Datasets:

Lambent

/

100k-finewebedu-samples-8kt

like 0

5. OUR APPROACH i. Tackling income inequality The Government Economic Strategy has set an ambitious target to deliver greater Solidarity in Scotland by reducing the nation's relatively high levels of income inequalities. Our aim is to reconnect more people to the mainstream economy and provide the opportunities - and incentives - for all to contribute to Scotland's economic growth. What the evidence says The evidence points to a number of key drivers of income inequalities in Scotland. These key drivers can be particularly acute for some groups in society. People from minority ethnic backgrounds, disabled people and those with caring responsibilities, for example, can be at a particular disadvantage: Low educational attainment and a lack of training A lack of qualifications can severely limit a person's likelihood of accessing, sustaining, and advancing in employment - and, indeed, of earning a decent wage. For adults on low pay or benefits, good quality vocational training and training within the workplace is a well-established route into jobs which provide a better wage. Substantial differences in life chances, quality of life and social inclusion are evident between those with low levels of literacy and numeracy and others at higher levels. Low level skills are associated with lack of qualifications, poor labour market experience and prospects, poor material and financial circumstances, poorer health behaviours and prospects, and lower social and political participation. The evidence tells us that most of those in the three lowest income deciles who are in work receive low hourly pay. In-work poverty is a very real problem in Scotland and can act as a disincentive to people who are looking to make the transition from benefits into work. Many women are concentrated in low paid employment and some minority ethnic communities, and in particular women from these communities, are disproportionately affected by low pay and occupational segregation, i.e. are over-represented in traditionally low-pay sectors. Caring responsibilities and other barriers to work The evidence tells us that families with caring responsibilities can face particular disadvantages in accessing and sustaining employment. Parents can face difficulties balancing the time burden of care and work - and can lose confidence and skills if they take time out of the labour force to care for their families. A lack of high quality reliable childcare can also discourage those furthest from the jobs market in seeking to take initial steps toward employability. A lack of incentives in the benefits system Evidence suggests that the threat of sudden benefits withdrawal can act as a real disincentive for many people who are looking to move from benefits into work. Currently, the tax credits and benefits system does not provide adequate support for people making these important transitions. To respond to these root causes of income inequality the Scottish Government, local government and their partners need to take an approach which: - Makes work pay - by providing people with the skills and training they need to progress in or into work and realise their potential; by supporting economic development and the creation of better employment opportunities; and by encouraging the enforcement of statutory workers' rights; - Maximises the potential for people to work - by removing any barriers to their employment, including through the provision of more accessible and affordable childcare, and learning the lessons from projects such as Working for Families. - Maximises income for all - so that everyone - including those who cannot enter the labour market - is well supported by income maximisation services and have a decent living standard whether or not they are in work. What more we will do The approach taken by local authorities in addressing income inequalities through the Single Outcome Agreements will support real improvement across Scotland - but, clearly, more needs to be done. Working with its partners across the broader public sector, Government will therefore take further, and more focused, action across the following areas: Making work pay - To help more people realise their potential - and to encourage more employers to deliver learning in the workplace - Government will provide additional funding through the Individual Learning Accounts Scotland scheme for in-work learning and ensure that it is targeted at those in the three lowest income deciles. - The Scottish Government will press the UK Government to transfer responsibility for personal taxation and benefits to Scotland, to allow the development of an approach to equity and boosting economic activity that fits with Scottish circumstances. Specifically, the Government will press for a simplification of the tax credits scheme and the promotion of greater availability of childcare vouchers. Moreover, it will continue to make the case for a single, progressive and accessible system for supporting parents with childcare costs and making work pay for low income parents. - The creation of stronger, more dynamic and sustainable communities is integral to the work of the enterprise agencies. This is particularly challenging in the fragile areas of the Highlands and Islands and in other rural communities, and both Highlands and Islands Enterprise ( HIE) and Scottish Enterprise will continue to support rural growth businesses and aid rural economic diversification. HIE will tackle the equity challenges through a new Growth at the Edge approach. This will bring together a range of activities - including community capacity building, leadership development, acquisition and development of assets for community benefit, support for business development and cultural initiatives - to enable disadvantaged communities to generate economic growth and create the conditions for population retention and growth. - The Scottish Government will publish in 2009 an analysis of the scope for further action on income inequality in Scotland through pay across the public sector, taking into account the interaction with the tax and benefits system. - The Scottish Government will with the Poverty Alliance, the STUC and Third Sector partners launch a campaign in 2009-10 to raise awareness of statutory workers' rights in Scotland in relation to the minimum wage, paid sick leave, holidays and maternity or paternity leave. - The Scottish Government will press the Department of Business, Enterprise and Regulatory Reform and Her Majesty's Revenue and Customs to step up their efforts in Scotland to raise awareness, increase enforcement with employers and ensure that all workers in Scotland get what is rightfully theirs. Maximise the potential for people to work - The Scottish Government will work with local authorities to identify and disseminate examples of projects which successfully remove barriers to employment, including the evaluation of the successful Working for Families project. - We will continue to roll-out Workforce Plus and early in 2009 we will launch and facilitate an Employability Learning Network. This will enable employability partnerships within CPPs to learn from the experience and best practice of others in Scotland and elsewhere in supporting the most disadvantaged in the labour market into work. - We will work with the Third Sector in 2009 to develop initiatives focused on fast-track entry into work, with transitional placements in the third sector and in-work support - all with the aim of addressing the gap that so often exists between those who are out of work and employers. - We will work with NHS Boards, Jobcentre Plus and others to provide better support for those with mental and physical health needs who are currently receiving benefits but who might be able to join the workforce. Many of Scotland's citizens who currently receive Incapacity Benefit would like to work, and this targeted support will help them make that important step. - We will work with the Third Sector to ensure that people are equipped with the financial skills that they need to help them manage their money during the transition into work. - We will set out plans in 2009 for improved employability and skills services to Scotland's black and minority ethnic communities, working with community organisations. - In line with our commitment in the Government Economic Strategy to improve the life chances of those at risk, we will extend our approach on inclusive employment for people with learning disabilities - so that other disadvantaged groups are able to benefit from this too. - NHSScotland is one of the largest employers in Scotland. Territorial Boards are required to offer pre-employment training and opportunities for employment for people on benefits, through Health Academies or similar schemes. Many Boards are signing up to Local Employment Partnerships with Jobcentre Plus, committing to providing opportunities for people identified as on benefits and wishing to return to work. Some local authorities are working in partnership with their local health boards to extend the scope of the schemes and efforts will be made to make the approach more widespread. The Scottish Government will work with COSLA in 2009 to promote to local authorities a common public sector recruitment approach to develop pools of appropriate individuals from which smaller public sector recruiters could also draw. - We will use the evaluation of our 14 existing pilots to support those with multiple and complex needs to focus investment on a smaller number of approaches aimed at supporting those with multiple and complex needs - such as disability or mental health issues - overcome barriers to employment and will announce plans for this in 2009. Maximising income for all - We will make significant new investment in 2009-10 and 2010-11 in income maximisation work. This will include a focus on benefits uptake for older people and other key groups, building on our existing pilots with Age Concern Scotland, and work to increase people's net disposable income - helping their money go further. We will build on what works and develop new approaches to boost the income of those in poverty or at risk of poverty. This will be linked to implementation of the income maximisation recommendations in the Equally Well report and from the National Fuel Poverty Forum. ii. Longer-term measures to tackle poverty and the drivers of low income What the evidence says The evidence suggests that, while dealing with the root causes of low income, we must also adopt an approach which breaks the inter-generational cycle of poverty and which addresses the following, major longer-term drivers of poverty in our society: Inequalities in attainment of our children and young people There is compelling evidence which shows that - despite the best efforts of Government, local authorities and others so far - many children and young people are still held back by social and economic barriers which hamper their development and make it much more likely that they will experience poverty in later life. Inequality resulting from discrimination and bias Despite the legislation to provide protection from discrimination, many people still experience disadvantage and limited opportunities because of their gender, race, disability, sexual orientation, faith, age or social background. Whilst huge progress has been made in making society fairer, discrimination still exists and institutions, public bodies, private enterprises and voluntary organisations can sometimes conduct their business in a way that may, unwittingly, disadvantage particular groups of people. The barriers and limited opportunities that arise as a result can lead to poverty and disadvantage. The gap in life expectancy in Scotland has increased consistently over the past 10 years. Problems from drugs and alcohol abuse; from mental ill health and from other key health problems are far more pronounced amongst our poorer citizens. The distribution of poor health has an impact upon income inequality and can pass from generation to generation. A lack of good quality, accessible and affordable housing - particularly, within our more deprived areas It is clear that housing supply must be increased in many parts of Scotland over the longer term if we are to meet the nation's future housing requirements, ensure greater fairness and stability in the housing market, and help regenerate our most disadvantaged communities. In particular a strong supply of affordable housing is essential to support the country's social housing needs and encourage labour mobility from disadvantaged areas to areas with greater demand for labour. Responding to these longer-term drivers of poverty in our society, therefore, the Scottish Government, Local Government and their partners need to take an approach which: - Provides all children and young people with the best start in life - by putting parenting at the heart of policy, providing better access to spaces to play, and making every pre-school and school a family learning environment, so that all can realise their potential and avoid poverty in later life. - Supports the broader effort to deal with the health inequalities in our society - by implementing the recommendations of the Equally Well report, including the development of financial inclusion activity within mainstream public services and promoting the evidence of the health benefits of employment and by taking a holistic approach to social issues such as violence - so current and future generations are able to live healthy working lives that are free from poverty. - Promotes equality and tackles discrimination - by challenging stereotypes, building on public sector equalities duties, and supporting individuals so that all can reach their potential. - Delivers good quality affordable housing for all - investing in house-building and protecting the housing stock - so that everyone in Scotland has the opportunity to live in a decent house that they can afford in a place where they can access services and employment. - Regenerates disadvantaged communities - promoting the lasting transformation of places for the benefit of the people that live there by: targeting investment; creating the right environment for private and public investment and devolving power to the local level. What more we will do The approach taken by local authorities in addressing the major, longer-term drivers of poverty through the Single Outcome Agreements will support real improvement across Scotland - but, clearly, more needs to be done. Working with its partners across the broader public sector, the Scottish Government will therefore take further, and more focused, action across the following areas: Providing children and young people with the best start in life - We will introduce an early years framework to address many of the root causes of disadvantage through a focus on supporting parents and communities to provide the nurturing, stimulating environment for children. This will involve shifting the focus from crisis intervention to prevention and early intervention. - By 2010-11, we will put in place arrangements for a weekly allowance to be paid to kinship carers of looked after children. This will be at an equivalent rate of the allowance paid to foster carers - subject to agreeing with the DWP that this will not negatively impact on the benefit entitlements of these carers. - Central to Curriculum for Excellence is the ongoing entitlement for all our young people to develop their skills for learning, skills for life and skills for work in whatever type of provision is best suited to their needs and aspirations. 16+ Learning Choices is our new model for ensuring that every young person has an appropriate, relevant, attractive offer of learning made to them, well in advance of their school-leaving date. We expect this to be a universal offer across Scotland by 2010; a specific focus will be needed by local authorities and their partners on the most vulnerable young people. - We will build on our abolition of the Graduate Endowment fee by progressing wider plans to ensure that access to higher education is based on the ability to succeed rather than the ability to pay. Supporting the broader effort to deal with the health inequalities in our society - We will implement the key recommendations from Equally Well, the report of the Ministerial Taskforce on health inequalities and tackle the shared underlying causes of health inequalities and poverty. This will include the establishment of test sites for the task force's approach to redesigning and refocusing public services, using the best available evidence to inform good practice. - Violence affects all of Scotland but it does not do so equally. We know that the death rate from assault in the most deprived communities is nearly four times that of even the Scottish average, and over ten times that in the least deprived communities. The Scottish Government will support the Violence Reduction Unit to deliver its 10 Year Violence Reduction Action Plan - launched on 17 December 2007 - in order to reduce significantly violence in Scotland. Promoting equality and tackling discrimination We will continue to progress a range of activities to advance equality and to tackle discrimination including: - Work with the public and third sector and the Equality and Human Rights Commission ( EHRC) to embed and progress equality, building on the public equality duties. - Activities to raise public awareness and challenge the stereotypes and attitudes which limit the opportunities for particular groups. - The development, in concert with the EHRC and the UK Government, of a framework for measuring progress on equality. - Working with disabled people, COSLA and the EHRC in shaping a programme to improve the opportunities for disabled people to live independently. - Developing guidance for CPPs on the Equality Impact Assessing of Single Outcome Agreements. We will set out the detail of these proposals with our partners in 2009. Delivering good quality affordable housing for all To deliver good quality affordable housing for all, the Scottish Government will implement the approach set out in Responding to the Changing Economic Climate: Further Action on Housing by: - Providing over £1.5 billion for affordable housing investment across Scotland during the period 2008-11 - with £100 million of that being brought forward to accelerate the building of affordable housing; - Legislating to exempt new social housing from the Right to Buy, to protect the stock for future generations of tenants; - Making £25 million available to Councils to encourage them to build new homes for rent; and - Making £250 million available over the period 2008-11 to increase the funding for the Scottish Government's Low-cost Initiative for First Time Buyers ( LIFT) programme to help first time buyers get a foot on the property ladder. - Funding an awareness campaign in 2008-09 to encourage those with financial difficulties to seek advice from the national debt-line to avoid home repossession. - Establish a home owner support fund of £25 million over 2 years to support mortgage to rent and mortgage to shared equity transfers. Regenerating disadvantaged communities - We will continue to support the six Urban Regeneration Companies ( URC) throughout Scotland to help transform our most deprived areas, and to lead improvements in employability, educational attainment, community safety and health in those areas. - Scottish Enterprise will engage with URCs and others delivering projects of a national or regional scale, to make regenerated areas attractive to inward investment and other business opportunities. New businesses and indigenous business growth will create further employment opportunities in high unemployment areas. - As indicated in our Government Economic Strategy, we will support social enterprise - as part of our wider investment in the third sector - to provide start-up assistance and to provide supported employment to those furthest from the labour market. - CPPs are seeking to use the Fairer Scotland Fund to accelerate the achievement of real outcomes for the most disadvantaged areas and vulnerable people. We will support them in this process by developing a community regeneration and tackling poverty learning network in 2009 to share best practice across Scotland. - The 2014 Commonwealth Games will provide individuals, groups and organisations across Scotland with a range of opportunities and has the potential to act as a catalyst for economic, physical, and social regeneration in Scotland. The Games will create an estimated 1,200 new jobs in Scotland of which 1,000 will be in Glasgow. Glasgow City Council is placing appropriate community benefit clauses in tenders relating to the 2014 Games. - Preparations for the Games are closely linked to the work of the Clyde Gateway URC in the east end of Glasgow and neighbouring South Lanarkshire, into which we are investing £62 million. The Gateway has the potential to transform one of the most deprived communities in Scotland. iii. Supporting those experiencing poverty What the evidence says Evidence suggests that, to help those experiencing poverty, the Scottish Government, Local Government and our partners must adopt an approach which: - Delivers a fairer system of local taxation - based on ability to pay, to bring much-needed relief to Scottish household budgets. - Supports those who face hardship as a result of rising energy prices - by implementing key recommendations from the National Fuel Poverty Forum and developing measures to make our citizens' money go further. - Puts in place measures to provide greater financial inclusion - to help people avoid falling into hardship, whether as a result of economic downturn, or health, family and personal problems - as well as to address the stigma of poverty, particularly among our children and young people. What more we will do The approach taken by local authorities in supporting those experiencing poverty through the Single Outcome Agreements will make a difference to many thousands who are currently experiencing poverty - but, clearly, more needs to be done. Working with its partners across the broader public sector, the Scottish Government will therefore take further, and more focused, action across the following areas: Replace the Council Tax with a fairer Local Income Tax - The Scottish Government will legislate to replace the regressive, unfair Council Tax with a fairer system of local taxation, based on ability to pay. This change will help to lift an estimated 90,000 people out of poverty. This will provide a vital financial boost to low and middle-income households across the country as the biggest tax cut in a generation. Eight out of ten families living in Scotland will be better or no worse off, with, for example, the average married couple with children saving £182.00 per year, and the average single pensioner £369.20 per year. Supporting those who face hardship as a result of rising energy prices - The Scottish Government re-established the Fuel Poverty Forum to advise us on how best to tackle fuel poverty in future. We will implement their recommendation of a redesigned Energy Assistance Package for the fuel poor. This will provide more help and advice on all aspects of fuel poverty - checking those vulnerable to fuel poverty are on the best fuel tariff and maximising their income and improving the energy efficiency of their homes. Energy companies have agreed to work with the Government on providing a package of insulation measures, funded under Carbon Emissions Reduction Target, to fuel poor households, and the Government will fund enhanced energy efficiency improvements to those households hardest hit by higher fuel bills. We expect many rural homes that are hard to insulate and not on the gas grid will be able to benefit from energy efficiency measures under the new Energy Assistance Package. - The Scottish Government will press energy companies and UK Ministers to take action to minimise the impact of high fuel prices, particularly on our most vulnerable people. - The Scottish Government will continue to call for action on fuel prices at a UK level, seeking greater consistency and clarity around the social tariffs being offered by energy companies and pressing the UK Government to reconsider its decision not to put social tariffs on a mandatory legal footing, and for more progress on data sharing which would help energy companies target help at those most in need. Put in place measures to provide greater financial inclusion and address the stigma of poverty - The Scottish Government will introduce legislation to extend entitlement to free school meals to all primary school and secondary school pupils whose parents or carers are in receipt of both maximum child tax credit and maximum working tax credit. This will increase entitlement to around an additional 44,000 pupils. - The Government will introduce legislation to enable local authorities to provide free school meals to P1-P3 pupils by August 2010. - We will increase availability and usage of money advice services and ensure they are appropriately targeted at and accessible to people from minority ethnic and faith communities, for example by being Sharia compliant for Muslims who seek it. - For the first time, all young people will be taught how to manage their money and understand their finances as a result of Curriculum for Excellence. To ensure that teachers are adequately supported to deliver financial education the Scottish Government will provide additional support and funding to the Scottish Centre for Financial Education. - There is strong evidence that problems with health, employment, housing or in the family put people at risk of falling into poverty, and can trigger further problems. Carefully targeted advice and representation can prevent this happening. We will work with advice providers and the Scottish Legal Aid Board to better integrate and so improve advice and support for people at risk of poverty. - The Scottish Government and COSLA will carefully consider the recommendations of the short life working group on the School Clothing Grant. - The findings of recent research carried out on behalf of the Scottish Government into the experience of poverty in rural areas and how that may differ from the experience in urban areas will be useful for service providers, including local authorities. We will publish that research and arrange an event at which we can share findings with relevant partners. iv. Making the Benefits and Tax Credits system work better for Scotland In the Government Economic Strategy, the Scottish Government pledged that it will continue to make the case for Scotland to have fuller, and eventually full, responsibility for personal taxation and benefits, to allow the development of approaches that better fit with Scottish circumstances. Over the months and years ahead, therefore, the Government will make the case for a benefits and tax credits system which provides security of income, supports transition to employment and allows those who cannot work to live with dignity. The Scottish Government and Scotland's local authorities believe that Scotland's benefits, tax credits and employment support systems must act to protect our people from poverty and help them fulfil their potential. Irrespective of the administrative arrangement governing tax and benefits, the following key principles must guide benefits and tax credits policy if poverty and income inequalities in Scotland are to be eradicated: - Individuals must have a strong degree of confidence around the security of their income. This means that the benefits system must be fair, transparent and sympathetic to the challenges faced by people living in poverty. - The benefits, tax credits and employment support systems must work in harmony to support those who are capable of pulling themselves out of poverty through work. The financial benefits of working for those who can work must be significant, sustained and clearly signposted. - Successful transitions into employment should never be undermined by financial uncertainty. This means that the system of transitional support must be transparent, responsive, quick and effective. - For some, work is not possible. It is essential that the benefits system does not relegate such people to a life of disadvantage, financial uncertainty and poverty. Benefits must provide a standard of living which supports dignity, freedom and social unity. This must include female pensioners disadvantaged under the current system for time spent caring for dependents. - The administration of benefits and tax credits should be as swift, streamlined and customer focused as possible to avoid administrative complexity leading to confusion and uncertainty about entitlement and support, particularly where individuals are trying to make a successful transition back into work. What more we will do: To make the benefits and tax credits system work better for Scotland's people, we will: - Seek to establish a high-level biennial meeting involving Scottish Ministers, COSLA leaders and Ministers from the Department for Work and Pensions, to examine ways of developing and co-ordinating policies that will work in the best interests of Scotland. - The Scottish Government will work in 2009 to develop these principles in the context of the National Conversation, and will present a range of policy options for tackling poverty and income inequality in the event of additional fiscal autonomy or independence. - Scottish Government and partners will encourage local DWP officials to engage in each of Scotland's Community Planning Partnerships, in line with current best practice. v. Supporting partners and engaging wider society We can only deliver significant and lasting improvements to the lives of those experiencing poverty through collective action with all parts of Scottish society playing a role. The Scottish Government is committed to supporting our partners in local government and the public sector, but also wider civic society in Scotland, to reduce poverty and income inequality in Scotland. Support for Community Planning Partnerships Community Planning is a process which helps public agencies to work together with the community to plan and deliver better services which make a real difference to people's lives. Community Planning Partnerships ( CPPs) have been formed across the country to deliver these benefits. Those partnerships were clear in their response to our consultation that the Scottish Government needs to provide them with more guidance on how to tackle poverty and income inequality in their local areas through a Framework such as this one. The Scottish Government will respond to CPP requests that we provide more information and support to their local level planning efforts, by: - Developing an online Tackling Poverty Toolkit in 2009 which will set out the national context within which CPPs' work will take place; a series of policy papers setting out the evidence of what works; links to the available data and guidance on interpretation; and a library of best practice examples of successful interventions. - Establishing learning networks in 2009 to support CPPs to access expertise on community regeneration and tackling poverty. - Work with the EHRC and COSLA to provide guidance to CPPs on equalities issues, including legal obligations and Equality Impact Assessments. - Recent guidance for CPPs on preparing SOAs provides advice to CPPs on how this Framework and its sister documents can support their SOAs, and stresses the importance of tracking inequalities on a cross-cutting theme for all SOAs. Learning from our neighbours Respondents to our consultation were impressed by those countries which have managed to combine economic growth with lower levels of poverty and income inequality, for example Finland and Norway. The Scottish Government will develop stronger links with all levels of government and public services in these countries and use the resultant learning. The Scottish Government and COSLA will also do more to engage with and learn from the European Anti-Poverty Network. Supporting the Third Sector The Third Sector can play an important role in connecting with individuals and communities. Social enterprise can create opportunities for employment and income in areas where the private sector might not choose to operate. The third sector is a key partner, bringing experience of practical issues and multiple and complex need to the design of public services, particularly through their contribution to Community Planning. We will provide training and funding to support the Third Sector in their contribution to tackling poverty and income inequality. To support the creation of the right environment for growth the Scottish Government has announced that it will: - Provide training for public sector purchasers to help open all markets to the third sector; - Invest £30 million in the Scottish Investment Fund. This will support enterprise in the Third Sector through strategic investment in individual organisations in combination with integral business support and management development. - Invest in a £12 million Third Sector Enterprise Fund aimed at building capacity, capability and financial sustainability in the Third Sector. - Provide funding, through Firstport, for social entrepreneurs to establish new social enterprises. - The Scottish Government will continue to support the social economy to increase access to affordable credit and other services offered by Third Sector financial services. - The Scottish Government and COSLA will work to ensure the structured engagement of the community and voluntary sector with local authorities and the Scottish Government. This will complement existing work to improve the engagement of Third Sector organisations with CPPs. It is critical that the Third Sector contribution to Community Planning is strengthened - that its voice is heard as SOAs are developed. We are working with the Third Sector to identify ways we can provide greater support to communities, allowing them to make change happen on their own terms. By harnessing their energy and creativity to identify solutions to local challenges and by giving them responsibility for delivering that change, we can make a lasting impact on poverty and income inequality. - The Scottish Government and COSLA, will publish a community empowerment action plan by April 2009, building on the learning from the use of the National Standards for Community Engagement. The Private Sector The Private Sector must play a key role if we are to successfully reduce income inequalities and tackle poverty in Scotland. Regeneration and economic development are dependent on the contribution of this sector. Private Sector involvement in CPPs must be strengthened. This will allow perspectives and experiences from this sector of the community to be more widely heard than they have in the past. - The Scottish Government will seek to further engage the Private Sector in delivering Solidarity at the national level through the work of the National Economic Forum in 2009. - COSLA will work in 2009 with national representative business organisations to investigate how businesses can be better engaged in the CPP process in all parts of Scotland. The success of the Framework should be judged by the extent to which it influences investment decisions and action in all parts of the public sector in Scotland, and engages with and supports action by other parts of Scottish society. Information on becoming involved in local CPPs for individuals, businesses and the Third Sector can be found at http://www.scotland.gov.uk/library5/localgov/cpsg-00.asp and at Scotland's Community Planning website: http://www.improvementservice.org.uk/community-planning Citizens in Scotland will be able to track progress on poverty and inequality at a national level through the Scotland Performs website: http://www.scotland.gov.uk/About/scotPerforms/performance The Scottish Government will consider with COSLA how The Poverty Alliance's National Forum can be best used to inform the national debate on progress with poverty and inequality. National Outcomes and Indicators Progress against the National Outcomes we have agreed with our partners, for example: |"We have tackled the significant inequalities in Scottish society."| Can be tracked through our basket of National Indicators, and local indicators adopted by CPPs. Those National Indicators include the following which are relevant to efforts to tackle poverty and income inequality in Scotland: - Improve people's perceptions of the quality of public services delivered; - Increase the proportion of school leavers (from Scottish publicly funded schools) in positive and sustained destinations ( FE, HE, employment or training); - Increase the proportion of schools receiving positive inspection reports; - Reduce the number of working age people with severe literacy and numeracy problems; - Decrease the proportion of individuals living in poverty; - 60% of school children in primary 1 will have no signs of dental disease by 2010; - Increase the proportion of pre-school centres receiving positive inspection reports; - Increase the social economy turnover; - Increase the average score of adults on the Warwick-Edinburgh Mental Wellbeing scale by 2011; - Increase Healthy Life Expectancy at birth in the most deprived areas; - Reduce alcohol related hospital admissions by 2011; - Reduce mortality from coronary heart disease among the under 75s in deprived areas; - All unintentionally homeless households will be entitled to settled accommodation by 2012; - Reduce overall reconviction rates by two percentage points by 2011; - Increase the rate of new housebuilding. Local partners have also developed a range of relevant local indicators as part of the first Single Outcome Agreement process. These include: - Reduce work-related benefit claimants per 1,000 of the population; - Reduce under-16-year-old pregnancies per 1,000; - Increase percentage of adults rating neighbourhood as 'very good' or 'fairly good'; - Increase percentage of social housing above quality standard; - Reduce percentage of children in benefit dependent households; - Increase number of affordable homes. These indicators and others give us a strong platform from which to observe progress and drive change. Reducing poverty and inequality will support a narrowing of the gap in outcomes between the poorest and most affluent members of society across a range of areas - including health, education - but it must also be driven by a narrowing of that gap. We will therefore continue to work with our partners, including the Improvement Service, to develop indicators which drive improvements fastest for our most deprived citizens. Information on each Local Authority's Single Outcome Agreement can be found at: http://www.improvementservice.org.uk/component/option,com_docman/Itemid,43/task,cat_view/gid,561/ Copies of this Framework are available from; Scottish Government - Tackling Poverty Team Area 2F (South) 0131 244 0064

<urn:uuid:a82eebef-3e2a-4e3a-a903-be607c59d2d8>

CC-MAIN-2019-47

https://www.gov.scot/publications/achieving-potential-framework-tackle-poverty-income-inequality-scotland/pages/5/

s3://commoncrawl/crawl-data/CC-MAIN-2019-47/segments/1573496668716.69/warc/CC-MAIN-20191116005339-20191116033339-00377.warc.gz

en

If you are looking for eco-friendly materials, there are many options you have. With many brands marketing their materials as sustainable and renewable resources, I always wonder which materials are the most eco-friendly. Eco-friendly is a material that is not harmful to the environment. I’ve done some research and created a handy reference guide to the most eco-friendly materials that are available. 1. Bamboo Fiber Bamboo is considered one of the most renewable resources on the planet due to its ability to rapidly grow in various climates throughout the world and its natural antibacterial properties, which don’t require the need for chemicals or pesticides. As a textile, bamboo is created from the pulp of bamboo grass. These natural fibers are then mechanically combed out and spun into yarn. As a result, you have a fabric with a very soft feel similar to linen. Bamboo textiles can also be created with an intense chemical process in which bamboo leaves and fibers are cooked with strong chemicals and then hardened into fine strands and spun into yarn. These strands result in a very soft and silky fabric known as “rayon from bamboo”. This process is not very eco-friendly as it involves the use of toxic chemicals that can be harmful to the environment when not disposed of properly. Some manufacturers have opted to use the less harmful process to chemically manufacture bamboo fibers called “lyocell” where these less-toxic chemicals are processed to be recycled and used again. Bamboo-derived textiles may not be the most perfect option for a fully sustainable and eco-friendly material, but no fabric is perfect. Polyesters and acrylics are fossil fuel based and require plenty of water, chemicals, and energy to produce. Cotton is available in both conventional and organic versions, but both are water and chemically intensive crops. 2. Bamboo Hardwood When compared to sustainable European hardwoods, bamboo is fast-growing and will reach maturity in five years, whereas other woods can take up to 25 years. Bamboo is also self-regenerating and will replant itself after harvesting. Most bamboo is grown and manufactured in China which can reduce its carbon footprint. It is commonly thought that the manufacturing of bamboo in China and then shipping west to Europe or North America, compromises its eco-friendly properties. This can be a slight disadvantage, but when hardwood is felled, it will be shipped to China to be manufactured, then shipped back west to be sold, making it travel which is twice as much as bamboo. When looking for truly eco-friendly bambo, make sure the material is treated according to environmental standards. The Forest Stewardship Council (FSC) certificate makes sure that the harvest of bamboo and timber preserves the natural biodiversity and ecology of the forest. Cork has naturally buoyant and waterproof properties. As a naturally harvested material, only the bark from the cork tree is taken which means the tree can keep on living and provide oxygen to the environment. Some cork trees can live up to 300 years! One cork tree is enough to supply many generations as the tree’s bark can be harvest every 9 years after the age of 25. With cork sequestering CO2 from the atmosphere, every time the cork is harvested, the tree absorbs more CO2 to aid in the regeneration of the bark. Cork trees that are regularly harvested can store 3-5 times more CO2 than those cork trees unharvested. This makes cork an excellent sustainable and renewable resource. Cork is a biodegradable and easily recyclable resource. During the manufacturing process, any cork waste that is produced can be recycled to make other cork products and will not pollute the environment. Cork isn’t just used to top wine bottles! In addition to household items and personal accessories, cork can be made into flooring, wall coverings and adapted into textiles for fashion. It is one of the best alternatives to leather and plastics. Teak is a hardwood from Southeast Asia that is a sustainable timber commonly used for both indoor and outdoor furniture along with patios and decking. Teak is prized over pine and oak woods due to its natural oils and rubber found inside the tight grains of the wood. Because of these natural oils, teak hardwood has naturally weather-resistant properties that prevent the wood from dry rotting and potentially damaging parasites. Produced in Indonesia on the island of Java, the government has strict regulations for teak grown on plantations. Only a predetermined number of trees can be felled each year with the requirement that one is replanted with each lost tree. Teak is known for its durability and elegance but it will come with an expensive price tag. In comparison to pine and oak, teak will save you from annual waterproofing and upkeep, lasting for many years. 5. Bioplastic Compostables Bioplastics are materials made from sugar cane fibers, corn, and potato starch. They are an eco-friendly alternative to petroleum-based plastics which can take hundreds of years to biodegrade in the environment. Since bioplastics they are generated from sustainable sources, they will break down naturally instead of producing more plastic waste into the environment. Bioplastic compostable products will look and feel just like regular plastic. Products such as compostable cutlery, tableware, straws, cups, plastic bags, and packaging are commonly made from bioplastics. Some multinational corporations, such as Coca-Cola and Heinz, are opting to switch to produce a percentage of their packaging using bioplastics in an effort to be more environmentally friendly. This may be the right step forward. Hemp is an eco-friendly material that is replacing plastic-based materials for both clothing and home decor. It is grown free of pesticides or fertilizers and will yield more than 250% more fiber than cotton and 500% more pulp fiber than forest wood per acre. Cotton uses 50% more water than hemp in order to be turned into fabric, this makes it a much more sustainable option over cotton. As a fabric, hemp is more porous than cotton and allows your skin to breathe better. It is resistant to mildew and will soften with age making it an ideal fabric for clothing and linens. Hemp farming today is very limited, so it can be difficult to find 100% hemp made clothing but mixtures of hemp and cotton can still be high-quality apparel. In addition to fabrics, hemp is used to make foods such as oils, seeds, protein powder, milk, butter, and even beer! Hemp is made from that infamous green plant family but because of stigma, hemp is often overlooked for its sustainability as a renewable resource. 7. Organic Cotton The “fabric of our lives” is used for nearly everything we come in contact with on a daily basis, from our clothes and bedsheets to even some of the food we eat. The growth of conventional cotton can have a huge environmental impact on the use of toxic pesticides and fertilizers. Organic cotton is grown without these harmful chemicals and requires less water so the surrounding environmental impact organic cotton farming is much lower. Any cotton sold as organic in the United States must meet strict governmental regulations. Unfortunately, less than 1% of all cotton grown is organic but today more and more brands are committing to using organic cotton during production; the retailer H&M is the world’s largest buyer of organic cotton. When looking for an eco-friendly organic cotton option, avoid dyes and go for textiles that come in the natural shades that cotton is grown in, light brown, cream, and pale green. Organic cotton can cost more than conventional cotton due to farming and manufacturing processes but may be worth the extra price to help promote a sustainable and eco-friendly industry. 8. Soybean Fabric Soybean fabric is a renewable resource as it is made from a by-product of soy foods such as tofu and soybean oil. It has a soft texture comparable to silk when it drapes and can be used for many textiles in the home. It’s also a cruelty-free alternative to silk and cashmere production, which both involve the use of animals. Soy fabric does undergo an extensive process from a plant into a fabric. This requires breaking down the proteins in the soybean with heat and chemicals which are filtered into fibers and spun into long strands. A positive is that the chemicals in this process are recycled in a closed-loop process, but some can be harmful when exposed to humans. Soybeans are used in many of the ingredients of the foods we eat today, with nearly 80% from GMO (genetically modified) soybeans. How the soybeans are grown can be a factor in it being environmentally friendly or not. GMO soy requires a large amount of water and pesticides for cultivation. If you want a more eco-friendly and sustainable option, look for fabric, garments, or yarn which made from organic soy. 9. Recycled Glass Recycled glass can be melted down into different forms of glass or glass fiber. When glass bottles arrive in the recycling facility, they are broken and crushed up into tiny pieces, sorted and cleaned, then prepared to be mixed with raw materials like sand, soda ash, and limestone. Combined with these raw materials, glass pieces are melted and molded into new glass bottles and jars. Glass produced from recycled glass is melted at lower temperatures thus lowering energy requirements for production compared to glass produced directly from raw materials. Recycling glass also reduces the amount of glass waste that will end up in landfills. Glass from food and beverage containers can are 100% recyclable. Some states in the US even offer a small amount of money, usually .05-10 cents per bottle as an incentive. Be aware that window glass, ovenware, Pyrex, and crystal are produced through a different process so they are not as easily recyclable. Glass can also be easily upcycled or reused in a creative way. Save your bottles and jars and turn them into reusable storage containers in the kitchen or garage. Some companies are even using recycled glass bottles to create mosaic-style countertops. 10. Recycled Paper Recycling paper is one of the easiest ways to have a positive impact on the environment. It hasn’t always been popular as the idea of reducing the number of trees felled didn’t catch on until the late 20th century. It wasn’t until 1993 that more paper was recycled than thrown away. Recycling paper products can have a large impact on the environment as it reduces the amount of “virgin paper” (paper that comes directly from trees) produced. For every ton (907kg) of paper that is recycled, 17 trees are saved. This number is enough to significantly impact the number of greenhouse gases in the atmosphere and keep paper out of our landfills. It’s worth noting that the recycling process is not perfect. Through the process of removing ink, some recycling facilities end up dumping 22% of the weight of recycled paper into sludge in the environment. Recycled paper also needs to be bleached which can cause the release of toxic chemicals. Some (but not all) companies are opting for chlorine-free bleach in order to reduce their environmental impact. Most curbside recycling programs allow you to recycled most paper, including newspaper, white office paper, and mixed-color paper. There are many eco-friendly household paper products that are made from recycled paper. Look for these options when next time you are buying toilet paper, paper towels, or napkins. You can also reduce your use and reuse your paper when possible. 11. Recycled Polyester Plastic PET stands for Polyethylene Terephthalate, which is a plastic resin and a form of polyester. This is identified as #1 PET on the resin identification code (RIC) classification. The number and initials are written inside the recycling symbol with “chasing arrows” and can be found on product labels or directly molded into the plastic. Most PET plastic containers are used to package food, water, soft drinks, salad dressings, oil, toiletries, and cosmetics. PET is a popular choice for manufacturers because it is a safe, inexpensive, lightweight, durable, and most importantly a recyclable plastic. After consumption, PET plastic is crushed and shredded into tiny flakes which are then reprocessed to make new PET bottles or packaging. They can also be spun into polyester fiber and made into textiles such as clothing, carpets, bags, and furnishings. Unfortunately, only 25% of PET bottles in the United States are actually recycled. This number could change in the future with many municipalities offering curbside pickup for recycled plastic readily available. Keep in mind PET plastic cannot be reused and is manufactured with the intent of only single-use. It’s not just for your children’s arts and crafts projects. Felt is a low-impact, eco-friendly and 100% biodegradable textile. Wool felt is non-woven and made by condensing and pressing wool fibers together while they are wet. The result is a soft fabric with a fine and dense texture that is often used by artists and craftspeople. Wool felt is also used for its beauty in fashion and is a well-insulating fabric. Synthetic felt can be made from recycled PET plastic bottles (see above) and turned into furniture or wall paneling with an excellent acoustic performance. Felt can also be made into a more rugged and durable material used in construction for roofing or siding on houses. 13. Reclaimed Wool Reclaimed sheep’s wool is an intelligent technology that is gaining some steam in the fashion industry. During the manufacturing of sheep’s wool products, leftover scraps are collected and recycled. They are first sorted by color, cut into small pieces, and then pulled apart so the fibers can be re-spun into yarn and then weaved into fabric. The result is a fabric that is made from 100% recycled materials. Reclaimed wool may not be commonplace in the fashion industry yet, but some small brands and manufacturers have taken a step towards sustainability and lowering the environmental impact of wool production. 14. Stainless Steel Stainless steel is a long-lasting, durable and 100% recyclable material. The average stainless steel object has nearly 60% recycled material and will not contain any potentially harmful chemicals making it food-safe. Stainless steel can be used for pipes in drinking water systems and is effective against preventing bacteria growth and minimize potential corrosion. In addition to its shine and beauty, it serves as an eco-friendly alternative to many commonly used plastic materials and appliances in the kitchen such as refrigerators, storage containers, bins, and kitchenware. A very popular alternative for portable food and drink containers, stainless steel products will stand the test of time. Just because the product shines and is metal does not make it stainless steel. Be sure to check with the brand to ensure that it is indeed stainless steel. Most high-quality brands will have the material listed on the product itself. Look for #304 or 18/8 food-grade stainless steel to make sure your product is food-safe. Aluminum is among one of the most eco-friendly and sustainable building materials and the most recycled industrial metal in the world. Often used as a beverage container, the average aluminum beverage can will contain 70% recycled metal and can be reused within 6 weeks from entering a recycling plant. Aluminum cans are also lightweight and can be stacked to ship efficiently thus lowering carbon emissions through logistics and supply chains. Aluminum cans are produced in a “closed loop” recycling chain and are infinitely recycled. When compared to the reusable plastic bottle, an aluminum bottle will be more durable and last much longer. Do your homework and make sure your aluminum bottle has a non-toxic water-based interior coating and is BPA-free to prevent any toxic chemicals from leaching into your beverage. 16. BPA-Free Plastic By now most are aware of the dangers of BPA in plastics. BPA or bisphenol A is a chemical that has been used to make certain hard plastics and resins since the 1960s. BPA is found in polycarbonate plastics and epoxy resins. These polycarbonate plastics are often used in food and beverage containers such as water bottles. BPA has been linked to a number of health concerns including altering hormone levels in children, brain and behavior problems, and even cancer. Recently, many state governments have taken action restricting the sale of products with BPA. Many consumers are also aware of this potential danger and make the choice for a safer option, therefore, brands have followed suit. If using plastic, especially for food or drinking, its advised to stay away from BPA. Most companies that produce high-quality products will have “BPA-Free” listed as a feature. Do your research to be sure. Avoid plastics that are marked #3 or #7 according to the resin identification code (RIC) as these have the highest possibility of containing BPA. You can also avoid BPA by switching from plastic to an alternative material such as glass or stainless steel. 17. Recycled Rubber Did you know rubber can actually be reclaimed and made into sidewalks? Old tires that were once destined to an eternity in the landfill are shredded up and made into paneling that fits together to form a rubber sidewalk. Not only is it softer and feels better under your feet, but when growing trees are near, the rubber will bend and raise around the roots. This prevents any tree removal due to roots tearing up concrete pathways. Reclaimed rubber can also be used for playground surfacing, sports surfaces, and outdoor interlocking floor tiles. There are two forms of rubber that can be produced, natural and synthetic. Natural rubber is found inside certain plants and is made from a liquid called latex. Synthetic rubber is derived from petroleum and goes through a chemical process during production. Natural rubber is non-toxic and the most eco-friendly option. Recycling rubber can save energy and ultimately reduce greenhouse gas emissions. Recycling just 4 tires reduces CO2 by about 323 lbs (105 kg), which is equivalent to 18 gallons (68 L) of gasoline. Using recycled rubber in molded products produces a carbon footprint that is 20 times lower than during the production of virgin plastic resins. 18. Reclaimed Wood Always keep your options open when it comes to purchasing new wood products. Instead of purchasing household items such as flooring and furniture which would be produced from virgin timber, opt for reclaimed wood as an eco-friendly alternative. This option will save energy, eliminate landfill burning, and reduce timber harvesting keeping more trees on the earth. Old wood can be reclaimed from many sources you may not think of, such as storm-damaged trees, old shipping pallets, unwanted furniture, and razed buildings. In the past, reclaimed wood was a choice more common for the eco-friendly conscious and those willing to spend money. Now more than ever, individuals with a thrifty and DIY mindset are transforming old wood in a new and creative use bringing character into your home. Not only will this save your wallet but also give you a sense of accomplishment if you decide to embark on a DIY reclaimed wood project. 19. Clay Brick Clay brick is all-natural and simply made from water and clay from the earth. It is completely recyclable. Old bricks build new buildings while crushed bricks can pave streets or provide natural mulch to soil. If a brick ends up in a landfill, there is no need for special handling and toxic chemicals will not enter the environment and can be naturally returned to the earth. Clay brick is energy efficient making it a heating and cooling system’s best friend. It absorbs and releases thermal energy. In the summer, it soaks up the heat keeping a house cooler. In the winter, it traps the internal heat longer to provide warmth. As one of the oldest materials used by humans, it serves as a durable and reliable building material lasting up to 100 years. Clay brick reduces the need for replacement and other resources needed during construction and has a lower environmental impact during its production compared to metals and other raw materials. 20. Eco-Friendly Paints and Finishes VOC’s (Volatile Organic Compounds) are extremely hazardous and pose dangers to our health by leaching into the air. They can cause eye, nose and throat irritation, headaches, dizziness, respiratory impairment, and even memory loss. VOC’s are found in many household products including cleaners, paints, and finishes. If you can smell the chemicals present, chances are they contain VOC’s! Be careful about your exposure especially when indoors due to the closed space. The good news is that many brands are now producing paints and finishes that are low-VOC which are more eco-friendly. They emit a much lighter odor to minimize any irritation. These tend to be water or oil-based paints and contain no chemical solvents and have no emissions during production. Some brands have even developed a paint that is made from milk protein, a super eco-friendly option! If you plan to paint or finish any DIY projects in your home, go non-toxic and avoid your exposure to VOC’s by choosing an eco-friendly option. Materials to Avoid - Non-organic cotton – do you have a piece of clothing labeled 100% cotton? Check again. The average 100% cotton item actually contains around 75% cotton, the remaining 25% is, well you guessed it, a cocktail of chemicals, binders, and resins used in the manufacturing process. Look for clothing labeled “organic cotton” with at least 95% of the fibers organically grown. - Acrylic fabric – this is a synthetic fabric that uses carcinogenic chemicals during its production. Due to these toxic chemicals, it is not biodegradable or recyclable. Not an eco-friendly choice. - Polyester fabric – virgin polyester production requires crude oil (petroleum) making it a non-renewable resource and giving it a high environmental impact during its production. As a fabric, polyester is reported as posing health risks and can be harmful to your skin. The only positive is that it can be recycled into PET plastic bottles. - BPA plastic – as a toxic and harmful chemical (see above) BPA should be avoided. Watch out for plastics that are marked #3 or #7 according to the plastic identification code (PIC) as these have the highest possibility of containing BPA. These are some of the most eco-friendly materials that you will commonly see brands marketing as “good” for the environment. Be an educated and proactive consumer. Always do your homework before purchasing to find out how the material or product is manufactured and what exactly is its environmental impact. I hope this guide has been informative and helped you make eco-friendly choices for the future and betterment of our environment.

<urn:uuid:4898fb22-0219-41ae-afb1-cf81e9c75d75>

CC-MAIN-2019-47

https://householdwonders.com/most-eco-friendly-materials/

s3://commoncrawl/crawl-data/CC-MAIN-2019-47/segments/1573496669431.13/warc/CC-MAIN-20191118030116-20191118054116-00098.warc.gz

en

The knee joint is the largest and most complicated joint in the human body. Bone structures, capsules, menisci, and ligaments provide static stability in the knee joint and are responsible for dynamic stabilization of the muscles and tendons. Menisci are fibrocartilage structures that cover two-thirds of the tibial plateau joint surface. The main functions of the meniscus are load sharing and loading of the tibiofemoral joint, shock absorption, helping to feed the cartilage by facilitating dissociation of the joint fluid, and contributing to the joint fit by increasing joint stability and joint contact surface area. Menisci are frequently injured structures. The incidence of acute meniscal tears is 60 per 100,000. It is more common in males. Trauma-related tears are common in patients under 30 years of age, whereas degenerative complex tears increase in patients over 30 years of age. There may not be a significant trauma story, especially in degenerative meniscus tears. They are sports traumas that come to the fore in the etiology of meniscus tears. It is the football that has the greatest risk of creating a meniscus lesion, followed by athletics, American football, and skiing. There is an indication for repair in peripheral ruptures where blood flow is excessive. In the central rupture where blood is not present, the treatment is meniscectomy. In this review, we compiled the diagnosis, etiology, and treatment methods of the meniscal tears. - meniscus tears The knee is an open joint to frequent injuries in sports activities. Direct impacts, forced movements, or repetitive overloads can cause anatomical damage. Menisci are formed from fibrous cartilage. It has a shock-absorbing feature. The main tasks are providing load transfer, increasing joint surface contact area and joint stability, and contributing to proprioception [1, 2]. A total of 100,000 people per year are found to have meniscus rupture in 60–70 . The most common pathology associated with meniscal tears is anterior cruciate ligament (ACL) ruptures . Today, in addition to professional sportsmen, people participate in sports activities for hobby purposes . Increasing interest in sports with high risk of injury, such as skiing, snowboarding, and mountain biking, has increased the frequency of traumatic meniscal tear [6, 7]. Decision-making process is difficult in professional sportsmen. Approximately 40% of all sports injuries involve the knee joint. Meniscus injuries account for 14.5% of these injuries . The most risky period in terms of age is between the ages of 20 and 29 . Male to female ratio of meniscus proplemia in sports injuries is 2–4/1 [8, 9]. The medial-lateral meniscus injury rate for all age groups was reported as 3/1. However, lateral meniscus tears are more common in young professional athletes . According to the age distribution, the medial meniscus tear is more likely to occur in the athletes who are under 30 years old and laterally in sportsmen over 30 years . In an epidemiological study of National Basketball Association (NBA) basketball players, 87.8% of meniscal tears are isolated, and 12.2% are associated with ligament injuries, often ACL . Acute ACL injuries are more common in lateral meniscus, and chronic ACL injuries are more common in medial meniscus tears . Body mass index (BMI) is specified in professional basketball players as a risk factor. It has been reported that especially above 25, it increases the risk of rupture more in the lateral meniscus . The high physical activity during play was more associated with the lateral meniscus . In an epidemiological study of athletic knee injuries, the distribution of 836 medial meniscus injuries according to sports branches was examined. Soccer was 32.7%, skiing 22.4%, tennis 7.8%, handball 5.4%, and cycling 3.5%. In the distribution of 284 lateral meniscus injuries, 34.5% of football, 19% of skiing, 9.8% of handball, 6.6% of tennis, and 3.5% of cycling sources were stated. In gymnastics and dancers doing lateral, tennis, and jogging, the risk of medial meniscus injuries is greater . Most of the injuries occur during the competition and are thought to be caused by faulty warming or overloading . 10–19 years is the period when lateral meniscus injuries are seen in sportsmen at the second frequency . It is thought that rapid and variable physiology of the age of growth has increased meniscus injuries in this age group . Nowadays, with the understanding of biomechanics and functions of the meniscus, tissue preservation has become the mainstay of treatment . Exposure to high physical activity levels and relatively early age causes injury to the athletes in terms of degenerative arthrosis . The diagnosis of symptomatic meniscus rupture can be made during the anatomy of the patient. The common complaints of patients are pain during hanging and flexion, which starts after the knee swelling or excessive flexion. On physical examination, joint tenderness, McMurray test, and Apley test were described as the most commonly used tests . Magnetic resonance imaging (MRI) can diagnose approximately 95% of cases. Because non-symptomatic individuals can also detect meniscal tears with MRI, treatment decisions should be made by combining them with the clinical findings of the patient, not just the MRI outcome . Many features should be taken into account when deciding on surgical treatment of meniscus tears. Among the factors that are effective in deciding on surgical technique for menisci are patient complaints, age, rupture size, and additional pathologies associated with morphology . Total meniscectomy has been used extensively in the pre-arthroscopic era and has caused many athletes to lose their sporting life . It has been shown that partial meniscectomy causes irreversible damage to joint cartilage in the long term . Since the 1980s, the development of arthroscopic techniques and the ability to repair the menstrual blood, and thus the healing possibilities, have led to the repair of suitable tears. Longitudinal tears, usually in the peripheral 25% area, are suitable for repairs in young and sporty people. With the understanding that menisci are indispensable for knee health today, indications for repair especially in lateral meniscus tears have been expanded. In the beginning, conventional sewing techniques have been described as repairs from the inside to the outside and from the outside . With a variety of meniscal fixators (meniscus fixation materials), the possibility of vascular nerve injury with complete internal repair has been reduced, and operation times have been shortened . In comparison with biomechanical stitches, conventional stitches have shown remarkably superior durability than meniscal fixators in many studies . When performing arthroscopic surgery, care should first be taken to protect the meniscus tissue. Accompanying lesions should be evaluated carefully, especially with frequent ACL problems. All problems should be solved together by following a holistic approach in treatment. These injuries cause serious morbidity in the short term when not properly treated. In the long term, it may also lead to degenerative changes in the knee joint resulting in osteoarthritis. Therefore, the treatment of meniscus injuries is very important. Today, it is understood that meniscus is protected as much as possible. Current treatment methods are being implemented and developed on the basis of this principle . In this article, we aim to present the latest developments in diagnosis, treatment, and follow-up of meniscus injuries in the light of the literature. 2. Meniscus tear Meniscus tears are the result of traumatic, degenerative, or congenital pathologies. Loads exceeding the normal endurance limit may result in a tear. In degenerative menisci, ruptures may also occur at normal loads. Traumatic tears usually occur in active people, aged between 10 and 40 years . Degenerative tears are generally over 40 years of age. Such tears are often associated with other degenerative changes in the cartilage and bone tissues of the knee. 3. Management of treatment Accelerating degenerative changes in the meniscus-deficient knees and the menisci played a key role in the functioning of the meniscus leading us to focus on the protection of the meniscus. In early 1948, Fairbank showed that total meniscectomy accelerated the radiological change in the knee . This was changed by partial meniscectomy . There is no randomized controlled trial showing that arthroscopic meniscus repair has a long-term benefit for joint protection. However, good results to date suggest that this may reduce the incidence of early degenerative changes . According to De Haven, all meniscus tears would not cause clinical symptoms . It has been shown that the tibial asymptomatic meniscus tears, which are intact and have biomechanical function, can recover spontaneously. Clinical studies could not explain whether meniscal injury or articular cartilage damage developed first . A recent study by Christoforakis evaluated 497 consecutive knee arthroscopies in patients with meniscal tear . These complex and horizontal tears were found to be statistically increased in outerbridge grade III or IV joint cartilage damage. Moreover, complex and horizontal tears had excessive joint damage compared to other types of tears. Nevertheless, the result does not answer which of the meniscus tears or articular degeneration occurred first. The general approach is to actively tear the young patients with clinical and radiological examinations including X-ray and MRI. If there is a tear or is very suspicious, arthroscopy and meniscus protection surgery are recommended. Non-operative treatment option is used in patients with suspected degenerative tears. The debridement of the degenerated meniscus is well documented that it cannot always result in long-term relief . 3.1 Non-operative treatment Small peripheral tears in young patients can be treated without surgery. The difficulty is to decide whether the tear is stable or not. Weiss et al. retrospectively reviewed 3612 arthroscopic procedures for meniscus lesions . They found 80 (2.2%) meniscus tears which were considered stable. They were not treated. Six patients presented for arthroscopy again due to meniscus symptoms. The authors suggest that stable vertical peripheral tears have a high healing potential . Physiotherapy has been shown to be beneficial to patients with degenerative meniscus tears. In a recent published randomized control study, patients who underwent surgical debridement with physiotherapy showed no better results than those who received only physiotherapy . Some patients with degenerative meniscal tears recover after a single corticosteroid injection into the knee. Corticosteroids are the first-line treatment for degenerative meniscus in the absence of locking symptoms. Because of the high functional expectations and the need for early return to sports, it is still preferred in selected cases . In the red-red zone, stable, incomplete longitudinal tears with a size below 1 cm may be suitable for conservative treatment . Bucket handle, radial, parrot beak, oblique tears, and degenerative and complex tears are not suitable for conservative methods . Conservative treatment can be used as a temporary treatment method in athletes, who are frequently asymptomatic in the season . Selection should be made when deciding on conservative treatment. Abnormal stresses should be avoided in the early period of rupture. The development of cartilage lesions after aggressive rehabilitation of a young professional athlete with lateral meniscus radial rupture to return to early sports shows that this treatment is not innocent . It should be kept in mind that meniscus tears, which cannot be repaired, may cause cartilage lesions due to mechanical problems that occur even if they are not symptomatic in athletes. Surgical treatment should be prioritized especially in athletes . 3.2 Operative management 3.2.1 Total meniscectomy With the development of arthroscopic techniques and understanding of biomechanics, the importance of meniscus has increased. Treatment led to a shift toward the protection of the meniscus tissue. Total meniscectomy treatment is rarely practiced today. 3.2.2 Open repair It was one of the first ways to repair meniscus tears . It is now used to fix the meniscus as part of the management of tibial plateau fractures. 3.2.3 Arthroscopic repair The high expectations and career concerns of the athletes have made the meniscus repairs even more important. Red-red zone often provides successful repairs due to the potential for cannulation. Discussions on repairs to the red-white zone are still ongoing. In a study, midterm and long-term acceptable results after repair of red-white zone tears of 22 athletes are promising . When deciding on the repair of meniscus in professional athletes, it is necessary to take into account the possibility of the meniscus recovery and to target 90% success. Considering the possible risks, the athletes should be careful to repair the tears in the red-white zone. White-white zone is considered to be the indication of repair today. But athletes should not consider arthroscopic repair . Meniscus tear is present in 60% of ACL-ruptured patients . When the ligament is not repaired, the meniscus is becoming more complicated as it is not healed . For this reason, repairs should be done in the early period and in the same session. Although it is accepted that there is an improvement in the repair area in about 6–8 weeks, the process actually lasts longer, and the athletes cannot return to competitive activities before 3 months . As stated by Forriol’s study, the improvement in the repaired meniscus depends on two basic elements. The first one is the extrinsic blood circulation, and the other is the ability to repair synovial fluid and fibrocartilage intrinsically . Histological studies after meniscus repair are based on animal experiments and cannot be fully adapted to human meniscus repair process . Therefore, the relationship between healing in tissue and return to movement is mostly based on clinical observations. The success rates after repair vary. Pujol et al. reported success rates between 5 and 43% of meniscus repair in basketball players . According to Stein et al. in the 8-year follow-up, the rate of return to pre-traumatic activity in the group undergoing athletes was found to be 96.2%, and in the meniscectomy group, it was 50% . Paxton et al. found failure after meniscectomy was 3.7% and in repair group 20.7% . In this article, better long-term clinical results have been reported in meniscus repairs despite high reoperation rates . It is reported that repair is better characterized by better functional scores and lower failure rates in the current meta-analysis of meniscectomy and repair . Reoperation depends not only on the technique but on the skill of the orthopedist, the tear itself, the age of the athlete, the level of activity, and the rehabilitation program applied . In a study evaluating the results of repair in athletes, failure in the medial meniscus was reported as 36.4%, and failure in the lateral meniscus was reported to be 5.6%. Reoperation rates are high in medial meniscus repairs. This is due to the less mobility of the medial meniscus and to the greater load on the medial compartment . Late repair of medial tears has also been implicated as the cause of this failure . Forty-two elite athletes and meniscus repair agressively recommend the study, after the repair reported 24% failure. Of the cases, 67% had medial meniscus, and 33% had lateral meniscus tears and a mean follow-up of 8.5 years . The success of repair in the complete radial tears of the lateral meniscus is low . However, in the studies of Haklar et al., successful results are obtained in approximately half of the patients, and return to sports is provided . Nevertheless, these patients should be shared with the athlete who may be a candidate for meniscus transplant in the future. The surgeon must also make efforts to repair the medial or lateral meniscus radial root tears in athletes. If the circumferential fibers are completely ruptured when the repair is not performed, the meniscus becomes functional. Therefore, primary repair of complete radial tears should be the first aim, especially in young athletes. Radial tears in the posterior meniscus posterior are more promising because of the region’s blood supply . Failure to achieve successful results with today’s repair techniques leads to new searches. The success of repair in meniscus tears combined with ACL reconstruction is thought to be the effect of growth factors and multipotent cells from the bone marrow . Similarly, synovial abrasion, trephination, mechanical stimulation, fibrin clot, or platelet-rich plasma (PRP) applications are always aimed for the same purpose . The growth factors released after mechanical stimulation and trephination contribute positively to meniscus healing. Ochi et al. showed that the mediators increased to the highest level in the joint after 14 days of mechanical stimulation . Trephination can be used successfully in the complete tears of the lateral meniscus posterior or in complete longitudinal tears less than 1 cm. Successful results of vertical, peripheral, and non-degenerative tears in trephination are seen in the literature . In a recent study on the effect of PRP on meniscus repairs, no significant difference was found in functional scores . Rights et al. used microfracture to create an effect similar to ACL reconstruction, and this would also contribute positively to recovery in the repair area of multipotent cells. Studies have shown that smoking has a negative effect on the results of meniscus repair . For successful results, it is important to remember the importance of combining vertical mattress sutures from the inside to the outside as far as possible, with the microfracture method . The presence of opposing views in the literature shows that there is still no consensus on rehabilitation and return to sports after repair . In the conservative approach, the return to sports takes a long period such as 3–6 months, while the aggressive approach is as short as 10 weeks . While limited conservative rehabilitation is recommended initially until the meniscus is healed , recent biomechanical studies report that early burden is not inconvenient . Even in animal experiments, it has been shown that blood flow to the repair site increases with mobilization . In a randomized controlled trial by Lind et al., the functional scores with MRI and arthroscopy are evaluated. The rate of failure was found to be 28% in the limited rehabilitation group and 36% in the nonrestricted rehabilitation group . As a result, we can say that the trend toward accelerated rehabilitation in the current studies is promising. In practice, the location of the tear, its size, the quality of the meniscus, and the stability of the repair affect the rehabilitation to be applied to the athlete . Neuromuscular control is very important in current rehabilitation . The individual needs and sports-specific approaches of the athlete should not be ignored in rehabilitation . Meniscal tears in young athletes have great challenges for orthopedists. High activity-level, long career expectancy requires all conditions to be repaired . The high potential of recovery according to adults is an important advantage . Athletes may be asked to be guided by the orthopedist athlete or club when planning treatment. Often, the athlete’s desire to return to sports early can create pressure on the physician. The rehabilitation process following the treatment of accompanying ligamentous injuries gives the physician the time required for recovery after meniscus repair . However, the expectation of early sports return to isolated meniscus tears may force the physician to perform meniscectomy. Taking into account the expectations of the athlete and the situation in which he/she is not affected from the orthopedic pressures, it is to make the right decision to give priority to anatomical and functional meniscus repair. 3.2.4 Meniscal rasping Meniscal rasping is used to clean the torn edges of the meniscus to stimulate bleeding. It is indicated in patients with stable, longitudinal tears in the vascular region of the meniscus. In the case of unstable knee or avascular region ruptures, this treatment is not appropriate. 3.2.5 Meniscal suturing Red-red zone or red-white zone tears can be repaired. Traditionally, longitudinal tears are most suitable for suturing and healing. The most important condition for a good recovery is a stable knee. Repair of meniscus in unstable knees results in failure of treatment. However, a stable knee with normal kinematics does not apply unnecessary shear force on the meniscus repair. Recently, positive results have been obtained regarding the repair of full-thickness radial tears . The results of the repair were not reported in randomized controlled trials. However, case reports seem to be positive. Repairs in the avascular region are at risk of failure. Meniscus repair, with ACL reconstruction, showed better recovery rates than ACL stable knees . 3.2.6 Meniscal suturing techniques Various techniques for the repair of meniscus have been described. 188.8.131.52 Outside-in meniscal suturing techniques It was the first arthroscopic node technique. It is now the least used method. Suitable for tears in the middle and anterior 1/3 section of the meniscus. Posterior 1/3 cut is not possible with this technique. The most important advantages of the outside-in repair method are that it is very easy to reach the anterior 1/3 region ruptures which are difficult to reach by other methods and it does not require additional posteromedial or posterolateral cuts to protect the vascular nerve pack. The most important disadvantage of this method is the difficulty in reaching tears extending to the posterior 1/3. 184.108.40.206 Inside-out meniscal suturing techniques Single- or double-lumen, special-inclined cannula through the needles passed through the repair. It can be applied to tears in every region, but it is more suitable for tears in the rear and middle 1/3 section. With this method, which is accepted as the gold standard in meniscus repair, the desired number and type of stitches can be placed easily in each region of the meniscus. The most important disadvantage of the method is the need for a second incision in the posteromedial or posterolateral to prevent the needles from the capsule from causing vascular nerve injury, requiring an experienced assistant and special instrumentation. The repair of tears near the posterior insertion of the meniscus is difficult and dangerous with the inside-out technique. In this type of tear, Morgan described the whole technique of sewing inside . 4. Meniscus fixators Implants called “meniscus fixators” have been developed due to the difficulties of sewing techniques, in some cases requiring additional incisions and vascular nerve complications. These implants manufactured as arrow, hook, anchor, screw, or staple are biodegradable or permanent. The most important advantage of the fixators is that they are technically very easy. In addition, there are advantages such as very low vascular nerve complications, no need for additional incisions, meniscus tears in hard-to-reach areas, “all-in-one” repair, no assistant, and no need for arthroscopic nodes. Generally, there is no problem in the visualization of the lateral compartment. Medial repair on very narrow knees can be difficult . However, the fixators have serious disadvantages. The mechanical forces are half or one-third of the vertical stitch . Another problem with meniscus fixators is the risk of rigid implants to damage the articular cartilage . This problem arises especially in puffy head implants, which are not fully embedded in the meniscus body. 5. Methods for improving the healing Methods for improving healing in tears extending to the nonvascular area have been described. Some authors recommend applying one or more of these methods in all isolated tears, regardless of the area in which they are located. These methods are described below. 5.1 Fibrin clot technique When the patient’s venous blood is mixed with a glass baguette, the paste-shaped clot is placed between the torn lips. Since Arnoczky showed the chemotactic and mitogenic factors involved in these dogs and showed that this clot had a positive effect on healing, this technique was also introduced in humans . 5.2 Trephination technique This method is based on the principle of opening radial tunnels in the meniscus body so that the peripheral vascular structures reach the avascular region. Zhang et al. showed that the trephination combined with the suture was more effective than the suture alone in avascular tears in the goat meniscus [68, 69]. 5.3 Synovial abrasion It is based on the principle of a hemorrhage and infusion responses as a result of filing the synovial tissue around the rupture with the help of a curette and contributing to the healing process . 5.4 Synovial flap transfer It was shown that a better repair tissue was formed in the animal experiments with the interposition of a vascular tissue, a pedicled flap, in the tear area of the synovium . However, this technique has not been widely used. 5.5 Texture adhesives An ideal tissue adhesive should include the following: tissue compatibility, biodegradable, good connect, minimal tissue reaction, and affordable . Tissue adhesives currently used in clinical practice are limited because they contain all of these features. 5.6 Growth factors in meniscus repair It is known that fibrin clots placed in meniscus tears increase the healing potential of these lesions. It has been shown that meniscal fibrochondrocytes have the ability to make matrix and cell proliferation when they are associated with mitogenic and chemotactic factors in wound hematoma . In fibrochondrocyte cell culture, platelet-derived growth factor (PDGF) has been shown to stimulate proliferation of these cells . Researchers showed that PDGF alone could not initiate meniscus repair in the central region of the meniscus . The effect of endothelial cell growth factor (ECGF) on the healing potential of meniscal injuries was investigated. It has been said that there is not much effect . 6. Rehabilitation in patients with meniscus repair The discussion in the literature is on rehabilitation protocols that should be applied after isolated meniscus repair . There is no consensus on knee movement, weight-bearing, knee pad use, and return to sports. In more conservative protocols, there are 4–6 weeks of partial load, knee movements gradually increased in knee pad control, and 6 months of deep crouching and sports ban. In contrast, aggressive protocols recommend immediate burdening, unlimited knee movement, and return to sports when muscle strength is acquired, as long as the patient can tolerate it. In 95 patients with aggressive and conservative protocols, there was no difference in failure rates . This study yields full knee movement width and allows for return to sports when pain and effusion are lost. Since the only factor affecting the success of the repair is not rehabilitation, the results of various series are difficult to compare. The generally accepted opinion is that rehabilitation using only meniscus fixators is a little more conservative. Scaffolds can be used as salvage interventions in meniscus ruptures with irreparable meniscus tears and athletes with segmental meniscectomy . The porous and absorbable structure should provide a meniscus-like tissue formation, while the biomechanical strength of the joint should be adequate. In a European-centered study, 52 partial meniscectomy patients underwent polyurethane scaffold. In the third month, 81.4% of the patients underwent MRI. In the 12th month of the arthroscopic evaluation, in 97.7% of the cases, scaffold integration was detected with real meniscus tissue . Zaffagnini et al. 43 patients with lateral menisectomy applied scaffold. At the sixth postoperative month, they showed functional improvement. At the 12th month, the knee swelling and fatigue decreased to the optimal level. At the 24-month follow-up, 58% of the cases had reached the pre-injury activity level, and 95% of the patients had patient satisfaction . However, it is recommended not to give a full load for 6–8 weeks after meniscus scaffold applications. This causes muscle atrophy especially in athletes and is inadequate to prevent rehabilitation muscle atrophy . Nowadays, cell scaffolds have been introduced. The benefit of cell-free scaffolds was questioned . The factors affecting the success of the procedure were indicated as chronicity of the injury, body mass index, and other accompanying knee problems . Long-term studies on the results of scaffold applications, especially in athletes, are needed. 8. Meniscus transplantation Meniscus transplantation has been proposed to prevent the development of arthrosis in young patients whose meniscus is completely removed, without axial impairment and arthritic changes. The structures used for meniscus replacement in experimental and clinical studies are as follows: autografts, allografts, xenografts, synthetic polymer implants, carbon fiber and polyurethane implants . It is doubtful that structures used as meniscus transplant may prevent the development of arthritis in the knee in the long term . 8.1 Allograft transplantation Subtotal or total meniscectomy after the functional deficiency and pain is applied in athletes . After close meniscectomy, especially under the influence of abnormal load distribution in the lateral compartment, chondral lesions develop in the early period. The rehabilitation of an athlete who develops a chondral lesion is more difficult, and in the late period, arthrosis develops frequently . For success in transplantation, it is important that the articular cartilage surface is smooth, stable, and normal or that BMI is below 30. In a recent meta-analysis, good and excellent results were reported in 84% of cases after transplantation. Again in a recent study, posttransplantation in 12 professional footballers was performed in 92% of the cases. At the 36th month, 75% of the cases were reported to continue their professional sports lives . Studies and discussions on transplantation still continue, with short-term to midterm results being positive . There is a rare risk of infection . The delay in returning to sports due to the long healing process is the biggest obstacle to the technique. Currently, randomized controlled long-term studies are needed . It should be kept in mind that this intervention can be applied after the professionalism of the athletes who have undergone meniscectomy in their careers and who are symptomatic or postponed transplantation in their careers. Meniscus injuries constitute a large part of the studies performed by orthopedist surgeons. The current management has progressed toward the meniscus protection. Although there has been a lot of progress in meniscus transplantation, this has still not become a routine procedure. Young athletes need to make more efforts to protect the meniscus, while long-term treatments in a professional athlete may be postponed at the end of their career. Radial tears of the lateral meniscus corpus and anterior junction are quite important in athletes. They need to be treated early. In the case of complete radial tears, the rate of recovery after repair should be tried, but it should be noted that these patients may be transplant candidates in the later period.

<urn:uuid:5fd572fe-832b-4ebd-844c-304f754d8693>

CC-MAIN-2019-47

https://www.intechopen.com/books/meniscus-of-the-knee-function-pathology-and-management/meniscus-tears-and-review-of-the-literature

s3://commoncrawl/crawl-data/CC-MAIN-2019-47/segments/1573496671260.30/warc/CC-MAIN-20191122115908-20191122143908-00138.warc.gz

en

Sushi Terminology and Pronunciation Guide Over the years we have tried to make this the most comprehensive list of terminology for foods one might find at a sushi restaurant. While we have worked hard, this list is by no means complete and we would love to hear any suggestion for additions from find in a Japanese restaurant. We thought to include items found in sushi, sashimi, courses, beverages, and accompaniments. You may notice that some of these items are links. Click on these links to go to a page devoted to that particular item to learn more about it and view images. Please contact us with anything you would like us to include that we may have missed. Looking for sushi grade seafood online? Abura Bouzu - ah-boo-rah boh-zoo) or Abura Sokomutsu (ah-boo-rah soh-koh-moo-tsoo) – This is Escolar (Oilfish) and sometimes called Shiro Maguro, although it is not tuna and should not be confused with that fish. Bright white in color and quite fatty, this fish is not always easy to find. Due to the high levels of fatty esters, this particular fish may cause digestive issues with some individuals, and for that reason has been prohibited in Japan since the 1970′s. If your body can tolerate it, the creamy texture and clean taste can be quite appealing. While escolar can be found called Abura Bouzu, this is in fact a different fish, called the "skilfish. Aburage - ah-boo-rah-ah-geh)-Fried tofu pouches usually prepared by cooking in sweet cooking sake, shoyu, and dashi. Used in various dishes, in Miso Shiru and for Inari Zushi. Aemono - ah-eh-moh-noh) -Vegetables (sometimes meats) mixed with a dressing or sauce. Agari - ah-gah-ree) – A Japanese sushi-bar term for green tea. Agemono - ah-geh-moh-noh) – Fried foods — either deep-fat fried or pan-fried. Ahi - aaa-hee) – Yellowfin Tuna. Aji - ah-jee) - Horse mackerel, Jack Mackerel (less fishy tasting than Spanish mackerel). Purportedly this is not actually a mackerel, but member of the Jack family. It is small – about 6" in length and they fillet it and serve marinated in vinegar. Aji-no-moto - ah-jee-no-moh-toh) – Monosodium glutamate (MSG). Aka miso - ah-ka-mee-soh) – Red soy bean paste. Akagai - ah-ka-gah-ee) – Pepitona clam, red in colour, not always available. Akami - ah-kah-me) – the leaner flesh of tuna from the sides of the fish. If you ask for ‘maguro’ at a restaurant you will get this cut. Ama Ebi - ah-mah-eh-bee) – Sweet Shrimp, Red Prawns. Always served raw on nigirizushi. Sometimes served with the deep-fried shells of the shrimp. Eat the shells like you would crayfish. An - ahn) – Sweetened puree of cooked red beans. Also called Anko, thought not to be confused with Monkfish, also called Anko, but contextually the difference will be apparent to Japanese speakers. Anago - ah-nah-goh) – Salt water eel (a type of conger eel) pre-cooked (boiled) and then grilled before serving, less rich than unagi (fresh water eel). Ankimo - ahn-kee-moh) - Monkfish liver, usually served cold after being steamed or poached in sake. Anko - ahn-koh)- Monkfish. Aoyagi - ah-oh-yah-gee) – Round clam. Also called Hen Clam. Awabi - ah-wah-bee) – abalone. Ayu - ah-yoo) – Sweetfish. A small member of the trout family indigenous to Japan, usually grilled. Azuki - ah-zoo-kee) – Small red beans used to make an. Azuki connotes uncooked form. Beni shoga - beh-nee shoh-gah)- Red pickled ginger. Used for Inari Zushi, Futomaki, and Chirashizushi, but not for Nigirizushi. Bonito - bo-nee-toh) – See Katsuo (kah-tsoo-oh). Buri - boo-ree) – Yellowtail. Hamachi refers to the young yellowtail and Buri are the older ones. Buri Toro - boo-ree toh-roh) – Fatty Yellowtail. The belly strip of the yellowtail. Incredibly rich with a nice buttery flavour. Butaniku - boo-ta-nee-koo) – Pork. Buta means pig. California Roll - maki) A California roll is an american style roll created in California for the American palate. It usually consists of kamaboko (imitation crab meat) and avocado, sometimes including cucumber. Chikuwa - chee-koo-wah) – Browned fish cake with a hole running through its length. Chirashi-zushi - chee-ra-shee-zoo-shee) – translates as "scattered sushi", a bowl or box of sushi rice topped with a variety of sashimi. Chutoro - choo-toh-roh) – The belly area of the tuna along the side of the fish between the Akami and the Otoro. Often preferred because it is fatty but not as fatty as Otoro. Daikon - Dah-ee-kohn) – giant white radish, usually served grated as garnish for sashimi. Dashi - dah-shee) – Basic soup and cooking stock usually made from, or from a combination of Iriko (dried Anchovies), Konbu (type of Kelp) and Katsuobushi (dried bonito flakes). However any form of stock can be called “dashi”. Donburi - dohn-boo-ree) – A large bowl for noodle and rice dishes. Also refers specifically to a rice dish served in such a large bowl with with the main items placed on top of the rice, Examples include Tendon (Tenpura Donburi) and Unadon (Unagi Donburi). Ebi - eh-bee) – Shrimp. Not the same as Sweet Shrimp, as Ebi is cooked, while Ami Ebi is served in raw form. Edamame - eh-dah-mah-meh) – Young green soybeans served steamed and salted and usually still in the pod. Fugu - foo-goo) – Fugu is puffer fish which is a delicacy, though its innards and blood contain extremely poisonous tetrodotoxin. In Japan only licensed fugu chefs are allowed to prepare fugu or puffer fish. Fuki - foo-kee) – Fuki is a Japanese butterbur plant which contains a bitter substance called "fukinon" (a kind of ketone compound), but upon blanching fukinon is easily washed out from its petioles (edible parts) and is prepared for an excellent Japanese vegetable dish. Futo-Maki - foo-toh-mah-kee) – Big, oversized rolls. Gari - gah-ree) – Pickled ginger (the pink or off-white stuff) that comes along with Sushi. Gobo - goh-boh) – Long, slender burdock root. Gohan - goh-hahn) – Plain boiled rice. Goma - goh-mah) – Sesame seeds. Gunkan-maki - goon-kahn-mah-kee) – Battleship roll. This is where the maki is rolled to form a container for the liquid or soft neta. Used for oysters, uni, quail eggs, ikura, tobiko, etc. Gyoza - gi-yoh-zah) – A filled wanton dumpling that has been either fried or boiled. Ha-Gatsuo - ha gat-soo-oh) – Skipjack tuna. This meat is similar to bonito but is a lighter, pinker product. Hamachi - hah-mah-chee) – Young Yellowtail tuna, or amberjack, worth asking for if not on menu. Hamaguri - hah-mah-goo-ree) – Hard shell Clam. Includes American littlenecks and cherrystones. Hamo - hah-moh) – Pike Conger Eel. Indigenous to Japan. Hanakatsuo - hah-nah-kah-tsoo-oh) – Dried bonito fish, shaved or flaked. Usually sold in a bag. Also called Katsuobushi (bonito flakes). Harusame - hah-roo-sah-meh) – Thin, transparent bean gelatin noodles. Hashi - hah-shee) – Chopsticks. Also called O-Hashi. Hatahata - hah-tah-hah-tah) – Sandfish. Indigenous to Northern Japan. Hijiki - hee-jee-kee) - Black seaweed in tiny threads. Hikari-mono - hee-kah-ree-mo-no) - A comprehensive term for all the shiny fish. However usually refers to the shiny oily fish, such as Aji, Iwashi, Sanma, Kohada. Himo - hee-moh) - The fringe around the outer part of any clam. Hirame - hee-rah-meh) – Generally speaking this name is used for many types of flat fish, specifically fluke or summer flounder. The name for winter flounder is really "karei" (kah-ray), but often restaurants do not discriminate between fluke or summer flounder when one asks for hirame. Some restaurants call halibut "hirame," however the actual Japanese word for halibut is "ohyo" (oh-yoh). Hocho - hoh-choh) - General Japanese term for cooking knives. Can be classified as Traditional Japanese style (Wa-bocho) or Western style (yo-bocho) Hokkigai - hohk-kee-gah-ee) - Surf Clam (also called Hokkyokugai). Sort of a thorn-shaped piece, with red coloring on one side. Hotate-Gai - hoh-tah-teh-gah-ee) – Scallops. Ika - ee-kah) – Squid. As sushi or sashimi the body is eaten raw and the tentacles are usually served parboiled then grilled or toasted. Ikura - ee-koo-rah) – salmon roe. (FYI, Ikura means ‘How much?’ in Japanese) The word Ikura is shared with the Russian word “Ikra” meaning salmon roe. Inada - ee-nah-dah) - Very young yellowtail. Inari-Zushi - ee-nah-ree-zoo-shee) – [see an image] – Aburage stuffed with sushi rice. Kaibashira - kah-ee-bah-shee-rah) – large scallops, actually giant clam adductor muscle, though often scallops are served, much like cooked scallops but more tender and sweeter. Kobashiri are small scallops and like kaibashira may or may not come from scallops or other bivalves. Kajiki - kah-jee-kee) – Billfish including Swordfish and Marlins. Swordfish specifically is called Me-Kajiki or Kajiki-Maguro. Kaki - kah-kee) – Oysters. Kamaboko - kah-mah-boh-ko) – Imitation crab meat (also called surimi) usually made from pollack. Generally used in California rolls and other maki, it’s not the same thing as "soft shell crab." Kampyo - kahn-piyoh) – Dried gourd. Unprepared is a light tan color. Prepared it’s a translucent brown. It comes in long strips, shaped like fettuccine. Kani - kah-nee) – Crab meat. The real stuff. Always served cooked, much better if cooked fresh but usually cooked and then frozen. Kanpachi - kahn-pa-chi) – Greater Amberjack. This is similar to hamachi, but this is actually a different fish (and is not Yellowtail or the Japanese Amberjack). Karasu Garei - kah-rah-soo gah-ray) – Literally translated this means "cow flounder" and is the term for Atlantic halibut. Karei - kah-reh-ee) – Winter flounder. Katsuo - kah-tsoo-oh) – Bonito. It is usually found in sushi bars on the West Coast because it lives in the Pacific Ocean, and doesn’t freeze very well. Sometimes confused with Skipjack Tuna, which is incorrect as Skipjack Tuna is called "ha-gatsuo." Katsuobushi - kah-tsoo-oh boo-shi) - Bonito flakes. Smoked and dried blocks of skipjack tuna (katsuo) that are shaved and uses usually to make dashi, or stock. Kazunoko - kah-zoo-noh-koh) – herring roe, usually served marinated in sake, broth, and soy sauce, sometimes served raw, kazunoko konbu. Kohada - koh-hah-dah) – Japanese shad (or young punctatus, it’s Latin species name). Kohada is the name when marinated and used as sushi neta. Prior to this the fish is called Konoshiro (ko-no-shee-roh). Kuro goma - koo-roh-goh-mah) – Black sesame seeds. Maguro - mah-goo-roh) – Tuna, which is sold as different cuts for the consumer, listed below in order of increasing fattiness: - Akami (ah-kah-me) - the leaner flesh from the sides of the fish. If you ask for 'maguro' at a restaurant you will get this cut. - Chu toro (choo-toh-roh) - The belly area of the tuna along the side of the fish between the Akami and the Otoro. Often preferred because it is fatty but not as fatty as Otoro. - O toro (oh-toh-roh) - The fattiest portion of the tuna, found on the underside of the fish. - Toro (toh-roh) is the generic term for the fatty part of the tuna (either chutoro or otoro) versus the 'akami' portion of the cut. Maki-zushi - mah-kee-zoo-shee) – The rice and seaweed rolls with fish and/or vegetables. Most maki places the nori on the outside, but some, like the California and rainbow rolls, place the rice on the outside. Makisu - mah-kee-soo) – Mat made of bamboo strips to create make-zushi. Masago - mah-sah-goh) – capelin (smelt) roe, very similar to tobiko but slightly more orange in colour, not as common as tobiko in North America (though often caught here). Capelin, shishamo, is also served grilled (after being lightly salted) whole with the roe in it as an appetizer. Matoudai - mah-toh-dai) – John Dory. Mirin - mee-rin) – Sweet rice wine for cooking. Mirugai - mee-roo-ghai) – Geoduck or horseneck clam, slightly crunchy and sweet. Miso - mee-soh) – Soy bean paste. Moyashi - moh-yah-shee) – Bean sprouts. Murasaki - moo-rah-sah-kee) – meaning “purple” an old “sushi term” for Shoyu. Namako - nah-mah-koh) – Sea cucumber. This is much harder to find in North America than in Japan. As a variation, the pickled/cured entrails, konowata (koh-noh-wah-tah), can be found for the more adventurous diners. The liver, anago no kimo (ah-nah-goh noh kee-moh) is served standalone as well. Nasu - nah-soo) – Eggplant. Also called Nasubi. Natto - naht-toh) – Fermented soy beans. (Not just for breakfast anymore) Very strong smell and taste, also slimy. Most people don’t like it. Order it once, if for no other reason that to see the confused look of the chef. Negi - neh-gee) – Green Onion. Scallion. Round onion is called Tama-negi. Neta - neh-tah) – The piece of fish that is placed on top of the sushi rice for nigiri. Nigiri-zushi - nee-ghee-ree-zoo-shee) - The little fingers of rice topped with wasabi and a filet of raw or cooked fish or shellfish. Generally the most common form of sushi you will see outside of Japan. Nori - noh-ree) – Sheets of dried seaweed used in maki. Ocha - oh-chah) – Tea. Odori ebi - oh-doh-ree-eh-bee) - (‘Dancing shrimp’)- large prawns served still alive. Ohyo - oh-hyoh) – Pacific halibut, sometimes incorrectly labeled "dohyo." Atlantic halibut is called Karasu Garei. Ono - oh-noh) Wahoo. As much fun to catch as to eat, ono (Hawaiian for ‘delicious’) has a very white flesh with a delicate consistency, similar to a white hamachi (yellowtail). Oshi-zushi - oh-shww-zoo-shee) – Sushi made from rice pressed in a box or mold. Oshibako - oh-shee-bah-koh) - Used for pressing the sushi to make Oshi-zushi. Oshibori - oh-shee-boh-ree) – The wet towel one cleans one’s hands with before the meal. Oshinko - oh-shin-ko) - A general term for the many and varied pickled vegetables that are not uncommon at the table in Japanese dining, and often found at sushi-ya. They include, but are not limited to pickled burdock root, daikon, cabbage carrots, and many others. Otoro - oh-toh-roh) – The fattiest portion of the tuna, found on the underside of the fish. Ponzu - pohn-zoo) – Sauce made with soy sauce, dashi and Japanese citron, such as Yuzu or Sudachi. Ramen - rah-mehn) – ‘Instant’ noodles, created by extrusion and often bought in packets for easy preparation. Chinese style noodles served in broth in a bowl. Traditional Japanese “fast food.” Instant ramen invented in the 1960s and now found worldwide. Today Cup-Ramen which is even easier to make is popular worldwide. Roe - Fish eggs) Generally, flying fish, smelt, and salmon roe are available in all sushi restaurants. "Roe" is a generic name. The roes are: Saba - sah-bah) - mackerel, almost always served after being salted and marinated for a period ranging from a couple of hours to a few days, so really cooked. In this form it is called Shime-Saba (shee-meh-sah-bah). Raw mackerel (nama-saba) is sometimes served but it must be extremely fresh as it goes off quickly. Sake - sah-keh) – Rice wine. Pronounced ‘sah-keh’ not “sah-key.” Served both hot and cold depending on the brand type. Some people love it, some people hate it. Sake - sah-keh) – Salmon. To avoid confusion, some people say Sha-ke. Sansho - sahn-shoh) - Japanese pepper. A must with most Unagi dishes. Sashimi - sah-shee-mee) – Raw fish fillets sans the sushi rice. Sazae - sah-zah-eh) – Type of conch, not found in the US. Shari - shah-ree) – Sushi Meshi (sushi rice). A sushi bar term. Shiokara - shee-oh-kah-rah) – A dish made of the pickled and salted internal organs of various aquatic creatures. It comes in many form such as ‘Ika no Shiokara’ (squid shiokara), shrimp, or fish. Shirako - shee-rah-koh) – The milt sac of the male codfish. Shirataki - shee-rah-tah-kee) – Translucent rubbery noodles. Shiro goma - shee-roh-goh-mah) – White sesame seeds. Shiro maguro - shee-roh mah-goo-roh) – (‘White Tuna’) Sometimes called ‘Bincho Maguro’ or ‘Bin-Naga Maguro.’ This is often either Escolar or white albacore tuna. It doesn’t handle as well and can change color (though doesn’t change in taste or quality) so it is not as common as other tunas. It will usually not be on the menu, and if available, must be asked for (or listed as a ‘special’). It is not unusual to find Escolar (oilfish) labeled as shiro maguro, however in quantity, this particular fish can have a laxative effect on some people. Recently, Black Marlin is also being served as ‘white tuna.’ Shiro miso - shee-roh-mee-soh) – White soy bean paste. Shiromi - shee-roh-mee) – This is the general term for any white fish, and if one asks for shiromi the itamae will serve whatever white fish may be in season at the time. Shiso - shee-soh) – The leaf of the Perilla plant. Used frequently with in makizushi and with sashimi. The sushi term is actually Ooba (oh-bah). Shitake - shee-tah-keh) – A type of Japanese mushroom, usually available dried. Shoga - shoh-gah) – Ginger root. Usually grated. Shoyu - shoh-yoo) – Japanese soy sauce. Shumai - shoo-mai) (another type) is always steamed. Soba - soh-bah) – Buckwheat noodles. Somen - soh-mehn) – White, threadlike wheat noodles. Spam - yes, SPAM!) – a sushi you can get in Hawaii (maybe Japan too), an acquired taste, perhaps. Su - soo) – Rice vinegar. Suimono - soo-ee-moh-noh) – Clear soup. Surimi - soo-ree-mee) – Imitation crab meat (also called kamaboko (kah-mah-boh-koh)) usually made from pollack. Generally used in California rolls and other maki, it’s not the same thing as "soft shell crab." Although “surimi” is used outside of Japan, most Japanese people use the term Kani-Kama, short for Kani-Kamaboko. Sushi - soo-shee)- Technically refers to the sweetened, seasoned rice. The fish is sashimi. Wrap the two together in portions and sell it as sushi, and the name still refers to the rice, not the fish. Sushi is the term for the special rice but it is modified, in Japanese, to zushi when coupled with modifiers that describe the different styles of this most popular dish. In Japan when one says “sushi” they are referring to the whole package, the sushi rice plus the neta. And this holds true for all kinds of sushi. When one wants to say “sushi rice” they say “sushi-meshi.” Also, in Japan when someone suggests going out for sushi, they are referring specifically to nigirizushi. Suzuki - soo-zoo-kee) – sea bass (of one species or another, often quite different). Tai - tah-ee) – porgy or red snapper (substitutes, though good), real, Japanese, tai is also sometimes available. Tairagi - tah-ee-rah-gah-ee) - The razor shell clam. Tako - tah-koh) – Octopus, cooked. Tamago yaki - tah-mah-goh-yah-kee) – egg omelet, sweet and, hopefully light, a good test of a new sushi restaurant, if its overcooked and chewy, go somewhere else. In Japan it is the trademark of each chef. Often potential customers in Japan will ask for a taste of the Tamago in order to judge the chef’s proficiency. Tarabagani - tah-rah-bah-gah-ni) – King Crab (the real thing, as opposed to kanikama, which is the fake crab leg made from surimi). Tataki - tah-tah-kee) - Tataki is a Japanese term which may mean seared on the outside only (as in Katsuo) or chopped up and served in its raw form (as in Aji). Temaki-zushi - the-mah-kee-zoo-shee) - Hand rolled cones of sushi rice, fish and vegetables wrapped in seaweed. Very similar to maki. Tempura - tem-poo-rah) – Seafood or vegetables dipped in batter and deep fried. Tobiko - toh-bee-koh) – flying-fish roe, red and crunchy, often served as part of maki-zushi but also as nigiri-zushi commonly with quail egg yolk (uzura no tamago) on top uncooked. Tofu - toh-foo) – Soybean curd. Tori - toh-ree) – Chicken. Torigai - toh-ree-gah-ee) – Japanese cockle, black and white shell fish, better fresh but usually frozen (and chewier as a result). Toro - toh-roh) – Fatty Tuna. There are several different types of tuna you can order in a sushi restaurant. It comes in many different grades which are from best to, well, not worst, o-toro, chu-toro, toro, and akami (which has no fat content). Udon - oo-dohn) – Wide noodles made from wheat. Unagi - oo-nah-gee) – Eel (Freshwater) – grilled, and brushed with a teriyaki-like sauce, richer than salt water eel. Uni - oo-nee) – Sea Urchin. If you are lucky you won’t like it, if not you have just developed an expensive habit. The most expensive (start saving now) is red in color, the least is yellow, luckily they taste the same. Lobsters eat sea urchin as a mainstay of their diet. Usukuchi shoyu - oo-soo-koo-chee-shoh-yoo) - Light Japanese soy sauce. Wakame - wah-kah-meh) – Dried lobe-leaf seaweed in long, dark green strands. Wasabi - wah-sah-bee) – Japanese ‘Horseradish.’ This is the small lump of green stuff that looks sort of like clay. Best done in extremely small doses. The actual rhizome is not related to American Horseradish except by name, but unfortunately, the ‘wasabi’ most often served is not real wasabi, but powdered and reconstituted American Horseradish with food coloring. Real wasabi is difficult to find in most restaurants, but is sometimes available upon request (and worth it, even with a surcharge, in my opinion). It is quite different in appearance (slightly more vegetal in color and obviously a ground up lump of rhizome, not powder) as well as taste. Real wasabi has a hotness that does not linger, and compliments and enhances the flavor of sushi rather well. Yakumi - yah-koo-mee) – A generic term for condiments.

<urn:uuid:078a4bae-688a-4c6a-96ca-cca4f5ade758>

CC-MAIN-2019-47

https://www.sushifaq.com/sushi-sashimi-info/sushi-terminology/

s3://commoncrawl/crawl-data/CC-MAIN-2019-47/segments/1573496668772.53/warc/CC-MAIN-20191116231644-20191117015644-00257.warc.gz

en

Patricia M. DeMarco December 21, 2018 Presentation is on video by Blue Lens, LLC : https://youtu.be/iJrSADqS9pA Our beautiful, fragile, resilient Living Earth provides everything we need to survive and thrive. All the living things on the planet have co-evolved forming an interconnected web of life with a life support system that provides oxygen-rich air, fresh water, and fertile ground. The functions of the living earth – ecosystem services – support life with elegance and simplicity following the laws of Nature. These laws were discovered to human knowledge over many years but still hold many mysteries. The laws of Nature – the principles of chemistry, physics, biology, ecology- are not negotiable, whether humans acknowledge them or not. The human enterprise has brought the delicate balance of the natural world under acute stress in modern times. Overpopulation, resource extraction for minerals and materials, fossil fuel combustion, and hyper-consumption now threaten the stability of our existence. Global warming from the accumulation of greenhouse gases, especially carbon dioxide and methane; and global pollution, especially from plastics, now threaten life on Earth as we have known it. If the goal of our entire civilization is to achieve sustainability for future generations, some adjustments must be made in the way people relate to the natural world. In a sustainable condition, “people meet the needs of today without compromising the ability of future generations to meet their own needs.”This condition of sustainability has a balance among environmental values, social and cultural values and economic values. In today’s civilization, the economic values far outweigh environment and social values, leading to an increase in environmental degradation and social inequity. The damages are distributed unevenly around the globe, with those least responsible for creating the problem most affected by the results of climate change. The children, non-human living things and those unborn of the next generation will pay the heaviest price for decisions made today. Therefore, this is not a technology issue; rather it is a moral and ethical issue: are our decisions going to preserve the wealth and privilege of the fossil industry corporations, or will our decisions move to preserve a viable planet for our children? Nothing characterizes modern life so well as plastic – long-lasting, resilient, malleable, diverse in applications and uses. We find plastic everywhere from food containers to personal care products, structural materials, fibers and finishes. Whether single use products like plastic bags or structural materials like car dashboards or PVC pipe, all plastics are made from materials found in fossil fuels- natural gas and petroleum. The plastics industry burst forth in the decade following the end of World War II when the industrial might amassed for munitions turned to domestic products like fertilizer, herbicides, pesticides, and plastics. Worldwide 8.3 billion tons of plastic have been produced since then, and over half of that material has been discarded as waste. The problem is only expected to grow as plastic production increases exponentially—from a mere two million metric tons annually in 1950 to more than 300 million metric tons today, and a projected 33 billion metric tons each year by 2050. Plastics are made of long-lived polymers, they do not break down easily in the environment, neither in landfills nor in the oceans. Plastics are not readily broken down by biological systems- they are indigestible and provide no nutrition when introduced into food chains. Nearly all the plastic ever made is still in the biosphere.Worldwide, factories produce 400 million tons of plastic per year, with plastic bottles produced at a rate of 20,000 per second.Globally, 60% of all plastics ever produced were discarded and are accumulating in landfills or in the natural environment. Americans discard 33.6 million tons of plastic a year; only 6.5% of plastic is recycled for re-use, and 7.7% is burned in trash to energy facilities.Until 2018, most of American recycled plastic was collected as mixed waste and sent to China for processing. However, China is no longer accepting material with more than 1% contamination for recycling.So, most of the plastic waste generated in America is now destined for landfill. Worldwide, plastic demand is expected to drive petroleum and natural gas production to use for feed stocks for many decades, especially to serve growing markets in Asia. The ubiquitous contamination of the earth from man-made plastics presents a system problem. We need to seek a systematic solution.The problem of global pollution from plastics has three components: 1. Economic Issues; 2. Environmental and health issues; and 3. Ethics Issues. 1. Economic issue: The entire plastics enterprise is based on taking fossil derived raw material extracted from natural gas and petroleum deep underground, refining the products and producing polymers, forming the polymers into the desired product, distributing and trucking to the wholesale and retail operations for a product that is often used once and discarded. Image from PA Department of Commerce and Economic Development https://dced.pa.gov/key-industries/plastics/ This system only works economically when fossil fuels are valued at a relatively low price, and no cost is imposed on the discarded or wasted material. This approach is entirely incompatible with a sustainable society. In many situations, the fossil extraction and production phases are heavily subsidized, and the single-use products are inexpensive to the users, or costs are unseen, as with plastic packaging or plastic bags at the retail check-out counter. In 2014, UN Environment Programme estimated the natural capital cost of plastics, from environmental degradation, climate change and health, to be about $75 billion annually.As of 2018, the hydraulic fracturing sector of the oil and gas industry continued its nine-year streak of cash losses. In 2018 Third Quarter, a cross section of 32 publicly traded fracking-focused companies spent nearly $1 billion more on drilling and related capital outlays than they generated by selling oil and gas.The fracking industry is anticipating the ultimate sale of gas liquids for plastic production in refineries, such as the proposed Shell Appalachia Project, to generate positive revenue from sales of plastic pellets for production of consumer goods, many of the single-use packaging like plastic bottles, bags and flatware. 2. Environment and Health Issue Many plastics and by-products of their production are directly toxic to humans and other living things. Some are also disruptors of endocrine functions, such as by mimicking hormone activity yielding results that over-stimulate or suppress normal hormone functions. Such compounds have been associated with reproductive and developmental disorders, obesity, fertility, and neurologic disorders. Over 80,000 synthetic chemicals are in common commercial use; of these only 200 have been directly tested for health effects. It is nearly impossible to avoid exposure to chemical contaminants- they are in BPA plastic packaging for food and containers, in consumer products phthalates and parabens as well as plastic microbeads are common; fire retardants in upholstery, curtains, and electronics expose people to PBDE (Poly-brominated di-phenyl ethers), and residues of long abolished chemicals like PCB (used in insulation oil for transformers and banned in 1979) continue to contaminate the food chain. Should we be concerned? Industry advocates argue that there is no “proof of harm” that any particular chemical caused a specific instance of illness or disease. But human epidemiology studies are uniquely challenging because individuals respond differently to the same exposure, and the effects can vary widely for children, elderly, and especially unborn fetus development. Furthermore, people are not exposed to one chemical at a time but experience a chemical stew of myriad chemicals, some without their knowledge. The use of animal models where some of the variables can be controlled present problems as well, especially in court where the industry defense can argue that animals are not exactly like humans, and reasonable doubt prevents a clear ruling of harm. The burden of proof is on the consumer, and the case is rarely successful. People are exposed as minute quantities of potentially harmful materials are magnified through the food chain. Observations in the field conflict with rosy promotion of the benefits of plastics. Attempts to move legislation to protect consumers and prevent widespread exposures to questionable materials become bogged down in a regulatory quagmire. Citizen action groups use information campaigns and argue for better testing, but as industry experts infiltrate the regulatory agencies, the credibility of government agencies is eroding. 3. Ethics Issue The entire matter of global pollution, especially from plastics products and the by-products associated with their production, is a question of moral commitment to preserve the life support systems of the Earth, or to allow destruction of the living part of the planet for the sake of short-term profit for a very few corporate interests. It is really a matter of asserting the right for life to EXIST! The surge in plastic use, especially single-use plastics like plastic bags for purchased items, developed as a consumer convenience. But we are seeing now the unintended consequences of convenience. But is it really from convenience that we see 48 tons of garbage, mostly plastic containers and packaging, left in the parking lot after a concert?Is this convenience, or is it really a consumer sense of entitlement and total oblivious disregard for the consequences of their actions? The freedom to act as we wish without the sense of responsibility for the consequences of our actions yields chaos. As we see the cumulative effects of single-use plastics in the environment, in fish and sea creatures, and even in human bodies, we must begin to question the obligation to control this material at its source. Recognizing that the source is a fossil-based feed stock, the need to re-think plastic reaches a higher plane. Are we killing our planet for convenience? As horrific images begin to filter into the media, people are beginning to move from awareness to action. The plastic problem will not go away without fundamental changes in expectations and the reality of packaging and single-use materials. According to a United Nations Environment Programme study: “To get the plastics problem under control, the world has to take three primary steps. In the short- term society needs to significantly curtail unnecessary single-use plastic items such as water bottles, plastic shopping bags, straws and utensils. In the medium -term governments need to strengthen garbage collection and recycling systems to prevent waste from leaking into the environment between the trash can and the landfill, and to improve recycling rates. In the long run scientists need to devise ways to break plastic down into its most basic units, which can be rebuilt into new plastics or other materials.”Three kinds of solutions present good options for re-thinking how we develop, use and dispose of plastic:1. Restructure the Value System;2. Use Green Chemistry to prevent environmental and health harms;3. Take precaution in protecting living systems. 1. Restructure the Value System To the consumer, and to many manufacturers, plastic looks cheap. The price of the oil or natural gas liquids used as feed stocks for plastic are way too low, compared to the actual cost to extract, refine, process and transport the plastic products. And, it is cheaper to produce plastic from virgin material than from recycled plastics because recycled material needs to be cleaned, sorted, and is difficult to define precisely. Plastic was designed to melt at temperatures lower than metals, so metal molds can be used repeatedly to shape plastic into products, conserving the capital needed for the machinery, while using a relatively cheap ingredient. Oil and natural gas have significant price supports for extraction and production embedded in the laws, tax treatments, and land uses that have supported the supremacy of mineral rights since 1837. These subsidies have kept the apparent cost of fossil based products artificially low.The system is set up to reward manufacturers for producing products in the form of profits, but to impose the cost of disposal of waste on the taxpayers. The system gives economic incentives for turning raw (fossil) material into trash as rapidly as possible. Thus, the cost of the entire life cycle of the plastic is not included in the price of the product. If the full life cycle cost of the extraction, production and disposal or recapture of the plastic were included in the price the consumer sees, plastics would not seem so inexpensive, and there would be a greater incentive to avoid waste. In a circular model of materials management, incentives for designing products to be re-used or recaptured and re-purposed would reduce the waste. Plastics also seems inexpensive because much of the cost of their production and use is not counted at all. The Gross Domestic Product, one of the most common measures of the economy, does not include the value if services provided by the living earth… essential things like producing oxygen, regenerating fresh water, and providing food, fuel and fiber from natural materials. The Gross National Product as measured for the global economy is about $19 Trillion (US Dollar equivalent) while the services provided by ecosystems have a value of $33 Trillion globally.By comparison, the global plastics industry is valued at $1.75 trillion, growing at an expected 3% annually.The degradation of ecosystems and ignoring the value of essential services we take for granted has allowed products like fossil fuels and plastics derived from fossil origins to seem cheap, when in fact, their use is destroying the priceless life support system of planet Earth. The artificially cheap price of plastics has contributed to the hyper-consumption that is clogging our landfills and oceans with wasted materials that may never completely break down to innocuous components. One large part of the solution would be to adjust the value calculation to reflect the true cost. 2. Use Green Chemistry to prevent environmental and health harms Just as plastics were engineered to resist breaking down, materials can be designed to serve useful functions without the biological and physical characteristics that make plastics a problem when they interact with living systems. Risk to health and to the environment is a function of the inherent hazard and the exposure to the hazard. The current regulatory system that controls environmental and health risks from chemicals and materials is based on limiting the amount of exposure, or emissions into the environment. Thus, even very toxic materials can be deemed “safe” if they are limited to a very small release. Under this system, over 5.2 billion pounds of toxic or hazardous material is emitted into the air and water by permit each year.Green chemistry takes the approach of designing chemicals and materials to have inherently benign characteristics. Thus, the risk is reduced by reducing or eliminating the inherent hazard itself, instead of trying to limit the exposure. Green chemistry uses the kind of processes found in nature- ambient temperature and pressure, catalysts and enzymes, biological processes, and non-toxic ingredients and by-products.Creative application of green chemistry principles has produced exciting innovations and has the potential for changing the way we produce and use materials.Green chemistry uses bio-mimicry as an inspiration for making new materials. Using catalysts simulating the processes of living systems to address the breakdown of organic chemical contaminants has proven productive. Using plant-based feed stocks instead of fossil resources has produced many innovations in both pharmaceutical applications and in materials. The whole field of bio-plastic is emerging with very promising innovations using algae, hemp, and bamboo. Taking the approach to design for benign, or even helpful, effects on the natural world will revolutionize materials management.The waste stream is part of the cost. The circular economy that can emerge offers productive and sustainable ways to meet the need for materials without increasing the burden on living systems from materials that cannot be used or broken down by living systems. 3. Precaution in protecting living systems The problem of global pollution from plastics will not go away without specific and deliberate intervention both from individuals and from governments. An ethic that places value on retaining and re-using materials that will not degrade in the environment must replace the expectation of convenience regardless of the true cost. The demand for convenience has come at a terrible price for the oceans, for the health and well-being of millions of creatures, including people. For the millions of people for whom using plastic is the only choice for clean water, or single-servings of essential items of food or sanitation, the systemic problems of wealth distribution must be addressed. There is an obligation upon the industrialized societies to resolve the material problem created initially as a by-product of industrialization. Making massive amounts of plastics without considering the implications of their disposal places an ethical burden upon the producers to protect the living systems that are being choked by the waste. Waste has become a cultural norm of modern life, but it is not a condition that can persist if survival of life on the planet is to be sustained. The regulatory system must also be adjusted to require independent testing for health and biological effects in advance of mass production, not only after consumer complaints materialize. The burden of proof of safety must rest on the producer, not on the consumer. It is critical to protect workers from chronic exposures and to evaluate by-products and wastes for the potential to cause harm as well. Consumers have a role to play in moving both the markets and the regulatory infrastructure of plastic. In re-thinking plastic, we can refuse single-use plastics. Ask yourself how materials will be disposed of at the point of purchase. Plan ahead when shopping to take a reusable bag, water bottle, cutlery with you. When in a restaurant, before the server brings anything just say, “No plastic, please,” and you will not have a plastic straw. You can carry bamboo or re-usable straws with you easily. While some situations may be challenging, it can become a focus for family joint activity to seek creative ways to avoid plastic in everyday functions. (You may find helpful suggestions here: https://myplasticfreelife.com/plasticfreeguide/) It is important for consumers to communicate to manufacturers and stores that the excessive plastic used in packaging everything is not acceptable. Challenge the grocery manager for wrapping individual vegetables in shrink-wrap. Ask for less packaging, and bring your own for as many items as you can. Obtain re-usable containers for storing produce and other foods at home instead of plastic wrap, bags or single-use containers. For things like yogurt or other dairy products, re-use the plastic containers for storage, re-purpose them for take-out containers; or craft projects. A little preventive thinking can eliminate much of the single-use waste stream: No K-Cups- use a single serve brass insert instead. Get out of the habit of buying beverages in plastic bottles. Cook real food to avoid excess packaging and choose bulk food items. Re-use and re-purpose as many items as possible. It is becoming fashionable again to use real dishes and glassware and cutlery. These need not be heirloom porcelain to be effective, and dishwashers without the heat element use less resources than the extraction, production and disposal of plastic goods. Choose quality forever items. You can swap or re-design clothing and visit consignment shops, especially for things that you will wear infrequently. It is more important than ever to recycle correctly. Many recycling requirements have changed recently, as mixed waste streams are harder to separate into useable product lines. It is most important to avoid Poly Vinyl Chloride (PVC), Styrofoam and styrene because these are the most difficult to recycle, and they have a 450-year life in the landfill. These materials are especially noxious when they arrive in the ocean, delivered there from materials washed down to the rivers and through the waterways to the ocean. Remember that the Mississippi River drainage covers more than one third of the U.S. land. Clean plastic for recycling and separate it from non-recyclable trash. Cross-contamination will disqualify an entire load. Recycle electronics at a recapture facility where the components are recovered and returned to the production cycle. These are not always free, but the cost is an important part of moving to a circular economy. Finally, to protect the living systems of the planet, it will be important for consumers to support policies that require less packaging, establish markets and procedures for recovery and re-use of materials, and align the value to reflect the true life-cycle cost of the plastic burden on the Earth. The Moral Imperative America operates under the banner of freedom, but has not embraced the concept that freedom without taking responsibility for consequences yields chaos. Technology used without accountability and wisdom yields disaster. We are seeing all around us today the unintended consequences of convenience. It is time to take responsibility for the trash. Everyone can dispose of plastic responsibly- litter kills. We can connect to the natural world and recognize its true value to our life, our survival, and the dependence we have as humans on all the other living things with which we share this time and space. We can find the courage to defend and protect the living Earth Citations and Sources: DeMarco, Patricia. “Listening to the Voice of the Earth.” Pathways to Our Sustainable Future- Global Perspective from Pittsburgh.2017. (University of Pittsburgh Press, Pittsburgh) Pages 13 to 35. Andrea Thompson. “Solving Microplastic PollutionMeans Reducing, Recycling – And Fundamental Re-thinking.” Scientific American November 12, 2018. https://www.scientificamerican.com/article/solving-microplastic-pollution-means-reducing-recycling-mdash-and-fundamental-rethinking1/?utm_source=newsletter&utm_medium=email&utm_campaign=policy&utm_content=link&utm_term=2018-11-12_featured-this-week&spMailingID=57769378&spUserID=MzUxNTcwNDM4OTM1S0&spJobID=1521540986&spReportId=MTUyMTU0MDk4NgS2 Accessed December 18, 2018. Laura Parker. “China’s Ban of Plastic Trash Imports Shifts Waste Crisis to Southeast Asia and Malaysia.” National Geographic. November 16, 2018. https://www.nationalgeographic.com/environment/2018/11/china-ban-plastic-trash-imports-shifts-waste-crisis-southeast-asia-malaysia/China refusal of mixed plastic waste UNEP. 2014. Valuing plastics: the business case for measuring, managing and disclosing plastic use in the consumer goods industry. United Nations Environment Programme. https://wedocs.unep.org/rest/bitstreams/16290/retrieve Clark Williams-Derry. “Nine-Year Losing Streak Continues for US Fracking Sector.” Sightline. December 5, 2018. www.sightline.org.) Irfan A. Rather et. Al. “The Sources of Chemical Contaminants in Food and their Health Implications.” Frontiers in Pharmacology. 2017. 8:830 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5699236/ Sam Levin and Patrick Greenfield. “Monsanto Ordered to Pay $289 million as Jury Rules Weedkiller Caused Man’s Cancer.” The Guardian. August 11,2018. https://www.theguardian.com/business/2018/aug/10/monsanto-trial-cancer-dewayne-johnson-ruling UNEP. 2014. Valuing plastics: the business case for measuring, managing and disclosing plastic use in the consumer goods industry. United Nations Environment Programme. https://wedocs.unep.org/rest/bitstreams/16290/retrieve Costanza, R., R. de Groot, L. Braat, I. Kubiszewski, L. Fioramonti, P. Sutton, S. Farber, and M. Grasso. 2017. “Twenty years of ecosystem services: how far have we come and how far do we still need to go?” Ecosystem Services. 28:1-16. Clare Goldsberry. “Global market for plastic products to reach $1.175 trillion by 2020” BusinessExtrusion: Film & Sheet, Extrusion: Pipe & Profile, Injection Molding. December 17, 2017 https://www.plasticstoday.com/author/clare-goldsberryAccessed December 19, 2018. For an explanation of Green Chemistry Principles see Paul Anastas and John Warner. 12 Design Principles of Green Chemistry. American Chemical Society. https://www.acs.org/content/acs/en/greenchemistry/principles/12-principles-of-green-chemistry.html DeMarco, Patricia. 2017. “Preventing Pollution.” Pathways to Our Sustainable Future – A Global Perspective from Pittsburgh. (University of Pittsburgh Press. Pittsburgh PA) Page140-169. Lord, R. 2016. Plastics and sustainability: a valuation of environmental benefits, costs and opportunities for continuous improvement. Trucost and American Chemistry Council. https://plastics.americanchemistry.com/Plastics-and-Sustainability.pdf A detailed description of the circular economy can be found in EMF, 2013. Towards a circular economy – opportunities for the consumer goods sector. Ellen MacArthur Foundation. https://www.ellenmacarthurfoundation.org/assets/downloads/publications/TCE_Report-2013.pdf

<urn:uuid:10c9dab8-e4e2-435f-a2cb-99d28e6f3ebc>

CC-MAIN-2019-47

https://patriciademarco.com/2018/12/21/re-thinking-plastics-in-our-future/

s3://commoncrawl/crawl-data/CC-MAIN-2019-47/segments/1573496667767.6/warc/CC-MAIN-20191114002636-20191114030636-00018.warc.gz

en

[Updated January 9, 2019] The heartworm (Dirofilaria immitis) is a nematode or roundworm named for its place of residence, inside the heart. To understand the challenge of controlling this parasite, you have to understand its life cycle, a complex and slightly bizarre process. Living in a dog’s pulmonary arteries, adult heartworms mate. Each female (which can reach sizes of up to 11 inches) produces thousands of eggs, each less than 1/800th of an inch, which are called microfilariae, and circulate in the blood. (A dog who hosts breeding adults may have as many as 10-15 microfilariae circulating in each drop of his blood.) The microfilariae cannot develop any further unless the dog meets up with mosquitoes, which are essential to the parasite’s development. Heartworm microfilariae conduct the next stage of their life cycle in the mosquito. When a mosquito drinks blood from an infected dog, it obviously drinks in some of the microfilariae, which undergo changes and are called larvae at this stage. They molt twice in the next two to three weeks (and are referred to as L1, L2, and L3 as they molt and change) after entering the mosquito. Then they must leave the mosquito and find a new host or they will die. The larvae move to the mosquito’s mouth, positioned so the insect’s next bite allows them to migrate into the victim’s subcutaneous tissue. If the mosquito bites an animal that does not host heartworm, the larvae die. If the mosquito bites an animal that heartworms thrive in, the larvae molt again (within three to four days) and take the form (called L4 or “tissue larvae”) they will use to migrate through the dog’s body to reach the circulatory system. It takes the L4 about 60 – 90 days to reach the heart, where, in three to four months, they become adults and begin to reproduce. Heartworm is most successful when hosted by dogs, red wolves, coyotes, red foxes, and grey foxes. Wild and domestic felids (cats), ferrets, wolverines, and California sea lions also host heartworm, but its life cycle differs significantly in these species. Few of these animals host adult heartworms that produce microfilariae, which generally die within a month of circulating in the animal’s blood. Also, adult heartworms live for much shorter periods in these animals, compared with five to seven years in the dog. Humans, bears, raccoons, and beavers are considered “dead-end hosts.” The larval form of the heartworm, transmitted by mosquito bites, do not reach adulthood in dead-end hosts. Facts about Heartworm (D. immitis) For heartworms to thrive and become endemic in an area, they require: 1) a susceptible host population (dogs), 2) a stable reservoir of the disease (dogs infected with breeding adults and circulating microfilariae), 3) a stable population of vector species (mosquitoes), and 4) a climate that supports the life cycle of both the heartworm’s reservoir species (dogs and wild canids), its vector species (mosquitoes), and its larval stages within the mosquito. The development of the larvae within the mosquito requires temperatures of about 80 degrees F or above for about two weeks. Only female mosquitoes suck blood and transmit heartworm microfilariae. The mosquito is the only known vector for the transmission of heartworm (except for scientists who inject research animals with heartworminfected blood). Heartworm shows a preference for certain species of mosquito. However, during its spread throughout the United States it has adapted well to using other mosquito species as vectors. It has also adapted to a wider temperature range for development of larval stages in the mosquito. Adult heartworms prefer to live in the heart and in veins leading to it, but they have been found in dogs’ liver, trachea, esophagus, stomach, feces, eye, brain, spinal cord, and vomit. For more information about heartworm, see the American Heartworm Society’s website. Effects of Heartworm Infestation in Dogs The number of adult worms in a dog’s body and the dog’s activity level determine the severity of heartworm disease symptoms. Sedentary dogs with 25 or fewer worms often remain symptom-free. A dog with a mild heartworm infestation – only a couple of heartworms – may exhibit a mild, occasional cough. Active dogs with the same number of heartworms and most dogs with 50 or more worms have moderate to severe symptoms. Moderate symptoms may include a cough, exercise intolerance, and abnormal lung sounds. A dog whose heart is clogged with worms may develop the same symptoms as one with congestive heart failure, including fatigue, a chronic cough, and fluid retention (edema). If adult worms fill the right side of the heart, increased venous pressure can damage liver tissue, alter red blood cells, and lead to blood disorders that cause a sudden, dramatic collapse called caval syndrome. Severe symptoms include a cough, exercise intolerance, difficulty breathing, abnormal lung sounds, radiographs showing visible changes to the pulmonary artery, liver enlargement, temporary loss of consciousness because of impaired blood flow to the brain, edema in the abdominal cavity, and abnormal heart sounds. Resistance to Heartworm However, as we have reported before, the immune systems of some dogs seem to be able to wage war, to a limited extent, on the heartworm. An immune-mediated response is thought to be responsible for some dogs’ ability to remove microfilariae from the dog’s circulatory system. And a very healthy dog may be able to outlive a light infestation of adult worms. This makes sense from a biological perspective. Parasites want to continue their own life cycle; if they kill their host, they kill themselves. Nature’s plan for parasites generally calls for a few hosts to die – thus weeding out weaker individuals of the host species – but for more hosts to live in great enough numbers to provide the parasite with a stable environment. In order for this to occur, says Richard Pitcairn, DVM, Ph.D., author of the best-selling book, Natural Health for Dogs and Cats, animals in the wild (coyotes, wolves, foxes, and other wild canines) develop a natural resistance to heartworm. “They get very light infestations and then become immune,” he explains. What few people realize, says Dr. Pitcairn, is that many domestic dogs display the same response. According to Dr. Pitcairn, an estimated 25 to 50 percent of dogs in high-heartworm areas are able to kill (through an immune-mediated response) any microfilariae in their bodies, so they cannot pass along the developing microfilariae. “Also, after being infested by a few heartworms, most dogs do not get more of them even though they are continually bitten by mosquitoes carrying the parasite. In other words, they are able to limit the extent of infestation. All of this points to the importance of the health and resistance mounted by the dogs themselves.” Despite the extensive use of heartworm preventive drugs, the rate of heartworm infestation in dogs in high-heartworm areas has not declined in 20 years. To Dr. Pitcairn, this statistic proves that drug treatments are not the answer. Conventional Veterinary Treatments for Heartworm Infection Years ago, there was only one option offered by conventional veterinary medicine for treating a dog harboring adult heartworms – an arsenic-based drug called Caparsolate that was administered several times intravenously. The treatment was effective, but fraught with potential side effects. Caparsolate has to be injected carefully into the dog’s veins; if even a minute amount comes in contact with muscle or other tissue, it causes horrible wounds accompanied by massive tissue sloughing. In 1995, Rhone-Merieaux introduced Immiticide, a drug that is injected into spinal muscles, which has quickly replaced Caparsolate as the treatment of choice. This drug, now made by Merial, also presents some side effects, including irritation at the injection site, pain, swelling, and reluctance to move, but none quite as dramatic as the tissue-sloughing danger of Caparsolate. Post-treatment symptoms are similar with both the old and the new treatment. The drugs kill the adult heartworms, and the dead and decaying worms must work their way out of the dog’s circulatory system. The dead worms are carried in the bloodstream to the lungs, where they are gradually reabsorbed. Depending on the dog’s health and the total number of worms in his system, this can be a mild or a violent process. Dogs usually cough, gag, and vomit, experience fever and lung congestion, and are understandably depressed and lethargic. Both treatments require the dog to be kept as quiet as possible (preferably caged) for the first few days. All increases in heart rate and respiration force a greater amount of dead worm fragments into circulation. If too many particles flood into the lungs at once, they can block the blood vessels to the lungs and cause death. Both the Immiticide and the Caparsolate treatments are contraindicated (not recommended) for the most severely infested dogs with Caval syndrome. Ten to 20 percent of dogs with a high worm burden will die as a result of the Immiticide treatment. The number seems grim until you consider that even without treatment, dogs with that level of infestation suffer a much slower, progressively debilitating death. If a heart radiograph, antigen test, or the dog’s symptoms suggest that the infestation is very severe, the dog can undergo a modified treatment protocol, consisting of a single injection, which kills the weaker worms, followed by two more injections a month later. A dog that experiences difficulties may require extended veterinary care, including administrations of fluids, steroids to reduce any fever or inflammation and help quell the coughing, and supportive therapies for the liver. After the adult heartworms are killed, the next step in conventional treatment is to kill any microfilariae that are still in circulation. Since the microfilariae cannot mature without an intermediate host (time spent in a mosquito), you’d think you could skip this step. However, at the dose at which they will surely be used to prevent further heartworm infections, heartworm preventive drugs can kill microfilariae at a dangerous rate, potentially causing shock and subsequent death of the dog. The veterinarian will dispense a filaricidal drug and monitor the dog until tests show that the microfilariae are absent from the blood, usually within one to two weeks. Conventional Veterinary Heartworm Preventive Drugs All commercial heartworm preventive medicines are targeted to kill heartworm in the “tissue larval” (L4) life stage (after the larvae have been deposited in the dog by an infected mosquito). For this reason, the preventives must be administered within the period of time that begins when the dog is bitten by an infected mosquito and the time it reaches the dog’s circulatory system – about 63-91 days. The preventives do not affect the heartworms once they reach the circulatory system. To provide a safe overlap of time, guaranteeing that any larvae that have been administered to a dog by an infected mosquito are killed before they reach the next, invulnerable life stage, most of the preventives are given every 30 days. All the preventives listed below kill some (but not all) heartworm microfilariae. If a dog hosts adult, breeding heartworms, has microfilariae in his bloodstream, and receives a preventive, the subsequent die-off of the microfilariae may cause the dog to suffer from labored respiration, vomiting, salivation, lethargy, or diarrhea. These signs are thought to be caused by the release of protein from dead or dying microfilariae. This is why the makers of all of the preventives recommend that dogs receive a heartworm test – to rule out the possibility that the dog hosts adults and/or microfilariae – before receiving a heartworm preventive. The U.S. Food and Drug Administration has approved four oral, one injectable, and one topical medication for use as heartworm preventives. These include: Filaribits (diethylcarbamazine citrate), manufactured by Pfizer, is widely considered to be the safest preventive, causing the fewest adverse reactions and deaths. Filaribits Plus adds oxibendazole, which targets hookworm, whipworm, and ascarid infections. Filaribits and Filaribits Plus are given to the dog daily. Heartgard Chewables or Heartgard Tabs (ivermectin), made by Merial, is given monthly. Heartgard Plus Chewables adds pyrantel, which controls ascarids and hookworms. Interceptor (milbemycin), by Novartis, is similar to ivermectin and also controls hookworm, roundworm, and whipworm. Novartis’ other heartworm preventive is Sentinal (milbemycin plus lufenuron). The added ingredient controls fleas by inhibiting the development of flea eggs (it does not kill adult fleas). ProHeart (moxidectin), by Fort Dodge, is a derivative of ivermectin that is given monthly. Fort Dodge also makes ProHeart6, an injectable form of moxidectin that is administered by a veterinarian every six months. This formulation allows for the moxidectin to be time-released, affecting heartworm larvae for a period of six months following injection. Revolution (selamectin) from Pfizer, is not an oral drug but a topical preparation that is applied monthly. It also kills fleas, ear mites, sarcoptes scabiei (the cause of sarcoptic mange), and the American Dog Tick, and prevents flea eggs from hatching. The following data are extracted from the 1987-2000 Adverse Drug Experience (ADE) Summary published by the Food and Drug Administration’s Center for Veterinary Medicine (FDA CVM). The summaries include all adverse drug reaction reports submitted to the CVM which the CVM has determined to be “at least possibly drug-related.” In reviewing these reports, the CVM takes into consideration “confounding factors such as dosage, concomitant drug use, the medical and physical condition of the animals at the time of treatment, environmental and management information, product defects, extra-label uses, etc.” The CVM warns readers that these complex factors cannot be fully addressed in its summaries, which are intended only as a general reference to the type of reactions that veterinarians, animal owners, and others have voluntarily reported to the FDA or the manufacturer after drug use. Also, the drugs or drug combinations listed below are not necessarily the products mentioned above. |DRUG||# OF REACTIONS||# OF DOGS DIED||TOP 5 SIGNS AND % OF DOGS WHO DISPLAYED THEM| |Diethylcarbamazine||187||7||vomiting (32%), depression/lethargy (15%), diarrhea (12%), anorexia (6%), collapse (4%)| |Diethylcarbamazine/oxybendazole||1033||128||vomiting (27%), increased alanine aminotransferase (liver enzyme)/blood outside the vascular system oxybendazole (hemorrhage, 25%), increased alkaline phosphatase (liver or bone enzyme)/blood outside the vascular system (hemorrhage,22%), anorexia (18%), depression/lethargy (18%)| |Ivermectin||681||134||depression/lethargy (31%), vomiting (26%), ataxia (loss of muscle coordination, 23%), mydriasis (prolonged dilatation of the pupil, 18%), death (13%)| |Ivermectin/pyrantel||209||30||vomiting (22%), depression/lethargy (17%), diarrhea (16%), death (11%), anorexia (9%)| |Milbemycin||460||67||depression/lethargy (34%), vomiting (31%), ataxia (12%), death (12%), diarrhea (11%)| |Milbemycin/lufenuron||400||14||vomiting (31%), depression/lethargy (23%), diarrhea (18%), pruritis (itching, 16%), anorexia (13%)| |Moxidectin||283||51||ataxia (56%), convulsions (22%), depression/lethargy (18%), trembling (17%), recumbency (lying down, won’t get up, 16%)| |Selamectin (topical)||1716||67||vomiting (17%), depression/lethargy (13%), diarrhea (13%), anorexia (9%), pruritis (9%)| |Figures for the injectable form of moxidectin not yet available. ProHeart 6 (injectable moxidectin) was released to market in late 2001.| Problems with Heartworm Preventives There is no doubt that preventive drugs have protected millions of dogs that may have otherwise become infected with heartworm. However, a small percentage of dogs treated with commercial preventives do suffer from mild to serious side effects. And many veterinarians, faced with a sick dog with no changes in its routine except a recent administration of heartworm preventive, are reluctant to consider the possibility that a veterinarian-developed and -prescribed drug may cause illness. In some cases, in fact, these drugs are the last thing veterinarians seem to consider. This was certainly the case in March 2000, when Terri Eddy of Rincon, Georgia, asked her veterinarian for a heartworm preventive for Sage, her two-year-old Australian Shepherd. Sage had been spayed, was an indoor dog, and had no bleeding or clotting disorders. Eddy’s veterinarian recommended Revolution, a topical medication that is used to kill heartworm larvae, fleas, the American Dog Tick, ear mites, and the mites that cause sarcoptic mange. Two days after Revolution was applied to Sage, the young Aussie developed a cough. Three days after that, she became quiet, didn’t want to play, developed bruising, and whimpered in pain. Eddy took Sage back to the veterinarian, and asked whether the Revolution could have caused Sage’s signs of distress. The veterinarians at the practice agreed that Sage’s symptoms, including blood in the whites of her eyes, could not have been caused by Revolution; they speculated that Sage must have ingested rat poison and/or suffered a blow to the head. Eddy, a nurse, felt that neither diagnosis was correct, and Sage did not respond to the treatment provided. The next day, Eddy took Sage to an emergency clinic when the dog lost her balance, could not stand, and began vomiting blood. At the clinic, she began having seizures. A few hours later at a specialist’s clinic, she continued to have seizures and bled into the orbits of her eyes. The following morning, she died. Eddy was told that another dog had died the previous month at the same clinic with identical symptoms after being treated with Revolution. An autopsy on Sage showed low platelets and intracranial hemorrhage from a toxin. “No dog should ever suffer the way Sage did,” says Eddy. “I encourage all owners to approach this product with caution.” Alternative Options for Treating A Dog’s Heartworm Sage’s story is an extreme example of what can go wrong when toxic drugs are used, and, of course, dogs with severe heartworm infestation suffer, too. However, dog guardians have many heartworm prevention options available to them – certainly more than either using the most toxic chemicals or going without any protection whatsoever from heartworm. Many veterinarians, holistic and conventional, take a conservative approach to heartworm preventives and other medicines. Rather than availing oneself of the most complicated combination drug on the market, a dog owner can focus on one threat at a time, and only when that threat is imminent. For example, in most parts of the country, mosquitoes are a seasonal danger, so an owner could safely discontinue heartworm preventives when mosquitoes are not present. If a dog was suffering from a second parasite, such as ear mites, an owner could address that issue separately, and with the least-toxic preparation available, rather than turning to a multi-target drug. Another approach is to keep careful records of your administration of preventive drugs, and stretch the time period between applications from the recommended 30 days to something a bit longer – thus reducing the number of doses per season a dog will receive. It takes heartworm larvae a minimum of 63 days after being deposited in a dog’s body by an infected mosquito to develop into a juvenile worm that cannot be affected by preventive drugs. It’s critical, then, to make sure the dog receives a preventive drug within that period, even allowing for some overlap. Some owners give their dogs preventives every 45 – 50 days, rather than every 30 days, sparing their dogs one or two doses per mosquito season. Obviously the success of this approach absolutely depends on the owner’s reliable record-keeping and administration. Still other guardians make their preventive decisions based on the incidence of heartworm in their part of the country. A person who lives in an area with lots of heartworm cases and a long mosquito season may make different decisions than a person living in an area where veterinarians rarely or never see heartworm cases. And then there are the guardians who forego conventional preventives in favor of alternative approaches. Fighting Heartworm by Fighting Mosquitoes (Without Toxins) The most effective way to avoid biting insects is to reduce their population, and the latest weapons in the war against mosquitoes – as wells as no-see-ums, biting midges, sand flies, and black flies – are machines that pretend to be people. The Mosquito Magnetemits a plume of carbon dioxide, warmth, and moisture in combination with octenol, a natural attractant that lures biting insects. A vacuum pulls them into a net, where they dehydrate and die. According to the maker, two months of continuous use causes local mosquito populations to collapse. The Mosquito Magnet comes in three models powered by electricity or propane, each protecting 3/4 to 1 acre. The machines cost $500 to $1300. ALTERING THE MOSQUITO’S ENVIRONMENT Low-tech mosquito control methods are important, too. Remove buckets, tires, and other objects that collect and hold rainwater; empty and refill birdbaths every few days; and maintain screens on doors, windows, and porches. “Mosquito fish” (Gambusia affinis), tiny fish that eat mosquito larvae, can be added to ponds, rain barrels, and other potential mosquito nurseries. They are available from some garden stores, agricultural extension offices, and fish & game departments. Look at your local organic garden supply for Bacillus thuringiensis (BTI), a biological control product that is added to standing water to prevent mosquito larvae from maturing. Agnique MMF is an environmentally friendly product that covers ponds and other standing water with an invisible film that smothers mosquito larvae and drowns egg-laying adults. Agnique MMF spreads rapidly, is safe for recreational and drinking water, and remains effective for 10 to 14 days. Arbicois a mail order company in Tucson, Arizona, that sells organic gardening supplies and biological insect control products, including BTI, plus battery-operated mosquito inhibitors. Arbico also sells fly parasites and all kinds of other organic pest control products. Infected Dog Recovers Without Conventional Treatment: While some dog guardians focus on finding alternative heartworm preventives, others find themselves in the unfortunate situation of needing alternative treatment for their dog’s heartworm infection. That was the case with Georgia resident Robin Sockness Snelgrove, the guardian of a small mixed-breed dog named Bandit. In January 2000, at the age of 10, Bandit developed signs of a heartworm infection, including a chronic cough and loss of appetite. Snelgrove’s veterinarian diagnosed a moderate to severe infection. Concerned about Bandit’s age and serious potential side effects, Snelgrove declined the option of conventional treatment. The veterinarian offered steroids to make Bandit more comfortable – and Snelgrove began investigating alternative treatments. Snelgrove contacted a friend who raises dogs holistically, and followed her friend’s suggestions for a herbal treatment program. This included using products made by Nature’s Sunshine, including two artemisias (mugwort and sweet Annie, or annual wormwood) and several other herbs in combination with black walnut* to kill the heartworms and their microfilariae; coenzyme Q10, hawthorn, garlic, and cayenne to strengthen the heart and help prevent clotting; and yucca to help relieve Bandit’s cough. The cough continued intermittently for four or five months before diminishing. “Then, almost overnight, he came back to life and started acting like a puppy again,” says Snelgrove. She kept Bandit on the herbs for a year before going back to the veterinarian for another heartworm test. “The vet couldn’t believe he was still alive,” she says, “but here he was, with a shiny new coat and full of energy.” Snelgrove says Bandit has tested negative for heartworm for the last two years, during which he has taken the same herbal products on a maintenance schedule. After Snelgrove posted Bandit’s story on her Web site, eight people put their heartworm-positive dogs on the same program. “So far two are completely cured with negative heartworm tests to prove it,” she says, “and the others are improving.” Snelgrove appreciates the seriousness of heartworm disease, and says she would rather prevent it than have to treat it. “But what I’ve learned from all this,” she says, “is that a diagnosis of heartworm infection doesn’t mean having to choose between expensive, dangerous treatments and letting your dog die. There are other options.” *Controversy over black walnut preventive: Some holistic veterinarians have reported having some success using black walnut capsules or extracts as heartworm preventives and even as a treatment for adult heartworm infections. In recent years, perhaps because more people have been trying this approach, more reports have surfaced of black walnut’s shortcomings as a preventive, with some dogs testing positive for heartworm despite their owners’ use of black walnut. Has black walnut been over-promoted as an alternative to conventional veterinary heartworm preventives? If a dog eats commercial pet foods, receives annual vaccinations, is exposed to pesticides and other chemicals, and has taken prescription drugs, her impaired immune system may fail to discourage heartworms. In addition, poorquality herbal preparations or good-quality products that have been damaged by exposure to heat, light, and air won’t help her. Because most powders lose their effectiveness quickly, tinctures (alcohol extracts) are usually a better choice than capsules, but even a freshly made tincture that wasn’t aged long enough or did not contain enough plant material may be too weak to help. One way to protect dogs from heartworm and other parasites with black walnut is to buy the best products you can find (Gaia and HerbPharm are excellent brands) from a store that receives frequent shipments. Freshness matters when products are stored under fluorescent lights or exposed to sunlight or heat. For additional protection from heartworm, intestinal worms, fleas, and mosquitoes, add garlic and other parasite-repelling herbs to your dog’s dinner. Several products designed for pets contain wormwood and other artemisias, noni, neem, rue, thyme, the white rind of pomegranates, or cloves. Building Your Dog’s Immune Competence Stephen Blake, DVM, of San Diego, California, is a holistic veterinarian who consults with preventive-drug-adverse clients all over the country, including areas where heartworm is endemic. “Many of my clients either never used conventional heartworm preventives or quit using them decades ago,” says Dr. Blake. “Today’s preventives are much improved, but they still can cause adverse side effects. Some dogs develop autoimmune disorders when heartworm chemicals alter normal cells so that the body considers them foreign and attacks them. The drug’s active ingredients wind up in the liver, where they may cause a form of hepatitis, or the drug might affect some other part of the body. The end result is that in trying to prevent heartworm, you might lose the patient to an autoimmune complex, liver failure, or the failure of whatever organ was most damaged by the drug. “Sometimes the damage caused by heartworm preventive medication is so subtle,” he says, “that no one makes the connection. It could show up as slightly reduced energy, a picky appetite, skin problems, ear infections, or any number of benign chronic conditions that the dog didn’t have before it went on the medication. Several of my patients had symptoms like this that went away when their owners discontinued the medication. That’s when I realized that the risk of damage from preventive drugs was greater than the risk of heartworm, and I started to focus on nutrition and natural preventives instead.” Dr. Blake monitors patients with heartworm blood tests every six months. “Negative test results reassure clients,” he says, “but even if a dog tests positive, it doesn’t mean the dog is going to die. This is a common misconception. If the dog’s test was negative six months ago, a positive result probably indicates the presence of just a few heartworms rather than a large number. In that case, nutritional and herbal supplements, dietary improvements, and other holistic strategies can help the dog eliminate adult worms and prevent microfilariae from maturing.” Dr. Blake is fond of citing a study conducted several years ago at Auburn University Veterinary Medical School by Dr. Ray Dillon, who attempted to infect impounded stray dogs with heartworm by injecting them with blood containing 100 microfilariae. At the end of the study, each of the dogs had only three to five heartworms. In contrast, Dr. Dillon found that when dogs bred for research were given 100 microfilariae, they typically developed 97 to 99 adult worms. “That’s a huge difference,” says Dr. Blake. “The stray dogs were from a control facility in Mississippi, which is a heartworm-endemic area, and no one was giving them heartworm protection medication. These dogs had developed their own resistance to heartworm in order to survive, which they probably did by manufacturing antibodies that prevented the heartworm larvae from maturing.” To improve a dog’s overall health in order to help him repel and eliminate heartworms, Dr. Blake recommends improving the diet (more protein, better-quality protein, and a gradual transition to raw food), digestive support (colostrum, digestive enzymes, and probiotics such as acidophilus), clean water (filtered or bottled), ample exposure to unfiltered natural light outdoors (something he believes kept the stray dogs healthy), and the elimination of everything that weakens the canine immune system. This includes pesticide treatments for fleas or ticks, vaccinations, exposure to garden chemicals, and most prescription drugs. “It isn’t necessary to fear every mosquito,” says Dr. Blake, “or to equate every positive heartworm test with a death sentence. Mother Nature has given your dog plenty of defense weapons that will work fine if you keep chemicals and inadequate nutrition from interfering. When I first stopped using heartworm prevention medicines, I went through stages of using homeopathic nosodes, herbs, and natural repellents in their place. I no longer use any of those replacements because I believe a dog’s best protection comes from a clean, toxin-free life-style and good nutrition.” Heartworm-Infected Mosquitoes: A Spreading Threat The first description of heartworm in dogs appeared 155 years ago in the October 1847 Western Journal of Medicine and Surgery. But until the late 20th century, America’s canine heartworm was a regional illness, with most cases occurring in the Southeast. Dogs living in Rocky Mountain and Western states rarely contracted heartworm, and if they did, it was because they picked it up while traveling through areas in which heartworm was endemic, or permanently established. Warm summer temperatures, conditions that favor mosquitoes, and an increasingly mobile canine population have contributed to the spread of heartworm. Mosquitoes thrive in swampy areas and wherever they have access to standing water. Sometimes natural disasters such as storms or floods spread heartworm by expanding the mosquitoes’ habitat. Other factors that contribute to heartworm infestation include the agricultural irrigation of previously dry land or the installation of swimming pools, ponds, and fountains. Wendy C. Brooks, DVM, at the Mar Vista Animal Medical Center in Los Angeles, California, is keeping a close eye on heartworm infections in areas thought to be safe from the parasite. Consider Salt Lake City, Utah, historically a low-risk area for heartworm. “A beautification project led to the planting of new trees throughout the city,” says Dr. Brooks. “The following year, these trees were pruned for the first time, leaving thousands of knot holes throughout Salt Lake City. This suited Aedes sierrensis, the ‘tree hole mosquito,’ just fine. Soon heartworm cases began appearing. Salt Lake City is now considered as endemic an area for heartworm as Texas, Louisiana, or Florida. Planting trees throughout a city is hardly a major climatic event, but it was enough to establish heartworm and its mosquito vector in a new area.” Between 1996 and 1998, researchers at the University of California at Davis School of Veterinary Medicine reviewed the heartworm tests of 4,350 dogs in 103 cities in Los Angeles County. Eighteen dogs tested positive, or 1 in 250. The result startled veterinarians not only because it was unexpected but because the infection rate was as high for dogs that had never traveled as it was for dogs that had, and 50 percent of the infected dogs were “indoor” dogs, which are considered less susceptible to heartworm than dogs that live outdoors. Age, sex, and coat length were ruled out as risk factors. “Veterinarians in Southern California do not usually test for heartworm,” says Dr. Brooks, “but we’re beginning to. In areas with swimming pools, reservoirs, lakes, ponds, and other mosquito-friendly environments, heartworm is infecting our dogs.” Is Alaska next? Thanks to global warming, mosquitoes have appeared in Barrow, the northernmost city in North America, and the mosquito-friendly Kenai Peninsula southwest of Anchorage reached heartworm-incubating temperatures in May. Making Decisions on Heartworm Treatment The success of alternative approaches for preventing or treating heartworm – or any other condition, for that matter – depends upon a complex multitude of factors. One should not simply replace conventional medications with “natural” remedies and expect miracles to happen; this is the sort of ill-considered approach that often fails and gives alternative medicine a bad reputation. Instead, dog guardians who are concerned about the risks of conventional prevention or treatment drugs should consult with a holistic veterinarian and look into a “whole dog” heartworm prevention program. This should include a review of and improvements in the dog’s diet, overall health status, exposure to toxins, and stress levels. Local conditions should also be taken into account, including the incidence of mosquitoes and of heartworm in any areas that you and your dog frequent. The decisions of whether or not to use natural or conventional preventives, and how and whether to treat a heartworm infection are not easy to make – but they are your choices. Find a veterinarian who will support and help you protect your dog according to your dog-care philosophy. 1. Inquire about the prevalence of heartworm in any areas where you and your dog frequent. 2. Rigorously employ a protection program (any protection is better than none) that suits your dog-care philosophy. 3. Have your dog tested for heartworm infection annually. The competence of your dog’s immune system is critical for protecting him from heartworm. 4. Use immune boosters such as an improved diet, pure water, reduced exposure to toxins, etc.

<urn:uuid:37806a48-eb73-4f7c-81cb-28d276fa3482>

CC-MAIN-2019-47

https://www.whole-dog-journal.com/health/heartworm-treatment-options/

s3://commoncrawl/crawl-data/CC-MAIN-2019-47/segments/1573496671260.30/warc/CC-MAIN-20191122115908-20191122143908-00138.warc.gz

en

"Welcome to LinuxQuestions.org, a friendly and active Linux Community.\nYou are currently viewing LQ(...TRUNCATED)

<urn:uuid:fccda6ba-1d4b-4494-8f52-c05f987d4f1b>

CC-MAIN-2019-47

https://www.linuxquestions.org/linux/answers/Networking/From_beginning_to_end_ProFTPD?s=3b9945f0d939de2dca6ea352884ac6c0

"s3://commoncrawl/crawl-data/CC-MAIN-2019-47/segments/1573496668594.81/warc/CC-MAIN-20191115065903-2(...TRUNCATED)

en

"When we became followers of Jesus Christ there were many practices we put behind us; lying, immoral(...TRUNCATED)

<urn:uuid:320c74a3-df42-4b9c-a45f-7cb7c20da9b4>

CC-MAIN-2019-47

https://www.goodfight.org/articles/cults-occult/christian-response-halloween/

"s3://commoncrawl/crawl-data/CC-MAIN-2019-47/segments/1573496667767.6/warc/CC-MAIN-20191114002636-20(...TRUNCATED)

en

"Titus Livius or Livy (59 BCE - 17 CE): Roman historian, author of the authorized version of the his(...TRUNCATED)

<urn:uuid:8a903a27-8200-463e-9eb3-62a3105dc41a>

CC-MAIN-2019-47

https://www.livius.org/sources/content/livy/livy-periochae-46-50/

"s3://commoncrawl/crawl-data/CC-MAIN-2019-47/segments/1573496670448.67/warc/CC-MAIN-20191120033221-2(...TRUNCATED)

en

"The link to Directions returns you to this page. Logical reasoning tests measure logical thinking f(...TRUNCATED)

<urn:uuid:e7d4520c-629f-4b8a-8545-855d8b8b3f15>

CC-MAIN-2019-47

http://keiz.taxi-marchal-lyon.fr/logical-reasoning-test-pdf.html

"s3://commoncrawl/crawl-data/CC-MAIN-2019-47/segments/1573496670156.86/warc/CC-MAIN-20191119144618-2(...TRUNCATED)

en