figure 4-1). Hazard identification involves the collection, organization, and evaluation of all information pertaining to the adverse effects of a given nutrient. It concludes with a summary of the evidence concerning the capacity of the nutrient to cause one or more types of toxicity in humans. Intake assessment evaluates the distribution of usual total daily nutrient intakes for members of the general population. Risk characterization summarizes the conclusions from Steps 1 and 2 with Step 3 to determine the risk. The risk assessment contains no discussion of recommendations for reducing risk; these are the focus of risk management. Thresholds A principal feature of the risk assessment process for noncarcinogens is the long-standing acceptance that no risk of adverse effects is expected unless a threshold dose (or intake) is exceeded. The critical issue con- cerns the methods used to identify the approximate threshold of toxicity for a large and diverse human population. Because most nutrients are not considered to be carcinogenic in humans, approaches used for carcino- genic risk assessment are not discussed here. The method described here for identifying thresholds for a general popu- lation is designed to ensure that almost all members of the population will be protected, but it is not based on an analysis of the theoretical (but practically unattainable) distribution of thresholds. For some nutrients there may be subpopulations that are not included in the general distribu- tion because of extreme or distinct vulnerabilities to toxicity. These factors are applied consistently when data of specific types and quality are available. This is identified for a specific circumstance in the hazard identi- fication and dose–response assessment steps of the risk. Uncertainty factors are applied in an attempt to deal both with gaps in data and with incomplete knowledge about the inferences required (e. The problems of both data and inference uncertainties arise in all steps of the risk assess- ment. A discussion of options available for dealing with these uncertainties is presented below and in greater detail in Appendix L. It is derived by application of the hazard identification and dose–response evaluation steps (Steps 1 and 2) of the risk assessment model. In the intake assessment and risk characterization steps (Steps 3 and 4), the distribution of usual intakes for the population is used as a basis for determining whether, and to what extent, the population is at risk (Figure 4-1). A discussion of other aspects of the risk characteriza- tion that may be useful in judging the public health significance of the risk and in risk management decisions is provided in the final section of this chapter “Risk Characterization. In the appli- cation of accepted standards for risk assessment of environmental chemi- cals to risk assessment of nutrients, a fundamental difference between the two categories must be recognized: within a certain range of intakes, nutrients are essential for human well-being and usually for life itself. Nonetheless, they may share with other chemicals the production of adverse effects at excessive exposures. Because the consumption of balanced diets is consis- tent with the development and survival of humankind over many millennia, there is less need for the large uncertainty factors that have been used for the risk assessment of nonessential chemicals. In addition, if data on the adverse effects of nutrients are available primarily from studies in human populations, there will be less uncertainty than is associated with the types of data available on nonessential chemicals. There is no evidence to suggest that nutrients consumed at the recom- mended intake (the Recommended Dietary Allowance or Adequate Intake) present a risk of adverse effects to the general population.
A Other regions of the Northern Hemisphere were hotter last winter than in previous years purchase kamagra super overnight b12 injections erectile dysfunction. Although the weather was very cold last winter buy 160 mg kamagra super impotence vs impotence, the winter before was of average B temperature. The claims that theories of global warming are incorrect are supported by further C evidence. All the people claiming that theories of global warming are incorrect come from areas D that had very cold weather last winter. Some of the people claiming that the theories of global warming are incorrect do not E come from areas that had very cold weather last winter. As two thirds of adults and a third of children are already obese or overweight, with serious risk of heart disease, diabetes and cancer, the need for proper labelling to warn people about the calorie content of these items is urgent. Which one of the following, if true, most strengthens the argument in the passage above? A Trials show that consumers alter their eating habits when food is calorie-labelled. Many people think that the food and drink consumed at the cinema is as important to the D visit as the film. People who are overweight are sometimes more concerned with their looks than the long E term health risks. Additionally, the availability of more formats means that there is more potential for copies of works to be shared with other fans, who do not pay for them. These fans do not show up in the ratings, so the official ratings do not reflect the relative popularity of a work. A The sharing of works with other fans is more widespread for certain types of music. C The calculation of ratings based on downloads and sales together is not difficult. D Artists are not interested in the popularity of their work, just the sales figures. There is a need to save energy usage in all public services and it is time that the government considered turning off street lighting. Modern cars have powerful headlights which provide a clear view of the road ahead even without overhead lighting. There is also evidence to suggest that when drivers move from an area with lighting to an area without they are more likely to have an accident than those drivers who have driven exclusively on roads without lighting. D Research suggests that older drivers find driving without lighting more difficult. There is evidence that there are fewer daytime accidents on those motorways without E lighting. The grey squirrel, a small, tree-dwelling rodent introduced to Britain over a century ago, is breeding so rapidly that the native red squirrel is disappearing. Encouraging the consumption of the grey species as food may help protect the red one, in her view. However, we can challenge this, as it is all just a cheap publicity stunt to increase business in the restaurant. Which one of the following is the best statement of the flaw in the above argument? D It assumes the disappearance of the red squirrel justifies eating the grey squirrel. They need a stable environment and clean water, uncontaminated by perfume or lotions. There should be a complete ban on this type of pedicure, or else there will soon be no garra rufa. Which one of the following is the best statement of the flaw in the above argument? Badgers are animals believed to be responsible for the spread of bovine tuberculosis which results in large numbers of cows having to be destroyed every year. Animal rights supporters have criticised the proposal, but it is clear that the lives of more cattle can be saved by destroying a smaller number of badgers. Which one of the following is the best statement of the flaw in the above argument? It assumes that the arguments from the animal rights supporters are about the number of A deaths. It assumes that the animal rights supporters believe that badgers have a greater right to B life than cows. It assumes that the animal rights supporters believe that animals that are living freely C have a greater right to life than those that are being bred on farms. However, some observers report that the real number of accidents may be much higher than is shown in the official records as many accidents are not reported by drivers. They also say that during the time when accident figures have decreased, the number of people going to hospitals because of road accidents has stayed constant. Positive views about continually improving road safety may not be supported by what A actually happens. B Government programmes have been unsuccessful in reducing the number of accidents. Hospital admissions are a good way of measuring changes in the number of accidents C on our roads. Biology 41 The following organelles are involved in processing amino acids into glycoprotein: 1. A ii and v B ii and iv C i and iii D iii and v E i and iv 46 Which one of the following molecules will contain the greatest number of different elements? Which one of the following pairs of elements is most likely to form a covalent bond? A first = slightly exothermic; second = very endothermic B first = slightly exothermic; second = very exothermic C first = slightly endothermic; second = very exothermic D first = slightly endothermic; second = very endothermic E first = very exothermic; second = very exothermic 64 In the following reactions, which substances are acting as oxidising agents? A 3 only B 1 only C 2 only D 2 and 3 only E none 66 What is the total number of electrons in the ions of sodium chloride? Amines Amides Row 1 Ethanoic acid reacts does not react Row 2 Nitrous acid reacts reacts Row 3 Sulphuric acid does not react hydrolyses A Rows 1 and 2 B None of the rows C Rows 1 and 3 D Rows 2 and 3 E All of the rows 68 Consider the following reactions. Physics and Mathematics 70 In a group of students, exactly 2 are male and exactly 1 study mathematics. The probability that a 5 3 male student chosen at random from the group studies mathematics is p. The transformation R is a rotation about the origin and maps A to B, B to C, C to D, etc. A R R S R S R B R S R S C S R D R S R R E S R R S R S 72 The line L has equation y = 2x - 1.
Keep the surface of the water clear of free-floating vegetation and debris during times of peak mosquito activity order kamagra super cheap erectile dysfunction treatment bangkok. Vector control (chemical) It may be necessary to use alternative mosquito control measures if the above measures are not possible or ineffective: Use larvicides in standing water sources to target mosquitoes during their aquatic stage order kamagra super 160mg without a prescription erectile dysfunction caused by hernia. This method is deemed least damaging to non- target wildlife and should be used before adulticides. However, during periods of flooding, the number and extent of breeding sites is usually too high for larvicidal measures to be feasible. The environmental impact of vector control measures should be evaluated and appropriate approvals should be granted before it is undertaken. Biosecurity Protocols for handling sick or dead wild animals and contaminated equipment can help prevent further spread of disease: Avoid contact with livestock where possible. Wear gloves whilst handling animals and wash hands with disinfectant or soap immediately after contact with each animal. Wear different clothing and footwear at each site and disinfect clothing/footwear between sites. Monitoring and surveillance Regular inspection of sentinel herds (small ruminant herds located in geographically representative areas) in high risk areas such as locations where mosquito activity is likely to be greatest (e. As a general guide, sentinel herds should be sampled twice to four times annually, with an emphasis during and immediately after rainy seasons. In livestock, clinical surveillance for abortion with laboratory confirmation and serology, and disease in humans in areas known to have had outbreaks. Restrict or ban the movement of livestock to slow the expansion of the virus from infected to uninfected areas: - Livestock should not be moved into/out of the high-risk epizootic areas during periods of greatest virus activity, unless they can be moved to an area where no potential vector species exist (such as at high altitudes). Bury animals rather than butchering them as freshly dead animals are a potential source of infection. For control of disease in captive collections of wild ruminant species, guidelines above for livestock, habitat and vector management may be applicable. Humans In the epidemic regions, thoroughly cook all animal products (blood, meat and milk) before eating them. Reduce the chance of being bitten by mosquitoes: Wear light coloured clothing which covers arms and legs. Use impregnated mosquito netting when sleeping outdoors or in an open unscreened structure. Note that some repellents cause harm to wildlife species, particularly amphibians. African buffalo and domestic buffalo are considered ‘moderately’ susceptible with mortalities of less than 10%. Camels, equids and African monkeys including baboons are all considered ‘resistant’ with infection being inapparent. Effect on livestock Pregnant livestock are most severely affected with abortion of nearly 100% of foetuses. Lambs and kids are most at risk with mortalities of 70– 100%, followed by sheep and calves (20–70%), and then adult cattle, goats and domestic buffalo (<10%). Economic importance There is potential for significant economic losses in the livestock industry due to death and abortion of infected animals and possible trade restrictions imposed during and after an outbreak. Illness in humans can result in economic losses due to the time lost from normal activities. An infectious zoonotic disease found in a range of animals including birds, caused by their exposure to species of Salmonella spp. The bacteria are found in the intestines of humans and animals but are also widespread in the environment and are commonly found in farm effluents, human sewage and any material that is contaminated with infected faeces. The bacteria can survive for several months in the environment, particularly in warm and wet substrates such as faecal slurries. The disease can affect all species of domestic animals, and many animals, especially pigs and poultry, may be infected but show no signs of illness. The infection can spread rapidly between animals, particularly when they are gathered in dense concentrations. Salmonellosis can occur at any time of year, however, salmonellosis outbreaks may be more common in certain seasons (e. European garden bird salmonellosis outbreaks occur most frequently during the winter months). Humans usually contract the bacteria through the consumption and handling of contaminated foods of animal origin and water, but also through direct contact with infected animals and their faeces. Salmonellosis is one of the most common and widely distributed food-borne diseases in humans globally, constituting a major public health burden and representing a significant cost in many countries. Causal agent Two species of bacteria from the genus Salmonella: Salmonella enterica, and S. Species affected Many species of domestic and wild animals including birds, reptiles, amphibians, fish and invertebrates can be infected with Salmonella spp. The importance of each Salmonella serovar (and phage type) differs between the host species. Some Salmonella serovars (and phage types) have a broad host range and others are thought to be highly host-adapted. All species seem to be susceptible to salmonellosis but clinical disease is more common in some animals than others. For example, disease is common in cattle, pigs and horses, but uncommon in cats and dogs. Outbreaks of passerine salmonellosis are typically observed in the vicinity of supplementary feeding stations in garden habitats. Salmonellosis outbreaks have also been reported in colonial nesting birds, such as gulls and terns. Children, the elderly, and people with weakened immune systems are at greatest risk of developing severe disease. Geographic distribution Found worldwide but most common in areas of intensive animal husbandry, especially in pigs, calves and poultry reared in confined spaces. Eradication programmes have nearly eliminated salmonellosis in domestic animals and humans in some countries but wild animal Salmonella spp. In general infection is transmitted by infected hosts, their faeces or contaminated inanimate objects. How is Salmonella Direct contact with infected faeces and through ingesting water and food transmitted to animals? In mammals, the bacteria can be transmitted from an infected female to the foetus, and in birds, from an infected adult to the egg. How does Salmonella Spread by infected animals which shed the bacteria into the environment in spread between groups their faeces. How the infection spreads between and within herds and flocks is not fully understood due to the difficulties of detecting clinical signs in animals infected with Salmonella spp. How is Salmonella Most commonly transmitted by handling and ingesting contaminated water transmitted to humans? Also transmitted through direct contact with infected animals and their faeces, particularly those of reptiles, chicks and ducklings, but also of livestock, dogs, cats, adult poultry and cage birds.