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Risk Factors For Gestational Diabetes Mellitus - 1765 Words

While a universal screening strategy is the best strategy to assure that all women with GDM are diagnosed and treated, the cost of such a strategy may prove to be prohibitive for some populations. Known risk factors for gestational diabetes mellitus include a family history of diabetes, race (Asian, African-American, Hispanic and Native American women have a higher incidence of GDM than non-Hispanic Caucasian women [Ferrara, 2007; Slocum and Burke Sosa, 2002]), obesity (body mass index [BMI] ≠¥25 kg/m2), high pre-pregnancy fasting blood glucose levels, increased maternal age, parity, polycystic ovarian syndrome, sociodemographic and behavioral attributes, previous adverse pregnancy outcomes, and previous GDM (Gunderson, et al., 2007;†¦show more content†¦The risk factors selected for this study were a family history of diabetes, a personal history of GDM, maternal age of 35 or older, a BMI ≠¥25 kg/m2, and a history of macrosomia in a previous pregnancy. It should be noted that two of these criteria (previous GDM and previous macrosomic infant) cannot be applied to nulliparous women. In this study, investigators found that the number of risk factors identified was directly proportional to the prevalence of GDM and the incidence of adverse events related to GDM, including preeclampsia, macrosomia, LGA infants, and shoulder dystocia. Interestingly, 35% of the women on the study that did not have any of the risk factors identified were subsequently diagnosed with gestational diabetes. These women also experienced more GDM-related events, despite being treated, than women without GDM. This high percentage is likely reflective of the low number of risk factors used in the study (only three risk factors for nulliparous women), combined with the fact that patients may be mistaken regarding family medical history. The patients in this study were predominantly of low socioeconomic status, which is considered by many experts to be a risk factor f or GDM (Gunderson, et al., 2007). If socioeconomic status had been used as one of the risk factors evaluated, it is likely that far fewer than 35% of patients without risk factors would have

The Crucible Comparison Free Essays

Katelyn Mittler 10/4/12 4th hour Hegemony through Terror Lost, terrified, and not in control of their own thoughts, Mary Warren and Shawn Hornbeck strive for the life they once lived. In 1692, The Crucible character, Mary Warren comes under the control of foil character, Abigail Williams. In a similar, more recent story, Shawn Hornbeck’s normal life of video games, hanging out with friends, and dirt biking, is ripped away from him with Michael Devlin forcefully kidnaps him with the intent of murder. We will write a custom essay sample on The Crucible Comparison or any similar topic only for you Order Now Everyday coerced by their fear, constantly reminded death reigns imminent. In Arthur Miller’s The Crucible, character Mary Warren, threatened by Abigail Williams not to release they are pretending, lives a lie; just as missing child, Shawn Hornbeck, manipulated by Michael Devlin, cannot release his true identity. Falling into great peer pressure while facing threats from Abigail, Mary makes the courageous decision to tell the truth, but Abigail strengthens her grip and the truth crumbles. Mary knows the girls are lying but struggles with the imminent threats from Abby in her rebuke to Proctor, â€Å"She’ll kill me for sayin’ that! (Miller 80). Mary gets this idea from the death threat imposed on her by Abby â€Å"and mark this. Let either of you breathe a word or the edge of a word, about the other things, and I will come to you in the black of some terrible night and I will bring a pointy reckoning that will shudder you† (20). Abigail scares not just Mary, but all the girls with threats. After trying to tell the truth, Mary suc cumbs to the torment of Abby. â€Å"Abby, Abby, I’ll never hurt you more† (119). The â€Å"pointy reckoning† that Abigail threatens Mary with does its justice and Mary morphs back into a powerless silenced girl. Similarly, from Shawn’s abduction on October 6th 2002 to his discovery on January 12th 2007, Devlin forces Shawn into living a lie. Shawn spares himself from the wrath of Devlin as he remains powerless in a glass case of emotions. â€Å"From day one he had the gun, he had the power. I was powerless and there was nothing I could physically do† (Kidnapped: Shawn Hornbeck). Devlin holds all of the power, leaving Shawn unable to even think clearly. According to Shawn’s stepdad, Craig Akers, â€Å"Devlin’s control over Shawn was complete and total† (Kidnapped: Craig Akers). Through Devlin’s â€Å"complete and total control,† Shawn makes what his parents call â€Å"A deal with the devil† to save his own life. â€Å"Shawn told the defendant that he would do whatever he wanted him to if he didn’t kill him† (Kidnapped: Akers). â€Å"Devlin agreed not to kill Shawn as long as he made what we called ‘a deal with the devil’. He could never contact anyone, never try to run. And if he did he would be killed† (Kidnapped: Akers). This â€Å"deal with the devil† results in Shawn living a lie. â€Å"Shawn became Shawn Devlin and for the next four and a half years the deal he made that day left him tied to his tormentor†(Kidnapped: Sheriff Gary Toelke). The haunting agreements made that day leaves Shawn trapped in a world of terror only known by few. Mary Warren and Shawn Hornbeck are under what psychologists call â€Å"control by terror†. Living a lie, both are coerced into deciding between saving themselves by staying in this lie or to reveal the truth and face the forever imminent death threats. Mary and Shawn fear if they release the truth, they will be killed. Through this fear, Shawn and Mary start to believe their fake stories. Mary believes the girls are doing God’s work, and Shawn starts accepting the harsh reality of being Shawn Devlin. Mary and Shawn predicaments are not predestined; they are, as Devlin says when he first grabs Shawn, â€Å"you were just in the wrong place at the wrong time†. Mary’s â€Å"wrong place† starts with her dancing in the woods. Shawn’s begins with taking the shortcut road to a friend’s house. Eventually, Mary gives up and gives in. she succumbs to Abby, becoming the person she never intended. On a brighter note, even though he accepts Shawn Devlin as his new identity, Shawn never gives up hope. Shawn knows his family is still seeking his safe return and makes some efforts to discreetly contact them. On the day the police find Shawn, a huge weight liftes off his shoulders. He says, â€Å"It was a new feeling to say who I really was. † Shawn starts slowly back into his old set of norms. Mary and Shawn lose their personal identities to save themselves, each take a different route in trying to rediscover them. Through further investigation, it is evident that Mary Warren and Shawn Hornbeck encounter the same feelings of terror but are also uniquely different from each other. They fear for their lives as they struggle internally with revealing the truth or living with the guilt and constant terror behind the lies. Shawn and Mary both encounter numerous times when opportunities to tell the truth stands right in front of them; however, struck by fear they remain silent. Though Mary’s story does not result in a sugar-coated ending, Shawn’s story of torment and terror leads to triumph and a truly heart-warming story. Shawn teaches everyone to never give up hope and that you will always find your way back home, Mary’s story teaches a valuable life lesson to stand up for what you believe in, even if you are standing alone. Though Shawn and Mary encountered horrific events, they are truly two people (fictional or not) who show evident and inspirational life lessons. How to cite The Crucible Comparison, Essay examples

History 111

History 111- Causes Of The Civil War Essay Causes of the Civil WarAlthough some historians feel that the Civil War was a result of political blunders and that the issue of slavery did not cause the conflict, they ignore the two main causes. The expansion of slavery, and its entrance into the political scene. The North didnt care about slavery as long as it stayed in the South. South Carolina seceded, because Abraham Lincoln, a Republican, was voted into office. The Republican party threatened the Souths expansion and so Southerners felt that they had no other choice. The United States was divided into three groups by the time the Civil War began: those who believed in the complete abolition of slavery, those who were against the expansionof slavery, and those who were pro slavery. The Republican party was formed in opposition to southern expansion. Their views were Free Soil, Free Men and Free Labor. The Republicans were anti-South but they were in not abolitionists. They believed that slavery was a flawed system that made th e south ineffective and because the Norths free labor system was superior it must be guardedfrom southerners. When the Republican candidate, Abraham Lincoln was elected in 1860, the South felt threatened, and because expansion was vital to the survival of slavery they also felt their way of life was being threatened. Because slavery was such an important part of Southern society, the Southfelt that they could not survive without it. Thats why they were not willing to compromise with the north. To own slaves was a sign of wealth and social prestige and poor farmers who could not afford slaves had a goal to work for. In the election of 1860 you can see that Lincoln only secured 4% ofthe popular vote in the South, only winning in the upper 5 states, where in the north he received 54% of the popular vote. This shoes how united the South was in their dislike for Lincoln. If the South had been more divided they might have been more willing to compromise. The central cause of conflict between North and South was slavery, but it was only in its expansion that it became a reason for war. The entrance of slavery into politics made it into a public issue, and once the issue became public the conflict had to be solved. From the first years in American history, we have drank. Records of the first Europeans on America’s mainland tell about the colonists’ great thirste after their original supplies of European-made alcohol ran out. The settlers made their own wine. Eve Alcohol was imported from all over the world. Innovative colonists made alcohol from almost anything. One song from the 1700’s went like this:If barley be wanting to make into malt,We must be content and think it no fault,For we can make liquor to sweeten our lipsOf pumpkins, and parsnips, and walnut-tree chips. Not everyone approved of drinking. Many Protestant groups, including the Methodists and Lutherans had strong antidrink traditions based upon religious teachings. Prohibition was first tried in America to protect colonial settlers from the attacks of I The earliest reformers called for moderation, not total abstinence, but as their movement gained strength it demanded a complete prohibition of all beer, wine, and liquor. The first temperance legislation was passed in Massachusetts in 1838. Called the Many people in this era were beginning to be categorized as either drys or wets. Drys were against alcohol and wets were for it. Even with the increasing number of Drys in office, the liquor trade was one of the nation’s biggest industries in the lat Saloons were called the Devil’s Headquarters on earth by some. Supporting the Dry cause were such enigmatic speakers such as Billy Sunday who said:The saloon is the sum of all villainies. It is worse than war, worse than pestilence, worse than famine. It is the crime of crimes. It is the mother of sins. It is the appalling source of miseries, pauperism and crime. With all of this prohibition propaganda, the Wets were having a hard time maintaining the upper hand. Large gifts of cash came for the Dry cause from rich industrialists such as Henry Ford. The Drys saw the prize and sought it with a new fervor. Within one year and eight days of being proposed, 36 states were backing the Eighteenth Amendment. Prohibition went into effect at midnight on Saturday, January 17, 1920. This new legislation out Under the Volstead Act, 1,500 poorly trained people were assigned to enforce Prohibition. They were very ineffective. One way to get alcohol was to make it yourself. Many people hid stills wherever they could. Most people enjoyed the danger of the aut As an inadvertent result of the Prohibition Amendment was a loss of jobs. Some saloon owners closed down and opened speakeasies. Speakeasies were illegal nightclubs which sold liquor. Some beer producers continued to produce beer. They accomplished t Most of the illegal liquor came from other countries. Canada imported huge amounts of liquor which was then smuggled into the United States. Many smugglers acquired alcohol overseas, and then brought it back to the United States. They’d wait until nigh The illegal liquor trade was very appealing to the gangsters of the time. At first, the gangsters were welcomed because they brought alcohol. Soon, however, the public learned better. In Detroit, school children weren’t allowed outside at recess becaus Americans were intrigued by this. Many Americans were captivated by what was happening to America and reflected their feeling is the arts. Underworld, by Ben Hecht, was one of the first popular gangster movies. The American public loved these action-pa Americans grew anxious and more adventuresome. They dared to bend the rules more and more. With speakeasies, the harder to was to gain access too, the more people wanted to get in. These speakeasies changed the nation. Here, people could drink and be On top for the rampant disregard for the law by civilians, many of the law enforcers were corrupt. Many crime lords had the public officials on their payroll. Occasionally, as in the case of Pottawatomie County, Oklahoma in 1927, the officials actually Then there were the good guys, those Federal agents who upheld the Prohibition laws to the fullest. Two of them were Izzy Einstein and Moe Smith, the self proclaimed masters of a thousand disguises. They would put on disguises and go into speakeasies President Hoover took administering the Volstead Act very seriously. Total enforcement, however, never came about. The problem was in the federal government. It placed all enforcement responsibilities on the city and state government. The enforcement as long as it wasn’t sold in saloons or taverns. No compromise could be reached. Many Drys hoped that the passing of the 19th amendment allowing women to vote could prevent the repeal of the 18th Amendment. However, many women’s groups such as the WCTU g The presidential elections of 1932 played a big part in the repeal. Hoover, being blamed for the Depression, lost to Roosevelt. Many Wet candidate won office that year as well. After being admitted to the House and Senate, the 21st Amendment was quickl One of Prohibitio n’s lasting legacies was organized crime. The vast amount of funds that the gangsters now had allowed them to gain control of prostitution, gambling, drug dealing, as well as other illegal activities. Prohibition has become a modern con BibliographyCoffey, Thomas M. The Long Thirst. New York: WW Norton and Co., 1975Dumenil, Lynn. Modern Temper. New York: Hill and Wang, 1995Hintz, Martin. Farewell, John Barleycorn. Minneapolis: Lerner Publications, 1996Karl, Barry D., The Uneasy State. Chicago: University of Chicago Press, 1983. Kerr, K. Austin, Organized For Prohibition. London: Yale University Press, 1985Lee, Henry, How Dry We Were: Prohibition Revisited. New Jersey, Prentice-Hall, 1963Organized Crime . Comptons Interactive Encyclopedia 1996 SoftKey International Inc. and its licensors. Parrish, Michael E., Anxious Decades. New York: WW Norton and Co., 1992. Prohibition. Comptons Interactive Encyclopedia 1996 SoftKey International Inc. and its licensors. Severn, Bill. The End of the Roaring Twenties: Prohibition and Repeal. New York: Julian Messner, 1969The Nineteenth Amendment On August 18, 1920 neither the United States nor any State could deny any U.S. citizen the right to vote on account of sex. (Constitution, 1987). Although the quest for equality was hard-fought, many of the women who worked for the vote were surprised they achieved it. (Ryan, 1983). The vote meant more to women than merely controlling money and jobs and equalitythe vote meant political power. Like all political changes affecting the United States, the vote was preceded by political discussion, and there were many brilliant women who spoke eloquently for womens rights. For suffragists, the issue started with manufacturing. It moved white women out of the household into a world where they could earn more than $16-22 a month. (Ryan, 1983). Unfortunately, the consequence of moving out of domestic employment left these low paying jobs to black women, which was not the intent of the movement. However, for purposes of achieving the vote, this consequence was ignored for the time being. In fact, reports Ryan, the politicos of the womens suffrage movement at the turn of the century, for political reasons, occasionally donned the ugly garb of racism and xenophobia, claiming themselves superior to blacks and immigrants. These slogans were part of an arsenal of expedient devices suffragists used to achieve their goal. (Ryan, 1983). One of the main leaders of the movement was Elizabeth Cady Stanton who wrote The Solitude of Self in 1892. (Stanton, 1892). She was one of the biggest proponents of self-sovereignty for women because she believed that ultimately all people came into the world alone and left the world aloneand for this reason they had to be self-reliant. Yet, under current conditions, women were denied self-reliancy, so Stantons main goal was to free up all institutions, particularly education for women. At the time, the only training wome n received was an elementary education, unless privileged, or training for factory jobs. This, said Stanton, did not provide women with the opportunity or training to use all her faculties for her own safety and happiness. (Stanton, 1892). Personal happiness, according to Stanton, not only related to the Declaration of Independence, but also to the enjoyment of self-sufficiency. When a women could develop her mind, she would have the resources thus provided under all circumstances to mitigate the solitude that at times must come to everyone. (Stanton, 1892). Stanton was not interested in convincing men they should sympathize with womans plight, she said that what was important was fitting every human soul for independent action. (Stanton, 1892). What she asked for was also constitutionalthe complete development of every individual for first, his own benefit, and secondly for the general good. (Stanton, 1892). She said that women are already the equals of men in the whole realm of th ought, in art, science, literature and government . . ., and their contributions had made them valuable to America. She said, Such is the type of womanhood that an enlightened public sentiment welcomes today, and such the triumph of the facts of life over the false theories of the past. (Stanton, 1892). One of the most important iterations of the plight of women came from Charlotte Perkins Gilman. Gilmans purpose was the opposite of Stantons. She wanted to show womens struggle. She wanted to point out not only what she had experienced after leaving her husband, but also that her choices outside of that relationship were extremely limited. She stated that wealth, power, social distinction, fame, even home and happiness, reputation, ease, pleasure, her bread and butter,all must come to her through a small gold ring. (Gilman, 1898). Having to depend on men, Gilman said, put every woman in the position of being re-humanized over and over again in households owned by father, husband, bro therall of which resulted in restriction, repression, denial, and the smothering no which crushed down all her h discover, to learn, to express, to advance. (Gilman, 1898). Using an argument familiar in the 1970s, Gilman expressed how this must seem to the future of young women, who knew they could break out of this mold without suffering economically. Gilman wrote that this environment in which young woman grew was equivalent to slavery. Not only was every young girl meticulously trained for a domestic position through her early years, but she was expected to instruct her daughters to accept oppression. Gilman further stated that any woman who did not have a man to back her and wanted economic freedom was destined to become a whore and make her money in private and alone, in the first-hand industries of savage times. (Gilman, 1898). Because of this, the repression of women was, therefore, a reflection on society itself. However, Gilman said, despite all of these realities known to young girls, despite the fact that women were repressed, a few women had broken out of that mold. These few had proven that women, who hold the same ideals men hold for themselves, could and had risen above their domestic status and had become important to the economy of America. Thomas wrote that this made women invincible, and used this as a means to empower the women who heard her. Men were intimidated by writings like Gilmans, so even as men and women discussed the possibility of equality for women, they also discussed ways in which women should be repressed. The most common of these discussions evolved around the amount of education women needed, considering their domestic lifestyles. As the discussion heated up, in 1901, Charles W. Eliot, the president of Harvard, was one of the first to express the idea that the education men received was of no service in womens education. (Ravitch, 1991). Eliot believed that a womans education should include those things that served to furth er their domestic functions, and that separate educational models and schools should designed for them. (Ravitch, 1991). Martha Carey Thomas believed that there was no such thing as womens work, and that true equality was based on the ability of women to transcend those roles and join men as equals in all industries. Drawing upon her own education at Cornell and Johns Hopkins, which transcended the domestic, she wrote Once granted that women are to compete with men for self-support as physicians or lawyerswhat is the best attainable training for the physician or the lawyer, man or woman? There is no reason that typhoid or scarlet fever or phthisis can be successfully treated by a woman physician in one way and by a man physician in another way. There is indeed every reason to believe that unless treated in the best way the patient may die. (Thomas, 1901). She argued for the same intellectual training and the same scholarly and moral ideals. (Thomas, 1901). Thomas was the first to re ach beyond equality and discuss discrimination. She wrote: . . . over one-third of all graduate students in the United States are women. In the lower grades of teaching men have almost ceased to compete with women, in the higher grade, that is, in college teaching, women are just beginning to compete with men. There are in the Untied States only eleven independent colleges for women. (Thomas, 1901). She said statistically No one could seriously maintain that, handicapped as women now are by prejudice in the highest branches of a profession peculiarly their own, they should be further handicapped by the professional training different from mens. (Thomas, 1901). The importance of Thomass argument is that she backed it with statistics, proving why women should be educated the same as men, and that anything else was not tenable. She left the burden of proof on anyone who believed schools should be segregated. (Thomas, 1901). All of these arguments were made articulately by women who wer e politically able to show their male counterparts that they were educated. Not only were they educated in politics and business, but many had educated themselves beyond grade school to become competitive. Finally, by 1920, their arguments were rewarded. After more than eighty years of struggle, American women convinced the majority of American men to open up their ranks to a once totally disenfranchised and politically invisible population. (Ryan, 1983). Works Cited Gilman, C.P. (1898). Women and economics. The American Reader. Ravitch, D. gen. ed. (1991). New York: HarperCollins. pp. 204-206. Stanton, E.C. (1892). The solitude of self. The American Reader. Ravitch, D. gen. ed. (1991). New York: HarperCollins. pp. 201-204. Ravitch, D., ed. (1991). The American Reader. New York: HarperCollins. pp. 208. Ryan, M. (1983). Womanhood in America, From Colonial Times to the Present, Third Ediction. New York: Franklin Watts. pp. 170, 213-215. Thomas, M.C. (1901). Should higher education for women differ? The American Reader. Ravitch, D. gen. ed. (1991). New York: HarperCollins. pp. 208-211. MANIFEST DESTINY and THE DEMOCRATIC PARTYThe Democratic party headed by President James K. Polk is manipulating the populous of theUnited States. President Polk, like his Democratic predecessor, is claiming to be adefender of all common men. However, this is only his public front. He is actuallycontrolling the system to ascertain personal wealth and political power. He then warrantshis actions by preaching John L. Sullivans concept of Manifest Destiny. It has been knownsince the beginning of the 1840s that the United States is prepared to begin expanding intoTexas and further westward. The Monroe Doctrine of 1823 has kept these Ripe Fruitswaiting for the United States to harvest. President Polks Mexico policy is abusive againstMexicans, Native Americans, and is irrational considering Mexicos feeble position. Hispersonal political agenda is not in cadence with the fundamental princi ples that the UnitedStates is based on. Let it not be forgotten that expansion of this great Union isimperative to its survival. Homelessness EssayBIBLIOGRAPHYBauer, K. Jack The Mexican War, 1846-1848. University of Nebraska Press. Lincoln: 1974 *Benton, Thomas Hart. A Thirty Years View. Graebner, Norman A. Foundation of American Foreign Policy: A Realist Appraisal from Franklin to McKinley. Scholarly Resources Inc. Wilmington: 1985 LaFeber, Walter. The American Age. Second Edition. WW Norton and Company. New York: 1994 Lander, Ernest McPherson. Reluctant Imperialists: Calhoun, The South Carolinians and the Mexican War. Louisiana State University Press. Baton Rouge: 1980 Polk, James K. Polk: The Diary of a President 1845-1849. First Edition. Longmans, Green and Co. New York: 1929 Price, Glenn W. Origins of the War With Mexico. University of Texas Press. Austin: 1967History Essays