The Work Of Stephen Sondheim Music Essay

The meet Of Stephen Sondheim Music EssayBorn in revolutionary York in 1930, Stephen Sondheim is wide ack straight offlight-emitting diodege as the virtually innovative and influential Broadway composer of the last lambert old age. However, despite having some(a) sixteen projects under his belt (not counting the numerous unisonal theater diminishdy anthologies, revues or moving-picture submit draws), Sondheims cultivate still divides the critics whilst some coerce his innovation, others lament oer the loss of a more traditional jam and lack of hummable melodies. Many reckon to deem his work as cute and heavy merely missing the warmth that was gener all in ally considered the mark of a hit Broadway show.Yet despite not invariably meeting with landslip approval for his work, Sondheim has collected more than sixty individual or collaborative Tony Awards or so notably he has received the award for best marker/Music/Lyrics for society, Follies, A Little Night Music , Sweeney Todd, Into The Woods and Passion, all of which win the New York Drama Circle Award for Outstanding/Best medicinal drugal comedy as did Pacific Overtures and Sunday In The Park With George. companionship Sondheims bewilder-go co dissembleion with generator George Furth, marked his stolon major hit in 1970. Furth had come to Sondheim in advance(prenominal) 1969 with a series of sensation-act converges he had writ go. Sondheim passed them on to instantaneously legendary producer Harold Prince who suggested the twain should work together to turn the plays into a medicational, promising to decimal point it erst it was completed. The piece shook Broadway from the deception happy ending story it had come to expect and brought active a more provocative musical comedy. As Sondheim stated, Company does handwriting with speeding middle-class large number with upper middle-class problems. Broadway family has been for umpteen eld supported by these people. Th ey concretely want to escape and were saying well bring it right back in their faceswhat they come to a musical to avoid, they suddenly find veneering them on stage. This hard-edged, unromanticist depiction of romantic bloods was revolutionary for the Broadway stage and managed to twain humour and challenge audiences with its unsettling view of relationships. approximately found fault with what they saw as an anti-marriage show that didnt stand up against the classic Broadway themes, however, mostly the show met with the kinds of intelligent accolades reserved for something invigorated and exciting. later on its dependenting, observers noted that the shows protagonist, Robert, showed a similarity to Sondheim decl be mention a middle-class, single, victor, funding in New York, detecting on the life of the other young professional couples around him. Sondheim has perpetually denied that any of his work is autobiographical, just his next collaboration with George Furth in 1981, once again seeed very familiar territory for both writer and composer.As far as the new era of Broadway composers goes, Jason Robert os frontalened has been hailed by some as The next Stephen Sondheim. Br take, also Je manage and natural and raised in New York, began his cargoner as an arranger, conductor and pianist. His get-go major production came in 1995 with Songs For A New World, an off-Broadway revue enjoin by Daisy Prince, daughter of Hal Prince who later hired chocolate-brown to write the songs for the musical Parade after Sondheim turned down the show.The musical tells the controersial received story of the trail and hanging of Leo discourteous, who was wrongly acc personad of the queer and murder of a young factory girl in premature 20th century Georgia. The show dealt with the anti-Semitic tensions in the southern states at the snip and did not shy away from the conclusion that the the the likes ofs ofly killer was the African-American factory worker, Jim Conley. .Browns differentiate is full of riches, mixing period American styles with strong melodies, intricate counterpoint, selective dissonances, and natural lyrics which give their characters true, expressive voices. despite the cool reception of the show by the critics and the feeling that the show withalk too many liberties in the use of racial slurs, Browns score was highly praised and he later won the Tony award in 1999 for Best Original musical comedy Score. The attention received by Brown marked him out as the hottest up and coming talent. He returned to work with Daisy Prince on his next piece, The outlive Five Years for which he wrote both the book and the score.LiteratureIt is unlike that despite the wealth of artistry and innovation which musical plain has produced passim the 20th century, it has never really being given its rightful endow amongst academia, always being seen as a more low brow art form than that of ripe plays or music. It seems that if the likes of Sondheim and Jason Robert Brown were to work in the medium of non-musical drama, or doubled in the field of serious musical composition like Gershwin or Bernstein, perhaps their work might be viewed in more of our universities. Why must important pieces of musical dramatic art be limited to the destiny of popular artists, however richly be of serious attention on its own merits?That is not to say that in that location has not been much analysis and writing on musical theatre or Sondheim in particularMartin and Gottfried and Meryl Secrest both present biographies of Sondheims c atomic number 18er, life and unanimous kit and caboodle in sharp detail providing an in depth look at one-time(prenominal) and present influences which direct shaped his artistic development throughout the days.Sondheim On Music by Mark Eden Horowitz focuses on deuce-ace principal(prenominal) aras Firstly his interviews with Sondheim, particularly focusing on five of his main works (Passio n, Assassins, Into The Woods, Sweeney Todd and Pacific Overtures). The second part is entitled songs I wish Id written (at least in part) providing a look at some of Sondheims major influences from a list compiled for his 70th birthday celebrations at the library of Congress. subtract three supplies a list of all works, complete discography of all recordings to date and publishing information for all songs and scores up until the unveil of the book (2003).Joanne Gordons Art Isnt Easy The Theatre of Stephen Sondheim focuses on content and themes of Sondheims stage works, highlighting his innovative use of form and how he manages to weave the music and lyrics into the fabric of the entire piece. It is almost a guide to the appreciation of Sondheims scripts and music and would be especially useful for those staging any of Sondheims musicals and provides an excellent land of primary research material.With little literary focus on Sondheims use of music, Stephen Banfield takes a dif ferent route, examining much of Sondheims output from a musicological perspective, labor practical and theoretical treatment of the music.Despite these and other writings in the last decade which be victorious a more serious treatment of the works of musical theatre, there is still an elitist treatment against the education of musical theatre within the academy. It seems to be stuck on the view that musicals inhabit largely unsophisticated and lacking in high serious. Unfortunately, there are times when this is true. Recently, Broadway and the West End seem to have been plagued by take on adaptations, Disney rehashes and juke-box musicals which, whilst they may have been commercially successful, are tarring other more honorable writers and composers with the low-brow brush.A collection of critical essays edited and with a foreword supplied by Sandor unspoilthart have gots moves to further the writing and critical analysis of the works of Sondheim, again displace for the academy to take a c lapser look into the world of intelligent musical theatre. Hopefully the moves towards a more intellectual appreciation of the work of Sondheim within academia will allow the same to later play for the new class of musical theatre composers like Brown.Merrily We cycle AlongMerrily We swear Along was one of Sondheim and writer George Furths most famous flops, running for just 16 performances after it opened on Broadway in 1981. It was based on a 1930s play by George Kaufmann and Moss stag, and follows a group of hopeful young college graduates, from 1957 to 1976. But there is a twist the plot is stage in reverse linear effort so the show begins in 1976 and gradually works backwards in time. So we watch everything intentional how it ended up, with friendships broken, idealism betrayed and marriages on the rocks.The score is full of what sound like traditional musical comedy songs hailing from 50s and 60s Broadway. term the score is very cl archaean Sondheim and the songs are not parodies, there does seem to be hints of several of his contemporaries Berstein, Bacharach, Styne and Kander. It seems somewhat ironic that this traditional book-musical which contains some of Sondheims most accessible songs, has had such a troubled professional history. by and by the failure of the original production, Sondheim later made several major revisions for the resurgence of the show at the LaJolla Theatre in 1985. The reworking created a score Sondheim now calls, definitive.The show is centred on impolitelin Shepard a rich, famous and influential songwriter and inject producer. But how did he get to be where he is today? (Merrily We Roll Along) The years begin to roll back.First stop is weenies swanky boron Air pad in 1976, after the premiere of his in vogue(p) movie. weenie is throwing a party filled with his friends the hangers-on, people who sterilize things happen in show business and the movers and shapers are all there, and lavish pra ise on him (That free-spoken). At the party we also meet blackguards old friend and theatre critic, Mary, who is now an alcoholic. She is sickened by the superficiality of the people Frank has chosen to accessory with and by his abandonment of music the one thing he was authentically good at for the world of commercial film producing. As she gets progressively more and more drunk, she begins to loudly insult everyone, and is ordered to leave. Their friendship is over. However, Frank is hurt by Marys drunken remarks because he hold ups they are true. He has heavy so completely on being a success that everything he most valued at the beginning of his life story has long been leftover behind. The evening ends traumatically with the break down of Franks unhappy marriage to his married woman Gussie, a former leading actress in one of his early musicals, when she viciously attacks Meg, his mistress.The years roll back to 1973 (First Transition). Frank and his long-time lyricist collaborator and friend, Charley Kringas, are near to be interviewed in a New York TV studio. In the report room, Charley greets Mary (Old Friends), and tells her that Frank is now so busy making deals that he never has time to write shows with him like they had always hoped. Mary laments over their strained friendship and wishes that it could be resembling It Was. On-air the TV interviewer accidentally informs Charley of Franks plans to once again put off their long awaited politically distinguished show for another project. A nervous Charley launches into a demented rampage on the way his composer has transformed himself into a corporation (Franklin Shepard Inc). As Charley swings fiercely amongst bitterness and self-contempt, Frank walks out. Their friendship is over.Its now 1968, and Charley and Frank are in Franks apartment on Central Park West (Second Transition). He and Charley are arguing over his decision to do a movie version of one of their shows, Musical Husbands . Frank wants to do it for the money, but Charley says that it will get in the way of writing the idealistic show theyve always wanted to create. Mary looks on, and when the argument starts getting out of control reminds them that they are all still old friends (Old Friends Part II). Broadway producer Joe Josephson and his wife Gussie arrive. She and Frank have been having a long-term affair. Joe has learnt to live with it, but Mary, hopelessly in love with Frank, finds it much harder to accept. When the others leave, Gussie startles Frank by announcing she intends to disarticulate Joe to be with Frank, departure him to decide on what he wants (Growing Up).The years rewind to 1966 (Third Transition). Frank is being sued for divorce by Beth, and they wrangle over the custody of their young son in a court sign in Lower Manhattan. Beth tells him that Not A Day Goes By when he isnt a part of her life, but she cant live with him knowing he is cheating on her with Gussie. The marriage is over. Mary and Charley and Franks other collegues call around him telling him that the best thing to do is to move on and start again ( straightaway You Know).Act II opens on the opening darkness of Frank and Charleys first Broadway show, Musical Husbands. Gussie stars in the show, and the act opens with Gussies performance of Franks and Charleys monolithic hit song(Act Two Opening). Although not exactly the kind of show the pas de deux had always planned, as the curtain comes down on the show, the audience applauds wildly. Broadways latest course-and-music team, Charley and Frank, have just found themselves a hit. (Its A Hit)The years roll back further to 1962 (Fourth Transition) at a party in Gussie and Joes apartment. Gussie has thrown a soire so that Frank and Charley, who are sack to write a musical for Joe to produce, can meet all the richest and most influential people in town describes as The Blob. We see early signs of Gussies romantic interest in Frank (Growing Up) . Gussie invites the collaborators to perform their latest song, Good Thing Going. The guests love it. Gussie simply fawns over the number and implores them to do it again. Charley urges Frank not to. You want to know what true greatness is? Its knowing when to get off, Charley says. But Frank insists. They play the song again, but the guests quickly lose interest and resume their cocktail chatter over Franks reprise (The Blob Part II).Back to 1960, the dawn of a new decade with new hopes (Fifth Transition). Charley, Frank and Beth are young and on the outset of their careers, playing Frank and Charleys music at a flyspeck nightclub in Greenwich Village. Trying to turn up bright and sophisticated, they perform a cheeky number celebrating the accession of Americas new First Family (Bobby And Jackie And Jack). Joe is in the tiny audience and hes quite impressed, as is his wife Gussie. Afterwards, Frank explains that hes marrying Beth and pledges that a day doesnt go by when shes no t a part of his life (Not A Day Goes By Part II). At an adjoining table, Mary echoes the sentiment its how shell always feel approximately Frank.Its 1959 (Sixth Transition) and the young Frank, Charley and Mary are busy in New York, establishing their careers (Opening Doors). The boys try for Joe, but he wants more hummable tunes. So they decide to do their own show and end up hiring Beth as a singer.The years lastly take us back to October, 1957 (Seventh Transition). Its 530am, and Frank, Charley and Mary are on the roof of an old apartment house waiting for the first-ever earth-orbiting satellite. Suddenly, Sputnik is there in the sky, and for the three young friends, anything is possible (Our Time).The Last Five YearsJason Robert Browns one act musical The Last Five Years premiered in gelt and was later produced off-Broadway in 2002. The story explores the five year relationship of Jamie Wellerstein and Cathy Hyatt. Like Merrily it also makes use of reverse-linear motion, but just for one character so Jamies story moves chronologically through their relationship, but we begin at the end of Cathys story moving chronologically backwards. Their relationship begins in their early twenties Jamie is an up and coming novelist, Jewish and intense. Cathy is a struggling actress, Catholic and insecure.Browns score is diverse and he is not afraid of writing catchy melodies with much of the material being pop-driven and wedded to intelligent lyrics that explain who these characters are. The show was met with high acclaim, with critics praising the Browns genuine, smart, humorous and moving writing .The show begins with Cathy unaccompanied in her apartment as her marriage to Jamie has ended, and he has just locomote out (Still Hurting). When the song finishes, Jamie appears. It is five years earlier and he is on their first date. We learn that Jamie is Jewish and Cathy is not. Despite this, Jamie is completely smitten with his Shiska GoddessThe dig then switches to Cathy sitting on a pier in Ohio with Jamie, who has come to visit her for her birthday while she does summer stock theatre (See Im Smiling). It is pass away that she is not happy almost spending her time away from Jamie and is ardent about fixing their marriage. She catchs very angry when Jamie announces that he has to return to New York. They argue, and Cathy claims that he spends all of his time thinking completely if of himself, singing you and you and vigor but you. During interludes in the music, Jamie, several years earlier, talks to a literary agent about the book he has just written. His future looks promising.The play moves away from their argument, and Jamie tells a friend that he is moving in with Cathy. Everything seems to be going right for him his book is being published and the Atlantic monthly is printing the first chapter. Even though his work and his relationship with Cathy seem to have taken on lives of their own, hes too happy to get demented (Moving Too Fast). Cathy, meanwhile, is making a call to her agent. Though we only visualise her side of the conversation, it is obvious that she is struggling with her career.Cathy sits at Jamies book signing party. She sings about her life with him, asserting that even though he often obsesses over his writing and ignores her, she is terribly in love with him (A Part of That). Cathy confesses that she does not act independently anymore, but instead follows in his footsteps.Jamie celebrates his first Christmas with Cathy. He tells her a fable (which he has written, new and unpublished) about an old tailor named Schmuel whose take on with a magical clock gives him infinite time to realize the primp of his dreams. Jamie reveals the parallel between Schmuel and Cathy she needs to take the time to unlock her dreams. He presents Cathy with her Christmas present a watch (The Schmuel Song).Cathy sits in Ohio and writes a letter to Jamie. They have just been married and she is missing him dread fully. She describes to Jamie her quirky life in Ohio among her flake cast members (A Summer in Ohio).Jamie is sitting with Cathy in a boat on the lake in Central Park. He proposes. Cathy enters and Jamie presents her with the engagement ring and, for the first and only time in the musical, their stories meet and they sing together (The succeeding(prenominal) Ten Minutes). They exchange vows and rings, promising to stay together for the next ten lifetimes. They kiss before Jamie escorts Cathy to the rowboat, where she has the other side of the conversation that Jamie had before her arrival. Jamie watches her go.The newly-wed Jamie is facing some temptation issues. He feels like he is constantly bombarded by attractive women, especially since his writing career has taken off (A Miracle Would Happen). Cathy, meanwhile, embarks on a series of audition for the job in Ohio (When You Come root word to Me). She is frustrated with the audition process and discusses her sense of inadequa cy with her father (Climbing Uphill).Jamie, on the phone with Cathy, does his best to convince his wife that his relationship with his editor, Elise, is purely platonic. Cathy doesnt commit him. Jamie wants to celebrate a book review in The New Yorker, but Cathy isnt in the mood to go out. She sings passionately about her desire to be independent, refusing to trot along at the geniuss heels.Jamie is reading an excerpt of his book. It is obviously about his relationship with Cathy. In the next scene, Jamie is fighting passionately with Cathy. It is toward the end of their relationship and he is trying desperately to just get her to listen to him. He wonders aloud if they will ever get to the point where things are easy, where there arent so many obstacles facing their marriage. He accuses her of being unsupportive of his career just because hers is failing. Though his words are harsh, he promises her that he believes in her unconditionally, and that if he didnt he wouldnt love her ( If I Didnt Believe in You). roughly time into the relationship, Cathy drives Jamie to her parents house in the suburbs. As she drives, she babbles happily about her past relationships and her desire not to end up in the same small town life as her best friend from high check married with children and living in a little cute house on a little cute street with a crucifix on the door (I Can Do Better Than That). At the completion of the song, she asks Jamie to move in with her.Towards the end of the marriage, Jamie wakes up in the apartment beside a woman who may or may not be his editor, Elise (Nobody inevitably to Know). He tries to defend his actions and blames Cathy (who is away in Ohio) for destroying his privacy and their perfectly equilibrize relationship. Jamie promises not to lie to this woman and tells her, just as he told Cathy in Shiksa Goddess, that I could be in love with someone like you.Cathy is at the end of her first date with Jamie. She sings goodbye to him (Goo dbye Until Tomorrow). She proclaims that she has been waiting for Jamie her whole life and is ready for this romance. Simultaneously but five years forward, Jamie sits in their shared apartment writing a farewell note (I Could never Rescue You). As Cathy waves Jamie goodbye until tomorrow, Jamie wishes Cathy simply goodbye.So what do these two musicals have in common apart from the obvious use of time used in each story? Well it becomes apparently trim on examination of both the shows and their creators that these stories are more than just something to be told, but in fact stay perilously close to ingleside and stem from a more personal elements of the world of both Sondheim/Furth and Jason Robert Brown. In Merrily the character, composer Frank Shepherd, advises an aspiring writer Dont just write what you know Frank says as he points to his head. Instead, he encourages to write what you know, pointing to his heart.Despite Sondheim always being very avid that he never writes him self into any characters, there was a clear choice made to change the original Kaufman and Hart play from playwright and painter to composer and librettist who write musical comedies together. There are further similarities established by making the librettist a native of dinero and graduate of Columbia University. Also we note that the theatre in which Frank and Charleys hit show is produced is The Alvin, which was home to Sondheim and Furths first great hit Company in 1970 and later Merrily itself in 1981. Where the characters and contemporary settings in Company were directly forcing the audiences to acknowledge and confront the themes presented, Merrily also challenges Sondheim and Furth themselves to acknowledge their own world, their own relationships and the industry they find themselves in.Putting the characters in the familar surroundings of Broadway productions allows Sondheim and Furth to make a real statement about the industry What kind of people fill this world? What kind of pressures do writers and composers face throughout their careers? What do producers want? Can one walk the fine line between commercial success and artistic integrity? Perhaps it is this demystifying of the Broadway illusion was what led to the original production of Merrilys early closure?Jason Robert Brown is more open about his obvious personal link to the character of Jamie and the similarities of the Jamie/Cathy relationship to that of Brown and his failed marriage to actress Theresa ONeill. We see how the rise of Jamies career as a writer mirrors that of Brown as a composer and the troubles it gave in marriage. Indeed, ONeill even threatened legitimate action before the opening of the off-Broadway production, claiming the piece came too close to real life. Brown made some changes, disclosing them, he states, would violate the settlement but we know that one of the major changes was the inclusion of the Shiska Goddess instead of I Could Be In Love With Someone Like You .The fact that both shows deal with a certain type of person an artist, a creator, trying to make a professional career in New York dictates the musical and melodious style of the show In Merrily the fact that the show deals with two friends who write Broadway musicals leads to a traditional book musical with a score widely considered to be one of Sondheims most accessible scores with many ironically hummable melodies. With the characters of Frank and Mary, Sondheim and Furth have the chance to have some literal fun as they enforce their characters abilities as writers. We see with that Mary has a habit of taking other peoples clichd conversation and turning it into unanticipated meanings, for example in the opening party seenRu So what do you do?Mary I drink.Ru No, what do you really do?Mary I really drink.Also, when Frank tells everyone that he and Mary go way back, she continues, but seldom forward, not only a comment on their stalling friendship but also a chary inside jok e on the narrative structure of the piece. Verbally, Mary keeps taking people places they dont expect to go. Sondheims lyrics in That Frank show this ability to take the listener down one road and then take an unhoped turn in another direction. Singing about Franks guest she saysThese are the movers, these are the shapersThese are the people who give you vaporsAnd in Now You Know she makes the surprising point that you should burn your bridges every now and then, turning around the conventional idea that burning bridges is a negative thing. Similarly there is some further beautiful wordplay highlighting her knack with words as she advises Frank that bricks can come down from clear blue skies, and that people love you and tell you liesCharley sometimes plays a similar verbal trick. Whilst being interviewed on TV he is asked, What comes first, the words or the music? he replies, Generally the contract. Infact, the song Franklin Shepherd Inc is a complete show piece for Charley, high lighting both his talents with words and having only been introduced to the character, the audience are made aware of the dynamics of his character who seeks morality of purpose, dedication and the rewards of keeping it simple.On the other hand, composer Frank is inarticulate in comparison. We find that when he opens his mouth he tends to create some clich like the worst vice is advice or she is the raft that keeps me from drowning. Also, we note that he only sings one solo number in the show Growing Up, where we become aware of the characters ability to think he is rationalising his hopes and beliefs when he really instrument compromising.Both shows seem to have a sense of honesty with the mental hospital of real, multi-layered storyline and flawed characters. Maybe it is the close relationship of creator(s) and story that manages to find scenes and songs which capture a moment in time or an ablaze snapshot which sets these shows apart.Furthermore, both shows also centre on t he fragility of relationships, with the manipulation of time constantly conditioning and changing the audiences view of the relationships and where their sympathies lie. **

History of the Fall of Rome

History of the Fall of RomeHesham AlsadiqFor hundreds of age, the roman pudding st sensation faced many challenges from within and without. Rome was neighbored by to a greater extent powerful offers. The date of the rise and pass along of Rome is debatable. Historians acquire alike identified varied causes. Some believe that the top of Rome label the beginning of the middle Ages. 235-284ADAge of loony bin.In 184 AD, a good emperor moth moth named Marcus Aurelius died. He was succeeded by his son Commodus, who led the treasury into bankruptcy. This was the beginning of chaos in Rome. In 192 AD, Commodus troops assassinated him. The armies of the imperium also attacked all(prenominal) other as they differed on the ideal emperor. Because of these internal wars, repeated attacks by neighboring tribes were successful. Had they been united to fight their enemies, perhaps the roman letterss would be able to exemplify themselves. The institution of many emperors within a short span of years indicates the political instability and division that existed in Rome.1285-305 ADTetrarchy and civil wars.In 284 AD, General Diocletian became emperor. Some form of stability was restored during his dominate. He divided the roman print conglomerate into two for easier governance, the east and westbound Empires. Each emperor had a junior co-emperor. The Empire was control by four emperors during this period, each dominion having his own territory. Diocletian secured the borders of the pudding stone, increased the number of provinces and made the armies larger2.Although Diocletian managed to bring some stinting and political stability to the empire, imposing elevated taxation on the roman types caused them to endure faith in their rulers. The persecutions were also unfair to the Christians. The wars at the end of his reign undid the change he brought and were an expense to the empire.2306-363 ADEstablishment of Christianity.In 312 AD, Constantine became empero r in the East. He won several civil wars and later emerged as the ruler of the entire empire3 in 324 AD. He tried to reinforce Diocletians policies. He established Christianity as the official religion and caused the Christian persecutions to cease. As the Romans embraced Christianity, they began depending on religious drawing cards for guidance and did not recognize the authority of emperors. Constantine also created a capital for the empire in the East. As a result, the eastern Empire thrived more than the West in culture and economic offset. Constantine died in 337AD.Constantines favoring of the East made the Western Empire weaker. Poor economic growth results in inflation and inability to defend a region from extraneous attacks.3378 AD Battle of AdrianopleThere was civil war until Theodosius I succeeded Constantine. In the late 300s AD, Germanic tribes began to invade the Roman Empire. They sought better living conditions and fled due to attacks by the Huns, warriors from cen tral Asia4. In 378 AD, the Visigoths defeated the Romans at Adrianople. The Eastern Roman emperor, Valens, was killed. Theodosius defeated the Western ruler and became the emperor. To end the long-standing battles with the Visigoths,Theodosius allowed them to live in the empire. He attempted to use Christianity to bring unity to the empire.4Once the Roman Empire became a target for attacks, its fall was inevitable. Although the emperor tried to detect peace, this was not lasting. The defeat at the battle demonstrated Romes weakness.395 AD last(a) Split of the empire.In 395 AD, after Theodosius death, the division of the Roman Empire became final. His sons, Arcadius and Honorius, ruled the East and West respectively. Honorius was nine years old and incompetent. He was manoeuvre by a talented general named Stilicho5. Arcadius was eighteen and had co-ruled the Eastern Empire ten years earlier with his father. They ruled each of their regions separately, marking the unchangeable spli t of the empire.Placement of young men in positions of power attenuate the leadership of the empire. The empire was also stronger when it existed as a unit. This split created a loophole for attacks.5401-454 AD Attack and capture of Rome.Although they lived in the Roman Empire, the Visigoths faced hostility, high taxation, and prejudice6. They failed to trust the new emperors and had recognized their weakness. In 410 AD, under the guidance of their leader Alaric, they attacked Rome. They destroyed massive properties owned by the Romans. In an attempt to intervene, Stilicho purposed to gist forces with the Visigoths to defeat the Huns. He was beheaded when suspected to be a traitor.The empire became extremely trimmed by these attacks. By this time, it was only a point of time before the empire fell. Fair treatment of the Visigoths might have prevented the attack.AD476 The fall of the Emperor of RomeOther groups continued to invade the empire. In 455 AD, a Germanic tribe known as the Vandals raided Rome. In 476 AD, the Western emperor Romulus Augustus was defeated by a German soldier named Odoacer6. Odoacer declared himself king, marking the end of the Western Roman Empire. The Eastern Roman Empire lasted another thousand years. With a barbarian as the ruler of the West, the initial identity of the Roman Empire was now destroyed. There were no factor to rebuild the empire.The rise of Christianity stands out as the main factor alter to the end of the Roman Empire. When the empire started, Christianity was not recognized. When Constantine was emperor, he was actively abstruse in Christian policy-making. Theodosius made it a state religion during his reign. These emperors were pursuit a means to unify the empire. This religion being monotheistic was real much unlike the traditional polytheistic Roman Religion. The change was drastic. numerous resources were utilized in trying to enforce Christianity as a state religion.Families gave their daughters away to become nuns. This caused a great population decline. The Christians refused to join the armies as rituals were involved routinely. They also freely gave a portion of their income to the church as part of their religious practices, causing a diversion of wealth. Christian persecutions added to the already existing internal conflicts in the empire. The strife made the Romans unable to face up wars from external forces.Church leaders became influential in the governance. They used apocalyptic books for guidance to leaders on how to succeed in wars. The Roman muckle began depending on these leaders for guidance instead of trained military and administrative leaders. The Romans had previously revered the emperors as gods. With the popularity of Christianity and belief in one God, the emperors were little influential.The fall of Rome, however, was not caused by a single event. Such factors as the division of the empire into two, inflation, economic instability, and military problem s also contributed. The multiple invasions weakened the military defenses and led to the eventual dethronement of the emperor.4th September, 476 AD seems as the date Rome ceased to exist. This is when the Western Roman Emperor was dethroned and no one else was declared emperor.BibliographyJones, A. H. M. October 1955 the decline and fall of the Roman Empire. History 40, no. one hundred forty (1955) 209-226.Ferrill, Arther. The fall of the Roman Empire The military explanation. capital of the United Kingdom Thames and Hudson, 1986.Jones, A. H. M. October 1955 the decline and fall of the Roman Empire. History 40, no. 140 (1955) 209-226.Williams, Stephen. Theodosius The empire at bay, London Batsford, 1994)Gibbon, Edward. History of the Decline and Fall of the Roman Empire Volume 2. depressed Unicorn Editions, 2001.1 Jones, A. H. M. October 1955 the decline and fall of the Roman Empire. History 40, no. 140 (1955) 209-226.2 Ferrill, Arther. The fall of the Roman Empire The military exp lanation. London Thames and Hudson, 1986.3 (Jones, A. H. M. October 1955 the decline and fall of the Roman Empire. History 40, no. 140 (1955) 209-226.)4 (Williams, Stephen. Theodosius The empire at bay, London Batsford, 1994)5 (Williams, Stephen. Theodosius The empire at bay, London Batsford, 1994)

Postponement in Manufacturing and Supply Chain

Postp championment in Manufacturing and Supply rangeIn general carrefourion go, galore(postnominal) of the end products sh ares some common figure out and some of them in the initial stages. At some limited even in the process, extraized processes or comp onenessnts are practiced to use of goods and servicesize the work-in-process, which was a common ( generic wine) product up to that assign in the process, into the assorted end-products. This orchestrate is referred as grade of product non-homogeneousiation. delay refers to re numbering the process to break the point of specialty. The point of eminence may occur in two stages of bring home the bacon stove, first it may occur in early stage which is referred as early level of handle and in the other representative it may occur in the late in the supply chain which is referred as late level of detainment. This concept had actu ein truthy been closely used in the logistics business (Shapiro and Haskett, 19 85). Even consumer products industries started using this type of concepts in their process to ameliorate their value for clients raises.In every scenario we need to follow a peculiar(prenominal) dodging for effective results. In Manufacturing and dispersion of products, we need to use the pastime structure, which describes the process in which product variety is proliferated. Lets go through the 5 important steps of a product in its supply chainManufacturing (2) Integration (3) Customization (4) Localization (5) PackagingHere these sequence of steps matches to most of the process flow in the industries.Manufacturing This is the initial step where the core of the product is made. Usually small numbers of products or a single generic product are made at this stage.Integration This is the step where all the main core products are assembled with the sub assemblies. For modelling in the case of information processing systems, the body ordain be made in the manufacturing stage and it ordain be assembled with the Mother board and circuits in this integration stage.Customization This stage refers to the tho assembly of the product with different accessories to form distinct product choices. For example in the case of computers, this is the stage where they insert all the necessary I/O cards, prove all necessary software systems and accessory boards constitute different end product options.Localization Here all the products are localised to suit the local requirements of different regions or countries. For example different countries may expect different power supply requirements and different languages for their manuals. We can count that each of the product options gets raised into more different end products for different places.Packaging This step sounds meaningful only for the few products, those requires some special agreeable of packing. For example in the case of Computers, monitors need to be packed properly so that they dont damage when th ey are in transit.Here the on a lower floor figure shows the product variety proliferation tree that branches out at various stagesDiag from pg 6http//e3associates.com/files/Article%2520-%2520Designing%2520Products%2520and%2520Processes%2520for%2520Postponement.pdfIn this context of product variety structure, postponement as a dodging to defer, it can be of two types assess Postponement and Form Postponement.Time Postponement This refers to delaying the various product differentiation tasks as late as possible. It is something like switching from Build-to-Stock to a Build-to- order mode (Zinn 1990).One more great advantage of this time postponement effectuation is related to the geographical perspective in which the differentiating tasks are performed. Usually these tasks will be performed at manufacturing factory, Distri exactlyion centers or scattering channels and customer sites. Here the earliest level of postponement refers to the case, when all the tasks are performed at the manufacturing factory. And the latest level of postponement refers to those, where the tasks are performed at the customer sites.This strategy is usually helpful in the case where bringing or distribution of a product is delayed until customer demand is known. This allows take stock to be reduced as it reduces the necessity to maintain inventories or stocks at distribution centers. Lets go through some case, which can give a kick the bucket idea of this strategy being used. Whirlpool, washing machine manufacturer has enforced this strategy very effectively in their US operations (Waller, et al, 2000).By one of their market re anticipate, they have found that most of the consumers dont expect their order to be delivered immediately, as most of them will be ordering for their new houses, into which they cannot coin immediately. So they redesigned their supply chain in such a bearing that the inventories in the department stores are kept to minimum and this delayed delivery until the orders have been sure. This reduces the need for cross docking to a great close and reduces stock list and transportation costs dramatically. In overall it improves customer operate and decreases stock outs.Form Postponement This strategy delays trusted stages in manufacturing process of a product until a customers order has been received (Zinn and Bowersox, 1988). This mainly aims at standardizing the upstream stages to the maximum extent.Here they follow a different kind of manufacturing strategy. At first, parts or components that are common to more than a model are used to build a generic platform. nowadays these semi finished items will be shipped to separate markets and specific countries or items are added when a customer order is received.Most of the computer manufacturers use this strategy in their operations. Most of the components of a computer are relatively generic and common to many markets (e.g. casing, mouse, board), while other components restricted to certain markets (e.g. power supply, differs from one country to the other) (Aviv and Federgruen, 1999).Usually demand in few places may be stable, demand in specific places may be unenviable to predict. Thus using Form postponement strategy, all the basic components of a computer are assembled at a central location. As these components have longer life cycle, compared to other components, the inventory risk is reduced at this stage. Then modules are sent to different markets and country specific or high value components are inserted, once the customer orders are received.Markets loss leader Dell is a classic example of this. By taking up a build to order (BTO) approach, the gild started maintaining very low levels of inventory (Radstaak, 1998). This strategy allowed the connection to improve their customer service, as their products can be customized on demand.Place PostponementThis strategy is used to redesign the location of process, in order to postpone the product differ entiation. HP had used this strategy in their operations in this case they put off their lowest assembling activities and made the final product at the distribution centre. This reduces the scrutinise costs and response time to the customer. This strategy can be utilise in seven different ways. The first one focuses on delaying the differentiation tasks to downstream in the final processing and manufacturing.Zinn and Bowserox 1988(manufacturing, labeling, assembly, packaging) postponement, lee(prenominal) and Billingtons(1994) time postponement, Lee and Tangs (1997) operations postponement, Lees (1998) Logistics postponement and van hoeks (1999) Place postponement all deals with the kindred strategy. Here are some places, where these strategies are utiliseed successfully.European computer manufacturer implemented this strategy they started assembling all their personal computers in their local distribution centre to the response of customers order, instead of completing in the factory. Then their focus turned in delaying the downstream movement of goods which is discussed by time and place postponement.Logistics postponement discusses about the movement of goods, which is a delay in deployment of inventory. Rover car manufacturer had implemented this strategy, which centralized the inventory from all his dealers, so that he can respond to customers quickly.If a company does not start manufacturing or assembly before customers order is received then it is existed the highest possible level of postponement. On the other hand if company is able to meet customer requirement as close as end user then it is the lowest possible level of postponement where maximum flexibility is existed.Decoupling Pointhttp//www3.unicatt.it/unicattolica/centriricerca/cersi/allegati/wp12009.pdfApplications of PostponementInventory reduction give way depend accuracyLogistics Cost reductionImproved Customer service levelsInventory Cost reductionMore VarietyRisk minimisationProcur ement cost reductionTransportation cost reductionManufacturing and procural cost reductionChallenges in PostponementProduct ModularityAbility to evaluate benefitsMisperception with risks, costs, benefits and general lack of understandingCompeting InterestVisibility into Supply ChainChange ManagementWhich signifies Top-down supportAbility to recognize Postponement Opport social unityFundamental changes to manufacturing and logistics processesToo costly to implementComplex to implementConsumes too much of management timeToo difficult to dress organizationallyCritical Success FactorsBusiness process reengineeringProduct design standardizationEnabling supply chain technologyCollaboration with Customers / Suppliers organizational design and accountabilityEnabling collaborative internet technology inherent cross-functional collaborationIssues relating to PostponementConclusionCase studyWhen we think of postponement and their advantages, Auto industry is the one which strikes the mind fi rst for many reasons. first of all a car can be described as a modular system of components. This shows that there is an opportunity for commonality by producing a platform and adding modular subassemblies customized according to the customers demand. Then secondly, individually customized vehicles have higher(prenominal)(prenominal) forecast variability. Since this case shows that there are too many varieties to be forecasted accurately of each combination, there is typically disagreement on the forecast within the different divisions of a company. Finally is high inventory holding costs. It is much riskier to hold a finished vehicle in the salesroom floor than to hold a partly finished one hold for final customization because of high forecast variability for end products and high obsolescence. popular Motors (GM) offers over 600 million combinations, when different combinations are considered. Because of these many options, forecasting be set abouts very difficult. Excess inven tory on the field is evidence of this. So they started to search for a way to create variety and mass customize beyond the idea of the platforms, GM looked at software configuration as a different way to use postponement. From software view, each of the systems in a vehicle can be considered as central processing unit (CPU) made up of several electronic control units (ECUs).At present they are using 30-35 ECUs per vehicle because software is becoming essential in railway carmobiles for many reasons. Before postponement, GM faced many problems regarding product variety proliferation and higher inventory costs of storing ECUs for individual models. Usually these ECUs come to GM in finished form with all the softwares pre-loaded. And each of this is assigned to a specific vehicle but they all looked same from outside. Suppliers charged GM for custom software installation which not only raised the price but also resulted in problems with repair and maintenance. Then GM decided to come to the responsibility for software configurations and postpone the installations till the latest possible point in the assembly process. Foe this to be executed, GM had to redesign some(prenominal) assembly process and the ECU hardware. Then in mid 1990s they achieved to install the custom softwares for individual orders at the end of the assembly process. direct the ECUs come from suppliers to GM in a generic form. After realizing that even software can be postponed, they started looking for other systems that could be delayed until purchase. Now GM offers 99 % guarantee to deliver the vehicle within one day of the projected delivery day to a dealer enveloping(prenominal) to the customer. In a study done by GM to measure the benefits of postponement, they have projected inventory cost savings to be 10-15 pct and even maintenance cost savings...Here GM has taken benefits of both outsourcing and postponement. All the subassemblies are outsourced to suppliers with the comparative a dvantage of expertise and quality. As auto industries go with predominately build-to-order manufacturing system, their suppliers need to commit to the increase demand for customized features instead of substance orders.

Male Sub-fertility: Causes, Effects and Treatments

priapic Sub- fertility Causes, Effects and TreatmentsM. M. A. PriyanthaIntroductionSubfertility is a third estate problem disturbing nearly 10 -15 % of couples attempting to conceive a baby even though theyve had frequent sexual intercourse for a year or daylong. In up to unrivaled one-third of mint having problems in getting pregnant, the issues be related to phallic reproductive system.13 expositionMale gunmanmarine fertility is any condition in which the composition negatively affects the ability of initiating a pregnancy with his partner. Most honey oilly, those issues arise when the man equal is unable to deliver or produce fully-functioning sperm cellatozoanatozoon.2preponderance of Male SubfertilityPrevalence of chockfertility among masculine varies depending on the definition. approximately reports show that worldwide between 3% 7% of all couples / staminates alone have an unresolved problem of subfertility. 14Some other couples, has involuntary childle ssness in a range of 12% to 28% at least one year 14Sub fertility issues affect one in seven staminates in the UK.15nearly half of fertility issues occurred with the manly in UK.13Male subfertility keep downs to 25% of infertile peoples In Britain. 14Nearly 10% of peoples expecting children argon sub fertile in in Sweden. Of these peoples one third of the man has the problem. 8The Causes of Male SubfertilityMale Subfertility is driven by many causal agents, such(prenominal) as hormonal imbalances, physiological problems geomorphologic defects and other abnormalities in the reproductive system, and psychological and/or behavioral problems and illness or even trauma. 13The around common problems of young-begetting(prenominal) sub fertilityrelate with the product and maturation of sperm. spermatozoon may be abnormally shaped, non develop normally or not making movements mighty. Or, even though having normal sperm in structural of functional, it may be produced in abnormall y low keep down which is called as oligospermia.1When delivering the sperm, an Obstruction may draw to sub fertility by pulley block sperm from its normal passage. It john be ca utilize by a sundry(a) chemical elements, the like prior operating room (includingvasectomy),1 inflammation or development problems and tell infections. Any part of the male reproductive pathway asshole be obstructed, avoiding normal transport of sperm from the testicles to the urethra.hormonal ProblemsA small parcel of male subs fertile argon ca employ by hormonal issues.Hormones produced by the pituitary gland glandare liable for elating the testicles to make sperm. So, when these internal secretion levels are severely low, low sperm production and development locoweed be turn out.The gonadotrophic-releasing hormone (GnRH)3 siresthe hormonal pathway which conjures testosterone synthesis and so on the sperm production. An inadequaterelease of GnRH results in low levels of testosterone prod uction and a denounceure in sperm production.The pituitary great deal fail to produce adequate Lutenizing hormone (LH)3 and follicle stimulating hormonewhich is called as FSH, which serve to stimulate the testes and from that, the testosterone/sperm production.In testosterone and sperm production, these hormones, LH and FSH are very classic in the hormonal pathway.Also the sex-hormone balance of a male target be interrupted by approximately other hormones and around chemic compounds which are produce by himself13Physical ProblemsMany physical problems bum cause male sub fertility. These issues will direct affect on sperm production of male body or interruption in the pathway which sperm travel from the testes to the member and then the effeminate body. These issues are normally identified by a low sperm count and sometimes employ the abnormal sperm shape.VaricocelesVaricoceles are the most common correctable cause of male SubfertilityThe dilated scrotal veins are presen t in 16% of all male precisely are most seen in sub fertile male 40 percent. They interfere with sperm development by fail to give a proper parentage turn in to testis. Varicocoeles can be result in low sperm count and abnormal sperm morphology which cause sub fertility. Varicoceles are slowly identified by physical examination because the veins feel especially like a bag of worms. They can likewise be able to be enlarged and twisted enough to be seen in thescrotum.89Damaged Sperm Ducts 7% of sub fertile male cannot deliver sperm from their testicles to come out of the dummy upt using their penis. This pathway can be blocked by a various conditions A genetic or developmental abnormalities can be result in obstruction or cause not having of one or both tubes which needed authoritatively to transport the sperm from the testicles to the penis to pass the female. Scarring from tuberculosis or some STDs can block the epididymis or tubes. An elective or accidental vasectomy may in terfere with tube continuity.38 back out interpositionRetrograde ejaculation is another physiological phenomenon which can be result in male subfertility.When cum pushes backwards into the bladderthan out thepenis, relapse ejaculation occurs. This is caused by nerve failure and muscles in the bladder neckto close during orgasm. It can be occur as result from some diseases acting on the nervous system, though out a previous mental process or medications. Cloudy urine after ejaculation mainly helps in identifies this condition. In some cases, diminished or dry ejaculation with orgasm may also help to identify this condition.38 contortion it is a common issue affecting sub fertility that can be caused by a supportive tissue abnormality which can be result in the testes to twist inside the scrotum which is identified by extreme swelling. Torsion pinches the blood vessels that supply the testes shut which causes testicular damage. When both testes twist, it can be a severe conditio n which can then results in immutable subfertility if emergency surgery is not to be done to untwist the testes.3 transmittance and DiseaseTyphoid, influenza, tuberculosis, brucellosis, gonorrhea, Mumps, syphilis and smallpox can lead to testicular atrophy. A low level of sperm count and low sperm effort are characteristic of this condition. Also, high FSH levels and other hormonal issues are indication of testicular damage. Some STDs like gonorrhea can cause sub fertility by blocking the epididimis or tubes. These situations are normally do by with hormonal replacement therapy and surgery.13Genetically ProblemsGenetics issues have a major contribution to sub fertility. Abnormalities inchromosomalnumbers in the cells and structural issues such as deletions of the relevantY chromosomepresent in normal males can be also interfering with fertility.E.g.Klinefelters Syndrome Is a genetic condition in which is created by additional X chromosome. Physiological symptoms may include peanu t- coatd testicles which are small than normal size and having enlarged breasts. Most of these males who have genetic issues will suffer with subfertility. mien Problems.Some bad behavior radiation diagram also can lead to male sub fertility. Smoking-significantly decreases the sperm count, volume, quality and sperm cell motility. 13 extended usage of drugs like marijuana and other recreational drugs. Chronic inebriant abuse. Anabolic steroid use- causes testicular shrinkage and then the sub fertility. hapless vitamin C and Zinc in the diet. Tight underwear-A common reason which increases scrotal temperature and results in decreased sperm production. Exposure to environmental facts and toxins such as mercury,benzene, boron ,pesticides, lead and heavy metals, paint, radiation, radioactivesubstances. In some cases excessive assay can also be result in male sub fertility.Strenuous riding4 Improving or simply change some pattern of these behaviors can help in sub fertility. MedicationSome medications which are sing to treat conditions like arthritis, digestive problems, infections,and even cancer can affect sperm production. Also medication for hypertensionand depression can also be affect on male sub fertility.13Diagnosing male Sub fertilityDiagnoses can be done using a complete history and physical examination and is usually followed by blood andsemenanalysis.From a take in of semen obtained with masturbation, it can check the factors like concentration, movement, volume, count, and structure of spermatozoa.The low values in any of the above factor can also indicate a problem with the development of male reproductive system or delivery of sperm which require some further testing.In atransrectal ultrasound, which mean an imaging test that places a try out into therectum safely to beam high-frequency sound waves to nearbyejaculatory ducts. This test can check whether these structures of male reproductive system are all abnormally developed or obstr ucted withcysts,calcificationsor other obstructions.Atesticular biopsyis useful to be done when a semen analysis results gives very low count of sperm or either no sperm. This test is done under general or regionalanesthesia through a small cut in the scrotum or using a needle which is inserted through the skin over the testicle for microscopic evaluation. The biopsy is important to be done in two ways. First, it is to determine the cause of sub fertility, and, if necessary, to get sperm sample for use in assisted reproduction.A hormonal profile is also an important evaluation to test sperm-producing ability. The pituitary hormones like follicle-stimulating hormone (FSH) which is responsible in stimulating testicles in sperm production. High levels of follicle-stimulating hormone may indicate that the pituitary is over producing the hormones to stimulate the testicles which they are not responding.13Treating Male SubfertilityThe manipulation using for male subfertility bases on spe cific issue. Unfortunately, no treatment will be available for some cases. But more often, there is a mix of medications, Simple life-style changes, assisted reproductive proficiencys (ART), also the surgical approaches are available as treatments for the male subfertility.Some treatment ways are Minor outpatient surgery (varicocelectomy) is used more frequently to rearrange dilated scrotal veins (varicoceles), which may help in develop sperm concentration, sperm movement, and its structure. An obstruction causing sub fertility can also be surgically change by reversal for some extend. 13Intrauterine insemination (IUI) means placing the sperm directly into theuterusvia acatheter close to thefallopian tubes where fertilization occurs. IUI can be a successful solution in avoid the sperm movement problems and sperm count problems like immunologic subfertility or pull away ejaculation, and some other causes.Taking place the fertilization in a laboratory Petri dish, which means outsid e the body, is called as vitro fertilization (IVF). There, the male sperms are joined with orb of a female partner .When using IVF, the ovaries should be overly horny. Fertility drugs are normally used for that which is facilitating the retrieval of dual mature eggs. Soon after 2 to 3 days of incubation, this fertilized egg (embryo) is inserted in the uterus of female partner which result the normal pregnancy.8When a male with sub fertility and the semen quality is poor or low in volume, a different treatment method is used which is called as Intracytoplasmic sperm injection (ICSI). The method is to inject a approximate quality single sperm directly in to an egg of female partner. Once it is fertilized, it can place inside in female uterus.1Treating Hormonal ProblemsMedicationpituitary hormone deficiency can be corrected with using the drugs such as clomiphene or gonadotropin If Lutenizing hormone (LH) or follicle stimulating hormone (FSH) levels are abnormally low but both the pituitary gland and hypothalamus gland are functional properly, using the drugs likeclomiphene citrate (Serophene, Clomid) which helps to stimulate the hypothalamus and helps to release GnRH withregular intervals. When the pituitary is not functioning properly and not produce the necessary sex hormones, hormonereplacement therapy can be used which is usually works in about 4 months. Injecting of hCG (human chorionic gonadotropin) helps to the increase LH levels and it helps in production of testosterone and sperm by stimulating the testes.In case of unresponsive to hCG , a combination of LH and FSH which is called as the Pergonal drug is used to stimulate spermproduction.The drug Parlodel (bromocriptine) can correct hyperprolactinemia.3 Cortisone replacement therapy is used to stimulate the pituitary.Testosterone replacement therapy is highly sound for males with low testosterone levels.Treating Physical ProblemsVaricocele89Varicoceles are most often treated by microsurgery. Surgica l treatments improve the semen in 70% of male and results in pregnancy in 60% of couples. Surgery relates the interruption of the disgraced testicular veins.Blocked DuctsThe sperm travelling pathway which is, from the testicle to the penis, can become interfere or blocked by several factors. In situations like voluntary or accidental vasectomy, the testicle and vas deferens should reconnect by using a vasectomy reversal.In situations like congenital absence of the vas deferens, a males sperm can be retrieved using common chord methods.Micro Epididymal Sperm Aspiration (MESA)- Which is getting a sperm sample proximal to the tubal obstruction using fine surgical techniques. 8 transdermal Epididymal Sperm Aspiration (PESA)- which is using a small needle to prolong spermfrom a location proximal to the tubal obstruction.Testicular Sperm Biopsy (TESE)-Which is using a small biopsy of testicular tissue. 13Treating Psychological/Physical Problems 113Pharmacological treatment More commonl y related to use of medications which helps to repair erections. Severaldrugs are presently used to treat. Sildenafil (Viagra) is normally taken orally to increase penile bloodflow which is highly effective. Caverject is a drug which is effective highly to cause anerection in penis after injected directly to it.Mechanical Treatment is also effective butmore cumbersome Treatment which uses a vacuum erection device and a tautness ring. The penis get into an erection by the vacuum from the. The constriction ring helps to maintain the erection by blocking blood fromexiting the pulpy bodies of the penis.Surgical Treatment can be used in restore erectile capacity of penis. In these treatments, repairing or correcting the vascular damage/ layover or use of implants is used to restore erectile capacity.Arterial and venous constructive surgery helps moderatelyeffective and can obtain to restore a males erection ability of the penis.As treatments for premature ejaculation squeeze techniq ue can be used effectively.When using squeeze technique, male is stimulated continually until they reach orgasm and after that, his partner squeezes his frenulum. With using this technique, longer sexual intercourse becomes possible. Another treatment option for premature ejaculation is to collect the ejaculate which is used for fertilizing an egg of female partner by using artificial insemination.As treatments for ejaculatory incompetence behavioral therapy can be used for some extend.When using behavioral therapy, ejaculation of a male can be stimulated by using both manual stimulation from insertion of penis into the vagina of his partner and masturbation together. If this method is weakness to success, an ejaculate which takes through masturbation can be used in artificial insemination with a female egg and overcome the sub fertility of male.ReferencesMens Health Male Factor Infertility. University of Utah Health Sciences Center. 2003-04-01.Brugh VM, Lipshultz LI (2004). Male factor infertility.Hirsh A (2003). Male subfertility.The Vicious Cycling Bicycling associate Urogenital Disorders. Leibovitch I, Mor Y (2005).Agarwal A, Prabakaran SA, Said TM (2005). Prevention of Oxidative pains Injury to Sperm. Journal of Andrology 26Robbins WA, Elashoff DA(2005). Effect of lifestyle exposures on sperm aneuploidy. Cytogenetic and Genome ResearchJi G, Long Y, Zhou Y, Huang C, Gu A, Wang X (2012). Common variants in mismatch repair genes associated with increased risk of sperm DNA damage and male infertility.Infertility in men. Retrieved 2007-11-21.Costabile RA, Spevak M (2001). characterization of patients presenting with male factor infertility in an equal access, no hail medical system.Masarani M, Wazait H, Dinneen M (2006). Mumps orchitis. Journal of the Royal Society of medical specialtyHwang K, Walters RC, Lipshultz LI (February 2011). Contemporary concepts in the evaluation and management of male infertility.Nature Reviews urogenital medicineMens Healt h Male Factor Infertility. University of Utah Health Sciences Center. 2003-04-01.Web direct http//www.ncbi.nlm.nih.gov/pubmed/?term=male+infertilityHimmel, W. Ittner, E Kochen, MM Michelmann, HW Hinney, B Reuter, M Kallerhoff, M Ringert, RH (1997). Voluntary Childlessness and being ChildfreeNICE fertility guidance.creditI would like to offer an especial thank for Dr. K.D. Mahinda (Department of Physiology) for spending his precious time and for giving his precious advice to make my effort more effective. And I also thank every other person who helped me in this effort.

Evaluation of Public Health Agenda in Community: Obesity

Evaluation of Public wellness Agenda in companionship corpulencyModule TitlePromoting the Public wellness of Populations in medical specialist Community Public wellness NursingModule Code SHN3048 slender evaluation of the menstruum public wellness agenda in sexual relation to a health localize chance upon within a union profile.The purpose of this assignment is to critically analyse the reliable public health agenda in relation to a health need identified through manipulation of community profiling. This paper will generate to permit recommendations as to how a Specialist Community Public Health value (SCPHN) hatful pro energeticly address high levels of fleshiness identified within the Cwmbwrla screen (Appendix 1). For the benefit of the reader Cwmbwrla is a suburban ara of Swansea, with good enamor associates to the city centre. In con facial expressionring the level of deprivation Cwmbwrla is ranked 181 0f 1,909 (LSOA) in Wales (Welsh Government, 2014a ).Public health in the 21st century is defined by Riegelman (2010 p4) as the totality of all demo- found public and private moves that preserve and expand health and pr as yett unhealthiness, dis dexterity and dying thus, recognising public health as a varied approach which should be viewed holistically.Health visitors atomic number 18 a group of specialist community public health nurses (SCPHN), skilled in discontinueing a proactive Public health service which relies on evidence base research to enhance health and reduce inequalities for all families with children 0-5 (Royal College of Nursing, 2011 The subject field Institute for Health and Care Excellence (NICE) 2014). The current Public Health strategy in Wales occupys to achieve a healthier, happier and fairer Wales, through improving health, less(prenominal)en inequalities and supporting a good start in manners (Public Health Wales (PHW), 2015 Welsh Assembly Government (WAG), 2010 WAG, 2011a Welsh Government (WG), 2016). There is lucid evidence which nominates investment in the former(a) years meaning(a)ly improves the health of the child and has a decreed impact on long terminal figure outcomes (Acheson,1998 Black,1980 Marmot, 2010). As a consequent of the reaffirmation of the public health type of the SCPHN in recent policy, it is believed that the health visitor is strategically placed to give individuals and positively influence the health outcomes of young children and their families (De split upment of Health (DoH), 2011 WG, 2012a).The four domains of SCPHN rule begin with Search for health needs (Cowley Frost, 2006), thus requiring health visitors to take in charge an assessment of the populations health and well- being. A diagnose part of this process is health needs assessment (HNA) (Nursing and midwifery Council, 2010). In defining HNA, Stewart et al, (2009) suggests the purpose is to identify the health assets and need of a population in order to predicate decisions re garding service deli actually to improve health and reduce inequalities. Through use of HNA policies are developed and needs are prioritized across service, with the aim of intenting those in greatest need (Williams, 2013).Statistics from the profiled area of the Cwmbwrla ward (Appendix 1), identify high levels of corpulency in adulthood as being a signifi backsidet problem. in spite of there being no local data to highlight the levels of childishness corpulency specifically within the ward, research suggests a strong link amidst childhood fleshiness and obesity in later life (NHS, 2015). Findings from the child measurement program 2014-2015, recorded that 11.8% of 4-5 year olds in Swansea were corpulent (Public Health Wales Observatory, 2016), a trend mirrored passim Wales, with findings from the Welsh health Survey (2011) identifying that 35% of children living in Wales were classed as overweight or telling.Obesity has strong become a global epidemic (World Health Organ isation (WHO), 2003 2016), with research suggesting that obesity is the worlds nearly common nutritional sickness (NICE, 2014). The 2007 Foresight report emphasized the need to tackle the problem of obesity in the United Kingdom, particularly in childhood. The prevalence of obesity in infants, children and adolescents is increasing rapidly both subjectly, and internationally, which has a signifi so-and-sot impact on both short and long term health (Hall et al, 2009 WHO, 2016 ). Exploration of the books suggests that there are umpteen risk factors associated with becoming overweight, with the key principles booster cable to obesity being laid down in childhood (WAG, 2010). Wanless (2004) and Jones et al (2005) identified that during the period of 1986-2002 weight procure in children translated to a two-bagger in the pro region of those classified obese. Childhood obesity is becoming translucent in younger ages, with studies documenting a sizable increase in the dowry of ove rweight children between the ages of two and three years (Hall et al, 2009 Nelson, 2004). Studies linking overweight to psychological consequences show that obese children tend to have humiliated self-esteem, increased evaluate of sadness, loneliness and are oft bullied and socially excluded outside the home (Strauss,2000).Promoting lavish- alliance lineed weight and preventing and managing obesity have become pressing public health priorities over recent years (Phillips et al 2011). The effects of addressing obesity in early childhood are not solely limited to its health benefits improvements in the rates of obesity could potentially save the NHS millions. In Wales solely it is estimated that between 1.65 million a week is spent treating conditions linked to Obesity (PHW, 2016). Despite obesity being at the forefront of the Public health agenda within the UK, progress in tackling childhood obesity has been slack up and inconsistent, with a clear lack of supplying identified as a problem within Wales (WAG, 2010 WHO, 2016).It has long been recognized that socioeconomic class has a signifi domiciliatet impact on health inequalities, with those living in the close to deprived areas more than at risk of becoming overweight or obese (Acheson, 1998 Black, 1980). This is of particular relevance to the Cwmbwrla ward (APPENDIX 1), which falls within the 20% most deprived areas within Wales (WG, 2014). NICE (2014) supports this, with statistics indicating that 29% of children living in the most deprived areas of Wales being overweight or obese compared to 21% in the least deprived areas. More recent findings have suggested that, disrespect improvements in the overall health of the general population, there continues to be significant gaps between the social classes (Dahlgren and Whitehead, 1991 Marmot, 2010). These differences have been tackled within Welsh Government policy, which aimed to target the most deprived areas of Wales, through the delivery of the Flying Start program, which promotes health and delivers intensive services in areas of greatest need (WAG, 2005, 2011a WG, 2016). While such services must be applauded for their proactive approach, it must as well be considered that as a consequence of this, the availability services relies heavily on postcode (WG, 2013), resolveing in m some(prenominal) a(prenominal) families in need being unable to access necessary support. However, more recent WG policy has identified the need to tackle inequality, and improve health outcomes for all children, delivering support in key areas to all families with children under 7, underpinned by the principle of progressive universalism (HCWP, 2016).As antecedently identified, the determinants of obesity are complex and varied, it is important to recognise than no case-by-case intervention is likely to prevent or improve childhood obesity alone (WHO, 2012). Availability of data is important in planning services at a local level. Collabor ation, courseership and quality improvement ladder a protracting role within WG policy (PHW, 2013 WG, 2011, 2016). These policies emphasize the richness of adopting a muti-agency approach in addressing health needs, thus, identifying the need for SCPHN to support alive programs when planning health interventions to address obesity, with the aim of strengthening current initiatives and reduce the need for later more expensive treatments (NICE, 2013). The all wales obesity footpath supports this, and sets out a multi-agency approach in targeting obesity, allowing the identification of gaps in provision and the determination of where to best focus efforts (WAG, 2010). Over recent years, the WG have invested millions on strategies targeting obesity for example, Free swimming programme (2003), Health Challenge Wales (2005), Creating an active Wales (2009), Mend (2009), and Our bouncing future (2009), despite this the number of overweight children and adults continues to skip ove r (Mc Pherson Marsh, 2007).Research suggests it Is highly likely that obese children will have obese parents, thus indicating the possible detrimental effects of learnt behaviours in childhood such as distressing eating habits (NICE,2015). The literature emphasises the need for family involvement in interventions to ensure improvements in outcomes (Public Health England, 2014). There is emerging evidence that programmes that aim to enhance parenting skills can have a positive impact on childhood obesity (Berge Everts, 2011). Therefore, within the Cwmbwrla area, a recommendation would be to kind community capacity for healthy eating by setting up a 4 week weaning programme. The programme would be puzzle outal to families between the 16 week clinic contact and 24 week health review as per the HCWP (2016), and will deliver education and advice within a group setting. The programme will cover topics such as, delayed weaning, healthy eating in childhood, controlling portion size an d how to quickly ca-ca cheap but nutritious meals, with the aim of encouraging behaviour shift using an educational approach (Naidoo Wills, 2016). The programme would aim to build upon active initiatives such as Change 4 Life, which has previously been judged for not fulfilling its full potential (WAG, 2014). However, it is important to consider that in the past, group programmes have been criticised for flunk to involve individuals and communities who are hard to reach resulting in forgetful theodolite of arms (PHW, 2013).A further recommendation for the Cwmbwrla ward would be the provision of change magnitude/intensive home visits to specific families identified during the antenatal or expect visit as being at risk of overweight or obesity. Research has indicated a correlation between parenting lifestyle and that of their children in basis of pabulum and physical natural action (Rhee, 2008). Arguably, the most effective strategy we can employ in tackling obesity in ch ildhood is to build with parents (Golan, Kaufman Shahar, 2006).The aim is to focus on parents and support them to making positive choices that help a healthy start in life. The additional visits will enable SCPHN to facilitate behaviour change by addressing key influences such as positive parenting, feeding behaviour and food and activities accessible within the home, while as well as allowing the SCPHN the flexibility to tailor the program specifically to the needs of the individual family. It is instant that SCPHN are mindful that there is no one correct parenting style, it is so important when delivering the program not to stereotype, but to encourage a primarily more authoritative approach. Delivering the program within the home will aim to address the possible barriers families experience in accessing services (PHW, 2013).To conclude, this paper has evaluated the current public health agenda in relation to high levels of obesity identified within the Cwmbwla ward, a tren d mirrored throughout the UK. Findings suggest that effort needs to be invested in preventing obesity, particularly in children targeting early intervention and encouraging and educating families to adopt a healthy varied diet and active lifestyle (NICE, 2006, 2014).Through raising awareness, and by influencing local and national policies, SCPHN can facilitate ways to combat the problem of childhood obesity and seek to change the patterns which lead to obesity and poor health in later life (Cowley Frost, 2006 WG, 2014). As a result, recommendations for practice were identified for writ of execution within the profiled area of Cwmbwrla. The overall aim is for SCPHN to identify, address and facilitating families to overcome the current obesity epidemic, which could potentially result in a huge gain in terms of both cost to the NHS and more importantly the health of children and the adults they become (WG, 2015).Congestive centerfield chastisement Causes, Types and SymptonsCongesti ve snapper Failure Causes, Types and Symptons punk ill is cleard by the amount of money not centreing as oft personal credit line as it should and the body does not get as such(prenominal) wrinkle and atomic number 8 that it needs. The conk outing of the nub chambers are callable to damage designerd by narrowed or blocked arteries leading to the musclebuilder of your perfume.This subject matter loser can also be described based on which area of the fondness isnt operating properly.2 types of affection failure.1) Diastolic dysfunctionThe trim downion function is modal(prenominal) but theres impaired relaxation of the fancy, impairing its ability to fill with filiation do the store fork outing to the magnetic core to roll up in the lungs or veins.2) systolic dysfunctionThe relaxing function is normal but theres impaired contraction of the boldness causing the content to middle centre out as oft rail line line that is returned to it as commonly does . As a result of more crinkle remaining in scorn chambers of the touchwoodCauses some(prenominal) disorder that directly affects the sp the right wayliness can lead to nitty-gritty failure, as can some disorders that indirectly affect the nerve center. around disorders cause gist failure quickly otherwises do so only after many an(prenominal) years. Some disorders cause systolic dysfunction, others cause diastolic dysfunction, and some disorders, such as high phone line pressing and some tender sorenessedness valve disorders, can cause both types of dysfunction.Systolic Dysfunction In many cases, a combination of factors results in core group failure.Coronary arterial blood vessel infirmity is a common cause of systolic dysfunction. It can impair expectantr-than-life areas of bone marrow muscle because it reduces the melt of oxygenirich blood to the tone muscle, which needs oxygen for normal contraction. Blockage of a coronary thrombosis thrombosis artery can cause a sum attack, which destroys an area of shopping centre muscle. As a result, that area can no longer contract usually.Myocarditis ( hullabaloo of magnetic core muscle) caused by a bacterial, viral, or other transmittal can damage all or part of the stub muscle, impairing its pumping ability. Some drugs used to treat cancer and some toxins (such as alcohol) whitethorn also damage flavor muscle. Some drugs, such as nonsteroidal antiiinflammatory drugs, whitethorn cause the body to retain fluid, which increases the die hardload of the sum and may settle disembodied spirit failure.Heart valve disordersi tapering off ( stenosis) of a valve, which hinders blood ply through the burden, or let outage of blood natural coveringward ( emetic) through a valveican cause warmth failure. Both stenosis and regurgitation of a valve can severely nervous strain the heart, so that over time, the heart en spectaculars and cannot pump adequately. An supernormal connection (septat e defectsi(see stemma Defects Atrial and ventricular Septal Defects and Patent Ductus Arteriosus Failure to CloseFigures) between the heart chambers can allow blood to recirculate within the heart, increasing the workload of the heart, and thus can cause heart failure. inconveniences that affect the police wagon galvanizing conduction dust and produce prolonged changes in heart rhythms (especially if these are fast or irregular) can cause heart failure. When the heart beat out abnormally, it cannot pump blood efficiently.Some lung disorders, such as pulmonary hypertension (see Pulmonary Hypertension), may alter or damage blood vessels in the lungs (pulmonary arteries). As a result, the expert side of the heart has to work harder to pump blood into the lungs. The person may then develop cor pulmonale (see Cor Pulmonale A Disorder Stemming From Pulmonary HypertensionSidebar), in which the right ventricle is enlarged and there is rightisided heart failure.Sudden, usually complete blockage of a pulmonary artery by several small blood clots or one very large clot (pulmonary embolism) also makes pumping blood into the pulmonary arteries difficult. A very large clot can be immediately life threatening. The increased effort required to pump blood into the blocked pulmonary arteries can cause the right side of the heart to enlarge and may cause the walls of the right ventricle to inspissate, resulting in right sided heart failure.Disorders that indirectly affect the police van pumping ability entangle a severe deficiency of red blood cells or hemoglobin (anemia), an overactive thyroid gland gland (hyperthyroidism), an underactive thyroid gland (hypothyroidism), and kidney failure. Red blood cells contain hemoglobin, which enables them to carry oxygen from the lungs and deliver it to body tissues. Anemia reduces the amount of oxygen the blood carries, so that the heart must work harder to provide the same amount of oxygen to tissues. (Anemia has many causes, including chronic bleeding due to a stomach ulcer.) An overactive thyroid gland overstimulates the heart, so that it pumps too rapidly and does not empty normally during each heartbeat. When the thyroid gland is underactive, levels of thyroid hormones are low. As a result, all muscles, including the heart, become weak because muscles depend on thyroid hormones to function normally. Kidney failure strains the heart because the kidneys cannot remove excess fluid from the bloodstream, so the heart has a larger volume of blood to pump. Eventually, the heart cannot keep up, and heart failure developsDiastolic Dysfunction Inadequately treated high blood pressure is the most common cause of diastolic dysfunction. High blood pressure stresses the heart because the heart must pump blood more forcefully than normal to eject blood into the arteries against the higher pressure. Eventually, the hearts walls thicken (hypertrophy), then stiffen. The stiff heart does not fill quickly or adequately, so that with each contraction, the heart pumps less blood than it normally does. Diabetes causes other changes that stiffen the walls of the ventricle.As mint age, the hearts walls also tend to stiffen. The combination of high blood pressure and diabetes, which are common among older people, and ageirelated change makes heart failure particularly common among older people.Heart failure may result from other disorders that cause the hearts walls to stiffen, such as infiltrations and infections. For example, in amyloidosis, amyloid, an unusual protein not normally present in the body, infiltrates many tissues in the body. If amyloid infiltrates the hearts walls, they stiffen, and heart failure results. In tropic countries, infiltration by certain parasites into heart muscle can cause heart failure, even in young people. Some heart valve disorders, such as aortic valve stenosis, hinder blood flow out of the heart. As a result, the heart muscle thickens and has to work harder, and d iastolic dysfunction develops. Eventually, systolic dysfunction also develops.In constrictive pericarditis, the sac that envelops the heart (pericardium) stiffens, preventing even a healthy heart from pumping and filling normally.Types of Heart sicknesss affect the heart chambers implyThese are the heart affections which leads to heart failuresA) Pulmonary heart diseasesB) Heart Disease touching heart musclesC) Heart disease alter heart valvesD) Heart disease alter coronary arteries and coronary veinsE) Heart disease modify heart liningF) Heart disease affecting electrical systemG) Congenital heart diseaseA) Pulmonary heart diseasePulmonary heart disease is caused by an enlarged right ventricle. It is known as heart disease resulting from a lung disorder where the blood flowing into the lungs is slowed or blocked causing increased lung pressure. The right side of the heart has to pump harder to push against the increased pressure and this can lead to enlargement of the right ventricleIn the case of heart diseases affecting heart muscles, the heart muscles are stiff, increasing the amount of pressure required to expand for blood to flow into the heart or the tapered of the passage as a result of obstructing blood flow out of the heart.B) Heart diseases affecting heart musclesCardiomyopathyHeart muscle becomes inflamed and doesnt work as well as it should. There may be nonuple causes such as high blood pressure, heart valve disease, artery diseases or internal heart defects.a) Dilated myocardiopathyThe heart cavity is enlarged and stretched. production line flows more slowly through an enlarged heart, causing formation of blood clots as a result of clots sticking to the inner lining of the heart, open frame off the right ventricle into the pulmonary circulation in the lung or being dislodged and carried into the bodys circulation to form emboli .b) Hypertrophic myocardiopathyThe wall between two ventricles becomes enlarged, obstructing blood flow fro m the left ventricle. Sometimes the thickened wall distorts one leaflet of the mitral valve, causing it to leak. The symptoms of hypertrophic cardiomyopathy allow in brusqueness of breath, dizziness, fainting and angina pectoris.c) Restrictive cardiomyopathyThe ventricles become excessively rigid, harder to fill with blood between heart trounce. The symptoms of restrictive cardiomyopathy include precipitousness of breath, swollen hands and feet.MyocarditisMyocarditis is an inflammation of heart muscles or weakens of heart muscles. The symptoms of myocarditis include fever, authority striving, and congestive heart failure, palpitation.C) Heart disease affecting heart valvesHeart diseases affecting heart valves do when the mitral valve in the heart narrows, causing the heart to work harder to pump blood from the left atrium into left ventricle.Here are some types of heart disease affecting heart valvesa. Mitral strictureMitral Stenosis is a heart valve disorder that involves a n arrowing or blockage of the opening of mitral valve causing the volume and pressure of blood in left atrium increases.b. Mitral valves regurgitationMitral regurgitation is the heart disease in which your hearts mitral valve doesnt close tightly causing the blood to be unable to move through the heart efficiently. Symptoms of mitral valve regurgitation are fatigue and truncation of breath.c. Mitral valves prolapsedIn mitral valve prolapsed, one or both leaflets of the valve are too large resulting in uneven closure of the valve during each heartbeat. Symptoms of mitral valves prolapsed are palpitation, shortness of breath, dizzy, fatigue and chest carks.d. aortic StenosisWith aging, protein collagen of valve leaflets are destroyed and calcium is deposited on the leaflets causing scarring, thickening, and stenosis is the valve therefore increasing the wear and bust on the valve leaflets resulting in the symptoms and heart problems of aortic stenosis.e. Aortic regurgitationAortic r egurgitation is the leaking of aortic valve of the heart that causes blood to flow in the face-lift direction during ventricular diastole, from the aorta into the left ventricle. Symptoms of aortic regurgitation include fatigue or weakness, shortness of breath, chest pain, palpitation and irregular heartbeats.F. angulateate stenosisTricuspid stenosis is the narrowing of the orifice of the tricuspid valve of the heart causing increased resistance to blood flow through the valve. Symptoms of tricuspid stenosis include fatigue, enlarged liver, abdominal swelling, do discomfort, leg and ankle swelling.g. Tricuspid regurgitation.Tricuspid regurgitation is the failure of the riht ventricular causing blood to leak back through the tricuspid valve from the riht ventricle into the riht atrium of the heart. Symptoms of tricuspid regurgitation include leg and ankle swelling, swelling in the abdomen.D. Heart disease affecting coronary arteries and coronary veinsHeart disease affecting corona ry arteries and coronary veinsThe malfunctioning of the heart may be due to damage caused by narrowed or blocked arteries leading to the muscle of your heart as well as blood backing up in the veins. Types of heart disease that affect the coronary arteries and veins includeAngina pectorisAngina pectoris occurs when the heart muscle doesnt get as much blood oxygen as it needs. Here are 3 types of angina pectorisa) unchanging anginaStable angina is chest pain or discomfort that typically occurs with activity or stress due to oxygen deficiency in the blood muscles usually follows a predictable pattern. Symptom of stable angina include chest pain, tightness, pressure, indigestion feeling and pain in the upper neck and arm.b) Unstable anginaUnstable angina is caused by blockage of the blood flow to the heart. Without blood and the oxygen, part of the heart starts to die. Symptoms of unstable angina include pain spread down the left shoulder and arm to the back, jaw, neck, or riht arm, d iscomfort of chest and chest pressure.c) Variant angina aiso known as coronary artery spasmCaused by the narrowing of the coronary arteries. This is caused by the contraction of the smooth muscle tissue in the vessel walls. Symptoms of kind angina include increasing of heart rate, pressure and chest pain.Heart attacks known as myocardial infarction or MIHeart attacks caused by plaque rupture with thrombus formation in a coronary vessel, resulting in an acute reduction of blood supply to a portion of the myocardium. Symptoms of MI include a squeezing sensation of the chest, sweating, nausea, vomiting, upper back pain and arm pain.Heart disease aiso known as coronary artery disease or coronary heart diseaseCaused by arteries hardening, narrowing, cutting off blood flow to the heart muscle resulting in heart attack. Symptoms of heart disease include shortness of breath, chest pains on exertion, palpitation, dizziness and fainting.atherosclerosis or hardening of arteriesArteries are bl ood vessels that carry oxygenirich blood to your heart and to other parts of your body. Atherosclerosis is caused by plaques that rupture in result of blood clots that block blood flow or break off and travel to another part of the body. Atherosclerosis has no symptom or warning sign.Silent ischemia.Ischemia is a condition in which the blood flow is restricted to a part of the body caused by narrowing of heart arteries. Siient ischemia means people have ischemia without pain. There is aiso no warning sign onwards heart attack.E) Heart disease affecting heart lining flea-bitten heart disease results from inflammation of the heart lining when too much fluid builds up in the lungs leading to pulmonary congestion. It is due to failure of the heart to remove fluid from the lung circulation resulting in shortness of breath, coughing up blood, pale skin and excessive sweating. Heart disease resulting from inflammation of all the endocardium or pericardium is called heart disease affectin g heart lining.Endocardium is the inner level of the heart. It consists of epithelial tissue and connective tissue. Pericardium is the fluid filled sac that surrounds the heart and the proximal ends of the aorta, vena valva and the pulmonary artery.a. EndocarditisEndocarditic, which is an inflammation of the endocardium is caused by bacteria get into the bloodstream and settling on the inside of the heart, usually on the heart valves that consists of epithelial tissue and connective tissue. It is the most common heart disease in people who have a damaged, diseased, or artificial heart valve. Symptoms of endocarditis include fever, chilling, fatigue, aching joint muscles, night sweats, shortness of breath, change in temperature and a persistent cough.b. PericardiumPericarditis is the inflammation of the pericardium. It is caused by infection of the pericardium which is the thin, tough bagiiike membrane surrounding the heart. The pericardium aiso prevents the heart from over expand ing when blood volume increases. Symptoms of pericarditis include chest pain, mild fever, weakness, fatigue, coughing, hiccups, and muscle aches.F) Heart disease affecting electrical systemThe electrical system within the heart is responsible for ensuring the heart beats correctly so that blood can be transported to the cells throughout our body. Any malfunction of the electrical system in the heart causes a fast, siow, or irregular heartbeat. The electrical system within the heart is responsible for ensuring that the heart beats correctly so that blood can be transported throughout our the body. Any malfunction of the electrical system in the heart malfunction can cause a fast, siow, or irregular heartbeat.Types of heart disease that affect the electrical system are known as arrhythmias. They can cause the heart to beat too fast, too siow, or irregularly. These types of heart disease includea. Sinus tachycardiaSinus tachycardia occurs when the sinus rhythm is fast-breaking than 10 0 beats per minute therefore it increases myocardial oxygen postulate and reduces coronary blood flow, thus precipitating an ischemia heart or valvular disease.b. Sinus bradycardiaSinus bradycardia occurs when a decrease of cardiac output signal results in regular but unusually siow heart beat less than 60 beats per minute. Symptoms of sinus bradycardia includes a feeling of weightlessness of the head, dizziness, low blood pressure, vertigo, and syncope.c. Atrial fibrillationAtrial fibrillation is an irregular heart rhythm that starts in the upper parts (atria) of the heart causing irregular beating between the atria and the lower parts (ventricles) of the heart. The lower parts may beat fast and without a regular rhythm. Symptoms of atrial fibrillation include dizziness, lightiheadedness, shortness of breath, chest pain and irregular heart beat.d. Atrial shiverAtrial flutter is an abnormal heart rhythm that occurs in the atria of the heart causing abnormalities and diseases of t he heart. Symptoms of atrial flutter includes shortness of breath, chest pains, anxiety and palpitation.e. Supraventricular tachycardiaSupraventricular tachycardia is described as rapid heart rate originating above the ventricles, or lower chambers of the heart causing a rapid pulse of 140i250 beats per minute. Symptoms of supraventricular tachycardia include palpitations, lightiheadedness, and chest pains.f. paroxysmal supraventricular tachycardiaParoxysmal supraventricular tachycardia is described as an occasional rapid heart rate. Symptoms can come on suddenly and may go away without treatment. They can last a few minutes or 1i2 days.g. Ventricular tachycardiaVentricular tachycardia is described as a fast heart rhythm that originates in one of the ventricles of the heart . This is a potentially lifeithreatening arrhythmia because it may lead to ventricular fibrillation or sudden death. Symptoms of ventricular tachycardia include light headedness, dizziness, fainting, shortness of breath and chest pains.h. Ventricular fibrillationVentricular fibrillation is a condition in which the hearts electrical activity becomes disordered causing the hearts lower chambers to contract in a rapid, unsynchronized way resulting in iittie heart pumps or no blood at all, resulting in death if left untreated after in 5 minutes.There are many heart diseases affecting electrical system such as premature arterial contractions, wolf parkinson, etc.G) Congenital heart diseaseThere are several heart diseases that people are innate(p) with. Congenital heart diseases are caused by a persistence in the fetal connection between arterial and venous circulation. Congenital heart diseases affect any part of the heart such as heart muscle, valves, and blood vessels. Congenital heart disease refers to a problem with the hearts structure and function due to abnormal heart development in the beginning birth.Every year over 30,000 babies are born with some type of connatural heart defect in US alone. Congenital heart disease is responsible for more deaths in the first year of life than any other birth defects. Some internal heart diseases can be treated with medication alone, whiie others require one or more surgeries.The causes of congenital heart diseases of newborns at birth may be in result from poorly controlled blood sugar levels in women having diabetes during pregnancy, some hereditary factors that see a role in congenital heart disease, excessive inspiration of alcohol and side affects of some drugs during pregnancy.Congenital heart disease is often divided into two types cyanotic which is caused by a lack of oxygen and nonicyanotic.A. CyanoticCyanosis is a blue coloration of the skin due to a lack of oxygen generated in blood vessels near the skin surface. It occurs when the oxygen level in the arterial blood falls on a lower floor 85i90%.The below lists are the most common of cyanotic congenital heart diseasesa) Tetralogy of fallotTetralogy of fallot is a c ondition of several congenital defects that occur when the heart does not develop normally. It is the most common cynaotic heart defect and a common cause of blue baby syndrome.b) cargo ships of the great vesselsTransportation of the great vessels is the most common cyanotic congenital heart disease. Transposition of the great vessels is a congenital heart defect in which the 2 major vessels that carry blood away from the aorta and the pulmonary artery of the heart are switched. Symptoms of transportation of the great vessels include blueness of the skin, shortness of breath and poor feeding.c) Tricuspid atresiaIn tricuspid atresia there is no tricuspid valve so no blood can flow from the riht atrium to the riht ventricle. Symptoms of tricuspid atresia include blue tinge to the skin and lips, shortness of breath, siow growth and poor feeding.d) Total abnormal pulmonary venous returnTotal anomalous pulmonary venous return (TAPVR) is a rare congenital heart defect that causes cyanos is or blueness. Symptoms of total anomalous pulmonary venous return include poor feeding, poor growth, respiratory infections and blue skin.e)Truncus arteriosusTruncus arteriosus is characterized by a large ventricular septate defect over which a large, iodine great vessel arises. Symptoms of truncus arteriosus include blue coloring of the skin, poor feeding, poor growth and shortness of breath.There are many more types of cyanotic such as ebsteins anomaly, hypoplastic riht heart, and hypoplastic left heart. If you need more information please touch with your doctor.B. NonicyanoticNonicyanotic heart defects are more common because of higher survival rates.The below lists are the most common of nonicyanotic congenital heart diseasesa) Ventricular septal defectVentricular septal defect is a hole in the wall between the riht and left ventricles of the heart causing riht and left ventricles to work harder, pumping a greater volume of blood than they normally wouid in result of failure of the left ventricle. Symptoms of ventricular septal defect include very fast heartbeats, sweating, poor feeding, poor weight gain and pallor.b) Atrial septal defectAtrial septal defect is a hole in the wall between the two upper chambers of your heart causing freshly oxygenated blood to flow from the left upper chamber of the heart into the riht upper chamber of the heart. Symptoms of atrial septal defect include shortness of breath, fatigue and heart palpitations or skipped beats.c) Coarctation of aortaCoarctation of aorta is a narrowing of the aorta between the upperibody artery branches and the branches to the lower body causing your heart to pump harder to force blood through the narrow part of your aorta. Symptoms of coarctation of aorta include pale skin, shortness of breath and heavy sweating.There are many more types of nonicyanotic such as pulmonic stenosis, patent ductus arteriorus, and atrioventricular cana. These problems may occur alone or together. Most congenital h eart diseases occur as an isolated defect is not associated with other diseases.