Readiness of Kindergarten Teachers along K-12 Curriculum Essay Example for Free

Readiness of Kindergarten Teachers along K-12 Curriculum Essay One of the major reforms in our country’s educational system is Republic Act 10157, otherwise known as â€Å"The Kindergarten Education Law† or the K to12 (K+12). This Law made the Kindergarten compulsory and mandatory entry to basic education. This Law was initiated by the Aquino administration in order to address the perceived decreasing quality of education in the country, and to meet the international standard regarding the number of years in basic education. This program will require all incoming students to enroll into two more years of basic education. The K+12 System will include the Universal kindergarten, 6 years of elementary, 4 years of junior high school with an additional 2 years for senior high school. The program is implemented and formulated along with the Commission on Higher Education (CHED) and with the Technical Education and Skills Development Authority (TESDA). The current k-12 model that had been implemented in the country is an educational landscape for basic and secondary system patterned after the United States, Canada and some parts of Australia had done it. According to Patricia  Velasco’s article, the K- 12 Curriculum envisions â€Å"holistically developed learners with 21st century skills† (DepEd Primer, 2011). This further means that every student would have an understanding of the world around him and a passion for life-long learning while addressing every student’s basic learning needs: â€Å"learning to learn, the acquisition of numeracy, literacy, and scientific and technological knowledge applied to daily life† (p. 6). The main objective of the K to 12 curriculum is to achieve the DepEd’s goal of eradicating illiteracy rate in the country. â€Å"No child is left behind. † (source). Every Filipino has the right to receive quality education in order to become an asset in all dimensions, competent, efficient, effective and productive citizen leading to a decent and comfortable living. The most interesting part concerning the K to 12 program is on its practical assistance for the poor but skillful students. For instance, the student cannot afford to go to college; he is given an option or privilege to be employed not as a professional but on technical job because his skills acquired and developed during his Senior High School can be a guarantee for his  qualification for a vocational employment. Moreover, the program aims to uplift the quality of education in the Philippines in order for graduates to be easily employed. Our country is the only country in Asia and among the countries in the world that has a 10 year pre- university program. The program also aims to meet the standards required for professionals who would want to work abroad. The system aims to fully enhance and develop the students in order for them to be well-prepared especially in emotional and cognitive aspects. Through this, graduates will be able to face the pressures of their future workplace. The K-12 aims the students to have a relevance or importance in the social and economic reality of life. The realm of their role as members of the country. Thus, this vision will be complete through an enhanced curriculum. (K-12 Kindergarten Curriculum Guide 2013) DepEd said that this is the right time to do something better for the field of education, having poor quality education. The DepEd released their stand along the reform. In stressing the need for the new system of basic education, President Benigno S. Aquino III said, â€Å"We need to add two years of our basic education. Those who can afford pay up to fourteen years  of schooling before university. Thus, their children are getting to the best universities and the best jobs after graduation. I want at least 12 years for our public school children to give them an even chance at succeeding. † (source) With the K-12 program, different arguments were formulated. Not all are in favor of the K+12 Education program. There are students complaining of the additional years and there are parents who are not in favor of the additional expenses. But it is an undeniable fact that additional years in the education system will really require more budgets not just from the government but from the  parents as well. Aside from this, students will need additional classrooms, school supplies and facilities. The program would need more qualified teachers as well. Teachers plays an important role 1 / 3 in the K-12 program because they are the ones who will teach the kindergarten pupils, especially the Pre – school teachers. Markovac amp; Rogulja, 2009, stated that the, early care main goal is to fulfill the Delors principles: â€Å"Learning to be, learning to do, learning to know and learning to live together and to live with others. † The early childhood is a time of rapid growth in all aspects of  children’s development fostered by their natural curiosity and adult support. Therefore, Preschool education is the foundation for a childs education. The skills and knowledge that a child develops in the preschool years will have a dramatic impact on a childs success when formal schooling begins as well as life success. Preschool education is important because it can give your child the edge in a competitive world and education climate. The first year of a child’s life is globally acknowledged to be the critical year for lifelong development because the pace of development during these years is  extremely rapid (National Council of Educational Research and Training, 2006 as cited in the K to 12 Curriculum Guide – Kindergarten). While children who do not receive the fundamentals during their preschool years will be taught the alphabet, counting, shapes and colors when they begin their formal education they will be behind the children who already possess that knowledge and skill set. The Pre – school teachers are supposed to have the courage and knowledge to teach the little ones. They will serve as the guide and the second mother at school. Children’s learning will greatly depend on the teachers strategies. Hence, kindergarten teachers should provide them with an engaging and creative curriculum that is developmentally – appropriate, age – appropriate and socio – cul;turally appropriate (DepEd K to 12 Curriculum guide for Kindergaten, 2012). Many new parents start hearing about K-12 since before their kids are born. However, they are not very clear about what K12 means, and why is necessary for them to start inform themselves about it as it will impact their kids’ future. What Is K12 Education? This term was coined to describe primary and secondary education. This includes kindergarten (K) all the way to the 12 grade. This extremely popular type of education is very common among several countries around the world. â€Å"K to 12† stands for kindergarten plus 12 years of elementary and secondary education. This educational system for basic and secondary education is widely adopted around the world. Early childhood education is intended to support and complement family upbringing and the main goal is to create good opportunities and conditions for each child’s well-being, create a stimulating environment for the child’s comprehensive development and learning while taking into account their age, gender and individual features. The role of early childhood care and education settings in improving children’s development has begun to be viewed with increasing importance. The recognition that centre-based childcare is associated with a host of positive developmental outcomes for children, such as increased cognitive abilities, language development, and emotional and social development (Kagan amp; Neuman, 1997; National Institute of Child Health and Human Development Early Childcare Research Network [NICHD], 2000, 2002, 2008; NICHD amp; Duncan, 2003), has led to the introduction of a new policy in Ireland that provides every three-year-old child with access to a free preschool place for one year (Office of the Minister for Children and Youth Affairs [OMCYA], 2009). The importance of preschool learning is that first, parents must remember that preschool education is the foundation for your childs education. As Adams (2008) stressed that early childhood education is the key to building a strong foundation for a child’s educational success. The skills and knowledge (not to mention aptitude and attitude) that your child develops in the preschool years will have a dramatic impact on your childs success when formal  schooling begins as well as life success, as supported by the House Bill 5367 (2009), aimed to incorporate preschool education to basic education with the DepEd at the frontier of its implementation all over the country. This bill was in consonance with the state’s policy to provide equal opportunities for all children to avail themselves of free and compulsory preschool education that effectively promotes physical, social, intellectual, emotional simulations, let alone values formation to adequately prepare them for formal elementary schooling, second is that by actively  promoting and encouraging your childs preschool learning you will promote his or her self esteem as well. Help your child gain confidence by making learning fun and easy at this age and you will 2 / 3 help make your child an eager lifelong learner and the finally preschool education is important because it can give your child the edge in a competitive world and education climate. While children who do not receive the fundamentals during their preschool years will be taught the alphabet, counting, shapes and colors when they begin their formal education they will be behind the children  who already possess that knowledge and skill set. According to Anita Woolfolk Hoy and Megan Tschannen – Moran ,(2002), teachers’ sense of efficacy has been related to students outcomes such as achievement (Ross, 1992), motivation, (Midgley, Feldlaufer, amp; Eccles, 1998) and students’ own sense of efficacy ( Anderson, Greene, amp; Loewen, 1998). DepEd Secretary Armin Luistro stated that enhancing the competencies of pre-school teachers will have a great impact on the young learners. â€Å"We should ensure that teachers are ready for the challenge of making our young kids’ first school experience enjoyable  and giving them a positive experience that will motivate them to remain in school and complete their education. † This means that pre-school teachers are the implementers of the socially defined curriculum objectives. They help children to adapt to the society and to become its members, to develop interaction between children and different generations, and absorb the main behavioral habits and roles of the community. Also their task is to educate children to become unique subjects and persons as they truly are (Dewey, 1916; Ojakangas, 1998; Siljander, 2002) To become preschool teachers one must have the ability to deal with pupils ages 5. A preschool teacher needs to be proficient in helping children learn how to cooperate, providing fun learning activities suitable for preschoolers, keeping children safe, working as a team member with other teachers and interacting with parents. Preschool teachers need to be eager participants in childrens growth and development, as well as helping students understand how to use their natural curiosity to help make the appropriate developmental leaps in their skills and abilities. They are expected to create an atmosphere where risks can be taken and discoveries made while children remain safe. POWERED BY TCPDF (WWW. TCPDF. ORG).

Role of Metformin for Treatment of Type Ii Diabetes Mellitus

Role of Metformin for Treatment of Type Ii Diabetes Mellitus The role of metformin in the treatment of type II Diabetes Mellitus Introduction: Diabetes mellitus is a sever inherited or acquired disease which occurs when either pancreas does not produce enough insulin, which characterises type I diabetes and it is most commonly diagnosed in children, or the insulin that has been produced does not get used by the body effectively, type II diabetes and therefore patients will have abnormally high level of glucose. Type II diabetes was previously called non-insulin-dependent or adult-onset diabetes (World Health Organisation, WHO website). The latest estimate of the number of diabetics worldwide in 2001 by the World health Organisation (WHO) is 171 million and this figure is likely to be doubled by 2030 (WHO website). A recent study conducted in the UK using the General Practice Research Database (GPRD) illustrate that the mortality rate is twice as high for patients with diabetes type II than those without it (Mulnier et al, 2006). The prevalence of type II diabetes is increasing rapidly both in the UK and worldwide. It has increased by 54% (from 2.8% to 4.3%) and the incidence has increased by 63% over the past decade (Gonzalez, 2009). In most of the cases Type II diabetes is associated with another disorder, obesity, (Krentz et al, 2008). Hence such high increase in the incidence rate for type II diabetes could be due to the increased rate of obesity over past few years as the life style of the population is generally getting poorer and 20% of the population is now obese (UK Obesity Statistics). Understanding and treatment of diabetes has advanced throughout the twentieth century and since insulin has been discovered, many antidiabetic therapies and oral agents such as, Sulphonylureas and Biguanides have been developed to improve glycaemia. Sulphonylurea was the first oral therapy to be discovered for diabetes. It is insulin secretagogues and hence it combats the abnormally high level of blood glucose but it also causes hypoglycaemia and weight gain as it can prolong insulin secretion (Warrell et al, 2006). Biguanides is a class of drugs that are considered antihyperglycemic agents. Metformin is a primary member of this class and it has surpassed sulfonylureas as the most prescribed oral antidiabetic drug in the UK and most parts of the world (Filion, 2009). Metformin is now the most popular treatment for diabetes type II as a study carried out using The Health Improvement database from 1966 to 2005 in the UK shows that only a small number of patients were treated with insul in and its use did not change significantly over the time of study period, in 1966 Sulphonylurea was the most common drug and metformin was relatively less common but by 2005 the use of Sulphonylurea had decreased remarkably and there had been a parallel increase in the use of metformin as a therapy for diabetes (Gonzalez, 2009). In 2006 the American Diabetes Association recommended it as the first drug of choice for patients. In the 15th edition of the Model list of Essential Medicine by WHO, metformin is one of the only two antidebetic oral drug agents (the other is glibenclamide) stated there (WHO, 2007). The other members of biguanides drug class are phenformin and buformin however these two drugs are no longer used in many countries because it carries a very high risk of lactic acidosis. Historical development: In medieval times, French lilac or Goats rue known as Galega officinalis was used as a remedy for intense urination associated with the disease that is now known as diabetes mellitus and the active ingredient in the French lilac that had blood glucose lowering properties was discovered as galegine or isomyleneguanidine, but later on it was discovered that this ingredient was toxic in the plant that caused death of grazing animals (Witters, 2001). In 1918, guanidine was discovered to be blood glucose lowering agent but then it was also found that it is too toxic to be used as a therapy (Foye, 2007). Whilst guanidine itself and some of its other derivatives were considered to be too toxic to be used for diabetes mellitus treatment, the biguanides, two linked guanidine, proved to be safe and effective for the treatment of diabetes (Witters, 2001). In the 1920s, in a search for these guanidine-containing compounds with antidiabetic activities, phenformin, buformin and metformin were discovered. Although they were known to have glucose lowering properties it was not until 1957 when these biguanides were tried on man and introduced clinically in Europe (Gottlieb Auld, 1962, Reitman Schadt, 2007). For the first time in a medical literature by Ungar et al (1957, as cited by Oubre et al 1997) biguanides were described as an efficacious new class of oral drug for the treatment of diabetes. Phenformin which is similar to metformin in structure was very popular in 1960s but in early 1970s it was found to be associated with lactic acidosis and by 1976 clinical studies proved that the hazards of phenformin treatment outweighed its benefits and therefore, phenformin and all the products containing phenformin were withdrawn by the Ministry of Health and buformin was also withdrawn from many countries for the same reason (WHO, 2003). Howe ver, metformin was proved to be safer and did not have same risk of lactic acidosis if appropriately prescribed, and it took another twenty years after a safe and effective use in the Europe until United States Food and Drug Administration (FDA) approved it for use in the United States (Reitman Schadt, 2007). Glucophage the trade name of metformin, formulated by a drug company called Bristol-Myers Squibb, was the first brand to be marketed in the United States (U.S. FDA). Metformin used to be only prescribed for diabetes but then studies published in European journal of clinical investigation 1998 proved that metformin can have a significant effect on reducing weight as well (Paolisso et al, 1998). Meformin has now been used for over 50 years and it has established to be first-line drug of choice for the treatment of diabetes type II, but to get its maximum effect in the anticipation to reduce insulin resistance, weight loss and also to contribute in the improvement of cardiovascular diseases,the American Diabetes Association and the European Association for the Study of Diabetes strongly recommend to use metformin along with lifestyle intervention (Papanas Maltezos, 2009). Mode of Action/ Physiological Effects: Metformin is an antidiabetic oral drug that belongs to a class of drugs called biguanides. It acts by lowering the amount of glucose that liver makes on its own in the body hence it has antihyperglycaemic effects. It was licensed as antihyperglycaemic medication in Europe in 1970s, at that time there was only little known about the mode of action and its physiological effects on body. Despite metformin being in use since 1950s, its cellular mechanism of action is not definite. It primarily acts by inhibiting gluconeogenesis in the liver and hence it reduces the hepatic glucose output; it has also been shown to enhance glucose uptake in the muscles and improve peripheral insulin sensitivity (Ronco et al, 2008). Insulin is a very powerful anabolic hormone and it is involved in the synthesis and storage of glucose, lipid, and amino acid/protein. When blood glucose level rises, insulin is produced by the beta cells of the pancreas. As described by Gropper et al (2008) in their book, it stimulates the uptake of glucose by muscle cells and adipocytes, it also inhibits the gluconeogenesis by the liver to bring about an overall decrease in plasma glucose level. Insulin binds to a specific receptor on the plasma membrane of muscle cells and adipocytes which initiates a cascade of second messenger system that stimulates the tubulovesicle-enclosed GLUT4 glucose transporters to be translocated to the plasma membrane. Insulin also activates the enzyme glycogen synthase and inhibits glycogen phosphorylase and together they help store glucose in the form of glycogen. Hence this way glucose is removed from the blood circulation and is brought to normal level (Gropper et al, 2008). The majority of individuals with type II diabetes are insulin resistant. They have plenty of insulin circulating but their body is not able to respond to it either by having defective or insufficient number of insulin receptors therefore, glucose cannot enter the cells resulting in increased level of plasma glucose. Pancreas continues to produce more insulin in an effort to lower the increased level of glucose and eventually when an individual can no longer produce enough insulin to compensate for the rise, type 2 diabetes develops (Kaufman, 2008). Figure 1shows an overview of antihyoerglycaemic effect of metformin in type II diabetes mellitus. Metformin has various metabolic effects on lowering the hyperglycaemia. It partially acts by improving insulin action and partially by non-directly insulin dependent effects (Krentz Bailey, 2005). Metformin suppresses the hepatic glucose output by decreasing gluconeogenesis, glycogenolysis and fatty acid oxidation and this is the most evident principal blood glucose lowering mechanism and it does so by mainly increasing insulin sensitivity (Krentz Bailey, 2005). In the skeletal muscles metformin increases the insulin mediated glucose uptake and glycogen formation (glycogenesis), it also reduces the fatty acid oxidation. These changes in the muscle cells increase glucose transporters to move to the plasma membrane surface so that glucose can enter the cells (Krentz Bailey, 2005). Another way in which metformin lowers hyperglycaemia is via increasing the anaerobic metabolism of glucose which produces lactate as a by-product and this contributes in lowering the amount of glucose available to move to the serosal side from the lumen, lactate is taken to the liver via portal system (Bailey et al, 2008). Another way in which metformin works independent of insulin action to lower glucose is via increasing the splancchic glucose turn over (Krentz Bailey, 2005). The effect of metformin on skeletal muscles and adipose tissues in improving glucose utilisation in them appears to work through improved binding of insulin to its receptors on the plasma membranes of these cells and therefore, metformin seems to be ineffective without some residual functioning islet cells (Porte et al, 2002). Metformin has no direct effect on insulin secretion in contrast to other antidiabetic drugs such as sulfonylureas, therefore it does not cause hypoglycaemia rather in clinical practice it shows anti-hyperglycaemic actions (Porte et al, 2002). The level of glucose throughout the day changes, it is typically higher after eating and lower in the fasting state. The fasting plasma glucose concentration is measured by the HbA1c test, HbA1c is a glycosylates haemologlibin that is glucose attached with hamemoglobin so the higher the concentration of glucose the higher the level of HbA1c ( Medline Encyclopaedia, 2009). A fasting glucose level lower than 6mmol/l or 7% is normal in non-pregnant individuals and an elevated level shows that either the patient is diabetic or the patient has impaired fasting glucose/impaired glucose tolerance (Bupas health information factsheet, 2008; American diabetes association, 2009). It is important for type II diabetes patients to achieve normal or near-normal glycaemic control with their oral anti hyperglycaemic medications. There are numerous studies that show the effect of metformin decreasing the fasting plasma glucose level. Such as a study by Lozzo (2003), done on type II diabetes patients over 26 weeks with metformin increased the whole-body insulin sensitivity and that was likely to be determined by the reduction in HbA1c and body weight. A similar study done on patients with newly diagnosed Type II diabetes mellitus showed that adding metformin to insulin therapy effectively decreased the HbA1c level from 10.8 to 5.9% and 100% patients achieved an HbA1c less than 7% (Lingvay, 2007). Metformin has also been suggested to work by a biochemical pathway through activation of a protein kinase enzyme 5 adenosine monophosphate-activated protein kinase (AMPK). Its activity is regulated by the depletion in ATP (Adenosin tri-phosphate) and raised level of AMP when energy demand increases, such as in a exercising muscle, thus it is a â€Å"metabolic stress-sensing enzyme† that regulates the energy demand and energy production balance by modulating various metabolic pathways that bring about glucose, protein and fatty acid metabolism homeostasis (Hawley Zierath, 2008). In order for metformin to be effective in the inhibition of the production of glucose, activation of AMPK is required (Zhou, 2001). Kim et al (2008) published a study in 2008 that further described the mechanism of metformin through the activation of AMPK. This study was done on hepatocytes and it showed that through AMPK-dependant pathway metformin increased the gene expression of small heterodimer pa rtner, (SHP), SHP protein represses the transcriptional activity of a number of nuclear reptors including hepatocyte nuclear factor, and that in turn inhibits the expression of the hepatic gluconeogenic genes PEPCK and Glc-6-pase, these are the two enzymes that perform a key role in the homeostatic regulation of blood glucose levels and inhibition of these enzyme gene expression lead to the hepatic glucose production in vivo. Metformin has advantageous effects on atherosclerosis by decreasing Low Density Lipoprotein levels by about 0.26 mmol/L (10 mg/dL), whereas other oral agents appear to have no obvious effects on LDL cholesterol levels (Bolen et al, 2007). Recent prospective and retrospective studies confirm this drug not only being safe for its glucose lowering effects but also indicate its potential anti-atherosclerotic and cardioprotective effects (Scarpello Howlett, 2008). In the UKPD (United Kingdom Prospective Diabetes Study) a randomised trial on obese and overweight patients with initial metformin monotherapy showed a significant reduction in myocardial infarction and diabetes related deaths, it showed 39% decrease in heart attacks and 36% decrease overall mortality rate; metformin was found to be more effective than any other medication with regards to the strokes and overall mortality rate in overweight patients (Krentz Bailey 2005). Kooy et al (2009) investigated whether metformin had sus tained beneficial effects on metabolic control and risk of cardiovascular disease. After a follow-up period of 4.3 years it was found that metformin added to insulin in type II diabetic patients improved body weight, glycaemic control and it reduced the risk of macravascular disease. A 2007 systematic review evaluating antidiabetic agents and outcomes in patients with both diabetes and heart failure showed that metformin is the only antidiabetic agent that is not associated with harm in patients with heart failure and diabetes. In this systematic review and meta-analysis of controlled studies, two of three studies showed association of metformin with reduced all cause mortality and no association with increased hospital admissions. (Eurich et al, 2007) Pharmacokinetics The chemical name of biguanide is  1-(Diaminomethylidene)guanidine (chemical  formula C2H7N5) and it includes compounds that  have biguanide structure. Figure 2 shows the  molecular structure of metformin that has  biguanide structure with two methyl groups  added on the amine group of the first carbon  atom therefore its chemical name being  1,1-dimethylbiguanide and chemical formula  C4H11N5 (Porte et al, 2002). Metformin is taken orally so it has to pass through the digestive system in order to get into the systemic circulation. It is absorbed from the small intestine and does not get metabolised, under fasting conditions the Bioavailability of metformin ranges between 40%-60% (Foye, 2007). From the gastrointestine it gets completely absorbed after 6 hours of oral administration and after absorption it is rapidly distributed and in the plasma it is completely undetectable after 24 hours; the plasma concentration of metformin reaches its peak value within three hours of its oral administration (Papanas maltedoz, 2009). Unlike other biguanides such as phenformin the binding of metformin to plasma protein is negligible and therefore it does not seem to interact with highly plasma protein bound drugs such as sulphonamides and is excreted unchanged (Foye, 2007). Metformin does not get metabolised by the liver and therefore is excreted in the urine from the body as unmetabolised drug through the active tubular excretion and about 30% of an oral dose is excreted through faeces that may be unabsorbed metformin and that retain in the gastrointestinal tract (Porte et al, 2002). It has plasma half life of about 2 to 5 hours in patients with normal renal function but and renal function impairments may lead to retention of metformin in the blood plasma (Foye, 2007). According to Diabetes UK the daily dosage of metformin should be started from 500mg and then gradually increased to a maximum of 2550mg per day but it is entirely individualistic that it depends on the health of individual to consider what dosage is required. Generic metformin is sold in the form of tablets. A slow or extended release preparation of metformin (Glucophage XR ®), introduced in 2004 can act over 24 hours, it has been designed to release metformin slowly over a longer period of time than standard metformin (acts over 8-12 hours) and so its half life is increased to four to eight hours. Timmins et al (2005), in their study on 16 volunteers with 1000mg standard metformin dose twice a day or 2000mg Glucophage XR ® once a day, found out that the pharmacokinetics parameters are similar in Glucophage XR ® to standard metformin, but Glucophage XR ® it is evident to report fewer gastrointestinal side effects than standard metformin so patients who cannot tolerate standard metformin can switch to Glucophage XR ® (Feher et al, 2007). Side effects and contradictions When prescribed appropriately the most common adverse side effects of metformin include a change in taste, nausea or vomiting, abdominal distension or gas, loss of appetite, diarrhea, skin rashes or urticaria, rare – Lactic acidosis (Warrell et al, 2006). These problems are usually mild and occur in the first few weeks for taking the medication but it may discourage the patient from taking the drug, starting the medication in low dosage and increasing it slowly help reduce these side effects (Warrell et al, 2006). In clinical trial done on a total of 286 subjects, 141 were given metformin and the rest were put on placebo. This trial found that 53.2% of subjects who were given Metformin reported diarrhea in comparison with 11.7% for those on placebo, and 25.5% subjects on metformin reported nausea/vomiting compared with 8.3% for those on placebo (Drug Facts and Comparisons, 2005). Compared with any other antidiabetic oral drug metformin is most associated with gastrointestinal distress (Bolen et al, 2007). Phenformin was withdrawn from its theraputical use because of its association with lactic acidosis. Metformin which is similar in structure to phenformin has also been associated with lactic acidosis; however the risk associated with metformin is ten times lower than phenformin (Warrell et al, 2006). A case control analysis on the study population of 50,048 type 2 diabetic subjects using the U.K – based General Practice Research Database found out that the rate of incidence of lactic acidosis per 100,000 person-years is 3.3 cases amongst metformin users (Bodmer et al. 2008). Lactic acid is a by-product of metabolism and it becomes toxic if it is not neutralised fast enough. Lactic acidosis associated with metformin is a very severe and potentially fatal condition that can be avoided easily if the drug is prescribed carefully (Fitzgerald et al, 2009). It arises by the mode of action of metformin, that is the inhibition of hepatic gluconeogensis- a process that consumes lactate, produced by glycolysis, continuously to produce glucose (Warrell et al, 2006). Adopted from Fitzgerald et al. BMJ 2009 In normal conditions during respiration glucose is broken down into two pyruvate molecules in the first step (glycolysis), in the presence of enough oxygen mitochondria oxidises the pyruvate into CO2 and H2O through Kreb cycle by the use of pyruvate dehydrogenase enzyme. But if there is not enough oxygen present, the mitochondria cannot oxidise all of pyruvate so this excess amount of pyruvate is converted into lactate by the lactate dehydrogenase and this lactate is then used in the process of gluconeogenses in the liver. (Fitzgerald et al, 2009; Nicks A, 2009) As shown in figure 3, at site A metformin decreases the activity of pyruvate dehydrogenase and the conversion of pyruvate into CO2 and H2O, therefore at site B it enhancing the anaerobic metabolism even in the presence of enough oxygen and resulting in the increased production of lactate and as metformin inhibits the process of gluconeogenses in the liver, the lactate is not used up and is built up to the toxic extent. Lactic acidosis is the built up of lactate level in the blood (usually >5 mMol/L). (Nicks A, 2009; Fitzgerald et al, 2009) As indicated in figure 3, lactate is excreted 70% by liver, 5% by kidneys therefore liver or renal dysfunctions lead to the retention of lactate and hence to a severe form of lactic acidoses even in the absence of metformin and because metformin is excreted by kidneys if kidneys do not function properly then metformin builds up and hence the severity of lactic acidosis is even greater (Misbin, 2004). The most common contraindications to the use of metformin in people with type II diabetes are renal and liver dysfunctions, congestive heart failure and advanced age, ≠¥ 80 years, and the mortality rate of lactic acidosis is close to 50% (McCormack et al, 2005). But although heart failure has long been known as a contraindication for metformin use a systemic review 2007 showed that metformin is the only anti-diabetic drug that is not associated with any harm in patients withheart failure Eurich et al, 2007). A Medline searched review on the evidence for the use of metformin in the presence of these contradictions concludes that metformin treatment alone does not result in lactic acidosis unless other contributing factors exist as well (Tahrani et al, 2007). However if ingested in toxic doses or in the presence of renal elimination impairment, lactic acidosis does occur (Fitzgerald et al, 2009). The renal function of patients using metfomin should be regularly monitored. It showed be withdrawn if there is any disturbance in the renal function found. Figure 4 shows the current recommendations on contraindications and guidelines for the withdrawal of metformin. Metformin dose should be reviewed if serum creatinine level is greater than 130  µmol/l and a cut-off serum creatinine level above which metformin should be stopped is 150 µmol/l (Fitzgerald et al, 2009). It should be withdrawn during suspected tissue hypoxia that is a condition in which body tissues are deprived of adequate oxygen so cells are forced to respire anaerobically. Patients aged greater than 80 years are at greater risk because they are more likely to have heart problems and kidney or hepatic dysfunctions and patients should be more careful about their alcohol intake while they are on metformin because alcohol can seriously harm liver and that can lead to lactic acidosis (Tahrani et al. BMJ 2007). Metfor min should be withdrawn before any radiographical procedures involving iodinated contrast and should remain discontinued until after three days as this contrast dye may temporarily impair kidney function and cause the retention of metformin indirectly leading to lactic acidosis (Thomsen andMorcos, 2003) â€Å"Review dose of metformin * If serum creatinine is >130  µmol/l or estimated glomerular filtration rate is Stop metformin * If serum creatinine is >150  µmol/l or estimated glomerular filtration rate is Withdraw metformin* * During periods of suspected tissue hypoxia (such as myocardial infarction, sepsis) * For three days after use of contrast medium that contains iodine * Two days before general anaesthesia *Reinstate when renal function stabilises Contraindications * Renal dysfunction * Congestive cardiac failure needing drug treatment * Hypersensitivity to metformin * Acute or chronic metabolic acidosis * Impaired hepatic function Precautions * Age >80 years until renal dysfunction ruled out * Acute myocardial infarction * Radiological studies involving iodinated contrast * Surgical procedures * Alcohol intake † Salpeter et al (2003), in a system review considered 194 studies published between 1, 1959, and March 31, 2002 that evaluated metformin mono therapy or in combination with other treatments for at least one month, in data from these 194 studies there were no fatal or nonfatal lactic acidosis cases found in 36,893 patient-years in the metformin group or in 30,109 patients-years in the nonmetformin or placebo group. It also did not find any difference in lactate levels in metformin therapy and placebo or other non-biguanide therapies. This systemic review concluded that there is no evidence to support association of metformin therapy with increased risk of lactic acidosis or increased lactate level compared with other antihyperglycemic treatments provided that the drugs are prescribed in a suitable dose and all the contraindications are taken into account. Another side effect to the use of metformin is that when it is used in long term it is associated with malabsorption of vitamin B12 (Ting et al, 2006). Combination with other antidiabetic drugs Metformin monotherapy works well with life style interventions in type II diabetic patients but when Type II Diabetes is not controlled with Metformin monotherapy adequately it is often combined with other antidiabetic drugs to maximise its effect. The combination of metformin with rosiglitazone as a single product is known as Avandame, itwas approved by the FDA in October 2002 for the treatment of diabetes and although it has not been appraised by the National Institute for Clinical Excellence (NICE) yet it is often prescribed to patients with type II diabetes who fail to control their glycaemia despite the maximum dose of metformin (Diabetes UK, 2009). The active constituent of Avandamet, metformin and rosiglitazone,have different mechanism of action complementing the action of each other. The tolerability profile of Avandamet is similar to that of metformin, it is more effective in terms of lowering the HbA1c level than metformin or rosiglitazone (Wellington, 2005). Pooled data from two double-blind studies that involved 550 patients randomised to be given metformin with rosiglitazone or placebo patients were divided into obese, overweight or non-overweight. Patients from all groups improved their level of HbA1c and fasting plasma glucose (FPG) to a clinically important extent but the greatest improvement was found in the obese group, these patients improved their glycaemic control, beta cell function and insulin sensitivity with the addition of rosiglitazone to metformin than those who received placebo/metformin (Jones et al, 2003). Metformin can be combined with glyburide which is a member of sulphonylureas and it acts by enhancing insulin release from the cell of pancrease. The combination of these two drugs is proves to be successful in improving the glycaemic control in patients with type II diabetes Studies, such as sixteen week multicenter, randomized, double-blind, 4-arm and parallel clinical trial study (Chien et al, 2007) that involved a total of 100 Chinese patients with type II diabetes and out of which 76 were randomly given metformin 500mg, glyburide 5mg, glyburide/metformin 2.5 mg/500 mg or glyburide/metformin 5.0mg/500mg. After 16 weeks, those who received a combination of both drugs had a greater decrease in both fasting plasma glucose and HbA1c compared with those who received either metformin or glyburide. Insulin therapy alone sometimes fails in patients for the treatment of type II diabetes so metformin can be added to improve the sensitivity of insulin and this combination of two drugs results in superior glycaemic control compared with metformin or insulin alone and it also minimizes the weight gain in insulin therapy ( Wulffele et al, 2002). Continued use of metformin after insulin introduction patients with type II diabetes not only reduce weight and improve glycaemic control but have beneficial effect on cardiovascular outcomes (Kooy, 2009). Addition of pioglitazone to metformin is another combination for the treatment of type II diabetes, this is shown in double-blind, placebo-controlled, clinical trial done by Kaku (2009), compared with metformin monotherapy patients who received pioglitazone plus metformin improved their HbA1C by mean 0.67% and they significantly improved their fasting glucose level and other important markers such as free fatty acids, adiponectin and HDL, that are linked with increased insulin resistance and cardiovascular risks. Metformin can also be combined with other antidiabetic oral agents as a triple therapy for diabetes type II. In a study which was supported by Bristol-Myers Squibb Pharmaceutical Research Institute, 365 patients who were given metformin/glyburide treatment prior to a 24-week double-blind treatment were either assigned to rosiglitazone or placebo while carrying on with metformin, 40% of those patients who received rosiglitazone in addition to metformin/glyburide were able to achieve final HbA1c less than 7.0% and this study concluded that combination of rosiglitazone to metformin/glyburide is â€Å"an effective therapeutic strategy† for those who are unable to control their glycaemia and this treatment is beneficial for lowering HbA1C and fasting plasma glucose levels (Dailey et al, 2004). Who should be treated? Metformin is a very effective antihyperglaecamic drug for patients with diabetes type II and the American Diabetes Association (2006) recommended it as the first drug of choice for patients. Metformin is a preferred treatment for obese diabetics. In most of the cases Type II diabetes is associated with another disorder, obesity (Krentz et al, 2008). Obesity increases the risk of developing type II diabetes and many antidiabetic drugs increase body weight whereas, metformin demonstrates a significant weight loss in type II diabetic patients, Golay (2007) in his review on summarising the effect of metformin on body weight confirms that metformin has been shown to induce weight loss in nondiabetic obese patients, although long term studies on these patients are very rare. Therefore patients with obesity and on the risk of developing diabetes type II should start on metformin. Metformin is also effective with regards to strokes in obese/overweight patients i.e. those on the risk of developing diabetes. UKPD showed a significant reduction in myocardial

Comparing the Two Theories of Cognitive Development Essay -- Papers Ps

Comparing the Two Theories of Cognitive Development There are three main types of cognitive development. There is Piaget's theory, Vygotsky's theory and the Information processing approach. The two theories that I am going to compare and contrast are Piaget and Vygotsky's theories. There are many differences between these two theories, but there are also many similarities too. Piaget suggests that cognitive development takes place as a result of experiences which force the child to accommodate new information, creating new schemas and occasionally leading to a qualitatively different kind of thinking- moving from one stage to another, but these changes need to depend on readiness. However, Vygotsky placed more of an emphasis on the importance of social context in transforming elementary into higher mental functions, and the role of the ZPD in understanding how this transformation takes place. Piaget's theory, also known as the 'discovery learning theory', brought up two ways in which schemas became more complex, assimilation and accommodation. Assimilation is basically the process of fitting new information and experiences into existing schemas, and accommodation is the process of changing the existing schemas when new information cannot be assimilated. An example of this could be when a child has a schema "wings, beak and being able to fly" (a normal bird). Every new instance of a creature with the same characteristics is assimilated into this schema. But when that child sees an aeroplane in the sky, the child asks what it is. The aeroplane challenges the current schema. This new information cannot be assimilated into the ... ...cross cultural research based on Piagets theory. Piaget produced the first comprehensive theory of children's cognitive development. The theory has been more extensively developed than any other it has changed our ideas about children and has had a general influence on educational practice has. Also the good theories should generate research and Piaget's theory has certainly done so. Piaget's theory under emphasizes the role of language and social interaction in cognitive development. Vygotskys theory focuses on the process of cognitive development rather than the outcome, and this is harder to test. Vygotskys ideas on cognitive development have had considerable influence. Although Vygotsky produced very little direct empirical evidence, other researchers have provided support for his ideas and their application.

Four Weddings And A Polaroid :: essays research papers

Ruby looked up from her cold mug of coffee just as a mysterious man walked into the diner. the sound of the bells on the door handle had startled her and interrupted her usual day dreaming. She watched the man from her counter stool as he seated himself at a nearby booth. He gazed out the window with a troubled look on his face and finally turned and met eyes with Ruby. He offered her a kind smile but Ruby turned her head quickly out of embarrassment. She hadn't even realized she was starring at him, but there was something so familiar about him she couldn't help herself. "Wishful thinking, gals like us never get guys like that." Ruby's thoughts were immediately shut off bye her friend Elaine's comment. "And just why not?" Ruby replied, Elaine just smiled and continued drying the silver wear. Elaine worked at the diner as a waitress, though Ruby never quite understood why. She hated her job, always complaining about everything and everyone there. But that was just Elaine's nature, never satisfied. "Well I better get going, I still have to get my dress from the tailor's, for the big event," started Ruby as she gathered her coat and purse. "I would hardly call your sister's wedding a big event," commented Elaine. "If I recall this is her third big event in two years." "Fourth!" Ruby called out over her shoulder on her way out the door. The days of the week seemed to fly by and before she knew it, Ruby was in her apartment dressing for her sister, Jillian’s wedding. The mysterious man from the diner had almost completely escaped her thoughts. Running late, as usual, she finished fastening the clasp on her bridesmaid gown and hurried outside to catch a cab. Ruby was her sister’s maid of honor and to her it was an honor, at least the first time she was chosen for the position. â€Å"Where to?† beckoned the cabby from the front seat. â€Å"Church of the Redeemer on 38th Street,† Ruby told the cabby as she searched through her purse for the lipstick she had bought strictly for the occasion. She recalled standing, starring at the cosmetics shelf of the drug store for close to twenty minutes trying desperately to locate a shade that would match her dress. She felt foolish for wasting so much time on such an insignificant thing, but how in the world do you match a color like sea-foam?

Shakespeares Othello - Iago Essay -- Othello essays

Othello’s Iago  Ã‚        Ã‚  Ã‚   We find in William Shakespeare’s tragic play Othello an example of personified evil. He is the general’s ancient, Iago, and he wreaks havoc and destruction on all those under his influence.    Louis B. Wright and Virginia A. LaMar in â€Å"The Engaging Qualities of Othello† comment on how the character of Iago is the wholly expected type of villain for an Elizabethan audience:      Iago at once captures the attention of the spectator. He is the personification of the villain that Elizabethans had come to expect from Italian short stories and from Machiavellian commentary. Villains of this type, as well as those of domestic origin, had long been popular on the stage. From the days of the mystery and morality plays, the characters personifying evil invariably had gripped the attention of audiences, for iniquity always stirs more popular excitement than virtue. (127)    First of all, Iago’s very words paint him for what he is. Robert Di Yanni in â€Å"Character Revealed Through Dialogue† states that the evil antagonist reveals his character quite plainly through his speech:    Iago’s language reveals his coarseness; he crudely reduces sexual love to animal copulation. It also shows his ability to make things happen: he has infuriated Brabantio. The remainder of the scene shows the consequences of his speech, its power to inspire action. Iago is thus revealed as both an instigator and a man of crude sensibilities. (123)    David Bevington in William Shakespeare: Four Tragedies enlightens us on the ancient:    Iago’s machinations yield him both â€Å"sport† and â€Å"profit† (1.3.387); that is, he enjoys his evildoing, although he is also driven by a motive. This Vice-like behavior inh... ...gton, David, ed. William Shakespeare: Four Tragedies. New York: Bantam Books, 1980.    Coles, Blanche. Shakespeare’s Four Giants. Rindge, New Hampshire: Richard Smith Publisher, 1957.    Di Yanni, Robert. â€Å"Character Revealed Through Dialogue.† Readings on The Tragedies. Ed. Clarice Swisher. San Diego: Greenhaven Press, 1996. Reprint from Literature. N. p.: Random House, 1986.    Shakespeare, William. Othello. In The Electric Shakespeare. Princeton University. 1996. http://www.eiu.edu/~multilit/studyabroad/othello/othello_all.html No line nos.    Wright, Louis B. and Virginia A. LaMar. â€Å"The Engaging Qualities of Othello.† Readings on The Tragedies. Ed. Clarice Swisher. San Diego: Greenhaven Press, 1996. Reprint from Introduction to The Tragedy of Othello, the Moor of Venice by William Shakespeare. N. p.: Simon and Schuster, Inc., 1957.   

Youths Are Overly Dependent on the Internet’

In today’s world, it is not surprising to find teenagers, even young children, using the latest gadgets on buses, trains or even in restaurants. If you ever try to think about the last day you went without the Internet or cell phone, chances are you would have a hard time coming up with the answer. Youths, also, eventually have developed a dependency on the Internet to socialize with their friends or search for information to an extent that they lack interaction skills.Actually, the Internet’s not too bad. It’s usually the number one thing youths use because of all its possibilities – to download homework, research, chat with friends and make plans. The Internet has also made it much easier to stay in touch and make new friends. Furthermore, teachers have also taken advantage of the advancements to develop some sense of responsibility in the students by moving away from some pen-and-paper to more interactive online assignments.However, with the fact that t he web is accessible almost everywhere, through data roaming on smartphones or connecting the laptop to free Wi-Fi at shopping malls, a research showed that teens spend an average of 20 hours a week in front of a computer or television. With so many distractions around us, when are teens supposed to make time to hang out with friends or relax with their families? Many youths are also unaware of the kind of personal information they put online for the world to see.For instance, some youths will post about when they are leaving for their vacation for a period of time on social network sites Facebook and Twitter, without thinking of the consequences such as strangers emptying their house when they are away. One of the biggest problems for children is not that they are vulnerable but that their parents don’t know what they’re doing. Furthermore, a recent survey concluded that 75% of those aged between 16 to 24 years old couldn’t live without the Internet. It is unde niable that the chance for danger exists when using the Internet, specially for youths. There is definitely a high chance that future generations of young people will only increase their dependence on computers and as long as the Internet exits, there will be risks. The best thing for youths to do is educate themselves regarding the Internet, to know what not to do and understand how to protect themselves. In a world where technology is becoming more and more prevalent, everyone must learn to cope with the risks if they are to continue enjoying the benefits. Youths Are Overly Dependent on the Internet’ In today’s world, it is not surprising to find teenagers, even young children, using the latest gadgets on buses, trains or even in restaurants. If you ever try to think about the last day you went without the Internet or cell phone, chances are you would have a hard time coming up with the answer. Youths, also, eventually have developed a dependency on the Internet to socialize with their friends or search for information to an extent that they lack interaction skills.Actually, the Internet’s not too bad. It’s usually the number one thing youths use because of all its possibilities – to download homework, research, chat with friends and make plans. The Internet has also made it much easier to stay in touch and make new friends. Furthermore, teachers have also taken advantage of the advancements to develop some sense of responsibility in the students by moving away from some pen-and-paper to more interactive online assignments.However, with the fact that t he web is accessible almost everywhere, through data roaming on smartphones or connecting the laptop to free Wi-Fi at shopping malls, a research showed that teens spend an average of 20 hours a week in front of a computer or television. With so many distractions around us, when are teens supposed to make time to hang out with friends or relax with their families? Many youths are also unaware of the kind of personal information they put online for the world to see.For instance, some youths will post about when they are leaving for their vacation for a period of time on social network sites Facebook and Twitter, without thinking of the consequences such as strangers emptying their house when they are away. One of the biggest problems for children is not that they are vulnerable but that their parents don’t know what they’re doing. Furthermore, a recent survey concluded that 75% of those aged between 16 to 24 years old couldn’t live without the Internet. It is unde niable that the chance for danger exists when using the Internet, specially for youths. There is definitely a high chance that future generations of young people will only increase their dependence on computers and as long as the Internet exits, there will be risks. The best thing for youths to do is educate themselves regarding the Internet, to know what not to do and understand how to protect themselves. In a world where technology is becoming more and more prevalent, everyone must learn to cope with the risks if they are to continue enjoying the benefits.

Impacts on Social Media Essay

As we begin to discuss social media and is impact on mass communications as a whole, we must first define what it is and how it came to be. The Dynamics of Mass Communications defines social media as a set of Internet tools that encourages content sharing and community relationships. Users are able to create online communities by exchanging, distributing and receiving content information. Social media has rapidly integrated itself into our personal and professional lives over the past decade or so. Information is more available to the public today because of social media. The history of social media started with the BBS (Bulletin Board System) in the late 70’s. Most BBSs were involved in illegal or other shady practices like adult content, virus codes, and instructions on hacking and phone hacking, but BBSs were the first type of sites that allowed users to log on to it and interact with one another. This interaction was a lot slower than what individuals are used to in today’s society. Genie was created by a General Electric subsidiary (GEIS) in 1985 and was an early online service. It was a text-based service, and was considered the first viable commercial competition to CompuServe. This specific service was created to make use of time-sharing mainframes after normal U>S. business hours. Not too long after, America Online (AOL) started as an online service and made great strides with making the Internet more universally accessible within the United States. In 1988, IRC (Internet Relay Chat) was developed and used for file and link sharing and even keeping in touch with others. Readers could classify it as the father of instant messages as we know it today, though it was limiting access to most people. Touching the topic of early social networks, dating sites are sometimes considered the first social networks. Dating sites began to crop up just as soon as people began to get online with the Internet. These sites allowed users to create profiles with a photo and contact other people. Let’s not forget about Classmates.com, but dating sites and Classmates.com rarely  allowed you to keep a friends list and profiles appeared to be severely limited. The actual social networks like Six Degrees and LiveJournal were a tad bit more advanced than what dating sites had to offer. Six Degrees allowed users to create a basically-static profile while LiveJournal was created in 1999 and was a social network built around blogs that were constantly updated that encouraged other users to follow one another and form groups to interact. It wasn’t soon after that social interaction had found its way to online games. World of Warcraft is one the most famous for allowing players to interact both in the game would and on related forum and community sites. Massively multiplayer online role-playing games became popular in the early 2000’s though there were indeed other role-playing and other games prior to that. Additionally, the early 2000’s brought more advanced social networks and social media to the playing field. Some examples that most people are familiar with would be Friendster (2002), YouTube (2005), MySpace (2006), Facebook (2004), Tumblr (2006), Twitter (2006), and Instagram (2010). All these networks took a toll on millions and billions of people around the globe. People are more connected and up to date because of them. Social Media as a whole has brought a lot of positive effects to the world as we know it today. Social Networks started as a place to connect with your friends in an easy, convenient, and free from charge way. Social networks play an important role with social media. It has allowed individuals to connect with old friends from school, co-workers, and even with complete strangers. It has also provided us with the opportunity to build back a lost relationship or even better relationships with whom that are unable to meet us personally, and involve them with our lives and even take input into their personal lives with specific events that are happening with us. We are now able to communicate our thoughts and perceptions over different topics with a large number of audiences. Our voices are heard louder than ever with the help of social media and social networks. For example, with the Trayvon Martin case, people used social media to conduct marches and protests. On social networks, like Instagram, users blocked out their profile picture to show their involvement for wanting justice for that specific case. We have the option to make groups with people who are like minded and share the  related news with them and ask for their opinion or input about the topic. Far as businesses, they are using social media and social networks to promote their own products and there are a number of customized applications that are being made on social platforms, whose main and only purpose is to promote the product or brand given to them. The negative effects of social media seem to be quite questionable. Studies have shown that the extensive use of social media can quite frankly cause addition to the users. Throughout the day, people tend to feel the need to post something on their pages and check other posts as it has become an important part of everyday life. Extreme usage of social media had resulted in isolation of the individual. The level of human interaction has decreased tremendously and people appear to be less active. Individuals would rather check their smart-phones or tablets than actually picking up a book or a newspaper per say. Interpersonal communication has reduced and there aren’t many face to face communications and meetings being held because many people have lost their full ability to converse while being in the same room. Social Media is also affecting the productivity of people. Users are more distracted. Again, I must state that people are so caught up in texting, blogging, updating a status, and posting any and everything that it to the point where they cannot get specific things done. A prime example would be texting while driving or being on a social network while attempting to write a research paper or even complete homework. According to media bistro, the average person spent three hours and seven minutes online each day in 2012. It appears as online media becomes more popular; other media sources become less popular. People are not reading magazines, newspapers, listening to the radio, or watching television as much as they used to. As the popularity of social networks and online video increases, so does our time online. YouTube has more than one billion users that visit their website each month. Seventy two hours of video are uploaded to YouTube every minute. The list just goes on and this also goes for Facebook, Twitter, Netflix, Pinterest, Hulu, and Instagram. It seems nowadays that there are social and user-generated sites for just about every activity you can possibly imagine. There are social shopping sites and social financial planning sites. There are even sites to share goals and meet like-minded people. Sites to plan your travels and share them with others. There are so many apps and sites that accommodate the average person for me to say that social media has indeed made life better for people. Social media has become a huge part of millions of lives worldwide. On the other hand, social media has made everyday life harder or horrific for everyday people. Because social media has grown in popularity and mainstream, it can be used by stalkers to track their victims or even find new ones. Social networks make these privacy settings available to users to help prevent stalkers and predators from being able to see their update. In addition to stalkers, we must also consider cyber-bulling. Cyber-bulling has increased over the years and has affected a lot of social network users. These things can make it harder on individuals. One final thing that needs to be discussed is the fact that the people who have degrees to be covering the news face their job being at risk. News stations and news broadcasts are now up with competition against social media and social networks. This is because people use their mobile devices to obtain the news now a days. This is because it is more convenient to access things from your phone than to take time out to turn on the television or go buy a newspaper. This could make everyday life harder for them if they lose their job. Social media has come a long way since the days of BBSs and IRC charts and social media continues to evolve on a daily basis. With major social networks and social media sites making changes and improvements, it’s sure to keep evolving in the coming years. While in many ways social media has allowed us to share everything from the simplest to most sacred events of our lives with more people in real time, it has also taken away from the action of â€Å"living in the moment.† The one thing we can all conclude is that social media is not just a phase, and it most definitely won’t be going away anytime soon or at least until something better comes along. WORS CITED http://www.relevantmagazine.com/life/whole-life/how-social-media-made-me-better-person http://www.digitaltrends.com/features/the-history-of-social-networking/ View as multi-pages